The Individuals with Disability Education Act (IDEA) requires state educational systems to provide school-based, health related services (RS). This survey determined the financing arrangements used by states for health-related services for school-aged children with disabilities. A survey was sent to directors of special education, Medicaid, and public health departments in each of the 50 states. Financial patterns for RS were sought at the state level for children ages 3-21 with disabilities for the 1993-1994 school year, the most recent year for which complete financial data were available. Univariate analyses probed the relationship between systems' variables and the extent of Medicaid usage by local education agencies. Respondents reported that schools tapped traditional health resources to supplement educational dollars in paying for related services in schools. Medicaid was by far the most common source with 29 states reporting established mechanisms for recouping Medicaid dollars and 10 states reporting phase-in activities. Seventeen states reported that departments of public health played some role in administration, training, and demonstrations, but only six states provided specific dollars for related services through the department. Use of private insurance was reported sporadically with only one state indicating a specific state-level program. Correlates of increased Medicaid usage were presence of interagency agreements (IAAs) (OR 11.1, p = 0.002), having specific personnel for school-based medical assistance (OR 17.7, p = 0.001), and utilizing school nursing services as a Medicaid optional service (OR 4.2, p = 0.048).
eb-based training is taking the training and education world by storm. Just to get a sense of how fast Web-based training is growing, consider some of these indicators. • The U.S. market for Web-based training generated $197 million in revenue in 1997, according to a report published by International Data Corporation (IDC). The IDC report forecasts that this market will exceed $6 billion by 2002, representing a compound annual growth rate of almost 95 percent from 1997 to 2002. • A survey by the Graphic, Visualization and Usability Center (GVU) at Georgia Tech found 64% of Web users in the United States surveyed have experienced Web-based training. • Training Magazine's 1998 Industry Report, which tracks training trends reported that 19 percent of formal training courses are delivered via computer (CD-ROM, diskettes, and online via the Internet). These indicators suggest Web-based training is here to stay and it will continue to grow. This article provides an overview of why Web-based training is growing so rapidly and a summary of the issues adult educators face when developing programs.
Objective-To better understand how risk factors for Coronary Heart Disease (CHD) mortality may interact.Methods-We conducted a moderator-mediator analysis of a representative national sample of 5,027 and 2,902 community-dwelling women and men in the first National Health and Nutrition Examination Survey free of CHD in 1982. The outcome was 10-year CHD mortality.Results-267 subjects experienced CHD mortality. In the complete sample, gender moderated the effect of depressive symptoms, and among women race-ethnicity moderated the effect of nonleisure activity on CHD mortality, defining 3 subgroups for further analysis: men, white women, and black/ other women. Among men, baseline differences from median age (55 to 64 years), systolic blood pressure (129 to 158 mmHg), or self-rated general health ("good" to "poor") were associated with equivalent increases in 10-year CHD mortality from 2.3% to 5.3% (Areaunder-the-curve effect size (ES)=.53). These factors appeared to mediate the effect of education on CHD mortality. Severe depression in men was associated with higher 10-year CHD mortality than less or no depression, 10.0% versus 2.5% (ES =.55). Among white women, increasing baseline age (from median 51 to 65 years) was also associated with 10-year mortality (1.2% to 13.4%, ES =.56), as was higher blood pressure (from median 125 to 151 mm Hg) or worse self-rated health (from median "very good" to "fair") to a lesser extent (1.2% to 3.5%, ES =.51). (gender, race-ethnicity) defined possible pathways to CHD mortality characterized by varying factors and interactions between factors, highlighting potential utility for targeted interventions among community-dwelling persons. Conclusion-Moderators
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