Health Services Research Commons^™

Dengue Haemorrhagic Fever And House Conditions In Kupang City, East Nusa Tenggara Province, Wanti Wanti, Ririh Yudhastuti, Hari Basuki Notobroto, Sri Subekti, Oktofianus Sila, Ragu Harming Kristina, Feby Dwirahmadi

Kesmas

Kupang City has the highest Incidence of DHF in East Nusa Tenggara and also higher than the national figure. This study aims to analyze the relationship between housing conditions and the DHF incidence in the Kupang City. This observational study uses a case-control study in 25 villages with a total sample of 500 people. Data is analyzed using t test and chi square test. The house conditions were significantly related to the DHF incidence (p≤0.05), namely house lighting, water usage, wall construction, ventilation area and ownership of clean water facilities. People are advised to ventilate the house ≥10% of the …

Risk Factor Analysis Of Overnutrition Among Elementary School Children In Pekanbaru: An Urban-Rural Perspective, Arfianti Arfianti

Kesmas

The prevalence of childhood overnutrition is increasing in many parts of the world including Indonesia. National basic health research (RISKESDAS) 2010 showed that over-nutrition in urban children (10.4%) was greater than in rural areas (8.1%). The purpose of this study was to analyse risk factors for overnutrition on elementary students in urban and rural areas in Pekanbaru. This was an observasional analytical study with cross-sectional design. This study involved 137 urban and 113 rural students from six elementary schools in Pekanbaru recruited by quota sampling technique. This study was conducted between April-May 2018. The results showed that the proportions of …

Occurrence Of Natural Vertical Transmission Of “Zika Like Virus” In Aedes Aegypti Mosquito In Jambi City, Tri Baskoro Satoto, Nur Alvira Pasca Wati, Wida Purwaningsih, Hari Kusnanto Josef, Purwono Purwono, Rumbiwati Rumbiwati, Hermanto Hermanto, Roger Frutos

Kesmas

Zika virus can be transmitted through mosquitoes such as Aedes aegypti and Ae. albopictus. During the transition period of 2014–2015, an outbreak of dengue was reported in Jambi City, during which several sufferers were screened positive for Zika virus infection by the Eijkman Institute. It was interesting to note that all of those positive for Zika virus infection were indigenous residents and none of them had a history of international travel. This descriptive analytic study with a cross-sectional design study was conducted to present an overview of Aedes spp. population using ovitrap and egg colonization methods and to detect the …

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 …

Suicidal Thoughts, Plans, And Attempts By Non-Metropolitan And Metropolitan Residence, Kathi Harp, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

• Mean prevalence rates for suicidal thoughts, plans, and attempts were significantly higher (P < .05) among residents of non-metropolitan than large metropolitan counties.
• The adjusted odds of suicidal thoughts, plans, and attempts did not improve significantly from 2010 to 2016 among residents of any county type.
• The study findings suggest that suicide prevention interventions should be further targeted toward non-metropolitan counties. However, new interventions may need to be specifically developed to meet the unique needs of residents in non-metropolitan counties.

Building Financial Management Capacity For Community Ownership Of Development Initiatives In Rural Zambia, Viviane Sakanga, Parker S. Chastain, Kathleen L. Mcglasson, Jeanette L. Kaiser, Misheck Bwalya, Melvin Mwansa, Kaluba Mataka, David Kalaba, Nancy Scott, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: Building financial management capacity is increasingly important in low- and middle-income countries to help communities take ownership of development activities. Yet, many community members lack financial knowledge and skills.

Methods: As part of a larger health intervention, we designed and conducted financial management training for 83 members from 10 community groups in rural Zambia. Change scores between pre- and post-tests on financial knowledge were calculated and multivariate linear regression models run. Qualitative feedback was elicited.

Results: The training significantly improved knowledge of financial concepts. Participants with some or more than some secondary education had greater improvements …

Prescription Opioid Use Patterns, Use Disorder Diagnoses, And Addiction Treatment Receipt After The 2014 Medicaid Expansion In Oregon, Rachel Springer, Miguel Marino, Steffani R. Bailey, Heather Angier, Jean O'Malley, Megan Hoopes, Stephan Lindner, Jennifer E. Devoe, Nathalie Huguet

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background/Aims: Evidence suggests Medicaid beneficiaries in the USA are prescribed opioids more frequently than are people who are privately‐insured, but little is known about opioid prescribing patterns among Medicaid enrollees who gained coverage via the Affordable Care Act Medicaid expansions. This study compared the prevalence of receipt of opioid prescriptions and opioid‐use‐disorder (OUD), along with time from OUD diagnosis to medication‐assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014, or returned to Medicaid coverage after expansion.

Design: Cross‐sectional study using inverse‐propensity weights to adjust for …

Challenges Of Training And Delivery Of Pediatric Surgical Services In Developing Economies: A Perspective From Pakistan, Amir Humza Sohail, Muhammad Hassaan Arif Maan, Mohammed Sachal, Muhammad Soban

Medical College Documents

Background: As the pediatric population requiring health services rises globally, developing countries are struggling to cater to the growing burden of non-communicable diseases - particularly those requiring specialized surgical care.
Main body: Despite the literature supporting specialized pediatric surgical care, the developing world is far from meeting the American Pediatric Surgical Association (APSA) Manpower taskforce recommendation of at least 1 qualified pediatric surgeon per 100,000 patients (0-15 years-old). In Pakistan, there is an unmet surgical need in the pediatric population due to a multitude of short shortcomings, notably in quality and quantity of the training programs on offer, and urgent …

Redesigning Systems To Improve Teamwork And Quality For Hospitalized Patients (Reset): Study Protocol Evaluating The Effect Of Mentored Implementation To Redesign Clinical Microsystems, Kevin J. O'Leary, Julie K. Johnson, Milisa Manojlovich, Jenna D. Goldstein, Jungwha Lee, Mark V. Williams

Center for Health Services Research Faculty Publications

Background: A number of challenges impede our ability to consistently provide high quality care to patients hospitalized with medical conditions. Teams are large, team membership continually evolves, and physicians are often spread across multiple units and floors. Moreover, patients and family members are generally poorly informed and lack opportunities to partner in decision making. Prior studies have tested interventions to redesign aspects of the care delivery system for hospitalized medical patients, but the majority have evaluated the effect of a single intervention. We believe these interventions represent complementary and mutually reinforcing components of a redesigned clinical microsystem. Our specific objective …

Barriers And Facilitating Factors To The Integration Of The First Uk-Trained Physician Associates Onto Secondary Care Services In The British National Health Service, Tamara S. Ritsema

Theses & Dissertations

Introduction: The Physician Associate (PA) profession was brought from the United States (where it is called the "Physician Assistant" profession) to the United Kingdom (UK) approximately 15 years ago. Universities have begun to train PAs and these graduates are now starting work in the British National Health Service (NHS) in both primary and secondary care. The number of PAs graduating from PA programs and beginning to work in secondary care will increase substantially over the next few years. No research has been conducted on barriers and facilitators to the integration of a UK-trained PA onto a secondary service.

Methods: A …

God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer

Theses & Dissertations

Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …

Examining The Effects Of Approaches On Reducing Hospital Utilization: The Patient-Centered Medical Home, Continuity Of Care, And The Inpatient Palliative Consultation At The End-Of-Life, Xiaoting Sun

Theses & Dissertations

Background: It has become a national priority to reduce the high health care expenditure in the United States while improving the quality of care. Hospital care is taking up one-third of the healthcare spending, and services offered in hospitals are costly compared to others. Only one-twentieth of the patients with high-needs account for about half of the health care spending. They consuming a high level of hospital services if their conditions are not well-managed in the outpatient settings. Therefore, it is important to examine the effectiveness of the approaches that have the potentials to reduce costly care utilization through improvements …

Impact Of Healthcare Delivery And Policies On Children's Outcomes After The Affordable Care Act Of 2010, Shreya Roy

Theses & Dissertations

The Patient Protection and Affordable Care Act (ACA) of 2010 introduced programs to promote integrated pediatric healthcare delivery and to expand public health insurance (Medicaid) eligibility for adults from low-income families in the United States. This dissertation examined whether progress was made towards integration of healthcare delivery for children with developmental disabilities after the implementation of ACA, and also whether expansion of Medicaid for adults impacted the preventive care utilization and school absenteeism of children from low-income families. A cross-sectional study design was used to examine whether integration of pediatric healthcare delivery was accomplished and a quasi-experimental difference-in-differences approach was …

Addressing Lapses In Medical Education In Relation To Lgbtqia+ Healthcare Disparities, Daniel Pinto, Aubrey Olson

Rowan-Virtua Research Day

As the LGBT community gains more visibility and acceptance, the individuals identifying as LGBTQIA+ have been increasing. Unfortunately for this community, healthcare disparities for LGBT individuals continue. In fact in a national online survey done with LGBTQIA+ physicians, 65% had heard discriminatory comments made towards LGBTQIA+ patients, and 34% witnessed discriminatory care given to LGBTQIA+ patients. (Bonvinci) Rose Chapman, a senior lecturer at Curtin University Nursing School, contributed this discomfort that medical professionals seem to have with LGBTQIA+ families with socioeconomic background such as religious beliefs or familiarity with the topic. (Chapman) Nevertheless, another study published by the Medical Journal …

Assessment Of The Perceived Access To Health Care By Migrant And Seasonal Farm Workers In Southern New Jersey, Karen Custodio, Xitlalichomiha O'Dell, Lori Talbot

Rowan-Virtua Research Day

Migrant and seasonal farm workers (MSFW) are one of the most economically disadvantaged populations in the United States. MSFW confront numerous health challenges as a result of occupational hazards, poor living conditions, and inadequate nutrition, in addition to common health concerns like diabetes and hypertension. The objective of this study was to identify major barriers to health care for individuals working in the agriculture industry in southern New Jersey. Though there are numerous factors which impact health for migrant farmers, we hypothesized that language, financial burden, and fear from immigration status will be the most significant. Research was conducted using …

Pre-Operative Clinical Variation By Health Insurance Carrier In 12,285 Male Surgical Patients With Moderate Morbid Obesity, Matthew E. Moore, Gus J. Slotman

Rowan-Virtua Research Day

In the ongoing obesity epidemic, every surgeon now treats patients with weight-related medical problems. In managing these medically fragile surgical patients, every clinical insight helps. While variation according to health insurance has been reported in mixed sex bariatric surgery populations, whether or not clinical characteristics in the subset of moderately obese male surgical patients vary by insurance carrier is unknown. The objective of this study was to identify clinical variation by insurance type in moderately obese men.

Results showed that pre-operative clinical characteristics of moderately obese male surgical patients vary by the health insurance coverage type to which they subscribe. …

Ethnic And Demographic Differences In Colectomy Rates And Timing For Ulcerative Colitis: 2007-2014, Daniel Bodek, Alana Persaud, Brian Blair, Ahlawat Sushil

Rowan-Virtua Research Day

Ulcerative Colitis (UC) is a chronic inflammatory disease of the bowel, with one third of patients requiring a colectomy for fulminant disease and tissue dysplasia. In 2007, infliximab was approved for induction and maintenance of remission in UC, with some evidence to suggest a potential reduction in colectomies. The aim of this study is to examine relative colectomy rates for UC among different ethnicities from 2007 to 2014 in order to evaluate for development of new trends or disparities.

Discrepancies in colectomy rates and timing are seen in our models which mirror closely findings in a prior study from 1999-2003 …

Pre-Operative Risk Of Medical Complications Varies By Health Insurance Carrier In Moderately Obese Women: Medicaid V Medicare V Private V Self-Pay, Paul Osterdahl, Melissa Gott, Amanda Sundling, Gus J. Slotman

Rowan-Virtua Research Day

Introduction: Clinical variation by health insurance status in mixed sex bariatric surgery populations is reported, but such variation among moderately obese women is unknown.

Objective: to identify pre-operative variation by health insurance in female surgical patients.

Conclusions: Pre-operative characteristics of moderately obese women vary by insurance. Medicare’s highest risk for cardiopulmonary problems and diabetes, and Medicaid’s highest asthma, abdominal-hepatobiliary, and psychological/behavioral complications should be considered in managing moderately obese women subscribing to these carriers.

Panniculectomy Performed In Conjunction With Gynecologic Surgery In The Morbidly Obese Patient - A Nsqip Analysis And Meta-Analysis Of The Literature, Shayoni Nag, Tirth Patel, Steven C. Bonawitz

Rowan-Virtua Research Day

Purpose: Panniculectomy is a common procedure in plastic surgery, often performed following massive weight loss and in morbidly obese patients. It can be performed in combination with various gynecologic procedures based on the rational that it will reduce complication rates.^{1, 2, 3} These studies fail to provide proof of these claims for reasons including study design and the lack of inclusion of both morbidly obese and non-morbidly obese patients. Recent medical practice has focused increasingly on minimizing patient morbidity and trends in reimbursement are moving towards penalizing practices which increase complications.

Methods/Results:We reviewed the NSQIP database to assess …