Public Health Commons^™

Perceived Health Competency And Health Value, Acculturation And Obesity In A Mexican American Population, Roberto Eliud Maldonado

Theses and Dissertations - UTB/UTPA

Mexican Americans have a higher incidence of obesity than non-Hispanic whites, yet this population seems to be less concerned with maintaining an ideal body weight than non-Hispanic whites. This puts the Mexican Americans population at higher risk for illnesses associated with increased body fat and obesity. One important factor found to influence health maintenance behavior is perceived self-efficacy, or the degree to which the individual feels capable of effectively managing his or her behavioral outcome. This study examines the moderating effect of health competency and health value on body weight in individuals undergoing acculturation.

Although no significant correlations were found …

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 …

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.

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.

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 …

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 …

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 …

Mental Health Parity: 1998 National And State Perspectives, Bruce Lubotsky Levin, Ardis Hanson, Richard Coe, Ann C. Taylor

Ardis Hanson

The federal Mental Health Parity Act of 1996 requires insurers to offer the same benefits for mental disorders and substance abuse as they would for physical disorders, including any annual or lifetime limitations and restrictions placed upon such coverage. To date, twenty states across the nation have enacted parity laws for mental health and/or substance abuse benefits. This report summarizes the essential issues facing the state of Florida in the development of state mental health parity legislation, including an examination of the experiences of other states, a look at potential benefits, and a discussion of the impact of managed care …

Prevalent Low Income Status In Canadian And United States Metropolitan Areas, 1980 And 1990, Kevin M. Gorey

Social Work Publications

As compared to Toronto’s poor people, three to four-fold as many of upstate New York’s poor live in severely impoverished neighborhoods, areas where 40% or more of the residents have annual incomes below the federally established low income or poverty criterion. However, the prevalence of such extremely degraded living conditions increased similarly (two-fold) on both sides of the Canadian-US border during the 1980s. This urban problem, of the concentration of poor people, seems to predominantly be an inner-city problem in the US, whereas it was found to be nearly equivalently extant in the inner-city, mid-suburban and outlying suburban areas of …

Secular Trends In The Incidence Of Anorexia Nervosa: Integrative Review Of Population-Based Studies, Kevin M. Gorey

Social Work Publications

OBJECTIVE AND METHOD: Aggregating across retrospective cohort samples, this integrative review synthesizes the findings of 12 cumulative incidence studies (45 hypotheses) on anorexia nervosa secular trends.

RESULTS: (1) The female/male anorexia incidence rate ratio was estimated to be 8.20, 18.46 versus 2.25 cases per 100,000 per year, p < .05; (2) female teenagers experienced anorexia at a rate fivefold greater than other women, 50.82 versus 10.37 incident cases per 100,000 per year, p < .001; (3) no secular trend or change in the incidence of anorexia was observed among teenagers, while a near threefold increase was observed over the past 40 years among women in their 20s and 30s, 6.28 (1950-1964) versus 17.70 (1980-1992) cases per 100,000 per year, p < .05; and (4) the two cohort characteristics of age, and the age by year interaction accounted for nearly two thirds of the variability among anorexia incidence estimates, R2 = .614, F(2,27) = 21.49, p < .001. After the two factors of age and the Age x Year interaction were accounted for, none of the other study characteristics, including study year(s), were found to be significantly associated with anorexia incidence, that is, a main effect of time was not observed.

DISCUSSION: The integrative evidence across the population-based epidemiologic studies covering 40 years in this field suggests strongly that, overall, the incidence of anorexia nervosa, particularly among those very young women at greatest risk of experiencing it, has not increased significantly. However, the risk does seem to have increased significantly among women in …

Effectiveness Of Case Management With Severely And Persistently Mentally Ill People, Kevin M. Gorey

Social Work Publications

This meta-analytic review synthesizes the findings of 24 published studies dealing with the effectiveness of case management with the severely and persistently mentally ill. Summative findings were: (1) Overall, case management interventions are effective--75% of the clients who participate in them do better than the average client who does not; (2) The estimated preventive fraction (e.g., prevention of re-hospitalization) among clients who experience relatively intense case management service (case loads of 15 or less, 89%) is nearly 30% greater than that estimated among similar clients receiving less intensive service; and (3) Various case management practice models did not differ significantly …

Gorey, K. Association Between Socioeconomic Status And Cancer Incidence In Toronto, Ontario: Possible Confounding Of Cancer Mortality By Incidence And Survival, Kevin M. Gorey

Social Work Publications

OBJECTIVE: To observe the association between socioeconomic status (SES) and cancer incidence in a cohort of Canadians.

DESIGN: Cases of primary malignant cancer (83,666) that arose in metropolitan Toronto, Ont., from 1986 to 1993 were ascertained by the Ontario Cancer Registry and linked by residence at the time of diagnosis to a census-based measure of SES. Socioeconomic quintile areas were then compared by cancer incidence.

RESULTS: Significant associations between SES and cancer incidence in the hypothesized direction--greater incidence in low-income areas--were observed for 15 of 23 cancer sites.

CONCLUSIONS: These findings, together with the recently observed consistent pattern of significant …

Secular Trends In The United States Black/White Hypertension Prevalence Ratio: Potential Impact Of Diminishing Response Rates, Kevin M. Gorey

Social Work Publications

In this integrative review, the authors analyzed 25 studies on hypertension prevalence among black and white adults (1960-1991). The authors made the following inferences: 1) both female (2.59 vs. 1.77) and male (2.20 vs. 1.38) black/white hypertension prevalence ratios have diminished by approximately a third over the past three decades; 2) response rates were significantly lower among the more recent surveys (i.e., 1976 or later, mean 69.2 percent (standard deviation (SD) 6.9) vs. 1960 to 1975, mean 86.1 percent (SD 9.1)); and 3) these two trends are directly associated--response rates may account for a third (women, R2 = 0.362) to …

Experiencing Physical Violence During Pregnancy: Prevalence And Correlates, Vilma E. Cokkinides, Ann L. Coker

CRVAW Faculty Journal Articles

Violence during pregnancy directly impacts the mental and physical health of pregnant women. We assessed the prevalence and correlates of physical violence around the time of pregnancy in a representative sample of 6,718 women in South Carolina. Physical violence, defined as "being physically hurt by husband or partner" or "being involved in a physical fight" was reported by 10.9% of recently pregnant women. These were correlates of violence: experiencing increased numbers of stressful life events, being unmarried, having increased parity, being on Medicaid, and having an unwanted pregnancy. Screening to identify violence in pregnancy in health care settings is vital …

Violence Against Women In Sierra Leone: Frequency And Correlates Of Intimate Partner Violence And Forced Sexual Intercourse, Ann L. Coker, Donna L. Richter

CRVAW Faculty Journal Articles

Violence against women is a significant public health problem which impacts women, men, and children. Little is known about the frequency or correlates of violence against women in Africa. In this cross-sectional study, we found that 66.7% of 144 women surveyed in a study of AIDS knowledge, attitude, and behaviours, report being beaten by an intimate male partner and 50.7% report having ever been forced to have sexual intercourse; 76.6% of women report either forced sex or intimate partner violence. Circumcised women were most likely to report intimate partner violence and forced sexual intercourse. To improve the health of women …

Manuel De Recherche Opérationnelle En Matière De Planification Familiale, Andrew A. Fisher, John E. Laing, John E. Stoeckel, John Townsend

Reproductive Health

Le Manuel de recherche opérationnelle en matière de planification familiale, publié pour la première fois en anglais par le Population Council en 1984, se basait sur des projets de recherche en Asie. Cette seconde édition contient des sections révisées et développées. Le cas échéant, des exemples d'Amérique latine et d'Afrique ont été ajoutés. Le chapitre d'introduction comprend une exposé actualisé sur le processus de la recherche opérationnelle (RO) en matière de santé et planification familiale. De nouveaux chapitres concernent le choix du type d’intervention à tester dans une étude RO ainsi que les principaux éléments constituant un programme d'intervention. Le …

Assessing The Quality Of Reproductive Health Services, Raeda Al Qutob, Salah Mawajdeh, Laila Nawar, Salama Saidi, Firas Raad

Reproductive Health

This paper offers a broad definition of quality of care and presents a comprehensive conceptual framework for the assessment of quality of reproductive health services and methodological approaches for its measurement. It presents three studies that were conducted between 1990 and 1991 by members of the regional Reproductive Health Working Group from Egypt, Jordan, and Tunisia. The studies provide examples of applications of the framework and its measurement using multiple data sources. Selected findings are presented to illustrate comparative results between countries. Based on the lessons learned from the studies, examples of reproductive health interventions that may improve the quality …

Seminar On Male Involvement In Reproductive Health In Egypt: Summary Of Research Findings And Future Directions, Nahla G. Abdel-Tawab

Reproductive Health

As more work in the area of male involvement in reproductive health (RH) is expected in Egypt, it is important that researchers and donor agencies become aware of existing studies, topics covered, and main research findings so duplication can be avoided. It is also important that policymakers and program managers learn about the results of existing studies so they can use those results in designing more effective policies to increase male involvement in Egypt. To address this need, the Population Council’s ANE OR/TA Project organized a seminar on “Disseminating Results of Research on Male Involvement in Reproductive Health in Egypt” …

Strengthening The Research Capacity Of Planned Parenthood Association Of Ghana, Robert A. Miller

Reproductive Health

The Planned Parenthood Association of Ghana (PPAG) is one of the most active nongovernmental organizations delivering reproductive health (RH) services in Ghana, focusing particularly on youth issues and services. USAID suggested to the Population Council’s Africa OR/TA Project II staff that PPAG might benefit from technical assistance. A large and well-funded IPPF program to promote sexual health among youth of the Volta Region offered a good opportunity to begin OR work. Earlier, the program was envisioned as a demonstration educational program of five years duration. Further discussions suggested that this program was unlikely to be duplicated anywhere, because of its …

Youth Centres In Ghana: Assessment Of The Planned Parenthood Association Of Ghana Programme, Evam Kofi Glover, Annabel Erulkar, Joana Nerquaye-Tetteh

Reproductive Health

The sexual and reproductive health of adolescents has become a major public concern, particularly with the advent of HIV/AIDS. Many organizations have tried to find strategies to reach youth with reproductive health (RH) information and services through various service delivery models. One such model has been the multipurpose youth center approach. Multipurpose youth centers typically include recreational or vocational services as entry points for RH and family planning (FP) information and services. There is some evidence in a variety of African settings (notably Kenya and Zimbabwe) suggesting that these centers are underutilized and not cost-effective. As a result, the Planned …

Reproductive Health Operations Research, 1995–1998, James R. Foreit, Federico R. Leon, Ricardo Vernon, Timothy D.N. King, Deborah L. Billings, A.B Friedman, Janie Benson

Reproductive Health

This book presents in-depth reports on promising new interventions that have been developed and important programmatic changes that have been achieved by operations research in Latin America between 1995 and 1998. The INOPAL III project has made advances in five areas including access and quality of services, integration of family planning and other reproductive health services, financial sustainability, post-abortion care, and emergency contraception. Each of these topics are represented by at least three studies conducted in two or more countries. The operations research projects discussed under each topic are not replications of a single study. They use different research designs …

Creating Linkages Between Incomplete Abortion Treatment And Family Planning Services In Kenya: What Works Best?, Julie Solo, Achola Ominde, Margaret Makumi, Deborah L. Billings, Colette Aloo-Obunga

Reproductive Health

Unsafe abortion constitutes a major public health problem throughout the world, leading to high levels of maternal morbidity and mortality. Abortion accounts for roughly one-third of maternal mortality in the world. Millions of other women experience short- and long-term morbidity, such as infertility and pain. The concept of postabortion care (PAC) has gained wide acceptance as a means to improve services provided to women with complications from spontaneous or unsafely induced abortions. One way to improve emergency treatment is through introducing manual vacuum aspiration (MVA), which has been shown to be safer and less costly than dilation and curettage (D&C). …

Workshop Report: Launching Of The Revised Reproductive Health Policy Guidelines And Standards, Division Of Primary Health Care, Kenya Ministry Of Health

Reproductive Health

The Government of Kenya recently revised its Policy Guidelines and Standards for family planning (FP) and other reproductive health (RH) services to encourage service providers to undertake a more comprehensive approach to service delivery. Some of the recommendations, especially those relating to the integration of STI/HIV/AIDS services into MCH/FP services, and to safe motherhood, include new practices and procedures. A number of research studies have been conducted in Kenya and elsewhere that provide data pertinent to many of these recommendations, and the Division of Primary Health Care (DPHC) used the results to provide a framework within which the guidelines were …

Towards Safe Womanhood: Supporting Safe Motherhood Initiatives And Women's Participation In Development, Meiwita B. Iskandar

Reproductive Health

Improvement in a woman’s quality of life is a prerequisite for development of human resources, because the quality of children’s physical and mental development is inextricably tied to the health and welfare of women as future mothers. If a mother is well protected during the pregnancy, birth, and postpartum period, the risk of illness and other problems in fetuses and newborn babies will be reduced. On the other hand, if a woman does not survive the pregnancy, birth, and postpartum period, her fetus or newborn will also be threatened. This paper provides a situation analysis of pregnant women, women in …

Needs And Risks Facing The Indonesian Youth Population, Desti Murdijana

Reproductive Health

Youth are the leaders of tomorrow, but right now they face a formidable collection of problems that will determine the quality of their future lives and the lives of us all. Education, jobs, substance abuse, violence, sexuality, and marriage are examples of adolescent issues that demand special attention from researchers, youth activists and advocates, parents, and policymakers. In attempting to address these complex issues, we must be willing to confront ignorance, controversy, and cultural obstacles. Clear and focused policy and strategies must play a basic role in tackling these issues facing Indonesian adolescents. This paper provides a concise situation analysis …

Involving Private Medical Practitioners In Family Planning Services In Bangladesh, Abu Yusuf Choudhury, Ubaidur Rob, Sharif M.I. Hossain

Reproductive Health

The project "Involving Private Medical Practitioners (PMPs) in Family Planning Services" is an innovative initiative to involve PMPs in protecting the reproductive health (RH) of couples, attract private investment in the family planning (FP) sector, and eventually reduce the increasing financial pressure on the government. The project was implemented in two phases. In phase I, qualified PMPs from urban areas were given training on FP. In phase II, nonqualified PMPs were given training on FP. PIACT Bangladesh, a local NGO, conducted two pilot projects to involve the PMPs in FP. The first one was to involve qualified PMPs in urban …

The Life Saver: The Mother Friendly Movement In Indonesia, Abdullah Cholil, Meiwita B. Iskandar, Rosalia Sciortino

Reproductive Health

The focus of this book is the Mother Friendly Movement in Indonesia, a collective effort to reduce maternal mortality. The idea of documenting the Mother Friendly Movement or Gerekan Sayang Ibu (GSI) was originally suggested by Her Excellency Mien Sugandhi, the State Minister for the Role of Women, Republic of Indonesia, in the belief that the Indonesian experience in reducing maternal mortality would be relevant to other countries struggling with the same problem. The authors were entrusted with producing an illustrated monograph on the pilot projects implemented in eight districts from June to December 1997. Besides extensively monitoring these activities, …

Advances And Challenges In Postabortion Care Operations Research: Summary Report Of A Global Meeting, Dale Huntington

Reproductive Health

The Global Meeting on Postabortion Care: Advances and Challenges in Operations Research was held at the Population Council’s New York office on January 19–21, 1998, to review progress made by three regional operations research (OR) projects in improving delivery of postabortion care. The resources of the three OR contracts were pooled, and, in collaboration with Ipas and the Ebert Program, approximately 65 researchers, senior program managers, and government officials from Africa, Latin America, the Middle East, and Southeast Asia were convened. Three objectives guided the planning of the meeting: review progress in the development of OR methodologies pertaining to postabortion …

Ethnicity And Child Mortality In Sub-Saharan Africa, Martin Brockerhoff, Paul C. Hewett

Poverty, Gender, and Youth

Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups-as in Côte d’Ivoire, Kenya, and Niger-these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda …

An Environmental History Of Fairfield/Wagner Point, Philip Diamond

Legal History Publications

This paper traces the history of the Fairfield/Wagner Point peninsula from the beginning of the European settlement to the present, observing the ambitions and dreams of developers and industrial entrepeneurs, the significant contribution the area made to our nation's wartime production in World War II, the rise and fall of the tight-knit workers' communities, the struggles of outside activists and community leaders to better the living conditions of these neighborhoods, and the environmental devastation of the area followed by the attempt to redevelop the area with “green" industry. A 'central strand in this complex and contradictory story will be the …