Workplace discrimination, deafness and hearing impairment: the national EEOC ADA research project

Data compiled by the US Equal Employment Opportunity Commission (EEOC), in its Integrated Mission System, provide documentation regarding the employment discrimination experience of Americans who are deaf or hard of hearing. This paper presents an analysis of 8,936 allegations filed by persons with hearing impairment and closed by EEOC between July 26, 1992 and September 30, 2003, as compared to 165,674 allegations filed by individuals with other physical or sensory disabilities. The investigators compare and contrast demographic characteristics of Charging Parties, characteristics of Respondents, the nature of allegations, and the outcomes of the allegations in order to illustrate how these variables differ between the two groups, herein referred to as HEARING (deaf, hard of hearing, or other hearing impairment) and GENDIS (general disability). Most allegations derived from both groups were filed against larger Respondents (those with 500+ workers). The most common allegation issues in the HEARING group involved matters of discharge, reasonable accommodation, and hiring. Outcomes derived from HEARING allegations were more likely to result in merit resolutions when compared to GENDIS, by a 25% to 21% margin.     

Endothelial progenitor cell therapy for atherosclerosis: the philosopher's stone for an aging population?

Much of the increased risk for atherosclerosis progression with age may be a result of age-related declines in the capacity of precursor cells to repair damage in the arterial endothelium. To estimate the impact of progenitor cell therapy for atherosclerosis on cardiovascular disease (CVD) mortality, life expectancy, and survival, as compared with the lifetime control of conventional risk factors, we modeled the health effects of bone marrow-derived endothelial progenitor cell therapy using data from the 1950 to 1996 follow-up of the Framingham Heart Study. To model cardiovascular disease mortality, we assumed that progenitor cell therapy was applied at age 30, with the effect assumed to be a 10-year delay in atherosclerosis progression. Age projections were constructed analytically using the stochastic process model for risk factor dynamics and mortality and microsimulation techniques. We considered three types of interventions: (i) keeping risk factors within selected limits to model current clinical recommendations; (ii) an age shift of 10 years to model the effects of progenitor cell therapy; and (iii) elimination of a competing risk (such as cancer). Our study suggests that progenitor cell therapy might increase life expectancy in the population as much as the complete elimination of cancer (in females, an additional 3.67 versus 3.37 years; in males, an additional 5.94 versus 2.86 years, respectively).     

From tragedy to triumph: a segue to community building for children and families

In 2000, more than 60 nonprofit agencies, health care providers, government officials, and community advocates in Tarrant County, Texas, came together to work for systemic change in the mental health care system. The coalition, known as the Mental Health Connection, began working toward a "No Wrong Door" approach to mental health services, which required aggressive coordination between federal, private, and nonprofit resources. The result is a five- to six-year plan for implementation of a new systems of care model for children with severe emotional disturbances and their families. The Mental Health Connection also focuses on legislative advocacy to bring about necessary policy changes at the local, state, and federal levels. Finally, the coalition focuses on developing sustainable revenue streams that will allow the new systems to remain in place once the group accomplishes the initial mission of the Mental Health Connection.     

What is driving increasing child welfare caseloads in Ontario? Analysis of the 1993 and 1998 Ontario incidence studies

Rates of substantiated maltreatment documented by the 1993 and 1998 Ontario Incidence Studies of Reported Child Abuse and Neglect doubled between 1993 and 1998. Although increasing public awareness and changes in investigation procedures appear to account for part of this change, the increase also reflects a significant shift in the types of maltreatment agencies are investigating and substantiating. Exposure to spousal violence has increased eightfold, and the proportion of neglect cases has more than doubled, whereas cases of sexual abuse are decreasing. The field requires a differentiated response to address the maltreatment-specific challenges underlying child welfare caseload increases in Canada.