Digital Commons Network^™

Who Will Be There To Care? The Growing Gap Between Caregiver Supply And Demand, Nora Super

National Health Policy Forum

This paper examines the increasing demand for long-term care services and the concurrent decrease in the supply of paid and unpaid caregivers. It considers workforce trends for paraprofessionals, such as certified nursing assistants, home health aides, and personal care attendants, as well as several public and private efforts to address staff shortages and quality-of-care. The paper explores the sociodemographic factors that have affected the demand for and supply of informal care provided by family and friends. It also reviewes policy proposals designed to provide support for family caregivers and/or to give choices to consumers.

Diagnostic And Therapeutic Procedures Among Australian Hospital Patients Identified As Indigenous, Joan Cunningham

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To determine whether hospital patients identified as Indigenous are less likely than other inpatients to have a principal procedure recorded, and the extent to which any disparity in procedure use can be explained by differences in patient, episode and hospital characteristics. Design: Retrospective analysis of routinely collected administrative data from the National Hospital Morbidity Database (NHMD). Setting: Australian public and private hospitals. Patients: All patients included in the NHMD whose episode type was recorded as acute and whose separation occurred between 1 July 1997 and 30 June 1998. Patients admitted for routine dialysis treatment were excluded. Main outcome measure: …

Managed Care: As Good As It Gets? (Los Angeles), Lisa Sprague

National Health Policy Forum

This site visit was a return trip to southern California to examine the state of managed care. Between the Forum's last visit (in late 1998) and this one, the marketplace underwent considerable change, including significant movement away from global capitation, the collapse of physician practice management firms, and the development of new insurance products. Site visitors were briefed on managed care trends in the state, and panel discussions focused on issues related to physician group solvency, employer and consumer expectations, managed care regulation, and plan and provider strategies for surviving and prospering in the difficult southern California market. Site visitors …

Estimating Causal Parameters In Marginal Structural Models With Unmeasured Confounders Using Instrumental Variables, Tanya A. Henneman, Mark Johannes Van Der Laan, Alan E. Hubbard

U.C. Berkeley Division of Biostatistics Working Paper Series

For statisticians analyzing medical data, a significant problem in determining the causal effect of a treatment on a particular outcome of interest, is how to control for unmeasured confounders. Techniques using instrumental variables (IV) have been developed to estimate causal parameters in the presence of unmeasured confounders. In this paper we apply IV methods to both linear and non-linear marginal structural models. We study a specific class of generalized estimating equations that is appropriate to these data, and compare the performance of the resulting estimator to the standard IV method, a two-stage least squares procedure. Our results are applied to …

Effectiveness Of Colors Used On Safety And Health Signs For Communicating Severity Of Injury, Andrew M. Mccammack, Roger C. Jensen

Safety Health & Industrial Hygiene

Signs are used extensively in workplaces and on products to identify hazards and provide instructions for appropriate behavior. A fundamental element of these signs is the signal-word panel located at the top of the sign. The colors and words in this panel are intended to convey information about the hazard identified. One type of hazard information concerns the severity of injury/illness associated with the hazard. The standard of the American National Standards Institute (ANSI) for facility signs uses three severity categories: 1) death or serious injury, 2) minor or moderate injury, and 3) property damage. The standard specifies which signal-word …

Case Study Of An Ergonomics Training Program For Nursing Home Workers, Roger C. Jensen

Safety Health & Industrial Hygiene

This paper describes a case study of a labor-based ergonomics-training program that makes use of some effective worker training methods. The program focus was on ergonomics awareness and back injury prevention for nursing home workers. It was developed and conducted by a not-for-profit organization affiliated with the Service Employees International Union. Training methods included the train-the-trainer model and the small group activity method. The investigation also compared the program components with those identified by the Occupational Safety and Health Administration (OSHA) as being key elements in effective safety training.

Safety And Health Sign Colors And Signal Words For Communicating Information On Likelihood And Imminence Of Threat, Roger C. Jensen, Andrew M. Mccammack

Safety Health & Industrial Hygiene

Signs are used extensively in workplace facilities and on products to identify hazards and provide instructions and safety information. A fundamental component of these signs is a signal-word panel located at the top of the sign. Certain colors and signal words in this panel are intended to convey information about a hazard, including likelihood of harm and imminence of the threat. The purpose of this study was to determine if young adults without prior training on safety signs associate signal words and color with likelihood of harm and imminence of the threat. The sample population consisted of 59 college students. …

An Evaluation Of Germ City : Finding A Suitable Design, Suzanne Cherie Lusher

Theses, Dissertations and Capstones

Evaluations are used to determine a program’s merit. “Germ City” utilizes experiential learning of adequate hand washing skills. An elementary school in southwestern West Virginia served to determine if the evaluation design for “Germ City” would prove to be an effective assessment for the hand-washing program. Four hundred and eighty-four participants completed an eight-question pre/post test; one hundred and forty-nine students underwent a hand quadrant evaluation. In addition, a soap and paper towel usage log was recorded. Fifty-four percent of the participants were male, forty-six percent female (n=483) with a mean grade level of 3.6 (n=484). Post test results indicated …

Comparison Of Domestic Violence Outcomes Among Emergency Department Nurses, Pamela S. Neal

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationships between domestic violence education, organizational support, screening, danger assessment, safety planning, and referral practices among professional registered nurses in two ED settings.

Sample & Setting: A convenience sample of 63 professional registered nurses provided data from two EDs. An ED located in Kentucky where state mandated continuing education in domestic violence was required (n = 33) and an ED in West Virginia (n = 30) where mandated continuing education in domestic violence was not required was the setting for the study. The samples were separated based on nurses who …

Surveillance For Waterborne-Disease Outbreaks--United States, 1999-2000, Sherline H. Lee, Deborah A. Levy, Gunther F. Craun, Michael J. Beach, Rebecca L. Calderon

Journal Articles: Epidemiology

PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists (CSTE) have maintained a collaborative surveillance system for the occurrences and causes of waterborne-disease outbreaks (WBDOs).This surveillance system is the primary source of data concerning the scope and effects of waterborne diseases on persons in the United States.

REPORTING PERIOD COVERED: This summary includes data regarding outbreaks occurring during January 1999-December 2000 and previously unreported outbreaks occurring in 1995 and 1997.

DESCRIPTION OF THE SYSTEM: The surveillance system includes data for outbreaks associated with drinking water and recreational water. State, territorial, and …

Mainecare Enrollees With Disabilities Work Experience: Results From A 2002 Survey, Sara T. Salley, Larry Glantz

Disability & Aging

No abstract provided.

Managed Healthcare And Integrated Delivery Systems: A Model For Getting Ahead Of The Change Curve, Philip Sheridan Carney

Theses Digitization Project

Managed care became the dominant model for moderating healthcare costs in the 1990's. The later half of this past decade witnessed early signs of a return to escalating premiums. Providers and consumers have reacted negatively to perceptions of health plan micro-management and restriction of choice.

Providers Choices In Web-Medical Records: An Analysis Of Trade-Offs Made By Physicians In San Bernardino County, Jay Eriah Shankar

Theses Digitization Project

This thesis concluded that offering physicians an appropriate Web-based transcription service should be well received and improve their medical record management and patient care.

Characteristic Differences Between Parents/Guardians Who Keep Immunization Records And Those Who Do Not, Rebecca Bonilla Mangual

Theses Digitization Project

No abstract provided.

Barriers To Initiation And Continuation Of Vision Care Among Diabetics, Jennifer Eilleen Werner

Theses Digitization Project

No abstract provided.

Delays In The Emergency Department And Their Effects On The Ambulance Provider, Simon Peter Moore

Theses Digitization Project

This thesis is a case analysis of the nature of delays in emergency room admissions and the effects on ambulance dispatching and availability as it occurred in Southern California.

Health Disparities, Neil Macnaughton

International Journal of Global Health

"Americans believe that we are a classless society, largely because just about everyone thinks they are members of the struggling middle class. In actuality the United States is a highly stratified society in terms of wealth, meaning that we have a much more significant problem of poverty than most industrialized nations. Members of ethnic minorities are more likely to be poorer and less powerful. Racist beliefs on the part of the dominant white ethnic groups exacerbate the problem of socioeconomic inequality (Brown, 1998 p. 259)." In healthcare we like to believe that we do not discriminate amongst patient populations and …

Associations Between Water-Treatment Methods And Diarrhoea In Hiv-Positive Individuals, J. N. S. Eisenberg, T. J. Wade, A. Hubbard, D. I. Abrams, R. J. Leiser, S. Charles, M. Vu, S. Saha, C. C. Wright, Deborah A. Levy, P. Jensen, J. M. Colford

Journal Articles: Epidemiology

This manuscript extends our previously published work (based on data from one clinic) on the association between three drinking water-treatment modalities (boiling, filtering, and bottling) and diarrhoeal disease in HIV-positive persons by incorporating data from two additional clinics collected in the following year. We conducted a cross-sectional survey of drinking water patterns, medication usage, and episodes of diarrhoea among HIV-positive persons attending clinics associated with the San Francisco Community Consortium. We present combined results from our previously published work in one clinic (n = 226) with data from these two additional clinics (n = 458). In this combined analysis we …

Risk Factors In Hiv-Associated Diarrhoeal Disease: The Role Of Drinking Water, Medication And Immune Status, J. N. S. Eisenberg, T. J. Wade, S. Charles, M. Vu, A. Hubbard, C. C. Wright, Deborah A. Levy, P. Jensen, J. M. Colford

Journal Articles: Epidemiology

In a cross-sectional survey of 226 HIV-infected men, we examined the occurrence of diarrhoea and its relationship to drinking water consumption patterns, risk behaviours, immune status and medication use. Diarrhoea was reported by 47% of the respondents. Neither drinking boiled nor filtered water was significantly associated with diarrhoea (OR = 0.5 [0.2, 1.6], 1.2 [0.6, 2.5] respectively), whereas those that drank bottled water were at risk for diarrhoea (OR = 3.0 [1.1, 7.8]). Overall, 47% always or often used at least one water treatment. Of the 37% who were very concerned about drinking water, 62% had diarrhoea, 70% always or …

The Hand Center: Considerations Related To The Design, Planning, Staffing, And Marketing, Marcia L. Miller

Community & Environmental Health Theses & Dissertations

A therapist intent on planning a hand therapy center has no resources that are specific to this specialty area of practice. There are contributions utilized to plan occupational and physical therapy departments that can be synthesized to a degree in the planning of a hand therapy center. The practice of hand therapy incorporates a high degree of physical interaction, with close proximity to the patient and handling by the therapist. This paper explores the unique requirements of a hand therapy department. In order to determine hand therapists' preferences for equipment and space utilization a survey was developed and distributed to …

Integrating Hiv Prevention And Care Into Maternal And Child Health Care Settings: Lessons Learned From Horizons Studies, Naomi Rutenberg, Sam Kalibala, Charles Mwai, James Rosen

HIV and AIDS

Many women in the developing world still lack access to high-quality HIV/AIDS prevention and care services. To address this problem, Horizons has undertaken a range of operations research efforts that examine the integration of HIV-related care in the maternal-child health setting. At a workshop held in Kenya in July 2001, participants discussed the experience to date and formulated practical strategies for improving the integration. This consultation report summarizes that discussion according to the following seven key program components: Training and Motivation to Improve the Performance of Health Workers; Supervision of HIV Services and Quality Assurance of HIV Testing; Caring for …

Hiv/Aids-Related Stigma And Discrimination: A Conceptual Framework And An Agenda For Action, Richard Parker, Peter Aggleton, Kathy Attawell, Julie Pulerwitz, Lisanne Brown

HIV and AIDS

In 1987, Jonathan Mann, then director of the WHO Global Programme on AIDS, identified three phases of the HIV/AIDS epidemic: the epidemic of HIV, the epidemic of AIDS, and the epidemic of stigma, discrimination, and denial. Despite international efforts to tackle HIV/AIDS since then, stigma and discrimination (S&D) remain among the most poorly understood aspects of the epidemic. This poor understanding is due in part to the complexity and diversity of S&D, but also to limitations in current thinking within the field and the inadequacy of available theoretical and methodological tools. This paper proposes a new conceptual framework to help …

Pick-Me-Up Newsletter - Issue 1, Volume 2, Nova Southeastern University

Pick Me Up Newsletter

No abstract provided.

Pick-Me-Up Newsletter - Issue 4 , Volume 1, Nova Southeastern University

Pick Me Up Newsletter

No abstract provided.

Cover - Front Matter - Table Of Contents

International Journal of Global Health

No abstract provided.

An Ethnographic Approach Describing Uses Of Medicinal Plants By Rural Guatemalan Women, Cynthia M. Goody

International Journal of Global Health

Much is known about the application of medicinal plants in health belief systems and in ethnopharmacological and botanical settings in Guatemala. What remains less understood is why and how rural women, the family's primary health care provider, use medicinal plants to treat family members' illnesses. Using an ethnographic approach, this work describes twenty women's responses about using medicinal plants as a traditional home remedy. Results suggest rural Guatemalan women traditionally use certain plants, because of their immediate availability at no cost, to treat psychological, gastrointestinal, and respiratory illnesses. Also discussed are the implications associated with honoring tradition, affordability, and availability …

One Year After 9/11: The Impact Of Global Terrorism On Public Health Education, Joseph K. Ogah

International Journal of Global Health

As we mark one year after the September 11 (9/11) attack of the World Trade Center in New York, and the killing or traumatizing of thousands of innocent persons, global terrorism remains an issue of concern for political leaders, the business world and educators. The implications of terrorism to public health education are many and varied. At the minimum, 9/11 increased the immediate need for additional public health education to help people cope and deal with both the immediate and long-term effects of terrorist acts all over the world. Public health education plays a leading role in managing the fear …

Invisible, Underserved, And Diverse: The Health Of Women In Prison, Janette Y. Taylor, Rachel Williams, M. J. Eliason

International Journal of Global Health

In the United States of America, women are the fastest growing segment of the criminal justice system. They are entering the system with far greater physical and mental health problems than men, but with fewer health services. Additionally, within this expanding population of incarcerated women, are disproportionately represented poor women of color with serious health needs. This article: a) uses an ecosocial model to examine and critique the health and healthcare of women in prison, b) examines social structures that influence incarceration and health status, and c) proposes reconsideration of current prison health services and education.

Genetic Epidemiology Of Cleft Lip And Palate, Bonnie Pedersen

International Journal of Global Health

Clefts of the lip and palate are birth defects with multifactorial etiology, involving important surgical, speech, social, behavioral, and developmental implications. Approximately 70% of clefts are nonsyndromic - they do not involve other types of abnormalities such as shorter limbs, shorter digits (toes or fingers), wider set eyes, and many other symptoms. A number of environmental factors also play a role in craniofacial deformities. These factors include nutritional deficiencies such as insufficient folic acid consumption or absorption, smoking, and alcohol consumption, factors relevant to socioeconomic status. The purpose of this review is to present information concerning cleft lip and palate …

Information For Authors

International Journal of Global Health

No abstract provided.