The purpose of this pilot study was to investigate the effect of preferred recorded music versus preferred live music provided as procedural support by a music therapist on reducing problem behaviors and increasing positive behaviors exhibited by persons with dementia during bathing procedures. Carrying out bathing procedures with persons who have dementia has been identified as one of the most challenging tasks faced by caregivers. Persons with dementia often exhibit aggressive and hostile behaviors when engaged in bathing procedures with their caregivers. Because of the lack of previous research designed to address these problem behaviors, and the personal nature of bathing procedures, an experimental probe was carried out with five individuals in the later stages of dementia living in a nursing facility. The designated caregivers of these five individuals volunteered their loved ones to serve as participants in this pilot study. Participants were observed for a total of three showers: one with no music, one with recorded preferred music, and one with music therapy with live preferred music. During the three showers, the music therapist and the staff member administering the bath observed the durations of both problem and positive behaviors. Results were mixed among the five participants; though preferred live music was generally more effective than recorded preferred music or no music in reducing problem behaviors and increasing positive behaviors. / A Thesis submitted to the College of Music in partial fulfillment of the Master of Music. / Fall Semester 2015. / October 26, 2015. / Bathing, Music therapy, Procedural Support / Includes bibliographical references. / Alice-Ann Darrow, Professor Directing Thesis; Dianne Gregory, Committee Member; Jayne Standley, Committee Member.

The study purpose is to link hospital structure, represented by each hospital’s professional contingent, service mix, and inpatient capacity; and its environment, characterized by the penetration of managed care enrollees. The secondary purpose is to test the relationship between hospital structural change and subsequent hospital performance. The study employs a non-experimental panel design, with a sample of 1882 community hospitals (service type: general medical and surgical). Environmental variables are measured for the base year 1989. Hospital structural variables are measured for 1989 and 1994, with change variables computed. Performance variables are measured for 1989 and 1995, with change computed for cost measures. Hospital structural change is viewed as a dependent variable related to the environment, as well as an independent variable related to performance. Descriptive data are extracted from the American Hospital Association Annual Survey of Hospitals. Hospital cost performance data are from the Health Care Financing Administration Prospective Payment System Minimum Data Sets. Hospital mortality data for 1989 are from Medicare Hospital Mortality Information. HMO enrollment data are extracted from the Interstudy Edge and aggregated to metropolitan statistical area (MSA) level. Market competition data are from the 1989 Area Resource File. A Herfindahl-Hirschman index (HHI) is calculated for each hospital’s MSA. Analytical hypotheses are tested using ordinary least squares (OLS) technique. Results from Part 1 suggest that where HMO penetration was relatively high, sample hospitals tended to contain growth in their registered nurse (RN) staff between 1989 and 1994. Higher HMO penetration is also associated with more stabilization in occupancy rates, preventive services, and ambulatory workload. In contrast, market competition is associated with changes to a higher Medicare case-mix index (CMI), and increase in ambulatory visits. Results from Part 2 indicate positive associations between increased RN staff and hospital cost growth between 1989 and 1995. Hospitals which did not experience an increased CMI are similarly linked with cost growth. Alternatively, reduction in hospital bedsize is associated with more controlled growth in hospital cost per patient day. Several control variables display noteworthy associations with the variables of interest. Theoretical and management implications for community hospitals are discussed.

The purpose of this study is to examine the determinants of the new entry of an HMO into a Medicare risk contract using a resource dependence—diversification model. This study is conducted through a non-experimental, panel design With one year time lag. An HMO’s market is defined as the service area. The primary sample for this study is composed of 440 HMOS that do not have a Medicare risk contract as of January 1994. Data for the variables are extracted from the 1994 and 1995 InterStudy and Group Health Association of America (GHAA) directories, the 1996 Area Resource File, the 1994 County and City Data Book, the 1993 County Business Patterns. Additional supplementary data on adjusted average per capita cost (AAPCC) and county-level Medicare beneficiaries are obtained from the Health Care Financing Administration. The dependent variable is discrete indicating an HMO’s market entry. Independent variables are grouped into four categories: market structure, resource munificence, market price, and organizational attributes. Twelve hypotheses are tested using multivariate logistic regression. This analysis reveals that HMO enrollment size is a predominant, positive factor in predicting a new market entry. HMOs are also sensitive to the level of AAPCC rates in making a market entry decision. Results from hypothesis testing suggest that competition encourages a new market entry. The importance of resource munificence is not statistically supported. This study demonstrates the appropriateness of a panel design to verify a cause-effect relationship and the applicability of the service area as an HMO’s market. This study also contributes to the theoretical understanding of an HMO’s market entry.

Thesis (Ph. D.)--University of Texas at Austin, 2003. / Vita. Includes bibliographical references. Available also from UMI Company.

Thesis (Ph.D.)--Antioch University, 2009. / Title from PDF t.p. (viewed October 7, 2009). Advisor: Elizabeth Holloway, Ph.D. "A dissertation submitted to the Ph.D. in Leadership and Change program of Antioch University in partial fulfillment of the requirements for the degree of Doctor of Philosophy 2009."--from the title page. Includes bibliographical references (p. 151-161).

Thesis (Ph. D.)--University of Wisconsin--Madison, 1982. / Typescript. Vita. Description based on print version record. Includes bibliographical references (leaves 209-214).

This research was completed in an attempt to enlighten the public about Long Term Care Insurance, and the issues that are related. Before this study began, there was very little research done to examine the world of Long-Term Care Insurance; and there was even a smaller amount of research done that looked at the employers and their role in purchasing this insurance for their employees. This study lasted a little over one year and within that time frame, a multitude of information was gathered and analyzed in an attempt to obtain a clear picture as to what the Central Florida market is doing with respect to Long-Term Care Insurance. Hopefully these findings will enlighten, and they may even be a little startling, but all of this information is factual and reliable. Enjoy!

A pre- and post-test survey design was used to help determine significant changes in students' HIV/AIDS-related knowledge, attitudes, and behaviors as a result of formal school education. Surveys were administered to students enrolled in a life sciences course at a minority-majority high school in Central Florida. Survey distribution took place once prior to these students' instruction in HIV/AIDS and once after the lesson. The results of these surveys were analyzed and used to provide insight on the effectiveness of this particular school-based HIV/AIDS education program. Survey results indicate that while the majority of students were knowledgeable in regards to the transmission of HIV, approximately half of those sexually active students reported not using condoms as a method of protection against transmission during sexual intercourse. Research analysis suggests the need for a more comprehensive HIV/AIDS unit that will increase the knowledge and retention rate among these students, as well as promote behaviors that will reduce the risk of spreading HIV/AIDS.

To increase patient safety and reduce aberrant accidents, the healthcare industry must address the emerging epidemic of medical errors, which demand investigation and resolvance. Through examination of error sources, several weaknesses emerge: lack of standardized training/education and performance techniques, lack of automation, and a 'blame and train' attitude. These factors interact and result in aberrant system errors with patient effects ranging from temporary ailments and extended hospital stays to death. Errors emerge as erroneous medication subscriptions, fillings, or dosage to amputation of incorrect limbs. Such situations are reducible if the medical profession incorporates proven systems from government and public peers. These systems are represented by standardized militaristic training methods, more specifically the United States Navy; technological innovations, such as Universal Product Codes in combination with automation; and attitudinal reform from administration to nurses, to accept that humans are fallible and physicians are humans.

The effective management of professionals requires achieving a balance between organizational control and professional autonomy. The problem of achieving a balance is important currently in the United States healthcare industry. This dissertation examined the antecedents and consequences of physician autonomy in both traditional fee-for-service (FFS) and non-traditional managed care settings. The population of physicians in one county were surveyed. Two models were developed arguing that physician practice choice affects autonomy. The antecedents and consequences of autonomy were compared both between FFS and managed care practice and between different types of managed care organizations (MCOs). Results indicate that most physicians in the survey area choose managed care practice, and the value physicians place on income is positively associated with the volume of patients from MCOs. FFS practice generated greater autonomy than MCO practice, and autonomy within MCOs positively affected practice satisfaction. Group practice positively affected autonomy within MCOs. Autonomy did not vary across different MCO types but was influenced by the process variables physician decision involvement and organizational formalization, thus suggesting that classifying organizations by autonomy requires knowledge of the processes used in the MCO.