Public Health Commons^™

Baseline Data For Maine Pediatric And Family Practices From Arra-Funded Hit Ambulatory Practice Survey Data, Kimberley S. Fox Mpa

Population Health & Health Policy

No abstract provided.

Individual And Combined Effects Of Dehydration, Hyperthermia, And Fatigue On Movement Patterns And Cognition, Rachel M. Karslo

Master's Theses

Individual and Combined Effects of Dehydration, Hyperthermia, and Fatigue on Movement Patterns and Cognition

Rachel M. Karslo, University of Connecticut

Purpose: The purpose of the study was to examine the individual and combined of effects of dehydration, hyperthermia, and fatigue on movement patterns and cognition.  Secondly, we wanted to see if the effects of dehydration, hyperthermia, and fatigue lead to a combined increase in injury risk.

Methods: 12 males completed a within-subject repeated measures design to study the effects of hyperthermia, dehydration and fatigue on movement and cognition.  Subjects completed 4 randomized test sessions in different conditions: hydrated normothermic, dehydrated …

Health Status Of Children Entering Kindergarten: Results Of The 2010-2011 (Year Three) Nevada Kindergarten Health Survey, Nevada Institute For Children’S Research And Policy, Amanda Haboush, Tara Phebus, Denise Tanata Ashby, Taylor Oliver, Spencer Hensley, Enrique Lopez

Nevada Institute for Children's Research and Policy Reports

Academic achievement for children is vital to their success in life. Those that do well in school have greater opportunities for post-secondary education, and later have better prospects for employment. One of the major factors that can affect a child’s academic achievement is his or her health status. Academic outcomes and health conditions are consistently linked in the literature (Taras & Potts-Datema, 2005). Children with poor health status, and especially those with common chronic health conditions, have increased numbers of school absences and more academic deficiencies (Taras & Potts-Datema, 2005). In a study concerning excused versus unexcused absences, children with …

International Evidence On Medical Spending, Robert D. Lieberthal

College of Population Health Faculty Papers

Abstract
U.S. medical spending is high by measures including the level of spending, level of spending per capita, and level of spending as a share of GDP. U.S. medical spending growth is average by measures including the annual growth rate, annual growth rate per capita, and annual growth in spending as a percent of GDP. The volatility of U.S. medical spending growth is low by measures including the standard deviation, skew, and excess kurtosis.

Foreign healthcare systems, with a much larger government involvement, have not been able to control medical spending growth better than the U.S. with its mixed system. …

The Influence Of Patient-Reported Provider Availability Factors On Nonurgent Emergency Department Use, Cheryl Anne Dewood

Theses and Dissertations (ETD)

Purpose. The purpose of this study was to examine the influence of patient‑perceived provider availability on nonurgent emergency department use (NUEDU). The study population consisted of a nationally‑representative population of non‑elderly adults who were continuously privately insured (CPI) for at least a year before an emergency department visit that was determined to be nonurgent, and who reported having a regular source of care (RSC).

Methods. Data were obtained from a nationally‑representative longitudinal survey, the Medical Expenditure Panel Survey (MEPS). The classification of ED visits as nonurgent was based on patient report using a method developed for this study. Patient­‑perceived provider …

Analysis Of Out-Of-Pocket Expenditures Of Oral Oncologics For Tennessee Recipients Of Medicare Part D, Eve Carolyn Elias

Theses and Dissertations (ETD)

Background: There are few studies that examine patients' costs of oral oncology drugs from Medicare Part D plan providers. These drugs can impose a financial burden to beneficiaries, and, due to their cost, place beneficiaries in the coverage gap in a short period of time. In addition to examining costs, there is little published concerning the potential impact of drug utilization management techniques on access to these drugs in Medicare Part D plans. This study examined the roles of prior authorization, step-therapy, and placement of drugs in higher formulary tiers on patients' out-of-pocket costs, and access to therapy.

Methods …

Effects Of Environment On Children's Motor Scores, Eligibility Status, And Administration Times, Derrick Mittelstadt, Abigail Parker, Kirsten Pickett, Heather Temkin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Best practices for assessing developmental skills in young children focus on naturalistic observation in everyday settings, but the effects of environment on test scores, eligibility status and administration time have not been explored. The Peabody Developmental Motor Scales-Second Edition (PDMS-2) was administered to 34 children aged 18 to 59 months in natural and pull-out settings. PDMS-2 total, gross, and fine motor quotient (TMQ, GMQ, and FMQ) scores were significantly lower in the natural environment (p’s≤.014). Based on our results, more children would qualify for services when tested in natural environments using TMQ and GMQ scores. It also took significantly longer …

Playing With Fire Or Arson? Identifying Predictors Of Juvenile Firesetting Behavior, Mary Ellen Britt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Firesetting is a complex behavior that spans a wide range of developmental stages in childhood and adolescence and involves varying motivations and intents. A better understanding of this destructive behavior is critical to developing strategies to control its devastating effects. The purpose of this research project was to identify potential predictors of juvenile firesetting behavior by studying youth who were enrolled in a regional firesetting intervention program. Data collected from firesetting assessment instruments completed by parents or guardians of program participants were examined. In the analyses, special emphasis was placed on evaluating associations between juvenile firesetting behavior and the socioeconomic …

Making Sense Of Health Care Planning In Ireland; The Street Level Public Organization (Slpo)., Vivienne Byers

Conference Papers

One of the central mechanisms of the Strategic Management Initiative (SMI) (Government of Ireland 1996) is the devolution of accountability and responsibility from the centre to executive agencies. Service planning was introduced in the Irish health care sector as part of this strategic planning ethos. This paper reports on a study that examined both the intent and the consequences of implementing legislatively mandated planning in the Irish health services, in the context of significant organizational change. In an effort to draw broader lessons, a comparison is drawn with the Canadian experience of service planning.

The choice was made to study …

A Case Study Of Health Interventions And The Caste System: Addressing The Social Determinants Of Health Through Development At Crhp Jamkhed, Laura Kroart

Independent Study Project (ISP) Collection

In the Southeast Asian country of India, the ancient but in some cases still rigidly intact caste system plays a role in determining health status and outcomes for much of its population of over 1.2 billion people.[1] The Comprehensive Rural Health Project, located in Jamkhed in the state of Maharashtra, India, approaches health interventions from a development standpoint, addressing biomedical needs, structural and environmental concerns, and the social and economic determinants of health that impact the lives of over a million villagers in the surrounding area.[2] This independent study project was designed to analyze how the Comprehensive Rural …

Adoption Of Electronic Health Records By Admitting Physicians: A Heuristic Model, John Sharon Hudson

Health Services Research Dissertations

Background: Although hospital electronic health records (EHRs) are generally perceived to improve care, physician resistance may hinder EHR adoption.

Purpose: This study uses constructs from diffusion of innovations and resource dependence theories to predict adoption and rate of adoption of an EHR by admitting physicians from three of ten hospitals in a highly integrated health system in Virginia. Functions evaluated: computerized physician order entry (CPOE), electronic history and physical (EH&P) and electronic discharge summary (EDS). The study tested hypotheses that adoption would be associated with: working at larger, academic hospitals; financial alignment; larger physician groups; office EHR; youth; males; medical …

The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague

National Health Policy Forum

From perhaps a few hundred practitioners in 1996 to an estimated 30,000 today, the discipline called hospital medicine has shown remarkably rapid growth. It represents a fundamental separation of the inpatient and outpatient components of internal and family medicine. The split has implications for the quality and efficiency of care delivery, the outlook for the physician workforce, and the development of new models such as accountable care organizations (ACOs).

Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit

National Health Policy Forum

Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs …

Substance Abuse In Georgia, The Burruss Institute Of Public Service And Research

Georgia Journal of Public Policy

In order to create a snapshot of substance use and abuse in Georgia, the Burruss Institute of Public Service and Research requested access to data from the National Survey on Drug Use and Health conducted on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), a unit of the Department of Health and Human Services (HHS).  SAMHSA would not provide access to the raw data; instead, the Institute was given a series of tables with estimates of the average annual number of users of various substances among Georgians ages 12 and older between the years 2002 and 2008. …

Lady Health Workers Programme In Pakistan: Challenges, Achievements And The Way Forward, Assad Hafeez, Bile Khalif Mohamud, Mobasher Riaz Shiekh, Syed Ayyaz Imran Shah, Rashid Jooma

Section of Neurosurgery

Objectives: To review the Lady Health Workers programme and critically explore various aspects of the process to extract tangible implications for other similar situations.
Methods: A descriptive study was carried out over a period of one year (2007-08). A detailed desk review of project documents, interaction with relevant stakeholders, performance validation and extensive feedback from the community were collected. The data so obtained was analyzed and evaluated against predetermined benchmarks.
Results: Each LHW serves a population of 1,000 people in the community and extends her services in the catchment population through monthly home visits. The scope of work includes over …

Providing Better Care At Lower Cost: Building Maine's Health Data Infrastructure To Support Financing And Delivery System Reform, Andrew F. Coburn Phd

Health System Reform

Maine needs a robust and functional health data infrastructure to support efforts by health care providers and purchasers to improve quality, address Maine’s health care cost problems, and improve the health of individuals and populations through payment and delivery system reform. Although Maine has been a leader in building and using health data systems such as the hospital discharge data set and the all-payer claims database, new performance-based financing and delivery system arrangements are highlighting shortcomings in these systems and the need for a renewed vision of Maine’s future health data infrastructure.

The Health Data Workgroup was created by The …

Pemanfaatan Fasilitas Pelayanan Kesehatan Pemerintah Dan Swasta Di Kabupaten Sleman, Anita Sulistyorini, Purwanta Purwanta

Kesmas

Di Sleman, masyarakat yang memanfaatkan fasilitas pelayanan kesehatan swasta (52%) lebih tinggi daripada yang memanfaatkan fasilitas kesehatan pemerintah (37,6%). Fenomena ini diduga berhubungan dengan kebijakan kesehatan. Penelitian ini bertujuan mengetahui pola pemanfaatan fasilitas pelayanan kesehatan pemerintah dan swasta oleh keluarga di Kabupaten Sleman serta berbagai faktor yang mempengaruhinya. Penelitian dengan rancangan studi cross sectional ini dilakukan di 13 kecamatan terpilih di Kabupaten Sleman. Teknik pengambilan sampel yang digunakan adalah cluster sampling dua tahap menghasilkan jumlah sampel penelitian 240 responden dari 30 cluster. Instrumen pengumpulan data yang digunakan adalah kuesioner yang sebelumnya telah disiapkan. Metoda uji chi-square digunakan untuk melihat hubungan …

Who Are The Health Center Pati Ents Who Risk Losing Care Under The House Of Representatives’ Pr Oposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Beta-Blocker Initiation And Adherence After Hospitalization For Acute Myocardial Infarction., Vittorio Maio, Pharmd, Ms, Msph, Massimiliano Marino, Phd, Mary Robeson, Md, Joshua J Gagne, Pharmd, Ms

College of Population Health Faculty Papers

Aims: We sought to: (1) estimate the proportion of patients who initiated beta-blocker therapy after acute myocardial infarction (AMI) in Regione Emilia-Romagna (RER); (2) examine predictors of post-AMI beta-blocker initiation; and (3) assess adherence to such therapy.

Methods and Results: Using healthcare claims data covering all of RER, we identified a cohort of 24,367 patients with a hospitalization for AMI between 2004 and 2007, who were discharged from the hospital alive and without contraindications to beta-blocker therapy. We estimated the proportion of eligible patients with at least one prescription for a beta-blocker following discharge and performed a multivariable logistic regression …

Sis-Map; Suicide Risk Assessment Scale, Amresh Srivastava

Data and Test Instruments

This is a New Scale for Assessment of suicide risk to evaluate clients referals and disposition. This Copy Right to Amresh Shrivastava and Chrles Nelson

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. 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, …

Snapshot 2011: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

Maine Pediatric And Family Practice Survey Chartbook: Improving Health Outcomes For Children, Martha Elbaum Williamson Mpa, Kimberley S. Fox Mpa, Al Leighton Ba, Stuart Bratesman Mpp

Population Health & Health Policy

As part of the IHOC initiative, the Muskie School of Public Service at the University of Southern Maine surveyed pediatric and family practices about how they use data, clinical guidelines and office systems to monitor and improve children’s healthcare quality. The purpose of the survey is to provide baseline information about quality improvement activities in primary care practices serving children in Maine. Survey data will be used to inform IHOC activities and to monitor changes over time. The web-based survey was conducted in the winter of 2011-2012 and sent to practice managers at a sample of 168 practice sites, of …

Migration And Hiv In India: Study Of Select Districts, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Alka Narang, Umesh Chawla

HIV and AIDS

Report of a study assessing the important role of migration in the spread of HIV in districts with high out-migration in India. The study suggests a considerable spread of HIV linked to migrants’ extramarital sexual behaviors, and subsequent delay in treatment for infected spouses. In order to control the spread of HIV, the study provides programmatic recommendations made by the study participants and the counselors from ICTCs and ART centers. These suggestions include village-level mapping of at-risk persons, mainstreaming HIV prevention interventions within current health resources, improving various village level HIV prevention programs, and involving women left behind by migrant …

Hiv Transmission Among Married Men And Women In Districts With High Out-Migration In India: Study Brief, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Umesh Chawla, Alka Narang

HIV and AIDS

This brief describes a study examining the links between male out-migration and HIV transmission among married men and women and other mechanisms by which HIV is transmitted within marital relationships in districts with high out-migration.

Facilitating Regulatory Approval Of Multipurpose Prevention Technologies For Sexual And Reproductive Health, Martha Brady

HIV and AIDS

This brief describes multipurpose prevention technologies (MPTs) that address women's sexual and reproductive health (SRH) needs, and how to go about facilitating regulatory approval of this technology. It outlines a strategic framework to examine current regulatory guidance, as well a product development pathway to bring MPTs to market.

What Regulatory Guidance Exists For Multipurpose Prevention Technologies (Mpts)? A Review Of Key Guidance Documents And Their Applicability To Mpts, Martha Brady, Heeyoung Park

HIV and AIDS

This brief reviews regulatory guidance documents and how they may apply to multi-purpose technologies (MPTs). It examines guidance documents from the Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The brief concludes by anticipating increased interactions with US regulatory agencies in hopes of finding new regulatory pathways that address MPTs specifically.

Evaluation Of The Informed Consent Process For Male Circumcision Scale-Up In Swaziland, Barbara Friedland, Louis Apicella, Katie D. Schenk, Meredith Sheehy, Paul C. Hewett

HIV and AIDS

This report evaluates the informed consent process for male circumcision conducted through the Male Circumcision Partnership for Swaziland, led by Population Services International, in partnership with Jhpiego, Marie Stopes International, and the Population Council. The study assesses participants' comprehension of the circumcision process, the informed consent process, as well as the affect of male circumcision counseling on their experience.

Constructing A Critical Path For Product Development, Commercialization, And Access, Martha Brady

HIV and AIDS

This brief discusses the Council's health technologies development and the product development path from conceptualization to market. It defines the steps in the Critical Path Framework, and examines activities at the preclinical and clinical stage.

"Knowing Myself First": Feasibility Of Self-Testing Among Health Workers In Kenya, Sam Kalibala, Waimar Tun, William Muraah, Peter Cherutich, Erick Oweya, Patricia Oluoch

HIV and AIDS

Report of a study exploring the feasibility and acceptability of free HIV home self-testing among health workers in Kenya, within the range of other HIV testing options available.