Health Services Research Commons^™

Don't Bring Me Your Tired, Your Poor: The Crowded State Of America's Emergency Departments, Jessamyn Taylor

National Health Policy Forum

If the time comes, people expect that the emergency department (ED) will have the resources necessary to treat them in a timely, high-quality manner. Increasingly, however, EDs may not be able to meet that expectation. Hospitals in urban areas with large populations, high population growth, and higher-than-average numbers of uninsured are particularly crowded: ambulances are often diverted to other hospitals and patients are frequently forced to “board” in the hallways (while they wait to be transferred to another facility or part of the hospital). This issue brief places EDs in the context of the U.S. health care system and its …

Using The Outcome Questionnaire 45.2 In Obesity Treatment, Adam L. Arechiga

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to determine if the Outcome Questionnaire 45.2 (OQ-45) can be used in the treatment of obesity to predict participant dropout and initial treatment success, in terms of weight loss (Lambert et. al, 2002a). The OQ-45 has been used with success to predict dropout from psychotherapy in clinical populations. It was hypothesized that higher pretreatment OQ-45 scores would be associated with less program completion and less weight loss by the end of treatment.

Method: The study employed a non-experimental time series design. Seventy-eight participants were recruited from the three local obesity treatment programs, which …

Guide To A Successful Pregnancy: A Resource Manual For Pregnant And Parenting Young Women In Las Vegas, Nevada Institute For Children's Research And Policy Reports

Nevada Institute for Children's Research and Policy Reports

A Guide to a Successful Pregnancy.

• Are you Pregnant? Taking a pregnancy test
• First steps of Pregnancy: Options of pregnancy, health plans, obtaining medical care such as a doctor
• Months 1, 2, 3: Maintaining a healthy diet, what you should stay away from, exercise, symptoms of danger, and normal symptoms of pregnancy
• Months 4, 5, 6: Following a routine, classes available during pregnancy, normal pregnancy symptoms
• Months 7, 8, 9: Following a routine, normal pregnancy symptoms
• Labor and Delivery: Symptoms of labor, symptoms of danger
• Parenting: Normal symptoms after birth, Routine to follow to return to normal state, Breast feeding …

The Relationship Of Attitude, Self-Efficacy, Physician, And Significant Other Influence To Type 2 Diabetes Outcomes, Heidi A. Larson

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to investigate the Theory of Planned Behavior (TPB) and its' relationship to Type 2 diabetes outcomes. One hundred and sixty-two adults ages 45 to 75 with Type 2 diabetes were recruited from two physicians' offices in the Midwest. Participants completed instruments that assessed (a) diabetes-specific attitude, (b) diabetes-specific self-efficacy, ( c) physician influence, ( d) significant other influence, and ( e) diabetes-specific quality of life. A measurement of metabolic control was also obtained. Multiple regressions were performed using (a) quality of life and (b) metabolic control as criterion variables. Attitude, self-efficacy, and physician influence …

Anemia And Blood Transfusion In The Critically Ill Patient: Role Of Erythropoietin, Howard L. Corwin

Dartmouth Scholarship

Critically ill patients receive an extraordinarily large number of blood transfusions. Between 40% and 50% of all patients admitted to intensive care units receive at least 1 red blood cell (RBC) unit during their stay, and the average is close to 5 RBC units. RBC transfusion is not risk free. There is little evidence that 'routine' transfusion of stored allogeneic RBCs is beneficial to critically ill patients. The efficacy of perioperative recombinant human erythropoietin (rHuEPO) has been n demonstrated in a variety of elective surgical settings. Similarly, in critically ill patients with multiple organ failure, rHuEPO therapy will also stimulate …

The Frank J. Manning Certificate In Gerontology Alumni Survey: 21 Years Of Service To Elders, Nina M. Silverstein, Jenai Murtha, Donna Sullivan, May Jawad

Gerontology Institute Publications

The Certificate Program in Gerontology at the University of Massachusetts Boston, a large urban university, was established in 1979 as part of an Administration on Aging (AoA) grant to develop and expand services to the elderly citizens of the Commonwealth of Massachusetts. In 1984, a line item was added to the state budget by the legislature and governor establishing the Gerontology Institute at the University of Massachusetts Boston and ensuring the continuation of training, research, and policy and advocacy work on behalf of and with Massachusetts’ elders (O’Brien, 1996). Upon Frank J. Manning’s death in 1986, the program was renamed …

Optimization Of Breast Cancer Screening Modalities, Yu Shen, Giovanni Parmigiani

Johns Hopkins University, Dept. of Biostatistics Working Papers

Mathematical models and decision analyses based on microsimulations have been shown to be useful in evaluating relative merits of various screening strategies in terms of cost and mortality reduction. Most investigations regarding the balance between mortality reduction and costs have focused on a single modality, mammography. A systematic evaluation of the relative expenses and projected benefit of combining clinical breast examination and mammography is not at present available. The purpose of this report is to provide methodologic details including assumptions and data used in the process of modeling for complex decision analyses, when searching for optimal breast cancer screening strategies …

Decreasing Barriers For Teens: Evaluation Of A New Teenage Pregnancy Prevention Strategy In School-Based Clinics, Abbey C. Sidebottom, Amanda Birnbaum, Sarah S. Nafstad

Department of Public Health Scholarship and Creative Works

Sidebottom et al seek to evaluate the effects of the change in distribution systems on students' receipt of requested contraceptives and demand for contraceptive school-based clinics (SBC). The result of the study reveals that the average number of requests per student was higher under the voucher system, possibly as a consequence of expires vouchers resulting in repeated requests. The findings also suggest that SBCs could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system..

Predictors That Affect The Caregiver's Health Status And The Role Of Social Support On The Caregiver's Health Status, Hong Wang

All-Inclusive List of Electronic Theses and Dissertations

This study examines whether the caregiver's self-rated health status is affected by the caregiver's demographic characteristics (age, education level, and income), caregiver's stressor (the number of ADL and IADL), mediating variables of the caregiver's appraisal (willingness to help non-family members, level satisfaction with life, and financial burden), of and mediating variable of social support (information and/or advice from other family members or friends). Data were drawn from Chronic Illness and Caregiving, a national telephone survey conducted by Harris Interactive Inc. on behalf of The Robert Wood Johnson Foundation, Johns Hopkins University, and Partnership for Solutions. The sample size of caregivers …

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Gerontology Institute Publications

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

A Survey Of Health Services And Identification Of Needs For Asian American Elderly Women In The Greater Boston Area, Connie S. Chan, Lin Zhan

Institute for Asian American Studies Publications

Over one hundred Asian American and mainstream health care providers in the greater Boston area were surveyed for this study. The authors have identified critical gaps in services for elderly Asian American women.

Justification For The Continuance Of A Pediatric Physician's Office Laboratory, Veronica C. Santilli

Seton Hall University Dissertations and Theses (ETDs)

The continued viability of the Physician's Office Laboratory (POL) has been questioned because of barriers imposed by managed care organizations, oversight by regulatory agencies and competition for professionally trained laboratory staff. Pediatricians view the POL as an important adjunct to quality healthcare services for children and do not consider the POL as a "profit center", whose priority is generation of revenues for the The practice. parents of pediatric patients consider an on-site laboratory a convenience and valuable service. Through an analysis of patients' satisfaction, physicians' perceptions of enhancement to quality care, managed care reimbursement data and costs associated with maintenance …

Transitions Along The Continuum Of Care: Elderly And Disabled Persons In New York, Lisa Sprague, Nora Super

National Health Policy Forum

This site visit examined transitions along the continuum of care for elderly and disabled persons in New York. The state offers its residents an extensive array of services, including nursing homes, home health care, personal care, and community-based services. New York spends more than any other state on its Medicaid program, which is reflected in a comprehensive benefit package, full-cost reimbursement of hospitals, high nursing home rates, and extensive coverage of personal care services. Site visitors were briefed on the history and development of long-term care in the state as well as the various care settings available. Panels discussed transitions …

West Bank And Gaza: Stress The Importance And Cost-Effectiveness Of Postpartum Care, Frontiers In Reproductive Health

Reproductive Health

To assess maternal health care in the West Bank and Gaza, the Health, Development, Information, and Policy Institute conducted a study from May to August 2000. This study served as a baseline for the Pilot Health Project (PHP), which seeks to improve antenatal and postpartum services in three areas of the West Bank and Gaza. Seven local and international agencies are implementing PHP in collaboration with the Palestinian Ministry of Health and with funding from the U.S. Agency for International Development. Data sources for the baseline study consisted of service statistics, interviews with health-care providers, and exit interviews with antenatal, …

Cisjordania Y Gaza: Subraye La Importancia De La Atención Postparto Y Su Cost-Efectividad, Frontiers In Reproductive Health

Reproductive Health

El Instituto de Salud, Desarrollo, Información y Políticas realizó un estudio de mayo a agosto de 2000 para evaluar la atención a la salud materna en Cisjordania y Gaza. Dicho estudio sirvió de línea basal para el Proyecto Piloto de Salud (PHP, por sus siglas en inglés), cuyo objetivo es mejorar los servicios prenatales y postparto en tres áreas de esa región. Siete agencias locales e internacionales implementan el PHP con la colaboración del Ministerio de Salud palestino y el patrocinio de la Agencia de los Estados Unidos para el Desarrollo Internacional. Las fuentes de la información para el estudio …

Toward Improved Support For Research On Delivery Of Home- And Community-Based Long-Term Care, Francis G. Caro

Gerontology Institute Publications

Stronger and more consistent support is needed for research on long-term care. A greater investment in research will strengthen the ability of public and private organizations to provide effective and efficient assistance to people with disabilities and their informal caregivers. This paper provides a rationale for stronger research funding for the field and outlines several options to strengthen research.

Nursing Homes To Medicare Waiver Programs In Vermont, Joseph Murray

New England Journal of Public Policy

This research examines the differences between nursing home residents and those who were able to leave nursing homes with the help of the Medicaid Waiver Program in Vermont. Ninety individuals who reentered the community with the aid of such waivers were compared with a random sample of nursing home residents through the use of the Nursing Home Minimum Data Set. The researchers found divergence in four key areas: cognition, continence, treatment categories, and desire to return to the community. Typically, those who left nursing homes for the community were cognitively intact, had moderate continence, received rehabilitative or clinically complex treatments, …

Factors Which Affect Post-Hospital Resource Use And Patient Health Outcomes Among Taiwanese Older Adults, Chouh-Jiaun Lin

Health Services Research Dissertations

The purpose of this study was to explore relationships among population characteristics, patient post-hospital resource use and patient health outcomes in terms of the Andersen health behavioral model. An additional purpose of this study was to examine a discharge planning screening instrument used in a large urban hospital in Taiwan to determine if it predicts resource use and patient outcomes. A longitudinal research design was adopted for this study. Data were collected from the general medicine departments of an 800-bed university teaching hospital. Out of 109 patients who were interviewed, 78 participants qualified (participation rate = 71.6%).

The majority of …

Filling The Geriatric Gap: Is The Health System Prepared For An Aging Population?, Janet Firshein

National Health Policy Forum

This issue brief explores the field of geriatrics, the ways practitioners meet the health care needs of the elderly, training gaps, and the impact of Medicare payment policies on the delivery of health care to older Americans.

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 …

Interaoperative Frozen Section Consultation: An Analysis Of Accuracy In A Teaching Hospital., Farrukh Aijaz, Suhail Muzaffar, Akbar Shah Hussainy, Shahid Pervez, Sheema H. Hasan, Hizbullah Sheikh

Department of Pathology and Laboratory Medicine

This Is a retrospective quality assurance study of all frozen sections done at The Aga Khan University Hospital during a six year period (1986 to 1991). There were 1,031 frozen sections out of a cumulative total of 42,985 surgical specimens (2.39%). Nine hundred and seventy-six (94.66%) were concordant. In 92(8.9%) fresh specimens were brought from other hospitals of Karachi, in 37 cases (3.58%) the diagnosis was deferred till the evaluation of permanent paraffin sections and 18 (1,74%) were discordant with 7 (0.67%) false positive and 11(1,06%) false negative. Among the discordant cases, 9 were attributed to misinterpretation, 7 due to …

Quantitative Respirator Fit Testing: Probed Facepiece Versus Probed Cartridge, Sonya Melissa Seward

Community & Environmental Health Theses & Dissertations

This study was performed to determine if there is a quantifiable difference between quantitative fit testing using a probed facepiece and a probed cartridge. Four subjects were tested on four different respirators. The respirators used were MSA & 3M full and half face respirator. Each subject performed each method five times per respirator. The results indicated no correlation between the two fit testing methods overall. However, a moderate correlation was found between the MSA respirators and the two methods. This study found many variables which influence fit testing. These include the type of respirator used (brand and facepiece), the probe …

Acute Care Bed Need In Maine: General Use Acute Care Facilities In Maine : Utilization, Occupancy Rates, And Bed Need Projected To 1990 And 1995, Stephen Greenberg

Maine Collection

Acute Care Bed Need in Maine: General Use Acute Care Facilities in Maine : Utilization, Occupancy Rates, and Bed Need Projected to 1990 and 1995

by Stephen Greenberg, Planning and Research Associate, Office of Data, Research, and Vital Statistics.

Prepared at the request of the Division of Planning, Bureau of Health, Maine Department of Human Services.

Produced under Appropriations 1310.4, 1305.1065 and 2210.2950 (November, 1988).

Contents: Overview and Discussion of Findings / Using the Data: An Example / List of Detailed Tables / Appendices

Factors That Influence Prepared Childbirth Couples' Use Of Epidural Anesthesia For Labor And Delivery, Terri S. Chambers

Community & Environmental Health Theses & Dissertations

The purpose of this study was to identify factors that influence a Prepared Childbirth couple's decision to utilize epidural anesthesia for labor and delivery. Review of the literature indicated a high correlation between epidural use for uncomplicated labors and deliveries and a high incidence of maternal complications and low neonatal neurological and behavioral scores.

A sample of twenty-nine couples was used in this prospective, non-experimental field study for the research. Data were collected utilizing two developed demographic and factual event tools, Rotter's Internal-External Locus of Control Tool and Spanier's Dyadic Marital Adjustment Tool.

Three hypotheses were developed and data were …

The Effectiveness Of Stimulation Therapy For The Cognitively Impaired Elderly, Sylvia H. Old

Community & Environmental Health Theses & Dissertations

The effectiveness of stimulation therapy for the cognitively impaired elderly living in an institution was assessed. Residents with varying degrees of cognitive impairment were treated with twenty, thirty-minute daily periods of reality orientation, reminiscence, resocialization, remotivation, and other stimulating therapies and were compared with a control group_ receiving no intervention. Treatment effects were assessed with a variety of instruments reflecting functioning across several domains. Included were ability to perform both basic self-care functions and activities of daily living, cognitive performance, affect, and satisfaction with the care received and the living environment in the nursing home. The experimental group was divided …

Namru-3 Translations Of Parasite Literature From Russian, French, Japanese, Etc. Into English (1929-1985) T1701-T1800, United States Naval Medical Research Unit Number Three, Cairo, Medical Zoology Department

United States Naval Medical Research Unit 3: Publications

T1701. TRANSLATION FROM RUSSIAN, OVEZMUKHAMMEDOV, A. and SAF'YANOVA, V. M. (1983), Occurrence of amastigotes of Leishmania gymnodactyli in the peripheral blood of Gymnodactylus caspius and Agama caucasica. Parazitologiya, Leningrad. 17(3):185-188.

T1702. TRANSLATION FROM RUSSIAN. YASTREBOV, V. K. and YURLOV, K. T. (1978). Possible arbovirus dissemination in western Siberia in connection with data on migrations and overwinterings of west Siberian birds. Dokl. Simp. Transkont. Svyazi Pereletn. Ptits Rol' v Rasp. Arbovirus. (Novosibirsk, July-August, 1976), pp. 167-172.

T1703. TRANSLATION FROM GERMAN. MOSKVIN, I. A. (1929). On the role of the tick Ornithodoros papillipes Bir. (Ixodoidea) in transmitting relapsing fever in Turkestan. Z. …

Namru-3 Translations Of Parasite Literature From Russian, French, Japanese, Etc. Into English (1973-1984) T1801-T1900, United States Naval Medical Research Unit Number Three, Cairo, Medical Zoology Department

United States Naval Medical Research Unit 3: Publications

T1801. TRANSLATION FROM RUSSIAN. KOLOTVINOV, S. V. and MASLENNIKOV, V. A. (1980). Method for evaluating the functional activity of viral antigens. Zh. Mikrobiol., Moskva, 57(8): 58-61.

T1803. TRANSLATION FROM GERMAN. CAFLISH, U., TONZ, O., SCHAAD, U. B., AESCHLIMANN, A. and BURGDORFER, W. (1984). Tick-borne meningo-radiculitis – a spirochetosis. Schweiz. Med. Wschr., 114(18):630-634.

T1804. TRANSLATION FROM FRENCH. LEW, D. (1984). Fevers developing after travels – some unusual cases. Schweiz. Med. Wschr., 114(29):1029-1031.

T1805. TRANSLATION FROM RUSSIAN. L'VOV, D. K., ANDREEV, V. P., ISACHENKO, V. A., YAKHNO, M. A. ZAKSTEL'SKAYA, L. Ya., SOKOLOVA, N. N. and VASIL' EV, V. I. (1974). Detection …

Namru-3 Translations Of Parasite Literature From Russian, French, Japanese, Etc. Into English (1915-1983) T1601-T1700, United States Naval Medical Research Unit Number Three, Cairo, Medical Zoology Department

United States Naval Medical Research Unit 3: Publications

T1603. TRANSLATION FROM RUSSIAN. SELIVANOV, Ya. M. and POLYAKOVA, A. N. (1981). Technic of preparing and producing experimental series of immunoglobulin erythrocytic polytype diagnosticums to certain arboviruses for the indirect hemagglutination test. Sborn. Trud. Inst. Virus. imeni D. I. Ivanovsky, Akad. Med. Nauk SSSR, pp. 145-151.

T1604. TRANSLATION FROM RUSSIAN. ROSLAYA, I. G., DEMENEV, V. A., PRYGOVA, A. I., ROSLYAKOV, G. E. and VERETA, L. A. (1981). Certain questions of ecology of tickborne encephalitis group viruses in the lower Pre-Amur'ye. Sborn. Trud. Inst. Virus. imeni D. I. Ivanovsky, Akad. Med. Nauk SSSR, pp. 90-94.

T1605. TRANSLATION FROM RUSSIAN. EMEL'YANOVA. N. …

Namru-3 Translations Of Parasite Literature From Russian, French, Japanese, Etc. Into English (1931-1982) T1501-T1600, United States Naval Medical Research Unit Number Three, Cairo, Medical Zoology Department

United States Naval Medical Research Unit 3: Publications

T1501. TRANSLATION FROM RUSSIAN. LEONOV, Yu. A. and KHARITONOVA, N. N. (1972). Experimental confirmation of the role of root voles in epizootiology of Omsk hemorrhagic fever. In: Transcontinental associations of migratory birds and their role in distribution of arboviruses, edited by Cherepanov, A. I. Mater. 5. Simp. Izuch. Roli Pereletn. Ptits Rasp. Arbovirus. (Novosibirsk, July 1969), pp. 355-358.

T1503. TRANSLATION FROM RUSSIAN. GASANOV, A. A. (1963). The infection of Rhipicephalus bursa (Can. et Fanz., 1877) with Babesia ovis in the Nakhichevan Region of the ASSR. Izv. Akad. Nauk Azerb. SSR, s. Biol. Med. Nauk, (4):117-123.

T1504. TRANSLATION FROM RUSSIAN. TSAPRUN, …

Namru-3 Translations Of Parasite Literature From Russian, French, Japanese, Etc. Into English (1921-1981) T1401-T1500, United States Naval Medical Research Unit Number Three, Cairo, Medical Zoology Department

United States Naval Medical Research Unit 3: Publications

T1401. TRANSLATION FROM RUSSIAN. L'VOV, D. K., GROMASHEVSKY, V. L., SIDOROVA, G. A., TSIRKIN, Yu. M. CHERVONSKY, V. L. GOSTINSHCHIKOVA, G. V. and ARISTOVA, V. A. (1971). Isolation of a new arbovirus Baku of Kemerovo group from argasid ticks Ornithodoros coniceps. in Azerbaijan. Vop. Virus., 16(4):434-437.

T1402. TRANSLATION FROM RUSSIAN. ALEKSANDROV, Yu. V., KORYAGIN, V. L. and YOVAL'CHUK, Zh. T. (1970). Observations on ecological biological properties of Hyalomma plumbeum ticks in eastern Crimea. Tezisy Dokl. 2. Akarol. Soveshch., (1):22-24.

T1403. TRANSLATION FROM RUSSIAN. MATEVOSYAN, K. Sh., KARASEVA, P. S. and SEMENOV, B. F. (1974). Study of potential arbovirus foci in …