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Since the Surgeon General's groundbreaking report of 1964, "Smoking and Health," the medical and scientific communities have uncovered the devastating effects of tobacco smoke on health. In reaction to these findings, local and state governments have enacted a variety of clean air acts to prevent unnecessary exposure to this known carcinogen. The Nevada Clean Indoor Air Act (NCIAA), a non-comprehensive smoke-free law, permits smoking in designated areas of casinos, bars, and taverns. With many Las Vegas casinos catering to all ages, this study was designed to evaluate the efficacy of NCIAA in protecting children from second hand smoke exposure. Using a device that measures ambient air particle matter concentrations, this study sampled the air quality in 15 casino gaming areas and corresponding non-smoking, children-friendly areas. The results indicate that current policy fails to preserve indoor air quality in these children-friendly areas. Furthermore, this research suggests the adoption of a more comprehensive, 100% smoke-free policy as the only effective remedy. [ABSTRACT FROM AUTHOR]

Examines the quality improvement in public sector healthcare organizations that target low-income and medically indigent population. Requirement for tax supported organizations to evaluate their effectiveness; Need to anticipate the obstacles to facing implementation of improvements; Means to overcome bureaucratic impediments.

Continuous Quality Improvement (CQI) methods offer healthcare organizations valuable tools for improving services to their patients. These tools are also useful in improving the way an organization delivers its services. In this ease study, the authors describe the use of quality improvement activities for improving the enrollment and screening for breast anti cervical cancer for the Women's Health Connection (WHC). The WHC is operated by the Nevada Department of Human Resources, Health Division, to provide screening for income eligible women between the ages of 40-64. Funding for the WHC was provided by the Department of Health and Human Services' Centers for Disease Control and Prevention (CDC) through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). By using Quality Improvement Teams, the WHC was able to restructure the way women were being enrolled in the program in order to increase the number of women screened and to help the program meet CDC performance indicators. This article documents the quality improvement process used in the case study, highlights the areas improved, and demonstrates how quality improvement was useful in improving services provided to women. It also describes staff acceptance of the quality improvement process and its potential future applications. [ABSTRACT FROM AUTHOR]

This study used a cross-sectional, multiple logistic regression design to examine the relationship between mental health service availability and the admission of 111,527 seriously mentally ill (SMI) patients from the emergency department (ED) in New York State in 2002. The study found that SMI patients were admitted from the ED in counties that were mental health professional shortage areas and in counties with less long-term inpatient psychiatric days. Contrary to expectations, counties with community mental health centers (CMHCs) had more admissions than counties without CMHCs. The results support prior research that indicates the need for more specialized mental health services for the SMI, including more psychiatric beds. [ABSTRACT FROM AUTHOR]