Health Services Research Commons^™

Wku Scholar, Pamela Napier, Editor-In-Chief

WKU Scholar

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Neurobiological Markers Of Schizophrenia: Findings From Indian Studies Of Early Psychoses, Amresh Srivastava, Megan Johnston, John John, Harsha Halahalli, Shivarama Varambally Varambally

Amresh Srivastava

Neurobiological Markers of Schizophrenia: Findings from Indian Studies of Early Psychoses. Amresh Srivastava, Megan Johnston, John John, Harsha Halahalli,Shivarama Varambally 1The University of Western Ontario, London, Ontario, Canada/3NIMHANS, Banglore , Karnataka , India OVERALL PANEL PROPOSAL: Advancement in technology together with early intervention studies have revealed a great deal about changes in neurobiological profile of brain in schizophrenia. In last fifteen years , there has been a trend all over the world to study early psychosis from the perspective of not only risk factors and causes of psychosis but also about brain vulnerability to understand what exactly happens that emotional …

Improving Health Outcomes For Children (Ihoc) In Maine Logic Model For Primary Care Practice Improvement, Cutler Institute Of Health And Social Policy

Population Health & Health Policy

Improving Health Outcomes for Children (IHOC) is a 5-year demonstration grant from the Centers for Medicare & Medicaid Services, and authorized by 401 (d) of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA).

IHOC works with doctors' offices, practices and other agencies who want to improve health care in Maine and Vermont to:

• Collect and report on the use of evidenced-based child health quality measures
• Expand the Health Information Technology to improve the flow of child health data
• Promote a collaborative child health learning environment

The State Health Insurance Assistance Program (Ship), Carol O'Shaughnessy

National Health Policy Forum

The State Health Insurance Assistance Program (SHIP), created by section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 and administered by the Centers for Medicare & Medicaid Services (CMS), supports grants to states and jurisdictions to provide information, counseling, and assistance to Medicare beneficiaries and their families on Medicare and other health insurance questions. This publication describes the program and presents its funding history.

Oral Health Checkup: Progress In Tough Fiscal Times?, Cynthia Shirk

National Health Policy Forum

Almost ten years after the surgeon general’s report designating dental disease as the “silent epidemic,” the nation continues to struggle with adequate access to and utilization of dental services. This is particularly true for low-income individuals, who experience more than twice the amount of untreated dental disease as their higher-income peers. This issue brief reviews sources of dental coverage for low-income children and adults and the challenges these programs face. It highlights some examples of state Medicaid initiatives to improve access and utilization for children and the progress of these initiatives. Finally, it examines the potential effects of the economy …

Management Of Kawasaki Disease In Texas: Policy Implications, Alberto Coustasse, Doohee Lee, Cody Arvidson, Julius J. Larry Iii, Witold Migala

Management Faculty Research

Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but KD has received little attention on its management from a policy perspective. The core objective of this paper is to review the literature, identify problems related to KD, and evaluate and offer some policy alternatives to effectively prevent and treat KD epidemiologically in Texas. Policy options suggested in this paper include, among others, (1) establishing a mandatory national KD registry system (along with active surveillance), (2) introducing sentinel providers, (3) requiring mandatory reporting of KD by hospitals, and (4) sponsoring policy KD research and practice.

Using The Stages Of Change Model To Choose An Optimal Health Marketing Target, Paula Diehr, Peggy A. Hannon, Barbara Pizacani, Mark Forehand, Jeffrey Harris, Hendrika Meischke, Susan J. Curry, Diane P. Martin, Marcia R. Weaver

UW Biostatistics Working Paper Series

Background: In the transtheoretical model of behavior change, “stages of change” are defined as Precontemplation (not even thinking about changing), Contemplation, Preparation, Action, and Maintenance (maintaining the behavior change). Marketing principles suggest that efforts should be targeted at persons most likely to “buy the product.”

Objectives: To examine the effect of intervening at different stages in populations of smokers, with various numbers of people in each “stage of change.” One type of intervention would increase by 10% the probability of a person moving to the next higher stage of change, such as from Precontemplation to Contemplation. The second type would …

The Ryan White Hiv/Aids Program, Jessamyn Taylor

National Health Policy Forum

This publication describes the basics of the Ryan White HIV/AIDS Program, the largest federal program solely focused on treating people living with HIV/AIDS in the United States. The program funds cities, states, and community-based organizations to provide primary care, prescription drugs, and support services to low-income, uninsured, and underinsured people living with HIV/AIDS.

Changing Po2licy: The Elements For Improving Childhood Asthma Outcomes, Anne Rossier Markus, Meagan Lyon, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and chronic health issue that affects one in seven U.S. children and their families, compromising their health and quality of life and placing a heavy financial burden on families as well as an enormous strain on the health care system. Treating, managing, and ultimately preventing and reducing the burden of asthma represents a critical test of the ability of the U.S. health system – health insurers, clinical care providers, and public health agencies – to work together. Our investigation found that, as a country, we already know enough to act and improve life for the …

Integrating Social & Clinical Parameters In Outcome Measures Of Schizophrenia: Clinician’S Perspective., Amresh Srivastava, Nilesh Shah, Yves Bureau

Amresh Srivastava

Schizophrenia is a complex neurobehavioral disorder for which there are many promising new treatments. There is, however, a discrepancy in outcome measure reports when they are obtained from patients, relatives, caregivers, or professionals, thus making it difficult to determine the level of recovery. The reason for this lack of agreement may be due to the limitations of the measurement tools themselves, which are not comprehensive and may be measuring different aspects of outcome. Alternatively, it could be that the conceptual understanding of outcome and recovery require development. Unfortunately for one of the above reasons or both, patients assessed as “recovered” …

Survivors On The Edge: The Lived Experience Of Professional Musicians With Playing-Related Injuries, Christine A. Guptill

Christine A Guptill

The purpose of this study was to understand the lived-experience of professional instrumental musicians who have experienced playing-related injuries. This study used a hermeneutic phenomenological methodology developed to examine this lived-experience. In-depth interviews were conducted with ten professional musicians. This was followed by a focus group where preliminary findings were presented to participants and their feedback was sought. Other sources of lived-experience included participant-observation by the researcher, who is a musician and has experienced injuries; and biographic and artistic representations of musical performance and its loss, including literature, films and television. The findings were summarized in a visual representation unique …

Double Red Blood Cell Donation Eligibility And Interest, Laura Anderson, Kovi Bessoff, Brandon Chapman, Angela Dunn, Michael Larochelle, Tessa Scripps, Jessica Wood, Christine Frenette, Carol Dembeck, Jan Carney, Mark K. Fung

Public Health Projects, 2008-present

Introduction: The process of double RBC donation by apheresis (DRBC), which facilitates the donation of two units of red blood cells (RBC) in a single donation session, was estimated to account for approximately 4% of blood donations in 2005, and is believed to be growing at a rate of 40% per year. Blood shortages in this country could be corrected by converting as few as 10% of current single unit whole blood donors to DRBC donors. Advantages of DRBC donation may include reduction in donor-related exposures in recipients, improved cost-effectiveness of the donation process, and improved convenience for donors. The …

The What’S, Where’S, And Why’S Of What Your Family Eats: The Burlington Children’S Space Farm To Table Program, Loren Babirak, Kelly Cunningham, James Dunlop, Jenny Nguyen, Cheddhi Thomas, Zea Schultz, Michael Visker, Nancy Drucker, Barbara Frankowski

Public Health Projects, 2008-present

Introduction: Preventing childhood obesity is a national priority, and changing dietary behavior in both children and adults is challenging. Burlington Children’s Space, Inc. (BCS), a private, non-profit early education and childcare center providing services for families in the Burlington area, is trying to do just that. The Farm to Table Project was designed to positively influence the food choices of students and their families as well as to cultivate a relationship between families and local farmers. In an effort to secure expanded funding for the school’s food program, BCS requested that we assess the effectiveness of their Food Program

Nutrition And Social Eating Habits Among Seniors Living Independently, Carl Cappelletti, Lindsay Corse, Aaron Kinney, Suleiman Lapalme, Nolan Sandygren, Danielle Scribner, Mariah Stump, Tom Delaney, Margaret Holmes, Molly Dugan, Patricia Berry

Public Health Projects, 2008-present

Background: Older adults have unique nutritional needs due to physiologic changes that occur as part of the normal aging process. Maintaining adequate nutrition has the potential to reduce morbidity and mortality related to chronic disease, fall risk, dementia and Alzheimer’s disease. Aging also poses an increased risk of isolation and lack of social interaction, particularly noted at meal times. Unintentional weight loss is an independent risk factor for early mortality. Social eating is related to higher food intake, and meal programs can improve nutritional risk for vulnerable seniors. We partnered with the Cathedral Square Corporation (CSC) to assess nutrition and …

Identifying Barriers To Care In The Burmese And Bhutanese Refugee Populations Of Burlington, Vermont, William Arscott, Brian Costello, Kathryn Dipalma, Alex Folkl, Megan Malgeri, Amanda Miller, Rebecca Purtell, Jon Bourgo, Rodger Kessler

Public Health Projects, 2008-present

Introduction: Many refugees who escape persecution in their own country have trouble navigating and accessing the American health care system. Language barriers often impair effective communication, while financial challenges can be prohibitive after the eight-month government insurance subsidy for new refugees expires. In addition many refugees do not understand the concept of chronic disease, which is a concern considering the overall rise in hypertension (HTN) and type-two diabetes mellitus (T2DM) in the US population. Understanding how refugees access health care, and how well they understand chronic disease, is essential for organizations providing medical care for these populations. Little is known …

Assessing The Current State And Potential Needs Of The Community For Autism Spectrum Awareness In The Classroom, Megan Berube, Adam David, Shannon Degroff, Sharif Nankoe, Kaitlin Petros, Steven Schaub, Scott Wasilko, Deb W. Lyons, Stephen Contompasis

Public Health Projects, 2008-present

Introduction: • Number of children with autism and related disorders has been growing in Vermont in the last ten years. • Puppets in Education, Inc (PiE) recently added a new program Friend 2 Friend Programs-Vermont (F2F), that will work with grades K?8 to educate students and teachers about autism spectrum disorders (ASD). • Goal is to promote understanding, acceptance, empathy and mutual friendships between children with ASD or other social communication disorders • Students from the University of Vermont College of Medicine partnered with PiE to evaluate the current needs of the community, determining what information would be most useful …

Nutrition And Exercise Education Initiatives In A Community Setting, Andrew Erb, Patrick Huffer, Tri Luu, Elizabeth Mebrate, Alyse Rymer, Eleonore Werner, Eric Worthing, Hal Colston, Halle Sobel

Public Health Projects, 2008-present

Introduction: Maintaining a nutritious diet and physical activity is a challenge for many people,but especially for those with limited financial and social resources. Barriers to adequate exercise and healthy food include prohibitive costs of gym membership and high quality foods, lack of time during the day in which to exercise or prepare meals, and lack of access or transportation to exercise facilities or grocery stores. We assessed whether adoption of healthy exercise and eating habits could be established and sustained by educating participants on healthy diet guidelines and on non-traditional exercise forms. We encouraged family-centered activities such as walking, gardening, …

Are Mandates The Answer? Improving Palliative Care And Pain Management In Vermont, Patrick O. Butsch, Laura C. Depouli, Nicholas A. Larochelle, Mckalyn G. Leclerc, Michael A. Maccini, Michael P. Morwood, Andrea M. Steely, Virginia Hood, George Philips, William Wargo, Tom Delaney, Jan Carney

Public Health Projects, 2008-present

Background: The Vermont legislature (bill H.435, Sec. 19) has tasked the Vermont Board of Medical Practice (VBMP) with making a formal recommendation on improving Vermont health professionals’ knowledge and practice of Palliative Care and Pain Management (PC/PM). In collaboration with the VBMP, our group set out to answer the following questions: • How confident/competent are VT physicians in the practice of PC/PM? • What are the barriers to achieving optimal patient care in PC/PM? • Do VT physicians believe mandatory CME would improve the overall quality of care in PC/PM? • What are the best methods of providing Continuing Medical …

Referral Patterns Between Allopathic Physicians And Complementary And Alternative Medicine Practitioners: A Followup Study, Molly Hubbard, Hany Khattab, Matthew Lecomte, Lindsay Peet, Meghan Small, Khine Win, Asha Zimmerman, Margaret Eppstein, Helene Langevin, Phil Trabulsy

Public Health Projects, 2008-present

Introduction: • Despite the high prevalence of Complementary and Alternative Medicine (CAM) usage, several recent surveys suggest that the vast majority of patient visits to CAM practitioners are self-referred and that communication between conventional and CAM practitioners is limited. • There is a need for a better understandingof factors influencing referral patterns across these two groups of practitioners. • Network analysis provides a useful tool to quantify relationships between members of an interrelated social network. • The goal of this follow up study was to quantify the cross-class referral patterns between conventional and CAM classes of practitioners in Chittenden County …

Food Shelf Friendly: Increasing The Nutritional Quality Of Food Shelf Donations, Daniel Carballo, Anne Kamarchik, Lindsay Nadeau, Isaac Noyes, Marianne Reed, Louisa Salisbury, Nathaniel Ward, Rob Meehan, Jan Carney

Public Health Projects, 2008-present

Introduction: Food insecurity is a household-level economic and social condition of limited access to nutritionally adequate and safe food. Food banks provide a major source of sustenance for individuals experiencing food insecurity, many of whom deal with obesity, diabetes and hypertension, however, the nutritional contents of many donations to these operations fail to meet the dietary recommendations set forth by the USDA for individuals with many chronic health conditions. In the present economy there is increasing demand for the services of local food shelves, however, often these organizations are unable to sufficiently meet the needs of their clients with regard …