<p> The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients&rsquo; safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians&rsquo; home state, state of license, field of license, age group, and graduation year group. The dependent variable was surgical medical errors. Physicians&rsquo; field of license and state of license were significantly associated with surgical error. Findings contribute to the knowledge base regarding the relationship between physician characteristics and surgical medical errors, and findings may be used to improve patient safety and medical care.</p>

Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references. Available also in a digital version from UMI/Dissertation Abstracts International.

<p> High blood pressure (HBP) is a worldwide concern in many countries (Keamey, et al., 2005). HBP is likely to be higher in underdeveloped countries, specifically in Africa (Addo, Smeeth, &amp; Leon, 2007; Kearney, et al.,2005; World Health Organization [WHO], 2015). The prevalence of HBP in South Africa is 21%, which is about 6 million individuals (Steyn, Gaziano, Bradshaw, Laubscher, &amp; Fourier, 2001). The purpose of the study is to examine the predictive factors of HBP among older adults in South Africa. This cross-sectional study used secondary data from the World Health Organization (WHO &amp; Phaswana-Mafaya, 2008). The total number of participants included in this sample was 2,145 adults age 60 and over, of which females comprise 59%. The average age was 69.50 years (<i>SD= 7.63</i>). The prevalence of reporting HBP among respondents was 37%. The multivariate analysis shows that, when other factors are controlled, being female, having a larger waist circumference, having a diagnosis of diabetes and depression, and urban residence significantly predicted HBP among older South Africans. When comparing men and women, the results of the logistic regression shows that the decrease of odds of having HBP among men who have diabetes and depression is less than the decrease of odds of having HBP among women who have diabetes and depression. These findings indicate that the risk factors, diabetes and depression, have a bigger effect on females compared to males. The results of the study will help to implement primary HBP prevention targeting South African older adult females who have been diagnosed with diabetes, depression, and who live in urban areas.</p><p>

<p> While obesity is a nationwide phenomenon, African Americans &ndash; especially women &ndash; continue to be more severely affected than any other ethnic group. According to the Centers for Disease Control and Prevention, over 20% of African American women are obese compared to 15.6% of Caucasian women. The church is an important community center for many African Americans, and is often a site for health promotion programs, though little is known of the effectiveness of these programs. The purpose of this qualitative study was to study the experiences and attitudes of African American women who have gone through a church-based weight-loss program. Questions were asked about the cultural, environmental and social barriers to weight loss, and the components of effective church-based weight loss programs. Using a phenomenological approach, this study was designed to capture new data for the development of sustainable church-based weight-loss programs. The theory of social support was used as a theoretical framework. The major themes arising from the data concerned the importance of: (a) social support on all levels; (b) the involvement of the pastor, his spouse, or other church leadership; (c) the inclusion of weight-loss participants in program design; (d) a holistic program design to meet the needs of the entire family; and (e) a culturally sensitive program. The inclusion of all these elements is recommended for future programs. The social change implication is that these recommendations could be helpful in the design, development, and implementation of sustainable church-based weight-loss programs for African American women.</p><p>

<p> Caregivers&rsquo; compliance with polio vaccine regimens and timely receipt of the recommended 4 doses of polio vaccine are pivotal to eliminating polio. This cross sectional study, conducted in Lagos State, Nigeria, examined polio vaccine compliance and demographic attributes of caregivers&rsquo; for statistically significant associations. Using an adapted health belief model theoretical framework, 1,200 participants were recruited from well-baby clinics in 8 local government areas in Lagos State. Participants completed a brief demographic survey providing data on caregivers&rsquo; age, gender, residence (rural or urban), and their level of education as well as records from their children&rsquo;s immunization cards. Data obtained were tested for associations between caregiver&rsquo;s demographic information and their children&rsquo;s receipt of polio doses within specified timelines using chi-square and logistic regression analysis. Fisher&rsquo;s exact analysis were conducted for variables with frequencies less than 5. The only significant association recorded was between the receipt of Polio Dose A and location of caregivers&rsquo; residence: Rural dwelling caregivers were less likely to receive the first dose of polio. Results showed Polio Dose D to be the dose most likely received in an untimely manner as well as most likely missed of the 4 doses. Logistic regression analysis did not show any variable to be of greater odds in predicting completion of the 4 doses or compliance with timelines of their receipt. Study&rsquo;s results may inspire polio program planners to develop interventions that broaden the immunization coverage for rural dwellers to include nontraditional maternity locations. Positive social change will ensue by the improvement caregivers&rsquo; compliance with full polio dose receipts with timelines, maximizing immunity. </p><p>

<p> The Human Papillomavirus (HPV) is a common sexually transmitted infection (STI) and etiological agent of cervical cancer. It has been suggested that religiosity may promote a generalized disassociation between all STIs/STDs, including HPV, and personal relevance thus contributing to lower levels of HPV awareness and knowledge among certain groups. This study sought to identify the role of religiosity as a predictor of HPV awareness and knowledge among women in a Christian university. Religiosity was defined and measured using the Duke University Religion Index (DUREL). The schemata and social identity theories provided the theoretical framework for this study. A total of 173 women completed the modified survey instrument to assess level of HPV awareness and knowledge, attitudes toward premarital sex, and level of religiosity. Multiple linear regression analysis was used to test the hypotheses. Religiosity, as defined by the intrinsic religiosity subscale of the DUREL significantly contributed to HPV awareness (<i>p</i> = .002) and HPV knowledge (<i>p</i> = .036). The positive social change implications of this study include a better understanding of the role of religiosity in HPV awareness and knowledge; consideration of religiosity in dissemination of health information by informing public health policies and programs to ensure adequate and culturally relevant education and awareness about HPV transmission, HPV-related cancers, and HPV vaccination.</p><p>

<p> Public health leaders lead a diverse workforce and organizations that are comprehensive in their breadth and scope of services. The purpose of this descriptive quantitative study was to describe the transformational and transactional leadership behaviors of federal public health leaders, their coaching practices, and the relationship between those leadership and coaching behaviors. Researcher recruited a convenience sample of 91 U.S. Public Health Service (USPHS) officers from training events between March-July 2014. Participants self-selected to voluntarily complete an internet-based survey comprising a researcher-designed questionnaire, the Multifactor Leadership Questionnaire 5X Form, and Get Fit for Coaching self-assessment. The first two research questions related to leadership and coaching behaviors were analyzed in SPSS 22 using Kruskal-Wallis H, Yates&rsquo; correction, and Monte Carlo significance tests. The Pearson&rsquo;s product-moment correlation analyzed the third research question examining the relationship between leadership and coaching behaviors. No difference was found in the leadership or coaching behaviors of junior and senior officers when examined by actual rank or seniority. The data revealed several relationships between leadership and coaching behaviors, with significant correlations found for 24 dichotomous pairs, indicating transformational and constructive transactional leadership and coaching behaviors as similar, complementary, and interrelated. The findings showed the act of providing feedback improved performance, while failure to take action or implement change stifles learning and growth. Recommendations for future research included: examining these behaviors among non-uniformed and non-federal public health leaders; exploring their leadership outcomes; and the inclusion of the 360-assessment to validate the self-reported leader data.</p><p>

<p> Women face great risks in pregnancy and childbirth, especially in developing countries where there are very few skilled birth attendants and negligible government investments in maternal health programs. As a result, obstetric fistula (OF), a potentially fatal but preventable and treatable condition, affects some 3 million women and girls globally. In Sierra Leone, the prevalence of OF is extremely high, but the absence of quality data to inform decision-making, both on prevalence and risk factors, is a barrier to creating an environment for OF prevention and care. The purpose of this phenomenological study was to explore and document the barriers to medical care, and the perceptions of patients and medical personnel concerning the complexities of OF. In-depth interviews were performed over a 2-month period with 12 patients and 8 medical personnel at the Aberdeen Women's Center in Freetown, Sierra Leone. Results showed that patients face multiple medical barriers including high costs, fear of hospital treatment, severely inadequate treatment, and severe physical sequelae including paralysis and foot dragging. Multiple emotional, social, and financial harms related to OF were also reported, including stigmatization, abandonment by family, embitterment, depression, and job loss. Most patients expressed a preference for traditional birth assistants over medical personnel. However, many also benefitted from the intervention of friends or other good Samaritans. The results and recommendations from this study should be helpful in informing the general public and policy-makers about OF as a major public health problem, and in the design and delivery of programs to eradicate or alleviate the problem of OF in Sierra Leone.</p><p>

This research demonstrates that people's ways of dealing with matters of life and daily occurrences are not the result of standard common sense deductions from learned facts. It has consistently shown that any presented information gets framed by the respondents in a multitude of ways depending on their habitual ways of dealing, viewing, judging, and challenging messages in their environment. Such ways of interacting with one's direct environment are shaped by the most common means of communication or the media that are being used. The literature that has inspired and guided this research is that of scholars like Ong, Havelock, McLuhan, and Burke who had great contributions to the Communication discipline. Consequently, this research challenges the existing public health literature, which, in its largest majority, is informed by the theoretical understanding of beliefs, attitudes, and behaviors within the sociological and psychological disciplines. It is a step away from the practice of crafting messages that are conducive to behavioral change and a step forward toward dealing with any health endeavor as something to be created, negotiated, and recreated within its environment. Among the research's most significant findings is that the respondents' assessment of the health risks of some of their behaviors had little to do with their knowledge of such risk, and more with their education level and the amount of time they spent watching television. Depending on whether the respondents were defined as “oral”, “literate”, “television viewer”, or “light-to-non viewer”, their responses to identical health information took different turns which reflected various ways of dealing with the issue at hand. The research also showed that the link between the educational level of the mothers and her position on some life threatening health risks weakened significantly when they had already undertaken such health risk, like in the case of smoking. Instead, a strong positive link proved to exist between television viewing and the inclination to admit to the presence of a personal risk due to smoking. The research proved however that underneath such positive health responses among the television viewers, was a reactive language that intended to conform yet remained optimistic about any personal repercussions.

The purpose of this study was to test the video education tool, Choosing Cambodian Foods Wisely, to determine if Cambodian refugees would respond to this intervention as culturally appropriate and nutritionally educational. An evaluation study consisting of a pretest, posttest 1 and posttest 2 was introduced to a cluster sample of 20 Cambodian refugees; however, due to attrition, the analysis of the data was based on 17 cases. An ANOVA test revealed a significant difference between the means of the test scores. These results supported the hypothesis that the video education tool was effective in increasing the knowledge, attitudes, and behaviors of the subjects in regard to the nutritional elements iron, calcium, cholesterol, sugar, and salt. The research further suggested that these increases were sustained over a one month period. Ninety percent of the subjects reported that the video provided at least some culturally appropriate, accurate, and useful nutrition information and that they would recommend the video to others. These study results suggest that health educators focus their attention on media methods to achieve health interventions for cultural groups.