Social and Behavioral Sciences Commons^™

Bending The Health Care Cost Curve In North Carolina: The Experience Of Community Health Centers, Patrick Richard, Peter Shin, Kristina Vasilkovska, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

North Carolina is known for innovative practices in primary care delivery and education, and accordingly one might expect to see greater efficiencies overall in care delivery, and less direct, measurable impact by community health centers on cost and outcome. Of interest is whether community health centers (CHCs) are cost effective providers in states with a sophisticated primary care infrastructure and focus on the needs of medically underserved communities. Building on the large body of health services research literature that has documented the quality and cost-effectiveness of federally-funded primary health centers nationwide, as well as estimates of national savings that are …

The Holistic Complementary Structure Of Western Bio-Medicine And Traditional Healing And Achieving Complete Health, Candace Gail Oubre

USF Tampa Graduate Theses and Dissertations

Achieving complete health requires a deep understanding of complementary cultural competency sensitivity between physician and patient. This may include but is not limited to access to preventative health care resources, access to health educational resources and access to cultural healing resources, for example, shamans, Ayurvedic physicians, and herbal healers. Advocates of cultural competency emphasize great importance on knowledge of the patients' cultural background; however, the transcendence of this knowledge can be explained further through complementary cultural competency sensitivity. This is when the cultures of the physician and patient complement each other in terms of understanding what is in the patients' …

Poster: Researchers Say The Darndest Things: Using Semi-Structured Interviews To Uncover The Unique Information Behaviors Of Basic Sciences Researchers In An Academic Health Center, Laura L. Haines

UVM Libraries Conference Day

Laura discusses the work she and her colleagues did in a qualitative study of semi-structured interviews examining the unique, information-seeking characteristics of basic sciences researchers. The team's ultimate goal was to then design a suite of library services that would better meet these researchers' needs.

An Analysis Of Clinical Questions Asked At Professor Rounds, Nancy A. Bianchi

UVM Libraries Conference Day

Nancy discussed the number of questions received during professor rounds, what kinds of questions they were, how many of these were answerable, and where she found the answers.

Behavioral Activation Of Religious Behaviors: Treating Depressed College Students With A Randomized Controlled Trial, Maria Elizabeth Anne Armento

Doctoral Dissertations

Abstract

Although spiritual or religious behaviors are sometimes targeted within behavioral activation protocols (Hopko & Lejuez, 2007; Hopko, Lejuez, Ruggiero, & Eifert, 2003), the efficacy of a protocol that exclusively develops a religiously-based behavioral repertoire has not been investigated. This randomized controlled study investigated the efficacy of a brief protocol for religious action in behavioral activation (PRA-BA) relative to a no-treatment “support” condition among mild to moderately depressed undergraduate students (n = 50). PRA-BA consisted of an individualized one-session intervention and 2-week activation interval. Clinical outcomes assessed depression, environmental reward, anxiety, and quality of life. Repeated measures ANOVAs indicated …

The High Costs Of Conserving Southeast Asia's Lowland Rainforests, Brendan Fisher, David P. Edwards, Xingli Giam, David S. Wilcove

Rubenstein School of Environment and Natural Resources Faculty Publications

Mechanisms that mitigate greenhouse-gas emissions via forest conservation have been portrayed as a cost-effective approach that can also protect biodiversity and vital ecosystem services. However, the costs of conservation - including opportunity costs - are spatially heterogeneous across the globe. The lowland rainforests of Southeast Asia represent a unique nexus of large carbon stores, imperiled biodiversity, large stores of timber, and high potential for conversion to oil-palm plantations, making this region one where understanding the costs of conservation is critical. Previous studies have underestimated the gap between conservation costs and conversion benefits in Southeast Asia. Using detailed logging records, cost …

Does Practice Make Perfect? A Randomized Control Trial Of Behavioral Rehearsal On Suicide Prevention Gatekeeper Skills, Wendi F. Cross, David Seaburn, Danette Gibbs, Karen Schmeelk-Cone, Ann Marie White, Eric D. Caine

Psychology Faculty Publications

Suicide is the third leading cause of death among 10-24-year-olds and the target of school-based prevention efforts. Gatekeeper training, a broadly disseminated prevention strategy, has been found to enhance participant knowledge and attitudes about intervening with distressed youth. Although the goal of training is the development of gatekeeper skills to intervene with at-risk youth, the impact on skills and use of training is less known. Brief gatekeeper training programs are largely educational and do not employ active learning strategies such as behavioral rehearsal through role play practice to assist skill development. In this study, we compare gatekeeper training as usual …

The Role Of Social Support In Multiple Morbidity Self-Management Among Rural Residents, Shoshana Bardach, Yelena N. Tarasenko, Nancy E. Schoenberg

Yelena N. Tarasenko

Social support generally is considered a valuable asset that may compensate for health service deficiencies among rural populations. Employing a mixed methods approach, we explored how vulnerable rural residents described social support in the context of self-management for multiple chronic conditions. Participants generally felt support was available, though emotional/ informational support was perceived as less available than other types of support. Participants did not rely heavily on informal support to help them manage their multiple morbidities, preferring to call on their doctor and their own resources. We discuss implications of these findings for meeting this vulnerable population’s self-management needs.

Changing The World With One Cell: The Story Of Hela, Allison Roberts

Allison Roberts

Poster Created for the Diversity Committee Fall 2011 Culture Corner featuring The Immortal Life of Henrietta Lacks. Henrietta Lacks’ cell culture spawned changes in medicine, science, ethics, society and the world. This Semester’s Culture Corner features selections from UT Libraries collection that highlight the areas effected by this one human and her immortal cell.

Why The Master? Human Capital Development For Practicing U.S. Cycling Coaches, Daniel Larson, Joel Maxcy

Faculty Articles

The economic structure of the industry of cycling coaches has yet to be the subject of any apparent published inquiry. This study describes the basic characteristics of practicing cycling coaches and presents economic models of the determinants of commercial success for individual coaches. Data were collected through an independent survey of current and former U.S.A. Cycling (USAC) coaches in 2010 (N = 386). Results of ordinary least squares and negative-binomial regression models suggest that coaching and competitive experience are associated with larger clienteles, but formal human capital investments do not generally add to a coach's ability to garner more clients. …

Perceived Parent-Child Relationship And High-Risk Behaviors Among Christian College Students, Karla G. Lavin Williams

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Adolescents and young adults today are participating in high-risk behaviors such as dangerous sexual behaviors and drug and alcohol abuse at high rates. An increased incidence of negative effects associated with the aforementioned behaviors has led researchers to examine factors that influence and protect adolescents from certain devastating effects (Davis, Hendershot, George, Norris, & Heiman, 2007; Goldstein, Bamett, Pedlow, & Murphy, 2007; Hamilton, et al., 2007; Hingson, Heeren, & Winter, 2006; Hingson, Heeren, Winter, & Wechsler, 2003; Hingson, Heeren, Zakocs, Winter, & Wechsler, 2003; McCarty, et al., 2004; Mokdad, Marks, Stroup, & Gerberding, 2004; Mosher, Chandra, & Jones, 2005; …

The Development Of Future Orientation: Underpinnings And Related Constructs, Sarah J. Beal

Department of Psychology: Dissertations, Theses, and Student Research

Future orientation has been conceptualized in a variety of ways across literatures in psychology, sociology, education, and vocation. The lack of a shared definition and measurement across theoretical perspectives has resulted in a challenge in comparing findings across literatures and organizing results in a way that provides a coherent sense of how future orientation impacts later outcomes. Trommsdorff (1979) provided a comprehensive definition of future orientation that included eight dimensions: extension, detail, domain, affect, motivation, control, sequence of events, and number of cognitions. Study 1 was designed to test this definition using measures from five prominent theories of future orientation …

Independent Living Program Evaluation For Rebuilding All Goals Efficiently, Patricia Armour, Debra Moulton, Araceli Pruett

UNLV Theses, Dissertations, Professional Papers, and Capstones

This paper evaluates the outcome of independent living (IL) services provided to clients with Spinal Cord Injuries (SCI) by a local non-profit organization, Rebuilding All Goals Efficiently (RAGE). Agency services are directed at increasing client self-sufficiency, self-advocacy, and maintenance of least restrictive living environment. Secondary data provided by RAGE for 22 SCI clients who received services in FY10 was used in the evaluation. Outcomes were measured for living arrangement at case closure, impact of services on client’s life, and cost effectiveness of services provided. Descriptive statistical analysis of the data revealed successful outcomes for all 22 SCI clients. All clients …

Stewardship In Health Policy And Its Relevance To Pakistan, Asaad Ahmed Nafees, Parvez Nayani

Community Health Sciences

Since the concept of stewardship in health care first appeared in World Health Report 2000 there has been very limited discussion in the academia about its implications. In the present paper we revisit this concept and review the literature that has been written about it. We have particularly focused on the role of stewardship in health policy of Pakistan. We also highlight the improvement that stewardship can bring about in the health policy of Pakistan and the possible constraints that might be faced during its implementation phase. The literature available is on the concept of stewardship in health policy. The …

Factors Associated With Duration Of Breastfeeding In Ireland: Potential Areas For Improvement, Roslyn Tarrant, Katherine Younger, Margaret Sheridan Pereira, John Kearney

Articles

There is a need to comprehensively examine why mothers in Ireland discontinue breastfeeding early and to explore thefactors influencing duration of breastfeeding during the first 6 months postpartum. Findings from this study provide valuabledirection for future strategies and interventions aimed at increasing breastfeeding duration rates in Ireland.

Impact Of An Online Support System On Health Related Quality Of Life Among Men Diagnosed With Prostate Cancer, Daniel K. Osei

Loma Linda University Electronic Theses, Dissertations & Projects

Prostate cancer is a major public health issue worldwide and a significant cause of male cancer death in the USA. Though early screening and treatment has greatly enhanced the outcome, men diagnosed with prostate cancer face problems that compromise quality of life after treatment. Online support for prostate cancer clients is a convenient way to help because it is anonymous, inexpensive, and can be used at clients’ convenience. Yet few studies have explored how these supports impact these clients. This study used a longitudinal randomized experimental design to examine the impact of online services on quality of life of prostate …

An Exploratory Investigation Of The Effects Of Dragon Boating On The Psychosocial Well-Being Of Female Cancer Survivors, Clara Therese Louise Vanherweg

Master's Theses

The purpose of this study was to prospectively examine the effects of dragon boat participation on the psychosocial well-being of female cancer survivors over time and compared with the population-based norms. Nine female cancer survivors belonging to the dragon boat team, SurvivOars, participated in the initial measurement process. The measurement packet was 21 page compilation of psychosocial questionnaires capturing demographics, quality of life, moods, depressive symptoms, perceived stress, self-esteem, self-efficacy, social support, physical activity levels, body image, and sedentary behaviors. After 8 weeks, 8 subjects completed the same follow-up questionnaire to assess changes in psychosocial variables over time. Scores were …

Symptom Persistence In Seriously Emotionally Disordered Children: Findings Of A Two-Year Follow-Up After Residential Treatment, Rebecca Cuthbert, Jeff St. Pierre, Shannon Stewart, Steven Cook, Andrew Johnson, Alan Leschied

Andrew M. Johnson

Residential treatment is arguably the most costly and intensive part of the children’s mental health system. Yet, research suggests that a subset of the emotionally disordered children and youth admitted to intensive tertiary care treatment facilities fail to demonstrate symptom reductions upon discharge, with many continuing to deteriorate in their adjustment during the follow-up period. This study reports on the factors that characterize the children and youth that, while showing marginal benefit from residential treatment, continue to show community conduct problems at a two-year follow-up period. The results are discussed in the context of how knowledge of these factors can …

How Far Do Low-Income Parents Travel To Shop For Food?, Amy Hillier, Carolyn Cannuscio, Allison Karpyn, Jacqueline Mclaughlin, Mariana Chilton, Karen Glanz

Amy Hillier

Research on the impact of the built environment on obesity and access to healthful foods often fails to incorporate information about how individuals interact with their environment. A sample of 198 low-income WIC recipients from two urban neighborhoods were interviewed about where they do their food shopping and surveys were conducted of food stores in their neighborhoods to assess the availability of healthful foods. Results indicate that participants rarely shop at the closest supermarket, traveling on average 1.58 miles for non-WIC food shopping and 1.07 miles for WIC shopping. Findings suggest that access to healthful foods is not synonymous with …

Sexual Health And Life Experiences: Voices From Behaviourally Bisexual Latino Men In The Midwestern Usa, Omar Martinez, Brian Dodge, Michael Reece, Phillip W. Schnarrs, Scott D. Rhodes, Gabriel Goncalves, Miguel Munoz-Laboy, David J. Malebranche, Barbara Van Der Pol, Ryan Nix, Guadalupe Kelle, J Dennis Fortenberry

David J Malebranche

Research on behaviourally bisexual Latino men in the USA has not yet examined sexual health issues among men living in diverse areas of the nation, including the Midwest. A community-based participatory research approach was used to engage a diverse sample of 75 behaviourally bisexual men (25 White, 25 Black and 25 Latino). Semi-structured interviews were conducted and standard qualitative analysis procedures were used to explore data from the 25 Latino participants. Men described their unique migration experiences as behaviourally bisexual men in this area of the USA, as well as related sexual risk behaviours and health concerns. Lack of culturally …

Comparing The Temporal Stability Of Self-Report And Interview Assessed Personality Disorder, Douglas B. Samuel, Christopher J. Hopwood, Emily B. Ansell, Leslie C. Morey, Charles A. Sanislow, John C. Markowitz, Shirley Yen, M. Tracie Shea, Andrew E. Skodol, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Findings from several large-scale, longitudinal studies over the last decade have challenged the long-held assumption that personality disorders (PDs) are stable and enduring. However, the findings, including those from the Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000), rely primarily on results from semistructured interviews. As a result, less is known about the stability of PD scores from self-report questionnaires, which differ from interviews in important ways (e.g., source of the ratings, item development, and instrument length) that might increase temporal stability. The current study directly compared the stability of the Diagnostic and Statistical Manual of Mental Disorders …

Ten-Year Course Of Borderline Personality Disorder: Psychopathology And Function From The Collaborative Longitudinal Personality Study, John G. Gunderson, Robert L. Stout, Thomas H. Mcglashan, M. Tracie Shea, Leslie C. Morey, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, John C. Markowitz, Charles A. Sanislow, Emily B. Ansell, Anthony Pinto, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Context: Borderline personality disorder (BPD) is traditionally considered chronic and intractable.

Objective: To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. Design: A collaborative study of treatment-seeking, 18- to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning.

Setting: Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities.

Participants: Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 …

24. Interviewing Children Versus Tossing Coins: Accurately Assessing The Diagnosticity Of Children’S Disclosures Of Abuse., Thomas D. Lyon, Elizabeth C. Ahern, Nicholas Scurich

Thomas D. Lyon

Telemedicine And Advanced Technology Research Center: Quarterly Report, April 18th, 2011 To July 17th, 2011, Bea Babbitt

Telemedicine & Advanced Technology Research Center

Development of a P.O.I. and a Blended Learning Ecology for use in Combat Lifesaver Skills Training for the Army.

The Levels Of Analysis Revisited., Scott A Macdougall-Shackleton

Brain and Mind Institute Researchers' Publications

The term levels of analysis has been used in several ways: to distinguish between ultimate and proximate levels, to categorize different kinds of research questions and to differentiate levels of reductionism. Because questions regarding ultimate function and proximate mechanisms are logically distinct, I suggest that distinguishing between these two levels is the best use of the term. Integrating across levels in research has potential risks, but many benefits. Consideration at one level can help generate novel hypotheses at the other, define categories of behaviour and set criteria that must be addressed. Taking an adaptationist stance thus strengthens research on proximate …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel M. Rickles, Silvia Domínguez (1961-), Hortensia Amaro (1950-)

Silvia Domínguez

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans' perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006. Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel M. Rickles, Silvia Domínguez (1961-), Hortensia Amaro (1950-)

Nathaniel Rickles

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans' perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006. Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel M. Rickles, Silvia Domínguez (1961-), Hortensia Amaro (1950-)

Hortensia Amaro

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans' perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006. Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Epigenetic Silencing Of Nucleolar Rrna Genes In Alzheimer's Disease, Maciej Pietrzak, Grzegorz Rempala, Peter T. Nelson, Jing-Juan Zheng, Michal Hetman

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Ribosomal deficits are documented in mild cognitive impairment (MCI), which often represents an early stage Alzheimer's disease (AD), as well as in advanced AD. The nucleolar rRNA genes (rDNA), transcription of which is critical for ribosomal biogenesis, are regulated by epigenetic silencing including promoter CpG methylation.

METHODOLOGY/PRINCIPAL FINDINGS: To assess whether CpG methylation of the rDNA promoter was dysregulated across the AD spectrum, we analyzed brain samples from 10 MCI-, 23 AD-, and, 24 age-matched control individuals using bisulfite mapping. The rDNA promoter became hypermethylated in cerebro-cortical samples from MCI and AD groups. In parietal cortex, the rDNA promoter …

The Importance Of Self-Efficacy And Basic Psychological Needs In Children’S Physical Activity: Measurement, Prediction And Intervention, Casey E. Gray

Electronic Thesis and Dissertation Repository

The importance of physical activity in the overall health promotion and primary prevention of cardiovascular disease risk factors and metabolic diseases in children is well established. Nonetheless, interventions to increase physical activity among this population have been largely unsuccessful. The main objective of the research in this dissertation was to explore the suitability of self-efficacy and basic psychological needs for physical activity prediction and intervention in children. Item generation and psychometric evaluation of psychological questionnaires occurred in study 1 (Chapter 2). Using a prospective design, study 2 (Chapter 3) established task efficacy, barriers efficacy, competence, and autonomy as significant predictors …