The objective of this study was to determine whether 11 independent variables or combinations of variables help to predict a diabetes-related hospital readmission for patients with diabetes within 60 days from discharge. The variables were categorized into four main groups: (a) patient characteristics, (b) lifestyle, (c) biomarkers, and (d) disease management aspects. A convenience sample of 389 historical medical records of patients who were admitted to a rural hospital in northeastern North Carolina with a diagnosis of, or relating to, diabetes was studied. After comparing predictive discriminant analysis (PDA) and logistic regression (LR), PDA performed better and was chosen to analyze a convenience sample of patients admitted to the hospital for a diabetes-related diagnosis from January, 2004 to December, 2006. The best overall subset accurately classified 27 cases with six predictors that included (a) systolic blood pressure, (b) smoking status, (c) blood glucose range, (d) ethnicity, (e) diabetes education, and (f) diastolic blood pressure. In an effort to simplify the prediction process, the subsets of two predictors were examined. The results of the analysis returned four subsets of 2-predictor variable combinations that correctly classified cases for readmission. Each of the four subsets has two predictors that are statistically and practically significant for predicting readmissions for a diabetes-related problem within fewer than 60 days. These combinations are the predictor subsets of (a) smoking status and being treated by a specialist or non-specialist physician, (b) a religious affiliation or a lack thereof and smoking status, (c) gender and smoking status, and (d) smoking status and ethnicity. / by Darwin E. Asper. / Vita. / Thesis (Ph.D.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

Thesis (DPhil (Informatics))--Cape Peninsula University of Technology, 2018. / As in many parts of the world, the need for healthcare services is increasing rapidly in South Africa. Owing to many official languages in the country, health service delivery is continuously challenged by spoken language and semantics. The challenges result to poor health services in many areas of the country. Thus, this study was undertaken with the aim: to develop a framework which can be used to guide the selection and implementation of mobile systems in the translation of language semantics for improved healthcare service delivery in South Africa. For this purpose, the study was based on one significant research question: How can the challenge(s) of semantics and language translation in South African healthcare delivery be addressed using mobile systems? In achieving the aim of the study, a qualitative study was conducted using the semi-strtructured interviews to collect the data. The analysis of the data was carried out using the hermeneutic approach within the interpretative paradigm, which was guided by two theories, actor network theory (ANT) and diffusion of innovation (DOI). The ANT was used to focus on the interaction and relationship between human and non-human actors within a heterogeneous networks, in the activities of healthcare. The DOI was employed to examine how mobiles systems can be diffused, in addressing the challenges and barriers which the health facilities encounter from language perspective. The case study approach was followed, based on three cases, two healthcare organisations, and a community in the northern part of South Africa were used in the study. Based on the analysis of the data, the influencing factors were found, and interpreted. The interpretation helps gain deeper understanding of the challenges, from which a framework (see Figure 6.5 in Chapter 6) was developed. From an understanding of the factors that influence language semantics, and its translaton by using mobile systems, challenges in the South African healthcare can be reduced, and quality improved. The way in which the theories were used brought a fresh perspective to the study. In practice, the framework can be used by both healthcare practitioners and ICT specialists to guide the selection, use and support of mobile systems for the translation of language semantics in South Africa. The complementary use of ANT and DOI in the study contributes methodologically.

Racial, ethnic, and linguistic minority workers suffer higher rates of work-related injuries and illnesses in the United States compared to their White counterparts. Explanations for these higher rates include potential socioeconomic causes (education, income, and wealth) and occupational segregation into more dangerous occupations. What is less studied are the post-injury sequelae for minority workers, which is their experiences in the workers' compensation system, as well as their health and return to paid employment. What is known comes primarily from qualitative literature, which includes themes of racial discrimination (from employers, health care providers, and workers' compensation employees), a lack of information on how to navigate the workers' compensation system, and linguistically inappropriate communication with those whose first language is not the majority language. In addition, qualitative studies have found differences in the treatment of minority workers, delays in receiving partial wage payments, and worse health outcomes. Most studies examining minority workers in the workers' compensation system have not provided a theoretical framework from which to test hypotheses as to why differences exist in a social insurance system based on race, ethnicity, and language. The purpose of this dissertation was to test the role of racial discrimination in creating worse post-injury workers' compensation outcomes for minorities, compared to English speaking Whites. This dissertation utilized fundamental cause theory to frame the hypotheses and analyses in a cross-sectional investigation of differences in workers' compensation system outcomes, using both administrative data from the workers' compensation agency, as well as survey responses from a sample of 488 injured workers in Washington State. The survey, conducted by Washington State University Social and Economic Science Research Center (SESRC), provided many variables not available in the WC administrative data including measures of perceived racial discrimination to test the hypotheses that racial discrimination is a fundamental cause of worse workers' compensation outcomes for minorities. Fundamental cause theory suggests that there are basic or fundamental reasons for health disparities that are not caused by mechanisms linking the fundamental cause with a health outcome; in fact, these mechanisms can and do change, but the relationship between the primary cause and the health disparity outcome will remain. In addition, a fundamental cause affects multiple outcomes via multiple mechanisms. Access to resources such as income, wealth, prestige, knowledge, and beneficial social connections can reduce the impact of a disease once it occurs. The analytic chapters in this dissertation are organized first, to address racial discrimination in health care provider outcomes; second, to address racial discrimination in workers' compensation agency outcomes; and third, to address the role of pre-injury racial discrimination in post-injury return to work outcomes. Racial discrimination was tested in this dissertation as the fundamental cause of health-care provider disparities in timeliness of follow-up care, adequacy of care, and patient satisfaction. Racial discrimination was tested in the workers' compensation agency as the fundamental cause of administrative delays and difficulties: delays in diagnostic approval and wage replacement payments, as well as language appropriate communication, and higher counts of independent medical exams. Racial discrimination was also tested as the fundamental cause of poor return-to-work outcomes (feeling a worker returned to work too early and overall general health). Workplace support, as a possible resource (social connection), was tested as a mediator in the relationship between racial discrimination and workplace outcomes. Due to the survey nature of the study design, replicate weights were calculated based upon information available in both the surveyed and not-surveyed population to account for non-response bias, and all analyses were bootstrapped using Stata survey software. The results support the role of racial discrimination as a fundamental cause of outcomes for hypotheses in the workers' compensation agency with clear differences in delays for diagnostic services, a higher number of independent medical exams, as well as linguistically inappropriate communication for language minorities. Racial discrimination (prior to injury) was found to be significant in overall general health for minority workers, and for feeling they had returned to work too early. Workplace support (a potential social resource), was found to mitigate the role of racial discrimination in the workplace return-to-work outcomes. This study is an initial effort to examine racial discrimination as a fundamental cause of disparities in occupational health after an injury. As the majority of adults will spend one-fifth to one-third of their lives in paid employment, the ability to heal and return to full and active employment after a work-related injury is critical to ones' self-worth, as well as to the economic stability of individuals, families, and societies. If racial, ethnic, and language minorities suffer worse outcomes in their post-injury sequelae, these results will have long-lasting implications in any quest for a more equitable society.

This thesis endeavours to explore, describe and portray the author's attempt to work with the people of Vanuatu, a small island nation in the South Pacific, establishing a preventative eye care project. The goal of this study is to offer a contribution to the understanding of cross-cultural health work in Vanuatu. / thesis (PhD)--University of South Australia, [2000]

Thesis (Ph.D.)--McMaster University, 2006. / Supervisor: Susan J. Elliott. Includes bibliographical references (leaves 166-171).

Thesis (Ph.D.)--McMaster University, 2006. / Supervisor: Wayne Warry. Includes bibliographical references (p. 154-164).

From February to September of 2001, a significant body of qualitive data was collected to investigate barriers for Hispanic participation in Oregon's managed care Medicaid program. As a means to investigate this topic, comments were solicited from physicians, hospital administrators, social service agencies, and low-income Hispanics through semi-structured focus groups and individual interviews. This methodology presents the reader with a rich enthnohistoric and cultural context to the local issues surrounding Hispanic under-participation in Oregon's managed care Medicaid program. Finally, through an analytical framework of critical medical anthropology, connections are drawn from local barriers to state and corporate policies. / Graduation date: 2002

Purpose: The Purpose of this research was to design, implement and evaluate a patient centered asthma intervention pilot program directed by physicians and administered by community pharmacists to a group of Managed Care contracted Oregon Health Plan asthmatics. The evaluation was to determine if the proposed intervention could improve the enrolled asthma patient's related education and quality of life while simultaneously creating economic benefit for the sponsoring health plan. Methods: The study was designed to be a prospective, six month pre and posttest quasi-experimental evaluation combined with a Solomon-like two-control group comparison. All patients in the sponsoring health plan twelve years of age and older who had six months of continuous enrollment were eligible. Enrollment of the target patients was voluntary and the time period of the evaluation (November, 1997 to May, 1998) was purposely conducted to capture the notoriously difficult asthma trigger cold and allergy seasons. Information regarding the cost and frequency of pre and post emergency room visits, hospitalizations, physician's office and medications use and Health Related Quality of Life (HRQL) was collected for the intervention group and control group. Satisfaction information for the major actors was collected and analyzed at posttest. Within group comparisons were conducted using the paired T-test and the unpaired T-test was used for between group comparison. Results: Patients in the intervention group who had their physician and pharmacist fully participate in respectively directing and administering the study protocol showed associated improvements in their quality of life measures. Economic benefit to the health plan is suggested by a cost benefit ratio of 1:5.71 resulting from favorable decreases in health care related resources and improved asthma related medication utilization. Analysis of the satisfaction measures suggests that all the major participants were very satisfied with the intervention. Conclusion: Even though the sample size in this pilot study was relatively small, the resulting information should not be immediately discounted. The evidence suggests that in those cases where the study protocol was followed, favorable economic, HRQL and satisfaction is comparable to larger, previously conducted studies. / Graduation date: 2000

Enrollments of international students have increased dramatically in the last several decades. The delivery of health care to these students has become a topic of study for college health care providers and medical researchers across the country. The purpose of this study was to explore how Asian international students cope with illness while in school at Oregon State University. Interviews were held with international students from Japan, Korea, China and selected health care providers from the Oregon State University health center. Information was sought describing health care issues, and perspectives on medical care. The interplay between the student's perspectives and experiences and those of health care providers was explored as they revealed the role of culture in the cross-cultural medical situation. In contrast to other findings I maintain that it is the effects of culture, that is, the envisioning of different realities, in similar situations, that affect both patients and practitioners in the cross-cultural medical encounter. American core cultural values, in conjunction with a biomedical paradigm, formulate a base from which university health care providers interpret their clinical reality. Asian international students bring with them to the medical encounter a different paradigm that, for them, provides a definitive view of illness and health care. It also is grounded in meanings learned from cultural experiences. The anthropological views presented here are powerful and of considerable value in clinical settings because they assist individuals in moving beyond culture-bound realities in order develop a pluralistic perspective that validates the existence of different illness realities in the cross-cultural medical encounter. / Graduation date: 1994

Univ., Diss.--Nijmegen, 2006.