Residence in HUD Housing Associated With Greater Benefit From HCBS Services for Medicaid Enrollees in Pennsylvania

State Medicaid programs seek to shift the delivery of long-term care services away from institutional settings and toward community-based settings by expanding access to home-and-community-based services (HCBS). HCBS are hypothesized to prevent or delay the need for protracted nursing home stays. This study explores the question of which types of community residence maximize this protective effect of HCBS. We used a probabilistic matching technique to identify whether waiver-eligible Medicaid enrollees were likely to reside in project-based HUD housing in 2013. We applied multinomial logistic regression to observe the risk of long-stay nursing home admission (>100 days) relative to persistent community residence in the subsequent four years. Our model controlled for age, race, gender, urban status, and receipt of home-and-community based services. Our predictor of interest was the interaction between receipt of home and community based services (HCBS) and residence in HUD housing. The eligible baseline population included 152,632 community-residing Pennsylvania Medicaid enrollees in 2013. The analytic sample excluded individuals who died during 2013 or who were no longer waiver-eligible after 2013. Residence in HUD project-based housing while receiving HCBS is independently associated with a 27% percent reduction in risk of long-stay nursing home admission (p = .01) when controlling for individual-level demographics. No significant association was observed between the predictor of interest and risk of death during the follow-up period, suggesting that this finding is not likely confounded by individual health status. Further research should test whether this association is causal and specify possible mechanisms.

ANALISA KUALITAS AIR LIMBAH TAHU DI KECAMATAN NANGGALO KOTA PADANG

<p>Air limbah industri tahu berpotensi mencemari lingkungan, maka sebelumnya perlu dilakukan pengolahan sebelum dibuang ke lingkungan. Dimana salah satu upaya awal untuk menangani hal tersebut dengan melakukan penelitian. Penelitian ini bertujuan untuk mengidentifikasi cemaran air limbah industri tahu terutama di Kecamatan Nanggalo Kota Padang. Metoda penelitian dilakukan dengan mengambil sampel air limbah industri tahu pada dua lokasi dan dua titik pengambilan sampel untuk masing-masing lokasi, yaitu didekat tempat pembuangan air limbah dan yang berdekatan dengan tempat tinggal masyarakat. Parameter pengujiannya meliputi : <em>BOD</em>, <em>COD</em>, pH, <em>TSS</em>, N-NH₃, dan N-Total. Hasil pengujian pada lokasi pertama dan titik pertama, nilai parameter secara berurutan dari BOD, COD, pH, TSS, N-NH₃ dan N-Total adalah 226 mg/L; 387 mg/L; 5,10; 156 mg/L; 2,20 mg/L dan 2,54 mg/L, sedangkan pada titik kedua nilainya 153 mg/L; 287 mg/L; 5,82; 128 mg/L; 1,17 mg/L dan 2,02 mg/L. Kemudian pada lokasi kedua dan titik pertama nilai nya secara berurutan, yaitu 154 mg/L; 282 mg/L; 4,87; 120 mg/L; 2,06 mg/L dan 2,76 mg/L, sedangkan pada titik kedua nilainya 121 mg/L; 234 mg/L; 5,11; 88 mg/L; 1,24 mg/L dan 1,67 mg/L. Hasil yang didapatkan menunjukkan kondisi air limbah tahu dengan parameter pH pada semua lokasi dan titik melewati batas baku mutu yang diizinkan menurut Permen Lingkungan Hidup No.5 Tahun 2014 tentang Baku Mutu Air Limbah Bagi Usaha dan/atau Kegiatan Pengolahan Kedelai.</p><p> </p><p>Tofu industry wastewater has the potential to pollute the environment, so it needs to be trated before it is discharged into the environment. Where is one of the initial efforts to deal with this by conducting research. This study aims to identify tofu industry wastewater contamination, especially in Nanggalo District, Padang City. The research method is carried out by taking tofu industrial wastewater samples at two locations and two sampling points for each location and two sampling points for each location, which are near the waste water disposal site and which is adjacent to the community residence. The testing parameters include : BOD, COD, pH, TSS, N-NH₃ and N-Total. The test results at the first location and first point, the parameter values in arrow of BOD, COD, pH, TSS, NH₃ and N-Total are 226 mg/L; 387 mg/L; 5,10; 156 mg/L; 2,20 mg/L and 2,54 mg/L, while at the second point the value is 153 mg/L; 287 mg/L; 5,82; 128 mg/L; 1,17 mg/L and 2,02 mg/L. Then at the second location and the first point the values are in sequence, which is 154 mg/L; 282 mg/L; 4,87; 120 mg/L; 2,06 mg/L and 2,76 mg/L, while at the second point the value is 121 mg/L; 234 mg/L; 5,11; 88 mg/L; 1,24 mg/L and 1,67 mg/L. The results obtained indicate the condition of tofu wastewater with pH parameters at all location and the point of exceeding the permitted quality standard according to Environmental Regulation No.5 of 2014 concerning Wastewater Quality Standars for Soybean Business and / or Processing Activities.</p>

Alcohol and Substance Misuse and People with Intellectual and/or Developmental Disabilities

The independence and freedoms associated with deinstitutionalization and increasing community residence has correlated with an increase in the use of both illicit and legal intoxicants among people with intellectual and/or developmental disability (IDD). While alcohol and substance use can be an important aspect of social inclusion in many cultures, the IDD population are at disproportionate physical side effects and psychosocial risks. Treatments and interventions have largely been designed to benefit the general population, and the IDD group experience a range of barriers to appropriate care, due to issues of accessibility, a lack of direct focus and research. This chapter reviews the prevalence, risk factors, physical, and psychological risks, treatment approaches, guidance. and research focusing on this multiply disadvantaged group. A number of recommendations are made, relating to the need for local and national development and evaluation of accessible interventions, service provision, and public health initiatives.

Correlation of Cadmium Intake from Water and Biomarkers in Resident Living Around Namobintang Dumpsite

Cadmium (Cd) is a toxic element ubiquitous in the environment and can cause kidneys damage. The aim of this study was to determine the concentration of Cd in wells water and urine of population that lived around Namobintang dumpsite, and to examine the quantitative relationship between urinary Cd and other risk factors and β2 microglobulin in urine (β2-MG-U) as a marker exposure to Cd. This study was performed in the community residence around Namobintang dumpsite. Water samples were collected from the wells around the dumpsite. The area selected was of about 1 km radius from the dumpsite. A total of eighty urine samples checked using primary data. Adult males and females aged 18-78 years old were the respondents. Study results showed that Cd levels from the wells revealed that 73 respondents (91.3%) had exposed to Cd higher than normal levels (5 µg/L). 14 urine samples (17.5%) had high Cd levels above the normal limits and 48 urine samples had high β2-MG-U levels. There was a significant correlation between the Cd levels from the wells and β2-MG-U levels (r = 0.278, p = 0.012). UCd levels had also significant correlation with β2-MG-U levels (r = 0.29, p = 0.009).

Community Residents’ Eco-Environment Protection Awareness in the Jiajin Mountains Giant Panda Sanctuary

The public eco-environmental protection awareness is a reflection of social morals standard and an important symbol of modern civilization. It is an important strategic measure to enhance the entire national eco-environmental protection awareness for eco-environmental protection in China. Understand the level of community residences’ eco-environmental awareness can provide the scientific basis and background to carry out good eco-environmental education.This paper utilized the method of questionnaire to investigate community residences’ eco-environmental protection awareness in the Jiajin Mountains Giant Panda Sanctuary. It analyzed the problems existed in the eco-environmental protection awareness of community residence in the Jiajin Mountains Giant Panda Sanctuary and found out the cause of the problem. The results showed that the knowledge awareness for environmental protection, the level of awareness of the eco-environmental concerns, the awareness of participating in eco-environmental protection and the eco-environmental behavior is high. The majority of community residences are lack of the ecology environmental protection laws knowledge. And the government and community are lack of propaganda about the eco-environment protection knowledge and policies. Finally, several measurements for improving community residences’ eco-environmental protection awareness level were proposed to protect the eco-environment.