Medicine and Health Sciences Commons^™

Nurse Workforce: Condition Critical, Wakina Scott

National Health Policy Forum

This issue brief provides an overview of the current nursing shortage. It discusses the multiple factors that make this shortage in the nurse workforce different from earlier ones. It also examines steps taken by nursing schools, the health care industry, the federal government, and states to address this issue.

Youth Violence Prevention: How Does The Health Care Sector Respond?, Anthony S. Raden

National Health Policy Forum

This background paper examines the health care sector's response to the complex problems associated with youth violence, identifies the unique challenges health professionals face in dealing with young victims and perpetrators of violence, and raises questions about the ability of health professionals in various types of practice settings to assume a more proactive role in preventing youth violence.

Enhanced Detection Of Surface-Associated Bacteria In Indoor Environments By Quantitative Pcr, Mark P. Buttner, Patrica Cruz-Perez, Linda Stetzenbach

Environmental & Occupational Health Faculty Publications

Methods for detecting microorganisms on surfaces are needed to locate biocontamination sources and to relate surface and airborne concentrations. Research was conducted in an experimental room to evaluate surface sampling methods and quantitative PCR (QPCR) for enhanced detection of a target biocontaminant present on flooring materials. QPCR and culture analyses were used to quantitateBacillus subtilis (Bacillus globigii) endospores on vinyl tile, commercial carpet, and new and soiled residential carpet with samples obtained by four surface sampling methods: a swab kit, a sponge swipe, a cotton swab, and a bulk method. The initial data showed that greater overall sensitivity was obtained …

Health Status Of Adult Montanans In Supported And Semi-Independent Living Arrangements, Meg A. Traci Ph.D., Sarah Geurts B.S., Tom Seekins Ph.D., Rebecca Burke M.S., Kathleen Humphries, Lisa Brennan M.L.S., University Of Montana Rural Institute

Health and Wellness

This study reports on the prevalence and severity of secondary conditions in adults with developmental disabilities living in 33 Montana counties. "Secondary conditions" are additional health problems acquired by an individual with a disability. Although the personal, social, and financial costs of these secondary conditions are extraordinarily high, they are frequently preventable. Ten of the top twelve secondary conditions reported by survey respondents involved issues that can be addressed by wellness activities or lifestyle management. In particular, survey ratings of “Communication,” “Weight,” and “Physical Fitness” problems suggest that these areas may contribute to other problems. Efforts to improve communication skills, …

The Field Of Disease Management At The Crossroads: An Interview With David B. Nash, Md, Mba, T. J. Basting

College of Population Health Faculty Papers

As David B. Nash, MD, MBA, takes the helm of Disease Management as Editor-in-Chief, the practice of disease management—now a decade old—depends on its practitioners to continue to provide "economic proof of concept." This effort to accrue the credibility needed to design and fund programs will provide further evidence that new technologies can be integrated into care programs across large populations to reduce costs while improving healthcare and access to it.

Quality Improvement Tools In Disease Management, Lisa E. Paddock, Amy L. Phillips, Peter Chodoff

College of Population Health Faculty Papers

Disease management programs require constant monitoring to assure quality and address problems efficiently. To initiate continuous quality improvement in a disease management program, there are several methods available to identify potential problems within the program that may be affecting quality. Some common quality improvement instruments include the Plan-Do-Check-Act model, check sheets, and so forth. Whatever model is used, Statistical Process Control using flow charts, histograms, Pareto diagrams, scatter diagrams, control charts, and cause-and-effect diagrams provides a better understanding about how the organization's processes are functioning. These tools facilitate problem recognition and allow an organization to meet established standards of quality …

Living Well Could Save $31 Million Annually, Craig Ravesloot Ph.D., Catherine Ipsen, Tom Seekins Ph.D., University Of Montana Rural Institute

Health and Wellness

Behavior change can improve health status for many adults. Further, for adults with chronic illness and permanent injuries, a growing body of literature identifies health promotion as both effective in improving health and cost-effective compared to treatment alternatives. Yet third-party payers (Medicaid, Medicare, and private insurance) typically do not reimburse health promotion interventions. This is a problem for many individuals with disabilities who have significant health care costs and cannot pay for health promotion programs. For more than a decade, the Office on Disability and Health at the Centers for Disease Control and Prevention has supported research culminating in the …

Perceptions Of The Family Mealtime Environment And Adolescent Mealtime Behavior: Do Adults And Adolescents Agree?, Kerri N. Boutelle, Leslie A. Lytle, David M. Murray, Amanda Birnbaum, Mary Story

Department of Public Health Scholarship and Creative Works

The family mealtime environment has great potential to affect the eating behaviors of youth in the family. It is difficult to determine the important elements of a healthy mealtime environment because a valid assessment of the family environment is so difficult to obtain. The objective of this study is to examine the level of agreement between adult and adolescent perceptions of the family mealtime environment and adolescent mealtime behavior. A telephone survey was used to query adult and adolescent family members about how they perceive the family mealtime environment and the adolescent's mealtime behavior. A convenience sample of 282 adult/adolescent …

State Benefit Design Choices Under Schip - Implications For Pediatric Health Care, Sara J. Rosenbaum, Anne Rossier Markus, Colleen Sonosky, Lee Repasch

Health Policy and Management Issue Briefs

This policy brief1 is the second in a series of reports focusing on the design of state SCHIP programs as they near full implementation. It examines the extent to which state agencies adopt conventional insurance norms or adhere to special principles of Medicaid coverage design for children in designing separately administered (or freestanding) SCHIP programs. The issue of coverage design is particularly relevant for children with low prevalence conditions and special health care needs. Increasingly, conventional insurance uses standardized coverage norms to limit coverage and treatment. These standardized norms take the form of across-the-board treatments and exclusions, limited definitions of …

Use Of Recommended Laboratory Testing Methods Among Patients With Tuberculosis In California, Steffi Kellam, Lisa Pascopella, Edward Desmond, Arthur Reingold, Daniel P. Chin

Public and Community Health Sciences Faculty Publications

This study assessed the extent to which laboratory methods recommended by the Centers for Disease Control and Prevention were used in tuberculosis testing of patients in California in 1998. While recommended methods were used for most patients, there was room for improvement by hospital and independent non-health maintenance organization laboratories.

The Relationship Between Drug Usage, Mental Well-Being And Felony Convictions Among A Sample Of Adult Recreational Drug Users: Case-Control Analyses, Venkata Chilakapti

Masters Theses & Specialist Projects

Changing lifestyles in today's world have resulted in the evolution of many human activities. One of them is recreational drug use. The purpose of this study was to explore the association between drug usage, mental well-being and felony convictions among a sample of adult recreational drug users. The primary purpose of this analysis was to develop a set of predictor variables from the DRUGNET data set (i.e., lifestyle, drug usage, GWBS) that were able to account for the criterion variables (i.e., drug-related felony vs. no drug- related felony and non-drug felony vs. no felony ). The analyses attempted to differentiate …

State-Based Pharmaceutical Assistance Programs: Temporary Fix Or Lessons For Medicare?, Robin J. Strongin

National Health Policy Forum

By early 2001, more than one-half of the states had established some type of pharmaceutical assistance programs for the elderly. This issue brief considers specific program parameters, such as eligibility criteria, cost-sharing arrangements, program administration, and marketing and outreach. It also considers programs in the broader context of a future Medicare outpatient prescription drug benefit.

Tanf And Work Support Services: On The Job In Greater Philadelphia, Lisa Sprague

National Health Policy Forum

This site visit looked at programs in the greater Philadelphia area to move welfare recipients into employment and support services aimed at keeping them employed. Four years after implementation of the Personal Responsibility and Work Opportunity Reconciliation Act, welfare caseloads were much reduced, but challenges remained. Pennsylvania officials described their plans to assist beneficiaries who would reach their five-year lifetime cash assistance limit beginning in 2002. Site visitors met with state and county assistance office staff, employers, consumer advocates, and employment and training contractors. They participated in discussions of how work support services, such as medical assistance, child care, and …

Quality In The Making: Perspectives On Programs And Progress, Lisa Sprague

National Health Policy Forum

This background paper considered the evolution of quality evaluation efforts, tracing their development from early initiatives to keep track of patients after surgery through the various guidelines, surveys, and measurement tools currently in use. It looked at both quality assurance and quality improvement strategies, highlighting the different philosophies that guide them. The paper examined the roles of purchasers, providers, consumers, and governments in furthering a quality agenda. Both regulatory and voluntary approaches were assessed.

The Health Care Safety Net In A Time Of Fiscal Pressures, Richard Hegner

National Health Policy Forum

This background paper reviewed the role played by the health care safety net in serving the nation's uninsured, underinsured, and indigent populations as well as those Americans who experience problems in obtaining access to health care. Against the backdrop of the March 2000 Institute of Medicine report, America's Health Care Safety Net: Intact But Endangered, the paper examined the recurrent choice in U.S. health policy between underwriting public insurance and subsidizing direct provision of health care. It recounted a number of reasons for direct federal interest in the safety net — including the important role played by Medicaid, the major …

Special Report On Children Born To Hiv Positive Parents In Nevada, 1991-1999, Drew Mather, Mary Guinan, Richard Whitley, Wei Yang

Public Health Faculty Publications

Background:

This report encompasses an effort to look at the number of children born to HIV (Human Immunodeficiency Virus) and/or AIDS (Acquired Immunodeficiency Syndrome) infected parents during the years 1991 to 1999 in Nevada.

According to the Healthy People 2000 (HP 2000) Review for the years 1998- 1999, infants of untreated or undetected HIV positive women have been identified as a distinct population at risk for contracting the virus that causes AIDS.

The State of Nevada’s Bureau of Disease Control and Intervention Services in collaboration with the Bureau of Health Planning and Statistics has taken the initial step to “cross …

The Study Of Periodicity Of Eating And Public Health Nutrition Issues, Karen E. Harrington

Doctoral

This thesis set out to provide an objective understanding of periodicity of eating in a group of free living adults, by determining the temporal pattern of nutrient intake during eating occasions throughout the day. A dietary assessment study was carried out using a 7-day estimated food diary in a sample of 133 adults recruited from a city local authority. During the survey period, respondents were met on at least three occasions to encourage and motivate them to follow their usual dietary habits and to record their intakes in a as detailed a manner as possible. A combination of quantification methods …

Behind The Counter: Pharmacies And Dispensing Patterns Of Pharmacy Attendants In Karachi., Fauziah Rabbani, F. H. Cheema, N. Talati, S. Siddiqui, S. Syed, S. Bashir, L. Z. Zuberi, A. Shamim, Q. Mumtaz

Community Health Sciences

BACKGROUND:

There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in developing countries.

OBJECTIVE:

This study obtained background information on pharmacies assessed the level of training, knowledge and dispensing patterns of pharmacy attendants in Karachi.

METHODOLOGY:

This is a descriptive cross sectional study with convenient sampling. A structured questionnaire was used to interview pharmacy attendants.

RESULTS:

Of the 219 pharmacies surveyed, 62% reported more than 50 customers daily and 20% also sold items of general provision. Mean operating hours were 13. Only 24 (11%) had a visible license. On an average 3 attendants were …

Welfare Reform And The Well-Being Of Families: Successes To Date And Challenges Ahead, Jane Koppelman

National Health Policy Forum

This issue brief discusses a key issue in evaluating the 1996 Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA): the status of families after the implementation of this landmark welfare reform program. The new block grant program to states to administer the Temporary Assistance to Needy Families(TANF) program has been extremely effective when measured by lower welfare rolls and higher work rates and earnings for recipients. However, an equally important dimension described by the paper is what is known about longer-term effects and the status of people who have left welfare, with special emphasis on how children have …

Welfare Reform And Substance Abuse: Innovative State Strategies, Ginger P. Parra

National Health Policy Forum

This issue brief highlights key facts about the impact of substance abuse on welfare reform and recipients of Temporary Assistance to Needy Families, or TANF. After outlining some of the data on the incidence of substance abuse as well as its costs and treatment, it concludes by describing innovative state welfare programs attempting to lower barriers to employment and self-sufficiency.

State Schip Design And The Right To Coverage, Sara J. Rosenbaum, Barbara Smith

Health Policy and Management Issue Briefs

No abstract provided.

Chief Medical Officers' Perceptions Of Disease Management Programs, Gang Xu, Lisa E. Paddock, John P. O'Connor, David B. Nash, Mark Zitter

College of Population Health Faculty Papers

The purpose of this article is to examine chief medical officers' (CMOs) perception of disease management programs. Five open-ended questions, each addressing a major issue in the development of disease management programs, were given to 31 CMOs who attended a series of invitation-only conferences on disease management in the fall of 1999. Qualitative data analysis was conducted using the transcripts on each of the issues. Overall, the CMOs viewed the emergence of capitated disease management programs positively. They considered the population of a program to be the contractual patients and/or those at risk for the target disease. On the issue …

Measurement Of The Impact Of Winona Health Online, David B. Nash, David Shulkin, Florence Comite, Ron Loeppke, Bruce Van Cleave, Robert Kane, Jon Christianson, Douglas Pousma

College of Population Health Faculty Papers

The purpose of this article is to present the methodology to study the clinical and financial outcomes associated with the use of Winona Health Online, a novel community-wide interactive healthcare Website in Winona, Minnesota. Outcome methodology was developed by the University of Minnesota School of Public Health and the Carlson School of Management in cooperation with nationally recognized outcomes and disease state management experts, healthcare practitioners in Winona, statisticians, and health economists. The main areas of measurement include health status, satisfaction, cost and utilization of services, and clinical quality.

How Can Health Serve As A Bridge For Peace? Certi Crisis And Transition Tool Kit, Rosalia Rodriguez-Garcia, James Macinko, F. Xavier Solorzano, Marita Schlesser, George Washington University School Of Public Health And Health Services

Global Health Faculty Publications

No abstract provided.

Strategic Plan, Steve Konkel, Joe E. Beck, Eric Barker

Environmental Health Science Faculty and Staff Research

The Kentucky Association of Counties (KACo) strategic effort was organized under the aegis of Robert Arnold, the Executive Director of KACo. Strategic Focus, a strategic planning and facilitation organization, was selected to facilitate the meetings and provide consultation regarding development of the plan.

Assessment Of Clinical Partner Violence Screening Tools, Ann L. Coker, Brian O. Pope, Paige H. Smith, Maureen Sanderson, James R. Hussey

CRVAW Faculty Journal Articles

Objective: to compare the Women’s Experience with Battering Scale (WEB) with the Index of Spouse Abuse-Physical Scale (ISA-P) as screening tools to identify intimate partner violence (IPV).

Methods: We conducted a large cross-sectional survey of women age 18 to 65 attending one of two family practice clinics from 1997 to 1998. All women completed both the WEB and the ISA-P and a telephone interview. We figured agreement estimates between the two tools, used stratified analyses to evaluate attributes of those more likely to screen as battered or physically assaulted, and compared associations between the WEB and ISA-P and a range …

Hormonal And Barrier Methods Of Contraception, Oncogenic Human Papillomaviruses, And Cervical Squamous Intraepithelial Lesion Development, Ann L. Coker, Laura C. Sanders, Sharon M. Bond, Tsilya Gerasimova, Lucia Pirisi

CRVAW Faculty Journal Articles

We assessed the influence of hormonal (oral, injectable, or levonorgestrel [Norplant, Wyeth-Ayerst, Philadelphia, PA]) and barrier methods of contraception on the risk of cervical squamous intraepithelial lesions (SIL), while adjusting for high-risk (HR) HPV infection. Subjects were women receiving family planning services through the state health department clinics from 1995 to 1998. We selected 60 cases with high-grade cervical/SIL (HSIL) and 316 with low-grade cervical/SIL (LSIL) and controls (427 women with normal cervical cytology) and analyzed cervical DNA for HR-HPV, using Hybrid Capture I (Digene; Gaithersburg, MD).When assessing ever use, duration, recency, latency, and age at first use, neither oral …

Globalization, Diet, And Health: An Example From Tonga, Mike Evans, Robert C. Sinclair, Caroline Fusimalohi, Viliami Liava’A

Aboriginal Policy Research Consortium International (APRCi)

The increased flow of goods, people, and ideas associated with globalization have contributed to an

increase in noncommunicable diseases in much of the world. One response has been to encourage lifestyle changes with educational programmes, thus controlling the lifestyle-related disease. Key assumptions with this approach are that people’s food preferences are linked to their consumption patterns, and that consumption patterns can be transformed through educational initiatives. To investigate these assumptions, and policies that derive from it, we undertook a broad-based survey of food-related issues in the Kingdom of Tonga using a questionnaire. Data on the relationships between food preferences, perception …

Tobacco Use Among Latinos, Gerardo Marín

Psychology

No abstract provided.

An Assessment Of Selected Sub-Systems Of The Egyptian Norplant® Program, Fatma El-Zanaty, Laila Nawar, Ramadan Hamed

Reproductive Health

The Egyptian Ministry of Health and Population and FRONTIERS discussed the need for investigating service delivery aspects of the Egyptian NORPLANT® program. This study emerged from those consultations. The study provides a comprehensive assessment of the program: how services are administered and used through the ongoing Introduction Program as it approaches five years of operation. The report lists major findings with program implications and offers recommendations regarding quality of care; tracking and locating NORPLANT® users; program sustainability; and information, education, and communication strategies.