Digital Commons Network^™

Care Management For Persistent Pain: An Introduction, Christine W. Hartmann, Neil I. Goldfarb, Susan S. Kim, Bhaskar R. Nuthulaganti, Raafat Seifeldin

College of Population Health Faculty Papers

Persistent pain is a frequently occurring condition with significant economic, clinical, and humanistic implications, for both individuals and society. Current literature, however, points to unresolved issues with regard to its identification, assessment, diagnosis, and treatment, and a number of suggestions have been made for improving the quality of care for pain sufferers. Because persistent pain shares many of the salient features of other chronic conditions such as diabetes and congestive heart failure, it is reasonable to believe that the adoption of a coordinated approach to care management could substantially improve the quality of care. Several strategiesincluding identification, appropriate referral, education, …

Long-Term Care: Informed By Research, Francis G. Caro

Gerontology Institute Publications

Health services research has contributed to health policy and service developments that have led to major improvements in the quality of long-term care in the United States. This policy brief highlights a few areas in which publicly and privately funded research has informed the long-term care field.

Cancer In Louisiana: 1996-2000, Volume 17, Louisiana Tumor Registry, Catherine N. Correa, Xiao-Cheng Wu, Patricia A. Andrews, Mei-Chin Hsieh, Vivien W. Chen

Policy & Position Papers

Mission:

To collect and report complete, high-quality, and timely population-based cancer data in Louisiana to support cancer research, control, and prevention.

Vision:

To reduce suffering and death from cancer using information collected by the Louisiana Tumor Registry.

History:

Cancer registration in Louisiana began in 1947 at the Charity Hospital Tumor Registry in New Orleans. In 1974, as part of its Surveillance, Epidemiology and End Results (SEER) Program, the National Cancer Institute provided funds for a population-based cancer incidence and survival registry covering Jefferson, Orleans, and St. Bernard parishes. Five years later, the Louisiana Tumor Registry (LTR) was transferred to the …

United Power For Action And Justice: Breaking The Cycle Of Homelessness Reports - Policy Brief, Center For Urban Research And Learning, Christine George, Chiara Sabina, Aparna Sharma

Center for Urban Research and Learning: Publications and Other Works

This is a story of two groups of determined people with intersecting interests. Group one: a dozen leaders within United Power for Action and Justice who set out to prove their conviction, that homelessness is one symptom of a complex of issues that destabilizes individuals and communities. Group two: persons who are homeless and struggle daily to “fit in” to a landscape that is, more and more, structured to shut them out. In 2000, a cluster of leaders within United Power organized member institutions in the north and northwest suburbs of Chicago, and initiated a relationship with Congressman John Porter …

The Role Of Health Promotion In Physical Therapy, Brenda L. Rea

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to investigate physical therapy practice patterns in four focus areas of Healthy People 2010 (focus area #6, disability and secondary conditions by looking at psychological well-being; focus area #19, nutrition and overweight; focus area #22, physical fitness and activity; focus area #27, tobacco use) and identify self-efficacy and outcome expectations related to those practice patterns across California, New York and Tennessee using Bandura’s Social Cognitive Theory as a framework. It was hypothesized that physical therapists’ self-efficacy and outcome expectations in the four focus areas of Healthy People 2010 would be significantly associated with …

Residency Program At Michael E Debakey Department Of Surgery, Baylor College Of Medicine, F Charles Brunicardi

Faculty, Staff and Students Publications

No abstract provided.

Doing It Rite: Exploring A Decade Of Health Coverage Innovation (Rhode Island), Jennifer Ryan, Ginger P. Parra

National Health Policy Forum

This site visit to the state of Rhode Island provided an opportunity to experience and understand the decade of health coverage innovation that has resulted in near universal coverage for children. Site visitors had the opportunity to interact with health care providers, state officials, and consumer advocates, as well as other leaders in health care community. The group also visited the Thundermist Health Center in Woonsocket; a school based health clinic at Woonsocket High School; the HELP Lead Safe Center in South Providence; and a local provider, St. Joseph’s Hospital for Specialty Care, that houses several preventive care clinics and …

Identifying Target Populations For Screening Or Not Screening Using Logic Regression, Holly Janes, Margaret S. Pepe, Charles Kooperberg, Polly Newcomb

UW Biostatistics Working Paper Series

Colorectal cancer remains a significant public health concern despite the fact that effective screening procedures exist and that the disease is treatable when detected at early stages. Numerous risk factors for colon cancer have been identified, but none are very predictive alone. We sought to determine whether there are certain combinations of risk factors that distinguish well between cases and controls, and that could be used to identify subjects at particularly high or low risk of the disease to target screening. Using data from the Seattle site of the Colorectal Cancer Family Registry (C-CFR), we fit logic regression models to …

Improved Confidence Intervals For The Sensitivity At A Fixed Level Of Specificity Of A Continuous-Scale Diagnostic Test, Xiao-Hua Zhou, Gengsheng Qin

UW Biostatistics Working Paper Series

For a continuous-scale test, it is an interest to construct a confidence interval for the sensitivity of the diagnostic test at the cut-off that yields a predetermined level of its specificity (eg. 80%, 90%, or 95%). IN this paper we proposed two new intervals for the sensitivity of a continuous-scale diagnostic test at a fixed level of specificity. We then conducted simulation studies to compare the relative performance of these two intervals with the best existing BCa bootstrap interval, proposed by Platt et al. (2000). Our simulation results showed that the newly proposed intervals are better than the BCa bootstrap …

Bootstrap Confidence Intervals For Medical Costs With Censored Observations, Hongyu Jiang, Xiao-Hua Zhou

UW Biostatistics Working Paper Series

Medical costs data with administratively censored observations often arise in cost-effectiveness studies of treatments for life threatening diseases. Mean of medical costs incurred from the start of a treatment till death or certain timepoint after the implementation of treatment is frequently of interest. In many situations, due to the skewed nature of the cost distribution and non-uniform rate of cost accumulation over time, the currently available normal approximation confidence interval has poor coverage accuracy. In this paper, we proposed a bootstrap confidence interval for the mean of medical costs with censored observations. In simulation studies, we showed that the proposed …

Disease Management To Population-Based Health: Steps In The Right Direction?, Lisa Sprague

National Health Policy Forum

This issue brief reviews the evolution of the disease management model and the ways it relates to care coordination and case management approaches. It also looks at examples of population-based disease management programs operating in both the private and public sectors and reviews the evidence of their success. Finally, the paper considers the policy implications of adapting this model to a Medicare fee-for-service population.

A Bootstrap Confidence Interval Procedure For The Treatment Effect Using Propensity Score Subclassification, Wanzhu Tu, Xiao-Hua Zhou

UW Biostatistics Working Paper Series

In the analysis of observational studies, propensity score subclassification has been shown to be a powerful method for adjusting unbalanced covariates for the purpose of causal inferences. One practical difficulty in carrying out such an analysis is to obtain a correct variance estimate for such inferences, while reducing bias in the estimate of the treatment effect due to an imbalance in the measured covariates. In this paper, we propose a bootstrap procedure for the inferences concerning the average treatment effect; our bootstrap method is based on an extension of Efron’s bias-corrected accelerated (BCa) bootstrap confidence interval to a two-sample problem. …

Development Of Dose Coefficients For Radionuclides Produced In Spallation Neutron Sources, Phillip W. Patton

Transmutation Sciences Physics (TRP)

A research consortium comprised of representatives from several universities and national laboratories has been established as part of this on-going project to generate internal and external dose conversion coefficients for radionuclides produced in spallation neutron sources. Information obtained from this multi-year study will be used to support the siting and licensing of future accelerator-driven nuclear initiatives within the U.S. Department of Energy complex, including the Spallation Neutron Source (SNS) and the Advanced Fuel Cycle Initiative (AFCI) Projects. Determination of these coefficients will also fill data gaps for several hundred radionuclides that exist in Federal Guide Report No. 11 and in …

Medicaid Prescription Drug Coverage: State Efforts To Control Costs, Dawn Gencarelli

National Health Policy Forum

This paper provides a brief summary of the Medicaid prescription drug benefit. It explains the mechanisms being used by states to control their prescription drug spending within the Medicaid program. The paper also highlights some of the concerns that have been expressed with these mechanisms and the litigation that has been initiated in several states as a result of these efforts. It takes a closer look at three states with cost containment strategies that have been the focus of increased scrutiny.

Patterns Of Cocaine Consumption: A Sub-Analysis Of The Drugnet Survey, Nivedita Seerpi

Masters Theses & Specialist Projects

The myths and misconceptions that surround cocaine use lead to the over-estimation of the prevalence of cocaine addiction in society. Health education curricula and drug policy do not differentiate between cocaine use and abuse. This study describes the cocaine consumption patterns in a nonclinical, non-incarcerated sample of cocaine users. The resulting patterns are compared to those found by Cohen (1989) and Cohen and Sas (1993, 1994, 1995). DRUGNET is an online survey of recreational drug use by nondeviant adults via the WWW. Self-selected subjects completed a survey over the Internet between February and October 1997 (N= 701). This sample was …

The Ignored Disease: The Aids Epidemic 1981–1987, Heather L. Graff, Heather Graff Bloom

College of Journalism and Mass Communications: Theses

Less than six months after Ronald Reagan was inaugurated as the 40th president of the United States, the federal Centers for Disease Control in Atlanta reported pneumocystis carinii pneumonia, in five gay men. In the United States, AIDS was first diagnosed among gay men in New York City and San Francisco. There were several media trends for AIDS coverage in the 1980s. In the early 1980s, AIDS was mainly thought of as a gay-related disease. In the mid- l 980s, AIDS cases were found in hemophiliacs, intravenous drug users and "celebrities." Coverage in the late 1980s focused on heterosexuals and …

Association Of Borrelia Garinii And B. Valaisiana With Songbirds In Slovakia, Klara Hanincova, Veronika Taragelova, Juraj Koci, Stefanie M. Schafer, Rosie Hails, Amy J. Ullmann, Joseph Piesman, Milan Labuda, Klaus Kurtenbach

United States Public Health Resources

In Europe, 6 of the 11 genospecies of Borrelia burgdorferi sensu lato are prevalent in questing Ixodes ricinus ticks. In most parts of Central Europe, B. afzelii, B. garinii, and B. valaisiana are the most frequent species, whereas B. burgdorferi sensu stricto, B. bissettii, and B. lusitaniae are rare. Previously, it has been shown that B. afzelii is associated with European rodents. Therefore, the aim of this study was to identify reservoir hosts of B. garinii and B. valaisiana in Slovakia. Songbirds were captured in a woodland near Bratislava and investigated for engorged ticks. Questing I. ricinus ticks …

Nevada "Nurselessness": An Acute Or Chronic Condition? An Examination Of The Etiology And Possible Treatment Alternatives, Jeanine Warren-Newmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Data released by the Department of Health and Human Services in February, 2001, revealed that Nevada has the lowest number of registered nurses per 100,000 population in the nation. The state’s population is growing faster than the nursing programs are currently able to produce new graduates. Current predictions are that the existing nursing shortage will become more severe and have a longer duration than has ever before been experienced. While there may not be one single identifiable causative factor, the aging nursing workforce, low unemployment, and the universal nature of the shortage magnify the problem. This paper focuses on the …

Co-Operation In Health And Safety: A Game Theory Analysis, Sylvie Nadeau

The University of New Hampshire Law Review

[Excerpt] “Health and safety managers face complex challenges in today’s production environments. They are confronted with increasingly flexible, autonomous and polyvalent contexts. Asymmetry of information on the workplace is widespread because various intervening parties rely on information lacking conformity. Social partners generate and use information which supports or benefits their pursuit of differing goals. Ascertaining and controlling this information can prove both difficult and costly. When addressing health and safety issues, one intervening partner alters or changes behavior in response to changes introduced by the other side. Strategic behaviors result, based on post-contract opportunism (moral hazard) and alliances with partners …

Toward A Better Understanding Of The Comparatively High Prostate Cancer Incidence Rates In Utah, Ray M. Merrill, Sterling C. Hilton, Jared D. Sturgeon, Charles L. Wiggins

Faculty Publications

This study assesses whether comparatively high prostate cancer incidence rates among white men in Utah represent higher rates among members of the Church of Jesus Christ of Latter-day Saints (LDS or Mormons), who comprise about 70% of the state's male population, and considers the potential influence screening has on these rates. Methods: Analyses are based on 14,693 histologically confirmed invasive prostate cancer cases among men aged 50 years and older identified through the Utah Cancer Registry between 1985 and 1999. Cancer records were linked to LDS Church membership records to determine LDS status. Poisson regression was used to derive rate …

Reauthorizing Head Start: The Future Federal Role In Preschool Programs For The Poor, Jane Koppelman

National Health Policy Forum

This paper describes the implications of President Bush’s proposal to devolve authority for running the Head Start program to the states and to alter the organization and funding of all government early childhood programs—with the goal of improving the school readiness skills of low-income children. The administration plan to allow states to mix Head Start funds with state-funded preschool money and, if desired, child care monies to create a more uniform early childhood care system with an educational focus raises numerous questions. This paper addresses questions raised by this plan, including the potential quality of these new systems, the extent …

The U.S. Health Workforce: Definitions, Dollars, And Dilemmas, Karen Matherlee

National Health Policy Forum

This background paper provides a comprehensive view of the structure of the health workforce. It explores public and private insurance coverage and payment policies, as well as discretionary grant programs, that govern it. The paper also looks at health workforce concerns: supplies of certain types of physicians, health workforce mix, challenges from complementary and alternative medicine, shortages of nurses and pharmacists (and some other practitioners), maldistribution issues, and lack of diversity in response to demographic changes. It presents proposals that are on the table to reform the health workforce, at a time when it is demanding greater attention from health …

Ua61/6 Newsletter, Issue 1, Wku Institute For Rural Development

WKU Administration Documents

Newsletter created by and about the Institute for Rural Development. This issue contents:

• Mobile Health & Wellness Unit
• The New Hazard & Emergency Awareness Training (HEAT) Mobile Unit Arrives at WKU
• Gardner, Marilyn. Emergency Medical Services Monograph Coming
• A Nursing Student’s Perspective
• Enhancing Rural Student Postsecondary Decisions
• Lu, Ning & Richard Wilson. Kentuckian Socioecomic Status, Health Behavior, Access to Medical Care, & Health Status
• Austin, Lynn. School-based Dental Sealant Program
• The Institute for Rural Health Development & Research

Population Mobility High-Risk Environments And The Diffusion Of Hiv/Stds: A Community Based Study In Southwest China, Hongyun Fu

Sociology & Criminal Justice Theses & Dissertations

Globally, population migration has been associated with the spread ofHIV/STDs in many countries. A similar trend has been observed in China from the very beginning of the HIV epidemic, but empirical research is very limited. Furthermore, the previous studies mainly focused on the micro impact of migration on individual migrant's risky behaviors. The impact of population mobility on the general population, especially on non-migrant residents, has been ignored. Using data collected from a specially designed community level survey, which was conducted in a province in the Southwest of China, this study examines the macro-level association between temporary migration and the …

Spiritual Function And Its Relationship To Health-Related Quality Of Life In A Population With Chronic Illness, Holly B. Orozco

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine the association between different aspects of spiritual function (intra- and interpersonal relationships, connectedness to God, and practices) and health-related quality of life, and to determine if perceived spirituality and perceived religiosity were significantly related to spiritual function and health-related quality of life. The study analyzed secondary data collected in the third year of a three year (1997-1999) Ambulatory Care Quality Improvement Project (ACQUIP) of the Veteran's Administration. A sample of 500 male veterans were randomly selected from a larger sub- sample of six Veterans Hospital Administration facilities across the U.S., having one …

Predictors Of Oral Health Behaviors: Examining The Effect Of Patient Perceived Humanistic Attitude In The Context Of The Health Belief Model, Linda Leigh Hawkins Carroll

Health Services Research Dissertations

The purpose of this study was to test the explanatory power of The Health Belief Model with the added environmental condition of perceived humanistic attitude of a dental hygienist in its ability to predict individual's performance of oral disease prevention behaviors. A cross section survey of an intact group of 1,943 full time employees of Old Dominion University was conducted. The response rate was 52% (n = 1001). An exclusionary rule eliminated respondents who did not have a dental hygienist provide preventive services during dental visits. Seven hundred and fifty four were included in the study analyses. The study participants …

Application Of The Traditional Epidemiological Model To Predict Occupational Injury Rates In Manufacturing Industries, Gary A. Morris

Health Services Research Dissertations

This study was designed to test the usefulness of the Traditional Epidemiological Model of disease causation in modeling occupational injury rates and the presence of occupational illness in the manufacturing industry. More specifically, this research involved use of the agent, host, and environment constructs of the Traditional Epidemiological Model to examine the effects of five environmental-related workplace health and safety practices on occupational injury and illness. Data from the National Occupational Exposure Survey (NOES), conducted by the National Institute for Occupational Safety and Health (NIOSH) in 1981–1983, were used to ascertain the presence of specific workplace characteristics and to calculate …

La Prévention Du Trouble De Stress Posttraumatique Chez Les Employés De Dépanneurs Victimes De Vols À Main Armée, André Marchand, Richard Boyer

Rapports de recherche scientifique

No abstract provided.

Transmission Of Mycobacterium Tuberculosis Associated With Failed Completion Of Treatment For Latent Tuberculosis Infection - Chickasaw County, Mississippi, June 1999-March 2002, T. Chamblee, D. Hartley, M. Holcombe, K. Parham, P. Upchurch, R. M. Webb, Alyssa G. Robillard, L. Diem, B. Metchock, N. Deluca, P. D. Mcelroy, T. Navin, W. Walton, P. K. Dewan

Faculty Publications

During June 1999-March 2002, a total of 16 tuberculosis (TB) cases were reported from Chickasaw County, Mississippi (2000 population: 19,440), corresponding to annual TB incidences of 20.5-27.6 cases per 100,000 population. In comparison, annual TB incidences for Mississippi during the same period decreased from 7.8 to 5.4 cases per 100,000 population. This report summarizes the results of an investigation of the patients and their contacts and demonstrates the need for strategies to increase the proportion of infection contacts that successfully complete treatment for latent TB infection (LTBI).

Estimating The Accuracy Of Polymerase Chain Reaction-Based Tests Using Endpoint Dilution, Jim Hughes, Patricia Totten

UW Biostatistics Working Paper Series

PCR-based tests for various microorganisms or target DNA sequences are generally acknowledged to be highly "sensitive" yet the concept of sensitivity is ill-defined in the literature on these tests. We propose that sensitivity should be expressed as a function of the number of target DNA molecules in the sample (or specificity when the target number is 0). However, estimating this "sensitivity curve" is problematic since it is difficult to construct samples with a fixed number of targets. Nonetheless, using serially diluted replicate aliquots of a known concentration of the target DNA sequence, we show that it is possible to disentangle …