Public Health Commons^™

Personal Experiences With Long Term Care Services And Supports, Julie Fralich Mba, Mark Richards Ba, Louise Olsen, Vanessa Bell, Jennifer Pratt

Disability & Aging

This report captures, in a direct way, the first hand experiences of older and disabled consumers of long term care services and supports. In addition, it includes the collective experiences of eight Maine communities regarding the long term care service delivery system in our state.

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

An Assessment Of The Hospitalization Rates And Associated Comorbid Conditions In Secondary Stroke Prevention, Andrea D. Boan

MUSC Theses and Dissertations

Introduction: An inherent risk from an incident stroke is recurrence. The most effective method to reduce stroke risk is to reduce the incidence of hypertension. Thus, antihypertension therapy has become imperative in the prevention of primary and recurrent stroke. In this dissertation we examine the confounding effects of race and age on recurrent stroke risk and the consistency of secondary prevention treatment regimens. Methods: One-year recurrent stroke risk was determined in relation to race, age, gender, and comorbid hypertension and diabetes by mixed effects regression and Kaplan-Meier survival analyses among hospitalized patients in South Carolina. A subset of patients were …

Summary Of Research In Speech Pathology, Deborah Hersh

ECU Research Week

No abstract provided.

Defining Speech And Language Fluency Profiles Before And After The Onset Of Stuttering: Preliminary Findings, Charn Nang

ECU Research Week

No abstract provided.

Risk Factors For Homelessness Among Community Mental Health Patients With Severe Mental Illness, Rupert Talmage Van Wormer

Dissertations and Theses

The purpose of this study was to identify risk factors associated with homelessness, assess the relationship between housing status and consumption of costly publicly funded resources, to identify characteristics associated with service retention, and to evaluate whether length of treatment is associated with better outcomes. The target population was homeless and formerly homeless adults with SMI enrolled in community mental health services at the Downtown Emergency Service Center SAGE mental health program located in Seattle. The sample consisted of 380 SAGE patients who had continuous enrollment in 2005. These patients formed the cohort for the study. Agency records for these …

Somatechnologies Of Body Size Modification: Posthuman Embodiment And Discourses Of Health, Meghan Griffin

Electronic Theses and Dissertations

This project focuses on persistent gaps in philosophies of the body: the enduring mindbody divide in accounts of phenomenology, the unfulfilled promises of representing and inhabiting the body in online and virtual spaces, and the difference between health as quantified in medical discourse versus health as lived experience. These tensions are brought to light through the electronic food journal genre where the difficulty in capturing pre-noetic, outsideconsciousness aspects of experience and embodied health are thrown into relief against circulating cultural discourses surrounding health, body size, self-surveillance, and self-care. The electronic food journal genre serves as a space for users to …

The Association Of Natural Elements And Trail Use By Adults, Anna E. Greer, Julian A. Reed, Steve P. Hooker

All PTHMS Faculty Publications

We used the System for Observing Play and Recreation in Communities to examine the association between variations in natural elements (ie, season, weather, and temperature) and adults’ use of a rail-trail in South Carolina (2006-2009). Most (62%) of the 4,468 trail users observed were walkers; 38% were observed participating in vigorous physical activity. Adults were most often observed using the trail during the summer (32%), sunny weather (78%), and moderate temperatures (54%). When promoting trail use among adults, natural elements should be considered.

Pengetahuan Klien Dan Kualitas Pelayanan Sebagai Dasar Pemilihan Alat Kontrasepsi Hormonal, Najib Najib

Kesmas

Tingkat pemakaian kontrasepsi hormonal oleh akseptor Keluarga Berencana di kelurahan Muktiharjo Kidul kota Semarang yang tinggi diduga merupakan dampak tidak diberikannya informasi yang luas tentang kelebihan dan kekurangan alat kontrasepsi dan pelayanan kontrasepsi yang berkualitas. Penelitian ini bertujuan untuk mengetahui hubungan pengetahuan dan kualitas pelayanan dengan pemilihan alat kontrasepsi hormonal pada pasangan usia subur di kelurahan Muktiharjo Kidul. Jenis penelitian adalah explanatory study dengan pendekatan cross sectional yang dianalisis secara deskriptif. Penarikan sampel dilakukan secara acak dari populasi pasangan usia subur yang menggunakan alat kontrasepsi di kelurahan Muktiharjo Kidul kota Semarang. Hasil penelitian menunjukkan bahwa prevalensi pasangan usia subur yang …

Kualitas Pelayanan Keluarga Berencana Dan Penggantian Kontrasepsi Di Indonesia, Mugia Bayu Rahardja

Kesmas

Keberhasilan program Keluarga Berencana Nasional tidak hanya diukur dari peningkatan peserta program, tetapi juga efektivitas dan durasi pemakaian kontrasepsi. Penelitian ini bertujuan menilai pengaruh kualitas pelayanan KB terhadap perilaku penggantian alat kontrasepsi di Indonesia. Penelitian sumber data sekunder histori pemakaian metode kontrasepsi dalam kalender data SDKI tahun 2007 dengan metode analisis regresi logistik dengan efek random. Wanita tanpa informed choice dan tanpa kunjungan petugas KB serta pengguna susuk KB berhenti karena ingin metode lebih efektif yang dapat membuat terlihat lebih muda, dan menghasilkan anak sedikit. Pada pasangan yang masa perkawinannya kurang dari 10 tahun, status pendidikan dan sosial ekonomi tinggi, …

Improving Health Outcomes For Foster Care Children In Maine Draft Conceptual Model, Culter Institute Of Health And Social Policy

Population Health & Health Policy

Improving Health Outcomes for Children (IHOC) is a 5-year demonstration grant from the Centers for Medicare & Medicaid Services, and authorized by 401 (d) of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA).

IHOC works with doctors' offices, practices and other agencies who want to improve health care in Maine and Vermont to:

• Collect and report on the use of evidenced-based child health quality measures
• Expand the Health Information Technology to improve the flow of child health data
• Promote a collaborative child health learning environment

The Aging Services Network: Serving A Vulnerable And Growing Elderly Population In Tough Economic Times, Carol O'Shaughnessy

National Health Policy Forum

In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of social support programs. The "aging services network," broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services …

Driving Qi With Research: Findings From Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are increasingly experimenting with quality improvement (QI) strategies designed to enhance the effectiveness and efficiency of their efforts. Does QI work in public health, and if so for whom and under what circumstances? What QI strategies work best for which types of public health process failures, and at what cost? Research underway through the Public Health Practice-Based Research Networks (PBRN) Program is examining these types of questions to build an evidence base for public health QI.

Prevalence And Risk Of Polypharmacy Among The Elderly In An Outpatient Setting: A Retrospective Cohort Study In The Emilia-Romagna Region, Italy, S. Lane Slabaugh, Vittorio Maio, Megan Templin, Safiya Abouzaid

College of Population Health Faculty Papers

Background: Polypharmacy, the simultaneous taking of many medications, has been well documented and is a topic of much concern for those looking to improve the quality of care for the elderly. Elderly patients often develop complicated and multi-factorial health states that require extensive pharmacotherapy, leaving this population at risk for exposure to drug-drug interactions and other adverse events. Previous literature supports an association between an increase in the rate of adverse events as the number of drugs taken by a patient increases.

Objective: We sought to evaluate the prevalence of polypharmacy, and to determine patient characteristics that are predictive of …

Current And Future Directions In Frailty Research., Anita Mohandas, Joanne Reifsnyder, Mimi Jacobs, Tim Fox

College of Population Health Faculty Papers

The concept of frailty has been evolving dramatically for the past 30 years. Through its evolution, a variety of single and multidimensional models have been used to describe frailty. This article reviews the current literature related to the defining dimensions of frailty and identifies the gaps in the literature requiring additional research. A detailed literature review was performed to identify key dimensions and models currently being used to define frailty, classify interventions that have been developed to reverse frailty, and identify potential areas for future research within this field. Despite the large body of research defining the dimensions of frailty, …

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

An Evaluation Of A Peer Led Bystander Intervention Program To Reduce Sexual Assault Violence Among College Students, Elizabeth Madeline Childers

Graduate Theses and Dissertations

It has been reported that sexual victimization among college women is three times higher than the general population. Because of these alarming rates, sexual violence prevention has become a main concern on college campuses. Sexual violence prevention programs have been implemented and evaluated throughout the years in order to decrease the incidence of sexual violence, but very few have explored the bystander intervention component. The current study developed and evaluated a program that promoted proSocial bystander behavior through a one-time educational program utilizing peer educators. Data for this study were collected with a pre/posttest design from a Division 1 university …

Analysis Of The Morbidity And Mortality Of Severe Influenza Infection In Clark County, Nevada For The 2010--2011 Influenza Season, Kindra Maureen St. Jacques

UNLV Theses, Dissertations, Professional Papers, and Capstones

Influenza circulates in the community in a fairly predictable manner each year; however, throughout the duration of any influenza season, influenza strains have the ability to evolve through antigenic mutations, viral reassortment, development of anti-viral resistance, and alterations in virulence. These changes are likely to cause illness among the unimmunized and can result in severe illness or death. Therefore, it is especially important to closely monitor severe influenza-associated hospitalizations and deaths. The University of Nevada, Las Vegas in collaboration with the Southern Nevada Health District (SNHD), Office of Epidemiology (OOE) analyzed data from the severe hospitalized influenza morbidity and mortality …

The Science Of Public Health Delivery: Evidence, Uncertainties & Research Needs, Glen P. Mays

Health Management and Policy Presentations

Policy initiatives to reform the nation's health system increasingly recognize the need to incorporate public health and prevention strategies. The nation's delivery system for public health, however, varies widely across states and communities in its structure, authority, and capabilities. This session examines research from the growing field of public health services and systems research to identify directions for improving public health delivery.

Estimating The Value Of Public Health Services & Systems: Evidence, Uncertainties, And Research Needs, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act authorized the largest expansion in federal funding for public health services and delivery systems in decades. These provisions, designed to support programs and services that promote health and prevent disease and injury on a population-wide basis, remain controversial because of uncertainties regarding their effectiveness in improving health and constraining medical cost growth. This session examines a series of recent studies to shed light on the health and economic value of spending on public health.

Disparities Research In Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are well positioned within the health system to play key roles in addressing oral health issues on a population-wide basis, However, current evidence reveals wide geographic variation in the delivery of public health interventions for oral health promotion. This session explores the factors contributing to this variation, and it highlights studies underway through the Public Health Practice-Based Research Networks (PBRNs) to produce more and better evidence about public health delivery and impact.

Response To The Data Challenges Of The Affordable Care Act: Surveys Of Providers To Assess Access To Care For People With Disabilities And The Presence Of Accessible Exam Equipment, Nancy R. Mudrick, Mary Lou Breslin, June Isaacson Kailes

Social Work - All Scholarship

No abstract provided.

Health Care Access And Use Among The Rural Uninsured [Policy Brief], Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd

Access / Insurance

In a landmark series of reports, the Institute of Medicine’s Committee on the Consequences of Uninsurance noted the policy significance of the “cascading” effects of uninsurance on patients, families, and communities.¹ Multiple studies confirm that rural residents are more likely to be uninsured than their urban counterparts.^2-4 Additionally, there is ample evidence that the uninsured have poorer access to care, delay care, and obtain care at levels of greater acuity than those with health insurance.⁵ However, the impact of being uninsured versus insured in rural areas, particularly compared to urban areas, is largely unknown.

Using data from …

Budaya Patient Safety Dan Karakteristik Kesalahan Pelayanan: Implikasi Kebijakan Di Salah Satu Rumah Sakit Di Kota Jambi, Solha Elrifda

Kesmas

Patient safety adalah salah satu komponen kritis dari mutu pelayanan kesehatan. Banyak kesalahan pelayanan dikaitkan dengan budaya patient safety. Catatan tentang kesalahan pelayanan di berbagai segara menunjukkan angka yang mengkhawatirkan, sementara di Indonesia belum ada catatan resmi. Demikian halnya dengan budaya patient safety dan kesalahan pelayanan di rumah sakit Kota Jambi. Penelitian ini bertujuan untuk mengetahui budaya patient safety dan karakteristik kesalahan pelayanan di salah satu rumah sakit di Kota Jambi. Desain penelitian ialah cross sectional dan kualitatif. Populasi dan sampel adalah petugas yang melayani pasien secara langsung di ruang rawat inap rumah sakit yang diteliti (dokter, perawat, dokter gigi, …

Kesehatan Dan Kualitas Kehidupan Kerja Terhadap Kinerja Perawat Di Rumah Sakit Umum Tangerang, Hafizurrachman Hafizurrachman, Laksono Trisnantoro, Adang Bachtiar

Kesmas

Penelitian ini bertujuan melihat pengaruh dan besaran berbagai variabel kesehatan dan kualitas kehidupan kerja terhadap kinerja perawat di Rumah Sakit Umum (RSU) Tangerang. Variabel kesehatan tersebut meliputi sejarah kesehatan keluarga, lingkungan kehidupan, perilaku gaya hidup, dan status kesehatan perawat. Desain penelitian yang digunakan pada penelitian ini adalah desain potong lintang. Data dianalisis dengan pendekatan Structural Equation Model (SEM) menggunakan software Smart-PLS. Populasi yang diamati adalah perawat yang bertugas di semua pelayanan RSU Tangerang dengan 250 perawat terpilih sebagai sampel yang dilakukan secara multistage random sampling. Hasil analisis menunjukkan bahwa kinerja perawat di RSU Tangerang dipengaruhi oleh semua variabel, yang berarti …

The Perfect Storm: How Pro-Abortion Activists In The Netherlands Incite Social Change From International Waters, Julia Ellis‐Kahana

Independent Study Project (ISP) Collection

This project is a sociological ethnography of the Women on Waves foundation, founded in 1999 by Dr. Rebecca Gomperts. As an international non-profit organization, they employ a direct action method: sailing to countries where abortion is illegal and providing safe abortion access. Local women board the ship that then travels 12 miles to international waters, where Dutch law applies, and the abortion pill can be administered legally. Using a feminist perspective, I interviewed five of the women at the organization in addition to the ship’s captain in order to understand the ideological beliefs about the reproductive rights that have inspired …

Social Support For Young Carers An Analysis Of The Available Social Support For Children Caring For Aids-Sick And Other-Sick Caregivers In Emoyeni, South Africa., Flannery Mcardle

Independent Study Project (ISP) Collection

The dual epidemics of HIV/AIDS and non-communicable diseases in South Africa are the principal drivers of the worsening orphan epidemic in South Africa. As orphanhood is often far from a singular event but rather one preceded by months or even years of the parent or guardian’s declining health, many children will become the primary caregivers for a sick or dying adult. This study explores the lives of the young carers, specifically, the social support available for these children and how the support available for children caring for AIDS-sick caregivers may differ from that available for children caring for an adult …

Using Public Health Pbrn Research To Inform Policy & Practice, Public Health Practice-Based Research Networks

Health Management and Policy Reports

The Public Health Practice-Based Research Networks Program is a national program of the Robert Wood Johnson Foundation that supports research networks dedicated to producing new scientific knowledge on how best to organize, finance, and deliver public health strategies in realworld practice settings. This body of scientific inquiry, known as Public Health Services and Systems Research (PHSSR), is a rapidly developing area of scholarship within the larger fields of public health research and health services research. A public health practice-based research network (PBRN) brings multiple public health organizations into collaboration with an academic research center for the purposes of designing and …

Migration, Vulnerability And Xenophobia: Central African Refugee And Asylum Seekers’ Access To Health Services In Durban, South Africa, Cathy Kaplan

Independent Study Project (ISP) Collection

In 1998, South Africa passed historic legislation that bridged international conventions on refugees and asylum seekers with the protections and rights defined in the South African Constitution and Bill of Rights. The 1998 refugees act defined specific rights that refugees and asylum seekers are entitled in South Africa, the most important of which include the provision of legal and immigration documentation, employment, adequate housing, and health and social services. When asylum seekers arrive in Durban, many are in the need of immediate health services as a result of long journeys, pre-existing conditions, pregnancy, or illnesses contracted in refugee camps throughout …

Effectively Filling Gaps In Care: A Comparative Study Of Models Of Government Partnerships With Community Health Organizations In Kwazulu-Natal, South Africa, Madeline Ross

Independent Study Project (ISP) Collection

This study conducted Amatkiulu, Impendle, and Durban, KwaZulu-Natal, South Africa, utilizes three case studies to form a comparative analysisof the effectiveness of different models of public-private partnerships. Two expert interviews, three informal interviews, and many hours of observation inform this analysis of community health worker organizations employed through government clinics, tuberculosis tracer teams hired by government clinics, and independent non-governmental organizations heavily subsidized by the government. Subjective analysis found that the partnership between the Department of Health and a primary healthcare NGO, providing a wide range of comprehensive services, operated with the best efficiency and quality of care.