Predictors of Emergency Room and Hospital Utilization Among Adults With Intellectual and Developmental Disabilities (IDD).

Emergency room (ER) and hospital utilization among people with intellectual and developmental disabilities (IDD) are significant contributors to rising healthcare costs. This study identifies predictors of utilization among 597 adults with IDD. Using a retrospective survey of medical charts, descriptive statistics and logistic regressions were conducted. Individual-level risk factors for ER utilization included age, number of chronic health conditions, a diagnosis of cerebral palsy or neurological disorder, mental illness, and polypharmacy. Environmental predictors included community-based supported living. Hospitalization predictors included age and number of chronic illnesses. People residing in group homes were less likely to be admitted. This study found risk factors unique to individuals with IDD that should be addressed with tailored interventions as states transition to Medicaid managed care.

Patient-centered medical homes for patients with disabilities.

The patient-centered medical home is an innovative approach to improve health care outcomes. To address the unique needs of patients with intellectual and developmental disabilities (IDDs), a large health care provider reevaluated the National Committee for Quality Assurance's 6 medical home standards: (a) enhance access and continuity, (b) identify and manage patient populations, (c) plan and manage care, (d) provide self-care and community support, (e) track and coordinate care, and (f) measure and improve performance. This article describes issues to consider when serving patients with IDDs.

Israeli employers' hiring intentions for recruiting employees with disabilities: how do they compare with US employers?

Focus groups were used to study differences between Israeli and U.S. nonprofit and for-profit employers' hiring intentions of potential employees with disabilities. Major differences were found between for-profit and nonprofit employers' hiring intentions rather than according to their national affiliation. However, U.S. for-profit employers would hire primarily entry-level and seasonal employees when market conditions allowed for it. In contrast, their Israeli counterparts thought that hiring people with disabilities at subminimum wage was an incentive to hire, regardless of the state of the economy. The findings are discussed with respect to the applicability of the theory of planned behavior and social work practice in the two countries.

Payoffs of Participatory Action Research: Racial and Ethnic Minorities with Disabilities Reflect on their Research Experiences.

The disability community has experienced a long history of segregation and exclusion. With the passage of the Americans with Disabilities Act of 1990, discriminatory attitudes and behaviors would no longer be tolerated under law. In recent decades, disability researchers have also experienced a shift in how research projects are designed and conducted, with participatory action research (PAR) playing a prominent role. This paper provides an overview of these shifts and presents a qualitative study that explored the extent to which racial and ethnic minorities with disabilities were empowered by a PAR project that aimed to increase the physical accessibility of their communities. Content analysis of individual interviews revealed the following main themes: (1) increased knowledge of disability rights; (2) increased sense of independence; and (3) increased desire to advocate. Implications of this study include the important role that PAR may play in empowering racial and ethnic minorities with disabilities.

Corporate culture and employment of people with disabilities: role of social workers and service provider organizations.

Corporate culture reflects an organization's value system and impacts the recruitment, retention, and promotion of employees. Individuals with disabilities are positively impacted by a corporate culture that espouses and establishes a diverse workforce as a priority. This article provides an overview of corporate culture and the employment of individuals with disabilities, and presents a case example of the corporate culture of a large not-for-profit disability service organization. With an in-depth understanding of corporate culture and disability issues, social workers can be particularly helpful to applicants and employees with disabilities as well as employers.

Moving beyond misperceptions: the provision of workplace accommodations.

This mixed-methods study examined the provision of workplace accommodations in the health care, hospitality, and retail sectors. First, focus groups with administrators from each sector revealed that accommodations costs were viewed as minimal (although frontline managers were perceived as having misperceptions). Second, the provision of accommodations as documented through human resources records for health care and hospitality indicated that accommodations were infrequent, not costly, and provided to employees with disabilities. Finally, retail employees (irrespective of disability status) reported many more accommodations than health care and hospitality workers. To dispel misperceptions related to accommodations, education is critical and social workers are well-positioned for this role.

Sedación intranasal en niños con midazolan / Intranasal sedation in children with midazolan

Se realizó un estudio prospectivo en el Servicio de Cirugía General del Hospital Dr. Luis Eduardo Aybar con 12 niños de 2 a 8 años de edad, 7 del sexo masculino y 5 del femenino, que iban a ser sometidos a cirugía electiva, en los cuales se evaluó la sedación con Midazolan por vía intranasal, en dosis de 0.3 mg/K de peso, como medicamento pre-anestésico. Para evaluar los resultados de la sedación se utilizó la escala de sedación de D. Ryan Cook. Comprobamos que a los 15 min de administrarse el Midazolan todos los pacientes estaban calmados y felices y fueron separados de sus padres facilmente

Variabilidad de la saturación de oxígeno en pacientes sometidos a colecistectomia bajo anestecia bloqueo epidural continuo en el hospital Dr. Luis E. Aybar / Variability of oxigen saturation in patients subject to colecystectomy under continued epidural blockage anesthesia at Dr. Luis E. Aybar Hospital

Se realizó un estudio prospectivo en 10 pacientes intervenidos quirúrgicamente en el hospital Dr. Luis E. Aybar, a los cuales se les realizó colecistectomía bajo bloqueo peridual continuo con bupivacaina simple 0.5//, con el objetivo de estudiar la variabilidad de la saturación de oxígeno en el trans-pre-post-quirúrgico. De este total de pacientes 70//mantuvo una saturación de oxígeno en 100//; el 30//restante estuvo entre 96 y 99//. El 40//de los pacientes requirió sedación