Medicine and Health Sciences Commons^™

Reducing Medical Error: Can You Be As Safe In A Hospital As You Are In A Jet?, Lisa Sprague

National Health Policy Forum

This issue brief looks at the incidence of error in the health care system, opportunities for a systems-based approach to error reduction, and changes needed in health system culture and training. The lessons of human factors research are considered, with examples of their application in the aviation industry. The paper reviews some error-reduction and patient-safety initiatives undertaken by private-sector organizations and by the Veterans Health Administration.

Physical Violence During Pregnancy: Maternal Complications And Birth Outcomes, Vilma E. Cokkinides, Ann L. Coker, Maureen Sanderson, Cheryl Addy, Lesa Bethea

CRVAW Faculty Journal Articles

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.

Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.

Results: The prevalence …

Turnover Of Personal Assistants And The Incidence Of Injury Among Adults With Developmental Disabilities, Meg A. Traci Ph.D., Ann Szalda-Petree Ph.D., Steve Seninger Ph.D., University Of Montana Rural Institute

Health and Wellness

Relatively little is known about the incidence and prevalence of injuries and other secondary conditions experienced by adults with developmental disabilities. Understanding the risk factors for secondary conditions and strategies for their prevention is important to people with disabilities, rehabilitation providers, and public health agencies. Many secondary condition prevention strategies require direct involvement of the individual with a disability. However, the nature of some disabling conditions requires help from an intermediary facilitator, frequently known as a “Personal Care Attendant” (PCA) or a “Personal Assistant” (PA).

Sex Education Programs In Schools: Influence On Knowledge And Behaviors Of Teenagers, Tina Graham

Masters Theses & Specialist Projects

Due to the teenage pregnancy rates and the incidence of sexually transmitted diseases (STDs) that exist in today's society, it is very important for teenagers to be informed of the facts related to pregnancy and STDs and how to prevent them from occurring. With this knowledge, they are able to make informed decisions related to their sexual experiences. The prime opportunity for such sharing of information can be in schools. The purpose of this study is to determine if sex education in school influences the knowledge and behaviors of teenagers toward sexual behavior, pregnancy, and sexually transmitted diseases. This research …

Economic Development And Health Status Among The Poor In Squatter Settlements Of Karachi., Fauziah Rabbani, Anwer T. Merchant

Community Health Sciences

OBJECTIVE:

Socioeconomic status is an important determinant of health outcome measures. This study examines and presents some of the important health outcomes amongst the higher and lower socioeconomic groups within the urban poor.

SETTING:

Data analysis is based on a Health and Demographic Survey conducted in urban squatter settlements of Karachi in 1996.

METHODS:

A structured questionnaire was administered to all households in the catchment area. The indicator used to assess economic status is ownership of assets.

RESULTS:

Comparison between the two economic levels shows that the lower socio-economic group was more likely to experience child mortality, (CI; 1.02-1.29, p …

Annual Report To The Nation On The Status Of Cancer, 1973–1996, With A Special Section On Lung Cancer And Tobacco Smoking, Phyllis A. Wingo, Lynn A. G. Ries, Gary A. Giovino, Daniel S. Miller, Harry M. Rosenberg, Donald R. Shopland, Michael J. Thun, Brenda K. Edwards

Public Health Resources

Background: The American Cancer Society, the National Cancer Institute (NCI), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS), provide the second annual report to the nation on progress in cancer prevention and control, with a special section on lung cancer and tobacco smoking.
Methods: Age-adjusted rates (using the 1970 U.S. standard population) were based on cancer incidence data from NCI and underlying cause of death data compiled by NCHS. The prevalence of tobacco use was derived from CDC surveys. Reported P values are two-sided.
Results: From 1990 through 1996, cancer incidence …

Substance Abuse Prevention: Could An Improved D.A.R.E. Program Help Bridge The Gap Between Research And Practice?, Colomba Sirica

National Health Policy Forum

This issue brief provides background information on the popular Drug Abuse Resistance Education (D.A.R.E.) program, begun in 1983 and supported by education and law enforcement communities throughout the country to provide drug abuse prevention programs in schools. It describes recent efforts to conduct evaluative studies to assess the short- and long-term impact of the D.A.R.E. curriculum on drug-using behavior of children and youth and the new dialogue opening between D.A.R.E. proponents and the research community.

Hipaa As A Regulatory Model: Early Experiences And Future Prospects, Karl Polzer

National Health Policy Forum

In the context of the debate over bolstering consumer protection in health care without imposing excessive costs or onerous regulatory requirements, this paper examines the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as a regulatory model. The paper reviews the provisions of the legislation, examines the roles of the Department of Labor and the Health Care Financing Administration in implementing HIPAA, raises issues surrounding implementation and enforcement, and examines the usefulness of the HIPAA model as a vehicle for applying consumer protection measures.

Margins As Measures: Gauging Hospitals' Financial Health, Karen Matherlee

National Health Policy Forum

Recognizing the considerable controversy over ways to measure hospitals' financial viability, this issue brief reviews various ways to assess their fiscal strength. The paper looks first at operating margins, traditional measures that some experts say are inadequate when considered alone. It then explores several recommendations: (a) net income, liquidity and cash flow, and debt burden, suggested by the National Advisory Panel; (b) factors that determine year-to-year changes in hospitals costs, such as hospital input price inflation, changes in care patterns, and the complexity of patients treated, put forth by the Medicare Payment Advisory Commission; and (c) 35 financial indicators and …

Examining The Links Between Retirement And Health Insurance: Implications For Medicare Eligibility, Nora Super

National Health Policy Forum

This issue brief examines trends in labor force participation and health care coverage for early retirees, as well as the relationship between retirement and health insurance and health status.

Knotted Log Rolls Off Truck And Kills Logger At Sawmill, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 42-year-old logger (the victim) was killed when he was struck by a log rolling off a loaded truck at a sawmill. At about 6:10 a.m., the victim and the truck driver arrived at the sawmill with a load of logs on the 20-foot flatbed truck. The stack of logs was rounded above the height of the 53-inch standards and secured by only one chain on the middle of the load. When they arrived, the victim got out of the truck and assisted the driver in backing the vehicle into place for unloading. The victim was in view of the …

Screening Seniors For Risk Of Functional Decline: Results Of A Survey In Family Practice, Dawn M. Dalby, John W. Sellors, Fred D. Fraser, Catherine Fraser, Cornelia Van Ineveld, Laura Pickard, Michelle Howard

Kinesiology and Physical Education Faculty Publications

To measure functional status, determine risk of functional decline and assess consistency between responses and standardized instruments. Design: A mailed survey which measured functional impairment, recent hospitalization and bereavement. A positive response on at least one of these factors indicated that the individual was “at risk” for functional decline. A random sample (n=73) of “at risk” subjects (specifically, family practice patients aged 70 and older) were assessed by a nurse. Results: The response rate was 89% (369/415), 59% of seniors were female and the mean age was 77.1 (SD=5.5) years. Self-reported risk, based on activities of daily living (ADLs), was …

Providing Outpatient Prescription Drugs Through Medicare: Can We Afford To? Can We Afford Not To?, Robin J. Strongin

National Health Policy Forum

The continuing debate over the issue of Medicare coverage for outpatient prescription drugs gave rise to this background paper, which discussed several key questions: Whose responsibility is it to provide coverage? Who should be covered? What should be covered? Who should pay for prescription drug coverage? How should costs be controlled? In addition, the paper explored options for structuring a Medicare outpatient prescription drug benefit. It also contained a glossary.

Welfare Reform And Its Impact On Medicaid: An Update, Judith D. Moore

National Health Policy Forum

Welfare reform, enacted in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), had a profound impact on the Medicaid program, delinking Medicaid from the new TANF program and for the first time allowing Medicaid eligibility to be divorced from welfare status. This paper reviews the national impact of this decoupling, describing research, implementation activities, and the impact of new state welfare programs on health programs in general.

Log Rolls Off Truck At Sawmill Killing Employee, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

In December 1998, a 31-year-old male (the victim) sawmill employee was killed when struck by a log that rolled off the top of the truck. He was preparing the truck to be unloaded when the log rolled off. While most of the logs received by the sawmill were delivered by independent loggers, the company did own one boom truck that their employees used to pick up timber. This was the truck the victim was driving the day of the incident. At the time of the incident, he was working alone.

When the victim returned to the sawmill, the logs were …

Lumber Company Employee Falls 48" From Storage Rack To His Death, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

In October 1998, a 58-year-old male truck driver/yard worker died of traumatic head injuries when he fell 48" from a storage rack. The employee had climbed onto the storage rack to retrieve 3/4" round molding, 8 feet in length for a customer to load into his truck. The employee placed his feet on pine boards that were being stored on the middle row and was trying to retrieve molding being stored above (approximately 9 feet off the floor). After he cut the bundle string to release the individual molding pieces, he began to pull the pieces out which were being …

Biological Terrorism: Is The Health Care Community Prepared?, Robin J. Strongin

National Health Policy Forum

This issue brief provides an overview of biological warfare and discusses the role of the Centers for Disease Control (CDC) and state health departments in detecting biologic agents. The brief also highlights the issue of threat assessment and discusses ways to improve the current level of preparedness as well as steps needed to convert the public health system into our best form of civil defense.

Medicare Hmo Pullouts: What Do They Portend For The Future Of Medicare+Choice?, Nora Super

National Health Policy Forum

National policymakers became alarmed in the fall of 1998 when, contrary to expectations, nearly 100 Medicare HMOs announced their decisions to pull out of Medicare in certain areas or to reduce their service areas. This issue brief explores the reasons plans withdrew from certain areas, the Balanced Budget Act of 1997 provisions that most directly influenced these decisions, the impact of the withdrawals on Medicare beneficiaries, and policy options for ensuring the viability of the Medicare+Choice program.

Exposure To Atmospheric Radon, Daniel J. Steck, R. William Field, Charles F. Lynch

Physics Faculty Publications

We measured radon (²²²Rn) concentrations in Iowa and Minnesota and found that unusually high annual average radon concentrations occur outdoors in portions of central North America. In some areas, outdoor concentrations exceed the national average indoor radon concentration. The general spatial patterns of outdoor radon and indoor radon are similar to the spatial distribution of radon progeny in the soil. Outdoor radon exposure in this region can be a substantial fraction of an individual's total radon exposure and is highly variable across the population. Estimated lifetime effective dose equivalents for the women participants in a radon-related lung cancer …

Log Rolls Off Truck At Sawmill Killing The Truck Driver, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

In November 1998, a 32-year-old male truck driver was killed when he was struck by a log that rolled off the top of his tractor trailer truck while preparing the truck for unloading at a sawmill complex. The victim accompanied by his father, had picked up a load of logs and transported them approximately 220 miles to the sawmill complex. He arrived at the mill with the logs secured by straps and stacked well above the standards of the trucks trailer. He drove to an unloading area. The victim and his father exited the truck and while the father waited …

Filling The Geriatric Gap: Is The Health System Prepared For An Aging Population?, Janet Firshein

National Health Policy Forum

This issue brief explores the field of geriatrics, the ways practitioners meet the health care needs of the elderly, training gaps, and the impact of Medicare payment policies on the delivery of health care to older Americans.

Farmer Killed When Tractor Punctures Gas Line Causing An Explosion, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 62-year-old male was killed when the tractor he was operating punctured an aboveground gas line. He had recently moved to the area and was in the process of acquiring some land for farming. The land was overgrown with weeds and brush about 5 feet high. On a warm, clear afternoon he went out to clear the land with a tractor and rotary mower. Although the incident was unwitnessed, apparently he began mowing the field near a roadway and was likely on the third pass when the front of the tractor ran into an aboveground valve of a natural gas …

State Laws On Tobacco Control – United States, 1998, Julie Fishman, Harmony Allison, Sarah Knowles, Burke Fishburn, Trevor A. Woollery, William T. Marx, Dana M. Shelton, Corinne G. Husten, Michael Eriksen

Public Health Faculty Publications

Problem/Condition: State laws addressing tobacco use, the leading preventable cause of death in the United States, are summarized. Laws address smoke-free indoor air, minors’ access to tobacco products, advertising of tobacco products, and excise taxes on tobacco products.

Reporting Period Covered: Legislation effective through December 31, 1998. Description of System: CDC identified laws addressing tobacco control by using an on-line legal research database. CDC’s findings were verified with the National Cancer Institute’s State Cancer Legislative Database.

Results: Since a previous surveillance summary on state tobacco-control laws published in November 1995 (covering legislation effective through June 30, 1995), several states have …

Farm Tractor Safety In Kentucky, 1995, Steven R. Browning, Susan C. Westneat, Helena Truszczynska, Deborah Reed, Robert Mcknight

Preventive Medicine and Environmental Health Faculty Publications

Objective: Tractor rollovers are a major cause of farm injuries and fatalities. The authors used data from a statewide surveillance study to estimate the prevalence of safety features such as rollover protective structures, seat belts, and power take-off shields on farm tractors in Kentucky.

Methods: Using data from the Farm Family Health and Hazard Surveillance Project, the authors report on the prevalence of farm tractor safety features by size of farm, by region of the state, by number of tractors per farm, and by tractor age and estimate the prevalence of tractors equipped with rollover protection by region and for …

Kentucky Partnership For Farm Family Health And Safety Coloring Book, The Kentucky Partnership For Farm Family Health And Safety

Nursing Faculty Publications

No abstract provided.

Evaluating The Program Of A Community Grassroots Organization, The Kentucky Partnership For Farm Family Health And Safety

Nursing Faculty Publications

No abstract provided.

Mobilizing The Community To Form And Sustain A Grassroots Organization, The Kentucky Partnership For Farm Family Health And Safety

Nursing Faculty Publications

No abstract provided.

Concepções De Doença Por Familiares De Pacientes Com Diagnóstico De Esquizofrenia: Illness Conceptions Among Relatives Of Patients Diagnosed With Schizophrenia, Cecilia C. Villares, Cristina Redko, E Jair J. Mari

Population and Public Health Sciences Faculty Publications

Family conceptions of the nature of their relative's illness are part of the coping process and reveal the cultural construction of the illness experience. As part of a larger qualitative study conducted at the Schizophrenia Program of the Department of Psychiatry, Escola Paulista de Medicina - Unifesp, 14 relatives of 8 out-patients diagnosed with schizophrenia were interviewed and invited to talk freely about their ideas and feelings concerning their relative's problem. Qualitative analysis was conducted to elicit categories of illness representations. Three main categories are presented for discussion, Problema de Nervoso, Problema na Cabeça and Problema Espiritual (Nerves, Head and …

Assessing The Potential Demand For And Effectiveness Of Integrating Sti/Hiv Management Services With Zimbabwe National Family Planning Council's Clinic-Based Family Planning Services, Baker Ndugga Maggwa, Ian Askew, Hazel M.B. Dube, Caroline S. Marangwanda, Sithokozille Simba, Ahmed Latif

Reproductive Health

HIV/AIDS is a threat to individual lives and the national economies of many sub-Saharan African countries, despite efforts to contain its spread. The region also suffers from high levels of other reproductive tract infections (RTIs), some of which increase the risk of sexual transmission of HIV. The control of RTIs is therefore seen not only as an important reproductive health care strategy, but as a key strategy in reducing the spread of HIV/AIDS. Most national health care programs in the region are actively seeking cost-effective ways of implementing an RTI management program that would reduce and prevent RTIs and HIV. …

The Continuing Decline In Medicaid Coverage, Leighton Ku, Brian K. Bruen

Health Policy and Management Faculty Publications

No abstract provided.