Medicine and Health Sciences Commons^™

Applying Lean Manufacturing Techniques To Improve The Performance Of An Emergency Department, Ramesh Pondhe

All-Inclusive List of Electronic Theses and Dissertations

The research was an attempt to apply lean manufacturing (LM) techniques, to the healthcare setting specifically to Emergency Department (ED) of a local hospital and to improve its performance. An ED is meant to attend/provide immediate care to a patient who needs medical care immediately and also balancing the care to patients with lesser acuity who arrive at the ED for treatment. The data was collected from the ED by direct observation. The data was statistically analyzed to find out the bottlenecks in the process during the course of a patient's treatment to further provide solutions and improve the performance …

Agricultural Pesticide Use And Risk Of T(14;18)-Defined Subtypes Of Non-Hodgkin Lymphoma, Brian C.-H. Chiu, Bhavana J. Dave, Aaron Blair, Susan M. Gapstur, Shelia Hoar Zahm, Dennis D. Weisenburger

United States Public Health Resources

Pesticides have been specifically associated with the t(14;18)(q32;q21) chromosomal translocation. To investigate whether the association between pesticides and risk of non-Hodgkin lymphoma (NHL) differs for molecular subtypes of NHL defined by t(14; 18) status, we obtained 175 tumor blocks from case subjects in a population-based case-control study conducted in Nebraska between 1983 and 1986. The t(14;18) was determined by interphase fluorescence in situ hybridization in 172 of 175 tumor blocks. We compared exposures to insecticides, herbicides, fungicides, and fumigants in 65 t(14;18)-positive and 107 t(14;18)-negative case subjects with those among 1432 control subjects. Multivariate polytomous logistic regression was used to …

An Experimental Study Of The Effectiveness Of Three Safety Training Delivery Methods And The Knowledge Gained During A Workplace Violence Safety Program, Shoji Nakayama

All-Inclusive List of Electronic Theses and Dissertations

Due to the numerous advantages of electronic media, many companies have begun to incorporate online courses as a means of delivering corporate training, including corporate safety training. Consequently, researchers are beginning to investigate the effectiveness of online training over traditional face-to-face training methods. Many studies have indicated that results of training programs conducted over the Internet are equivalent to those results obtained from traditional face-to-face training. At the same time, other literature indicates that face-to-face training is better than Internet training due to the level of interaction between students and instructor. Some investigations on this subject have been conducted within …

College Students And Gambling: Gauging The Effects Of Gender On Impulse Control, Sensation Seeking, And Mental Health As Predictors Of Involvement, Terry D. Burger

All-Inclusive List of Electronic Theses and Dissertations

The main purpose of the current study was to enhance the global understanding of adolescent Internet gambling involvement by examining rates of participation and the influence of impulse control, sensation seeking, and mental health problems as predictors of involvement. In addition to a demographic survey to gather information including year in school, age, gender, mode of gambling participation (online vs. traditional venues), age gambling participation began (for both non-Internet and Internet modes), disposable income, and hours spent online each week, the current research study questionnaire was comprised of a three standardized instruments: {a) the South Oaks Gambling Screen (SOGS); (b) …

Determinants Of Long-Term Care Service Utilization By Mexican-American Family Caregivers, Angelica P. Herrera

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: Participation in long-term care services may prevent the deterioration of family caregivers' mental and physical health, yet research suggests that Latino caregivers may forego using long-term care services in the absence of other barriers to long-term care use (e.g., lack of insurance).

Methods: An adapted version of the Andersen Model of Health Care Service Utilization served as a framework for examining familism, acculturation, gender roles, religiosity, and knowledge and perceptions about long-term care, as potential determinants of long-term care service use, alongside other factors known for their association with long-term care use (e.g. functional status of care recipient, caregiver …

Insights From The 2006 Disease Management Colloquium, David B. Nash, Robert A. Greene, Ronald R. Loeppke, Nancy Mccall, Tracey Moorhead

College of Population Health Faculty Papers

This roundtable discussion emanates from the presentations given and issues raised at the 2006 Disease Management Colloquium, which was held May 10–12, 2006 in Philadelphia, Pennsylvania.

Examining The Structural Covariates Of Methamphetamine Use: A Social Disorganization Perspective, Justin Smith

Masters Theses

There have been many anecdotal accounts describing the characteristics of individuals involved in methamphetamine use, trafficking and production. However, prior to the current study there was yet to be a macro-level analysis of methamphetamine use. The extant macro-level literature on drug use has suggested that areas with high levels of social disorganization experience high rates of drug use. It was expected that school-districts with low SES and high rates of ethnic heterogeneity, residential instability and family disruption will experience high rates of methamphetamine use. In addition, it was expected that rural school districts would show higher rates than urban and …

The Clinical Research Forum And Association Of American Physicians Disagree With Criticism Of The Nih Roadmap, William Crowley Jr, John Courtney, Larry Jameson, Herbert Pardes, Jay Moskowitz, Eugene Orringer, Arthur Rubenstein, Alastair Wood, Richard Rettig, Dennis Ausiello, David Brenner, Francis Collins, Jack Elias, Warner Greene, Ralph Horowitz, Larry Jameson, Elliott Kieff, Craig Thompson, Judith Swain

Faculty Publications

No abstract provided.

Mechanisms Of Sickle Cell Anemia, Gary M. Onady, Lawrence Prochaska, John F. Donnelly, John Paietta, Dean Parmelee, Barbara Schuster

Family Medicine Faculty Publications

Team-based learning (TBL) is a well-defined instructional strategy that allows a single instructor to teach by conducting multiple small groups simultaneously in the same classroom. Learners actively participate in and out of class as they move through three phases: independent study assignments, readiness assurance testing, and group activities that force them to put knowledge into practice. Students prepare in advance by reading an assigned article. Class time is shifted away from learning facts and toward application and integration of information. The instructor retains control of content and acts as both facilitator and content expert. This TBL program is designed to …

Obesity, Physical Activity, And Mortality In A Prospective Chinese Elderly Cohort, Mary Schooling, Tai Hing Lam, Zhi Bin Li, Sai Yin Ho, Wai Man Chan, Kin Sang Ho, May Ked Tham, Benjamin J. Cowling, Gabriel M. Leung

Publications and Research

Background
In older people, it is unclear whether obesity relates to mortality, which calls into question its etiologic role in disease and its public health relevance. This apparent lack of relationship in older people could be an artifactual result of their diverse health states.

Methods
We used Cox regression analysis to determine whether the effect of body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) or physical activity on mortality varied with health status in a prospective cohort study of Chinese people 65 years or older enrolled from 1998 to 2000 at …

Relative Risk Regression In Medical Research: Models, Contrasts, Estimators, And Algorithms, Thomas Lumley, Richard Kronmal, Shuangge Ma

UW Biostatistics Working Paper Series

The relative risk or prevalence ratio is a natural and familiar summary of association between a binary outcome and an exposure or intervention. For rare events, the relative risk can be approximately estimated by logistic regression. For common events estimation is more difficult. We review proposed estimation algorithms for relative risk regression. Some of these give inconsistent estimates or invalid standard errors. We show that the methods that give correct inference can be viewed as arising from a family of quasilikelihood estimating functions for the same generalized linear model, differing in their efficiency and in their robustness to outlying values …

Premium Assistance In Medicaid And Schip: Ace In The Hole Or House Of Cards?, Cynthia Shirk, Jennifer Ryan

National Health Policy Forum

This issue brief explores the use of premium assistance in publicly financed health insurance coverage programs. In the context of Medicaid and the State Children’s Health Insurance Program (SCHIP), premium assistance entails using federal and state funds to subsidize the premiums for the purchase of private insurance coverage for eligible individuals. This paper considers the evolution of premium assistance and some of the statutory and administrative limitations, as well as private market factors, that have prevented widespread enrollment in Medicaid or SCHIP premium assistance programs. Finally, this issue brief offers some ideas for potential legislative and/or programmatic changes that could …

Investigating Mediation When Counterfactuals Are Not Metaphysical: Does Sunlight Uvb Exposure Mediate The Effect Of Eyeglasses On Cataracts?, Brian Egleston, Daniel O. Scharfstein, Beatriz Munoz, Sheila West

Johns Hopkins University, Dept. of Biostatistics Working Papers

We investigate the degree to which a reduction in ocular sunlight ultra-violet B (UVB) exposure mediates a relationship between wearing eyeglasses and a decreased risk of cataracts. An estimand is proposed in which causal effects are estimated locally within strata based on potential UVB exposure without glasses and the degree to which glasses use reduces UVB exposure. We take advantage of the structure of the data in which the counterfactual UVB exposures if the participants in the study who wore glasses had not worn glasses are considered observable.

Don't Bring Me Your Tired, Your Poor: The Crowded State Of America's Emergency Departments, Jessamyn Taylor

National Health Policy Forum

If the time comes, people expect that the emergency department (ED) will have the resources necessary to treat them in a timely, high-quality manner. Increasingly, however, EDs may not be able to meet that expectation. Hospitals in urban areas with large populations, high population growth, and higher-than-average numbers of uninsured are particularly crowded: ambulances are often diverted to other hospitals and patients are frequently forced to “board” in the hallways (while they wait to be transferred to another facility or part of the hospital). This issue brief places EDs in the context of the U.S. health care system and its …

Aboriginal Health Workers And Diabetes Care In Remote Community Health Centres: A Mixed Method Analysis, Damin Si, Ross S. Bailie, Samantha J. Togni, Peter H N D'Abbs, Gary W. Robinson

Aboriginal Policy Research Consortium International (APRCi)

Objective: To assess the effect of employing Aboriginal health workers (AHWs) on delivery of diabetes care in remote community health centres, and to identify barriers related to AHWs’ involvement in diabetes and other chronic illness care.

Design, setting and participants: Three-year follow-up study of 137 Aboriginal people with type 2 diabetes in seven remote community health centres in the Northern Territory.

Main outcome measures: Delivery of guideline-scheduled diabetes services; intermediate outcomes (glycated haemoglobin [HbA1c] and blood pressure levels); number and sex of AHWs at health centres over time; barriers to AHWs’ involvement in chronic illness care.

Results: There was a …

Causal Comparisons In Randomized Trials Of Two Active Treatments: The Effect Of Supervised Exercise To Promote Smoking Cessation, Jason Roy, Joseph W. Hogan

COBRA Preprint Series

In behavioral medicine trials, such as smoking cessation trials, two or more active treatments are often compared. Noncompliance by some subjects with their assigned treatment poses a challenge to the data analyst. Causal parameters of interest might include those defined by subpopulations based on their potential compliance status under each assignment, using the principal stratification framework (e.g., causal effect of new therapy compared to standard therapy among subjects that would comply with either intervention). Even if subjects in one arm do not have access to the other treatment(s), the causal effect of each treatment typically can only be identified from …

Measuring The Influence Of Built Neighborhood Environments On Walking In Older Adults, Yvonne L. Michael, Tracey Beard, Dongseok Choi, Stephanie Farquhar, Nichole Carlson

Community Health Faculty Publications and Presentations

Examined the degree of association between perceived and objective characteristics of the neighborhood environment and the relation of each type of measurement to neighborhood walking in older adults. Participants included 105 adults aged 65-92 (mean age 75.1) from 10 neighborhoods in Portland, Oregon, participating in Senior Health and Physical Exercise (SHAPE), a randomized walking intervention. Neighborhoods were stratified by a "walking friendliness" ranking variable. This variable was derived for each neighborhood based on available social and environmental data that were hypothesized to correlate with walking and physical activity: high income, high older adult population density, high proportion of white residents, …

Predictors Of Influenza Immunization Among Home Care Clients In Ontario, John P. Hirdes, Dawn M. Dalby, R. Knight Steel, G. Iain Carpenter, Roberto Bernabei, John N. Morris, Brant E. Fries

Kinesiology and Physical Education Faculty Publications

Background: This study examined factors associated with the receipt of influenza vaccination among Ontario home care clients.

Methods: Home care clients were assessed, as part of a routine home visit, during a pilot study of the Resident Assessment Instrument – Home Care (RAI-HC) in 12 Ontario Community Care Access Centres (CCACs). The RAI-HC is a multidimensional assessment that identifies clients’ needs and level of functional ability. Multiple logistic regression was used to identify factors associated with influenza immunization in the two years prior to assessment.

Results: The overall rate of immunization reached about 80% by 2002. Factors …

Evaluation Of Serum Immunoglobulins Among Individuals Living Near Six Superfund Sites, Dhelia M. Williamson, Mary C. White, Charles Poole, David Kleinbaum, Robert Vogt, Kari North

United States Public Health Resources

Residents living in communities near Superfund sites have expressed concern that releases from these facilities affect their health, including adverse effects on their immune systems. We used data from six cross-sectional studies to evaluate whether people who live near several Superfund sites are more likely to have individual immunoglobulin test results (IgA, IgG, and IgM) below or above the reference range than those who live in comparison areas with no Superfund site. Study participants consisted of target-area residents who lived close to a Superfund site and comparison area residents who were not located near any Superfund or hazardous waste sites. …

Focus On The Future Of Clinical Care, Brian G. Harrison, Robert L. Barchi

Thomas Jefferson University Administrative Documents and Reports

2006 Annual report of Thomas Jefferson University

Jefferson Medical College Annual Report, 2006, Thomas J. Nasca

Jefferson Medical College Administrative Documents and Reports

No abstract provided.

Clark County Child Death Review: 2006 Annual Report, Nevada Institute For Children’S Research And Policy

Nevada Institute for Children's Research and Policy Reports

The primary goal of all Child Death Review Teams is to prevent future child deaths. The child death review process enables jurisdictions to come together in a collaborative, multidisciplinary forum to openly discuss detailed circumstances in an effort to gain a better understanding of child deaths. The team provides a venue for representatives from a variety of both public and private agencies as well as community organizations to share information in a confidential and non-threatening environment. The National Center for Child Death Review (hereinafter, National Center), which is supported by the Maternal and Child Health Bureau of the U.S. Department …

Ahrq Action

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

New Senior Scholars

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Department Publications And Presentations

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Health Policy Forum: Fall 2006

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The 15th Annual Grandon Lecture: Improving Ambulatory Care, Joshua Gagne

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Considering "Faculty Priorities Reconsidered", Sara L. Thier, Kenneth D, Smith

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Whyy Seeks Guidance From Healthcare And Community Leaders, Sara L. Thier

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Einstein-La Salle Nursing Careers Partnership Program, Mary Beth Kingston, Etienne Phipps

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.