Digital Commons Network^™

The Economics Of Quality: Changing Incentives In Cincinnati, Lisa Sprague, Nora Super

National Health Policy Forum

This site visit focused on private market dynamics and quality improvement initiatives. Cincinnati is characterized by strong players in all sectors of the market: employers such as Procter and Gamble and General Electric, hospital systems, health plans, and physician groups with the power to “push back” in contract negotiations. The city is a pilot site for Bridges to Excellence, a pay-for-performance initiative spearheaded by GE. Cincinnati Children’s Hospital Medical Center is a grantee under the Robert Wood Johnson Foundation’s Pursuing Perfection program. Among the issues explored were physician supply, incentive structures, specialty hospitals, and information technology.

Religion And Crime: A Study Of Inmates In State And Federal Prisons In The United States., Dhanalakshmi Thirumalai

Electronic Theses and Dissertations

Persistent high levels of crime in this country have provided support for the need for public programs that help in reducing crime rates through effective interventions. Spirituality and religion are considered to play a major part in determining an individual's attitude towards committing a crime. This study analyzed if inmates in State and Federal prisons in the US are involved in prison religious activities and personal prayers in order to determine if criminality (measured by offense type) of inmates affects their participation in religious activities. Based on logistic regression analysis, gender, race, and marital status of inmates were found to …

International Art Therapy Program Development: An Exploratory Cultural Encounter In Ayacucho, Peru, Haley Johnstone

EVMS School of Health Professions Theses & Dissertations

Humanitarian aid organizations, both domestic and international, provide health care, mental health services, education, and community development for traumatized children worldwide living in regions affected by political violence. Sparse information exists regarding the role of an art therapist within these organizations. The profession of art therapy lacks research specific to the benefits of intervention and program development within the context of an international humanitarian aid team. This thesis reviews the ethnographic research of an art therapy graduate student who explored the opportunities for art therapy within such a team.

Cultural competency was an essential component of the researcher’s success while …

Influenza Vaccination Coverage Among Adults With Asthma: Findings From The 2000 Behavioral Risk Factor Surveillance System, Earl S. Ford, Seymour G. Williams, David M. Mannino, Stephen C. Redd

United States Public Health Resources

The prevalence of asthma has increased substantially in the United States since 1980 (1). The primary clinical and public health strategy to reduce the burden of asthma is to prevent exacerbation of the disease, of which upper and lower respiratory tract infections are a major cause (2–5). One such infection—influenza— and its complications are potentially preventable with annual vaccination, which is a safe and effective method (6,7), including among persons with asthma (8). Because persons with asthma are at increased risk of complications from influenza, they are advised to receive annual influenza vaccinations (9), unless there are contraindications.
Little is …

Evaluating Markers For Selecting A Patient's Treatment, Xiao Song, Margaret S. Pepe

UW Biostatistics Working Paper Series

Selecting the best treatment for a patient's disease may be facilitated by evaluating clinical characteristics or biomarker measurements at diagnosis. We consider how to evaluate the potential of such measurements to impact on treatment selection algorithms. For example, magnetic resonance neurographic imaging is potentially useful for deciding whether a patient should be treated surgically for carpal tunnel syndrome or if he/she should receive less invasive conservative therapy. We propose a graphical display, the selection impact (SI) curve, that shows the population response rate as a function of treatment selection criteria based on the marker. The curve can be useful for …

Monitoring Physical Activity: Uses And Measurement Issues With Automated Counters, Michelle L. Granner, Patricia A. Sharpe

Faculty Publications

Background: Promotion of physical activity is a public health priority, and environmental factors influence physical activity behavior. Valid and reliable automated measurement tools of physical activity for assessment and evaluation within public settings are needed. Methods: Searches of the research literature and governmental reports from physical activity, transportation, and recreation fields were conducted to identify methods of automated counting and validation studies. The article provides a summary of (a) current methods and uses of automated counters, (b) information about validity and reliability where available, (c) strengths and limitations of each methods, and (d) measurement issues. Results: Existing automated counting technology …

Examination Of Impact Of Polk County Florida’S Safe And Drug Free Schools Program

Florida Public Health Review

No abstract provided.

Health Educators In Florida’S County Public Health Departments: Frequency Of And Perceived Confidence In Performing Entry-Level Competencies, Michele Johnson Moore

Florida Public Health Review

No abstract provided.

A Bayesian Hierarchical Approach To Multirater Correlated Roc Analysis, Tim Johnson, Valen Johnson

The University of Michigan Department of Biostatistics Working Paper Series

In a common ROC study design, several readers are asked to rate diagnostics of the same cases processed under different modalities. We describe a Bayesian hierarchical model that facilitates the analysis of this study design by explicitly modeling the three sources of variation inherent to it. In so doing, we achieve substantial reductions in the posterior uncertainty associated with estimates of the differences in areas under the estimated ROC curves and corresponding reductions in the mean squared error (MSE) of these estimates. Based on simulation studies, both the widths of confidence intervals and MSE of estimates of differences in the …

The Influence Of Social Status On Token Women Leaders’ Expectations About Leading Male-Dominated Groups, Theodore W. Mcdonald, Loren L. Toussaint, Jennifer A. Schweiger

Public and Population Health Faculty Publications and Presentations

Prior research has shown that women report mostly negative expectations about being a gender-token in male-dominated work groups. We speculate that this is partially caused by the socially-ascribed status devaluation of women. In the present study we investigated the degree to which elevated social status may lessen negative expectations of gender-token women assigned to leadership positions. Sixty-three undergraduate women participated in one of three tokenism conditions: 1) nontoken, 2) gender-token, and 3) high-status gender-token. In all conditions participants were led to believe that they would be leading a group of men in a decision-making exercise. Leader expectations were then assessed. …

An Assessment Of Hiv/Aids Risk In Higher Education Students In Yerevan, Armenia, Talin Babikian, Mary Catherin Freier, Gary L. Hopkins, Ralph Diclemente, Duane C. Mcbride, Matt Riggs

Faculty Publications

Armenia's current sociopolitical and economic instability and the alarming HIV incidence rates in neighboring countries amplify its risk for a national epidemic. The goals of this study were to assess HIV/AIDS knowledge and risk behaviors among higher education students in Yerevan. Knowledge of HIV transmission through sexual intercourse was markedly higher than that on intravenous transmission and prevailing myths; however, HIV/AIDS knowledge was not related to risk behaviors. Tobacco and alcohol prevalence was relatively high. Students reported risky sexual behaviors, including inconsistent condom use, casual sex, and multiple partners. In addition to descriptive statistics delineating gender differences across the target …

The Prevalence And Treatment Of Pain Among Rural Medicaid Beneficiaries With Disabilities, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Pain has an enormous impact on the lives of many people with disabilities. Recent research suggests that nearly 80% of people whose primary disability is not a pain disorder are still limited by pain as a secondary condition. As many as half of those people report that their pain is ongoing, intractable and limiting (Ehde, Jensen, Engel, Turner, Hoffman & Cardenas, 2003). Our research suggests strong associations between an individual’s pain and his or her quality of life, depression and the number of hours worked.

Pain As A Secondary Condition Experienced Byrural Medicaid Beneficiaries With Disabilities, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Secondary conditions are disability-related problems that further limit a person’s ability to engage in daily activities. People who live independently in the community and who have mobility impairments consistently report being limited by 14 secondary conditions annually.

Consumer Perspectives On Quality In Adult Day Care, Amy Leventhal Stern, Francis G. Caro

Gerontology Institute Publications

Purpose: The purpose of this project was to gain insight into the quality of care and services provided through adult day care from the user’s perspective. Design and Methods: The project utilized 13 focus groups to explore aspects associated with user needs, preferences, and satisfaction with adult day care centers. Results: Focus group participants described aspects of adult day care that are important in delivering quality care, program features that are effective, and key areas in need of improvement. Ensuring the safety of clients; having caring, friendly, and compassionate staff available to provide one-on-one attention; engaging clients in stimulating activities; …

Accroître Les Efforts De Prévention : La Santé Et La Sécurité Du Travail Dans La Construction Au Québec, Jean-Pierre Brun

Rapports de recherche scientifique

Ce rapport présente les résultats d’une recherche s'intéressant au processus d'application de mesures de prévention dans l'industrie de la construction. L'objectif de la recherche est donc de comprendre comment et pourquoi les mesures préventives sont appliquées ou non sur divers chantiers de construction. Les conditions susceptibles d'influencer l'application des mesures préventives peuvent être situées sur un axe partant d’un contexte global à un contexte local. Nous les regroupons selon qu'elles concernent principalement le contexte général (cadre législatif, organisation industrielle, etc.), le contexte d’affaires (marché, clients, maître d’œuvre, etc.), le chantier (environnement physique, type de chantier, etc.), les acteurs collectifs (syndicats, …

Economic Efficiency And Consumer Choice Theory In Nutritional Labeling, Michael Mccann

Law Faculty Scholarship

As more Americans consume fast food each year, more Americans are contracting serious diseases related to obesity. Considering that obesity ranks second behind tobacco use as the largest contributor to mortality rates in the United States, and also that it gives rise to greater publicly funded health care expenses than does tobacco, this phenomenon begs the obvious question: To what extent does the growing consumption of fast food contribute to the obesity epidemic and the incidence of disease? If the answer indicates a meaningful contribution, a natural follow-up question then emerges: In a sensible legal system, what instruments would best …

Correlates Of Adherence With Transdermal Nicotine., Theodore Cooper, M. Debon, M. Stockton, T. Steenbergh, D. Sherrill-Mittleman, L. Jennings, R. Klesges

Selected Works Temporary Series

No abstract provided.

Correlates Of Adherence With Transdermal Nicotine., Theodore Cooper, M. Debon, M. Stockton, T. Steenbergh, D. Sherrill-Mittleman, L. Jennings, R. Klesges

Departmental Papers (Psych)

No abstract provided.

Farm Fatalities To Youth 1995–2000: A Comparison By Age Groups, Michael Goldcamp, Kitty J. Hendricks, John R. Myers

United States Public Health Resources

Problem: Although a myriad of research illustrates the safety issues related to farm fatalities in youth populations, very little empirical evidence exists that includes work and non-work related farm fatalities to all youths under 20 years of age at the national level.
Methods: This research will use death certificate data for the six years from 1995 to 2000 that were collected by NIOSH from all 50 state vital statistics registries. Demographic data from the 1998 CAIS were used in rate calculations. In addition to providing annual fatality rates and descriptions of the general causes of death, this research will examine …

Neurobehavioral Evaluation For A Community With Chronic Exposure To Hydrogen Sulfide Gas, Steven G. Inserra, Betty L. Phifer, W. Kent Anger, Michael Lewin, Roberta Hilsdon, Mary C. White

United States Public Health Resources

In May 2000, the Agency for Toxic Substances and Disease Registry of the US government conducted a health investigation in response to community concerns regarding ambient and indoor hydrogen sulfide (H₂S), odor, and health symptoms in Dakota City, Nebraska. The objective was to determine whether adult residents in an area with repeated exposure to H₂S showed poorer performance on neurobehavioral tests than unexposed residents. Study participants were required to meet age (≥16 years of age) and length of residency (2 years) eligibility requirements. A battery of computer-assisted standardized neurobehavioral tests was administered in English or Spanish. …

Maximizing Resources To Meet Client Needs: Evaluation Of A Comprehensive Hiv/Aids Care And Support Model In India, Yrg Care, Horizons Program, International Hiv/Aids Alliance

HIV and AIDS

To examine the benefits and feasibility of service delivery, the Horizons program and the International HIV/AIDS Alliance undertook a multifaceted operations research study of YRG CARE, a nongovernmental organization which offers services to PLHA in southern India. Data from this study suggest that comprehensive care and support services have had a positive impact on perceived quality of life, serostatus disclosure, number of illness episodes, and household expenditures for those patients who participated in the study. The results of this component of the study support the value of scaling-up the YRG CARE service model to other NGOs in India to expand …

Expanding The Care Continuum For Hiv/Aids: Bringing Carers Into Focus, Jessica Ogden, Simel Esim, Caren Grown

HIV and AIDS

This review by the International Center for Research on Women explores the specific issues that cluster around the provision of care in the context of the global HIV/AIDS pandemic. With the support of the Population Council’s Horizons program, this review applies the care economy lens to two key sectors, health and social protection, and finds that while important strides are being made, much more needs to be known and done to enable individuals, families, and households to survive in a world shaken by AIDS. The report documents the challenges faced by family care providers, who are primarily women and unlinked …

Equitable Access To Hiv Counseling And Testing For Youth In Developing Countries: A Review Of Current Practice, Ann P. Mccauley

HIV and AIDS

While many people get HIV-related counseling and testing, only those who receive pre- and post-test counseling, and test voluntarily, are participating in voluntary counseling and testing (VCT). The high rates of HIV infection among youth make it crucial to find programs to prevent infection. Because there is evidence that many adults benefit from VCT, there is increasing interest in extending these services to young people. VCT counseling helps adolescents evaluate their own behavior and its consequences. A negative test result offers the opportunity to recognize vulnerabilities and develop risk-reduction plans to adopt safe behaviors. Young people who test HIV-positive can …

A Rapid Situation Analysis Of The Access To Care Project In Northern Thailand, Ratana Panpanich

HIV and AIDS

A rapid situation analysis (RSA) study, supported by the Horizons program, was undertaken to understand the strengths and weaknesses of the Thai government’s Access to Care (ATC) project in northern Thailand. The ultimate aim of the study was to make recommendations for action that will improve the quality of the antiretroviral (ARV) therapy that clients receive and to enhance their adherence to HAART. The RSA has shown high levels of support for the ATC project from health providers, HAART clients, their relatives, and even those who had dropped out of the program. However, the RSA has also shown that there …

Public Posting As A Strategy To Increase Walking: A Worksite Intervention, Rayleen Earney, Timothy J. Bungum

Environmental & Global Health Faculty Research

Because most American adults do not meet recommended physical activity guidelines, the need for new and innovative strategies is apparent. The current study employed public posting in an attempt to increase walking behavior in a worksite setting. Pedometer generated data was publicly posted in a prominent location in the worksite. In our study that utilized a pre-experimental design, we found that walking steps were statistically higher during the intervention and in a post intervention period as compared to the baseline data. We conclude that the public posting of physical activity data has the potential to increase walking behavior.

A Comparison Of Perceptions Of Students, Parents And School Personnel Regarding Bullying Behavior, Joan Buchar

Masters Theses & Specialist Projects

A COMPARISON OF PERCEPTIONS OF STUDENTS, PARENTS AND SCHOOL PERSONNEL REGARDING BULLYING BEHAVIOR Joan Buchar July 2, 2004 52 Pages Directed by: Richard W. Wilson, J. David Dunn, Lisa L. Lindley Department of Public Health Western Kentucky University Bullying in America's schools is a problem that is, at best, a nuisance and at worst, the suspected cause of school shootings. Bullying is a persistent, physical or psychological abuse of power. It takes many forms from physical assault and name calling to shunning, ridicule or exclusion. The victims are usually powerless to change conditions and often bullying is ignored or dismissed …

Perceptions Of Pediatric Overweight And Weight Management: A Comparison Of Parents And Physicians, Lisa K. Thomason

Masters Theses & Specialist Projects

Pediatric overweight is of paramount importance in Kentucky, as studies show prevalence rates are higher in the state than the national average. Research suggests that comprehensive treatments involving diet training, exercise training, and psychological counseling are most effective at reducing overweight in children. Little research has been done, however, to compare parents' and physicians' perceptions of obesity, its treatment, or barriers to weight management.

The purpose of this study is to examine differences in attitudes toward pediatric obesity and weight management among parents and physicians, specifically related to the importance of diet training, exercise training, and psychological counseling. Surveys were …

Attracting Youth To Voluntary Counseling And Testing Services In Uganda, Ann P. Mccauley, Milka Juma, Edward Kirumira, Nelson Kakande, Scott Geibel, C. Hitimana-Lukanika, Daniel Lukenge, Edith Mukisa

HIV and AIDS

Little is known about the use of voluntary counseling and testing (VCT) by youth, a group that comprises more than half of those newly infected with HIV. An exploratory study conducted in Nairobi, Kenya, and Kampala and Masaka in Uganda revealed that young people want information, confidentiality, low-cost HIV testing, and friendly, professional counseling. Two facilities in Kampala, the AIDS Information Center (AIC) and Naguru Teenage Information and Health Center (NTIHC), implemented new youth-oriented strategies to increase VCT utilization and satisfaction with services among young people. In 2001, AIC established a youth corner behind the regular adult clinic with a …

Access To Health, Natalie Huls

Human Rights & Human Welfare

Access to health is an often-overlooked aspect of the right to health. Without practical access, the right to health becomes an empty promise. International human rights conventions and declarations do not directly mention access to health, but the above comment on the International Covenant on Economic, Social, and Cultural Rights does address the issue.

Improving The Reproductive Health Of Youth In Mexico, Ricardo Vernon, Maricela Dura

Reproductive Health

This project assessed the impact of the Mexican Foundation for Family Planning’s Young People Program (YPP) on: a) the attitudes of community stakeholders toward informing youth about reproductive health issues and making reproductive health services available for sexually-active youth; b) the sexual and reproductive health knowledge, attitudes, and behaviors of adolescents; and c) the way that providers offer reproductive health services to adolescents. In addition, the project determined whether adding a school-based sex education component increased the impact of community interventions on the knowledge, attitudes, and behaviors of adolescents. Survey results showed that the reproductive health knowledge and attitudes of …