Medicine and Health Sciences Commons^™

Incentives For Orphan Drug Research And Development In The United States, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio, Sheryl L. Szeinbach, Jay Visaria

Pharmacy Faculty Articles and Research

Background: The Orphan Drug Act (1983) established several incentives to encourage the development of orphan drugs (ODs) to treat rare diseases and conditions. This study analyzed the characteristics of OD designations, approvals, sponsors, and evaluated the effective patent and market exclusivity life of orphan new molecular entities (NMEs) approved in the US between 1983 and 2007.

Methods: Primary data sources were the FDA Orange Book, the FDA Office of Orphan Drugs Development, and the US Patent and Trademark Office. Data included all orphan designations and approvals listed by the FDA and all NMEs approved by the FDA during …

Medicaid Financing: How The Fmap Formula Works And Why It Falls Short, Christie Provost Peters

National Health Policy Forum

Medicaid costs for health and long-term care services for low-income individuals are substantial. As a result, each state’s “match rate,” or federal medical assistance percentage (FMAP), which determines the share of Medicaid benefit costs the federal government pays, has enormous implications for state budgets and state economies, as well as for Medicaid beneficiaries and providers. Shifts in the FMAP from year to year, even minor ones, can mean the gain or loss of tens or hundreds of millions of federal matching dollars, depending on the size of the state’s Medicaid program. This paper explains the FMAP formula, examines the limitations …

Students Campaign For Clean Water, Jessica Block ‘09

News and Events

No abstract provided.

Factors Affecting Long-Term Outcomes Following Intensive In-Home Services, Sarah Hurley

Theses and Dissertations (ETD)

Intensive in-home services (IIHS) work with families toward building skills and resources to better manage their children with behavioral difficulties. Factors that impact long-term outcomes following IIHS are not well understood. This study examined the relative importance of youth demographic and clinical characteristics, family history variables, characteristics of program participation, and organizational-level factors in explaining placement stability, educational progress, and contact with legal authorities one year following discharge from IIHS.

The sample included all youth who received IIHS, were discharged between January 1, 2001 and December 31, 2006, and completed a follow up at one-year post-discharge (n = 2,649) from …

Technical Analysis: The Interface Of Rational And Irrational Decision Making, William Martin

Publications – Dreihaus College of Business

No abstract provided.

What's Happening: December, 2008, Maine Medical Center

What's Happening

No abstract provided.

Application At The Bedside: Moving From Knowing How To Knowing Why In Nursing, Joyel J. Brule

Walden Dissertations and Doctoral Studies

The nursing field is beginning to emerge as a profession with curricula that emphasis nursing as a discipline distinguished from a medically dominated paradigm. This changing focus places emphasis on professional competence upon graduation and entry into practice to foster fitness for purpose within an environment of continuously changing expectations of the nurse by society. Despite a growing body of research on transition into practice, a gap exists as to when this transition occurs and how this finding may influence educational preparation of nurses. This qualitative, exploratory study examined nurses’ perceptions of their transformation from novice to professional practitioner by …

Examining The Perceived Benefits For Engaging In Cybersex Behavior Among College Students, Delores D. Rimington

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

This study examined college students’ cybersex use, perceived benefits of use, time spent online, and compulsive cybersex. Participants consisted of students attending Utah State University Spring semester 2007. Data were collected via an online survey, and 262 surveys were used in the correlation and regression analyses.

Results indicated that age, religion and gender are predictive of perceiving more benefits for cybersex participation. A strong positive correlation was found between perceived benefits and compulsive cybersex use. Students’ lack of social skills was predictive of more time spent online. Time spent online for cybersex was predictive of sexually compulsive behavior. There was …

Technical Analysis: The Interface Of Rational And Irrational Decision Making, William Marty Martin

William Marty Martin

No abstract provided.

Primary Care Physician Supply, Physician Compensation, And Medicare Fees: What Is The Connection?, Laura A. Dummit

National Health Policy Forum

Primary care, a cornerstone of several health reform efforts, is believed by many to be in a crisis because of inadequate supply to meet future demand. This belief has focused attention on the adequacy of primary care physician supply and ways to boost access to primary care. One suggested approach is to raise Medicare fees for primary care services. Whether higher Medicare fees would increase physician interest in primary care specialties by reducing compensation disparities between primary care and other specialties has not been established. Further, many questions remain about the assumptions underlying these policy concerns. Is there really a …

A New Application Of Spatiotemporal Analysis For Detecting Demographic Variations In Aids Mortality: An Example From Florida, Yuwen Chiu, Chiehwen Ed Hsu

Chiehwen Ed Hsu

The purpose of the present study was to characterize, geographically and temporally, the patterns of acquired immune deficiency syndrome (AIDS) death disparity in 67 Florida jurisdictions, and to determine if the detected trends varied according to age, race, and sex. The space-time scan statistic proposed by Kulldorff et al was used to examine the excess AIDS deaths that occurred between 1987 and 2004. Results were geographically referenced in maps using EpiInfo and EpiMap made available by the Centers for Disease Control. Miami-Dade and the nearby counties including Broward, Martin, and Palm Beach are the most likely clusters (observed/expected: 1505.16) with …

What's Happening: November, 2008, Maine Medical Center

What's Happening

No abstract provided.

Tending To Richmond's Children: Community Strategies To Bridge Service Gaps, Judith D. Moore, Jessamyn Taylor

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to Richmond, Virginia, in October 2008 to explore social and environmental determinants of children’s health, including the impacts that poverty and exposure to lead-based paint have on birth outcomes, child development, and school readiness; and the community's efforts to address them. Though not large in population terms, Richmond faces many of the social and economic problems often common in larger urban areas—concentrated poverty, migration of wealth and services to the surrounding counties, a high infant mortality rate, and troubled schools. The site visit explored community strategies to improve birth outcomes and …

Medicaid And Mental Health Services, Cynthia Shirk

National Health Policy Forum

Medicaid is the largest payer of mental health services in the United States, contributing more than any other private or public source of funding. This background paper highlights the variety of services and supports needed by individuals with mental illness and Medicaid’s increasing role in mental health coverage. It provides an overview of Medicaid coverage of mental health services and identifies some of the key challenges in providing that coverage.

The Percentage Of Beds Designated For Medicaid In American Nursing Homes And Nurse Staffing Ratios, Christopher Donoghue

Department of Sociology Faculty Scholarship and Creative Works

Previous analyses of the inverse relationship between a nursing home's Medicaid census and its quality of care have been based on samples limited to specific geographic regions, for-profit entities, or only skilled care facilities. The present study uses national-level data from the 1999 National Nursing Home Survey to examine the association between the proportion of beds designated for Medicaid residents and nurse staffing ratios. The results indicate that homes which designate a higher proportion of their beds for Medicaid recipients maintain lower ratios of registered nurses and nurse's aides to residents, even when key facility characteristics are controlled. It was …

Introduction To Research Ethics., Scott Lipkin Dpm

Network Office of Research and Innovation

No abstract provided.

A Case Of Cutaneous Larva Migrans Acquired From Soiled Toilet Floors In Urban Kuala Lumpur, Noorzurani Robson Associate Prof. Dr., S Othman

Associate Prof. Dr. Noorzurani Robson

Despite being a common skin dermatosis in the tropics, physicians in the tropics may miss the diagnosis of cutaneous larva migrans for other pruritic skin manifestation. This is especially in those who live in urban housing with no history of travel. Cutaneous larva migrans, an intensely pruritic skin pathology is mainly contracted by people with history of beach holiday or contact with moist soft sand which had been contaminated with dog or cat faeces. This article reports a patient who presented with intensely itchy papular spots over the dorsum of his foot after walking barefooted in an urban toilet soiled …

What's Happening: October, 2008, Maine Medical Center

What's Happening

No abstract provided.

Rules Of Engagement: Residents' Perceptions Of The In-Training Evaluation Process, Christopher Watling, Cynthia Kenyon, Elaine Zibrowski, Valerie Schulz, Mark Goldszmidt, Indu Singh, Heather Maddocks, Lorelei Lingard

Lorelei Lingard

BACKGROUND: In-training evaluation reports (ITERs) often fall short of their goals of promoting resident learning and development. Efforts to address this problem through faculty development and assessment-instrument modification have been disappointing. The authors explored residents' experiences and perceptions of the ITER process to gain insight into why the process succeeds or fails.

METHOD: Using a grounded theory approach, semistructured interviews were conducted with 20 residents. Constant comparative analysis for emergent themes was conducted.

RESULTS: All residents identified aspects of "engagement" in the ITER process as the dominant influence on the success of ITERs. Both external (evaluator-driven, such as evaluator credibility) …

Covering All Kids: States Setting The Pace, Jennifer Ryan, Safiya Mojerie

National Health Policy Forum

Providing health insurance coverage for the uninsured is a challenge that has remained unresolved for decades. In the absence of a national solution, states have initiated their own efforts to expand access to health insurance coverage, particularly for children. This issue brief provides a history and status of state universal children’s coverage initiatives and features several states that appear to be setting the pace by developing successful strategies for expansion and cultivating the political will and leadership needed to institute them. In highlighting some of the key lessons that can be learned from states’ experiences, this paper may inform the …

What's Happening: September, 2008, Maine Medical Center

What's Happening

No abstract provided.

Community-Based Long-Term Care In Milwaukee: Wisconsin Still Ahead, Judith D. Moore, Carol O'Shaughnessy, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum has made two site visits to Wisconsin in two years. The first, in August 2007, focused on an overview of Family Care, the state's managed long-term care program, and looking at service delivery in a rural setting. The August 2008 site visit focused on the operations of MCOs and Family Care service providers in the urban environment of Milwaukee. Issues examined included the link between housing and social services, care management, capitation and rate-setting, measuring quality, and integrating people with disabilities into a program that initially targeted the elderly.

Strong As The Weakest Link: Medical Response To A Catastrophic Event, Eileen Salinsky

National Health Policy Forum

Natural disasters and acts of terrorism have placed a spotlight on the ability of health care providers to surge in response to catastrophic conditions. This paper reviews the status of efforts to develop the capacity and capabilities of the health care system to respond to disasters and other mass casualty events. Strategies for adapting routine medical practices and protocols to the demands posed by extraordinary circumstances and scarce resources are summarized. Existing federal roles, responsibilities, and assets relative to the contributions of state and local government and the private sector are described, including specific programmatic activities such as the Strategic …

What's Happening: August, 2008, Maine Medical Center

What's Happening

No abstract provided.

The Quality Control System, Tony Badrick

Tony Badrick

Quality Control System: an understanding of analytical error; synthetic QC material; a set of QC rules; a process to follow if the rules signal. Quality Control (QC) Sera: reconstitution - staff trained; stability tested - post reconstitution and frozen. QC Rules: rules documented - basis of adoption; action to follow in case of failure documented; evidence of this procedure being used in place; are QC rules defined for both batch and continuous analysis - how is a 'run' defined for a continuous analytical process; means and standard deviations (SDs) of controls based on sufficient data points and reflects true state …

Medicare Demonstrations, Amanda Cassidy

National Health Policy Forum

This publication provides an overview of Medicare demonstration projects, including what they are, how and by whom they are initiated, and how they differ from research projects. This document highlights several significant demonstrations in Medicare history and outlines several current demonstration projects. Key considerations in designing, implementing and evaluating demonstrations are mentioned.

Medicaid And Schip Waivers, Cynthia Shirk

National Health Policy Forum

No abstract provided.

Shaping Medicaid And Schip Through Waivers: The Fundamentals, Cynthia Shirk

National Health Policy Forum

The use of waivers has become one of the key vehicles for innovation in Medicaid and the State Children’s Health Insurance Program (SCHIP). This background paper examines the use of research, demonstration, and program waiver authorities to test new approaches to the delivery of and payment for health care and long-term care services. The paper reviews the statutory basis and mechanics of demonstrations and program waivers, as well as their history and political context in shaping Medicaid and SCHIP. It also explores the ways the changing state-federal relationship and the ever-growing demand for state flexibility have driven waiver policy. Finally, …

The Fundamentals Of Medicare Demonstrations, Amanda Cassidy

National Health Policy Forum

Demonstrations are experiments that test Medicare policy changes without permanently changing the Medicare program. They allow policymakers to learn about the potential impact and operational challenges of a proposed modification to Medicare, but in a more controlled environment and on a limited basis. Since demonstrations can affect hundreds of thousands of beneficiaries and providers and involve millions of dollars, they are often controversial. This paper describes the basics of Medicare demonstrations, including what they are, how they are initiated, and why they are undertaken. The paper also explores the relationship between demonstrations and other research projects. The primary challenges in …

The Relationship Of Patient Falls To Prevention Policies In Hospitals: A Case Study, Cornelia Branzan

Master in Public Administration Theses

There have been a lot of studies over the past decade on patient falls, risk factors, and strategies for preventing the falls. However, these studies provide answers for long term care; acute care and community hospitals need more specific interventions. Falls and their consequences are important for patients and families, health care providers, insurance companies, state agencies, hospital accreditation, and others. Furthermore, they are causing psychological and physiological injuries among the patients, take a greater time to recover, prolong hospitalization [15 days in Switzerland, Sweden, USA, Western Australia, Province of British Columbia and Quebec in Canada www.stopfalls.com )] and increase …