Health Policy Commons^™

Factors Related To Adolescent Behavior Towards Hiv/Aids Prevention, Yuliasti Eka Purnamaningrum, Ratyas Ekartika Puspita Candra Nugrahawati, Munica Rita Hernayanti, Anne Vajee

Kesmas

In 2016 Special Region of Yogyakarta was ranked 9th as the province with the highest number of people suffered from HIV/AIDS especially at Sleman regency. Globally, AIDS was the second leading cause of adolescents’s death aged of 10-19 years. The purpose of this study was to find out factors affecting the behaviour of the adolescents towards HIV/AIDS prevention. This research using with cross sectional study design. The sampling technique which used was stratified random sampling resulted in 59 respondents from 11th grade students at SMA Negeri 2 Sleman were selected as sample. Data were collected using questionnaire and analyzed using …

Risk Assesment Of Air Pollution Exposure (No2, So2, Total Suspended Particulate, And Particulate Matter 10 Micron) And Smoking Habits On The Lung Function Of Bus Drivers In Palembang City, Elvi Sunarsih, Suheryanto Suheryanto, Rini Mutahar, Rahmi Garmini

Kesmas

Nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), Particulate Matter (PM10) and TSP are the most common and harmful air pollutants to humans. In short period, air pollution exposure at 5 ppm for 10 minutes to humans causes dyspnea, and when the level is increase to 800 ppm could cause 100% mortality in animals. This study was an analytical research, with cross sectional design and risk analysis. One hundred subjects were analyzed in this study. The results showed that non-cancer Hazard Index (HI) for realtime exposure with mean value was NO2: 1.85; SO2: 2.92; TSP: 7.09; and PM10: 11.7 …

Post Hypertension And Stroke: A Case Control Study, Aulia Imanda, Santi Martini, Kurnia Dwi Artanti

Kesmas

The purpose of this study was to determine the factors that influence the incidence of stroke including smoking status, past hypertension , past diabetes, diet, physical activity, alcohol consumption. The design of this study is case control with a ratio of 1: 1. The total number of respondents is 132 people. Research subjects were selected using systematic random sampling. This research was conducted at Ngudi Waluyo Hospital in Wlingi. Blitar, Indonesia in October till November 2017. Bivariate analysis showed that factors significantly related to stroke were smoking status (p=0.011, OR=2.6), history of past hypertension (p=0.00, OR= 6), past diabetes (p=0.015 …

Gambling-Related Harms: Developing Priorities For Harm Reduction Policy Setting, Judith Glynn Msc, Margo Hilbrecht Phd

International Conference on Gambling & Risk Taking

As jurisdictions worldwide have overseen gambling expansion, most have implemented regulatory and public policy regimes to reduce harm. This study was conducted to specify the nature and extent of gambling-related harm that public policy efforts could prevent or mitigate in Ontario, Canada.

Research has historically operationalized harm from gambling as cases of disordered gambling; and policy work has focused on the prevalence and treatment of these cases. Recent work to fully conceptualize and measure gambling-related harm in individual gamblers, their families, and communities (Blaszczynski et al, 2015, Browne et al., 2016, 2017; Langham et al., 2016,) dovetailed with the desire …

An Examination Of The Potential Threat Of A State-Sponsored Biological Attack Against The United States: A Study Of Policy Implications, Courtney Anne Pfluke

Graduate Theses/Dissertations

In 2002, US Navy Seals found a list of pathogens in an Afghanistan cave that Al Qaeda had planned to use in a series of biological attacks. Unique about the discovery was that the pathogens were not limited to human ones. Six pathogens targeted livestock and four targeted crops. Despite this discovery, limited attention has been given to the possibility of a state-sponsored terrorist attack utilizing biological agents against the US population, food source, or water supply. Throughout history, biological agents have been developed for use as an offensive weapon for both states and terrorist groups. The United States may …

Impact Of The Affordable Care Act On The Cooper Women’S Care Center, Amanda Malik, Natali Franzblau

Cooper Rowan Medical Journal

Background: The Affordable Care Act (ACA) increased access to women’s health care by expanding Medicaid eligibility and requiring that insurance plans cover many gynecologic preventive services at no cost to patients. Before implementation of the ACA, pregnant women with low incomes qualified for Medicaid but childless adults of the same income did not, and though prenatal obstetrical visits were covered by plans at no or low cost to patients, most gynecologic services required out of pocket payments.

Objective: This study aimed to identify changes in the types of visits (gynecologic or obstetric) and patient demographics (including age, race, …

“Greening” Worcester: Municipal Best Practices For Sustainability, Erin Mckeon, Charline Kirongozi, Jared Duval, Antannia Greene, Qianshu Sun, Zewei Yao

School of Professional Studies

In response to the urgent threat posed by climate change, more and more cities, including Worcester, are attempting to become more environmentally responsible and sustainable. Worcester is attempting to develop ways to become more sustainable; both to strengthen their communities and to protect the planet. The Green Worcester Working Group (GWWG) tasked the Clark Capstone Team with researching best practices for municipal sustainability. The GWWG has set the following priorities: climate change mitigation, resilience, open spaces, sustainable resource management, education and awareness. Taking these into account, the Clark Capstone Team researched the sustainability practices of cities in New England, across …

Worcester Chamber Of Commerce: Recruiting Minority Business Owners, Ryan Dimaria, Alexander Hull, Xikun Lu, Haopeng Wang, Jiacheng Hou, Danning Zhao

School of Professional Studies

Our capstone project was to help the Worcester Regional Chamber of Commerce identify how to re-frame their marketing so it would be appealing to immigrant and minority owned businesses. Based on interviews and external research, our group was able to create a tangible and resourceful data set that provided justified recommendations and ideas on how the Chamber could make adjustments to their marketing plan to attract more businesses of this particular demographic in the city of Worcester. By implementing these recommendations, we believe the Chamber has the opportunity to create a more diverse group of Chamber members, add value to …

Service Now: Cmdb Research, Monika Patel, Smita Patil, Katerina Tzanavara, Manish Chauhan, Yuhao Wang, Houmin Xie, Lei Shi

School of Professional Studies

The MAPFRE Capstone team has been tasked with reviewing and recommending roadmap on the existing CMDB configuration. Paper discusses the team’s overall research on ServiceNow CMDB, Client’s deliverables and introduction to the latest technological innovations. Based on given objectives and team’s analysis we have recommended key solutions for the client to better understand the IT environment areas of business service impact, asset management, compliance, and configuration management. In addition, our research has covered all the majority of the technical and functional areas to provide greater visibility and insight into existing CMDB and IT environment.

For One Child, Zion Bereket, Xin Huang, Yitong Lin, Ruobing Pei, Rachel White, Ziyuan Li

School of Professional Studies

The entirety of this project was completed on the foundation of the three focus areas, which were identified by our client as areas of high need. The client wanted to prioritize these three areas as they believed that these three areas were the most integral to the successful achievement of their mission, as well as to the overall health and longevity of the organization.

Hiv/Aids In The Latino Community Of San Francisco: Past And Present, Jessica Da Silva

School of Professional Studies

There are approximately 122,000 people of Latino origin in San Francisco, which account for 15% of the total population (Census, 2010). Historically, Latinos have and still face several barriers to access healthcare and improvements in health (Aguirre-Molina, Molina & Zambrana, 2001). When the world was exposed to the spread of a new and unknown virus, the broader population suffered from the epidemic. The Latino community in San Francisco was and still is one of the hardest hit by the virus.

Changing The Current Perception Of Affordable Housing In Worcester, Simone Mcguinness, William Roberts, Vaske Gjino, Tong Zhou, Mengxin Ma, Sarawadee Sonpuak

School of Professional Studies

One of Worcester Interfaith’s goals is to eradicate the stigma of affordable housing in Worcester. Currently, the perception of affordable housing is of an image of unkept and old residences filled with destitute citizens who cannot afford basic needs to live in a city, let alone housing. This image is perpetuated by media, stigma, and a lack of education of the true reality of affordable housing and who its recipients are. Affordable housing-qualified citizens represent a range of educations, professions, age, race, and income levels. Affordable housing units, too, represent a variety of homes, many of which are extremely well-kept …

The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd

Disability & Aging

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.

Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.

Policy Implementation On The Flint Water Crisis, Esoheosa Igbineweka

Senior Honors Projects

The world is made up of 75% water and it may seem unbelievable that water scarcity still exists. It is one thing to have access to water, but having access to clean water is a major problem not only in developing countries around the world, but also in developed countries such as the United States. That’s right! The U.S. which is considered one of the most developed countries worldwide, is facing a crucial water crisis that’s affecting millions of people. In 2014, The Flint Michigan Water Crisis became a public health crisis that shocked the nation. Residents and civilians in …

California Rural Legal Assistance Employment Education Outreach Project, Daisy Leon Melendrez

Capstone Projects and Master's Theses

California Rural Legal Assistance is a nonprofit law firm that provides no cost legal services to low-income individuals in Santa Cruz County. The social problem is that too many workers face employment rights violations. The agency problem is a reduction in the number of people seeking employment legal services from CRLA. This outreach project focused on spreading awareness of CRLA’s employment legal services by attending local grocery stores and farmer’s market, with the purpose of promoting agency’s services to the community. Agency materials were distrusted and a questionnaire was used to determine why people are not seeking CRLA legal services. …

Implementation Of The Drug Medi Cal Organized Delivery System In An Outpatient Sud Rehabilitation Agency, Casie Greene

Capstone Projects and Master's Theses

A new funding strategy called the Drug Medi-Cal Organized Delivery System (DMC-ODS) has been implemented in Santa Cruz County in efforts to combat the rising Substance Use Disorder (SUD) epidemic in the community. This system increases access to treatment services in hopes of decreasing the harmful effects of substance abuse in communities. The program aids in efforts to reduce barriers accessing care and show the people in the community the importance of and whole person care. This capstone project consisted of the implementation process of a system evaluation aligned with DMC-ODS at Sobriety Works, using data collection and analysis to …

Sweeping Exposures: Lead Poisonings And Black Working Poor Populations In The United States, Shirley Reid

Dissertations, Theses, and Capstone Projects

The focus of my thesis is to explore some of the realities that the impoverished urban black poor populations face in America today. The goal of my thesis is to illustrate how poverty is reproduced within impoverished neighborhoods through the idea and mechanism of lead exposure, by recognizing how specific exposure to the element lead and its by-products is both a symbol and a material cause of black urban poor illness and disability. There is no mistake that people living in the U.S. are aware of the social injustices against black populations in the form of racial injustice. However, …

The Patient-Physician Relationship: Overcoming Language And Cultural Barriers, Corrilynn Lynch

Senior Honors Theses

The patient-physician relationship governs the field of medicine, forming the basis for all relationships, interactions, and procedures in medicine. The degree to which a patient trusts his physician and thus is willing to be receptive to medical advice and adhere to assigned treatment is dependent on the quality of his relationship with his physician. The method of relationship chosen will dictate how the patient feels he is perceived and thus to what extend he will participate in his healthcare. A patient-centered approach to medicine will increase this confidence and lead to improved clinical results. Additionally, the rise of physician burnout …

Preventive Health Service Use Among Rural Women, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Nathan Paluso Mph, Jaclyn Janis Bsn, Rn

Access / Insurance

Preventive health services and screenings are an important component in the continuum of care provided to individuals across all ages. Yet, research has shown that rural residents generally use fewer preventive health services and screenings. This study used the National Health Interview Survey to examine receipt of preventive health services (cholesterol check, fasting blood sugar test, mammogram, pap smear, and receipt of the HPV vaccine) by rural and urban women over the age of 18. Findings indicate that rural women were less likely than their urban peers to receive preventive health services, and that some of the differences may be …

British Government Information Resources, Bert Chapman

Libraries Faculty and Staff Creative Materials

Provides an overview of British Government information resources. Contents include basic British economic and political background and information from British Government websites including the Department of Environment, Food, and Rural Affairs (DEFRA), Brexit related material produced by British government agencies such as the Department for Exiting the European Union,, the Ministry of Defence, the National Museum of the Royal Navy, the Home Office Visas and Immigration Section, the Office of National Statistics, Her Majesty's Treasury, the British Parliament including parliamentary committees and research agencies, the website of Member of Parliament (MP) Jacob Rees-Mogg (Conservative-North East Somerset), a webcast of House …

Nhs England Always Events® Program: Developing A National Model For Co-Production, Claire Marshall, Angela Zambeaux, Esther Ainley, David Mcnally, Jenny King Miss, Lorraine Wolfenden, Helen Lee

Patient Experience Journal

NHS England, the Institute for Healthcare Improvement, Picker and NHS Improvement started the work described in this article to strengthen how patients, carers and staff working together in co-design and co-production can make a real difference in improving experience of care. Always Events®, which is an improvement methodology for the co-design and consistent implementation of those aspects of patient experience that matter most to patients in a health care setting, was chosen. The approach has been to first test the methodology with three organizations then to spread to a substantial proportion of acute health care providers, with concurrent scale-up within …

Interprofessional Collaboration To Improve And Sustain Patient Experience Outcomes In An Ambulatory Setting, Natalie Sanchez, Kimberly Hermis

Patient Experience Journal

Patient experience is an important factor across diverse healthcare delivery settings. Despite enhanced attention to and advances in patient experience, many of the published initiatives focus on in-hospital care and opportunities have been identified to continue to strategically address patient experience in the ambulatory setting. This quality improvement initiative presents the development of an interprofessional approach to patient experience in a freestanding ambulatory oncology center. The objective of this initiative was to improve and sustain patient experience, as reflected in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores via Press Ganey. This approach consisted of redesigning a previously …

Twelve Principles To Support Caregiver Engagement In Health Care Systems And Health Research, Kerry Kuluski, Kristina M. Kokorelias, Allie Peckham, Jodeme Goldhar, John Petrie, Carole Anne Alloway

Patient Experience Journal

Family and friend caregivers (i.e., unpaid carers) play a critical role in meeting the needs of people across various ages and illness circumstances. Caregiver experiences and expertise, which are currently overlooked, should be considered in practice (such as designing and evaluating services) and when designing and conducting research. In order to improve the quality of health care we need to understand how best to meaningfully engage caregivers in research, policy and program development to fill this important gap. Our study aimed to determine principles to support caregiver engagement in practice and research. A pan Canadian meeting brought together 48 stakeholders …

A Case Study Of The Patient Wait Experience In An Emergency Department With Therapy Dogs, Colleen A. Dell, James Stempien, Lindsey Broberg, Alicia Husband, Lacey Jurke, Betty Rohr, Jane Smith, Joseph Rubin, Susan Tupper, Donna Goodridge, Cathie Fornssler, Logan Fele-Slaferek

Patient Experience Journal

The quality of patient healthcare is a growing concern in Canada’s hospital emergency departments (ED) due to increasing wait times and associated adverse outcomes. A developing body of literature indicates that therapy dogs can positively impact the patient experience. In 2016, members of our team partnered with the Royal University Hospital (RUH) in Saskatchewan to become the first ED in Canada to integrate a visiting therapy dog to positively impact the patient wait experience. The aim of this preliminary case study was to examine if and how this unique initiative impacted patients’ feelings during their ED wait. A brief questionnaire …

Comparing Psychiatric Care Experiences Shared Online With Validated Questionnaires; Do They Include The Same Content?, Rebecca Baines, John Donovan, Samantha Regan De Bere, Julian Archer, Ray Jones

Patient Experience Journal

Patient feedback is considered integral to patient safety and quality of care. However, limited research has compared the content of validated questionnaires with subjective patient experiences shared online. The aim of this study was to therefore identify and compare the content of psychiatric care experiences shared online with validated questionnaires. All research was conducted in co-production with a volunteer mental-health-patient-research-partner. We analysed all reviews published on the United Kingdom’s leading health and social care feedback platform Care Opinion, between 2005-2017 that discussed adult psychiatric care and compared findings with two validated questionnaires (ACP360 and General Medical Council patient feedback questionnaire). …

“Can I Still Get A Tattoo?” Patients’ Experiences Across The Clinical Trajectory For Metastatic Melanoma: A Dynamic Narrative Model Of Patient Journey, Klay Lamprell, Melvin Chin, Jeffrey Braithwaite

Patient Experience Journal

Advanced and metastatic cancer has a complex diagnostic and management profile that places a heavy long-term burden on patients and healthcare systems. Little attention has been given to patients’ experiences across their entire clinical journey. Using a qualitative, longitudinal methodology over a ten-month period, we examined the symptom-to-outcome trajectories of seven people attending a medical oncology clinic at a large, public tertiary referral center in Sydney, Australia. Rather than care being experienced as a largely linear progression through diagnosis, treatment and onto surveillance in which life may return to ‘normal’, participants are embedded in a cyclical clinical pathway. Recurrence or …

Patient Perception Of Telephone Follow-Up After Resection For Colorectal Cancer: Is It Time For An Alternative To The Out-Patient Clinic?, Marcus Gilmartin, Nicholas Leaver, George Hall, Helena Fawdry, Seung Lee, James Nicholson, Ramya Kalaiselvan, Raj Rajaganeshan

Patient Experience Journal

The economic reality of modern healthcare provides a timely reminder to clinicians of their duty to provide outstanding and cost-effective care. Although multiple guidelines outline investigation, management and surveillance of colorectal cancer, none advocate a particular delivery method. Nurse-led telephone follow-up in multiple specialties has demonstrated equivalent clinical outcomes and patient satisfaction when compared to traditional outpatient department follow-up. This paper aims to compare nurse-led telephone and outpatient follow-up, following surgical resection of colorectal cancer (CRC), focusing on patient perceptions. This cross-sectional study distributed adapted patient satisfaction questionnaire (PS-Q 18) to patients undergoing surveillance following CRC resection via either nurse-led …

How Have Patients' Experiences Of Cancer Care Been Linked To Survival? A Systematic Review, Saleh A. Alessy, Margreet Lüchtenborg Dr, Elizabeth A. Davies Dr.

Patient Experience Journal

Patient experience of care remains an important indicator of health care quality. Although studies show care experiences are associated with health outcomes for some conditions, the situation for cancer is unclear. New datasets on cancer patients in the US, Canada, and UK linking information on experiences and survival may enable an exploration of any association. This review aimed to identify studies linking any aspect of cancer patients’ experiences to their survival, to inform future analyses. We performed a systematic review using Medline database from January 1998 until March 2018.

The settings included outpatient oncology clinics, primary care, hospitals, and cancer …

Exploring Interventions To Increase Primary Care Providers’ Use Of Self-Management Goals, Nanci Reiland, Kathleen Fitzgerald, Mary E. Maragos

Patient Experience Journal

Accreditors, such as the Joint Commission, consider evidence of patient engagement strategies for awarding Primary Care/Patient-Centered Medical Home (PCMH) accreditation. This project explored the use of brief Motivational Interviewing (MI) training at a local county health center and evaluated the impact on the documented use of self-management goals (SMGs) for patients with diabetes and hypertension. Methods included a professional development program, including an online module, presentation, and educational materials. The goal was to increase providers’ MI knowledge and skills to better construct and document SMGs. The program impact was evaluated by chart review to determine the use of SMGs by …

One Patient's Experiences And Expectations In The Healthcare System: Complicated And Critical Illness With Rare Diagnosis Described By His Advocate, Jennifer Cademartori

Patient Experience Journal

The health care business serves as a profession in the art of human illness. But unlike other businesses there is the human side, the patient experience. These patients are the “customers” receiving the care, but they, unlike customers at a retail store, are vulnerable and scared and must trust their lives in the hands of people they don’t know. The paradigm must change to reflect how the health care business is handled from the eyes of the person receiving the care from the first office visit, through the inpatient stay, to follow up visits. Patient focused training on all levels …