Patient Satisfaction in a Statewide Cervical Cancer Screening Program

A cross-sectional study of patients participating in the Nevada State Health Division’s Women Health Connection Program (WHC) was conducted to assess patient satisfaction for cervical cancer screening. In this study, 528 WHC program patients provided information regarding their satisfaction with the treatment services they received, accessibility issues, breast and cervical cancer health education and information, and overall program satisfaction. A large majority of patients reported high levels of satisfaction with the program services and clinic personnel. Significant positive correlations were found when comparing satisfaction with services received at the clinic to treatment received by physicians, nurses, and admissions personnel, how well information provided to patients eased their concerns, and when results were discussed with patients. Wait time for admission and to see a physician were negatively correlated to satisfaction. Those who reported that they would not use services again indicated lower levels of satisfaction with the information received and treatment from caregivers and admissions personnel when compared to those who would use the program again

Evaluation of the impact of a Health Care Administration Student Practicum

As the health care industry becomes increasingly complex, many leaders and practitioners in the field are worried about the quality and preparation of health care administration graduates (Robbins, Bradley, & Spicer, 2001). Academic health care administration programs prepare students for a professional career in the health care field. One of the biggest challenges for university health care administration programs is to meet industry needs by effectively incorporating practical skills and knowledge into the academic curricula. For students, coursework provides some insight into the demands of the industry, but they also require hands-on experience to be relevant in a highly competitive job market. Many academic institutions have incorporated student internships or practicums as a way to meet the needs of both the health care industry and graduates

The Economic Impact of the Nevada Clean Indoor Air Act in Clark County, Nevada – Preliminary Findings

Objective. The primary purpose of this exploratory study was to quantitatively evaluate the economic impact of the Nevada Clean Indoor Air Act (NCIAA) on businesses in Clark County. Methods. The goal of this research was to assess economic indicators over a ten year period utilizing measurable data points, including restaurant and drinking establishment employment rates, taxable sales, openings and closings, as well as slot gaming revenues. This ten year time period consisted of a seven year span prior to the enactment of the NCIAA, and three years post enactment. Researchers conceived this study as a means to independently evaluate and address the potential economic impact of a smoke-free law in a region dependent upon tourism and gaming. Results. Economic indicators did in fact decrease after the NCIAA was enforced but most of the declining trends began prior to the passage of the smoke-free act and are consistent with downward trends in other, non-NCIAA affected segments of our economy. Conclusion. The overall findings of this study are consistent with similar non-tobacco industry supported economic studies showing little or no statistically significant downward economic trends after passage of smoke-free legislation

Levels of Adoption of Electronic Health Records and Patient Safety: Effectiveness and Efficiency

Patient safety, including hospital acquired infections has become one of the major concerns in healthcare delivery in recent years Electronic health records are becoming an integral aspect of the health care delivery Health policies have been looking to improve quality / patient safety and efficiency of healthcare through the adoption of electronic health record (EHR) systems Can EHR adoption improve patient safety? Can EHR adoption reduce cost? H1: Patients treated at hospitals with a higher level of EHR adoption are less likely to incur poorer patient safety indicators H2: Patients treated at hospitals with a higher level of EHR adoption are more likely to incur lower costs for their respective patient safety indicator

The structure and segmentation of the Southeast Indian Ridge

The Southeast Indian Ridge (SEIR) spreads at a relatively narrow range of intermediate rates (59–75 km/Ma) but exhibits the full range of slow to fast spreading morphology and segmentation. Satellite gravity data reveal transitions in the structure of the spreading center where it is influenced by the Amsterdam and Kerguelen hotspots and at the Australian– Antarctic Discordance (AAD). Although the spreading rate between the hotspots and the AAD is nearly constant, the ridge exhibits a variety of distinct styles of morphology and segmentation not observed at fast or slow spreading centers. Recently, collected multibeam bathymetry data reveal a transition from East Pacific Rise style overlapping axial highs near 92°E to Mid-Atlantic Ridge style axial valleys with non-transform offsets near 116°E. The intervening segmentation is characterized by propagating offsets coexisting with stationary transforms, which exhibit different degrees of temporal stability. Currently, there are 10 transform offsets between the hotspots and the AAD but only five of these have persisted since seafloor spreading stabilized at 35 Ma. The other five appear to have formed since 35 Ma and several more have disappeared by transform shortening or coalesced by along-axis propagation. There is a transition from monotonic offset propagation near the hotspots to oscillatory propagation approaching the AAD. This change in offset stability corresponds to transitions in depth, axial morphology and offset structure. Through much of the transitional region, higher order segmentation is characterized by en-echelon offsets of a diffuse spreading axis that generally lacks a well-defined neovolcanic zone. Since the spreading rate is nearly constant, the regional variation in axial morphology and segmentation appears to be controlled by an upper mantle thermal gradient - possibly a result of flux of asthenosphere from the hotspots to the AAD. This is consistent with the gradual increase in average ridge flank depths along this part of the plate boundary but segment scale changes in axial depth reveal spatio-temporal variability in the dynamic topography that are not preserved on older lithosphere. Intrasegment transitions in axial morphology and en-echelon offsets within first order segments suggest that local variations in mantle thermal structure introduce short-lived instabilities in higher order segmentation and dominate the short term evolution of the plate boundary

Low Temperature Performance of Bio-Derived/Chemical Additives in Warm Mix Asphalt

Corn and soy based bio-derived warm mix asphalt (WMA) additives are currently being developed. In the past, additives with similar properties have been shown to successfully reduce the mixing and compaction temperatures of asphalt by as much as 30°C. Isosorbide distillation bottoms (IDB), a WMA additive, is a co-product from the conversion of sorbitol to isosorbide, where sorbitol is derived by hydrogenating glucose from corn biomass. Past research utilizing IDB at several dosage rates showed there was improvement in low temperature binder performance using the bending beam rheometer (BBR) between dosage rates of 0.5% and 1.0% by weight of the binder. This research investigates whether low temperature improvement occurs with several new bio-derived material additives that have similar properties to materials used in past research, as well as compares their performance to two commercially available/bio-derived WMA additives from the forest products industry. In cold regions of the United States, the main observed distress in asphalt pavements is low temperature cracking. Characterization of binder performance at low temperature is possible with the use of the BBR. For asphalt mixtures, characterization is more challenging at low temperatures due to the response from the aggregate phase of a mixture. To examine low temperature performance of hot mix asphalt (HMA) and WMA, the semi-circular bend (SCB) test was used to characterize the fracture properties. SCB tests showed that additive choice was a statistically significant factor in fracture energy properties but not for stiffness and fracture toughness. All of the new additives were successfully used at reduced mixing and compaction temperatures and did not adversely impact low temperature mix fracture properties of WMA when compared against the control HMA. However, improvement of fracture energy was observed when comparing the epoxidized esterified fatty acid additive to the other five additives used in this work

Development of Bio-Based Polymers for Use in Asphalt

Asphalt binder is typically modified with poly type (styrene-butadiene-styrene or SBS) polymers to improve its rheological properties and performance grade. The elastic and principal component of SBS polymers is butadiene. For the last decade, butadiene prices have fluctuated and significantly increased, leading state highway agencies to search for economically viable alternatives to butadiene based materials. This project reports the recent advances in polymerization techniques that have enabled the synthesis of elastomeric, thermoplastic, block-copolymers (BCPs) comprised of styrene and soybean oil, where the “B” block in SBS polymers is replaced with polymerized triglycerides derived from soybean oil. These new breeds of biopolymers have elastomeric properties comparable to well-established butadiene-based styrenic BCPs. In this report, two types of biopolymer formulations are evaluated for their ability to modify asphalt binder. Laboratory blends of asphalt modified with the biopolymers are tested for their rheological properties and performance grade. Blends of asphalt modified with the biopolymers are compared to blends of asphalt modified with two commonly used commercial polymers. The viscoelastic properties of the blends show that biopolymers improve the performance grade of the asphalt to a similar and even greater extent as the commercial SBS polymers. Results shown in this report indicate there is an excellent potential for the future of these biopolymers as economically and environmentally favorable alternatives to their petrochemically-derived analogs

Physician Satisfaction in a Cancer Prevention Program for Low-Income Women in Nevada

Physicians and health care organizations that provide services to low-income patients are valuable partners in improving health care access for the uninsured and medically underserved. In this pilot study, we explored physicians' needs and factors for satisfaction in the Women's Health Connection (WHC), a breast and cervical cancer-screening program for low-income women in Nevada. Of the 126 physicians in the WHC program, 50 physicians completed a needs-and-satisfaction questionnaire. Survey data were subjected to factor analysis using Varimax rotation. The results yielded three components, which accounted for 65% of the variance. The three components or dimensions for physician satisfaction were: (1) appropriate administrative support and documentation, (2) availability of support for medical management, and (3) timeliness of diagnostic reports. Amount of reimbursement was not a significant factor. The respondents serving in this cancer prevention program for low-income women were satisfied in their involvement in the program. Further attention should be given on the identified issues for satisfaction among physicians, which could lead to quality improvement and serve as a model for other programs that serve low-income patients in cancer prevention