Ronald C. Althouse

Retirement to the Porch in Rural Appalachia

Successful retirement in old age depends on the existence of a set of social arrangements in which a person has accumulated a considerable longtime social standing that justifies his claims for support from the community. In a small, rural Appalachian settlement, the pattern of retirement to the porch illustrates how claims by old men for social attention and care are anchored in the interests of others and are vested with significance for the entire community. While the use of the porch to facilitate the assertion of such claims on others may be more evident in small settlements, it is suggested that comparable strategies to afford successful retirement can occur in urbanized areas. These may be more difficult to develop and maintain, since collective sanctions to enforce the performances of relevant juniors are weakened or are transferred to formal facilities that render common services, not personal recognition, to old people.

Realities of rural emergency medical services disaster preparedness

INTRODUCTION Disaster preparedness is an area of major concern for the medical community that has been reinforced by recent world events. The emergency healthcare system must respond to all types of disasters, whether the incidents occur in urban or rural settings. Although the barriers and challenges are different in the rural setting, common areas of preparedness must be explored. PROBLEM This study sought to answer several questions, including: (1) What are rural emergency medical services (EMS) organizations training for, compared to what they actually have seen during the last two years?; (2) What scale and types of events do they believe they are prepared to cope with?; and (3) What do they feel are priority areas for training and preparedness? METHODS Data were gathered through a multi-region survey of 1801 EMS organizations in the US to describe EMS response experiences during specific incidents as well as the frequency with which these events occur. Respondents were asked a number of questions about local priorities. RESULTS A total of 768 completed surveys were returned (43%). Over the past few years, training for commonly occurring types of crises and emergencies has declined in favor of terrorism preparedness. Many rural EMS organizations reported that events with 10 or fewer victims would overload them. Low priority was placed on interacting with other non-EMS disaster response agencies, and high priority was placed on basic staff training and retention. CONCLUSION Maintaining viable, rural, emergency response capabilities and developing a community-wide response to natural or man-made events is crucial to mitigate long-term effects of disasters on a local healthcare system. The assessment of preparedness activities accomplished in this study will help to identify common themes to better prioritize preparedness activities and maximize the response capabilities of an EMS organization.

West Virginia survey of visual health: Low vision and barriers to access

The West Virginia Survey of Visual Health was conducted to determine the types and frequency of barriers to vision treatment experienced by persons with visual health problems and low vision in West Virginia. The study used a Random Digit Dial (RDD) sample to gather information from 1026 households. Cross-tabulation of two variables were used to classify respondents or their family members as having low vision. Among the 1026 homes surveyed, 233 households reported having at least one or more persons with vision health problems. Out of the 233 households, 57 individuals were classified as having low vision. West Virginians who report vision health problems are older and tend to rate their physical health lower compared to those with normal vision. Treatment patterns illustrate that a large number of respondents see an eye doctor on an irregular basis. Economic barriers for the vision health population appear substantial. Transportation barriers are common among the low vision population. The impact of vis...

Vision Rehabilitation: Recipients' Perceived Efficacy of Rehabilitation

Objective/Purpose: This survey was conducted to determine the effect on activities of daily living of persons who report that they have received vision rehabilitation. Design/Methodology: This study used a clinical sample to gather information from 417 patients. Of the 417, 105 reported receiving vision rehabilitation. The efficacy of rehabilitation was assessed by asking 20 questions about their activities of daily living prior to and after their rehabilitation. A retrospective pretest (post-then-pre) design was used. Paired t tests were conducted to evaluate the effect of rehabilitation. Results: A significant difference was found for 13 of 20 questions. Difficulty reading ordinary prints in newspapers showed a large effect size (p = 0.0005). Difficulty reading the small print in a telephone book showed a large effect size (p = 0.0005). Difficulty doing work or hobbies that require one to see up close showed a moderate effect size (p = 0.0005). Difficulty finding something on a crowded shelf showed a moderate effect size (p = 0.0005). Difficulty figuring out whether bills received are accurate showed a moderate effect size (p = 0.0005). Difficulty shaving, styling ones hair, or putting on makeup showed a small effect size (p = 0.016). Difficulties seeing and enjoying programs on television showed a moderate effect size (p = 0.0005). Conclusion: Patients with low vision who report having received vision rehabilitation show significant improvements in activities of daily living or specific types of functioning after rehabilitation. Improvement in both near and distance vision activities and in social activities indicates daily functioning was improved and that barriers to activities of daily living were removed.

Microanalysis of Roof Bolter Injuries

Abstract The purpose of this article is to demonstrate the method and value of microanalysis through its application to reported personal injuries to roof bolters. The technique involves analysis of accident narratives in order to classify the reported injuries according to where they occurred in the roof bolters work cycle. Microanalysis allows an investigator to use the narrative descriptions to frame the conditions and situations under which miners were injured, results which then may be used in annual refresher training to make breakout sessions site and job specific. A combination of microanalysis and work-site observations of roof bolters was used in this study to classify accidents into selected work routines, to calculate new accident indices, to characterize the situations and conditions surrounding the accidents, and to describe the causes of many of the accidents in work-related terms.