Public Health Commons^™

Nutrition And Disability, Kathleen Humphries, Meg Traci, Tom Seekins Ph.D., Joyce Brusin, University Of Montana Rural Institute

Health and Wellness

A disability often can be complicated by additional medical, psychological, or environmental problems. Under an emerging framework of health promotion for persons with disabilities, these additional health problems are referred to as secondary conditions (Brandt & Pope, 1997; Marge, 1988; Pope & Tarlov, 1991). Until recently, it was common to conceptualize these ailments as symptomatic of the primary disability; however, it is now presumed that because these conditions can be prevented or managed, they are secondary conditions distinct from the primary disability. Although information on secondary conditions experienced by people with developmental disabilities is limited, the literature does contain descriptions …

A Description Of Female, Adult Recreational Drug Users: A Sub-Analysis Of The Drugnet Survey, Leslie Bickett

Masters Theses & Specialist Projects

Drug abuse can be a serious, chronic, and relapsing health problem for both men and women. Among women, however, drug use and abuse present an array of different challenges to health and well-being. In addition, the health of women has been given less attention than the health of men. Little research has been conducted to identify and describe the invisible or hidden population of drug users, not abusers, who are not in treatment or incarcerated on drugrelated charges. The purpose of this study is to provide a descriptive and behavioral profile of adult, female, recreational drug users (i.e., not abusers). …

Tribal Wisdom For Today’S World, H Sudarshan

IIMB Management Review

No abstract provided.

Comparing Bottled Water And Tap Water: Experiments In Risk Communication, Branden B. Johnson

RISK: Health, Safety & Environment (1990-2002)

The author discusses results of experiments in risk communication comparing bottled water and tap water.

Measuring Health Status And Quality Of Life In Disease Management Programs, Dea Belazi

College of Population Health Faculty Papers

Current medical practice is largely disease and problem focused, concentrating on the diagnosis and treatment of anatomic or physiologic problems. This approach assumes that physiologic parameters accurately reflect the patient's status of health. It also assumes that, when a patient's disease is ameliorated, his or her quality of life will improve. Many health services researchers find these parameters to be imperfect determinates for good outcomes of patients' perceived health status. However, there are many valid and reliable methods to measure patients' health status and quality of life. Recently available survey tools that measure quality of life are based on modern …

Epidermal Growth Factor Receptor (Egfr) As A Prognostic Marker: An Immunohistochemical Study On 315 Consecutive Breast Carcinoma Patients, S. A. Aziz, Shahid Pervez, N. Kayani, M. H. Rahbar, S. Khan

Department of Pathology and Laboratory Medicine

Objective: To assess the independent and interdependent prognostic value of epidermal growth factor receptor (EGFR) in carcinoma of breast in female population. The Type I family of growth factor receptors includes epidermal growth factor receptor (EGFR also known as EGFRI).

Methods: The expression of EGFR protein was analysed immunohistochemically on 315 tumour specimens of infiltrating ductal carcinoma of breast. These patients also had axillary lymph nodes sampling.

Results: Overexpression and/or amplification of EGFR was observed in 70 (22.00%) tumours. Eleven (16%) were grade I, 43 (61%) grade II and 16 (23%) grade Ill tumours. Axillary lymph node metastasis had significant …

Welfare Reform In Maryland: Flexibility In Action, Jennifer Ryan, Judith D. Moore

National Health Policy Forum

This site visit took federal participants on a tour around Maryland, providing a three-way comparison of suburban, urban, and rural service delivery in a diverse state. The site visit focused on the Family Investment Program, a statewide effort to reduce the state's welfare caseload through temporary cash assistance (TCA) and other needed supports to help customers become self-sufficient. In particular, site visitors examined rural perspectives on reform, substance abuse assessment and treatment innovations, and fatherhood and family support initiatives. The group heard from state officials, researchers, advocates, and a variety of direct service providers about the successes and challenges of …

Promoting Marriage As Welfare Policy: Looking At A Public Role In Private Lives, Jane Koppelman

National Health Policy Forum

This issue brief discusses the interest in and politics surrounding government's using welfare reform legislation to carve out a stronger role in promoting marriage. It examines trends in family formation, their impact on society, and the effect of single parenting, divorce, and stepparenting on child well-being. The paper also looks at the treatment of marriage in current government programs, new state activities to promote marriage, proposals for a stronger government role, and marriage experts' expectations for the success of marriage education programs.

Correlates Of Vigorous Physical Activity For Children In Grades 1 Through 12: Comparing Parent-Reported And Objectively Measured Physical Activity, James F. Sallis, Wendell C. Taylor, Marsha Dowda, Patty S. Freedson, Russell R. Pate

Faculty Publications

Correlates of physical activity were examined in young people in grades 1 through 12, and analyses were conducted separately for eight age/grade and sex subgroups. Twenty-one explanatory variables were assessed by parental report. Physical activity was assessed in 781 young people via parent report, and 200 wore an accelerometer for seven days. Between 11% and 36% of parent-reported child vigorous physical activity was explained. The most consistent correlates were peer support and use of afternoon time for active rather than sedentary recreation. Peer support was the only significant correlate of objectively monitored activity in multiple subgroups.

From Diagnosis To Payment: The Dynamics Of Coding Systems For Hospital, Physician, And Other Health Services, Karen Matherlee

National Health Policy Forum

This background paper reviews the two principal coding systems used to describe health services in the United States: ICD-9-CM and HCPCS, a combination of CPT-4 and national and local codes. It probes the relationships of these coding systems to payment policy, administrative simplification under HIPAA, and other concerns. The paper also addresses four coding issues: governance of CPT; adoption of ICD-10-CM; the appropriateness, accuracy, and responsiveness to change of the codes themselves; and the degree of documentation needed to monitor health services and determine payment.

Who Will Be There To Care? The Growing Gap Between Caregiver Supply And Demand, Nora Super

National Health Policy Forum

This paper examines the increasing demand for long-term care services and the concurrent decrease in the supply of paid and unpaid caregivers. It considers workforce trends for paraprofessionals, such as certified nursing assistants, home health aides, and personal care attendants, as well as several public and private efforts to address staff shortages and quality-of-care. The paper explores the sociodemographic factors that have affected the demand for and supply of informal care provided by family and friends. It also reviewes policy proposals designed to provide support for family caregivers and/or to give choices to consumers.

Diagnostic And Therapeutic Procedures Among Australian Hospital Patients Identified As Indigenous, Joan Cunningham

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To determine whether hospital patients identified as Indigenous are less likely than other inpatients to have a principal procedure recorded, and the extent to which any disparity in procedure use can be explained by differences in patient, episode and hospital characteristics. Design: Retrospective analysis of routinely collected administrative data from the National Hospital Morbidity Database (NHMD). Setting: Australian public and private hospitals. Patients: All patients included in the NHMD whose episode type was recorded as acute and whose separation occurred between 1 July 1997 and 30 June 1998. Patients admitted for routine dialysis treatment were excluded. Main outcome measure: …

Managed Care: As Good As It Gets? (Los Angeles), Lisa Sprague

National Health Policy Forum

This site visit was a return trip to southern California to examine the state of managed care. Between the Forum's last visit (in late 1998) and this one, the marketplace underwent considerable change, including significant movement away from global capitation, the collapse of physician practice management firms, and the development of new insurance products. Site visitors were briefed on managed care trends in the state, and panel discussions focused on issues related to physician group solvency, employer and consumer expectations, managed care regulation, and plan and provider strategies for surviving and prospering in the difficult southern California market. Site visitors …

Estimating Causal Parameters In Marginal Structural Models With Unmeasured Confounders Using Instrumental Variables, Tanya A. Henneman, Mark Johannes Van Der Laan, Alan E. Hubbard

U.C. Berkeley Division of Biostatistics Working Paper Series

For statisticians analyzing medical data, a significant problem in determining the causal effect of a treatment on a particular outcome of interest, is how to control for unmeasured confounders. Techniques using instrumental variables (IV) have been developed to estimate causal parameters in the presence of unmeasured confounders. In this paper we apply IV methods to both linear and non-linear marginal structural models. We study a specific class of generalized estimating equations that is appropriate to these data, and compare the performance of the resulting estimator to the standard IV method, a two-stage least squares procedure. Our results are applied to …

Effectiveness Of Colors Used On Safety And Health Signs For Communicating Severity Of Injury, Andrew M. Mccammack, Roger C. Jensen

Safety Health & Industrial Hygiene

Signs are used extensively in workplaces and on products to identify hazards and provide instructions for appropriate behavior. A fundamental element of these signs is the signal-word panel located at the top of the sign. The colors and words in this panel are intended to convey information about the hazard identified. One type of hazard information concerns the severity of injury/illness associated with the hazard. The standard of the American National Standards Institute (ANSI) for facility signs uses three severity categories: 1) death or serious injury, 2) minor or moderate injury, and 3) property damage. The standard specifies which signal-word …

Case Study Of An Ergonomics Training Program For Nursing Home Workers, Roger C. Jensen

Safety Health & Industrial Hygiene

This paper describes a case study of a labor-based ergonomics-training program that makes use of some effective worker training methods. The program focus was on ergonomics awareness and back injury prevention for nursing home workers. It was developed and conducted by a not-for-profit organization affiliated with the Service Employees International Union. Training methods included the train-the-trainer model and the small group activity method. The investigation also compared the program components with those identified by the Occupational Safety and Health Administration (OSHA) as being key elements in effective safety training.

Safety And Health Sign Colors And Signal Words For Communicating Information On Likelihood And Imminence Of Threat, Roger C. Jensen, Andrew M. Mccammack

Safety Health & Industrial Hygiene

Signs are used extensively in workplace facilities and on products to identify hazards and provide instructions and safety information. A fundamental component of these signs is a signal-word panel located at the top of the sign. Certain colors and signal words in this panel are intended to convey information about a hazard, including likelihood of harm and imminence of the threat. The purpose of this study was to determine if young adults without prior training on safety signs associate signal words and color with likelihood of harm and imminence of the threat. The sample population consisted of 59 college students. …

An Evaluation Of Germ City : Finding A Suitable Design, Suzanne Cherie Lusher

Theses, Dissertations and Capstones

Evaluations are used to determine a program’s merit. “Germ City” utilizes experiential learning of adequate hand washing skills. An elementary school in southwestern West Virginia served to determine if the evaluation design for “Germ City” would prove to be an effective assessment for the hand-washing program. Four hundred and eighty-four participants completed an eight-question pre/post test; one hundred and forty-nine students underwent a hand quadrant evaluation. In addition, a soap and paper towel usage log was recorded. Fifty-four percent of the participants were male, forty-six percent female (n=483) with a mean grade level of 3.6 (n=484). Post test results indicated …

Comparison Of Domestic Violence Outcomes Among Emergency Department Nurses, Pamela S. Neal

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationships between domestic violence education, organizational support, screening, danger assessment, safety planning, and referral practices among professional registered nurses in two ED settings.

Sample & Setting: A convenience sample of 63 professional registered nurses provided data from two EDs. An ED located in Kentucky where state mandated continuing education in domestic violence was required (n = 33) and an ED in West Virginia (n = 30) where mandated continuing education in domestic violence was not required was the setting for the study. The samples were separated based on nurses who …

Surveillance For Waterborne-Disease Outbreaks--United States, 1999-2000, Sherline H. Lee, Deborah A. Levy, Gunther F. Craun, Michael J. Beach, Rebecca L. Calderon

Journal Articles: Epidemiology

PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists (CSTE) have maintained a collaborative surveillance system for the occurrences and causes of waterborne-disease outbreaks (WBDOs).This surveillance system is the primary source of data concerning the scope and effects of waterborne diseases on persons in the United States.

REPORTING PERIOD COVERED: This summary includes data regarding outbreaks occurring during January 1999-December 2000 and previously unreported outbreaks occurring in 1995 and 1997.

DESCRIPTION OF THE SYSTEM: The surveillance system includes data for outbreaks associated with drinking water and recreational water. State, territorial, and …

Mainecare Enrollees With Disabilities Work Experience: Results From A 2002 Survey, Sara T. Salley, Larry Glantz

Disability & Aging

No abstract provided.

Managed Healthcare And Integrated Delivery Systems: A Model For Getting Ahead Of The Change Curve, Philip Sheridan Carney

Theses Digitization Project

Managed care became the dominant model for moderating healthcare costs in the 1990's. The later half of this past decade witnessed early signs of a return to escalating premiums. Providers and consumers have reacted negatively to perceptions of health plan micro-management and restriction of choice.

Providers Choices In Web-Medical Records: An Analysis Of Trade-Offs Made By Physicians In San Bernardino County, Jay Eriah Shankar

Theses Digitization Project

This thesis concluded that offering physicians an appropriate Web-based transcription service should be well received and improve their medical record management and patient care.

Characteristic Differences Between Parents/Guardians Who Keep Immunization Records And Those Who Do Not, Rebecca Bonilla Mangual

Theses Digitization Project

No abstract provided.

Barriers To Initiation And Continuation Of Vision Care Among Diabetics, Jennifer Eilleen Werner

Theses Digitization Project

No abstract provided.

Delays In The Emergency Department And Their Effects On The Ambulance Provider, Simon Peter Moore

Theses Digitization Project

This thesis is a case analysis of the nature of delays in emergency room admissions and the effects on ambulance dispatching and availability as it occurred in Southern California.

Health Disparities, Neil Macnaughton

International Journal of Global Health

"Americans believe that we are a classless society, largely because just about everyone thinks they are members of the struggling middle class. In actuality the United States is a highly stratified society in terms of wealth, meaning that we have a much more significant problem of poverty than most industrialized nations. Members of ethnic minorities are more likely to be poorer and less powerful. Racist beliefs on the part of the dominant white ethnic groups exacerbate the problem of socioeconomic inequality (Brown, 1998 p. 259)." In healthcare we like to believe that we do not discriminate amongst patient populations and …

Associations Between Water-Treatment Methods And Diarrhoea In Hiv-Positive Individuals, J. N. S. Eisenberg, T. J. Wade, A. Hubbard, D. I. Abrams, R. J. Leiser, S. Charles, M. Vu, S. Saha, C. C. Wright, Deborah A. Levy, P. Jensen, J. M. Colford

Journal Articles: Epidemiology

This manuscript extends our previously published work (based on data from one clinic) on the association between three drinking water-treatment modalities (boiling, filtering, and bottling) and diarrhoeal disease in HIV-positive persons by incorporating data from two additional clinics collected in the following year. We conducted a cross-sectional survey of drinking water patterns, medication usage, and episodes of diarrhoea among HIV-positive persons attending clinics associated with the San Francisco Community Consortium. We present combined results from our previously published work in one clinic (n = 226) with data from these two additional clinics (n = 458). In this combined analysis we …

Risk Factors In Hiv-Associated Diarrhoeal Disease: The Role Of Drinking Water, Medication And Immune Status, J. N. S. Eisenberg, T. J. Wade, S. Charles, M. Vu, A. Hubbard, C. C. Wright, Deborah A. Levy, P. Jensen, J. M. Colford

Journal Articles: Epidemiology

In a cross-sectional survey of 226 HIV-infected men, we examined the occurrence of diarrhoea and its relationship to drinking water consumption patterns, risk behaviours, immune status and medication use. Diarrhoea was reported by 47% of the respondents. Neither drinking boiled nor filtered water was significantly associated with diarrhoea (OR = 0.5 [0.2, 1.6], 1.2 [0.6, 2.5] respectively), whereas those that drank bottled water were at risk for diarrhoea (OR = 3.0 [1.1, 7.8]). Overall, 47% always or often used at least one water treatment. Of the 37% who were very concerned about drinking water, 62% had diarrhoea, 70% always or …

The Hand Center: Considerations Related To The Design, Planning, Staffing, And Marketing, Marcia L. Miller

Community & Environmental Health Theses & Dissertations

A therapist intent on planning a hand therapy center has no resources that are specific to this specialty area of practice. There are contributions utilized to plan occupational and physical therapy departments that can be synthesized to a degree in the planning of a hand therapy center. The practice of hand therapy incorporates a high degree of physical interaction, with close proximity to the patient and handling by the therapist. This paper explores the unique requirements of a hand therapy department. In order to determine hand therapists' preferences for equipment and space utilization a survey was developed and distributed to …