<p> The purpose of this project is to create fun and educational lesson plans for before and after school childcare providers of children in kindergarten through fifth grade. The lesson plan will incorporate aspects of physical activity and nutrition into the basic curriculum for this age group. The nutrition and physical activity curriculum contains four themed weekly lessons. Each lesson incorporates a nutrition discussion, an activity related to the discussion, and one group game. The lessons and activities were designed to incorporate minimal materials so that any facility could easily incorporate them. A committee of nutrition professionals and educators reviewed the curriculum and improvements were made based on their recommendations.</p>

<p> Childhood obesity is a disease that affects 17% of children aged 2-19. This disease, best described by a social ecological perspective, is multifactorial in nature and includes individual, familial, community, and societal contributors. As the causes are multifactorial, so too should be prevention and treatment. Healthcare providers, specifically physicians, can play an important role in the diagnosis, prevention, and treatment of childhood obesity, especially if they appropriately utilize nutrition behavior change counseling to facilitate lifestyle changes. Behavior change falls within the realm of the social and behavioral sciences, disciplines that will receive greater emphasis on the newly designed MCAT 2015^&reg;; therefore, premedical and medical programs may need to alter their approaches to disseminating this discipline-specific knowledge. Nutrition education is currently limited in medical education; and thus, just as premedical programs seek to increase the social and behavioral sciences, so too should they increase nutrition education. In light of these recommended curricular changes, researchers sought to investigate the current state of premedical and medical students. views of childhood obesity. This dissertation describes three studies conducted for that purpose. In study 1, researchers investigated 30 pre-healthcare undergraduate seniors. views of childhood obesity and their sources of knowledge through in-depth qualitative interviews. Investigators found that students with specialized coursework and significant volunteer and/or internship experience had a deeper understanding of childhood obesity; however, as a whole, students failed to see the role of healthcare providers in prevention and treatment. These findings provide justification for premedical programs to guide students to see their role in prevention and treatment through educating them on the social ecological model and providing them with relevant service-learning opportunities and guided reflection. In study 2, researchers conducted a similar nationwide qualitative investigation in 78 third and fourth year medical students. These students described student-, patient- and healthcare system-centered barriers, including their lack of knowledge, patients. lack of access, and their lack of time in practice. Students also requested more applicable information and counseling training in order to equip them to prevent and treat childhood obesity. Much like the pre-healthcare seniors, these medical students failed to discuss their role in prevention and treatment. Therefore, medical schools need to help their students overcome barriers by providing them knowledge and skills and helping them understand their role in prevention and treatment. In study 3, researchers built on the knowledge gained from study 1 and study 2 and developed a valid and reliable computerized tool, the Childhood Obesity Prevention Self-efficacy (COP-SE) survey. Factor analysis of 444 completed surveys from students at 53 medical schools revealed a two factor structure with a correlation of 0.637 between factors. Factor 1 assesses self-efficacy in nutrition counseling while Factor 2 measures self-efficacy to assess readiness to change and initiate nutrition lifestyle changes. There was high reliability within factors (Factor 1 = 0.946; Factor 2 = 0.927), and the correlation (0.648) between the COP-SE survey and a general self-efficacy survey confirmed that the COP-SE measures domain-specific self-efficacy. This valid and reliable survey can be used by medical schools as a formative or summative assessment of students. self-efficacy in childhood obesity prevention and treatment. Further research should include confirming the factor structure and exploring the significance of response trends seen in this sample. The findings of all three studies can be used by premedical and medical programs to maximize the effectiveness of their preparatory programs to provide students with the necessary skills for prevention and treatment of childhood obesity. With the appropriate preparation, future healthcare providers can build their self-efficacy in disease prevention and treatment, hopefully resulting in improved patient outcomes.</p>

Infection of the human urinary tract is one of the commonest bacterial infections, with uropathogenic E.coli (UPEC) being responsible for 90% of the diagnosed cases, with significant morbidity and mortality. The urinary bladder is a remarkable autonomic musculomembranous organ under conscious control. Its two main functions are, storage and voiding of urine. Any disturbance to normal urination leads to various clinical conditions, such as urinary incontinence, bladder retention, overactive bladder syndrome, prostatitis in men and urinary tract infections (UTI). Determining the predisposition of an individual to UTI by discovering a biomarker would allow for a more rational selection of patients who might best benefit from either antibiotic prophylaxis or preemptive surgical intervention. The purpose of this study was to examine the epigenetic effects of UPEC infection directly, or indirectly in the bladder. The study also identified potential gene candidates, such as TLR4 and CTCF, for development of DNA methylation biomarker targets.

<p> Low health literacy impacts an individual's ability to comprehend communication from healthcare providers, reduces access to healthcare, and contributes to increased mortality. The purpose of this study was to evaluate the impact of learning style on adult health literacy education. The health belief model, protection motivation theory, the transtheoretical model, and social cognitive theory were used to analyze the data in this study, and to further develop effective health literacy education. The research questions addressed the effectiveness of educational intervention adjusted to their appropriate learning style in comparison to a standardized health literacy intervention and potential difference, according to type of learning style, in the amount of changed performance between pretest and posttest. A sample of 80 adults in an urban community was recruited through organizations serving low-income individuals. The participants were assessed for baseline health literacy level, followed by identification of learning style, educational intervention, and posttest assessment, which led to determination by <i>t</i> test that changes between pretest and posttest scores were statistically significant between the control group and the study groups. This finding suggests that health education should be delivered to patients according to individual learning style in order for patients to comprehend and retain information provided. Social change implications include healthcare professionals appropriately addressing health literacy so that patients may participate more actively in their personal healthcare decisions to improve healthcare quality outcomes, decrease long-term costs of delivering healthcare services, and improve the general health of the community.</p>

<p> Individuals enrolled in both the Medicare and Medicaid programs, the "dually eligible," are generally vulnerable and face a wide range of health care needs; numerous studies have found that their health care is beset with problems of cost and quality. Health policy researchers find that these problems are directly associated with the inadequate coordination of benefits and services, but studies about care coordination have largely used quantitative approaches and focused on providers&mdash;they have not explored the critical perspective of patients receiving the care. To improve the complex processes of care coordination, this hybrid case study examines the experience of a sample of dual eligible enrollees served in North Carolina's patient centered medical home, and care managers. The subjects were generally independently living, and at lower-risk that typical dual eligibles. Although some experienced some continuity of care issues within NC's PCMH, generally they described receiving the right care, at the right time, in the right care settings. However, some experienced barriers to accessing necessary care, especially in the areas of prescription drugs and navigating the health care delivery system. Some of these challenges could potentially be resolved by NC's PCMH, but many issues are outside the program's control. Care managers who were interviewed suggested modifications to the Agency for Healthcare Research and Quality's Care Coordination Ring, which represents care coordination for a more stable, middle-class population than the dual eligibles they serve.</p>

<p> The present study examined the relationship between compassion fatigue, burnout, compassion satisfaction, and self-care among counselors and counselors-in-training. Additionally, the current study investigated if recent life changes, age, sex, race, years of experience, education level, and work/internship setting impacted counselors' and counselors'-in-training self-reports of compassion fatigue, burnout, compassion satisfaction, and self-care. </p><p> A total of 253 counselors and counselors-in-training were surveyed through a professional conference, internship classes, and email listservs. Variables were measured through the use of a demographic questionnaire, the Professional Quality of Life Scale (ProQOL 5), the Self-Care Assessment Worksheet (SCAW), and the Recent Life Changes Questionnaire (RLCQ). Pearson-product moment correlations, analysis of variances (ANOVAs), and t-tests were utilized to determine potential relationships between variables. </p><p> Results indicated that recent life changes impact both burnout and compassion fatigue. Compassion satisfaction appeared to influence burnout, but not compassion fatigue. Results also determined that burnout and compassion fatigue are positively correlated with each other. </p><p> When examining the demographic variables, results revealed that women experience higher levels of compassion fatigue than men. Burnout was found to be higher for participants who are working or interning in agency and school settings than those in private practices or hospitals. Participants in agency and school settings were also found to be associated with lower amounts of self-care than those in private practices. Nonstudent agency workers were determined to have higher amounts of compassion satisfaction with age and increased engagement in psychological self-care activities. However, self-care was negatively correlated with compassion satisfaction for participants in school settings. </p>

<p> Healthcare spending has risen astronomically over the recent past. Some of the blame has been placed upon an inefficient healthcare system. Whether true or not, we are in the midst of burdensome financial trend in healthcare that cannot continue. Thus, private payers, government payers and taxpayers alike, are looking at ways to reduce such spending. At the same time, healthcare providers wish to remain profitable enough to continue delivering care, well into the future. One proposed answer to the conditions plaguing an inefficient and expensive health system is the new focus on collaborative care models for healthcare delivery. This paper examines collaboration, particularly the joint venture between hospitals and healthcare providers. This paper also assesses the financial viability of such organizations, and recommends areas for further exploration in collaborative design.</p>

<p> "<b>Healthcare organizations rely heavily on communications to deliver services and certify quality treatment outcomes. Specifically, communication and communication processes are critical determinants in whether a dental practice succeeds or fails. There has been a substantial amount of research on communication and its influence on patient satisfaction, employee morale, and work productivity within various organizations. However, limited existing qualitative research examines communication processes and their impact on health institutions. This research study explored the communication process and its influence on employee work performance within a dental practice. The researcher conducted semi-structured interviews to obtain descriptive, information-rich responses from a purposeful sample of 10 participants regarding their perception of the communication process. Utilizing an embedded, exploratory, case study research design, descriptions and experiences from leaders and employees revealed four major gaps within the organization's communication process. Consequently, six themes emerged that identified the four intricacies of an effective communication process within a private dental practice. The following complexities, lack of comprehension, lack of employee awareness, lack of precision and clarification of instruction, and inconsistent exchange of information, are crucial facets of the communication process. From the perspective of study participants, improvement in these areas would foster employee engagement, produce desirable outcomes, and enhance employee work performance</b>"</p>

<p> Electronic Medical Records (EMRs) are increasingly being used in healthcare organizations. However, there are few factors influencing the physician adoption rate of EMRs. The purpose of this paper is to investigate the meaningful use incentives, and the type of specialty practices in relationship to the physician use of EMRs. Data from the National Ambulatory Medical Care Survey (NAMCS) were analyzed to how meaningful use incentives and the type of physician practices affect the physician use of EMRs. The Chi-Square test and ANOVA test have been use to examine the hypothesis, and the association was found to be statistically significant.</p>

Purpose: This study aimsto analyze managerial aspects of governance within Icelandic healthcare institutions, particularly regarding job descriptions and policy-making plans. Method: We used a qualitative research method and content analysis to examinedata collected from semi-structured interviews Ten participants (5 malesand 5 females) who worked as senior managers, middle-management executives in the healthcare service, and Ministry of Welfare officials. The participants reflected a breadth of experience and education across the spectrum of age, length of service, and work experience in both hospitals and primary care. Results: Data analysis revealed three main categories including policy-making plans in healthcare, which identified a considerable gap between managers and executives on one side and the Ministry of Welfareon the other, especially regarding strategy. Incidental control and effect of politicians on healthcare operation. Second, inrelation to the Ministry of Welfareand healthcare institutions we observed unstructured, onerous, and remote communications and organization that focused too little on professional issues. The Ministry of Welfare tended to interfere with managers’ responsibilities and scope of work. Third, we observeds trengths and weaknesses in management. Strengths includedad ministrators’ enthusiasm, ideas of empowerment, short lines of communications, and often straightfor ward interactions, compared withweaknesses in the workprocesses within healthcare institutions and toward the Ministryo f Welfare, and also in job descriptions and vague definitions of the institutions’role. Conclusion: The indications reported here suggestun clear policy-making plansfor healthcare institutions. Although managers and executives maintained that visions for the futureare vague, the Ministry of Welfare stated that the strategy was clear. The study identified a need of strengthening and restructuring the way of communications, as well as clarifying managers’ role toward the Ministry of Welfare / <p>ISBN 978-91-982282-7-4</p>