Digital Commons Network^™

Is Community Care A Civil Right? The Unfolding Saga Of The Olmstead Decision, Randy Desonia

National Health Policy Forum

This paper lays the groundwork for understanding the implications of the historic U.S. Supreme Court decision in the case of Olmstead v. L.C., which has far-reaching consequences for the long-term care of people with disabilities. The paper reviews the critical components influencing the case: the Medicaid program’s role in funding community-based long-term care; the Americans with Disabilities Act, which serves as the statutory basis for the decision; and the Court’s legal reasoning. The paper also describes the federal and state responses to the ruling and concludes with a brief discussion of some legal issues that will be debated in the …

A Cost-Effectiveness Analysis Of A Community-Based Health Promotion Intervention For Adults With Mobility Impairments: Living Well With A Disability, Craig Ravesloot Ph.D., Tom Seekins Ph.D., Catherine Ipsen M.A., Steve Seninger Ph.D., Colleen Murphy-Southwick Ph.D., Lisa Brennan M.L.S., Rita K. Fjeld M.A., Glen W. White Ph.D., Ann Branstetter Ph.D., Vivian Chapman M.A., Amanda Jay M.A., James A. Bovaird M.A., Janet Marquis Ph.D., University Of Montana Rural Institute

Health and Wellness

This document reports on research conducted by the University of Montana and the University of Kansas for the Office of Disability and Health at the Centers for Disease Control and Prevention. The research project, conducted between August 1,1997 and July 31, 2001, was conducted in four separate but related studies. The research was conducted in eight States. We contracted with nine centers for independent living (CIL) to conduct 34 Living Well with a Disability health promotion workshops and to collect outcome measures. These programs included 246 individuals. In the first study, we evaluated the effectiveness and cost outcomes of the …

A Comparative History Of Aids In Latin America: Brazil And Cuba, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

According to a joint report of the World Health Organization and the Pan American Health Organization in September 2002 there were approximately 1.4 million HIV+ people in Latin America, and a further 420,000 HIV+ people in the Caribbean. The number of infections had increased by nearly 10% from the previous year in Latin America, and 16% in the Caribbean. While striking, these figures may obscure the diversity of the HIV epidemic in the region. Latin America has a varied pattern of infections, which means that the experience of Bolivia, Ecuador and Mexico is quite different from that of Honduras, Haiti …

Reasonable Modification Or Fundamental Alteration? Recent Developments In Ada Caselaw And Implications For Behavioral Health Policy, Sara J. Rosenbaum, Joel B. Teitelbaum, D. Richard Mauery, Alexandra M. Stewart

Center for Integrated Behavioral Health Policy

No abstract provided.

Selecting Differentially Expressed Genes From Microarray Experiments, Margaret S. Pepe, Gary M. Longton, Garnet L. Anderson, Michel Schummer

UW Biostatistics Working Paper Series

High throughput technologies, such as gene expression arrays and protein mass spectrometry, allow one to simultaneously evaluate thousands of potential biomarkers that distinguish different tissue types. Of particular interest here is cancer versus normal organ tissues. We consider statistical methods to rank genes (or proteins) in regards to differential expression between tissues. Various statistical measures are considered and we argue that two measures related to the Receiver Operating Characteristic Curve are particularly suitable for this purpose. We also propose that sampling variability in the gene rankings be quantified and suggest using the “selection probability function”, the probability distribution of rankings …

Semiparametric Receiver Operating Characteristic Analysis To Evaluate Biomarkers For Disease, Tianxi Cai, Margaret S. Pepe

UW Biostatistics Working Paper Series

The receiver operating characteristic (ROC) curve is a popular method for characterizing the accuracy of diagnostic tests when test results are not binary. Various methodologies for estimating and comparing ROC curves have been developed. One approach, due to Pepe, uses a parametric regression model with the baseline function specified up to a finite-dimensional parameter. In this article we extend the regression models by allowing arbitrary nonparametric baseline functions. We also provide asymptotic distribution theory and procedures for making statistical inference. We illustrate our approach with dataset from a prostate cancer biomarker study. Simulation studies suggest that the extra flexibility inherent …

Semi-Parametric Regression For The Area Under The Receiver Operating Characteristic Curve, Lori E. Dodd, Margaret S. Pepe

UW Biostatistics Working Paper Series

Medical advances continue to provide new and potentially better means for detecting disease. Such is true in cancer, for example, where biomarkers are sought for early detection and where improvements in imaging methods may pick up the initial functional and molecular changes associated with cancer development. In other binary classification tasks, computational algorithms such as Neural Networks, Support Vector Machines and Evolutionary Algorithms have been applied to areas as diverse as credit scoring, object recognition, and peptide-binding prediction. Before a classifier becomes an accepted technology, it must undergo rigorous evaluation to determine its ability to discriminate between states. Characterization of …

Increased Morbidity And Mortality In Single Parent Families: A Review, Katie Steneroden

International Journal of Global Health

American families have changed dramatically in composition in recent decades. Increasing proportions of children are being raised in single parent households, reflecting both rising divorce rates, the growing percentage of births to unmarried women and adoption by single parents. As fewer children grow up in traditional families, there is increasing concern about the impact of alternative family structures on children's health and well-being. Many believe that there is a vital connection between family structure and youth well-being, with the nuclear family constituting the optimal structure for fostering "normal" development. Some say the change in the typical nuclear family is one …

Assessing The Integrity Of Motivational Interviewing Interventions: Reliability Of The Motivational Interviewing Skills Code, Theresa Moyers, Tim Martin, Delwyn Catley, Kari Jo Harris, Jasjit S. Ahluwalia

Public and Community Health Sciences Faculty Publications

The motivational interviewing skills code (MISC) was used to review 86 audiotaped interactions between clinicians and patients participating in a smoking cessation intervention. Intraclass correlations (ICCs) were completed for two of the MISC elements: global evaluations and behavior counts. Results indicate 75% of the global ratings yielded ICCs in the good to excellent range, while only 44% of the behavior counts yielded this level of accuracy. Adherence scores were created to form overall ratings of clinician adherence to using motivational interviewing and 80% of these competence measures yielded ICCs in the good to excellent range. Specific recommendations regarding modifications for …

Progress And Opportunities In Lesbian, Gay, Bisexual And Transgender Health Communications, Laurie A. Drabble, J. Keatley, G. Marcelle

Faculty Publications

This article describes elements of effective health communication and highlights strategies that may best be adopted or adapted in relation to lesbian, gay, bisexual, and transgender (LGBT) populations. Studies have documented the utility of multidimensional approaches to health communication from the macro level of interventions targeting entire populations to the micro level of communication between health care provider and consumer. Although evidence of health disparities in LGBT communities underscores the importance of population-specific interventions, health promotion campaigns rarely target these populations and health communication activities seldom account for the diversity of LGBT communities. Advances in health communication suggest promising direction …

The Treatment Of Hypnotic Dependent Sleep Disorder: A Case Study, Theodore Cooper, K. Lichstein, N. Aguillard

Selected Works Temporary Series

No abstract provided.

A Prospective Evaluation Of The Relationships Between Smoking Dosage And Body Mass Index In An Adolescent, Biracial Cohort., Theodore Cooper, R. Klesges, L. Robinson, S. Zbikowski

Selected Works Temporary Series

No abstract provided.

Impact Of Traditional Practices On Women's Health In Africa: Research Conducted In Cape Coast, Ghana, June 2001, Clementine M. Msengi

International Journal of Global Health

Traditional cultural practices are found in every social unit, in all societies. They stem from values and beliefs intrinsic in the cultural fabric of any given society. Such beliefs lead to certain practices in the area of health that can be a detriment or a benefit to a segment of a population. Examples in Africa range from FGC (female genital cutting); preadolescent or early adolescent marriage; nutritional taboos; social, cultural, and educational preference for male children; pregnancy practices and taboos, dowry-related mistreatment and enslavement of wives; abuse related suicides; etc. In all these examples, it is women who are affected …

A Prospective Evaluation Of The Relationships Between Smoking Dosage And Body Mass Index In An Adolescent, Biracial Cohort., Theodore Cooper, R. Klesges, L. Robinson, S. Zbikowski

Departmental Papers (Psych)

No abstract provided.

Reproductive Health Services In Kwazulu Natal, South Africa: A Situation Analysis Study Focusing On Hiv/Aids Services, Lewis Ndhlovu, Catherine Searle, Robert A. Miller, Andrew A. Fisher, Ester Snyman, Nancy L. Sloan

HIV and AIDS

This Horizons report examines the readiness of reproductive health services in South Africa, which are primarily geared to women, to deliver HIV and AIDS treatment, care, and prevention services. The goal of the study was to obtain information from a representative sample of provincial health care facilities offering reproductive health services in KwaZulu Natal to meet the growing demand for HIV/AIDS-related services. Ninety-eight hospitals, community health centers, and clinics participated in the situation analysis that identified gaps in service delivery and determined priorities for service integration. Results of the study were presented to a large audience of Department of Health, …

Improving Postpartum Care Among Low Parity Mothers In Palestine, Center For Development In Primary Health Care (Cdphc)

Reproductive Health

In an effort to improve the health status of Palestinian women and their children in the West Bank and Gaza, USAID, in collaboration with the Palestinian Ministry of Health and a number of NGOs, designed and funded a 28-month pilot activity, the Pilot Health Project (PHP), that was expected to have a positive impact on the health of women and children. This report describes the results of the intervention designed to measure the effectiveness of a second home visit on low-parity women in 1) improving their knowledge and practices regarding their own health as well as the health of their …

The Ghana Community-Based Health Planning And Services Initiative: Fostering Evidence-Based Organizational Change And Development In A Resource-Constrained Setting, Frank K. Nyonator, John Koku Awoonor-Williams, James F. Phillips, Tanya C. Jones, Robert A. Miller

Poverty, Gender, and Youth

Research projects demonstrating ways to improve health services often fail to have an impact on what national health programs actually do. An approach to evidence-based policy development has been launched in Ghana that bridges the gap between research and program implementation. The Community-based Health Planning and Services (CHPS) initiative employs strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteers, resources, and cultural institutions to support community-based primary health care. Over the 1999 to 2002 period, 100 out of the 110 districts in Ghana adopted a CHPS initiative. This paper reviews features of the initiative …

My Father Didn't Think This Way': Nigerian Boys Contemplate Gender Equality, Françoise Girard

Poverty, Gender, and Youth

One of the lessons emerging from adolescent programs around the world is the need to create settings where young men can question things that are often seen as unquestionable, such as what it means to be a man. This issue explores the Conscientizing Male Adolescents (CMA) program in Nigeria which, unlike many programs targeting adolescent boys that emphasize short-term activities aimed at preventing disease and unwanted pregnancy, is a long-term program focusing on sexism and critical-thinking skills. An initial evaluation indicates that such programs affirm that we do know how to engage young men, and that historically reinforced gender attitudes …

« Mon Père Pensait Autrement » : Des Garçons Nigérians Réfléchissent À L'Égalité Entre Les Sexes, Françoise Girard

Poverty, Gender, and Youth

L’une des leçons émergeant des programmes pour adolescents dans le monde entier concerne la nécessité de créer des cadres où les jeunes hommes peuvent remettre en question ce qui est souvent considéré comme incontestable, par exemple ce que signifie « être un homme ». Ce numéro décrit le programme nigérian « Conscientiser les adolescents de sexe masculin » (CMA, Conscientizing Male Adolescents). Contrairement à beaucoup de programmes visant les adolescents de sexe masculin, qui mettent l’accent sur des activités à court terme destinées à prévenir la maladie et les grossesses non désirées, le modèle proposé par CMA est un programme …

The Living Arrangements Of Older Adults In Sub-Saharan Africa In A Time Of Hiv/Aids, Zachary Zimmer, Julia Dayton

Poverty, Gender, and Youth

The detrimental consequences of the AIDS epidemic for older adults in sub-Saharan Africa suggest the need to investigate their characteristics, living situations, and well-being. In this study, we examine the living arrangements of persons aged 60 and older in 16 countries. Data come from the household roster component of recent Demographic and Health Surveys. The focus is on the tendency of the elderly to live with children and grandchildren, and we examine distributions and determinants. Results show that older adults in sub-Saharan Africa live in a variety of household arrangements. Men are more likely to be living in a nuclear …

How Indicators Of Socioeconomic Status Relate To Physical Functioning Of Older Adults In Three Asian Societies, Zachary Zimmer, Napaporn Chayovan, Hui-Sheng Lin, Josefina N. Natividad

Poverty, Gender, and Youth

In developed countries, socioeconomic status has been identified as one of the most important demographic and social determinants of older adult health. The relationship has not been well studied or contrasted across much of the developing world. Yet, with population aging occurring rapidly in much of Asia, understanding the factors that distinguish between those in better and worse health becomes important. To this end, the current study has two main aims. It first examines the degree to which two measures commonly used to indicate socioeconomic status, education and income, relate to the physical functioning of older adults in three Asian …

Consistency In The Reporting Of Sexual Behavior Among Adolescent Girls In Kenya: A Comparison Of Interviewing Methods, Paul C. Hewett, Barbara Mensch, Annabel Erulkar

Poverty, Gender, and Youth

This paper explores the consistency in reporting of sexual behavior in a household survey of adolescents aged 15-21 in the Kisumu district of Kenya. Respondents were randomly assigned to different interviewing modes: face-to-face interviews, paper-and-pencil self-administered interviews, and audio computer-assisted self-interviewing (ACASI). The analysis focuses on the reporting of sexual behavior by adolescent girls in the face-to-face and ACASI modes and compares responses to a variety of questions about sexual activity, including sexual initiation, risky sexual behavior, and coerced sex. All sexual behavior questions were asked of each adolescent girl even if she answered “no” to the initial question about …

Taking Postabortion Care Services Where They Are Needed: An Operations Research Project Testing Pac Expansion In Rural Senegal, Engenderhealth

Reproductive Health

EngenderHealth, in collaboration with the Ministry of Health, conducted an operations research project to examine the feasibility of introducing an integrated three-element model of postabortion care (PAC) services in secondary- and primary-level sites in two predominantly rural regions in Senegal. The intervention provided health personnel with: 1) training to improve clinical competence, counseling, infection prevention, and general care; 2) technical assistance, materials, and support to aid in overcoming challenges; and 3) ongoing monitoring and supervision. The project findings attest to the benefits of expanding existing PAC programs in rural settings and suggest that the advantages of such an expansion outweigh …

Cultural Norms And Behavior Regarding Vaginal Lubrication During Sex: Implications For The Acceptability Of Vaginal Microbicides For The Prevention Of Hiv/Stis, Sarah Braunstein, Janneke Van De Wijgert

Reproductive Health

This paper presents the results of an extensive review of the literature pertaining to the relationship between vaginal lubrication and the acceptability of microbicides, spermicides, and male and female condoms. The review highlights the need for research that better elucidates norms, preferences, and practices regarding lubrication during sex within and across countries. The second part of the report presents the results of the first phase of a qualitative study on lubrication during sex showing that diverse personal and cultural factors shape preferences and practices and may ultimately affect the acceptability of microbicides. The immediate challenge is to provide women with …

Non-Consensual Sexual Experiences Of Young People: A Review Of The Evidence From Developing Countries, Shireen J. Jejeebhoy, Sarah Bott

Reproductive Health

Although there is increasing evidence of risky consensual sex among young people in developing countries, non-consensual sexual experiences among them have rarely been studied and few interventions have been designed to protect them from the risks of such experiences. However, what is available suggests that coercion and unwantedness may play a considerable role in the sexual relations of young people—girls and young women but also boys and young men. The implications of non-consensual sexual experiences for young people’s rights, their health and development and the risks they pose in the transition to adulthood are enormous. This review collates what is …

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

Theses and Dissertations (ETD)

No abstract provided.

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. …

Effectiveness Of Education On Diabetes Control, Irene Nganga

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

The purpose of this study was to examine the effect of a diabetes education intervention strategy on the clinical and biochemical status of patients in the Diabetes Complications Prevention Study (DCPS) at Candler County Hospital in Metter, Georgia. The participants in this study were all active members in the DCPS program. This intervention group was paired to control group members of a similar age and race. A sample size of 18 participants and an equal number of controls was chosen for this evaluative study. The sampling method utilized for participants in the study was non-probability quota sampling. Medical records were …

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). …

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 …