Medicine and Health Sciences Commons^™

Transparent Development Of The Who Rapid Advice Guidelines, Holger J. Schunemann, Suzanne R. Hill, Meetali Kakad, Gunn E. Vist, Richard Bellamy, Lauren Stockman, Torbjorn Fosen Wisloff, Chris Del Mar, Frederick Hayden, Timothy M. Uyeki, Jeremy Farrar, Yazdan Yazdanpanah, Howard Zucker, John Beigel, Tawee Chotpitayasunondh, Tran Tinh Hien, Bulent Ozbay, Norio Sugaya, Andrew D. Oxman

Christopher Del Mar

Emerging health problems require rapid advice. We describe the development and pilot testing of a systematic, transparent approach used by the World Health Organization (WHO) to develop rapid advice guidelines in response to requests from member states confronted with uncertainty about the pharmacological management of avian influenza A (H5N1) virus infection. We first searched for systematic reviews of randomized trials of treatment and prevention of seasonal influenza and for nontrial evidence on H5N1 infection, including case reports and animal and in vitro studies. A panel of clinical experts, clinicians with experience in treating patients with H5N1, influenza researchers, and methodologists …

Whose Duty Is It Anyway?: The Kennedy Krieger Opinion And Its Implications For Public Health Research, Diane E. Hoffmann, Karen H. Rothenberg

Karen H. Rothenberg

In this article, the authors discuss the Maryland Court of Appeals decision in the case of Grimes v. Kennedy Krieger Institute, Inc. and its implications for the tort duty owed by researchers, in particular public health researchers, to their subjects. The Opinion resulted from two lawsuits alleging lead poisoning of children enrolled in a study conducted by the Kennedy Krieger Institute, a world renown pediatric research and treatment facility. The opinion shocked the research establishment with its scathing characterization of researchers and its apparent holding that in Maryland a parent cannot consent to the participation of a child in "nontherapeutic …

Got Junk? The Federal Role In Regulating “Competitive” Foods, Eileen Salinsky

National Health Policy Forum

A wide variety of food and beverage items are available in schools in addition to the school meals provided through the National School Lunch Program and School Breakfast Program. A long-standing source of controversy, the need for stronger federal restrictions on foods that compete with school meals is again under debate. This issue brief examines the availability and consumption of competitive foods, explores the regulation of these foods at the federal level, considers trends in state and local restrictions, and summarizes perceived barriers to improving the nutritional quality of competitive food options.

No Free Lunch? Current Challenges Facing The National School Lunch And School Breakfast Programs, Eileen Salinsky

National Health Policy Forum

This background paper describes important characteristics of the National School Lunch Program and the School Breakfast Program, reviews U.S. Department of Agriculture rules regarding the nutritional content of school meals, and examines compliance with current nutrition standards. It also considers the dietary status and obesity risk of meal program participants, discusses proposed improvements to nutritional standards and meal requirements, and highlights key legislative issues.

The Role Of Ombudsmen In Assuring Quality For Residents Of Long-Term Care Facilities: Straining To Make Ends Meet, Carol O'Shaughnessy

National Health Policy Forum

Assuring quality of care for residents in long-term care facilities has been a serious and continuing concern of policymakers for decades. The Older Americans Act’s long-term care ombudsman program is a consumer advocacy model intended to improve quality of care by helping the 2.5 million residents of almost 67,000 nursing and other residential care facilities resolve complaints about their care and protect their rights. Despite broad recognition of its value in assisting residents and its efforts to complement federal and state oversight of long-term care facilities, some observers are concerned about the program’s ability to meet its legislative mandates. Limited …

Impact Of Parent’S Hiv Status On Their Uninfected Child—A Comparative Analysis Of The Child’S Healthcare Utilization, Access And Health Outcomes, Arijit Ganguli

Theses and Dissertations (ETD)

With the advent of effective antiretroviral medication and increased expectancy of life span among HIV-infected individuals has lead to an increase in the at-risk population of uninfected children living with their HIV-infected parent(s). The purpose of this study was to investigate the impact of parent’s HIV status on their child’s access to healthcare resources, healthcare utilization and health outcomes.

This was a cross-sectional study in which the information on the children of HIV seropositive parent(s) was collected through a face-to-face interview of the HIV-infected parents having children currently residing with them. The comparative group comprising of children of HIV seronegative …

Analogical Reasoning: A Process For Fostering Learning Transfer From The Classroom To Clinical Practice, Timothy E. Speicher, Marijke Kehrhahn

All PTHMS Faculty Publications

In 2001, the Institute of Medicine (IOM), a committee of physicians and health policy experts charged to improve the health of the United States by the National Academy of Science, identified a gap in the area of education of health care practitioners as one of the reasons for medical error. However, one of the most common instructional methods in medical education to promote transfer and problem solving is examination of a single patient case (Shine, 2002), a pedagogical practice shown to be ineffective (Gentner, Loewenstein & Thompson, 2003; Norman et al., 2007). Therefore, adult learners in health care may be …

Direct Healthcare Costs Of Hip, Vertebral, And Non-Hip, Non-Vertebral Fractures., Nianwen Shi, Kathleen Foley, Gregory Lenhart, Enkhe Badamgarav

College of Population Health Faculty Papers

Limited data exist regarding the cost of non-hip, non-vertebral (NHNV) fractures. Although NHNV fractures may be less expensive than hip and vertebral fractures, they have a higher incidence rate. The objective of this study was to quantify first-year healthcare costs of hip, vertebral, and NHNV fractures. This was a claims-based retrospective analysis using a case-control design among patients with commercial insurance and Medicare employer-based supplemental coverage. Patients were > or =50 years old with a closed hip, vertebral, or NHNV fracture between 7/1/2001 and 12/31/2004, and continuous enrollment 6 months prior to and 12 months after the index fracture. Adjusted mean …

Uptake Of A Team Briefing In The Operating Theatre: A Burkean Dramatistic Analysis, Sarah Whyte, Carrie Cartmill, Fauzia Gardezi, Richard Reznick, Beverley Orser, Diane Doran, Lorelei Lingard

Lorelei Lingard

Communication among healthcare professionals is a focus for research and policy interventions designed to improve patient safety, but the challenges of changing interprofessional communication patterns are rarely described. We present an analysis of 756 preoperative briefings conducted by general surgery teams (anesthesiologists, nurses, and surgeons) at four urban Canadian hospitals in the context of two research studies conducted between August 2004 and December 2007. We ask the questions: how and why did briefings succeed, how and why did they fail, and what did they mean for different participants? Ethnographic fieldnotes documenting the coordination and performance of team briefings were analyzed …

A Comparison Of Frequentist And Bayesian Approaches To The Estimation Of Long-Stay Per-Diems, Jeff Hatcher, Jason M. Sutherland

Dartmouth Scholarship

Within many diagnosis related group (DRG) systems, there is recognition that a single cost weight per DRG is not suitable, and that cost weights should take into account extremely lengthy hospital stays. Long lengths of stay are considered to be due to factors largely beyond the control of the hospital, and a single weight per DRG would potentially place hospitals under financial risk.

Within Canada's acute-care, inpatient grouping methodology - Case Mix Groups (CMG+) - long-stay episodes represent approximately 4.5% of all discharges. Within a CMG (analogous to DRG), the cost weight assigned to long-stay cases consists of the typical …

Lot Quality Assurance Sampling (Lqas) And The Mozambique Malaria Indicator Surveys, Caitlin Biedron, Marcello Pagano, Bethany L. Hedt, Albert Kilian, Amy Ratcliffe, Samuel Mabunda, Joseph J. Valadez

Harvard University Biostatistics Working Paper Series

No abstract provided.

Tailoring Messages To Individual Differences In Monitoring- Blunting Styles To Increase Fruit And Vegetable Intake, Pamela Williams-Piehota, Amy E. Latimer, Nicole A. Katulak, Ashley Cox, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

Objective

To examine whether messages matched to individuals' monitoring-blunting coping styles (MBCS) are more effective in increasing fruit and vegetable intake than mismatched messages. MBCS refers to the tendency to either attend to and amplify, or distract oneself from and minimize threatening information.

Design/Setting

Randomly assigned messages were tailored to resonate with either monitors or blunters and delivered at baseline, 1 week, 2 months, and 3 months later. Surveys were conducted at baseline and 2 and 4 months later.

Participants

531 callers to a cancer information hotline who did not meet the 5 A Day guideline.

Intervention

A brief telephone-delivered …

Selected Comparison Of Global Health Organizations, Steven C. Mccullar

Scholarship in Medicine - All Papers

Due to a potential, worldwide adverse impact on health, transnational dependencies, and the need for effective response, global cooperation is imperative (Buchanan & Decamp, 2006). There are more than 100 global health agencies, including the World Health Organization. As the number of organizations increases, each with their own agendas, so does the concern for lack of coherence and collaboration among organizations in the effort of disease eradication and development of health systems (Beaglehole & Bonita, 2008). The focus of this study is on comparing the effectiveness of selected global health organizations in efforts to detect a need to either establish …

Health Insurance Patterns Among Latinos In Comparative Perspective 2004 — 2007, Rachael Varra

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report examines the rates at which the four major racial/ethnic groups in the United States — Latinos, non-Hispanic Whites, non-Hispanic Blacks and Asians — lacked health insurance from 2004- 2006 in the U.S. overall and in the ten states with the largest Latino populations: California, Texas, Florida, New York, Illinois, Arizona, New Jersey, Colorado, New Mexico and Georgia.

Methods: The “lack of insurance data” in this report were derived from Health Statistics Data obtained by the Center for Disease Control from 2004 to 2006. In September 2008 these data became available by race, age and ethnicity/race on a …

Early Childhood Summit On Comprehensive Services For Homeless Children And Their Families, Nevada Institute For Children’S Research And Policy, Nevada Head Start State Collaboration Office, Head Start State Training And Technical Assistance Office For Nevada, Nevada Public Health Foundation

Nevada Institute for Children's Research and Policy Reports

On October 23, 2009 the Nevada Head Start State Collaboration Office in partnership with the Nevada Institute for Children’s Research and Policy, Head Start State Training and Technical Assistance Office for Nevada and the Nevada Public Health Foundation sponsored the Early Childhood Summit on Comprehensive Services for Homeless Children and Their Families. The Summit brought together 142 professionals working with homeless children and families in Nevada from a variety of different organizations and backgrounds. The goal of the summit was to discuss the problem of families experiencing homelessness and offer solutions to professionals in how to better serve these populations.

Early Psychosis: A Novel Gateway For Suicide Prevention, Amresh Srivastava, Megan Johnston

Amresh Srivastava

Early psychosis: A Novel Gateway For Suicide Prevention

Amresh Shrivastava 1, Megan Johnston 2 Address: 1. Department of Psychiatry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada); Mental Health Foundation of India (PRERANA Charitable Trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602 (Present Address: Regional Mental Health Care, 467 Sunset Drive, St. Thomas, Ontario, Canada N5H 3V9; 2. Department of Psychology, University of Toronto.

Early psychosis and early intervention initiative in by now a well established model for treatment …

Duration Of Untreated Psychosis & Long-Term Outcome Of First Episode, Hospitalized Schizophrenia: Search For A Missing Link In A Linear Correlation, Amresh Srivastava, Nilesh Shah, Meghana Thakar, Larry Stitt, Gurusamy Chinnasamye

Amresh Srivastava

Duration of untreated psychosis & Long-term outcome of First episode, hospitalized schizophrenia: Search for a missing link in a linear correlation Amresh Shrivastavaa,*, Nilesh Shahb, Meghana Thakarc, Larry Stittd, Gurusamy Chinnasamye a Excecutive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, Currently: Assistant Professor of Psychiatry, The University of western Ontario, & associate Scientist, Lawson Health Research Institute, London, Ontario,Canada, E Mail : amresh.edu@gmail.com b Professor of Psychiatry LTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 c Clinical psychologist, Silver …

Peer-Led, School-Based Nutrition Education For Young Adolescents: Feasibility And Process Evaluation Of The Teens Study, Mary Story, Leslie A. Lytle, Amanda Birnbaum, Cheryl L. Perry

Department of Public Health Scholarship and Creative Works

Peer education has become a popular strategy for health promotion interventions with adolescents, but it has not been used widely in school‐based nutrition education. This paper describes and reports on the feasibility of the peer leader component of school‐based nutrition intervention for young adolescents designed to increase fruit and vegetable intakes and lower-fat foods. About 1,000 seventh‐grade students in eight schools received the nutrition intervention. Of these, 272 were trained as peer leaders to assist the teacher in implementing the activities. Results from a multicomponent process evaluation based on peer leader and classroom student feedback, direct classroom observation, and teacher …

A Community Benefit Reporting Toolkit For Critical Access Hospitals, John A. Gale Ms, Melanie Race Ms

Rural Hospitals (Flex Program)

No abstract provided.

Profiling Maine’S Long Term Support System [Project Brief], Eileen Griffin Jd

Disability & Aging

A recent report by the Muskie School and the Maine Department of Health and Human Services provides a new way of looking at the state’s long term support system. With an emphasis on developing a common approach for description and analysis across programs, the profile reveals that users of long term services and supports in Maine span all age groups and types of service users. In fact, 28% are ages 17 or younger and 29% are between the age of 35 and 64. Long term service users include people with physical impairments, cognitive and intellectual disabilities, and people who need …

It's Your Life: Building Connections Through Work - Project Summary Report, Sherrie Winton Med

Disability & Aging

This report gives a detailed description of It's Your Life: Building Connections Through Work project from design, to implementation and evaluation of the workshop sessions. It is our hope that you enjoy learning about this project and that professionals working in the rehabilitation field continue to seek out opportunities to provide co-training models, partnering with adults with disabilities to train their peers.

Current Practice In Physical Child Abuse Forensic Reports: A Preliminary Exploration, Marcellina Mian, Catherine Schryer, Marlee Spafford, Jan Joosten, Lorelei Lingard

Lorelei Lingard

No abstract provided.

Community Demographics And Access To Care Among Us Hispanics, Carole Gresenz, J. Rogowski, Jose Escarce

Carole Roan Gresenz

No abstract provided.

Community Empowerment Through An Academic Product: Implications For The Social-Justice, Tamara Leech, Edrose Potts Jr.

Department of Public Health Scholarship and Creative Works

Often, African American community organizations are distanced from government institutional practices. In response, they may approach local academics to help bridge the divide. This think piece explores lessons that one academic scholar learned during the process of writing and distributing an applied report that ultimately helped a community organization to gain access to the governmental decision-making process. In exploring the project, we first focus on the process and value of shifting from a charity orientation to a social justice orientation. Second, we use the report itself to provide examples of essential, concrete aspects of social justice-oriented products. In the end, …

First Episode Is The Best Episode: Lessons And Limitations In Duration Of Untreated Psychosis (Dup) And Outcome In Schizophrenia, Amresh Srivastava

Amresh Srivastava

First episode is the best episode: Lessons and limitations in duration of untreated psychosis (DUP) and outcom Amresh Shrivastavaa, *, Nilesh Shahb, Meghana Thakarc, Larry Stittd, Gurusamy Chinnasamye

a Executive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, Currently: Assistant Professor of Psychiatry, The University of western Ontario, & associate Scientist, Lawson Health Research Institute, London, Ontario, Canada, E Mail : amresh.edu@gmail.com Professor of Psychiatry LTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 c Clinical psychologist, Silver Mind Hospital, Mumbai, …

Family Education For Psychosis, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Coverage And Payment For Prescription Drugs Under Medicare Part B: A Complex Patchwork, Amanda Cassidy

National Health Policy Forum

As part of the diverse discussions around health care reform, many have looked to refining Medicare payment systems as a way to give health care practitioners and providers greater incentives to deliver care more efficiently, and thus slow health care spending growth. Understanding how Medicare currently pays for Part B services, including drugs covered under Part B, is essential to understanding the potential impact of these types of reforms. Most items and services covered under Part B, including most Part B drugs, are paid individually, which means practitioners and providers generally receive more payments for providing more services. Some reform …

Stimulus Bill Implementation: Expanding Meaningful Use Of Health It, Rob Cunningham

National Health Policy Forum

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish health IT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government’s leadership role in promoting health IT. But successful adoption and utilization across the health system will …

Issues For Dsm-V: The Role Of Culture In Psychiatric Diagnosis, Renato D. Alarcón, Anne E. Becker, Roberto Lewis-Fernández, Robert C. Like, Prakash Desai, Edward Foulks, Junius Gonzales, Helena Hansen, Alex Kopelowicz, Francis G. Lu, María A. Oquendo, Annelle Primm

Publications from Provost Junius J. Gonzales

No abstract provided.

Solar Water Disinfection In Household Settings:Hype Or Hope?, Zulfiqar Ahmed Bhutta

Woman and Child Health

No abstract provided.