Delaware

ABSTRACT: In Delaware, asthma affects almost 14,000 children. The American Lung Association of Delaware and the University of Delaware surveyed school nurses to identify the needs of children with asthma and the services and accommodations available for these children. Researchers developed a survey instrument that was mailed to all Delaware schools (N=324). The response rate was 38.6% (n=125). According to respondents, a variety of protocols were in place regarding the administration of asthma medications. Respondents also reported that several measures had been taken to modify the school environment to improve air quality and reduce asthma triggers. Most respondents (77%) indicated they did not have asthma education programs in their schools. Findings from this study sparked development of a multidisciplinary Delaware Asthma Committee, an Asthma Education Center, and a statewide system for communicating with the parents of children with asthma.

This article describes the development and field testing of five 1-minute videotaped nutrition public service announcements focusing on the role of nutrition in reducing cancer risks. Topics include dietary fat, vitamin A, vitamin C, cruciferous vegetables, and fiber. Produce departments in two large supermarkets were the test sites. Videotapes were shown over a 3-day period for a total of 20 hours in each store. Of the total 1,196 customers intercepted, 1,050 (88 percent) agreed to be interviewed to determine whether they had viewed the video; the impact of the video on nutrition awareness, diet, and immediate purchases; and their perception of the stores' providing nutrition information. Only 26 percent of the customers viewed the videotapes. The main reason cited for nonviewing was lack of time. Forty-three percent of viewers stated that this was new information to them, and 21 percent said they would change their eating habits as a result of seeing the tape. Seventeen percen...

Lesser known illnesses (LKI) such as hemochromatosis, celiac disease, and Lyme disease are likely to be under-diagnosed due to the often varied and sometimes vague symptoms and lack of familiarity with testing. Insufficient testing and diagnoses of these LKI could result in poor outcomes for patients and unnecessary costs. The objective of this research was to evaluate the effectiveness of educational campaigns designed to inform physicians about the symptoms of LKIs and the basis to test patients for the diseases. A multi-level educational intervention was designed and conducted. The prevalence rate of testing, diagnosis, and the ratio of diagnoses to testing (D/T ratio) for hemochromatosis, celiac disease, and Lyme disease were determined for pre-intervention, intervention, and post-intervention time periods. Using the prevalence rates, ANOVA regression analysis was used to estimate the effect of the educational intervention on clients in Medicare Professional System, Medicare Ins...

Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per tr...

The rate of motor vehicle crashes in the United States is higher among adolescent drivers than among any other age group. This study was conducted to determine whether implementation of a graduated driver's licensing program is associated with a reduced the rate of motor vehicle crashes and injuries involving adolescent driver. Time periods before and after establishment of Delaware's GDL program were compared. The one year "before" period spanned January 1, 1998, through December 31, 1998, and the 3-year "after" period spanned January 1, 2000, to December 31, 2002. Following enactment of the GDL program on July 1, 1999, we delayed data collection during the "after" period for 6 months to allow for full implementation of the program. Information was obtained for all Delaware registered drivers between ages 16 and 17 years were involved in motor vehicle crashes involving property damage or injury from 1998 to 2002. The rate of crashes involving property damage, EMS transport, injury, hospitalization, and death were determined pre- and post-GDL,. Length of hospitalization and hospital charges were compared, and the presence and age of passengers, along with time of day were determined. The total number of licensed 16- and 17-year-old drivers in Delaware was 14,320 during 1998 (the before period), 16,849 for 2000, 14,098 for 2001, and 14,276 for 2002, for a total of 45,223 licensed drivers studied during the after period. The proportion of hospitalizations, injuries, crashes involving property damage and total number of crashes involving registered 16- and 17-year-old drivers after GDL each decreased by at least 30%. In addition, this GDL program was associated with a reduction in nighttime crashes and in crashes involving cars with multiple passengers in comparison with the time period before GDL. Two years after implementation, the hospitalization rate, injury rate, and crash rate decreased significantly with enactment of the GDL program in the State of Delaware. The Delaware's GDL program appears successful in decreasing motor vehicle crashes and resultant injuries in adolescent drivers.

To evaluate the safety and outcomes of endovascular recanalization of chronic total occlusions (CTOs) of the superior mesenteric artery (SMA) in patients with chronic mesenteric ischemia (CMI). A single-institution retrospective review was performed of 47 consecutive patients (18 male, 29 female) who underwent endovascular stent placement for CTOs of the SMA between February 2006 and November 2012. All patients had symptoms of CMI. Procedural and follow-up data were collected for assessment of technical success, safety, and outcome. Technical success was achieved in 41 of 47 patients (87%). Forty-two of the 47 procedures were performed from a femoral approach. Fifteen patients underwent concurrent revascularization of the celiac artery. All patients who underwent successful recanalization reported symptomatic improvement. Kaplan-Meier analysis revealed primary freedom from symptomatic recurrence of 95% at 12 months and 78% at 24 months. Symptomatic recurrence was observed in seven p...

Limited partnerships (LPs) and limited liability companies (LLCs) permit formation with a unique management structure in that these entities may be managed by another limited liability entity, such as a corporation. Thus, the true managers are those individuals who manage the manager. It is well settled that the managing entity, such as a corporate general partner, owes default fiduciary duties, but what of these second-tier managers? Technically, it is the managing entity that owes the duties, not the managing entity’s owners, officers, and directors, yet courts have struggled with strict adherence to this separation when it would seem inequitable to do so. Unfortunately, courts and commentators have failed, thus far, to articulate a clear rule as to when fiduciary duties should attach to second-tier managers that also makes allowances for countervailing concerns regarding the scope of such a duty. This article offers an approach aimed at resolving this problem by simply re-examining what it is that courts are doing when they attach liability. In the process of doing so, this article makes three major contributions to the existing scholarship. First, it is the only article describing the three main approaches courts have adopted to address the problem. Second, the article explains why alternate equitable theories, as currently applied, are inadequate to address this issue. Finally, this article offers a unique solution as to when fiduciary duties should attach to second-tier managers. Specifically, this article posits that liability should attach under a form of piercing the corporate veil. Unlike traditional piercing, which focuses on the abuse of the corporate form, this limited form of piercing, which I dub “piercing the fiduciary veil,” should focus on the abuse of the control exercised by second-tier managers.

Most amateur historians of New York and the tri-state area are aware of the Lenape as the region's first inhabitants. But how many know they are still active and engage with them as neighbors? It was partly with this in mind that a group of young Nanticoke Lenni-Lenape drummers from Bridgeton, New Jersey, were invited by a graduating MFA painting student to perform in his thesis show at Rutgers University on March 4 in the Mason Gross School of the Arts galleries, marking the first such performance by people of Native descent at a studio program on the East Coast, and by the traditional people of the particular area. A brief history of the Nanticoke Lenni-Lenape, the political and cultural context of the performance, and reactions to the work.