Public Health Commons^™

A Clinical Score To Predict Dose Reductions Of Antidiabetes Medications With Intentional Weight Loss: A Retrospective Cohort Study., Ghanshyam Palamaner Subash Shantha, Anita Ashok Kumar, Vimal Ravi, Rohit C Khanna, Scott Kahan, Lawrence J Cheskin

Health Policy and Management Faculty Publications

Abstract

Background

We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: “WIG”) to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss.

Methods

Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed.

Results

Mean period of follow-up was 12.5 ± 3.5 months. To derive the “WIG” scoring algorithm, one point each was assigned to “W” (loss of 5% of initial body weight within the first 3 months of attempting weight loss), “I” (triglyceride [TGL]/highdensity lipoprotein ratio >3 …

Effect Of Ambient Particulate Matter 2.5 Micrometer (Pm2.5) To Prevalence Of Impaired Lung Function And Asthma In Tangerang And Makassar, Budi Haryanto, Budy Resosoedarmo, Sri Tjahjani Budi Utami, Budi Hartono, Ema Hermawati

Kesmas

Emisi partikel debu 2,5 mikrometer (PM2.5) meningkat dengan bertambahnya jumlah penduduk kota akibat peningkatan angka kendaraan bermotor sebagai transportasi penduduk sehari-hari. Penelitian ini bertujuan untuk mengetahui tingkat gangguan fungsi paru dan asma serta hubungannya dengan kadar ambien PM2.5 pada masyarakat migran di Tangerang dan Makassar dan kondisi sosial ekonomi. Desain potong lintang digunakan dengan melibatkan 4.250 dan 2.900 responden di Tangerang dan Makassar pada bulan April sampai September 2010. Pendekatan cluster sampling diterapkan. Pengukuran ambien PM2.5 di masing-masing kota berdasarkan koordinat 40 lokasi Global Positioning System (GPS). Kadar PM2.5 ditemukan lebih tinggi pada pagi hari dibandingkan siang hari di kedua …

Birth Intervals Among Multiparous Women In Indonesia, Dini Kurniawati, Sabarinah Prasetyo

Kesmas

Angka kematian ibu dan angka kematian bayi di Indonesia masih tinggi. Salah satu faktor yang menyebabkan tingginya risiko kematian pada ibu dan bayi adalah kelahiran terlalu dekat. Penelitian ini bertujuan untuk mempelajari determinan jarak antarkelahiran pada perempuan multipara di Indonesia. Penelitian ini menggunakan data Survei Demografi Kesehatan Indonesia tahun 2012 pada 9.945 perempuan multipara. Analisis data menggunakan uji Mann Whitney, Kruskal Wallis, dan regresi logistik. Median jarak antarkelahiran sebesar 62 bulan dan 22,8% perempuan memiliki jarak antarkelahiran kurang dari tiga tahun. Hasil menunjukkan determinan jarak antarkelahiran pendek meliputi pendidikan ibu, usia terakhir melahirkan, ukuran ideal keluarga, pemakaian kontrasepsi, riwayat kematian …

Child Health Improvement Through Implementation Of Food Safety Model, Arief Safari, Machfud Machfud, Eriyatno Eriyatno, Heny Kuswanti Daryanto

Kesmas

Pemenuhan akan pangan merupakan komponen dasar untuk mewujudkan sumber daya manusia yang berkualitas. Namun, masih terdapat permasalahan dalam mewujudkannya, di antaranya masalah keamanan pangan dengan persentase kasus keracunan makanan masih tinggi. Penelitian ini bertujuan untuk menganalisis situasi pelaksanaan keamanan Pangan Jajanan Anak Sekolah (PJAS) yang ada saat ini dan memilih alternatif model keamanan pangan yang paling efektif dan efisien diterapkan di usaha mikro kecil (UMK) guna meningkatkan keamanan pangan yang dihasilkannya sehingga terjadi peningkatan kesehatan anak. Penelitian dilakukan pada kuartal II tahun 2015 sampai dengan awal kuartal III tahun 2015 melalui survei lapangan dan survei pakar dengan mengambil studi kasus …

Housewives’ Compliance In Reading Food Labels In Gorontalo City, Imran Tumenggung, Lucky Herawati, Sofyawati Talibo

Kesmas

Di Indonesia, masalah label pada kemasan makanan kurang mendapat perhatian konsumen. Penelitian ini bertujuan untuk mempelajari determinan kepatuhan membaca label pada kemasan makanan oleh ibu rumah tangga di Kota Gorontalo. Penelitian dengan metode survei ini dilakukan dari bulan Juni sampai Agustus 2013. Data dikumpulkan secara potong lintang dengan menggunakan angket. Variabel terikat adalah kepatuhan membaca label pada kemasan makanan yang terdiri dari label informasi nilai gizi, komposisi makanan, masa kedaluwarsa, harga, dan status halal. Variabel bebas adalah usia, tingkat pendidikan, dan keterpaparan dengan media informasi. Besar sampel 262 orang ditentukan secara accidental technique. Analisis data menggunakan uji kai kuadrat. Hasil …

Husband’S Support Towards Unmet Need Of Hiv Positive-Infected Women Of Childbearing Age, Sophia Sophia, Anita Deborah Anwar, Bony Wiem Lestari

Kesmas

Jutaan wanita usia subur (WUS) dengan HIV positif di negara berkembang saat ini tidak menggunakan kontrasepsi untuk menunda atau mengakhiri kehamilan. Pencegahan kehamilan yang tidak diinginkan pada WUS dengan HIV positif sangat penting untuk meningkatkan kualitas hidup ibu dan anak. Tujuan penelitian ini untuk menganalisis faktor-faktor yang berpengaruh terhadap unmet need pada WUS dengan HIV positif. Metode penelitian adalah cross sectional dengan sampel berjumlah 130 WUS dengan HIV positif yang diambil secara consecutive sampling. Penelitian dilakukan pada 24 Maret - 30 Juni 2015 di Klinik Mawar Kota Bandung. Pengumpulan data dilakukan melalui wawancara dengan menggunakan kuesioner, kemudian data dianalisis dengan …

Impact Of Husband’S Participation In Antenatal Care On The Use Of Skilled Birth Attendant, Febri Wicaksono

Kesmas

Pendekatan alternatif diperlukan untuk mengatasi persoalan kesehatan reproduksi, salah satunya dengan meningkatkan partisipasi laki-laki pada kesehatan reproduksi perempuan. Penelitian ini bertujuan untuk menelusuri dampak partisipasi suami dalam pelayanan antenatal pada penggunaan tenaga persalinan terlatih setelah mengontrol karakteristik sosial demografi. Sampel sebanyak 4.000 perempuan berusia 15 – 49 tahun yang memiliki persalinan terakhir pada tahun lalu sebelum survei diambil dari Survei Demografi dan Kesehatan Indonesia tahun 2012. Penelitian menggunakan model regresi logistik biner untuk mengidentifikasi dampak partisipasi suami dalam pelayanan antenatal pada penggunaan tenaga persalinan terlatih setelah mengontrol karakteristik ibu dan sosial demografi. Peluang setelah mengontrol faktor lainnya mengindikasikan perempuan yang …

The Effect Of Structured Counseling Towards Knowledge, Attitude, And Participation Of Modern Contraceptive Among Unmet Need Couples, Herlina Simanjuntak, Bony Wiem Lestari, Anita Debora Anwar

Kesmas

Unmet need Keluarga Berencana (KB) masih tinggi di negara berkembang termasuk di Indonesia. Konseling kontrasepsi terstruktur berpotensi meningkatkan penggunaan kontrasepsi secara efektif, menjaga keberlangsungan penggunaan dan meningkatkan kepuasan klien. Selama ini seling kontrasepsi yang dilakukan belum optimal, sehingga penelitian ini bertujuan untuk menganalisis pengaruh konseling terstruktur terhadap peningkatan pengetahuan, sikap dan partisipasi kontrasepsi modern pada pasangan usia subur (PUS) yang unmet need. Penelitian ini merupakan eksperimen semu dengan rancangan pretest-posttest dengan kelompok kontrol. Penelitian ini dilakukan pada periode Maret – Juni 2015. Pengambilan sampel dilakukan dengan stratified random sampling pada 48 orang untuk kelompok perlakuan (konseling terstruktur) dan 48 orang …

Toward A Common Secure Future: Four Global Commissions In The Wake Of Ebola, Lawrence O. Gostin, Oyewale Tomori, Suwit Wibulpolprasert, Ashish K. Jha, Julio Frenk, Suerie Moon, Joy Phumaphi, Peter Piot, Barbara Stocking, Victor J. Dzau, Gabriel M. Leung

Georgetown Law Faculty Publications and Other Works

The world is becoming increasingly vulnerable to pandemics resulting from globalization, urbanization, intense human/animal interchange, and climate change. A series of global health crises have emerged since 2000, ranging from Severe Acute Respiratory Syndrome (SARS) and its phylogenetic cousin Middle East Respiratory Syndrome (MERS), to pandemic Influenza A (H1N1), Ebola, and the ongoing Zika virus epidemic. The Ebola epidemic gave rise to four global commissions proposing a bold new agenda for global health preparedness and response for future infectious disease threats.

Four global commissions reviewing the recent Ebola virus disease epidemic response consistently recommended strengthening national health systems, consolidating and …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

How Are Migrant Health Centers And Their Patients Faring Under The Affordable Care Act?, Jessica Sharac, Rachel Gunsalus, Chi Tran, Peter Shin, Sara Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Migratory and seasonal agricultural workers (MSAWs) provide essential labor for farming in all its branches in the United States. Between 2.4 and 3 million MSAWs live across the U.S. in every state but are clustered in areas dense with agricultural employment. As a population already susceptible to poor health outcomes because of poverty and work-related health risks, MSAWs depend on community health centers, especially those known as migrant health centers that receive additional migrant funding. Reporting data from a national survey of agricultural workers, as well as findings from analyses of data from the Uniform Data System (UDS) that covers …

Public Health Spending And Its Contributions To The Total Spend On Health, Glen P. Mays

Health Management and Policy Presentations

This presentation provides an overview of recent research on governmental public health expenditures and their interaction with medical spending, carried out through the Robert Wood Johnson Foundation supported initiatives on Public Health Services and Systems Research (PHSSR) and the new Systems for Action research program. This work illustrates the value of tracking resource use across multiple sectors that influence health and well-being in American communities. As such, this work can inform the ongoing dialogue about methodologies for summarizing total health spending for the U.S. and for state and local areas.

A Yellow Fever Epidemic: A New Global Health Emergency?, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The worst yellow fever epidemic in Angola since 1986 is rapidly spreading, including the capital, Luanda. In Angola, the epidemic began in December 2015 and the laboratory-confirmed outbreak was reported to the World Health Organization (WHO) on January 21, 2016. Angola has had 2023 suspected cases and 258 deaths as of April 26, 2016. China, the Democratic Republic of Congo, and Kenya also have reported cases arising from infected travelers from Angola. Namibia and Zambia also share a long border with Angola, with considerable population movement between the countries. Similar to other recent epidemics, quick and effective action to stop …

Learning From Geographic Variation And Change In Preparedness: The 2016 National Health Security Preparedness Index, Glen P. Mays

Health Management and Policy Presentations

The 2016 release of the National Health Security Preparedness Index tracks the nation's progress in preparing for disasters and other emergencies that create health risks for large groups of people. Recent improvements in the Index computational methodologies and measures allow results to be compared validly across states and over time. The Index aggregates more than 130 individual measures from nearly 60 data sources into valid composite measures for 6 domains and 19 subdomains that reflect core functional areas of emergency preparedness and response. Improvements in normalization, weighting, imputation, and confidence interval construction enhance the validity and reliability of Index estimates …

Impacts Of Environmental Quality On The Demographics Of Three Nations, Emily Hummel

Honors Projects

This study will examine how the correlation between air and water quality and the population demographics of India, South Africa, and the United States. India is a country with a growing population, increasing income inequality, and gender roles that reflect its status as a developing nation. South Africa is much smaller in area and the population is beginning to level off, but South Africa’s income inequality is growing much faster than India’s and gender inequality is less of an issue in South Africa. The population of the United States is decreasing and gender roles are fairly equal, despite income inequality …

Charlton Fire Department Resident Expectations: Survey And Analysis, Natalie Omary, Jingxin Wen, Junchen Chen, Denis Kornev

School of Professional Studies

The Town of Charlton is located in the heart of the Massachusetts with a resident population of just under 14,000 people. The Charlton Fire Department serves the town for needs related to fire fighting, fire prevention, burning permits and inspection services along with emergency medical services. The Department has requested the assistance of the Clark University COPACE Capstone students in creating and conducting survey in order to get a sense of what the resident of the town know about the fire department and to better gauge their expectations about what the department can provide for them. The survey was formulated …

Information Technology Proposal For The Town Of Spencer, Vijay Basava, Corey Kenyon, Mahdi Soltani

School of Professional Studies

The Town of Spencer came to us looking for a plan to build and maintain their own personal fiber network for connection between departments and to improve data security for important information. After assessing the existing landscape and determining the various paths forward, we created network diagrams and plans for the movement forward of this project.

After assessing a variety of plans, we found that a full single-mode fiber network would be the best system for the implementation in Spencer. While it was the highest cost, it also scored the highest in our assessment.

Developing An Online Database Of Experts For The Worcester Regional Chamber Of Commerce, Zikan Chen, Douglas Grey, Pranjal Shah

School of Professional Studies

The Worcester Regional Chamber of Commerce as part of their mission to attract business to the Worcester area, want to create an online searchable database of industry experts made up of faculty members of the Colleges and Universities in the Worcester area. This online database will be placed on the Worcester Regional Chamber of Commerce Higher Education – Business Partnership page on their website. The limitations placed on this request are that the Regional Chamber as of this moment have no monetary or Information Technologies resources to provide for the realization of this request.

The proliferation of as A Service …

Cybersecurity Awareness Shrewsbury Public Schools, Brittany Crompton, David Thompson, Manuel Reyes, Xueyan Zhao, Xueke Zou

School of Professional Studies

In the 21st Century, technology reaches every aspect of our lives. As “digital citizens” we must be aware of the dangers both to our technological equipment and our personal information stored, transmitted, and processed on this equipment. The Cybersecurity Awareness curriculum developed for the Shrewsbury Public School district is designed to meet this need, as well as foster an interest in technology and ethical computer use.

Analysis Of The Point Of Sales System At Tower Hill Botanical Garden And Suggested Courses Of Action, Brian Dunn, Keerthi Bandi, Chantal Kopwa Epse Kassa, F.N.U Shelly

School of Professional Studies

As Tower Hill Botanic Garden continues to improve on its operations and enhance the experience of its visitors and members, they are on a quest for a new Point-Of-Sale (POS) system that not only works with its existing hardware and interface with Raiser’s Edge, a smartcloud fundraising and relationship management software central to the garden’s operations but also, have a restaurant module and the capability of operating both in a wireless and hard-wired environment.

Health Information Exchange: A Strategy For Improving Access For Rural Veterans In The Maine Flex Rural Veterans Health Access, Karen B. Pearson Mlis, Ma, Amanda Burgess Mppm, John A. Gale Ms, Andrew F. Coburn Phd, Anush Yousefian Hansen Ms, Ma

Access / Insurance

This paper reports on the design and implementation of a first-in-the nation project to expand rural veterans’ access to healthcare by establishing a bi-directional connection between Maine’s statewide health information exchange (HIE) and Veterans Administration facilities and centers. The paper reviews key factors that have contributed to implementation challenges and successes and lessons relevant to efforts to create interoperable health IT systems across multiple, complex organizational settings.

Enhancing Access To Alcohol Use Disorder Pharmacotherapy And Treatment In Primary Care Settings: Adapt-Pc, Hildi J. Hagedorn, Randall Brown, Michael Dawes, Eric Diepernick, Donald Myrick, Elizabeth M. Oliva, Todd H. Wagner, Jennifer P. Wisdom, Alex Harris

Health Policy and Management Faculty Publications

Background: Only 7.8% of individuals meeting diagnostic criteria for alcohol use disorder (AUD) receive treatment in a given year. Most individuals with AUDs are identified in primary care (PC) settings and referred to substance use disorders (SUD) clinics; however, only a minority of those referred attend treatment services. Safe and effective pharmacological treatments for AUD exist, but they are rarely prescribed by PC providers. The objective of this study is to refine, implement, and evaluate an intervention to integrate pharmacological AUD treatment options into PC settings. This paper provides a detailed description of the intervention design and the evaluation components. …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Alternatives Unlimited Inc. Property Service Application, Jalpa Dave, Pennie Nataliya, Neelakshi Bali

School of Professional Studies

The purpose of this project is to propose Property service application to be enforced for documenting and managing the work orders raised throughout the residencies. The company is looking into an application that would facilitate to track and monitor the maintenance request received in a systematic order and ensuring priority work request is resolved within the set time frame. The project is to enhance the property service's work more efficiently as this will provide a high level of charge for the occupants by providing quicker response to their requests. The Objectives set to achieve for this project are realistic and …

The Story Of Emily, Lori L. Jennings Ms, Barb O'Neil, Kim Bossy, Denise Dodman, Jill Campbell

Patient Experience Journal

This case study describes Bluewater Health’s quest to weave the philosophy and practice of patient and family-centered care from the boardroom to the bedside by introducing Emily. Emily’s image is a composite of photographs of staff, physicians, volunteers, patients and families exemplifying that each has a role in Emily’s care. Emily represents every patient and family of the past, present, and future. Emily’s journey started with the launch of Bluewater Health‘s 2013-2015 strategic plan and moved throughout the organization as patient councils were established and the organization embedded three foundational patient and family-centered RNAO Best Practice Guidelines into daily practice …

Applying Experience-Based Co-Design With Vulnerable Populations: Lessons From A Systematic Review Of Methods To Involve Patients, Families And Service Providers In Child And Youth Mental Health Service Improvement, Alison Mulvale, Ashleigh Miatello, Christina Hackett, Gillian Mulvale

Patient Experience Journal

The objective was to identify methods used to involve patients, family and service providers in child and youth mental health service improvement research. We analyzed the alignment of methods used with Experience-Based Co-Design (EBCD) methodology, and how power imbalances among participants were addressed. A systematic review of the English-language peer review literature since 2004 was carried out. The EMBASE, Scholar’s Portal, PubMed, Web of Science databases and the Ontario College of Art and Design University libraries were searched electronically for variations of ‘child’, ‘mental health’, ‘experience-based co-design’, ‘participatory research’ and ‘health care services’. Textual data was systematically extracted and analyzed. …

Impact Of Logo Wear On Provider Perception Of Patient, Bill R. Gombeski Jr

Patient Experience Journal

Patient’s appearance affects provider perception of patients and subsequent provider behavior. Based on anecdotal information, it was hypothesized that wearing a health organization’s brand would result in a more positive perception of a patient by providers and subsequently a better patient experience. A study of 121 individuals with patient contact was conducted. Using photos of patients with and without a health care brand on their shirts, study subjects rated the attractiveness and willingness to engage with photos of patients. Patients with a Mayo brand and UK HealthCare brand showed some significant positive attractiveness over the same patient without the brand. …

Patient Evaluations Of The Interpersonal Care Experience (Ice) In U.S. Hospitals: A Factor Analysis Of The Hcahps Survey, Geoffrey A. Silvera, Jonathan R. Clark

Patient Experience Journal

The Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) is widely used to evaluate patients’ perceptions of their inpatient healthcare experiences. The HCAHPS is organized into 10 measures: six composite measures, two individual measures, and two global measures.¹ In prior research on the link between patients’ care experiences and hospital’s quality and cost outcomes, scholars have grouped these measures in a variety of ways. The evident lack of consistency in these groupings along with the persistent lack of empirical justification for these groupings suggests a need to empirically examine the relational structure of HCAHPS measures. …

Developing Approaches To The Collection And Use Of Evidence Of Patient Experience Below The Level Of National Surveys, Elizabeth J. Gibbons, Chris Graham, Jenny King, Kelsey Flott, Crispin Jenkinson Professor, Raymond Fitzpatrick Professor

Patient Experience Journal

National approaches to collecting patient feedback provide trust level information which although can provide a benchmark for trusts often doesn’t provide information about specific services or patients experiences of pathways of care. This more granular level of data could be more informative for local service development and improvement. This research explored the feasibility and usefulness of such approaches. A conceptual model and standard questionnaire of patient experience was developed that might work across a range of services and pathways of care. Seven trusts were recruited as collaborating sites in which the model and survey instrument was tested. These were from …

Impact Of Hospital Diagnosis-Specific Quality Measures On Patients’ Experience Of Hospital Care: Evidence From 14 States, 2009-2011, Emily M. Johnston, Kenton J. Johnston, Jaeyong Bae, Jason M. Hockenberry, Arnold Milstein, Edmund Becker

Patient Experience Journal

In order to assess consistency across quality measures for Untied States hospitals, this paper uses patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for three years (2009-2011) from 1,333 acute-care hospitals in fourteen states to analyze patterns in hospital-reported patient experience-of-care scores by diagnosis-specific process and outcome measures for acute myocardial infarction, heart failure, and pneumonia. We also evaluate how scores have changed over the three-year period. We find significant differences in patient experience-of-care scores for 195 out of 230 relationships between HCAHPS patient experience-of-care scores and 23 diagnosis-specific process and outcomes measures. We …