Health Services Research Commons^™

Connecting Kids To Coverage, Florida Covering Kids & Families

Florida Covering Kids & Families

This issue provides examples of application assistance strategies that can be used to enroll the uninsured in health coverage programs.

Prevalence Of Obesity, Type Ii Diabetes Mellitus, Hyperlipidemia, And Hypertension In The United States: Findings From The Ge Centricity Electronic Medical Record Database., Albert G Crawford, Christine Cote, Joseph Couto, Mehmet Daskiran, Candace Gunnarsson, Kara Haas, Sara Haas, Somesh C Nigam, Rob Schuette

College of Population Health Faculty Papers

This study analyzed GE Centricity Electronic Medical Record (EMR) data to examine the effects of body mass index (BMI) and obesity, key risk factor components of metabolic syndrome, on the prevalence of 3 chronic diseases: type II diabetes mellitus, hyperlipidemia, and hypertension. These chronic diseases occur with high prevalence and impose high disease burdens. The rationale for using Centricity EMR data is 2-fold. First, EMRs may be a good source of BMI/obesity data, which are often underreported in surveys and administrative databases. Second, EMRs provide an ideal means to track variables over time and, thus, allow longitudinal analyses of relationships …

Comparison Of Ge Centricity Electronic Medical Record Database And National Ambulatory Medical Care Survey Findings On The Prevalence Of Major Conditions In The United States., Albert G. Crawford, Christine Cote, Joseph Couto, Mehmet Daskiran, Candace Gunnarsson, Kara Haas, Sara Haas, Somesh C Nigam, Rob Schuette, Joseph Yaskin

College of Population Health Faculty Papers

The study objective was to facilitate investigations by assessing the external validity and generalizability of the Centricity Electronic Medical Record (EMR) database and analytical results to the US population using the National Ambulatory Medical Care Survey (NAMCS) data and results as an appropriate validation resource. Demographic and diagnostic data from the NAMCS were compared to similar data from the Centricity EMR database, and the impact of the different methods of data collection was analyzed. Compared to NAMCS survey data on visits, Centricity EMR data shows higher proportions of visits by younger patients and by females. Other comparisons suggest more acute …

Early Childhood Professional Development: A Synthesis Of Recent Research, Allyson Dean

Children, Youth, & Families

This literature review explores the current status of research on the impacts of investments in different types of professional development in early child care settings.

'Slowing Down When You Should': Initiators And Influences Of The Transition From The Routine To The Effortful, Carol-Anne Moulton, Glenn Regehr, Lorelei Lingard, Catherine Merritt, Helen Macrae

Lorelei Lingard

BACKGROUND: 'Slowing down when you should' has been described as marking the transition from 'automatic' to 'effortful' functioning in professional practice. The ability to 'slow down' is hypothesized as an important factor in expert judgment. This study explored the nature of the 'slowing down' phenomenon intraoperatively and its link to surgical judgment.

METHODS: Twenty-eight surgeons across different surgical specialties were interviewed from four hospitals affiliated with a large urban university. In grounded theory tradition, data were collected and analyzed in an iterative design, using a constant comparative approach. Emergent themes were identified and a conceptual framework was developed.

RESULTS: Surgeons …

Should ‘Risk Syndrome Of Psychosis’ Be Included In Dsm V As A Diagnosis? A Road Towards Preventive Psychiatry”, Amresh Srivastava

Amresh Srivastava

Psychiatric diagnosis has acquired a position of a quasi-legal document for mental health services and agencies working with mental health. Its utility has gone far beyond ‘clinical diagnosis for treatment’.

The concept of risk syndrome for schizophrenia has been thoroughly researched in last ten years or so. Significant advancement has been made in phenomenology, diagnostic criteria, classification, & neurobiology. The research of prodromal or at-risk or Ultra high-risk psychosis has significantly contributed to the body of knowledge of aetio-pathogenesis of schizophrenia.

The science of risk syndrome has apparently matured and its proponents are ready for its inclusion in DSM V …

Outcome, Early Intervention & Dup: The Matrix Of Research In Early Psychosis, Amresh Srivastava, Megan Johnston

Amresh Srivastava

There has been little investigation of the relationship of DUP to other long-term outcomes such as negative symptoms and cognitive functioning neither have the possible confounds of DUP been widely investigated or controlled. It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention. Shorter duration of untreated psychosis was associated with greater response to antipsychotic treatment, as measured by severity of global psychopathology, positive symptoms, negative symptoms, and functional outcomes. At the time of treatment initiation, duration of initially untreated psychosis was associated …

Physician Assessment: Measuring Competence And Performance, Lisa Sprague

National Health Policy Forum

No abstract provided.

The Effects Of An Actiped Pedometer Intervention Program On Body Composition And Aerobic Capacity Of Youth In A School System In East Tennessee., Kristie Russell Coleman

Electronic Theses and Dissertations

The purpose of this study is to determine if the ActiPed Pedometer Intervention Program would sustain or improve aerobic capacity or body composition scores over a 12-week period for students ages 8-12 in a school system in East Tennessee. Obesity is an epidemic in Tennessee and in the United States. In fact, Tennessee has the 5^th highest obesity rates for youth in the United States. National and State Legislations with physical activity and wellness mandates are being passed at an alarming rate as the need to combat the obesity epidemic is astonishing. The responsibility to decrease the obesity rates …

Evaluating The Impact Of The Guatemalan Nursing Program On Staff, Organizational, And Clinical Outcomes, Sara Williamson Day

Theses and Dissertations (ETD)

There is great disparity between the outcome of childhood cancer in developed and developing countries. Nurses, who comprise the largest group of health care professionals globally, are essential to successful treatment. Pediatric oncology education is generally unavailable for nurses in developing countries. This lack of education is likely to contribute to the disparity in survival rates, as undereducated nurses are unable to meet the demands of pediatric cancer care. A second critical problem in developing countries is the workload of the nurse, with a patient nurse ratio reported as high as 30 patients per one nurse.

In 2006, the quality …

Assessing The Sensitivity Of The Canadian Adverse Event Following Immunization Surveillance System ( Caefiss), Mina Tadrous

Theses and Dissertations (ETD)

Background: Vaccines are important to public health, but because of the way they are manufactured, their mechanism of action, and their indicated population, careful monitoring of their adverse events is necessary. Canada has a national surveillance system that collects reports on adverse events that may be associated with vaccine administration. Sensitivity is one of the tools used with surveillance systems to study the extent and characteristics of reporting of a surveillance system. To date, the sensitivity of the Canadian system has not been assessed.

Purpose: To assess the sensitivity of the Canadian Adverse Event Following Immunization Surveillance System …

School-Based Outreach: A Way In, Florida Covering Kids & Families

Florida Covering Kids & Families

According to the Urban Institute, 3.4 million U.S. children aged 6-18 are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) but are uninsured. These school-aged children make up about 68% of the total eligible but uninsured population. Child and family advocates have long considered schools to be valuable partners for Florida KidCare outreach.

Rational Use Of Radiology Services, Saba Sohail

Department of Radiology

No abstract provided.

Pain Management In Nursing Home Residents With Cancer And Dementia With And Without Hospice Services, Todd Bryant Monroe

Theses and Dissertations (ETD)

Aims: We sought to identify differences in pain management between two groups; nursing home residents with malignant cancer and dementia with and without hospice services.

Methods: Decedent records from 2003-2009 were assessed for diagnosis of dementia and cause of death as cancer. Ten malignant cancer diagnoses were determined a priori from the CDC 2004 data on the top 10 malignant cancers for all races and genders. Fifty-five decedents from 10 nursing homes were included in the final sample. Four instruments were used: Minimum Data Set (MDS) a standardized assessment tool required of most U.S. nursing homes. A large …

Opportunities For Intervention: Characteristics Of Alcohol Related Visits To United States Emergency Departments, 2003 - 2007, Jonathon Lavalley

UNLV Theses, Dissertations, Professional Papers, and Capstones

The cycle of alcohol intoxicated patients passing through United States (US) emergency departments (ED) and repeated inpatient detoxification for alcohol inebriates is costly, as these patients are continually exposed to injury and other health and legal consequences of their continued at risk alcohol use. The high proportion of ED resources used by these alcohol intoxicated patients has contributed to increased patient wait times, increased ambulance diversions, forced closures of US EDs, increased numbers of patients leaving without being seen, and an overall reduction in the quality of medical services provided in the ED. In order to contribute to efforts towards …

Need For Risk Assessment Of Suicide Across Mental Health Services, Amresh Srivastava, Megan Johnstom

Amresh Srivastava

Clinical practice of psychiatry has acquired role and responsibility which goes far beyond traditional expectations .Incident of suicide, particularly, is considered a high liability for then professionals, organizations and the consumer. It also remains a clinical issue which examines can we prevent suicide which in the system of care. Studies have shown about 1 in 6 psychologists or psychiatrist are likely to loose a patient due to suicide in a mean duration of 18-20 years practice. Repeatedly it has demonstrated that clinical skill training for risk assessment is the necessary for all professionals not only in mental health but also …

Optimizing Outcome Measures For Schizophrenia: From Research To Clinics, Amresh Srivastava, Nina Schoolar, Alexander Miller, Jitenra Trivedi

Amresh Srivastava

Outcome measures in schizophrenia have evolved considerably to bring in more objectivity, uniformity and attempt to reflect ‘real-life’ situation. It has significantly moved away from measurement of symptom remission to assessment of level of functioning and quality of life parameters. Schizophrenia is a complex neurobehavioral disorder afflicting approximately 1% population, with onset in early adolescence, across the world. It cause immense burden of patients, families and caregivers. The economic cost of schizophrenia is enormous. It is therefore important that assessment of schizophrenia be reflective of ground reality, scientific, evidence-based and comprehensive. Several researchers have proposed multidimensional outcome parameters. The heterogeneity …

To Be Or Not To Be: Education For Clinical Decisions In Risk Assessment Of Suicide Behavior, Amresh Srivastava, Megan Johnston

Amresh Srivastava

Clinical practice of psychiatry has acquired role and responsibility which goes far beyond traditional expectations .Incident of suicide, particularly, is considered a high liability for then professionals, organizations and the consumer. It also remains a clinical issue which examines can we prevent suicide which in the system of care. Studies have shown about 1 in 6 psychologist or psychiatrist are likely to loose a patient due to suicide in a mean duration of 18-20 years practice. Repeatedly it has demonstrated that clinical skill training for risk assessment is the necessary for all professionals not only in mental health but also …

Belize As A Classroom, Jordan Norris, Molly Calico

Impact Belize

During the week of January 7-14, 2010, Molly Calico and Jordan Norris participated in the Impact Belize program through the College of Health and Human Services. This program took place in Gales Point, a rural, underserved community in Belize. Impact students provided medical, dental and public health services to the community in an interdisciplinary service-learning format. As Master of Public Health students, Molly and Jordan directed health education initiatives and served on the Leadership Team for the program. Having participated in January of 2009 as well, Molly and Jordan were well prepared to conduct public health research and to assume …

Cognitive Factors In Long Term Outcome Of First Episode Psychosis, Amresh Srivastava, Megan Johnston, Nilesh Shah, Meghana Thakar, Larry Stitt

Amresh Srivastava

Cognitive factors in long term outcome of first episode psychosis

Amresh Shrivastava, Megan Johnston, Nilesh Shah , Meghana Thakar , and Larry Stitt

a Excecutive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, Currently: Assistant Professor of Psychiatry, The University of western Ontario, & associate Scientist, Lawson Health Research Institute, London, Ontario,Canada, E Mail : amresh.edu@gmail.com b Professor of Psychiatry LTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 c Clinical psychologist, Silver Mind Hospital, Mumbai,India d Department of Epidemiology & …