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Full-Text Articles in Social and Behavioral Sciences

Talk, Trust And Time: A Longitudinal Study Evaluating Knowledge Translation And Exchange Processes For Research On Violence Against Women, C. Wathen, Shannon Sibbald, Susan Jack, Harriet Macmillan Sep 2011

Talk, Trust And Time: A Longitudinal Study Evaluating Knowledge Translation And Exchange Processes For Research On Violence Against Women, C. Wathen, Shannon Sibbald, Susan Jack, Harriet Macmillan

Shannon L. Sibbald

BACKGROUND: Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies including two randomized trials, the McMaster University VAW Research Program studied one key research gap: evidence about the effectiveness of screening women for exposure to intimate partner violence. This project developed and evaluated KTE strategies to share research findings with policymakers, health and community service providers, and women's advocates. METHODS: A longitudinal cross-sectional …


Medicare’S Bundled Payment Pilot For Acute And Postacute Care: Analysis And Recommendations On Where To Begin, Neeraj Sood, Peter Huckfeldt, Jose Escarce, David Grabowski, Joseph Newhouse Aug 2011

Medicare’S Bundled Payment Pilot For Acute And Postacute Care: Analysis And Recommendations On Where To Begin, Neeraj Sood, Peter Huckfeldt, Jose Escarce, David Grabowski, Joseph Newhouse

Peter J. Huckfeldt

In the National Pilot Program on Payment Bundling, a subset of Medicare providers will receive a single payment for an episode of acute care in a hospital, followed by postacute care in a skilled nursing or rehabilitation facility, the patient’s home, or other appropriate setting. This article examines the promises and pitfalls of bundled payments and addresses two important design decisions for the pilot: which conditions to include, and how long an episode should be. Our analysis of Medicare data found that hip fracture and joint replacement are good conditions to include in the pilot because they exhibit strong potential …


A Qualitative Study Examining Tensions In Interdoctor Telephone Consultations, Anupma Wadhwa, Lorelei Lingard Jun 2011

A Qualitative Study Examining Tensions In Interdoctor Telephone Consultations, Anupma Wadhwa, Lorelei Lingard

Lorelei Lingard

OBJECTIVE: Communication skills have gained increasing attention in medical education. Much of the existing literature and medical curricula addresses issues of doctor-patient communication. The critical importance of communication between health professionals, however, is now coming under the spotlight. The interdoctor telephone consultation is a common health care setting in which health professional communication skills are exercised. Breakdowns in this communication commonly occur and, surprisingly, this skill is not formally addressed in medical training. This study sought to clarify the communication issues that can occur during interdoctor telephone consultations in order to inform future educational initiatives in this domain. METHODS: Data …


Towards Safer Interprofessional Communication: Constructing A Model Of "Utility" From Preoperative Team Briefings, Lorelei Lingard, Sarah Whyte, Sherry Espin, G. Baker, Beverley Orser, Diane Doran Jun 2011

Towards Safer Interprofessional Communication: Constructing A Model Of "Utility" From Preoperative Team Briefings, Lorelei Lingard, Sarah Whyte, Sherry Espin, G. Baker, Beverley Orser, Diane Doran

Lorelei Lingard

"Improved team communication" is broadly advocated in the discourse on safety but rarely supported by a precise understanding of the relationship between specific communication practices and concrete improvements in collaborative work processes. We sought to improve such understanding by analyzing the discourse arising from structured preoperative team briefings among surgeons, nurses, and anesthesiologists prior to general surgery procedures. Analysis of observers' fieldnotes from 302 briefings yielded a two-part model of communicative "utility", defined as the visible impact of communication on team awareness and behavior. "Informational utility" occurred when team awareness or knowledge was improved by provision of new information, explicit …


A Theory-Based Instrument To Evaluate Team Communication In The Operating Room: Balancing Measurement Authenticity And Reliability, Lorelei Lingard, Glenn Regehr, Sherry Espin, Sarah Whyte Jun 2011

A Theory-Based Instrument To Evaluate Team Communication In The Operating Room: Balancing Measurement Authenticity And Reliability, Lorelei Lingard, Glenn Regehr, Sherry Espin, Sarah Whyte

Lorelei Lingard

BACKGROUND: Breakdown in communication among members of the healthcare team threatens the effective delivery of health services, and raises the risk of errors and adverse events. AIM: To describe the process of developing an authentic, theory-based evaluation instrument that measures communication among members of the operating room team by documenting communication failures. METHODS: 25 procedures were viewed by 3 observers observing in pairs, and records of events on each communication failure observed were independently completed by each observer. Each record included the type and outcome of the failure (both selected from a checklist of options), as well as the time …


The Rhetorical 'Turn' In Medical Education: What Have We Learned And Where Are We Going?, Lorelei Lingard Jun 2011

The Rhetorical 'Turn' In Medical Education: What Have We Learned And Where Are We Going?, Lorelei Lingard

Lorelei Lingard

This paper presents a critical reflection on the contributions and challenges associated with one rhetorical approach to studying teaching and learning communication in health professions education. A rhetorical approach treats language as a social act, and attends to the role of language in establishing professional identities and relationships. The research has produced insights into the use of standard communication formats to teach novices, the nature of socialization on clinical teams, and the relationship between communication patterns and patient safety. Challenges and emerging questions include the problem of accounting for the material dimensions of communication in a rhetorical model, grappling with …


Pharmaceutical Use Following Generic Entry: Paying Less And Buying Less, Peter Huckfeldt, Christopher Knittel Apr 2011

Pharmaceutical Use Following Generic Entry: Paying Less And Buying Less, Peter Huckfeldt, Christopher Knittel

Peter J. Huckfeldt

We study the effects of generic entry on prices and utilization using both event study models that exploit the differential timing of generic entry across drug molecules and cast studies. Our analysis examines drugs treating hypertension, high blood pressure, type 2 diabetes, and depression using price and utilization data from the Medical Expenditure Panel Survey. We find that utilization of drug molecules starts decreasing in the two years prior to generic entry and continues to decrease in the years following generic entry, despite decreases in prices offered by generic versions of a drug. This decrease coincides with the market entry …


Hiv/Aids And Food Insecurity In Sub-Saharan Africa: Challenges And Solutions, John Mazzeo Apr 2011

Hiv/Aids And Food Insecurity In Sub-Saharan Africa: Challenges And Solutions, John Mazzeo

John Mazzeo, Ph.D.

No abstract provided.


Medical Expenditure Measures In The Health And Retirement Study, Dana Goldman, Julie Zissimopoulos, Yang Lu Mar 2011

Medical Expenditure Measures In The Health And Retirement Study, Dana Goldman, Julie Zissimopoulos, Yang Lu

Yang Lu

This paper reviews out-of-pocket (OOP) medical expenditure measures collected in the Health and Retirement Study (HRS). Medical expenditures are an important cost of poor health. Medical expenditure measures are important for understanding retirement decisions, financial preparation for retirement, and predicting the consequences of health care reform, particularly Medicare reform. Despite the comprehensiveness of the HRS, there are always limitations to what can be learned from population interviews. To assess the quality of current HRS measures of OOP spending, we compare various measures of OOP spending across survey waves to the Medical Expenditure Panel Survey (MEPS) and Medicare Current Beneficiary Survey …


Assessing The Needs And Guiding The Future: Findings From The Health Needs Assessment In 13 Asian American Communities Of Maryland In The United States, Sunmin Lee, Chiehwen Ed Hsu Mar 2011

Assessing The Needs And Guiding The Future: Findings From The Health Needs Assessment In 13 Asian American Communities Of Maryland In The United States, Sunmin Lee, Chiehwen Ed Hsu

Chiehwen Ed Hsu

There is lack of in depth data on health needs of diverse Asian American communities. We conducted 19 focus groups in 13 Asian American communities in Maryland in 2007. We developed a moderator’s guide to collect qualitative data on health needs from 174 participants, and used MAX QDA to analyze data and code emergent themes. Cardiovascular disease related conditions, diabetes, and mental health were the top three health concerns. Weight concerns, cancer, arthritis, smoking, osteoporosis, and hepatitis B followed next. Many participants were not receiving preventive health service such as cancer screening due to a lack of access to health …


How Do We ‘See’ Occupations? An Examination Of Visual Research Methodologies In The Study Of Human Occupation, L. Hartman, A. Mandich, L. Magalhaes, Treena Orchard Dec 2010

How Do We ‘See’ Occupations? An Examination Of Visual Research Methodologies In The Study Of Human Occupation, L. Hartman, A. Mandich, L. Magalhaes, Treena Orchard

Dr. Treena Orchard

This article argues that visual research methodologies have potential to contribute to the study of occupation. The use of visual research methodologies is quickly growing in a number of disciplines and can help researchers to access information and reasoning not accessible through interview, log or survey. The reflexive, reflective, engaged process of creating and analysing visual materials allows for rich representations on behalf of participants, and immersion in the data on the part of researchers. This paper explores photovoice, body mapping and textual analysis of visual materials to understand how they can contribute to occupational science research. These methods were …


Almost Random: Evaluating A Large-Scale Randomized Nutrition Program In The Presence Of Crossover, Sebastian Linnemayr, Harold Alderman Dec 2010

Almost Random: Evaluating A Large-Scale Randomized Nutrition Program In The Presence Of Crossover, Sebastian Linnemayr, Harold Alderman

Sebastian Linnemayr

Large-scale randomized interventions have the potential to uncover the causal effect of programs applying to a large population, thereby improving on the insights gained from currently dominant smaller randomized studies. However, the external validity gained through larger interventions typically risks deviation from the randomization protocol. This paper investigates the impact of the Nutrition Enhancement Program, which aims to improve child nutrition in Senegal. The analysis deals with deviation from the planned treatment and suggests approaches for combining ex-post adjustments such as propensity score matching with the randomized treatment plan. The authors do not detect a strong overall program impact on …


Risk Communication And College Students: The 2009 H1n1 Pandemic Influenza, Francisco Soto Mas, Chiehwen Ed Hsu Dec 2010

Risk Communication And College Students: The 2009 H1n1 Pandemic Influenza, Francisco Soto Mas, Chiehwen Ed Hsu

Chiehwen Ed Hsu

No abstract provided.


Economic Status And Coping Mechanisms Of Individuals Seeking Hiv Care In Uganda, Sebastian Linnemayr, Brooke Stearns Lawson, Peter Glick, Glenn Wagner Dec 2010

Economic Status And Coping Mechanisms Of Individuals Seeking Hiv Care In Uganda, Sebastian Linnemayr, Brooke Stearns Lawson, Peter Glick, Glenn Wagner

Sebastian Linnemayr

This study uses novel data to conduct a comprehensive evaluation of the demographic and economic circumstances facing HIV-positive individuals who have just entered HIV care in Uganda. While the provision of HIV care and ART may improve physical health, to achieve the broader goal of improving the quality of life and socioeconomic viability of people living with HIV/AIDS, appropriate social and economic programs may need to complement treatment. We report results from baseline data of a longitudinal, prospective cohort study with a 12-month follow-up period in two Ugandan HIV clinics. We use t-tests to examine differences across sample subpopulations and …


Cognitive Processes In Object-Oriented Requirements Engineering Practice: Analogical Reasoning And Mental Modelling, Linda Dawson Dec 2010

Cognitive Processes In Object-Oriented Requirements Engineering Practice: Analogical Reasoning And Mental Modelling, Linda Dawson

Associate Professor Linda Dawson

This paper presents a background in cognitive processes such as problem solving and analogical reasoning for considering modeling from an object-oriented perspective within the domain of requirements engineering. The paper then describes a research project and the findings from a set of four cases which examine professional practice from perspective of cognitive modeling for object-oriented requirements engineering. In these studies, it was found that the analysts routinely built models in their minds and refined them before committing them to paper or communicating these models to others. The studies also showed that objectoriented analysts depend on analogical reasoning where they use …