Digital Commons Network^™

A Study Of The Effects Of Certificate Of Need Law On Inpatient Occupancy Rates, Jomon Aliyas Paul, Huan Ni, Aniruddha Bagchi

Aniruddha Bagchi

Biosimilars: Exploring The History, Science And Proogress, Joseph D. Tariman Phd

Joseph D Tariman PhD, RN, ANP-BC, FAAN

Rebuilding Postgraduate Medical Education Programmes In Afghanistan, Vivian C. Mcalister

Vivian C. McAlister

Aca Implementation In The South: The Political Economy Of Full Participation In Kentucky, Glen P. Mays

Glen Mays

This analysis, conducted as part of the ACA Implementation Research Network, examines economic and political forces shaping Kentucky's early experience with implementation of the Patient Protection and Affordable Care Act.

A Model For Deceased-Donor Transplant Queue Waiting Times, Steve Drekic, David A. Stanford, Douglas Woolford, Vivian C. Mcalister

Vivian C. McAlister

No abstract provided.

Prenatal Oral Health Education In U.S. Dental Schools And Obstetrics And Gynecology Residencies, Megan Curtis, Hugh Silk, Judith A. Savageau

Judith A. Savageau

Prenatal oral health (POH) is an important health issue, but dental and obstetrical clinicians are not meeting the oral health needs of pregnant patients. This study evaluates how training contributes to this paradox with a national survey of sixty dental school deans and 240 obstetrics and gynecology residency program directors. Response rates were 53 percent and 40 percent for deans and program directors, respectively. According to the respondents, 94 percent of responding dental schools provided POH education, only 39 percent of responding residencies taught POH, and 65 percent of responding deans and 45 percent of responding program directors were aware …

The Impact Of Health Care Reform On Emergency Medical Services, Richard N. Bradley, Sabina A. Braithwaite

Richard N Bradley

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. The reforms introduced through PPACA present a paradigm shift in the future delivery model of all health care, including Emergency Medical Services (EMS). Changes embodied in this law offer a variety of opportunities to improve the delivery of care in urgent and emergent medical situations in the out-of-hospital setting. PPACA offers a number of avenues for EMS to engage at a much higher level as professional members of the health care team going forward. Certain components of the law stand to facilitate and …

Nonpunctuated And Sweeping Policy Change: Bhutan Tobacco Policy Making From 1991 To 2009, Michael S. Givel

Michael S. Givel

This paper examines policy outputs associated with the 2004 Bhutan antitobacco law, including 2009 amendments, to determine if the law is congruent with punctuated equilibrium or social policy realism theories of policy change. There was no direct and sudden tobacco policy output change in Bhutan due to a shock to the policy system contrary to what punctuated equilibrium theory would predict. Rather, policy change was sweeping but nonpunctuated. This paper reconfirms prior findings of social policy realism theory that various and complex policy output patterns occur due to a mixture of contingent and complex factors. Under social policy realism, a …

Agricultural Health In The Gambia I: Agricultural Practices And Developments, R. Kuye, K. Donham, S. Marquez, W. Sanderson, L. Fuortes, R. Rautiainen, M. Jones, Kennith R. Culp

Kennith R. Culp

This manuscript reports results of our study to characterize the historical developments of agricultural practices in The Gambia and related health risks of farm workers. It surveys the various factors that shape production agriculture in the country and examines the degrees to which hand tools, animal traction, motorized traction and manual labour all contribute to the inherent hazards of farm work. The principal objective of this study is to lay the ground work for detailed research of occupational health hazards in Gambian agriculture; and development of policies and programmes to promote the health of Gambian farmers. The authors of this …

Some Thoughts On Health Care Exchanges: Choices, Defaults, And The Unconnected, Brendan S. Maher

Brendan Maher

One feature of the ACA that appealed to observers across the political spectrum was the creation of health insurance “exchanges.” Among other things, exchanges are intended to aid consumers in making simple and transparent choices regarding the purchase of health insurance. This Article considers how exchanges might benefit from the use of “default” options-both online and off. Given the significant number of Americans that have limited or no Internet access, offline defaults may be an attractive way to promote coverage of the “unconnected.”

Anatomia Da Privatização Neoliberal Do Sistema Único De Saúde: O Papel Das Organizações Sociais De Saúde, Fabiano Tonaco Borges, Suzely Abas Saliba Moimaz, Carlos Eduardo Siqueira, Cléa Abas Saliba Garbin

C. Eduardo Siqueira

O objetivo da elaboração desta obra foi dissecar as partes

que compõem o processo de privatização do Sistema Único de Saúde (SUS). Para isto, utilizou-se, metaforicamente, o termo anatomia para descrever as estruturas do corpo chamado privatização do SUS. Importante ressaltar que o termo público se

sobressai em todo o texto numa referência ao povo, termo mais apropriado do que estatal na contraposição à coisa particular, de domínio privado.

Partiu-se do princípio que a dependência externa dos países em desenvolvimento propicia condições para a exportação do modelo privado de saúde a partir dos países desenvolvidos, em particular, os Estados Unidos. …

Vocational Health Schools (Etsus) In Brazil: Regulation Of The Integration Of Teaching-Service-Administrative Sustainability Of Etsus, Fabiano Tonaco Borges, Cléa Ada Saliba Garbin, Carlos Eduardo Siqueira, Artênio Jósé Crispin Garbin, Najara Barbosa Da Rocha, Luíz Fernando Lolli, Suzely Adas Saliba Moimaz

C. Eduardo Siqueira

The scope of this study was to discuss the administrative sustainability of Brazil’s Vo- cational Health Schools (ETSUS) based on the principle of teaching and service integration, which brings a new dimension to healthcare work as yet unregulated by Brazilian public adminis- tration. It was a qualitative study using case study methodology. The research involved a semi-struc- tured questionnaire given to ETSUS managers addressing institutional, administrative, and work management aspects. The sample was composed of 6 ETSUS that belong to the Network of Vocational Health Schools (RET-SUS). The ETSUS showed centralized planning and management, and decentralized implementation of their core …

Bureaucratic Advocacy And Ethics A State-Level Case Of Public Agency Rulemaking And Tobacco Control Policy, Michael S. Givel, Andrew Spivak

Michael S. Givel

Before 2001, the Oklahoma Department of Health achieved little to protect the public from the dangers of secondhand tobacco smoke. In an ongoing effort between 2000 and 2003, the department joined with health groups to lobby for stronger requirements, resulting in a new Oklahoma administrative rule in 2002 and legislation in 2003 regulating secondhand tobacco smoke. This action was congruent with the American Society of Public Administration's Code of Ethics for interactive democratic policymaking, in which administrators are required to serve the public interest with compassion, benevolence, fairness, and optimism.

Agricultural Health In The Gambia I: Agricultural Practices And Developments, R. Kuye, K. Donham, S. Marquez, W. Sanderson, L. Fuortes, R. Rautiainen, M. Jones, Kennith R. Culp

Kennith R. Culp

This manuscript reports results of our study to characterize the historical developments of agricultural practices in The Gambia and related health risks of farm workers. It surveys the various factors that shape production agriculture in the country and examines the degrees to which hand tools, animal traction, motorized traction and manual labour all contribute to the inherent hazards of farm work. The principal objective of this study is to lay the ground work for detailed research of occupational health hazards in Gambian agriculture; and development of policies and programmes to promote the health of Gambian farmers. The authors of this …

Progress Delayed: State Of Tobacco Control Policymaking In Oklahoma From 2005-2011, Michael Givel, Ami Stearns, Andrew Spivak

Michael S. Givel

EXECUTIVE SUMMARY • Oklahoma’s 1987 Smoking In Public Places Act required the inclusion of smoking sections in restaurants and pre-empted more stringent local anti-tobacco laws with state regulations. • With the 2001 arrival of an aggressive new Commissioner of Health, Dr. Leslie Beitsch, the tide turned with new legislation (Senate Joint Resolution 21 in 2003) that prohibited smoking inside public places and restaurants were allowed to build separately-ventilated “smoking rooms.” • In 2004, State Question 713 increased the cigarette tax by 80 cents per package. • Dr. Beitsch resigned in 2003 and since that time, efforts toward clean air have …

Drills And Exercises: The Way To Disaster Preparedness, Vivian C. Mcalister

Vivian C. McAlister

Catastrophes, natural or man-made, are very rare events in the life of hospitals in the developed world. None of the hospitals that coped with well known recent events such as Hurricane Katrina or the Madrid bombings had actually experienced or prepared for such an occurrence. A mass casualty incident (MCI), sometimes called “MASCAL,” is a situation in which a hospital receiving multiple casualties does not have the resources to deal with the patients simultaneously. Bottlenecks may occur at any point from the trauma bays to the point of discharge. There are 2 phases in which hospitals fail to cope. In …

In Search Of The Less Hazardous Cigarette, Michael Givel

Michael S. Givel

Since the 1950s, despite considerable and long-term tobacco industry and government efforts, attempts to develop a less risky cigarette that reduces harmful ingredients, generally or specifically, have failed. Moreover, even under ideal conditions with adequate scientific testing, the efficacy of purportedly reducing the severe health effects cannot be scientifically verified for up to 20 years after the introduction of a product on the market. A key and central provision in the 2009 U.S. Food and Drug Administration (FDA) legislation is to reduce the risk or harm of cigarettes. Because creating a less risky cigarette is not currently possible, this renders …

Mass Casualty Training Exercise At The Canadian Surgery Forum

Vivian C. McAlister

On September 18, 2011 second year Schulich School of Medicine & Dentistry students helped run the first mass casualty training exercise, directed by Dr. Vivian McAlister, Division of General Surgery, at the Canadian Surgery Forum held this year at the London Convention Centre.

Tobacco Use Policymaking And Administration In Bhutan, Michael S. Givel

Michael S. Givel

No abstract provided.

Obesity: The Bioethics We Need Now, Or What We Owe To Each Other, Lee T. Nutini

Lee T Nutini

This is an essay written to address the philosophical and food industrial practices underlying the current obesity epidemic in the United States. It appears in its modified lecture format, given at Yale University in 2009. As such, citations are not included. For any question about a specific citation, please contact the author directly.

The Effect Of A Global Multiculturalism Track On Cultural Competence Of Preclinical Medical Students, Michael A. Godkin, Judith A. Savageau

Judith A. Savageau

BACKGROUND: We evaluated the effect of an elective (the Global Multiculturalism Track), including international and domestic immersion experiences, on the cultural competence of preclinical medical students. METHODS: A self-assessment instrument was used to measure cultural competence, and it was administered to Track participants and nonparticipating class cohorts at the beginning and the end of the preclinical years. RESULTS: Track participants (n=26) had a higher level of cultural competence both at the beginning and at the end of the program. At the end of their second year, students participating in the Track had, for the first time, greater knowledge of certain …

Waiting For Liver Transplantation In Canada: Waitlist History 2000--2004 And Sensitivity Analysis For The Future., David Stanford, Elizabeth Renouf, Vivian C. Mcalister

Vivian C. McAlister

Report Of The Global Health Task Force, Vivian C. Mcalister

Vivian C. McAlister

The mandate of the Global Health Task Force was to advise the Dean regarding the development of Global Health at SSMD by broadly analyzing Global and international Health activities, within SSMD at The University of Western Ontario and in other Canadian universities, in order to make recommendations with respect to scope, coordinating structure, required administrative support, existing and potential academic activity and placement within the formal undergraduate curriculum for medical and dental students, as well as elective offerings and volunteer opportunities that may also involve students from professional programs within the Faculty of Health Sciences. The Task Force reviewed structures …

Reducing The Risk Of Falls And Fall-Related Injuries Among Older People , David A. Ganz, Shinyi Wu

Shinyi Wu

This paper reviews approaches to preventing falls in older adults at the individual, community and national levels. We find extensive evidence to support fall prevention at the individual level, with exercise programs and multifactorial evaluation and intervention showing the most promise. Good data also exist to support community-level fall prevention strategies, and several national fall-prevention programs are ongoing. Officials in countries implementing fall-prevention programs should monitor their efforts for effectiveness and sustainability, so that program design can be improved based on sound evidence, and so that results and lessons may provide guidance for other countries. Over the long term, only …

Mental Health Parity Laws, Louis Graham, Kisha Braithwaite

Louis F Graham

Neighborhood Design And Walking Trips In Ten U.S. Metropolitan Areas, Rob Boer, Yuhui Zheng, Adrian Overton, Gregory K. Ridgeway, Debra A. Cohen

Yuhui Zheng

Despite substantial evidence for neighborhood characteristics correlating with walking, so far there has been limited attention to possible practical implications for neighborhood design. This study investigates to what extent design guidelines are likely to stimulate walking.

Systematic Review: Impact Of Health Information Technology On Quality, Efficiency, And Costs Of Medical Care, Shinyi Wu, Basit Chaudhry, Jerome Wang, Margaret Maglione, Walter Mojica, Elizabeth Roth, Sally C. Morton, Paul G. Shekelle

Shinyi Wu

Background: Experts consider health information technology key to improving efficiency and quality of health care.

Purpose: To systematically review evidence on the effect of health information technology on quality, efficiency, and costs of health care.

Data Sources: The authors systematically searched the Englishlanguage literature indexed in MEDLINE (1995 to January 2004), the Cochrane Central Register of Controlled Trials, the Cochrane Database of Abstracts of Reviews of Effects, and the Periodical Abstracts Database. We also added studies identified by experts up to April 2005. Study Selection: Descriptive and comparative studies and systematic reviews of health information technology.

Data Extraction: Two reviewers …

"Body Contouring After Massive Weight Loss," Edited By A. Aly., Vivian C. Mcalister

Vivian C. McAlister

Nowhere is the failure of the health care system, as currently managed, more evident than in the surgical care of obesity. A marked contrast has emerged between surgery in the United States and Canada for these patients. It is not clear whether the reluctance to supply surgical services in Canada is due to a bias in favour of “more deserving” patients or whether the considerably higher rate of obesity surgery in the US is due to the excesses of private enterprise. Governments have acknowledged that an element of the former proposition is true by referring obese patients to centres in …

Sacred Disease Of Our Times: Failure Of The Infectious Disease Model Of Spongiform Encephalopathy, Vivian Mcalister

Vivian C. McAlister

BACKGROUND: Public health and agricultural policy attempts to keep bovine spongiform encephalopathy out of North America using infectious disease containment policies. Inconsistencies of the infectious disease model as it applies to the spongiform encephalopathies may result in failure of these policies.

METHODS: Review of historical, political and scientific literature to determine the appropriate disease model of spongiform encephalopathy.

PRINCIPAL FINDINGS: Spongiform encephalopathy has always occurred sporadically in man and other animals. Hippocrates may have described it in goats and cattle. Transmission of spongiform encephalopathy between individuals is too uncommon for it to be usefully considered an infection. Spongiform encephalopathy is …

Scolding John Q.: Articulating A Normative Relationship Between Politics And Entertainment, Emily West

Emily E. West

The 2002 hostage drama John Q. triggered a discussion among journalists, the public, and the policy community about the proper relationship between politics and entertainment. In this debate the criteria for good journalism and good political discourse were frequently invoked to evaluate this Hollywood film. This discussion, which spilled out of the film criticism pages into news and commentary pages, shows how public sphere models of political discourse are privileged even though they may not be a good fit for fictional media. John Q.’s success in triggering public discussion and awareness about health policy issues seems to illustrate DeLuca & …