Digital Commons Network^™

Is Uncompensated Care Affecting Quality Assurance Of Rural Hospitals?, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse

Management Faculty Research

Healthcare disparities in rural areas remain significant in the U.S. healthcare industry. Uncompensated care makes healthcare disparities in rural areas worse and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. As many rural residents experience difficulty accessing high quality care and the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality care barriers and opportunities, suggested strategies to strengthen the position of rural hospitals in response to uncompensated …

Management Of Kawasaki Disease In Texas: Policy Implications, Alberto Coustasse, Doohee Lee, Cody Arvidson, Julius J. Larry Iii, Witold Migala

Management Faculty Research

Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but KD has received little attention on its management from a policy perspective. The core objective of this paper is to review the literature, identify problems related to KD, and evaluate and offer some policy alternatives to effectively prevent and treat KD epidemiologically in Texas. Policy options suggested in this paper include, among others, (1) establishing a mandatory national KD registry system (along with active surveillance), (2) introducing sentinel providers, (3) requiring mandatory reporting of KD by hospitals, and (4) sponsoring policy KD research and practice.

Consumer Consent Options For Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein

Health Policy and Management Faculty Publications

The issue of whether, to what extent, and how individuals should have the ability to exercise control over their health information represents one of the foremost policy challenges related to the electronic exchange of health information. The current landscape of possible consent models is varied, and the factors involved in choosing among them are complex. States and other entities engaged in facilitating the exchange of electronic health information are struggling with a host of challenges, chief among them the establishment of policies and procedures for patient participation in their exchange efforts. While some have adopted policies enabling patients to exercise …

Climate Change, Environmental Justice, And Vulnerability: An Exploratory Spatial Analysis, Sacoby M. Wilson, Roland Richard, Lesley Joseph, Edith M. Williams

Faculty Publications

Research has demonstrated that vulnerable populations including disadvantaged populations of color live in areas that may place them at higher risk of exposure to social and environmental hazards. Due to climate change, these populations may experience worse health outcomes and environmental health disparities. The purpose of this project was to explore the use of Geographic Information Systems (GIS) to assess areas that may be vulnerable to climate change across the United States. We employed ArcGIS 9.3 to create vulnerability scores for areas across the country that may be that may be impacted by climate change at the county level in …

Using The Stages Of Change Model To Choose An Optimal Health Marketing Target, Paula Diehr, Peggy A. Hannon, Barbara Pizacani, Mark Forehand, Jeffrey Harris, Hendrika Meischke, Susan J. Curry, Diane P. Martin, Marcia R. Weaver

UW Biostatistics Working Paper Series

Background: In the transtheoretical model of behavior change, “stages of change” are defined as Precontemplation (not even thinking about changing), Contemplation, Preparation, Action, and Maintenance (maintaining the behavior change). Marketing principles suggest that efforts should be targeted at persons most likely to “buy the product.”

Objectives: To examine the effect of intervening at different stages in populations of smokers, with various numbers of people in each “stage of change.” One type of intervention would increase by 10% the probability of a person moving to the next higher stage of change, such as from Precontemplation to Contemplation. The second type would …

The Prevalence And Causes Of Vision Loss In Indigenous Australians: The National Indigenous Eye Health Survey, Hugh R. Taylor, Jing Xie, Sarah Fox, Ross A. Dunn, Anna-Lena Arnold, Jill E. Keeffe

Aboriginal Policy Research Consortium International (APRCi)

Aim: To determine the prevalence and causes of vision loss in Indigenous Australians. Design, setting and participants: A national, stratified, random cluster sample was drawn from 30 communities across Australia that each included about 300 Indigenous people of all ages. A sample of non-Indigenous adults aged 􏱄 40 years was also tested at several remote sites for comparison. Participants were examined using a standardised protocol that included a questionnaire (self-administered or completed with the help of field staff), visual acuity (VA) testing on presentation and after correction, visual field testing, trachoma grading, and fundus and lens photography. The data were …

The Ryan White Hiv/Aids Program, Jessamyn Taylor

National Health Policy Forum

This publication describes the basics of the Ryan White HIV/AIDS Program, the largest federal program solely focused on treating people living with HIV/AIDS in the United States. The program funds cities, states, and community-based organizations to provide primary care, prescription drugs, and support services to low-income, uninsured, and underinsured people living with HIV/AIDS.

The Responsibility To Protect Haiti, Linda A. Malone

Popular Media

No abstract provided.

High Volume Air Sampling For Viral Aerosols: A Comparative Approach, Casey W. Cooper

Theses and Dissertations

The United States Air Force has high volume biological air sampling equipment available including the XMX/2L-MIL and DFU-1000. Neither system has been evaluated for effectiveness in the collection of viruses. Furthermore, decontamination methods have not been evaluated for these systems after use in sampling for a viral agent. MS2 bacteriophage was used as a surrogate virus. Aerosolized MS2 was released into a 12 m3 exposure chamber. High and moderate airborne concentrations of MS2 were evaluated. Low volume impingers were used for comparative purposes as well. Samples were analyzed using plaque assay and polymerase chain reaction (PCR). At high viral loads …

Development Of A Novel Noise Delivery System For Jp-8 Ototoxicity Studies, John E. Stubbs

Theses and Dissertations

Numerous chemicals with ototoxic properties may cause hearing loss directly, potentiate noise-induced hearing loss, or produce additive effects. Of interest to the US Air Force are studies showing ototoxic effects of JP-8 jet fuel and its hydrocarbon constituents. The Naval Health Research Center (NHRC) at Wright-Patterson AFB, Ohio, in conjunction with the USAF, is studying the ototoxic effects of JP-8 in rats. The study requires a white noise source that is one octave band wide, centered at 8 kHz frequency, delivered from outside of exposure chambers. Sound pressure levels must be within ± 2 dB at all exposure points within …

Particulate Characterization And Control Evaluation For Carbon Fiber Composite Aircraft Crash Recovery Operations, Matthew R. Ferreri

Theses and Dissertations

Within the United States Air Force (USAF) Advanced Composite Material (ACM) is gaining an increasing use in military aircraft. With the number of aircraft that have increasingly large amounts of ACM materials, the probability of an incident with one of these aircraft also increases. When such an incident occurs the aircraft needs to be disassembled, removed, and later inspected as part of the accident investigation process. This disassembly process is termed “Crash Recovery Operations.” Carbon fibers have been shown to be hazardous to human health and a pilot study raised the suspicion that nanosized aerosol may be generated during the …

Hip Fracture Types In Men And Women Change Differently With Age, David A. Tanner, Marita Kloseck, Richard G. Crilly, Bert Chesworth, Jason Gilliland

Health Studies Publications

BACKGROUND: Hip fractures are expensive and a frequent cause of morbidity and mortality in the elderly. In most studies hip fractures have been viewed as a unitary fracture but recently the two main types of fracture (intertrochanteric and subcapital) have been viewed as two fractures with a different etiology and requiring a different approach to prevention. The relative proportion of intertrochanteric fractures increases with age in women. In previous studies no particular pattern in men has been noted. In this study, we explored changes in the relative proportion of the two fracture types with age in the two genders. METHODS: …

Effects Of Leas And Mecury On The Blood Proteome Of Children, Robert E. Birsall, Michael P. Kiley, Zaneer M. Segu, Christopher D. Palmer, Milan Madera, Brooks B. Gump

Falk College Research Center

Heavy metal exposure in children has been associated with a variety of physiological and neurological problems. The goal of this study was to utilize proteomics to enhance the understanding of biochemical interactions responsible for the health problems related to lead and mercury exposure at concentrations well below CDC guidelines. Blood plasma and serum samples from 34 children were depleted of their most abundant proteins using antibody-based affinity columns and analyzed using two different methods, LC-MS/MS and 2-D electrophoresis coupled with MALDI-TOF/MS and tandem mass spectrometry. Apolipoprotein E demonstrated an inverse significant association with lead concentrations (average being one microgram/deciliter) as …

Unmasking The Moving Threat: Reckless Driving, Borderline Personality Disorder, And The Impact On Motor Vehicle Accidents, Charlene Lam

Master of Public Health Program Student Publications

Background: Motor vehicle accidents (MVAs), a leading cause of mortality in the United States have an enormous impact on public health. Researchers contend that approximately 90% of all MVAs are, to some extent, a result of driver characteristics and behavior (Lewin, 1982). One of the least researched driver characteristics is psychiatric comorbidity, especially borderline personality disorder (BPD), a disorder that is characterized by impulsivity and emotional volatility.

Objective: The purpose of this study is to examine the relationship between BPD and driving citations.

Method: Using two measures for BPD, we surveyed a consecutive sample of patients who were being seen …

Campaigns To Change Health Damaging Corporate Practices, Nicholas Freudenberg

Publications and Research

When corporations claim the same citizenship rights as human citizens, they exercise an undue influence on health policy and democratic processes. Surprisingly, the same basic repertoire of tactics has been found to be employed by corporations to effect this influence, regardless of the specific industry at work. In this book, authors from around the world reveal the range of tactics used across the corporate world that ultimately favor the bottom line over the greater good.

The Bottom Line or Public Health deconstructs some of the most ubiquitous tactics at play, including public relations, political influence, legal maneuvering, and financial power, …

Changing Po2licy: The Elements For Improving Childhood Asthma Outcomes, Anne Rossier Markus, Meagan Lyon, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and chronic health issue that affects one in seven U.S. children and their families, compromising their health and quality of life and placing a heavy financial burden on families as well as an enormous strain on the health care system. Treating, managing, and ultimately preventing and reducing the burden of asthma represents a critical test of the ability of the U.S. health system – health insurers, clinical care providers, and public health agencies – to work together. Our investigation found that, as a country, we already know enough to act and improve life for the …

Strengthening Science In Government: Advancing Science In The Public's Interest, Susan F. Wood Phd, Ruth W. Long Ma, Mph, Liz Borkowski, David Michaels Phd, Mph

Health Policy and Management Issue Briefs

No abstract provided.

Conceptions Regarding Children’S Health: An Examination Of Ethnotheories In A Sending And Receiving Community, Maria Rosario De Guzman, Jennifer Deleon, Gloria Gonzalez-Kruger, Rodrigo Cantarero

Department of Child, Youth, and Family Studies: Faculty Publications

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty-four Mexican adults in six focus groups discussed well-being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components …

Workers Killed While Working With Forklifts, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Other

To prevent forklift injuries:

• Do not operate a forklift without being certified and trained.
• Forklift operators should wear their safety belts.
• Do not jump from an overturning forklift. Keep your body inside the forklift frame. Ride it out and lean in the opposite direction of the overturn.
• Do not place yourself between two forklifts.
• Do not handle loads that are heavier than the load capacity of the forklift.
• Make sure that the travel path of the forklift is clear from the floor to the height of the load being moved.
• Do not step on elevated loads.
• It is a violation …

Correlates Of Physical Activity In Black, Hispanic, And White Middle School Girls, Evelyn B. Kelly, Deborah Parra-Medina, Karin A. Pfeiffer, Marsha Dowda, Terry L. Conway, Larry S. Webber, Jared B. Jobe, Scott Going, Russell R. Pate

Faculty Publications

Background: A need exists to better understand multilevel influences on physical activity among diverse samples of girls. This study examined correlates of moderate-to-vigorous physical activity (MVPA) among adolescent girls from different racial/ethnic backgrounds. Methods: 1,180 6th grade girls (24.5% black, 15.7% Hispanic, and 59.8% white) completed a supervised self-administered questionnaire that measured hypothesized correlates of PA. MVPA data were collected for 6 days using the ActiGraph accelerometer. Hierarchical regression analysis was used to examine correlates of PA in each racial/ethnic group. Results: Hispanic girls (n=185) engaged in 21.7 minutes of MVPA per day, black girls (n=289) engaged in 19.5 minutes …

Residential Tree Trimmers Killed While Working, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent tree trimmer injuries:

• Tree trimming or cutting should not be performed without appropriate safety training.
• Appropriate personal protective equipment should be worn at all times while removing trees.
• All trees and limbs should be inspected for structural weakness before work commences.
• Safe work procedures should be used for climbing, felling, topping, and pruning trees.
• A jobsite hazard assessment should be performed to identify hazards so that hazards can be controlled for.

Pregnancy Outcome In Women With Antiphospholipid Syndrome On Low-Dose Aspirin And Heparin: A Retrospective Study., T. Naru, Rozilla Sadia Khan, R. Ali

Department of Obstetrics & Gynaecology

This retrospective review of hospital records analysed pregnancy outcome with 2 different treatments for women with recurrent miscarriage diagnosed with antiphospholipid syndrome in the index pregnancy. Of 64 women, 29 had received aspirin and 35 aspirin plus heparin. Pregnancy-induced hypertension, prematurity, intrauterine growth restriction and neonatal death were considered as maternal and fetal complications. There were no significant differences in antenatal and maternal complications between the groups. However, there were significant differences in mean anticardiolipin IgG antibody levels. Aspirin alone or in combination with parin was equally efficacious in women with antiphospholipid syndrome and recurrent miscarriage.

The President's Emergency Plan For Aids Relief (Pepfar): A Social Work Ethical Analysis And Recommendations, Robert J. Barney, Stephan L. Buckingham, Judith M. Friedrich, Lisa M. Johnson, Michael A. Robinson, Bibhuti K. Sar

The Journal of Sociology & Social Welfare

The President's Emergency Plan for AIDS Relief (PEPFAR) is the most recent international social program instituted by the U.S. Government to combat HIV/AIDS. Since its inception in 2003, this foreign policy initiative has dedicated $63 billion for HIV/AIDS prevention and treatment in foreign countries. Despite PEPFAR's many accomplishments, it continues to promote controversial prevention strategies. This paper analyzes these prevention strategies, utilizing social work values as described in the NASW Code of Ethics. Policy, practice, and research implications are discussed.

Emerging Issues In Adolescent Healthcare : An Urgent Call For Action, Waris Qidwai Dr, Tabinda Ashfaq Ashfaq

Department of Family Medicine

No abstract provided.

Maternal And Neonatal Outcomes By Labor Onset Type And Gestational Age, Jennifer L Bailit, Kimberly D Gregory, Uma M Reddy, Victor H Gonzalez-Quintero, Judith U Hibbard, Mildred M Ramirez, D Ware Branch, Ronald Burkman, Shoshana Haberman, Christos G Hatjis, Matthew K Hoffman, Michelle Kominiarek, Helain J Landy, Lee A Learman, James Troendle, Paul Van Veldhuisen, Isabelle Wilkins, Liping Sun, Jun Zhang

Faculty, Staff and Student Publications

OBJECTIVE: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age.

STUDY DESIGN: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age.

RESULTS: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor.

CONCLUSION: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction …

The Influence Of Cultural Orientation, Alcohol Expectancies, And Self-Efficacy On Adolescent Drinking Behavior In China, Duane F. Shell, Ian M. Newman, Xiaoyi Fang

Department of Educational Psychology: Faculty Publications

Objective: We hypothesized that the drinking behavior of adolescents in China is influenced by expectancies and self-efficacy and that adolescents’ cultural orientation towards western versus traditional Chinese values influences expectancies, self-efficacy and drinking behavior, with western values leading to more dysfunctional patterns of beliefs and drinking, and that these beliefs are influenced by students’ gender and school environment. Methods: A total of 1020 high school students from Beijing completed the Chinese Adolescent Alcohol Expectancy, the Chinese Cultural Orientation and the Chinese Self-regulation Self-efficacy questionnaires. Results: Results generally confirmed our hypotheses. Higher negative expectancies and higher self-efficacy reduced …

Faktor Dominan Yang Mempengaruhi Kejadian Malaria Di Perdesaan, Dewi Susanna, Tris Eryando

Kesmas

KLB malaria selama periode 1998-2003 telah menyerang 15 propinsi yang meliputi 84 desa endemis dengan jumlah penderita 27.000 dengan kematian 368. Hewan besar seperti sapi, kerbau dan kuda adalah merupakan cattle barrier malaria. Hewan tersebut perlu diteliti agar dapat diketahui jenis hewan dan tempat hidup hewan (kandang) terhadap kejadian malaria. Tujuan umum penelitian ini adalah untuk mengetahui faktor dominan yang mempengaruhi kejadian malaria di pedesaan. Jenis penelitian adalah non-intervensi, merupakan analisis lanjut data sekunder yaitu “Riset Kesehatan Dasar 2007”. Subyek yang dianalisis sebanyak 618.593 yang bertempat tinggal di perdesaan. Analisis dilakukan dengan metoda multivariat menggunakan regresi logistik. Ternak dibagi menjadi …

Perencanaan Penanggulangan Keadaan Darurat Transportasi Darat Bahan Kimia Butadien Rute Bojonegara - Cengkareng Pada Pt X Indonesia, Nelvy Roza, Fatma Lestari

Kesmas

PT X Indonesia mentransport butadien dari terminal penimbunan di Bojonegara ke pengolahan di Cengkareng. Penelitian ini bertujuan mengidentifikasi potensi bahaya, memprediksi risiko, dan mengevaluasi prosedur penanggulangan keadaan darurat. Sampel diambil di salah satu rute perjalanan Bojonegara - Cengkareng. Data diperoleh dari observasi, wawancara, catatan, pelaporan dan prosedur penanggulangan keadaan darurat. Rencana penanggulangan keadaan darurat dianalisis secara kualitatif dengan membandingkan PT X Indonesia dengan standar Manitoba Industrial Accidents Council dan Advisory Committee on the Transport of Dangerous Goods - Prosedur penanggulangan keadaan darurat meliputi kebijakan perusahaan, analisa risiko, organisasi, sarana dan prasarana, tindakan penanggulangan serta pelatihan dan simulasi. Hasil penelitian menunjukkan …

Identifikasi Penyebab Diare Di Kabupaten Karangasem, Bali, I N. Sujaya, N.P. Desy Aryantini, N.W. Nursini, S.G. Purnama, N.M.U. Dwipayanti, I G. Artawan, I M. Sutarga

Kesmas

Pada Februari hingga Maret 2008 terjadi kejadian luar biasa muntah berak (diare) di Kabupaten Karangasem Bali. Tercatat sekitar 600 orang mengalami muntaber dan 5 orang meninggal dunia. Ini merupakan kejadian KLB muntaber pertama kali di Bali serta belum diketahui patogen penyebab diare tersebut. Tujuan penelitian ini adalah mengidentifikasi penyebab diare di Karangasem serta kemungkinan rantai penularannya. Penelusuran penyebab KLB dilakukan dengan menganalisis sampel air yang diambil dari sumber air umum, cubang/sumur penduduk, bahan makanan, serta rectal swab penderita dengan kombinasi teknik pemupukan kuman dan PCR spesifik dengan target gen pembentuk toksin pada Escherichia coli. Dengan melakukan kultur pada sampel makanan …

Analysis Of Primary Risk Factors For Oral Cancer From Us States With Increasing Rates, Anthony Bunnell, Nathan Pettit, Nicole Reddout, Kanika Sharma, Susan O'Malley, Michelle Chino, Karl Kingsley

School of Public Health Faculty Research

Objectives

To examine the primary risk factor for oral cancer in the US, smoking and tobacco use, among the specific US states that experienced short-term increases in oral cancer incidence and mortality.

Methods

Population-based data on oral cancer morbidity and mortality in the US were obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database for analysis of recent trends. Data were also obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to measure current and former trends of tobacco usage. To comprehensive measures of previous state tobacco use …