Health Services Research Commons^™

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Nina Silverstein

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Nina Silverstein

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. Medicaid is a major source of funding for long term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional, …

The Frank J. Manning Certificate In Gerontology Alumni Survey: 21 Years Of Service To Elders, Nina M. Silverstein, Jenai Murtha, Donna Sullivan, May Jawad

Nina Silverstein

The Certificate Program in Gerontology at the University of Massachusetts Boston, a large urban university, was established in 1979 as part of an Administration on Aging (AoA) grant to develop and expand services to the elderly citizens of the Commonwealth of Massachusetts. In 1984, a line item was added to the state budget by the legislature and governor establishing the Gerontology Institute at the University of Massachusetts Boston and ensuring the continuation of training, research, and policy and advocacy work on behalf of and with Massachusetts’ elders (O’Brien, 1996). Upon Frank J. Manning’s death in 1986, the program was renamed …

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Nina Silverstein

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

A Survey Of Health Services And Identification Of Needs For Asian American Elderly Women In The Greater Boston Area, Connie S. Chan, Lin Zhan

Connie Chan

Over one hundred Asian American and mainstream health care providers in the greater Boston area were surveyed for this study. The authors have identified critical gaps in services for elderly Asian American women.

Long-Term Trends In Short-Term Outcomes In Acute Myocardial Infarction, Hoa Nguyen, Jane Saczynski, Joel Gore, Molly Waring, Darleen Lessard, Jorge Yarzebski, George Reed, Frederick Spencer, Shu-Xia Li, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: The objectives of this study were to examine the magnitude of, and 20-year trends in, age differences in short-term outcomes among men and women hospitalized with acute myocardial infarction (AMI) in central Massachusetts.

METHODS: The study population consisted of 5907 male and 4406 female residents of the Worcester, MA, metropolitan area hospitalized at all greater Worcester medical centers with AMI between 1986 and 2005.

RESULTS: Overall, among both men and women, older patients were significantly more likely to have developed atrial fibrillation, heart failure, and to have died during hospitalization and within 30 days after admission compared with patients …

Setting Research Priorities To Reduce Global Mortality From Childhood Pneumonia By 2015, Igor Rudan, Shams El Arifeen, Zulfiqar Ahmed Bhutta, Robert E. Black, Abdullah Brooks, Kit Yee Chan, Mickey Chopra, Trevor Duke, David Marsh, Antonio Pio, Eric A. F. Simoes, Giorgio Tamburlini, Evropi Theodoratou, Martin W. Weber, Cynthia G. Whitney, Harry Campbell, Shamim A. Qazi

Department of Paediatrics and Child Health

No abstract provided.

The Referral Process: Rural Primary Care Physicians' Perspectives On Providing Counseling Referrals, Casey N. Tallent

College of Education and Human Sciences: Dissertations, Theses, and Student Research

The advantages to collaborative care between physicians and mental health care providers have been known for many decades. Rural primary care physicians (RPCPs) are the first professionals that most patients contact when they have a mental health concern, particularly in rural communities. It is therefore important to understand the process that occurs when a referral for counseling is made from a RPCP and the subsequent collaboration that occurs. The purpose of this qualitative study was to generate a model that provides a better understanding of the counseling referral process from the perspective of RPCPs in private practice in the Midwest. …

Technical Skills In Paediatrics: A Qualitative Study Of Acquisition, Attitudes And Assumptions In The Neonatal Intensive Care Unit, Susan Bannister, Robert Hilliard, Glenn Regehr, Lorelei Lingard

Lorelei Lingard

PURPOSE: While the effective acquisition of technical skills is essential for excellent paediatric care, little is known about how technical skills are learned in the paediatric setting. This study sought to describe and theorise the variables influencing technical skills acquisition in a tertiary care neonatal intensive care unit (NICU) inpatient setting. METHODOLOGY: Using non-participant field methodology, paediatric residents and their teachers (nurses, respiratory therapists, neonatal staff and fellows) were observed at various times in the NICU for 8 weeks. Thirteen semistructured interviews with these teachers and learners and 1 focus group of additional learners were conducted and used to triangulate …

Baseline Data For Maine Pediatric And Family Practices From Arra-Funded Hit Ambulatory Practice Survey Data, Kimberley S. Fox Mpa

Population Health & Health Policy

No abstract provided.

Effects Of Environment On Children's Motor Scores, Eligibility Status, And Administration Times, Derrick Mittelstadt, Abigail Parker, Kirsten Pickett, Heather Temkin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Best practices for assessing developmental skills in young children focus on naturalistic observation in everyday settings, but the effects of environment on test scores, eligibility status and administration time have not been explored. The Peabody Developmental Motor Scales-Second Edition (PDMS-2) was administered to 34 children aged 18 to 59 months in natural and pull-out settings. PDMS-2 total, gross, and fine motor quotient (TMQ, GMQ, and FMQ) scores were significantly lower in the natural environment (p’s≤.014). Based on our results, more children would qualify for services when tested in natural environments using TMQ and GMQ scores. It also took significantly longer …

Virtual Reality In Stroke Rehabilitation: A Meta-Analysis And Practical Implications For Clinicians, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

The Characteristics Of Successful Evidence Retrieval By Nephrologists And The Impact Of Pubmed Search Filters, Salimah Shariff

Electronic Thesis and Dissertation Repository

Background: Clinicians frequently search PubMed to guide patient care. This study investigated the factors that impact successful searching and the utility of PubMed search filters.

Methods: A random sample of nephrologists was surveyed between 2008 and 2010; 160 valid responses were received (72% response rate). One group of 60 respondents was presented with the same two clinical questions, while the other 100 were each presented with a unique clinical question. The clinical questions were based on recently published systematic reviews. Respondents provided the search terms they would type into PubMed to address their clinical question(s). All physician-provided searches …

Advising Patients To Increase Fluid Intake For Treating Acute Respiratory Infections, Michelle Guppy, Sharon Mickan, Chris Del Mar, Sarah Thorning

Sarah Thorning

Background
Acute respiratory infection is a common reason for people to present for medical care. Advice to increase fluid intake is a frequent treatment recommendation. Attributed benefits of fluids include replacing increased insensible fluid losses, correcting dehydration from reduced intake and reducing the viscosity of mucus. However, there are theoretical reasons for increased fluid intake to cause harm. Anti-diuretic hormone secretion is increased in lower respiratory tract infections of various aetiologies. This systematic examination of the evidence sought to determine the benefit versus harm from increasing fluid intake.

Objectives
To answer the following questions.
(1)Does recommending increased fluid intake as …

Creating The Organizational Capacity To Serve Families With Parental Mental Illness: The Implementation Of Family Options, Kathleen Biebel, Katherine Woolsey

Kathleen Biebel

Summary: The purpose of this presentation is to present preliminary findings describing the organizational context of a traditionally adult-serving community mental health program, Employment Options, Inc., as they implement a family-centered, strengths-based intervention for families living with parental mental illness.

Iscore: A Risk Score To Predict Stroke Mortality, Gustavo Saposnik

Gustavo Saposnik

Stroke is a leading cause of death and adult disability. The ability to estimate prognosis in acute stroke patients directly affects treatment decisions for patients. It may also guide supportive care plans, facilitate patient and/or family counseling or discussions pertaining to end-of-life decisions. At the population level, prognostic estimations may assist policymakers in conducting fair comparisons when evaluating stroke fatality among different facilities for hospital outcomes and performance assessment. Clinicians usually rely on their own personal experience or average mortality reported in observational studies, which do not account for valuable information available at the time of the hospital presentation. Unfortunately, …

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. Medicaid is a major source of funding for long term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional, …

Maine Pediatric And Family Practice Survey Chartbook: Improving Health Outcomes For Children, Martha Elbaum Williamson Mpa, Kimberley S. Fox Mpa, Al Leighton Ba, Stuart Bratesman Mpp

Population Health & Health Policy

As part of the IHOC initiative, the Muskie School of Public Service at the University of Southern Maine surveyed pediatric and family practices about how they use data, clinical guidelines and office systems to monitor and improve children’s healthcare quality. The purpose of the survey is to provide baseline information about quality improvement activities in primary care practices serving children in Maine. Survey data will be used to inform IHOC activities and to monitor changes over time. The web-based survey was conducted in the winter of 2011-2012 and sent to practice managers at a sample of 168 practice sites, of …

One Student One Family And The Mozambique Eyecare Project, Stephen Thompson, Aoife Phelan, Tatiana Santana, Elizebete Catarino, Vivien Ocampo, Cesar Faria, James Loughman

Articles

Background - The Mozambique Eyecare Programme is funded by Irish Aid and designed to address the need for optometric education in Lusophone Africa. It is a multi-partner collaboration between Universidade Lúrio, Mozambique, Technological University Dublin, Ireland, University of Ulster, Northern Ireland, and The International Centre for Eyecare Education (ICEE) an international Non Government Organisation. A key output from the programme is the development of an optometry school based at Universidade Lúrio, the first of its kind in Mozambique. The aim is to address unmet eye care needs through human resource development.

All students enrolled at Universidade Lúrio, including the optometry …

Handbook Of Health Social Work, Teri Browne

Teri Browne

No abstract provided.

The Effect Of Aids Clinical Trials Group Protocol 5164 On The Time From Pneumocystis Jirovecii Pneumonia Diagnosis To Antiretroviral Initiation In Routine Clinical Practice: A Case Study Of Diffusion, Dissemination And Implementation, Elvin Geng

Elvin H Geng

No abstract provided.

Retention In Care And Connection To Care Among Hiv-Infected Patients On Antiretroviral Therapy In Africa: Estimation Via A Sampling-Based Approach, Elvin Geng

Elvin H Geng

No abstract provided.

Retention In Care For Hiv-Infected Patients In Resource-Limited Settings: Challenges And Opportunities, Elvin Geng

Elvin H Geng

No abstract provided.

Benefits And Barriers: An Exploratory Study Of Nephrology Social Work Field Education, Teri Browne

Teri Browne

No abstract provided.

Trends In Hiv-Infected Patients Accessing Antiretroviral Therapy In Kenya, Uganda And Tanzania Between 2002 And 2009, Elvin Geng

Elvin H Geng

No abstract provided.

Correcting Mortality For Loss To Follow-Up: A Nomogram Applied To Antiretroviral Treatment Programmes In Sub-Saharan Africa, Elvin Geng

Elvin H Geng

No abstract provided.

The Relationship Between Social Networks And Pathways To Kidney Transplant Parity: Evidence From Black Americans In Chicago, Teri Browne

Teri Browne

No abstract provided.

Organized Outpatient Stroke Care, Gustavo Saposnik

Gustavo Saposnik

Background and Purpose—Organized inpatient stroke care decreases mortality and morbidity irrespective of patient age, stroke severity, or stroke subtype. Limited information is available on whether organized outpatient care models such as stroke prevention clinics (SPC) improve outcomes after a transient ischemic attack or ischemic stroke. We compared 1-year mortality and stroke readmission in patients with transient ischemic attack or ischemic stroke referred versus not referred to an SPC. Methods—This was a retrospective cohort study including 16 468 consecutive patients with ischemic stroke or transient ischemic attack who were seen in the emergency department or admitted to a hospital between July …

Penumonia: Risk Factors And Outcomes After Stroke, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.