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Site Visit To Richmond And Hampton Roads — Bon Secours Health System, Inc., Nora Super Mar 2000

Site Visit To Richmond And Hampton Roads — Bon Secours Health System, Inc., Nora Super

National Health Policy Forum

The first in a series of three site visits leading to an April 27–28, 2000, conference in Annapolis, Maryland, on hospital-based health care systems in transition after the enactment of the Balanced Budget Act of 1997 (BBA) and the Medicare, Medicaid, SCHIP Balanced Budget Refinement Act of 1999 (BBRA). The site visit was designed to better understand how changing payment incentives — particularly the move to prospective payment systems for postacute services — has affected the ability to implement a continuum of care across delivery sites. It examined the Bon Secours Health System's operations in Virginia, which include four hospitals …

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Improving Quality And Preventing Error In Medical Practice, Lisa Sprague Mar 2000

Improving Quality And Preventing Error In Medical Practice, Lisa Sprague

National Health Policy Forum

Drawing on the Institute of Medicine's report To Err Is Human, this issue brief looks at quality-improvement and error-reduction efforts at the institutional, regional, and state levels and analyzes the roles of government and the private sector in bringing such efforts into national focus. Questions considered include whether error reporting should be mandatory or voluntary, who should perform error analysis, and the role of the individual in an institutional accountability model.

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Pharmacotherapy Of Smoking Cessation, Kolawole S. Okuyemi, Jasjit S. Ahluwalia, Kari J. Harris Mar 2000

Pharmacotherapy Of Smoking Cessation, Kolawole S. Okuyemi, Jasjit S. Ahluwalia, Kari J. Harris

Public and Community Health Sciences Faculty Publications

Tobacco use is the number one cause of preventable diseases in the United States. Smoking accounts for more than 400,000 deaths yearly and 30% of all cancer deaths. Primary care physicians have access to 70% of smokers, approximately 60% of whom are perceived to be in excellent health. Recent advances in the pharmacotherapy of nicotine addiction, including nicotine nasal spray, nicotine inhaler, bupropion hydrochloride, and over-the-counter transdermal nicotine patches, have increased the treatment options physicians can offer to smokers. Physicians, especially thosein primary care specialties, should familiarize themselves with these products to improve efforts to help their patients stop smoking. …

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Rural Managed Care And Disability: A National Perspective, Colleen Murphy-Southwick Ph.D., Tom Seekins Ph.D., University Of Montana Rural Institute Rural Institute Mar 2000

Rural Managed Care And Disability: A National Perspective, Colleen Murphy-Southwick Ph.D., Tom Seekins Ph.D., University Of Montana Rural Institute Rural Institute

Health and Wellness

Rural access to health care has historically been a concern in the United States. In the late 1980s and early 1990s, lower rural reimbursements for the same services provided in urban areas contributed to a substantial decline in the number of rural hospitals and health care providers. Rural Americans with and without disabilities experienced the negative consequences of those changes. The rapid introduction of managed care is producing explosive changes in the marginal, aging, rural medical care services sector. Managed care policies directly affect both access to medical services by people with disabilities and the economic infrastructure of small rural …

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Rural Managed Care And Disability: Emerging Issues From Preliminary Interviews And Case Studies, Colleen Murphy-Southwick Ph.D., Tom Seekins Ph.D., University Of Montana Rural Institute Rural Institute Mar 2000

Rural Managed Care And Disability: Emerging Issues From Preliminary Interviews And Case Studies, Colleen Murphy-Southwick Ph.D., Tom Seekins Ph.D., University Of Montana Rural Institute Rural Institute

Health and Wellness

Since the 1980s, rural access to health care information, resources and services has become increasingly problematic. The shift toward managed care complicates the picture. While some argue that managed care will devastate rural health services due to sparsely populated areas’ high costs and low profit margins, others suggest that market forces will make the health care system more efficient and re-distribute resources now concentrated in urban areas toward rural areas. Managed care is penetrating public programs

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Impact Of Violence Prevention Programs On The Attitudes Towards Guns And Violence Among Third Through Sixth Grade And Seventh Grade Students In The Bowling Green Independent School District, Michelyn Bhandari Mar 2000

Impact Of Violence Prevention Programs On The Attitudes Towards Guns And Violence Among Third Through Sixth Grade And Seventh Grade Students In The Bowling Green Independent School District, Michelyn Bhandari

Masters Theses & Specialist Projects

The purpose of this study is to assess the efficacy of violence prevention programs on the attitudes toward guns and violence among students in grades three through seven. This study represents an attempt to prove that third through sixth grade students who receive anger control training and seventh grade students who receive conflict resolution training will show a significantly lower attraction towards guns and violence than students receiving no such training. By understanding interrelation between adolescents' attitudes towards guns and violence and their psychosocial functioning, the public can seek out ways of preventing violence. To measure the impact and to …

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Psychological Pathways To Minimizing Human Rights Violations Against Children, Ibpp Editor Feb 2000

Psychological Pathways To Minimizing Human Rights Violations Against Children, Ibpp Editor

International Bulletin of Political Psychology

This article identifies several psychological pathways that governments and human rights organizations can employ to minimize human rights violations against children.

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Physician Connectivity: Electronic Prescribing, Robin J. Strongin Feb 2000

Physician Connectivity: Electronic Prescribing, Robin J. Strongin

National Health Policy Forum

This issue brief focuses on physician connectivity — the electronic linking of physicians with online resources such as clinical databases and sophisticated formulary systems. As physician connectivity increasingly allows physicians to prescribe online via a handheld computer complete with formulary information as well as patient data and drug information, this issue brief examines the issues raised by this technological advance within the broader context of online prescribing.

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A Mycobacterium Ulcerans Toxin, Mycolactone, Causes Apoptosis In Guinea Pig Ulcers And Tissue Culture Cells, Kathleen M. George, Lisa Pascopella, Diane M. Welty, P. L. C. Small Feb 2000

A Mycobacterium Ulcerans Toxin, Mycolactone, Causes Apoptosis In Guinea Pig Ulcers And Tissue Culture Cells, Kathleen M. George, Lisa Pascopella, Diane M. Welty, P. L. C. Small

Public and Community Health Sciences Faculty Publications

Mycobacterium ulcerans is the causative agent of Buruli ulcer, a tropical ulcerative skin disease. One of the most intriguing aspects of this disease is the presence of extensive tissue damage in the absence of an acute inflammatory response. We recently purified and characterized a macrolide toxin, mycolactone, from M. ulcerans. Injection of this molecule into guinea pig skin reproduced cell death and lack of acute inflammatory response similar to that seen following the injection of viable bacteria. We also showed that mycolactone causes a cytopathic effect on mouse fibroblast L929 cells that is characterized by cytoskeletal rearrangements and growth arrest …

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Integronlike Structures In Campylobacter Spp. Of Human And Animal Origin, Brigid Lucey, D. Crowley, P. Moloney, B. Cryan, M. Daly, F. O'Halloran, E. J. Threlfall, S. Fanning Feb 2000

Integronlike Structures In Campylobacter Spp. Of Human And Animal Origin, Brigid Lucey, D. Crowley, P. Moloney, B. Cryan, M. Daly, F. O'Halloran, E. J. Threlfall, S. Fanning

Department of Biological Sciences Publications

Resistance to antimicrobial agents used to treat severe Campylobacter spp. gastroenteritis is increasing worldwide. We assessed the antimicrobial resistance patterns of Campylobacter spp. isolates of human and animal origin. More than half (n = 32) were resistant to sulphonamide, a feature known to be associated with the presence of integrons. Analysis of these integrons will further our understanding of Campylobacter spp. epidemiology.

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Correlates Of Physical Activity In Male And Female Youth, Timothy Bungum, Marsha Dowda, Anne T. Weston, Stewart G. Trost, Russell R. Pate Feb 2000

Correlates Of Physical Activity In Male And Female Youth, Timothy Bungum, Marsha Dowda, Anne T. Weston, Stewart G. Trost, Russell R. Pate

Faculty Publications

This study examined associations between psychosocial factors and physical activity in a group of youth (n=520). Students completed the Previous Day Physical Activity Recall and a survey of potential determinants of physical activity. Regression analyses of intentions to be physically active revealed that enjoyment and self-efficacy predicted intentions for both males and females. Attitudes predicted moderate to vigorous activity (MVPA), and enjoyment and self-efficacy predicted vigorous activity (VPA) for males. Self-efficacy predicted both MVPA and VPA for females. The findings suggest that intervention programs targeted at youth should include developmentally appropriate activities that are fun and promote physical …

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Associations Among Hospital Capacity, Utilization, And Mortality Of Us Medicare Beneficiaries, Controlling For Sociodemographic Factors., E. S. Fisher, J. E. Wennberg, T. A. Stukel, J. S. Skinner, S. M. Sharp Feb 2000

Associations Among Hospital Capacity, Utilization, And Mortality Of Us Medicare Beneficiaries, Controlling For Sociodemographic Factors., E. S. Fisher, J. E. Wennberg, T. A. Stukel, J. S. Skinner, S. M. Sharp

Dartmouth Scholarship

To explore whether geographic variations in Medicare hospital utilization rates are due to differences in local hospital capacity, after controlling for socioeconomic status and disease burden, and to determine whether greater hospital capacity is associated with lower Medicare mortality rates.

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Site Visit To Arizona — Managed Medicaid: Arizona's Ahcccs Experience, Nora Super, Lisa Sprague, Judith D. Moore Jan 2000

Site Visit To Arizona — Managed Medicaid: Arizona's Ahcccs Experience, Nora Super, Lisa Sprague, Judith D. Moore

National Health Policy Forum

This site visit featured a review of a unique Medicaid managed care system, the Arizona Health Care Cost Containment System (AHCCCS), which has operated as a research and demonstration waiver since its inception in 1982. Site visitors heard from speakers who provided historical and background information, a discussion of competitive bidding, contracting and performance management, and insights into the delivery of behavioral health under the mandatory AHCCCS program. The group also heard discussions about services to the uninsured and Arizona's safety net providers. Other topics covered during the visit included the state's KidsCare program under the State Child Health Insurance …

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Reshaping Ahcs' Role In Biomedical Research, Karen Matherlee Jan 2000

Reshaping Ahcs' Role In Biomedical Research, Karen Matherlee

National Health Policy Forum

This issue brief explores the reconfiguration of academic health centers (AHCs) in response to health marketplace and other pressures. It reviews four roles AHCs play in medical innovation: (a) development of new drugs, devices, diagnostic techniques, and therapeutic procedures; (b) adoption of new technologies, instruments, and drugs; (c) evaluation of new technologies; and (d) assessment of the need for new modalities and monitoring of their initial uses. The paper examines ways in which these roles are enhanced or threatened by evolving economic forces in the public and private sectors.

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How Tuberculosis Threatens Supporters And Opponents Of Racial Profiling, Ibpp Editor Jan 2000

How Tuberculosis Threatens Supporters And Opponents Of Racial Profiling, Ibpp Editor

International Bulletin of Political Psychology

This article explores peculiarities of logic and reason among supporters and opponents of racial profiling as a tool of developing and implementing public policy.

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Frequency Of Use And Perceived Credibility Of Information Sources And Variations By Socioeconomic Factors Among Savannah River Stakeholders, Bryan L. Williams, Alex Vallei, Sylvia Brown, Michael Greenberg Jan 2000

Frequency Of Use And Perceived Credibility Of Information Sources And Variations By Socioeconomic Factors Among Savannah River Stakeholders, Bryan L. Williams, Alex Vallei, Sylvia Brown, Michael Greenberg

RISK: Health, Safety & Environment (1990-2002)

The authors examine the factors effecting credibility of risk communication in the communities surrounding the Savannah River Nuclear Weapons Site.

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Effect Of Preventive Home Visits By A Nurse On The Outcomes Of Frail Elderly People In The Community: A Randomized Controlled Trial, Dawn M. Dalby, John W. Sellors, Fred D. Fraser, Catherine Fraser, Cornelia Van Ineveld, Michelle Howard Jan 2000

Effect Of Preventive Home Visits By A Nurse On The Outcomes Of Frail Elderly People In The Community: A Randomized Controlled Trial, Dawn M. Dalby, John W. Sellors, Fred D. Fraser, Catherine Fraser, Cornelia Van Ineveld, Michelle Howard

Kinesiology and Physical Education Faculty Publications

Background: Timely recognition and prevention of health problems among elderly people have been shown to improve their health. In this randomized controlled trial the authors examined the impact of preventive home visits by a nurse compared with usual care on the outcomes of frail elderly people living in the community. Methods: A screening questionnaire identified eligible participants (those aged 70 years or more at risk of sudden deterioration in health). Those randomly assigned to the visiting nurse group were assessed and followed up in their homes for 14 months. The primary outcome measure was the combined rate of deaths and …

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Attributional Style And Disability Outcome, Craig Ravesloot Ph.D., Quincy-Robyn Young, Tom Seekins Ph.D., Ann Szalda-Petree Ph.D., University Of Montana Rural Institute Jan 2000

Attributional Style And Disability Outcome, Craig Ravesloot Ph.D., Quincy-Robyn Young, Tom Seekins Ph.D., Ann Szalda-Petree Ph.D., University Of Montana Rural Institute

Health and Wellness

Disability is both a very personal and social issue. In 1999, The World Health Organization (WHO) published their latest revisions to the ICIDH-2. This document includes the latest conceptual developments in understanding the structure and process of disabling conditions. The document highlights that disability outcome occurs within a dynamic system characterized by the impairment itself, environmental and personal factors (World Health Organization, 1999).

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Erisa Health Plan Liability: Issues And Options For Reform, Karl Polzer Jan 2000

Erisa Health Plan Liability: Issues And Options For Reform, Karl Polzer

National Health Policy Forum

This background paper was written as congressional conferees faced the task of resolving differences between patient protection bills by the U.S. House of Representatives and U.S. Senate in late 1999. In order to discuss the principal issues facing policymakers and options for reform, it begins by describing problems raised by the federal law governing private-sector employee health plans (the Employee Retirement Income Security Act of 1974) from a consumer perspective. It then discusses approaches proposed by the Clinton administration and the House and Senate to give consumers greater ability to challenge health plan coverage decisions, focusing in particular on issues …

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Sulfa Or Sulfone Prophylaxis And Geographic Region Predict Mutations In The Pneumocystis Carinii Dihydropteroate Synthase Gene, Laurence Huang, Charles B. Beard, Jennifer Creasman, Deborah A. Levy, Jeffrey S. Duchin, Sherline Lee, Norman Pieniazek, Jane L. Carter, Carlos Del Rio, David Rimland, Thomas R. Navin Jan 2000

Sulfa Or Sulfone Prophylaxis And Geographic Region Predict Mutations In The Pneumocystis Carinii Dihydropteroate Synthase Gene, Laurence Huang, Charles B. Beard, Jennifer Creasman, Deborah A. Levy, Jeffrey S. Duchin, Sherline Lee, Norman Pieniazek, Jane L. Carter, Carlos Del Rio, David Rimland, Thomas R. Navin

Journal Articles: Epidemiology

To determine factors associated with mutations in the Pneumocystis carinii dihydropteroate synthase (DHPS) gene, a prospective study of human immunodeficiency virus (HIV)-infected patients with confirmed P. carinii pneumonia was conducted in Atlanta, Seattle, and San Francisco. Clinical information was obtained from patient interview and chart abstraction. DHPS genotype was determined from DNA sequencing. Overall, 76 (68.5%) of 111 patients had a mutant DHPS genotype, including 22 (81.5%) of 27 patients from San Francisco. In multivariate analysis, sulfa or sulfone prophylaxis and study site were independent predictors of a mutant genotype. Fourteen (53.8%) of 26 patients who were newly diagnosed with …

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Ambulatory Care Physician Barriers Contributing To The Low Advance Directive Education Rate, Cindy Lynn Grant Jan 2000

Ambulatory Care Physician Barriers Contributing To The Low Advance Directive Education Rate, Cindy Lynn Grant

Theses Digitization Project

No abstract provided.

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The Effects Of An Educational Intervention On Calcium Intake And Bone Mineral Content In Young Women With Low Calcium Intake., B. Peterson, R. Klesges, E. Kaufman, Theodore Cooper, C. Vukadonovich Jan 2000

The Effects Of An Educational Intervention On Calcium Intake And Bone Mineral Content In Young Women With Low Calcium Intake., B. Peterson, R. Klesges, E. Kaufman, Theodore Cooper, C. Vukadonovich

Selected Works Temporary Series

No abstract provided.

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Current First Aid And Cpr Credentials Of Selected Head High School Athletic Coaches In West Virginia, Amy Robinson Jan 2000

Current First Aid And Cpr Credentials Of Selected Head High School Athletic Coaches In West Virginia, Amy Robinson

Theses, Dissertations and Capstones

Coaches are typically the immediate caregivers to high school athletes. To date the state of West Virginia has no mandatory laws that coaches be first-aid and CPR certified before they are hired as a coach. The general purpose of this study is to assess current status of first-aid and CPR certifications held by high school head athletic coaches in the state of West Virginia. A packet will be sent to the 160 high schools in West Virginia. The principal will randomly choose five head coaches, at least two females and two males, to fill out the survey which are to …

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Healthy Families Maine: Final Evaluation Report, Erin E. Oldham Phd, Tammy Richards, Anne B. Keith Rn, Drph, C-Pnp, Julie Atkins Ma Jan 2000

Healthy Families Maine: Final Evaluation Report, Erin E. Oldham Phd, Tammy Richards, Anne B. Keith Rn, Drph, C-Pnp, Julie Atkins Ma

Children, Youth, & Families

The first year's evaluation featured a process study documenting the implementation of the program at six pilot sites. The second year evaluation report followed the evolution of the Healthy Families Maine program, through both a process study and the introduction of an exploratory outcomes study.iv While the second year report focused on all of the children being served by the six Healthy Families programs, the present report is a more in-depth, longitudinal study of a group of 89 children and families served by their local Healthy Families program.

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Response To Critique Of The Claim Of Cannibalism At Cowboy Wash, Patricia M. Lambert, Banks L. Leonard, Brian R. Billman, Richard A. Marlar, Margaret E. Newman, Karl J. Reinhard Jan 2000

Response To Critique Of The Claim Of Cannibalism At Cowboy Wash, Patricia M. Lambert, Banks L. Leonard, Brian R. Billman, Richard A. Marlar, Margaret E. Newman, Karl J. Reinhard

Karl Reinhard Publications

The original authors of Billman et af. (2000) are joined by three other analysts from the Cowboy Wash research team to respond to the critique of this article by Dongoske et af. (2000). Dongoske and his coauthors state that Billman et af. (2000) failed to test alternative hypotheses or to consider alternative explanations for the findings at 5MTJOOJO and similar sites. The original authors point out that alternative hypotheses were examined and rejected, leaving a violent episode of cannibalism as the most plausible explanation for the remains found at 5MTJOOJO. Dongoske et af. also question many aspects of the osteological, …

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Realities And Treatment Of Rape, Alison S. Brennan Jan 2000

Realities And Treatment Of Rape, Alison S. Brennan

Graduate Research Papers

One in three women have experienced a sexual assault. The impact of sexual assault can affect numerous aspects of a woman's life including: sexual health, cognitions, behaviors, emotions, interpersonal relationships, and self-perceptions. The healing journey for a rape victim is often initiated with the aid of a counselor. For this reason alone, it is crucial for counselors to have a basic knowledge of the symptoms as well as the various treatments for rape victims.

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The Effects Of An Educational Intervention On Calcium Intake And Bone Mineral Content In Young Women With Low Calcium Intake., B. Peterson, R. Klesges, E. Kaufman, Theodore Cooper, C. Vukadonovich Jan 2000

The Effects Of An Educational Intervention On Calcium Intake And Bone Mineral Content In Young Women With Low Calcium Intake., B. Peterson, R. Klesges, E. Kaufman, Theodore Cooper, C. Vukadonovich

Departmental Papers (Psych)

No abstract provided.

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‘Gene Shaving’ As A Method For Identifying Distinct Sets Of Genes With Similar Expression Patterns, Trevor Hastie, Robert Tibshirani, Michael B. Eisen, Ash Alizadeh, Ronald Levy, Louis Staudt, Wing C. Chan, David Botstein, Patrick Brown Jan 2000

‘Gene Shaving’ As A Method For Identifying Distinct Sets Of Genes With Similar Expression Patterns, Trevor Hastie, Robert Tibshirani, Michael B. Eisen, Ash Alizadeh, Ronald Levy, Louis Staudt, Wing C. Chan, David Botstein, Patrick Brown

United States Public Health Resources

Background: Large gene expression studies, such as those conducted using DNA arrays, often provide millions of different pieces of data. To address the problem of analyzing such data, we describe a statistical method, which we have called ‘gene shaving’. The method identifies subsets of genes with coherent expression patterns and large variation across conditions. Gene shaving differs from hierarchical clustering and other widely used methods for analyzing gene expression studies in that genes may belong to more than one cluster, and the clustering may be supervised by an outcome measure. The technique can be ‘unsupervised’, that is, the genes and …

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Interleukin-1 Polymorphisms Associated With Increased Risk Of Gastric Cancer, Emad M. El-Omar, Mary Carrington, Wong-Ho Chow, Kenneth E. L. Mccoll, Jay H. Bream, Howard A. Young, Jesus Herrera, Jolanta Lissowska, Chiu-Chin Yuan, Nathaniel Rothman, George Lanyon, Maureen Martin, Joseph F. Fraumeni Jr., Charles S. Rabkin Jan 2000

Interleukin-1 Polymorphisms Associated With Increased Risk Of Gastric Cancer, Emad M. El-Omar, Mary Carrington, Wong-Ho Chow, Kenneth E. L. Mccoll, Jay H. Bream, Howard A. Young, Jesus Herrera, Jolanta Lissowska, Chiu-Chin Yuan, Nathaniel Rothman, George Lanyon, Maureen Martin, Joseph F. Fraumeni Jr., Charles S. Rabkin

United States Public Health Resources

Helicobacter pylori infection is associated with a variety of clinical outcomes including gastric cancer and duodenal ulcer disease1. The reasons for this variation are not clear, but the gastric physiological response is influenced by the severity and anatomical distribution of gastritis induced by H. pylori. Thus, individuals with gastritis predominantly localized to the antrum retain normal (or even high) acid secretion2, whereas individuals with extensive corpus gastritis develop hypochlorhydria and gastric atrophy3, which are presumptive precursors of gastric cancer4. Here we report that interleukin-1 gene cluster polymorphisms suspected of enhancing production of interleukin-1-beta …

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U.S. Obstetric Procedures, 1998, Sally C. Curtin, T. J. Mathews Jan 2000

U.S. Obstetric Procedures, 1998, Sally C. Curtin, T. J. Mathews

United States Public Health Resources

According to the latest birth data from the National Center for Health Statistics, the use of electronic fetal monitoring, ultrasound, stimulation of labor, and induction of labor continued to rise in 1998 to unprecedented levels (1). At the same time, the total cesarean rate, which had fallen each year from 1989 to 1996, rose for the second consecutive year while the primary cesarean rate (rate per 100 births to women with no previous cesarean) rose for the first time during the 1989–1998 period. After increasing by 50 percent between 1989 and 1996, the rate of vaginal birth after previous cesarean …

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