ABSTRACT
In November 1994, the Texas Department of Health embarked upon a major initiative to "reinvent" maternal and child health services funded through the Title V Maternal and Child Health Block Grant and related state general revenue. This article describes the rationale, planning process, and implementation issues associated with the initiative to redefine the fundamental roles and priorities of the department and traditional public health entities in the delivery of maternal and child health services.
Subject(s)
Maternal-Child Health Centers/organization & administration , Models, Organizational , Privatization/organization & administration , Public Health Administration/trends , Aid to Families with Dependent Children , Child , Efficiency, Organizational , Female , Humans , Maternal-Child Health Centers/economics , Maternal-Child Health Centers/standards , Medical Indigency , Pregnancy , Public Health Administration/economics , Public Health Administration/standards , Texas , Total Quality Management , United StatesABSTRACT
Maximally fast, self-terminated elbow flexion movements were performed by 10 male and 10 female college-aged subjects to assess potential gender-related differences in kinematics and the triphasic electromyographic (EMG) pattern. The subjects were instructed to move their forearms as fast as possible through 90 degrees of elbow flexion range of motion and stop as sharply as possible at the terminal point. An electromagnet, set to 0, 40, and 70% of each subject's maximal isometric torque, provided resistance to movement initiation and resulted in quick release movements. Surface EMG was collected from the biceps b. and triceps b. muscles. Results indicated that the males had faster movements and accelerations under all conditions. EMG records indicated that the males had faster rates of EMG rise, particularly in the triceps b., and more tightly coupled reciprocal activation. The quick release afforded faster accelerations for both groups, yet only the males moved faster throughout the full range of motion. Following the quick release, the males differed from the females by increasing the triceps b. EMG amplitude. Hence, the males were able to shorten movement time in quick release movements by increasing triceps b. activation and, thus, braking ability. These results suggest that the females were more neurally constrained than the males with respect to rapid EMG activation of the triceps b., resulting in limits in the braking process.
