Digital Commons Network^™

The Public Stake In Biomedical Research: A Policy Perspective, Karen Matherlee

National Health Policy Forum

An introduction to a Forum series on biomedical research policy issues, this paper provides background on the organization and structure of both public and private research entities. It outlines the federal components, from the National Institutes of Health (NIH) to the Department of Veterans Affairs. It also looks at the rapid growth in pharmaceutical, biotechnology, and medical device research and development and the varying responses from managed care plans, practice-based research networks, and contract research organizations. After laying out various tensions in the field, such as competition among disease-oriented advocates, alignment of different priorities, allocation of dollars between basic and …

The Abcs Of Pbms, Robin J. Strongin

National Health Policy Forum

This issue brief describes the evolution of the pharmacy benefit manager (PBM) industry since the late 1960s and outlines current business practices in the areas of payment, services, drug formularies, and rebates. Tools of the trade, such as cost-sharing and generic substitution, used to control costs and improve quality are also discussed.

Update: West Nile Virus Encephalitis — New York, 1999, Centers For Disease Control And Prevention, Denis Nash

Publications and Research

The West Nile virus (WNV) encephalitis outbreak continues to wane in the Northeast with the onset of cooler temperatures and continued vector-control operations. This report updates the progress of the ongoing investigation. Since the last published update (1), five additional domestic human cases and one international case have been identified. As of October 19, 56 (31 confirmed and 25 probable) cases of WNV infection have been identified, including seven deaths (Figure 1). The date of onset of the latest cases was September 22. The international case was a Canadian citizen who had visited the New York City (NYC) area in …

Site Visit To Baltimore And Fort Detrick, Maryland — Preparing For A Bioterrorist Incident: Linking The Public Health And Medical Communities, Robin J. Strongin

National Health Policy Forum

As follow-up to the NHPF's February 1999 session entitled "Biological Terrorism: Is the Health Care Community Prepared?" the Forum organized a site visit on October 4 and 5, 1999, to Baltimore and Fort Detrick, Maryland. The site visit provided federal congressional and agency staff with the opportunity to learn first-hand how one local area is preparing for the possibility of a bioterrorist incident. Several themes were stressed throughout the two days, including the following: distinguishing bioterrorism from chemical terrorism, understanding the relationships between various agencies and institutions and their related funding streams, determining how the federal government can …

Behavioral Checklist Forms, Unknown Unknown

All Current Publications

No abstract provided.

In The Affirmative, Vol.6, No.8 (Mid-September / Mid-October 1999), Mike Martin, The Aids Project

In the affirmative (1993-1999)

No abstract provided.

The Nursing Center In Concept And Practice: Delivery And Financing Issues In Serving Vulnerable People, Karen Matherlee

National Health Policy Forum

This issue brief looks at ways in which nurse-managed centers — with support from the Health Resources and Services Administration and private foundations — are carving a role in providing preventive and primary care to vulnerable populations. Two case studies — one in Philadelphia and the other in the Utah-Nevada border area — llustrate nursing centers' mission, outreach, services, workforce, payment concerns, and educational tie-ins.

The Hidden Work Of The Farm Homemaker, Deborah B. Reed, Susan C. Westneat, Steven R. Browning, Lana Skarke

Preventive Medicine and Environmental Health Faculty Publications

Despite women’s involvement in agricultural production, the work role of women residing in farm households has not been thoroughly examined. Data collected in 1994-1995 as part of the NIOSH-sponsored Farm Family Health and Hazard Surveillance Project were used to address task issues and health status of farm women in Kentucky. In 1996, the farm woman component of the Kentucky study was replicated in five counties in west Texas, allowing an examination of farm women in two large agricultural states. The Kentucky study employed a two-stage cluster design;the Texas study was based on a systematic quota sample of farms. Both studies …

The Perception Of Spirituality And Its Manifestations In The Lives Of African American Male College Students, Adrienne Coleman

Adrienne Coleman

This study initiated in response to the lack of information on spirituality in African Americans and more specifically African American males. It is very important that spirituality be studied to make health educators knowledgeable about its overall nature. With awareness the health educators will be prepared to implement health promotion interventions that are appropriate and consistent with the beliefs of this subculture. The literature regarding this subject addressed many different aspects of spirituality. There was only a minute amount of information on African Americans and even less on African American males. Instead the literature search concentrated on areas such as: …

Access To Home Health Services Under Medicare's Interim Payment System, Nora Super

National Health Policy Forum

This issue brief explores the impact of the interim payment system (IPS) for home health agencies established under the Balanced Budget Act of 1997 (BBA). IPS was intended to constrain program outlays by imposing limits on spending per beneficiary and spending per visit in the existing cost-based reimbursement system. This issue brief examines the impact of the IPS on access to home health care, including home health agencies' responses to the payment system and its impact on provider availability and, ultimately, access to care for the sickest or most expensive populations

Implementing The Bba: The Challenge Of Moving Medicare Post-Acute Services To Pps, Karen Matherlee

National Health Policy Forum

This issue brief examines the challenge of putting skilled nursing facilities (SNFs), medical rehabilitation units, and home health under prospective payment, requiring the development of classification systems for each. It looks at the three-year phase-in of SNF resource utilization groups (RUGs) that began July 1, 1998 and the debate over classification systems for medical rehabilitation facilities and home health. The paper goes beyond issues of classification to consider coordination problems in placing these post-acute services under Medicare PPS.

Factors Which Affect Post-Hospital Resource Use And Patient Health Outcomes Among Taiwanese Older Adults, Chouh-Jiaun Lin

Health Services Research Dissertations

The purpose of this study was to explore relationships among population characteristics, patient post-hospital resource use and patient health outcomes in terms of the Andersen health behavioral model. An additional purpose of this study was to examine a discharge planning screening instrument used in a large urban hospital in Taiwan to determine if it predicts resource use and patient outcomes. A longitudinal research design was adopted for this study. Data were collected from the general medicine departments of an 800-bed university teaching hospital. Out of 109 patients who were interviewed, 78 participants qualified (participation rate = 71.6%).

The majority of …

Canada's Generalist Training: Are There Lessons For The United States?, Lee Hawkins

National Health Policy Forum

Addressing the premise of an inappropriate skewing of the U.S. medical education system toward specialty medicine, this issue brief compares and contrasts the U.S. and Canadian graduate medical education (GME) systems, including the organization and financing of each. The issue brief also explores various lessons that might be learned from the Canadian GME system, such as full integration of primary care and GME and the use of incentives to achieve desired policy goals.

Photonovels: Educational Resources To Prevent Agricultural Illnesses And Injuries, M. Susan Jones, Carol A. Koetke

Nursing Faculty Publications

Photonovels use photographs and a story featuring people from the community, familiar settings, and a simple text to deliver an educational message. This unique educational tool lends itself to a wide variety of topics and targets audiences including farmers, farm workers and their families. Information on how to design, create and use photonovels to prevent agricultural injuries and illnesses will be presented.

In The Affirmative, Vol.6, No.6 (Mid-June/Mid-July 1999), Mike Martin, The Aids Project

In the affirmative (1993-1999)

No abstract provided.

Commencement Program 1999, Loma Linda University

Commencement Programs

CONTENTS

2 | 1999 Events of Commencement

3 | The Academic Procession

4 | The Speakers

9 | The University Honorees

15 | The School Honorees

The Programs

• School of Medicine, 23
• School of Dentistry, 30
• Graduate School, 38
• School of Nursing, 47
• School of Allied Health Professions - Physical Therapy, 52
• School of Allied Health Professions, 58
• School of Public Health, 65

Views About Women's Mental Health: Study In A Squatter Settlement Of Karachi., Fauziah Rabbani

Community Health Sciences

OBJECTIVE:

Mental health of women is globally receiving particular attention. This study assessed community's view on certain aspects of women's mental health prior to introducing an intervention.

SETTING:

The study was conducted in an urban squatter settlement located in District West of Karachi in 1997 where the Aga Khan University has set up a Primary Health Care program in partnership with the communities.

METHODS:

Using convenient sampling, door to door household survey was conducted by medical students.

RESULTS:

Two hundred and eighty one residents were interviewed. Respondents were asked to list contributory factors which lead to mental distress in women. …

Reducing Medical Error: Can You Be As Safe In A Hospital As You Are In A Jet?, Lisa Sprague

National Health Policy Forum

This issue brief looks at the incidence of error in the health care system, opportunities for a systems-based approach to error reduction, and changes needed in health system culture and training. The lessons of human factors research are considered, with examples of their application in the aviation industry. The paper reviews some error-reduction and patient-safety initiatives undertaken by private-sector organizations and by the Veterans Health Administration.

Physical Violence During Pregnancy: Maternal Complications And Birth Outcomes, Vilma E. Cokkinides, Ann L. Coker, Maureen Sanderson, Cheryl Addy, Lesa Bethea

CRVAW Faculty Journal Articles

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.

Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.

Results: The prevalence …

Sex Education Programs In Schools: Influence On Knowledge And Behaviors Of Teenagers, Tina Graham

Masters Theses & Specialist Projects

Due to the teenage pregnancy rates and the incidence of sexually transmitted diseases (STDs) that exist in today's society, it is very important for teenagers to be informed of the facts related to pregnancy and STDs and how to prevent them from occurring. With this knowledge, they are able to make informed decisions related to their sexual experiences. The prime opportunity for such sharing of information can be in schools. The purpose of this study is to determine if sex education in school influences the knowledge and behaviors of teenagers toward sexual behavior, pregnancy, and sexually transmitted diseases. This research …

Parental Awareness And Lead Poisoning: A Suburban Analysis, Deborah M. Reed

Seton Hall University Dissertations and Theses (ETDs)

Lead poisoning is one of the most common pediatric health problems in the United States. A direct result of industrialization, the toxic substance lead has contaminated our environment. Parents of young children should be aware of the hazards of lead, the environmental sources, the need for annual screening. the implications of screening results. and steps to reduce the chances of exposure. Questionnaires were distributed at a pediatrician's office. Parents with children under six years of age were asked to complete the survey. Sixty-two questionnaires were completed and returned. It was determined that parents have a good understanding of the pathways …

The Accuracy Of Nitrous Oxide Passive Dosimeters As Compared With An Infra-Red Spectrographic Reference Method, Susan Allen

Community & Environmental Health Theses & Dissertations

Nitrous oxide is a gas often used in dental, surgical and veterinary operations as an anesthetic agent. Employees stationed in proximity of fugitive gas emissions may potentially suffer adverse health effects from chronic exposure to this agent. Passive dosimeters can be worn in the breathing zone of potentially affected personnel during exposure periods, then later analyzed to quantify nitrous oxide exposure. This study sought to establish the accuracy of several commercially available passive monitoring devices for nitrous oxide by comparison against an infra-red spectrophotometric reference method.

In The Affirmative, Vol.6, No.4 (Mid-April/Mid-May 1999), Mike Martin, The Aids Project

In the affirmative (1993-1999)

No abstract provided.

A Study Of The Knowledge And Attitudes Of Physicians Toward Victims Of Spouse Abuse, Ramani N. Garimella

Health Services Research Dissertations

The purpose of this study is to measure the knowledge and attitudes of physicians toward victims of spouse abuse. All 150 practitioners in the specialities of emergency medicine, family medicine, obstetrics-gynecology and psychiatry, in a large area general hospital are included in the sampling frame; 76 responded (RR = 51%). Knowledge and attitudes were measured using the Physician Survey on Spouse Abuse. Rosenberg's Tripartite Model of Attitude formed the theoretical basis for this study. Participants were 72% male, 90% white, 88% currently married, with a mean age of 44 years (SD = 7.99). Mean years in practice was 14.61 (SD …

Screening Seniors For Risk Of Functional Decline: Results Of A Survey In Family Practice, Dawn M. Dalby, John W. Sellors, Fred D. Fraser, Catherine Fraser, Cornelia Van Ineveld, Laura Pickard, Michelle Howard

Kinesiology and Physical Education Faculty Publications

To measure functional status, determine risk of functional decline and assess consistency between responses and standardized instruments. Design: A mailed survey which measured functional impairment, recent hospitalization and bereavement. A positive response on at least one of these factors indicated that the individual was “at risk” for functional decline. A random sample (n=73) of “at risk” subjects (specifically, family practice patients aged 70 and older) were assessed by a nurse. Results: The response rate was 89% (369/415), 59% of seniors were female and the mean age was 77.1 (SD=5.5) years. Self-reported risk, based on activities of daily living (ADLs), was …

Medicare Hmo Pullouts: What Do They Portend For The Future Of Medicare+Choice?, Nora Super

National Health Policy Forum

National policymakers became alarmed in the fall of 1998 when, contrary to expectations, nearly 100 Medicare HMOs announced their decisions to pull out of Medicare in certain areas or to reduce their service areas. This issue brief explores the reasons plans withdrew from certain areas, the Balanced Budget Act of 1997 provisions that most directly influenced these decisions, the impact of the withdrawals on Medicare beneficiaries, and policy options for ensuring the viability of the Medicare+Choice program.

Filling The Geriatric Gap: Is The Health System Prepared For An Aging Population?, Janet Firshein

National Health Policy Forum

This issue brief explores the field of geriatrics, the ways practitioners meet the health care needs of the elderly, training gaps, and the impact of Medicare payment policies on the delivery of health care to older Americans.

Kentucky Partnership For Farm Family Health And Safety Coloring Book, The Kentucky Partnership For Farm Family Health And Safety

Nursing Faculty Publications

No abstract provided.

Evaluating The Program Of A Community Grassroots Organization, The Kentucky Partnership For Farm Family Health And Safety

Nursing Faculty Publications

No abstract provided.

Mobilizing The Community To Form And Sustain A Grassroots Organization, The Kentucky Partnership For Farm Family Health And Safety

Nursing Faculty Publications

No abstract provided.