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So Many Hospitals, So Little Information: How Hospital Value Based Purchasing Is A Game Of Chance, Andrew I. Friedson, William C. Horrace, Allison F. Marier 2018 University of Colorado, Denver

So Many Hospitals, So Little Information: How Hospital Value Based Purchasing Is A Game Of Chance, Andrew I. Friedson, William C. Horrace, Allison F. Marier

Center for Policy Research

As part of the Patient Protection and Affordable Care Act, participating Medicare hospitals have part of their Medicare reimbursements withheld and then redistributed based on quality performance. The Hospital Value Based Purchasing reimbursement plan relies partly on ordinal rankings of hospitals to determine how money is distributed. We analyze the quality metric distributions used for payment and show that there is not enough information to reliably differentiate hospitals from one another near the payment cutoffs; and conclude that a large part of the payment formula is driven by sampling variability rather than true quality information. Alternative reimbursement plans are developed.


Water Scarcity: Sudan, Catherine Priebe 2018 Augustana College, Rock Island Illinois

Water Scarcity: Sudan, Catherine Priebe

Global Issues in Public Health

Water scarcity is an environmental global problem that will only become more pressing as time goes on. It is a public health issue that affects every continent, although certain areas of the world are facing more serious water scarcity than others such as Sudan. Populations that are more vulnerable to the effects of water scarcity are the poor, women, children, and those living in areas of political unrest. For example, South Sudan’s urban water systems have been damaged during recent warfare. Water scarcity is also an issue that disproportionately affects women who are forced from a young age to ...


Addicts Speak: An Exploratory Ethnographic Study Of Opioid Addiction, James A. Hamm 2018 Bucknell University

Addicts Speak: An Exploratory Ethnographic Study Of Opioid Addiction, James A. Hamm

Honors Theses

This thesis explores the experiences of people in recovery from opioid addiction in order to better understand the many process of recovery. Employing both participant observation and focused life history interview, and utilizing a grounded theory approach to data analysis, this research emphasizes data-driven conclusions. The research provides numerous insights into the process of recovery from opioid addiction, as well as factors that help to facilitate and sustain the process, the role that services play, and how services can be developed to better meet the needs of those in recovery.


Evaluation Of Patient-Centered Tool For Measuring Opioid Addiction Recovery, Laura A. Till 2018 University of Vermont

Evaluation Of Patient-Centered Tool For Measuring Opioid Addiction Recovery, Laura A. Till

Family Medicine Clerkship Student Projects

Vermont has expanded access to medication assisted treatment (MAT) since the onset of the opiate epidemic. This has included the use of family medicine clinicians as waivered prescribers of buprenorphine. In the absence of clear expectations or knowledge of discontinuation and detox, patients and providers must now reframe the traditional understanding of addiction recovery success as simply abstinence, maintenance medication detox, and survivorship. A 20-question, interactive “POWERS Form” has been developed by Stowe’s MAT team as part of routine counseling and clinical visits. Tracking score changes with patients allows reflection on the broader life changes during recovery process. This ...


Review Of A Medical Pre-Clinical Curriculum For Competencies In Caring For Patients Who Are Lgbt, Gender Nonconforming, Or Born With Dsd, Nina Abon, Mandi L. Pratt-Chapman 2018 George Washington University

Review Of A Medical Pre-Clinical Curriculum For Competencies In Caring For Patients Who Are Lgbt, Gender Nonconforming, Or Born With Dsd, Nina Abon, Mandi L. Pratt-Chapman

GW Research Days 2016 - Present

This review aimed to assess whether the George Washington University medical, pre-clinical curriculum met any of the Association of American Medical College’s (AAMC) 30 professional competencies to improve health care for people who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming, or born with disorders of sex development (DSD).

Methods:

Relevant sessions were reviewed based on instructors’ PowerPoint slides, audio recording of sessions (when available), assigned pre-session material, and notes taken by a student. Content and objectives from each session were mapped to corresponding AAMC competencies, and each competency was qualitatively graded as completely met, partially met, or unmet ...


Book Review: Surrogacy: A Human Rights Violation By Renate Klein, Kate Rose 2018 Dare To Tell

Book Review: Surrogacy: A Human Rights Violation By Renate Klein, Kate Rose

Dignity: A Journal on Sexual Exploitation and Violence

No abstract provided.


Dynamics Of Household Role Performance And The Culture Of Child Health Production In Igbo-Ora, Southwestern Nigeria, Kabiru K. Salami, Ayodele S. Jegede, Frederick O. Oshiname 2017 University of Ibadan, Ibadan Nigeria

Dynamics Of Household Role Performance And The Culture Of Child Health Production In Igbo-Ora, Southwestern Nigeria, Kabiru K. Salami, Ayodele S. Jegede, Frederick O. Oshiname

Journal of Social, Behavioral, and Health Sciences

Studies about production of health for children have mainly concentrated on the behavior of one or two key household members compared to the dynamics in households involving three or more members. Health production refers to the process of directing available knowledge, skills, and resources towards ensuring, maintaining, and sustaining the health of the members. This cross-sectional design study explored how the dynamics of household structure and members’ roles influence the process of health production in a rural Nigerian community. An interviewer-moderated questionnaire was administered through a panel survey approach in 576 households. Twelve in-depth interviews and eight group discussion sessions ...


Postmodern Social Control: Dividuals And Surveillance, Ernest M. Oleksy 2017 Cleveland State University

Postmodern Social Control: Dividuals And Surveillance, Ernest M. Oleksy

The Downtown Review

As a society's foundational philosophy changes, so, too, will its forms of social control. By using the works of thinkers like Deleuze and Foucault as pivot points, the dynamic nature of social interactions and the agents to mediate those actions shall be investigated. This article includes findings from archival analysis written in a journalistic prose for simplicity of consumption.


Hiv In The Heartland: Experiences Of Living With Hiv In Urban And Rural Areas Of The Midwest, Sarah B. Donley, C. Patrice Lockett 2017 Jacksonville State University

Hiv In The Heartland: Experiences Of Living With Hiv In Urban And Rural Areas Of The Midwest, Sarah B. Donley, C. Patrice Lockett

The Qualitative Report

Scholarly research on HIV/AIDS and stigma has largely demonstrated a different experience for people living with HIV and AIDS (PLWHA) who inhabit urban and rural areas. Largely missing from this scholarship are experiences in low prevalence areas. Low prevalence areas typically have fewer resources, social networks, and HIV infection and prevalence is less common. In this paper, we examine the challenges PLWHAs in rural and urban areas of the Midwest face and how these individuals manage, respond, and combat HIV/AIDS related stigmas in their communities. This paper utilizes interview data to understand the lived experiences of 18 persons ...


The U.S. Heath Care Experience, Cristian Montes 2017 UNC

The U.S. Heath Care Experience, Cristian Montes

Ursidae: The Undergraduate Research Journal at the University of Northern Colorado

This research project intends to look in depth into the U.S. health care system specifically the Affordable Care Act (ACA). The overview of the ACA will be evaluated to see if it has reached all its objectives it was pursuing prior to being signed into law in 2010. The questions we seek to answer is if the ACA is working or not. Additionally the project will also overview health care systems in other countries and understand how other private insurance functions along with how countries with universal health care and how its people are able to benefit from these ...


Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh 2017 University of Louisville

Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh

Electronic Theses and Dissertations

Over the last hundred years, the Appalachian region has been dominated by the coal industry. It has also been and currently is one of the unhealthiest regions in the United States. Recent scholarship has examined the relationship between coal mining and health and mortality rates in the Appalachian region. The first study incorporates air quality and pollution data to examine if coal mining counties have higher levels of pollution and if this pollution contributes to mortality disadvantage. In the second study, I construct a population-based coal-exposure measure to better evaluate the relationship between coal mining and health I find that ...


Strategies For Delivering Sexual Health Education To Adolescents With Autism Spectrum Disorders: An Integrative Review Of The Literature, Megan Harris 2017 DePaul University

Strategies For Delivering Sexual Health Education To Adolescents With Autism Spectrum Disorders: An Integrative Review Of The Literature, Megan Harris

Grace Peterson Nursing Research Colloquium

Autism spectrum disorder (ASD) is a neurobiological condition leading to cognitive and social deficits within individuals on the spectrum. Adolescence is a time of intense physical and psychosocial changes that prove difficult for youth with ASDs. As families work through this transition they try to navigate teaching sexual health to their adolescent with an ASD. Teaching should be done to promote health, healthy relationships, and to prevent victimization. Yet, parents report that they lack the knowledge and support to complete this task. The purpose of this literature review was to synthesize research on strategies for teaching sexual health education to ...


Patient Experience Of Taking Adjuvant Endocrine Therapy For Breast Cancer: A Tough Pill To Swallow, Kuang-Yi Wen, Rita Smith, Aruna Padmanabhan, Lori Goldstein 2017 Fox Chase Cancer Center

Patient Experience Of Taking Adjuvant Endocrine Therapy For Breast Cancer: A Tough Pill To Swallow, Kuang-Yi Wen, Rita Smith, Aruna Padmanabhan, Lori Goldstein

Patient Experience Journal

Adjuvant endocrine therapy (AET) has substantially improved the mortality rate among breast cancer survivors. Despite the proven efficacy, the non-adherence rate to therapy is still high. This study is aimed to examine women’s challenges related to AET adherence and management. Semi-structured interviews were conducted with six Caucasian and six African American breast cancer survivors who were prescribed for AET. The transcripts of audio-taped interviews were qualitatively analyzed. Key themes were: 1) positive beliefs in AET, 2) uncertainty about long-term adherence, 3) experiences with side effects, 4) forgetting and remembering, 5) other concerns and information needs, 6) potential intervention format ...


Doing And Undoing Gender In The Hospital Workplace, Nayyara Tabassum, Antonio Chiesi 2017 Università Degli Studi Di Milano

Doing And Undoing Gender In The Hospital Workplace, Nayyara Tabassum, Antonio Chiesi

Journal of Interdisciplinary Feminist Thought

In the hospital, both male and female doctors ‘do gender’, but because men and masculinity are associated with greater authority (and by association, competence), masculinised traits are favoured over feminine traits in the hospital workplace. In order to be accepted as competent doctors, female doctors expend a great deal of ‘emotional labour’ and ‘do gender’ by acting out prized masculine traits through appearance and behaviour strategies and thereby gaining legitimacy as respected, competent doctors in their interactions with other co-workers (doctors, nurses) and patients. Our study looks at the varied experiences of both older/senior and younger/junior medical doctors ...


Rethinking The Design Of Low-Cost Point-Of-Care Diagnostic Devices, Faith W. Kimani, Samuel M. Mwangi, Benjamin J. Kwasa, Abdi M. Kusow, Benjamin K. Ngugi, Jiahao Chen, Xinyu Liu, Rebecca Cademartiri, Martin M. Thuo 2017 Kiambu District Hospital

Rethinking The Design Of Low-Cost Point-Of-Care Diagnostic Devices, Faith W. Kimani, Samuel M. Mwangi, Benjamin J. Kwasa, Abdi M. Kusow, Benjamin K. Ngugi, Jiahao Chen, Xinyu Liu, Rebecca Cademartiri, Martin M. Thuo

Materials Science and Engineering Publications

Reducing the global diseases burden requires effective diagnosis and treatment. In the developing world, accurate diagnosis can be the most expensive and time-consuming aspect of health care. Healthcare cost can, however, be reduced by use of affordable rapid diagnostic tests (RDTs). In the developed world, low-cost RDTs are being developed in many research laboratories; however, they are not being equally adopted in the developing countries. This disconnect points to a gap in the design philosophy, where parameterization of design variables ignores the most critical component of the system, the point-of-use stakeholders (e.g., doctors, nurses and patients). Herein, we demonstrated ...


“First, Do No Harm”: Old And New Paradigms In Prehospital Resuscitation In The Aquatic Domain, John H. Pearn, Richard Charles Franklin 2017 Lady Cilento Children's Hospital, Brisbane, Queensland, Australia

“First, Do No Harm”: Old And New Paradigms In Prehospital Resuscitation In The Aquatic Domain, John H. Pearn, Richard Charles Franklin

International Journal of Aquatic Research and Education

The balance between benefit and risk is central to the work of all those involved in aquatic services. The Hippocratic exhortation of Primum non nocere, “First, do no harm,” has a history of over 2000 years. Superficially, all would support this dictum, but harm can result from inaction. The balance between no or little intervention on the one hand and proactive intervention with iatrogenic risk on the other is complex and enduring. Risk implies that one does not have all the information available to know the exact likelihood of an outcome, a common situation involving rescue, first aid, and resuscitation ...


When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport 2017 SIT Study Abroad

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study ...


Tibetan Women’S Experiences With Childbirth: A Comparative Study Of Present-Day Shangri-La And Previous Studies In Tibetan Communities, Billie Dunn-McMartin 2017 SIT Study Abroad

Tibetan Women’S Experiences With Childbirth: A Comparative Study Of Present-Day Shangri-La And Previous Studies In Tibetan Communities, Billie Dunn-Mcmartin

Independent Study Project (ISP) Collection

What are the experiences of Tibetan women living in and around Shangri-La with pregnancy, childbirth, and motherhood? In order to explore this topic, one must first understand the context in which this topic exists: Tibetan Buddhism and culture. This paper gives a short background on women and the female body in Tibetan Buddhism, the Tibetan Medical system, and the current accessibility and regulation of hospitals, before entering into the topic of Tibetan women’s experiences with childbirth. The experiences and traditional practices of childbirth are important, as birth is universally significant as well as particularly religiously significant in Tibetan Buddhism ...


When Knowledge Flows: A Case Study Of Village Health Workers’ Motivations In Jamkhed, Selaem Hadera 2017 SIT Study Abroad

When Knowledge Flows: A Case Study Of Village Health Workers’ Motivations In Jamkhed, Selaem Hadera

Independent Study Project (ISP) Collection

Across the field of global health, there have been many attempts to cater to the health needs of the most marginalized populations. Community health workers (CHWs) are individuals that live in the communities they serve and are typically low-­‐income women with little to no formal education. After a period of training by their program, they enter their communities equipped as a bridge between the community and the health system. Although CHWs do play a substantial role in health delivery and education, the structure of CHW programs varies widely, but a common characteristic of these programs is that the CHWs ...


Hiv Harm Reduction Methods: A Comparison Between Switzerland And The United States, Erin Major 2017 SIT Study Abroad

Hiv Harm Reduction Methods: A Comparison Between Switzerland And The United States, Erin Major

Independent Study Project (ISP) Collection

This paper explores the connections between harm reduction methods and the prevalence of HIV/AIDS in Switzerland and the United States of America, focusing primarily on the harm reduction methods of needle exchange programs, safe drug consumption spaces, and sex education. While these two countries are largely similar in their culture and geopolitical approaches, there are some key differences in how HIV is approached in each. Switzerland’s somewhat unique approach with relaxed drug policies and more pragmatic, harm reduction based response to the AIDS epidemic sets a model framework for other countries to follow, with comparatively widespread use of ...


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