Medicine and Health Sciences Commons^™

In The Affirmative, Vol.5, No.7 (Mid-July/ Mid-September 1998), Mike Martin, The Aids Project

In the affirmative (1993-1999)

No abstract provided.

Medicare Coverage And Technology Diffusion: Past, Present, And Future, Robin J. Strongin

National Health Policy Forum

This issue brief provides an overview of the Medicare coverage process. Coverage involves deciding whether or not to pay for a particular service or product. This brief examines Medicare's coverage determination process, which includes technology assessment, payment determination, and the demand for evidence. Options for improving the coverage determination process are reviewed.

Measurement Of Hospital Performance: Environmental And Organizational Factors Associated With Cost, Debra Kay Dierksmeier Anderson

Health Services Research Dissertations

As U.S. health care expenditures top the $1 trillion mark, there is increased interest in measuring the performance of health care providers. For bottom line oriented payors such as government and business, the focus is on measuring cost. As hospitals account for over one-third of health care expenses, hospital cost per admission is a common measure of performance.

Many environmental and organizational factors come into play in determining hospital cost per admission. This research examines several of these factors, using Raymond Zammuto's model of organizational effectiveness assessment. Using Zammuto's framework, this research looks at the relationship of social, physical, and …

Erisa Health Plan Denials: Exploring Models For External Review, Karl Polzer

National Health Policy Forum

This paper outlines the current process under the Employee Retirement Income and Security Act (ERISA) by which plan participants can appeal a claim denial as well as changes to the claims procedure requirements being considered by the Department of Labor. It describes state legislative activity in this area and summarizes research describing practices currently in place among managed health care organization. The paper also describes two existing models for external review of managed care plan decisions, one used by the Medicare program and another by the state of Florida.

Educational Attainment, Non-English Language Usage, And Ability To Communicate In English In 30 Massachusetts Cities/Towns, Edward C. Besozzi, Carole C. Upshur

Gastón Institute Publications

Data regarding an individual's ability, or the ability of members of a household to speak English, primary language spoken at home, educational attainment, and the level of literacy proficiency should be taken into consideration when designing and implementing policies regarding health care initiatives and the publication of health care information. This report highlights data collected from three sources: 1) The National Adult Literacy Survey; 2) The 1990 Federal Census; and 3) The Massachusetts Institute for Social and Economic Research.

Commencement Program 1998, Loma Linda University

Commencement Programs

2 | 1998 Events of Commencement

3 | The Academic Procession

4 | The Speakers

8 | The University Honorees

16 | The School Honorees

26 | The Zapara Award

The Programs

• School of Medicine, 28
• School of Dentistry, 35
• Graduate School, 43
• School of Nursing, 52
• School of Allied Health Professions, 57
• School of Allied Health Professions (Physical Therapy), 65
• School of Public Health, 71

Health Risk Behaviors Among Maine Youth : Results Of The 1997 Youth Risk Behavior Survey, Grades 7-12, Chuck Rhoades

Maine Collection

Health Risk Behaviors Among Maine Youth : Results of the 1997 Youth Risk Behavior Survey, Grades 7-12

Prepared for the Maine Department of Education by Chuck Rhoades of CERES Associates, Inc., Survey Administered by Pan Atlantic Consultants / Strategic Marketing Services (June, 1998).

Contents: Introduction / Methodology / Demographics / Safety, Violence & Suicide / Alcohol, Drug & Tobacco Use / Sexual Behaviors / Health Care, Physical Activity & Nutrition / References

Review Of: Allan Mazur, A Hazardous Inquiry: The Rashomon Effect At Love Canal, Thomas G. Field Jr.

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

Review of: Allan Mazur, A Hazardous Inquiry: The Rashomon Effect at Love Canal (Harvard University Press 1998). Abbreviations,, appendices: Chron- ology and The Basics of Toxicology, bibliography, chronology, figures, index, photos, references. LC 97-44639; ISBN 0-674-74833-6 [255+xiv pp. $26.00 Cloth, 79 Garden Street; Cambridge MA 02138.]

Nuclear Waste And Native America: The Mrs Siting Exercise, M. V. Rajeev Gowda, Doug Easterling

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

Drs. Gowda & Easterling provide cross-cultural perspectives on issues of risk perception, equity and policy as they affect nuclear waste storage on Native American sites.

Causation In Occupational Disease: Balancing Epidemiology, Law And Manufacturer Conduct, Richard M. Lynch, Mary S. Henifin

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

Drs. Lynch & Henefin examine evolution of disease causation theory and its impact on public health, as well as how these relate to the courtroom admissibility of expert opinion evidence.

The Relationship Between Tamoxifen And Depressive Symptoms In Women With Breast Cancer, Terry Marie Lynn

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine whether women with breast cancer and the presence of the drug tamoxifen, are more severely depressed than women with breast cancer and the absence of tamoxifen. Average Beck Depression Inventory (BDI) scores did not differ between the two sub-groups; however, two significant group differences were found. First, 10 women in the tamoxifen group had scores of zero (versus 4 in the absence of prescribed tamoxifen group). Research has shown that scores of zero do not always reflect an absence of depression. Second, the most severely depressed women (BDI scores in the 25 …

The Relation Of Weight Loss And Improved Fitness To Survival In Healthy Males, Joanna Lynn Bokovoy

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a critical public health problem because of its prevalence, medical and psychosocial effects, and resistance to intervention. Weight loss in overweight individuals has been encouraged by the United States Public Health Service and by the medical community as a means for improving health. However, recent studies have suggested either positive or negative effects of weight loss on survival. It is possible that physical fitness may have a confounding effect, or be an effect modifier on survival in weight loss studies.

This study used Cox Regression analysis to address the separate and combined association of weight loss and improved …

Nursing Home Ownership And Public Policy: An Historical Analysis, K. R. Kaffenberger

Graduate Doctoral Dissertations

In the early days of the United States, care of the disabled elderly outside the home meant the public almshouse. By the 1920s, private, nonprofit homes for the aged were prevalent. More recently, private, for-profit facilities have grown to dominate the field.

For-profit ownership has been controversial. Underlying the controversy is the concern that quality might be lowered in order to enhance profit.

This study asks why most nursing homes are privately owned and why most privately owned nursing homes are operated for profit. It does so with reference to The Nonprofit Economy, in which Burton Weisbrod describes a …

Development And Testing Of A Quantitative Food Frequency Questionnaire For Use In Kerala, India, James R. Hébert, Prakash C. Gupta, Ramesh B. Bhonsle, P. R. Murti, Hemali Mehta, Florence Verghese, Mira Aghi, Kamala Krishnaswamy, Fali S. Mehta

Faculty Publications

Objective: To develop and test a food frequency questionnaire (FFQ) for use in rural areas of Kerala, India. Design: Based on food use and market surveys of the study area, a quantitative 81- item interviewer-administered FFQ was developed. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 8 days randomly selected over an entire year and two administrations of the FFQ, one at the beginning of the l-year period and the other at the end. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by examining differences in the nutrient scores. Setting: …

Site Visit To New Jersey — State And County Experiences With Welfare Reform And Access To Health Care, Michael Anzick, Richard Hegner

National Health Policy Forum

This site visit was the second in a series to examine what is occurring at the state and local level with respect to welfare reform, Medicaid, public health, and safety net and other supportive services. During this visit, policymaker discovered how state officials, directors, and front-line staff at urban and suburban county welfare offices are working with clients to move them off the welfare rolls into jobs and providing the support services necessary for job retention; heard from clients about how programmatic changes are affecting them and their families; learned how the role of safety net health care and temporary …

Farmer Run Over By Tractor, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

An 80-year-old male farmer (the victim) died when he was run over by the right rear wheel of his tractor. He had backed the tractor to the door of a shed in order to hook a tiller to it. After parking the tractor on a slight incline in front of the shed, he left it in neutral while he went inside for the tiller. The parking brake did not hold, however, and the tractor began to roll. He apparently noticed this and tried to remount the tractor, but was knocked down by the wheel and run over. To prevent similar …

How Do Hmos Achieve Savings? The Effectiveness Of One Organization's Strategies., Ann B. Flood, Allen M. Fremont, K Jin, David M. Bott

Dartmouth Scholarship

To examine how a group practice used organizational strategies rather than provider-level incentives to achieve savings for health maintenance organization (HMO) compared to fee-for-service (FFS) patients. A large group practice with a group model HMO also treating FFS patients. Data sources were all patient encounter records, demographic files, and clinic records covering 3.5 years (1986-1989). The clinic's procedures to record services and charges were identical for FFS and HMO patients. All FFS and HMO patients under age 65 who received any outpatient services during approximately 100,000 episodes of the seven study illnesses were eligible.

The Effects Of Managed Care On The Quality Of Dental Hygiene Care, Marybeth Magner

Masters Theses & Specialist Projects

Managed care has become a prominent mechanism for insuring dental care. Empirical research suggests that managed dental plans provide lower quality care to patients. However, few studies have specifically addressed the effects of managed care on the quality of dental hygiene care. Thus, in this study the researcher examines whether dental hygienists deliver a lower level of treatment to managed care patients than to those who are not subject to managed care. Questionnaire data were gathered from 193 members of the American Dental Hygienists' Association residing in the Chicago area. The primary independent variable, managed care, was measured with an …

In The Affirmative, Vol.5, No.4 (Mid-April/Mid-May 1998), Mike Martin, The Aids Project

In the affirmative (1993-1999)

No abstract provided.

Dual Diagnoses: The Challenge Of Serving People With Concurrent Mental Illness And Substance Abuse Problems, Richard Hegner

National Health Policy Forum

This paper describes the prevalence of comorbid mental disorders in the population and discusses what is known about causality and relapse. The relationship between dual diagnosis and homelessness and crime is also discussed. The paper also explores options for improving treatment among the dually diagnosed.

Electrician Dies In 6-Foot Fall From Ladder, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 51-year-old male electrician (the victim) died after falling approximately six feet to the concrete floor of a fertilizer plant. The victim had been doing electrical work while standing on an aluminum extension ladder at a switch box attached to a steel post near a rear exit of the plant. His co-worker, who was approximately 20 feet away, heard him hit the floor, but did not see him fall. The co-worker ran for help. A 911 call was placed at 8:46 am, and Emergency Medical Services (EMS) personnel arrived in three minutes. The victim was transported to the local hospital, …

Increasing The Federal Cigarette Tax: A Means Of Reducing Consumption?, Lauren Tran, Richard Hegner

National Health Policy Forum

This issue brief probes the economic issues associated with tobacco and cigarettes. It examines the possible effectiveness of a tax increase as a strategy to reduce cigarette consumption, especially among young people, and the likely ramifications of a tax increase for the tobacco industry.

Allopurinol As An Additive To Quinine In The Treatment Of Acute Complicated Falciparum Malaria, P. S. A. Sarma, Anil K. Mandal, Harry Khamis

Population and Public Health Sciences Faculty Publications

The emergence of chloroquine resistance, and a world-wide scarcity of quinine, have resulted in a search for newer antimalarial drugs directed against falciparum malaria. Allopurinol causes virtually complete inhibition of purine biosynthesis of malaria parasites, which may prove lethal to the parasites. This study was designed to examine if allopurinol is additive to quinine in the treatment of acute falciparum malaria. Forty-seven Asian-Indian adults with acute complicated falciparum malaria were assigned to a treatment period of five days. They were randomly assigned to receive either oral allopurinol (12 mg/kg in three divided doses for five days) plus quinine (600 mg …

Impact On Material And Child Health Knowledge As A Result Of Participation In A Family Resource\Youth Services Center New And Expectant Parenting Series, Donna Sims

Masters Theses & Specialist Projects

The purpose of this study was to determine whether participation in a Family Resource\Youth Services Center New and Expectant Parenting Series had an impact on maternal and child health knowledge of parents and their future behavior choices. The study had two components. First, a telephone survey was conducted with 40 past program participants asking them nine questions concerning behavior and lifestyle choices in regards to child safety, breast or bottle feeding, immunizations, car seat use, etc. Secondly, thirty participants were given a pretest and posttest questionnaire. As a control group, there were 25 Lamaze class participants, who also completed the …

Treatment Outcome Of Personality Disorders, Charles A. Sanislow, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To review the treatment outcome of personality disorders.

Method: A literature search of studies pertaining to personality disorder and outcome was conducted, and studies that focused primarily on Axis II were retained. Of these, naturalistic outcome studies were distinguished from those that addressed treatment outcome specifically. The treatment outcome studies were examined in terms of type of treatment intervention, dependent variables, and outcome.

Results: Contrary to contemporary assumptions about Axis II, a substantial number of treatment outcome studies were identified. Trends in the assumptions underlying psychosocial and pharmacologic approaches were identified on the basis of dependent variables.

Conclusion: There …

Restructuring The Va Health Care System: Safety Net, Training, And Other Considerations, Barbara Skydell

National Health Policy Forum

This paper provides an historical overview of the modern Veterans Administration (VA) healthcare system and describes the multiple missions of the VA — patient care, health professions education, research, and medical preparedness. The VA's reform plan, which addresses issues related to decentralization, management and oversight, resource allocation, eligibility reform, and primary/ambulatory care, is also described and discussed. Challenges facing the VA as it transitions to a greater focus on prevention, primary care, and care management are also addressed.

Dengue Fever - A Public Health Problem Along The Texas-Mexico Border, Frank Cortez Flores

Frank Cortez Flores

My primary public health interest is the reemerging arboviral infections (e.g., dengue) that are increasing in incidence, expanding into new geographic areas, affecting new populations, and are threatening to increase in the near future, especially following a natural disaster (e.g., hurricanes). The goal of the dengue lecture series is to promote the recognition of dengue and dengue hemorrhagic fever and improve the understanding of factors involved in prevention, surveillance and control of the Aedes aegypti mosquito, the principal mosquito vector of dengue virus. The purpose of these lectures is to accelerate learning and development of an effective dengue prevention and …

The Federal Employees Health Benefits Program: What Lessons Can It Offer Policymakers?, Karl Polzer

National Health Policy Forum

This paper provides an historical overview of the Federal Employees Health Benefits (FEHB) program and its marketplace dynamics. It also reviews key program features and issues, including payments to health plans, strategies used to mitigate the opportunities for risk selection, and costs.

Interprofessional Working And Continuing Medical Education., Linda Headrick, Peter Wilcock, Paul Batalden

Dartmouth Scholarship

No abstract provided.

Site Visit To Philadelphia — Providing Community-Based Primary Care: Nursing Centers, Chcs, And Other Initiatives, Karen Matherlee

National Health Policy Forum

This site visit provided federal congressional and agency health staff opportunities to visit facilities and engage in discussions on essential community health services. Focused on community-based primary care in a managed care environment, it featured delivery and financing concerns relating to nursing centers, community health centers, public-mission hospitals, and homeless services. In examining the impact of managed care in a rapidly changing health marketplace, it explored the implementation of the Medicaid HealthChoices program in the city as well as access to and delivery of care to persons with neither public nor private insurance. It also looked at the role of …