Patient bill of rights 2001

Breaking gridlock on managed care reform, a bipartisan coalition in Congress introduced the newest version of a patient bill of rights. Unlike last year's ill-fated Norwood-Dingell bill, the Bipartisan Patient Protection Act of 2001 has strong bipartisan support; concern remains, however, on the provisions that allow patients to sue their managed care plan. The debate now focuses on the type of liability reform that Congress and the White House can agree on. If they are able to agree, a patient bill of rights may soon become law.     

Dominican‐American Etbnic/Racial Identities and United States Social Categories

The majority of Dominicans have sub‐Saharan African ancestry, ¹ 1 In the 1980 Dominican census, 16 percent of the population were classified as blanco (‘white’), 73 percent were classified as indio (‘indian‐colored’), a term used to refer to the phenotype of individuals who match stereotypes of combined African and European ancestry and 11 percent were classified as negro [‘black’] (Haggerty, 1991). These categories are social constructions, rather than objective reflections of phenotypes. The positive social connotations of “whiteness,” for example, lead many Caribbean Hispanics to identify themselves as white for the public record regardless of their precise phenotype (Dominguez, 1978:9). Judgments of color in the Dominican Republic also depend in part upon social attributes of an individual, as they do elsewhere in Latin America. Money, education and power, for example, “whiten” an individual, so that the color attributed to a higher class individual is often lighter than the color that would be attributed to an individual of the same phenotype of a lower class (Rout, 1976:287).
which would make them “black” by historical United States ‘one‐drop’ rules. Second generation Dominican high school students in Providence, Rhode Island do not identity their race in terms of black or white, but rather in terms of ethnolinguistic identity, as Dominican/Spanish/Hispanic. The distinctiveness of Dominican‐American understandings of race is highlighted by comparing them with those of non‐Hispanic, African descent second generation immigrants and with historical Dominican notions of social identity. Dominican second generation resistance to phenotype‐racialization as black or white makes visible ethnic/racial formation processes that are often veiled, particularly in the construction of the category African‐American. This resistance to black/white racialization suggests the transformative effects that post‐1965 immigrants and their descendants are having on United States ethnic/racial categories.     

The importance of difference: conceptualising increased flexibility in gender relations at home

In this paper we have three goals. First, to provide a critique of attempts to theorise in the area of intimate care and domestic division of labour which do not pay adequate attention to issues of plurality/difference. We argue that the ideological environment within which contemporary couples operate consists of more than one existing normative structure, and that therefore an approach which can incorporate the idea of change can only really arise in the context of a focus on plurality and difference among households. Secondly, to discuss large-scale empirical evidence relating to the domestic division of labour which seem to indicate an increasingly narrow basis for blanket 'no change' arguments. Historical series of time-use diaries suggest that over a long period consistent changes have occurred in the amount of time that both women and men devote to domestic labour, such that (some) women are doing on average proportionately less, and (some) men proportionately more. Finally, to offer a framework for the discussion of difference and change in gender relations in the home. This focuses on the analysis of the continuing marital conversation as the key arena where the institutional and interactional dimensions of gender relations are played out. Our evidence suggests that the 'opening up' of the marital conversation is an important indicator and facilitator of change, and that mechanisms underlying this 'opening' can be shown to facilitate higher levels of men's participation in family work.     

A general systems approach to the patient, hospital staff, family, and community: implications for health care services

This article concerns the application of a general systems concept to the health care system. A system consists of a set of interacting components which are interrelated and interdependent, and function as a unit. In order to identify some of the significant influences on the patient who has been hospitalized, this general systems concept has been applied to health care systems at a number of open systems levels in which he or she participates. These are the body-mind system of the patient (an organism); the patient-hospital staff system (an organization); the system relating the patient to his or her family (a group); and the patient-community system. Analyses of the strategic parts of these systems, their mutual dependencies and the processes which link them, together with their functions, have implications for both hospital-based health-care professionals and hospital administrators. These analyses are generalizable across these four levels of systems. Their implications have importance for health care services.     

The Supreme Court rules: the FDA and tobacco regulation

The United States Supreme Court recently ruled that the U.S. Food and Drug Administration does not have the legal authority to regulate tobacco products. This ruling significantly affects public health efforts to reduce tobacco addiction, especially among the nation's youth. This decision has broader health implications as well, since tobacco-related diseases are among many of the top ten leading causes of death. Paradoxically, this decision comes at a time where states are developing new health programs to address tobacco-related illnesses using funds from the landmark tobacco lawsuit.     

Different pathways explain alcohol-related problems in female and male college students

ABSTRACT

Objectives: Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARPs), and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways. Methods: College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs. Results: Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males. Conclusions: Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption.     

Assessment of Cardiovascular Risk in Collegiate Football Players and Nonathletes

Abstract

Collegiate American football players may be at risk for cardiovascular disease. Objective: To compare cardiovascular disease risk factors and cardiovascular structure and function parameters of football players, stratified by position, to a group of sedentary, nonathletes. Participants: Twenty-six collegiate football players and 13 nonathletes participated in this study. Methods: Blood pressures, anthropometrics, and blood chemistries were obtained and analyzed using standardized procedures. Resting echocardiography was used to evaluate cardiac morphology and function. Brachial artery flow-mediated dilation was assessed using high-resolution ultrasonography. Results: The prevalence of the metabolic syndrome was significantly higher amongst the linemen compared to the skill-position players (46% versus 0%, p < .05). Mildly abnormal wall thickness was noted in 20% of the football players. No significant differences in vascular function were observed between the groups. Conclusions: The increased prevalence of the metabolic syndrome and its components in the collegiate linemen may increase cardiovascular disease risk.