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Developing new markets in tourism is vital for the prosperity of Small Island Tourism Economies like Bermuda (McElroy). Countries must continuously improve and reinvent themselves in order to maintain growth. SCUBA diving in Bermuda is a market that could be improved. Most SCUBA divers are of higher than average household income and can make an attractive tourist base. This thesis analyzes SCUBA tourists in Bermuda to ascertain their characteristics, economics impacts, and participation in island activities in order to help guide future endeavors involving SCUBA tourism in Bermuda and provide an outline of how to analyze other Niche markets. Comparisons are made between SCUBA and Non-SCUBA tourists (those who participated in Scuba against those that did not). The results show that spending, activities/events participated, and SCUBA tourists characteristics are not all significantly different from one another at the 5% level. Meaning that some variables were significant and some weren't , with in their respective groups. Within Trip Expenditures it was shown that, of the 9 variables tested, 3 were significant. In Activities, 8 of the 11 tested were significant, attractions there were 8 of the 18 variables that were significant and in Evening Entertainment, there was 2 out the 6 variables being significant at the 5% level.
ContributorsJack, Alastair (Author) / Tyrrell, Timothy (Thesis advisor) / Knopf, Richard (Committee member) / Herbst, Chris (Committee member) / Arizona State University (Publisher)
Created2012
Description
As a medical scribe working in an Emergency Department (ED) at Banner Gateway Medical Center (BGMC), the researcher was able to identify how the work flow and satisfaction of those in the ED would decrease when there were no Physician Assistants (PA's) being utilized during specific shifts. As for other shifts where PA's were on shift and were being utilized, the work flow would drastically increase, more patients would be seen in less time and the satisfaction of the researchers co-workers would increase. This paradigm of how PA's are implemented brought the researcher to understand the overall success of having Physicians Assistants in partnership with Physicians, consulting physicians and management in the ED. The researcher conducted a five-month long analyses of how implementation of Physician Assistants in the ED could effect overall satisfaction. The researcher looked at the satisfaction of the PAs themselves, attending physicians, nurses, nursing assistants, ED manager, ED director, ED co-director and the patients themselves. The researcher collected questionnaires, conducted interviews and retrieved data from Banner Health Services for the year 2014 to compare her data. The researcher conducted the study both at Banner Gateway Medical Center (BGMC) Emergency Department and also at Banner Baywood Medical Center (BBMC) ED. In comparison of the data collected from BGMC ED to BBMC ED resulted in a significant difference in overall satisfaction based on implementation. Although both emergency departments are owned by the same Banner corporation and only a few miles apart in distance, they implement Pas differently. The difference in the implementation did prove to effect the overall satisfaction. BGMC ED employees as well as manager and patients were more satisfied than those of BBMC ED. Some of the noted differences were that BBMC PAs see more patients per hour, they see higher acuity patients, are less compensated, are placed further apart from their attending physicians and other staff in the ED, there is minimal communication, PAs feel there voice is not heard and they feel pushback on feedback with no plan for improvement. BGMC PAs reported overall increase in satisfaction as compared to BBMC because of the increased communication, placement of PAs within the ED is closer to attending physicians and other staff, they see lower acuity patients, are better compensated and monthly meetings on improvements that can be made and the PAs feel their voice is being heard. Productivity scores for BGMC ED PAs were 1.71 patients per hour as compare to BBMC ED which was 1.86 patients per hour. BBMC PA patient satisfaction on average was 60.6 as compared to BGMC where the PA average satisfaction was 67.8.
ContributorsApplegate, Lauren Mckenzie (Author) / Kashiwagi, Dean (Thesis director) / Coursen, Cristi (Committee member) / Kashiwagi, Jacob (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
Description
According to the Tax Policy Center, a joint project of the Brookings Institution and Urban Institute, the Earned Income Tax Credit (EITC) will provide 26 million households with 60 billion dollars of reduced taxes and refunds in 2015 \u2014 resources that serve to lift millions of families above the federal poverty line. Responding to the popularity of EITC programs and recent discussion of its expansion for childless adults, I select three comparative case studies of state-level EITC reform from 2005 to 2013. Each state represents a different kind of policy reform: the creation of a supplemental credit in Connecticut, credit reduction in New Jersey, and finally credit expansion for childless adults in Maryland. For each case study, I use Current Population Survey panel data from the March Supplement to complete a differences-in-differences (DD) analysis of EITC policy changes. Specifically, I analyze effects of policy reform on total earned income, employment and usual hours worked. For comparison groups, I construct unique counterfactual populations of northeastern U.S. states, using people of color with less than a college degree as my treatment group for their increased sensitivity to EITC policy reform. I find no statistically significant effects of policy creation in Connecticut, significant decreases in employment and hours worked in New Jersey, and finally, significant increases in earnings and hours worked in Maryland. My work supports the findings of other empirical work, suggesting that awareness of new supplemental EITC programs is critical to their effectiveness while demonstrating that these types of programs can affect the labor supply and outcomes of eligible groups.
ContributorsRichard, Katherine Rose (Author) / Dillon, Eleanor Wiske (Thesis director) / Silverman, Daniel (Committee member) / Herbst, Chris (Committee member) / Barrett, The Honors College (Contributor) / School of International Letters and Cultures (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Economics Program in CLAS (Contributor)
Created2015-05
Description
Objective: To investigate current HCP stillbirth aftercare practices and use findings to inform suggestions for stillbirth aftercare guidelines. Study Design: Participants (n=18) were HCPs (MDs, DOs, or NPs) in the field of Obstetrics and Gynecology or Maternal Fetal Medicine. Focus groups and surveys were conducted. A phenomenological approach was used to explore and understand current stillbirth aftercare practices and thoughts about protocols for stillbirth aftercare. Descriptive statistics were used to analyze demographics of participants and prevalence of references to stillbirth aftercare topics. Results: Sixteen obstetric HCPs (medical doctors and nurse practitioners in the fields of obstetrics and gynecology and/or maternal and fetal medicine) participated in Focus Groups and two obstetric HCPs alternatively completed surveys. Current stillbirth aftercare practices and perceptions related to stillbirth aftercare protocols and guidelines were clustered around the following themes: recommendations made to mothers after stillbirth, subsequent pregnancy care, perceptions and use of protocols for stillbirth aftercare, and responsibilities of nurses and nurse practitioners after stillbirth. Conclusion: Findings were used to develop a list of stillbirth aftercare practice suggestions and may be used to help design future research related to HCPs' stillbirth aftercare practices and the need for training on existing guidelines and development of further protocols or guidelines.
ContributorsMartinez, Lauren Ann (Author) / Huberty, Jennifer (Thesis director) / Coursen, Cristi (Committee member) / Leiferman, Jennifer (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Social determinants of health present significant barriers to utilization of maternal health services in transitional countries. This dissertation study examined associations between household autonomy and utilization of prenatal services among women of reproductive age in Armenia and Azerbaijan. Using nationally representative survey data, this study explored if household autonomy of women positively influenced the timing of the first prenatal visit, the number of prenatal care visits, and the content of care during visits. Results showed that household autonomy was positively associated with the timing of the first visit for prenatal care and the number of prenatal care visits. The content of care was negatively associated with the autonomy of women. Findings also pointed to an endogenous influence of a woman's position in the household structure. Additionally, this study analyzed associations between women's reproductive history and utilization, and economic disparities in utilization of prenatal care. The findings demonstrated that a history of complications during pregnancy and stillbirths were positively associated with utilization of prenatal care. Economic disparities in utilization of care were identified. Future interventions to increase utilization of maternal health services should account for traditional household structures in transitional countries. Women from poor families should receive support from social assistance and the health sector in accessing services pertaining to their health and well-being.
ContributorsUrbaeva, Zhyldyz (Author) / Anderson, Steven (Thesis advisor) / Krysik, Judy (Thesis advisor) / Herbst, Chris (Committee member) / Arizona State University (Publisher)
Created2015
Description
The Patient Protection and Affordable Care Act (PPACA or ACA) Public Law No: 111-148, substantially changed health insurance access in the United States. One group that the law particularly affects is young adults, defined as individuals between the ages of 19 to 26. Specifically, the expansion of young adult dependent coverage was one of the first provisions that went into effect after the ACA’s enactment. This dissertation comprehensively studies the impact of the ACA’s dependent coverage provision on young adults. Across three empirical chapters, the dissertation examines outcomes related to health insurance coverage, labor market outcomes, and educational enrollment. Chapter 1, titled “Impact of the Affordable Care Act on Young Adults Insurance Coverage,” documents the changes in health insurance take-up for the young adults population, which has historically had the lowest rates of such coverage. Changes in coverage are also evaluated separately for sub-groups of young adults. Chapter 2, titled “Labor Market Outcomes for Young Adults,” evaluates whether the law altered employment decisions and earnings for this group. It also assess whether the ACA led to increased job mobility for young adults. Finally, Chapter 3, titled “Does having Dependent Coverage from the ACA impact Educational Enrollment,” evaluated changes in educational enrollment levels for young adults following the expansion of parental dependent coverage. The research conducted in this dissertation provides evidence of the ACA’s impact on health insurance coverage, employment, and education. It also provides support for the claim that the ACA covers insurance gaps that young adults might experience as they go through life transitions when they are likely to lose coverage.
ContributorsKaul, Zoram (Author) / Herbst, Chris (Thesis advisor) / Callan, Benedicte (Committee member) / Coursen, Cristi (Committee member) / Arizona State University (Publisher)
Created2017
Description
Intake of alcohol, tobacco, and illicit substances such as marijuana and methamphetamine during pregnancy can have significant deleterious effects on a developing fetus and the resulting infant. The existence of substance-exposed newborns also has negative impacts on society as a whole; these include financial burdens placed on taxpayers and the additional time and resources required by health care professionals, social workers, and law enforcement authorities to properly care for such infants. Existing literature show a strong correlation between prenatal care and improved birth outcomes, including abstinence from or reduction of prenatal substance abuse. The Health Start Program in the state of Arizona attempts to mitigate the incidence of substance-exposed newborns, among other goals, by employing community health workers who identify high-risk pregnant and postpartum women, inform these women about how to receive prenatal care services, educate them on appropriate prenatal and neonatal care, and provide program and referral services to both pregnant and postpartum women. Community health workers interact directly with women most at-risk for prenatal substance abuse and should be well-versed in the understanding of the complex issues related to substance-exposed newborns. In an attempt to discover, analyze, and compile those complex issues with which community health workers should be knowledgeable, this project explores existing federal regulations regarding substance-exposed newborns, compares Arizona’s regulations to Minnesota’s, Virginia’s, and Washington’s, and analyzes prevailing literature in the field about the various implications associated with screening and reporting substance-exposed newborns to law enforcement authorities. After an intensive literature review, this project concludes that the Health Start Program needs a comprehensive resource document which enumerates federal and select state policies, landmark cases involving substance-abusing pregnant women and the precedence set by each, and recommendations from medical and public health experts. The document should also provide clear guidelines by which each stakeholder should abide and why, and recommend potential best practices the state of Arizona could adopt into law based on other state policies which have proven to be effective.
ContributorsTantibanchachai, Chanapa (Author) / Maienschein, Jane (Thesis advisor) / Ellison, Karin (Thesis advisor) / Coursen, Cristi (Committee member) / Arizona State University (Publisher)
Created2015