Health Services Research Commons^™

The Perception Of Menstruation And Treatment Of Menstrual Ailments Among Tibetan Women In Mcleod Ganj, Himachal Pradesh, Kara Spafford

India: Public Health, Policy Advocacy, and Community

Despite recent incorporation of quality of life assessments into goal setting, menstrual ailments are still left out of public health initiatives in developing countries. Due to lack of studies on perceptions of menstruation and treatment options for menstrual ailments, the specific health needs of Tibetan women are not met. The present study seeks to determine how Tibetan women are influenced by societal views of menstruation and to explore access to treatment for menstrual problems in McLeod Ganj, Himachal Pradesh. A total of thirty-seven semi-structured interviews were conducted among Tibetan doctors at Men-Tsee-Khang (Tibetan Medical and Astronomy Institute) and Tibetan women …

How Social Determinants Of Health, Health-Seeking Behaviors, And Treatment Adherence Influence And Interact With Endemic Levels Of Pulmonary Tb And Mdr-Tb In Urban Rajasthan, Michelle Kagei

Independent Study Project (ISP) Collection

Tuberculosis, the worlds most deadly infectious disease, remains as one of the major causes of morbidity and mortality in modern-day India. The country has the highest burden of both tuberculosis as well as multidrug-resistant tuberculosis, a more recently emerging menace. This study focuses on the social determinants of health pertaining to tuberculosis, identifying and discussing “at-risk” groups in the population of urban Rajasthan. Jaipur was chosen as the field study location because of the city’s extensive levels of healthcare institutions and facilities. In order to identify common patient demographics as well as issues regarding treatment adherence, medical records and interviews …

Community Health Workers: Health System Integration, Financing Opportunities, And The Evolving Role Of The Community Health Worker In A Post-Health Reform Landsacape, Mary-Beth Malcarney, Patricia Pittman, Leo Quigley, Naomi Seiler, Katie B. Horton

Health Workforce Research Center Publications

Community Health Workers (CHWs) have been gaining attention from policymakers because of their unique role in addressing health disparities and socioeconomic drivers of disease, and because of their potential integration into the health care delivery system. To date, there has been limited research specifically describing the variation in CHWs’ roles and relationships, and how that variation relates to management, to financing, to health system integration, and to the competencies CHWs should have in different contexts.

The purpose of this report is to better understand the varied landscape; to offer categories of analysis that may help inform policy, management, and research; …

The Conceptualization Of Self-Identity Among Residents Of Appalachia Ohio, Jessica L. Krok-Schoen, Angela L. Palmer-Wackerly, Phokeng M. Dailey, Janice L. Krieger

Department of Communication Studies: Faculty Publications

Social identity and its association to culture, place, and health is an important, but understudied, area of research. One social group that illustrates this connection between place and identity is people living in Appalachia. This exploratory mixed-method study investigates the appropriateness of the self-concept of Ohio Appalachian adults with cancer as “Appalachian,” the context associated with that identity and its association with community identification, rural identity, Appalachian Regional Commission (ARC) status, demographic data, and clinical trial (CT) enrollment. Forty-nine adults with cancer residing in Appalachia were recruited. Participants were cancer patients who (1) were offered a randomized clinical cancer trial; …

Challenges Of Providing Timely Feedback To Residents: Faculty Perspectives, Tabassum Zehra, M. Tariq, Afaq Motiwala, Syeda Kauser Ali, John Boulet

Department for Educational Development

Objective

To explore faculty's perceptions of challenges in providing verbal feedback to the Residents and suggest ways to overcome the barriers.

Methods

As part of a larger study on feedback assessment, five focus group discussions were conducted at the Department of Medicine, Aga Khan University Hospital, Karachi, during faculty development workshops held from January to June 2010. Qualitative grounded theory was used to explore faculty perceptions of challenges in providing verbal feedback to the Residents.

Results

Of the 54 faculty members, 49(91%) participated. Four themes that emerged were 'time constraint' indicating high patient load; 'faculty related issues' indicating faculty's apprehension …

Hispanic Ethnicity Is Associated With Increased Hospital Charges After Radical Cystectomy In The United States, Mark D. Tyson, Erik P. Castle

Journal of Health Disparities Research and Practice

Objective: To examine the impact of race and ethnicity on financial charges associated with radical cystectomy (RC).

Data Sources/Study Setting: The Nationwide Inpatient Sample was used to identify patients who underwent RC for bladder cancer between 1998 and 2010.

Study Design: The primary outcome was total hospital charges adjusted for inflation. Multivariate analysis was performed using a generalized linear model on the logarithmically transformed outcome variable (total hospital charges) after adjusting for age, sex, race, Elixhauser comorbidities, surgical approach, year, primary payer, hospital and surgeon annual RC volume, hospital characteristics, and postoperative complications.

Principle findings: A total of 14,873 patients …

Challenges Of Forecasting Physician Workforce Needs Amid Delivery System Transformation, Rob Cunningham

National Health Policy Forum

As population growth and the aging of the overall population increase demand for health care, policymakers and analysts grapple with whether sufficient health care providers, particularly physicians, will be available to meet that demand. Some argue there are too few physicians already; others say our current supply-demand problems lie with efficiency. But suppose both are correct? Perhaps the real challenge is to understand how the provision of health care services is changing in response to market forces such as payment changes, patients' expectations, provider distributions, and technology innovations. This issue brief revisits what is known about evolving practice organizations, professional …

Dual Use Of Va And Non-Va Hospitals By Veterans With Multiple Hospitalizations, Alan N. West, Mary E. Charlton, Mary Vaughan-Sarrazin

Dartmouth Scholarship

Background: Veterans who are hospitalized in both VA and non-VA hospitals within a short timespan may be at risk for fragmented or conflicting care. To determine the characteristics of these “dual users,” we analyzed administrative hospital discharge data for VA-enrolled veterans of any age in seven states, including any VA or non-VA hospitalizations they had in 2004 – 2007. Method: For VA enrollees in Arizona, Iowa, Louisiana, Florida, South Carolina, Pennsylvania, or New York in 2007, we merged 2004 – 2007 discharge data for all VA hospitalizations and all non-VA hospitalizations listed in state health department or hospital association databases. …

A Comparison Of A Multistate Inpatient Ehr Database To The Hcup Nationwide Inpatient Sample., Jonathan P Deshazo, Mark A Hoffman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data.

METHODS: In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010.

RESULTS: The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent …

Presence Of Athletic Trainers In Michigan High Schools, Monica Lininger, Gayle Thompson

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Context: Each year an estimated 1.4 million sports related injuries occur annually to student-athletes at the high school level. It has been over 20 years since a systematic investigation into the presence of athletic trainers to treat these injuries in the state of Michigan has been conducted. Within the past 5 years in Michigan, licensure as well as several laws and regulations have been enacted for athletic trainers.

Purpose: To investigate the prevalence of athletic trainers in secondary schools in Michigan.

Design: Cross-sectional study.

Setting: Questionnaires were given to all 400 athletic directors in attendance of the Michigan Interscholastic Athletic …

Local Health Departments’ Costs Of Providing Environmental Health Services, Simone Singh, Nancy L. Winterbauer, Ashley Tucker, Lisa Macon Harrison

Frontiers in Public Health Services and Systems Research

Background: A detailed understanding of the costs that local health departments (LHDs) incur in the provision of public health services plays an important role in their efforts to provide services in an effective and efficient manner. However, surprisingly little evidence exists about the key cost components that LHDs incur in the provision of services.

Purpose: The purpose of this report was to provide empirical estimates of LHDs’ cost structure.

Methods: Using cost information for 2012 from 15 LHDs in North Carolina for two public health services—food and lodging and onsite water—this report first presents estimates of the total costs per …

Use Of Facebook By Local Health Departments: Usage, Public Health Themes, And Maintenance, Rakhi Trivedi, Gulzar H. Shah, Ankit Bangar

Frontiers in Public Health Services and Systems Research

Background: Recent research shows that social media offer unprecedented opportunities for communications with stakeholders in public health and other industries.

Purpose: This study examines the manner in which U.S. local health departments (LHDs) use Facebook. Public health program themes discussed on Facebook profiles of LHDs were analyzed and ranked by the frequency of mentions on Facebook.

Methods: LHDs included in the study were those indicating use of Facebook in the 2010 National Profile of Local Health Departments. Using the list from the profile study, the primary data from LHDs’ public Facebook profiles were collected over a period of 4 months. …

Trends In Health Care Delivery Systems: Implications For Cancer Prevention And Control, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act and larger economic forces are leading both health care providers and public health agencies to renegotiate their roles and responsibilities within the U.S. health system. This session reviews major changes occurring in both health care and public health delivery systems, with a focus on the implications for cancer prevention and control. The information infrastructure created by cancer registries and other health information systems are increasingly important for enabling greater coordination, alignment and accountability within the nation's changing delivery systems.

The National Health Security Preparedness Index: Proposed Updates For 2015-16, Glen P. Mays

Health Management and Policy Presentations

The U.S. Centers for Disease Control and Prevention (CDC) initiated development of the National Health Security Preparedness Index in 2012 to create a platform for measuring the nation’s progress in preparing for, responding to, and recovering from disasters and other large-scale emergencies that pose risks to health and well-being in the United States. As a measurement tool, the Index is designed to summarize levels of preparedness achieved within individual states and for the nation as a whole. This session summarizes proposed updates to the Index for 2015-16 that are designed to improve the validity and reliability of Index measures and …

Preparedness Of Hospitals In The Republic Of Ireland For An Influenza Pandemic, An Infection Control Perspective, Mary Reidy, Fiona Ryan, Dervla Hogan, Seán Lacey, Claire Buckley

Department of Mathematics Publications

When an influenza pandemic occurs most of the population is susceptible and attack rates can range as high as 40–50 %. The most important failure in pandemic planning is the lack of standards or guidelines regarding what it means to be ‘prepared’. The aim of this study was to assess the preparedness of acute hospitals in the Republic of Ireland for an influenza pandemic from an infection control perspective.

Wdph Summer Internship Report, Samantha Arsenault

Mosakowski Institute for Public Enterprise

The Mosakowski Institute is working with the Worcester Division of Public Health (DPH) in an effort that merges classroom skills and real world experience to improve the health of the Greater Worcester community. During the summer of 2015, thirteen Clark students interned with the DPH working on five projects that advanced goals of the Community Health Improvement Plans in the areas of healthy eating and activing living; substance abuse and mental health; health equity and health disparities; violence prevention, and more. More information about the summer 2015 internship projects can be found in the report.

Longitudinal Analysis Of Electronic Health Records On Staffing Mix In Community Health Centers, Bianca K. Frogner, Xiaoli Wu, Jeongyoung Park, Patricia Pittman

Health Workforce Research Center Publications

Community health centers (CHCs) have long faced clinical staffing challenges especially in rural areas of the US due to providers perceiving a lack of socioeconomic opportunities. A recent study found that CHCs are adaptable and manage to maintain productivity levels across different staffing configurations by leveraging the clinical staff available. What is unknown is how two major changes in the health care landscape—adoption of an electronic health record (EHR) system and recognition of being a patient-centered medical home (PCMH)—have impacted staffing in CHCs, which may in turn have productivity implications.

Assessment Of Nutrition Information System Using Health Metrics Network Framework, Mochamad Iqbal Nurmansyah, Catur Rosidati, Riastuti Kusuma Wardani, Badra Al-Aufa

Kesmas

Sistem informasi gizi (Sigizi) dikembangkan oleh Direktorat Bina Gizi Kementerian Kesehatan sejak 2011. Data Sigizi mencakup data penimbangan balita di posyandu, kasus gizi buruk, cakupan pemberian tablet Fe pada ibu hamil, konsumsi garam beryodium, pemberian vitamin A, dan ASI eksklusif. Penelitian ini bertujuan untuk mengukur kinerja pengelolaan Sigizi di Dinas Kesehatan Kota Tangerang Selatan menggunakan kerangka Health Metrics Network yang dikeluarkan oleh WHO tahun 2008. Sigizi merupakan sistem informasi yang diaplikasikan pada tingkat nasional dengan mekanisme pelaporan berjenjang, dari 508 kabupaten/kota menuju 34 provinsi dan bermuara di tingkat nasional. Di Provinsi Banten, terdapat delapan kabupaten/kota yang menjalankan Sigizi. Informan penelitian …

Sikap Remaja Terhadap Keperawanan Dan Perilaku Seksual Dalam Berpacaran, Desi Rusmiati, Sutanto Priyo Hastono

Kesmas

Laporan Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2007 dan 2012 menunjukkan terjadinya penurunan jumlah remaja yang memiliki sikap positif terhadap pentingnya mempertahankan keperawanan bagi seorang perempuan. Dari laporan yang sama juga diketahui adanya peningkatan perilaku seksual remaja dalam hal berpegangan tangan, berciuman bibir, petting, dan melakukan hubungan seksual. Penelitian ini bertujuan untuk membuktikan adanya hubungan antara sikap remaja terhadap keperawanan dengan perilaku seksual dalam berpacaran dengan melibatkan usia, jenis kelamin, pendidikan, tempat tinggal, usia pertama kali pacaran, pengetahuan, dan pengaruh teman sebaya sebagai variabel perancu. Penelitian ini merupakan penelitian kuantitatif dengan rancangan potong lintang menggunakan model faktor risiko dari …

Sociodemographic Factors To Dengue Hemmorrhagic Fever Case In Indonesia, Desy Nuryunarsih

Kesmas

Demam berdarah dengue (DBD) adalah penyebab utama rawat inap dan kematian pada anak-anak. Indonesia adalah salah satu negara yang oleh WHO dikategorikan hyperendemicity dengan empat serotipe virus tersebar di daerah perkotaan. Faktor sosiodemografi dianggap sebagai faktor pendukung terjadinya DBD di Indonesia. Studi ini menggunakan data sekunder yang diunduh dari Basis Data Kesehatan Provinsi tahun 2010 Kementerian Kesehatan Republik Indonesia untuk menentukan korelasi antara ketiga faktor sosiodemografi dengan insiden DBD. Penelitian ini menggunakan metode kuantitatif deskripsi korelasi. Hasil penelitian menunjukkan bahwa dua faktor sosiodemografi terpilih memiliki korelasi linier dengan insiden DBD. Analisa regresi multivariat menunjukkan kecilnya korelasi antara insiden DBD dengan …