Doctor of Philosophy

dissertationPhysician assistants (PAs) have become an integral part of the United States (U.S.) health care system since the profession began in the late 1960s. Physician assistants have been suggested as the solution to predicted physician shortages, especially in primary care. Utah has experienced unprecedented growth in the profession over the last 10 years. This study will determine the new patterns of physician assistant practice in the state of Utah. A cross sectional survey design was utilized. A paper-based survey tool was mailed to 700 physician assistants practicing in Utah. The survey was sent from October 2008 through January 2009. The outcome variables of interest were practice specialty (primary care versus specialty practice) and practice location (urban versus rural). The predictor or independent variables were age, gender, number of years in practice, location of upbringing, and professional school of graduation. The survey was developed by a group of PA stakeholders based on the literature and relevant clinical and academic experiences. There was a response rate of 67.7%. The Utah Division of Occupational and Professional Licensing (DOPL) provided the list of licensed PAs in the state, while population projections were used from the Utah Governor's Office of Planning and Budget (GOPB). iv Projection models for PAs in the state of Utah were developed using methods adapted from the Association of American Medical Colleges (AAMC) Center for Workforce Studies. One model used data on the number of PAs currently in practice, the current utilization of PAs in primary care and specialty care, and future population estimates by age from the GOBP. The second model used data about the number presently in practice and the number that leave the profession through retirement, attrition or death. Practice patterns are shifting to specialty practice and urban environments in Utah. Physician assistants brought up in a rural area were more likely to practice in rural environments. Female PAs had lower odds of practicing in a rural area. Age and years of practice was not significantly associated with predictors of rural practice. Female PAs had lower odds of practicing in primary care versus their male counterparts. PAs had lower odds of practicing primary care if they reported a rural upbringing. Graduation from the Utah PA Program was more likely to result in primary care practice

The Adventist Woman In The Secular World: Her Ministry and Her Church

This paper examines how best Adventist women may minister to their secular colleagues. It seeks answers to questions such as: Who is the Australian/New Zealand Adventist business and professional woman? How active is in her church? What assists or prevents her from ministering to her colleagues more effectively? To answer these questions, a survey was designed with a mix of multiple questions and open-ended questions. A total of 220 surveys were returned.https://digitalcommons.andrews.edu/hrsa/1049/thumbnail.jp

Identification of \u3ci\u3eFrancisella tularensis\u3c/i\u3e subsp. \u3ci\u3etularensis \u3c/i\u3eA1 and A2 Infections by Real-Time Polymerase Chain Reaction

Francisella tularensis subsp. tularensis (type A) is subdivided into clades A1 and A2. Human tularemia infections caused by A1 and A2 differ with respect to clinical outcome; A1 infections are associated with a higher case fatality rate. In this study, we develop and evaluate TaqMan polymerase chain reaction (PCR) assays for identification of A1 and A2. Both assays were shown to be specific to either A1 or A2, with sensitivities of 10 genomic equivalents. Real-time PCR results for identification of A1 and A2 were in complete agreement with results obtained by pulsed field gel electrophoresis analysis or conventional PCR when specimens from sporadic tularemia cases and a tularemia outbreak involving both A1 and A2 were tested. In addition, outbreak samples not previously typed to the clade level could be classified as A1 or A2. The assays described here provide new diagnostic tools with a level of sensitivity not previously available for identification of A1 and A2 infections

General Interviewing Techniques: Developing Evidence-Based Practices

This poster is a hands-on demonstration of the in-progress General Interviewer Techniques (GIT) materials described by Schaeffer, Dykema, Coombs, Schultz, Holland, and Hudson. Participants will be able to view and listen to the lesson materials, delivered via an online interface, and talk to the GIT developers

Identification of \u3ci\u3eFrancisella tularensis\u3c/i\u3e subsp. \u3ci\u3etularensis \u3c/i\u3eA1 and A2 Infections by Real-Time Polymerase Chain Reaction

Francisella tularensis subsp. tularensis (type A) is subdivided into clades A1 and A2. Human tularemia infections caused by A1 and A2 differ with respect to clinical outcome; A1 infections are associated with a higher case fatality rate. In this study, we develop and evaluate TaqMan polymerase chain reaction (PCR) assays for identification of A1 and A2. Both assays were shown to be specific to either A1 or A2, with sensitivities of 10 genomic equivalents. Real-time PCR results for identification of A1 and A2 were in complete agreement with results obtained by pulsed field gel electrophoresis analysis or conventional PCR when specimens from sporadic tularemia cases and a tularemia outbreak involving both A1 and A2 were tested. In addition, outbreak samples not previously typed to the clade level could be classified as A1 or A2. The assays described here provide new diagnostic tools with a level of sensitivity not previously available for identification of A1 and A2 infections

General Interviewer Techniques: Developing Evidence-Based Practices for Standardized Interviewing

The practices of standardized interviewing developed at many research sites over many years. The version of standardization that Fowler and Mangione codified in Standardized Survey Interviewing has provided researchers a core resource to use in training and supervising standardized interviewers. In recent decades, however, the accumulation of recordings and transcripts of interviews makes it possible to re-visit the practices of standardization to describe both how respondents actually answer survey questions and how interviewers actually respond. To update General Interviewer Training (GIT), we brought observations of interaction during interviews together with research about conversational practices from conversation analysis, psychology, and other sources. Using our analysis of the question-answer sequence, we identified the principal actions covered in training as reading a survey question, recognizing a codable answer, acknowledging a codable answer, and follow-up for an uncodable answer. Our analysis of each of these actions is influenced by our observations of the participants’ behavior – interviewers must be trained how to repair the reading of the question, for example -- and by how that behavior is influenced by characteristics of survey questions – follow-up differs for yes-no and selection questions. We developed a set of criteria to use in evaluating the likely impact of the choices we recommend on, for example, interviewer variance and the motivation of the respondent. Although research is not available for all (or even most) criteria, we attempted to be systematic in assessing the likely costs and benefits of our decisions. We focus on standardized interviewing, which attempts to train interviewers in behaviors that all interviewers can perform in the same way. However, the evidence supplied by studies of interviewer-respondent interaction makes clear that the impact of the question on the respondent’s answer, and the way that respondents answer questions must be taken into account in any style of interviewing

Chapter 3: General Interviewing Techniques: Developing Evidence-Based Practices for Standardized Interviewing Appendix 3

Table A3A.1 Summary of Basic Techniques of Standardized Interviewing (adapted from Fowler and Mangione 1990, pp. 35-53) Table A3A.2 Basic Question Forms (Response Formats

A Qualitative Evaluation of Double Up Food Bucks Farmers’ Market Incentive Program Access

Objective Explore factors affecting access to and use of Double Up Food Bucks (DUFB), a farmers’ market program that doubles Supplemental Nutrition Assistance Program benefits for use toward the purchase of fruits and vegetables (FV). Design Focus groups. Setting Metro and nonmetro counties in Utah and western Upstate New York. Participants Nine groups composed of 62 low-income adults (3–9/group). Phenomena of Interest Satisfaction with, barriers to, and facilitators of program use; suggestions for improvement. Analysis Transcribed verbatim and coded thematically in NVivo 11 software according to template analysis. Results Program satisfaction was high and driven by FV affordability, perceived support of local farmers, positive market experiences, and high-quality FV. Primary barriers to using DUFB were lack of program information and inconvenient accessibility. Insufficient program communication was a consistent problem that elicited numerous suggestions regarding expansion of program marketing. Emergent topics included issues related to the token-based administration of DUFB and debate regarding stigma experienced during DUFB participation. Conclusions and Implications Results suggest that although DUFB elicits many points of satisfaction among users, program reach may be limited owing to insufficient program marketing. Even among satisfied users, discussion of barriers was extensive, indicating that program reach and impact may be bolstered by efforts to improve program accessibility

How well can the theory of planned behavior account for occupational intentions?

We tested the capacity of an extended version of the theory of planned behavior (TPB) to account for intentions to work for the UK’s National Health Service as a nurse, physiotherapist or radiographer amongst three groups: professionally unqualified (N = 507), in professional training (N = 244), and professionally qualified (N = 227). We found strong support for attitude and subjective norm as predictors of behavioral intention, with or without controlling for alternative career intentions. There was some support for perceived behavioral control as a predictor of intention, but less for moral obligation and identity. As hypothesised, attitude was a stronger predictor of intention amongst the qualified respondents than the other two groups. We conclude that the TPB is less effective for the bigger and harder-toimplement decisions in life than for smaller and easier-to-implement ones. Also, the absolute and relative importance of some TPB variables varies with personal circumstances

Perceptions of radiography and the NHS: a qualitative study

Purpose: To identify the factors that determine the attractiveness of radiography as a career choice and the NHS as an employer to potential recruits and returners. Methods: Individual and group interviews were conducted in the East Midlands region to explore participants’ perceptions of the attractiveness of the NHS as an employer to potential radiography staff. Interviews were conducted with school pupils, radiography students, mature students, radiography assistants, agency radiographers and independent sector radiographers. Results: Eighty-eight individuals participated in the qualitative stage of the study. Analysis of the interview transcripts indicated that radiography as a career choice is perceived as boring and routine, involving high workloads and with little recognition from the general public. Working with patients is the source of considerable job satisfaction but is offset by staff shortages, lack of flexibility over working hours and a lack of consideration of family commitments in the NHS. Financial costs are highlighted as dissuading many participants from considering a career as a radiographer in the NHS or returning to work for the NHS. Greater use of open days in conjunction with more advertising of the profession is suggested as tactics to improve recruitment. Conclusions: The provision of more flexible working hours, greater consideration for family commitments and increased financial support for training are necessary to improve the attractiveness of a radiography career. NHS Human Resource Managers should consider these findings concerning the applicant and returner pools when developing strategies to address the current shortfall of radiographers