Digital Commons Network^™

Family Connectedness And Sexual Risk-Taking Among Urban Youth Attending Alternative High Schools, Christine M Markham, Susan R Tortolero, S Liliana Escobar-Chaves, Guy S Parcel, Ronald Harrist, Robert C Addy

Faculty, Staff and Student Publications

CONTEXT: Youth in alternative high schools engage in risky sexual behavior at higher rates than do their peers in regular schools, placing themselves at an increased risk of sexually transmitted disease and unintended pregnancy. Family connectedness is associated with reduced adolescent sexual risk-taking, although this association has not been tested among alternative school youth.

METHODS: A sample of 976 urban, predominantly minority alternative high school students in Houston, Texas, were surveyed in 2000-2002. Survey data were analyzed using logistic regression to determine whether family connectedness is related to sexual risk-taking.

RESULTS: Overall, 68% of students reported ever having had sex. …

Characteristics And Follow-Up Of Adult Female Victims Of Recent Sexual Assault, Anita Boykins

Theses and Dissertations (ETD)

No abstract provided.

The Prevalence Of Disordered Eating Behaviors Among Sorority Versus Non-Sorority Women, Angela Lynn Guzman

College of Graduate Studies: Theses & Dissertations (1964–2006)

Eating disorders among college women is a serious psychological problem. Disordered eating behaviors were examined and diagnosed at a mid-sized university in southeast Georgia. The target group of this study was university sororities. The purpose of this study was to examine sorority versus nonsorority women to determine if there was a higher prevalence for those involved in sororities to develop disordered eating behaviors.

Surveys were distributed to both sorority and non-sorority women to determine the prevalence of disordered eating behaviors among each group. A quantitative, quasi-experimental design was used in conjunction with the Eating Attitudes Test (Gamer & Garfmkle, 1979). …

In Pursuit Of Best Practice : Benchmarking Tools And Processes For The Management Of Hazardous Substances In The Workplace, Barry Chesson

Theses: Doctorates and Masters

Many organisations now strive to achieve excellence in various aspects of occupational health and safety. Benchmarking of the techniques and approaches of other organisations is becoming a popular way of bridging gaps and seeking to achieve high levels of performance. There exist many sources of guidance in the form of external and internal standards, regulations, codes of practice, publications by professional institutions and similar. However, there are clear shortfalls in terms of tools and processes needed to identify areas of opportunity and to overcome barriers to the efficient transfer of ideas and techniques from one enterprise to another. This is …

The Politics Of Public Health: A Response To Epstein, Lawrence O. Gostin, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

Conservatives are taking aim at the field of public health, targeting its efforts to understand and control environmental and social causes of disease. Richard Epstein and others contend that these efforts in fact undermine people’s health and well-being by eroding people’s incentives to create economic value. Public health, they argue, should stick to its traditional task—the struggle against infectious diseases. Because markets are not up to the task of controlling the transmission of infectious disease, Epstein says, coercive government action is required. But market incentives, not state action, he asserts, represent our best hope for controlling the chronic illnesses that …

Healthcare Trends And Attitudes Of Migratory Winter Visitors In The Rio Grande Valley, Caprica Ann Neal

Theses and Dissertations - UTB/UTPA

This original research explores the general trends and attitudes of migratory winter visitors to the Rio Grande Valley regarding the local healthcare environment/options, general health status, and attitudes toward alternative medicine. The sample consisted of 115 winter visitors to the Valley, and exploratory data was gathered through a self-administered questionnaire. The average respondent was female, over 70 years old, had a high school level education, and reported earning a minimum average of $20,000/year for the past five years. Most respondents had Medicare coverage; over half had private insurance coverage. Commonly reported health conditions were visual problems, joint/bone problems, and high …

Is It 'Too Bloody Late'? : Older People's Attitudes To Physical Activity And To The Recommendations In The National Physical Activity Guidelines, Joan Jackson

Theses: Doctorates and Masters

Participation in physical activity confers many health benefits by reducing the risk factor for a number of lifestyle related diseases such as diabetes, colon cancer, and heart disease. Other benefits include improved mental and physical well-being. For older people the benefits are even more important; engagement in physical activity extends to such health benefits as reduction in the risk of falls and related potential injuries. However the most significant benefit to older people is that physical activity enables older people to live independently for longer and with a greater sense of well-being. This study explores, through qualitative research, older people's …

An Ethnographic Investigation Of The Relevance Of Shop Floor Culture To Effective Safety Communication In An Australian Minerals Refinery, David R. Leith

Theses: Doctorates and Masters

Many organisations which aim to achieve excellent workplace safety choose 'culture change' as the means to achieve this. They make use of employee communication media to help re-form the values, beliefs, norms and behaviours which are generally thought to comprise culture. However, culture is a complex and profound phenomenon. Successful communication between two culturally separate groups requires each to achieve an understanding of the other, no less so in workplaces than in societies composed of different cultures.Yet even employers who believe in communicating fully with their workforces find it difficult to convey viewpoints other than their own. Their communication tends …

Migrant Worker Dies In Tractor Rollover, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

On September 13, 2002, a 26 year-old male Hispanic migrant worker (decedent) died when the tractor he was driving on a country roadway overturned. The decedent had experience driving the tractor in a field, but did not have experience driving it on a public roadway. On the afternoon of the incident, the decedent drove the tractor, pulling a wagonload of tobacco, from the farm where it had been harvested to the tobacco barn one mile away. The road was hilly and had a sharp curve to the right at the bottom of the hill. As the decedent drove the tractor …

The Effectiveness Of Heart Failure Disease Management: Initial Findings From A Comprehensive Program, Janice L. Clarke, David B. Nash

College of Population Health Faculty Papers

A prevalent, chronic condition among members of the mushrooming elderly population in the United States, heart failure (HF) is a logical focus for population-based disease management. Evidence supporting the premise that multidisciplinary interventions can significantly improve clinical outcomes while decreasing the cost of medical care for people with HF is steadily mounting. A growing number of controlled and observational studies focus on the effects of HF disease management on re-admission rates, length of stay, and improvement in appropriate diagnostic testing and prescribing. This paper describes a large-scale, comprehensive HF program and reports on clinical quality, utilization, and financial outcomes observed …

Ua3/9/5 Special Announcement - Kelly Autism Project, Wku President's Office

WKU Administration Documents

Speech delivered by WKU president Gary Ransdell announcing the beginning of the Kelly Autism Project at Western Kentucky University.

The Medicare And Medicaid Intersection: Caring For Arizona's Seniors, Nora Super, Lisa Sprague, Judith D. Moore

National Health Policy Forum

This site visit to Phoenix examined the interplay between Medicare and Medicaid and how payment streams and regulatory requirements affect the delivery of health and long-term care services. The visit explored trends related to Medicare+Choice plan participation, physician acceptance of Medicare patients, and care management for individuals with chronic illnesses, such as Alzheimer’s disease. It also considered Arizona’s capitated Medicaid long-term care program, which recently implemented competitive bidding among plans in Maricopa County.

Prescription Drugs In Nursing Homes: Managing Costs And Quality In A Complex Environment, Dan Mendelson, Rajeev Ramchand, Richard Abramson, Anne Tumlinson

National Health Policy Forum

This issue brief provides a description of prescription drug use in nursing homes and a summary of policy issues in this area. It first profiles the nursing home pharmaceutical market, outlining the major trends in demographics and drug utilization, the supply chain by which drugs go from manufacturers to pharmacies to nursing home residents, and the alternative arrangements by which prescription drugs in nursing homes are financed. The paper then provides a synopsis of current policy issues, focusing in turn on cost containment and quality improvement initiatives.

U.S. Childhood Vaccine Availability: Legal, Regulatory, And Economic Complexities, Robin J. Strongin

National Health Policy Forum

Despite the vital role they play in public health, childhood vaccines travel a complicated road from laboratory to provider and patient. From the fall of 2000 until well into 2002, a combination of factors, including market dynamics, legal challenges, and regulatory hurdles, led to a shortage of some childhood vaccines. This paper examines each of these factors, focusing on the important roles of both the public and the private sectors.

Laboratory Response To Anthrax Bioterrorism, New York City, 2001, Michael B. Heller, Michel L. Bunning, Martin E.B. France, Debra M. Niemeyer, Leonard Peruski, Tim Naimi, Phillip M. Talboy, Patrick H. Murray, Harald W. Pietz, John Kornblum, William Oleszko, Sara T. Beatrice, Joint Microbiological Rapid Response Team, New York City Anthrax Investigation Working Group, Denis Nash

Publications and Research

In October 2001, the greater New York City Metropolitan Area was the scene of a bioterrorism attack. The scale of the public response to this attack was not foreseen and threatened to overwhelm the Bioterrorism Response Laboratory’s (BTRL) ability to process and test environmental samples. In a joint effort with the Centers for Disease Control and Prevention and the cooperation of the Department of Defense, a massive effort was launched to maintain and sustain the laboratory response and return test results in a timely fashion. This effort was largely successful. The development and expansion of the facility are described, as …

Running On Empty: The State Budget Crisis Worsens, Randy Desonia

National Health Policy Forum

This issue brief reviews the status of state budget shortfalls and their growing impact on the Medicaid program. It describes the magnitude of the shortfalls, the forces behind them, and how states have responded with spending cuts and tax increases. It also discusses how long the budget crisis is expected to continue and what budget balancing options remain for fiscal year 2003.

Relationship Between Low Quality-Of-Care Scores And Hmos' Subsequent Public Disclosure Of Quality-Of-Care Scores, Danny Mccormick, David U. Himmelstein, Steffie Woolhandler, Sidney M. Wolfe, David H. Bor

Publications and Research

Context Public disclosure of quality data on health maintenance organizations (HMOs) might improve public accountability, inform consumer decision making, and promote quality improvement. But, because disclosure is voluntary, some HMOs could subvert these objectives by refusing to release unfavorable data.

Objective To determine the association between HMO quality of care and withdrawal from public disclosure of quality-of-care data the subsequent year.

Design and Setting Retrospective cohort study of administrative and quality-of-care data on HMOs from the National Committee for Quality Assurance (NCQA) annual Quality Compass databases for 1997, 1998, and 1999, including Health Plan Employer Data and Information Set (HEDIS) …

Erisa Health Plans: Key Structural Variations And Their Effect On Liability, Phyllis Borzi

Health Policy and Management Faculty Publications

No abstract provided.

Strong Partnerships Make Good Partners: Insights About Physician-Hospital Relationships From A Study Of Physician Executives, Marc A. Bard, Michael L. Buehler, Andrew L. Epstein, David B. Nash, John P. O'Connor

College of Population Health Faculty Papers

While physicians are likely to respond favorably in concept to hospital-based disease management and other clinical programs, they are less likely to accept their structural and functional characteristics. Because of their role at the hospital-physician interface, hospital physician executives are often tasked with implementing such programs. Given the challenges involved, a deeper understanding of the role of these executives in building the hospital-physician relationship will therefore be an important contribution. To this end, we surveyed senior physician executives at hospitals and health systems (n = 326), to assess their view of the hospital-physician relationship at their institutions, focusing especially on …

Reducing Childhood Pedestrian Injuries: Proceedings Of A Multidisciplinary Conference, Richard A. Schieber, Maria Vegega

United States Public Health Resources

EXECUTIVE SUMMARY
Motor vehicle crashes are associated with one of every five deaths among children 1 to 14 years of age in the United States, and pedestrian injuries account for a third of them. Compared with occupant injuries, pedestrian injuries are more severe; death is five times more likely to occur among those injured. In 1999, 533 child pedestrians were killed, and at least 30,000 children were nonfatally injured in traffic. Another 200 were killed in non-traffic areas, including driveways, sidewalks, and parking lots. Traumatic brain injury accounts for more than half the fatalities.
Dr. Schieber noted that the decline …

School-Based Health Centers And Managed Care Arrangements: A Review Of State Models And Implementation Issues, Jennel Harvey, Lissette Vaquerano, Lea Nolan, Colleen Sonosky

Health Policy and Management Faculty Publications

No abstract provided.

Building Jefferson's Future, Douglas J. Macmaster Jr., Paul C. Brucker

Thomas Jefferson University Administrative Documents and Reports

2002 Annual report of Thomas Jefferson University.

Jefferson Medical College Annual Report, 2002, Thomas J. Nasca

Jefferson Medical College Administrative Documents and Reports

No abstract provided.

Managing Advanced Illness: A Quality And Cost Challenge To Medicare, Medicaid, And Private Insurers, Karen Matherlee

National Health Policy Forum

This issue brief examines approaches to delivering and financing health services for persons with advanced chronic illness. It focuses on the nature and structure of the Medicare hospice benefit and its use as a model for Medicaid and other federal programs. The paper also looks at palliative-care approaches along the continuum of inpatient and post-acute services and raises cost, quality, and access issues for end-of-life care. In addition, it provides an overview of coverage through private insurance, including indemnity, point-of-service, and preferred-provider-organization products.

Will The Nation Be Ready For The Next Bioterrorism Attack? Mending Gaps In The Public Health Infrastructure, Eileen Salinsky

National Health Policy Forum

This paper provides an overview of critical weaknesses in public health preparedness capabilities and discusses policy initiatives to address these shortcomings. It examines developmental needs related to communication and coordination, information systems, laboratories, the development and distribution of vaccines and other countermeasures, emergency medical preparedness and response, and the public health workforce. The paper summarizes the status of federal and state plans to respond to these developmental needs and touches on the challenges likely to emerge as these plans are implemented.

Contracting For Quality: Medicare's Quality Improvement Organizations, Lisa Sprague

National Health Policy Forum

This paper examines the role of quality improvement organizations (QIOs, formerly known as PROs, or peer review organizations) in improving the quality of medical care delivered to Medicare beneficiaries in both fee-for-service and managed care environments. It looks at the expansion of the QIOs' portfolio in their seventh contract cycle to include quality improvement activities in nursing homes, home health services, and physicians' offices as well as responsibilities for public education. The paper explores the evolution of QIOs, changes in their priorities over time, and the projects in which they are engaged. It also considers their role in the formulation …

Transportation: A Crucial Issue For Adult Day Care In Vermont, Francis G. Caro, Regula H. Robnett, Jennifer Higgins

Gerontology Institute Publications

Transportation arrangements are an integral but fragile element in the effectiveness of adult day care services in Vermont and nationwide. Almost by definition, adult day center participants generally cannot drive due to cognitive and/or physical limitations. Since adult day care services are congregate in nature and serve community-residing elders, this long-term care option is feasible only when there are arrangements to transport elders to and from service centers. Transportation is therefore a major issue for adult day care services.

The aim of this report is to call attention to transportation issues in adult day care services in Vermont. The report …

Evaluation Of A Comprehensive Diabetes Disease Management Program: Progress In The Struggle For Sustained Behavior Change, Janice Clarke, Albert Crawford, David B. Nash

College of Population Health Faculty Papers

The successful management of diabetes with a goal of achieving near-normoglycemia requires patients to make multiple lifestyle changes as part of an intensive, complex, and coordinated therapeutic regimen aimed at reducing the risk of complications associated with the disease. The difficulty in creating and sustaining these lifestyle behavior changes is a major stumbling block in achieving the desired therapeutic goal. An underlying assumption of comprehensive disease management is that regular, personal contact with nurses and ancillary health professionals will facilitate these lifestyle behavior changes for program participants. The results of a survey of self-reported data from 750 participants in a …

Commencement Program 2002, Loma Linda University

Commencement Programs

CONTENTS

2 | 2002 Events of Commencement

3 | The Academic Procession

4 | Significance of Academic Regalia

5 | The Speakers

11 | The University Honorees

18 | The School Honorees

27 | The Programs

• School of Medicine, 28
• School of Dentistry, 35
• Graduate School, 43
• School of Nursing, 53
• School of Allied Health Professions - Physical Therapy, 58
• School of Allied Health Professions, 66
• School of Public Health, 75

The Federal-State Struggle Over Medicaid Matching Funds: An Update, Karen Matherlee

National Health Policy Forum

This background paper updates NHPF Issue Brief No. 760, "The Federal-State Medicaid Match: An Ongoing Tug-of-War over Practice and Policy," December 15, 2000. The paper presents actions taken since then by the Centers for Medicare and Medicaid Services, Department of Health and Human Services, to address what the Bush administration calls abusive funding practices used by states to draw federal Medicaid matching funds. Tracing the Clinton and Bush administrations' policies, the document reviews final regulations, published in January 2001 and January 2002, on these practices. The paper also reports on a lawsuit filed in federal court to block …