Digital Commons Network^™

Evolution Of Telehealth-Its Impact On Palliative Care And Medication Management, Syed N Imam, Ursula K Braun, Mary A Garcia, Leanne K Jackson

Center for Medical Ethics and Health Policy Staff Publications

Palliative care plays a crucial role in enhancing the quality of life for individuals facing serious illnesses, aiming to alleviate suffering and provide holistic support. With the advent of telehealth, there is a growing interest in leveraging technology to extend the reach and effectiveness of palliative care services. This article provides a comprehensive review of the evolution of telehealth, the current state of telemedicine in palliative care, and the role of telepharmacy and medication management. Herein we highlight the potential benefits, challenges, and future directions of palliative telemedicine. As the field continues to advance, the article proposes key considerations for …

Crisis Support Through Policies For Medical Professionals In 2020 And 2021 During The Covid-19 Pandemic, Malik James Fonville-Simmons

Walden Dissertations and Doctoral Studies

No abstract provided.

Rational Prescribing Of Pancreatic Enzymes For Patients With Pancreatic Cancer, Mary Acelle G Garcia, Syed Imam, Ursula K Braun, Leanne K Jackson

Center for Medical Ethics and Health Policy Staff Publications

Most patients with pancreatic cancer at some point present with symptoms related to exocrine pancreatic insufficiency (EPI). These include diarrhea, abdominal bloating, indigestion, steatorrhea, weight loss, and anorexia. Even though up to 80% of pancreatic cancer patients eventually present with symptoms related to exocrine pancreatic insufficiency, only 21% are prescribed pancreatic enzyme replacement therapy (PERT). Its effectiveness is also highly dependent on its proper timing of administration, and patients must be thoroughly educated about this. The impact of symptoms of EPI can lead to poorer overall well-being. Pharmacists play a crucial role in properly educating patients on the correct use …

A Systematic Review Of Naldemedine And Naloxegol For The Treatment Of Opioid-Induced Constipation In Cancer Patients, Ursula K Braun, Leanne K Jackson, Mary A Garcia, Syed N Imam

Center for Medical Ethics and Health Policy Staff Publications

Background: Opioid-induced constipation (OIC) is a pervasive and distressing side effect of chronic opioid therapy in patients with cancer pain, significantly impacting their quality of life. Peripherally acting μ-opioid receptor antagonists (PAMORAS) were developed for treatment-resistant OIC but most studies were conducted with non-cancer patients.

Objective: to discuss two oral formulations of PAMORAs, naldemedine and naloxegol, and to review available evidence of the effectiveness of these drugs for OIC in cancer patients.

Methods: a comprehensive search to identify primary literature for either naldemedine or naloxegol for OIC in cancer patients.

Results: Only three prospective randomized, double-blind, placebo-controlled clinical trials for …

Identifying Rural Health Clinics Within The Transformed Medicaid Statistical Information System (T-Msis) Analytic Files, Katherine Ahrens Mph, Phd, Zachariah Croll, Yvonne Jonk Phd, John Gale Ms, Heidi O'Connor Ms

Rural Health Clinics

Researchers at the Maine Rural Health Research Center describe a methodology for identifying Rural Health Clinic encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.

Background: There is limited information on the extent to which Rural Health Clinics (RHC) provide pediatric and pregnancy-related services to individuals enrolled in state Medicaid/CHIP programs. In part this is because methods to identify RHC encounters within Medicaid claims data are outdated.

Methods: We used a 100% sample of the 2018 Medicaid Demographic and Eligibility and Other Services Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files for 20 states …

2024, Camp Research Forum Book Of Abstracts, American Camp Association

ACA National Camp Research Forum Abstracts

This book includes 29 abstracts that will be presented at the 2024 American Camp Association (ACA) Research Forum to be held during the ACA annual conference from February 5-9 in New Orleans, LA. Abstracts have been grouped into similar areas and will be presented across five verbal sessions and one poster session.

How Should Focus Be Shifted From Individual Preference To Collective Wisdom For Patients At The End Of Life With Antimicrobial-Resistant Infections?, Jeannie P. Cimiotti, Kimberly Adams Tufts, Lucia D. Wocial, Elizabeth Peter

Ellmer School of Nursing Faculty Publications

Despite growth in numbers of organizational antimicrobial stewardship programs, antimicrobial resistance continues to escalate. Interprofessional education and collaboration are needed to make these programs appropriately responsive to the ethically and clinically complex needs of patients at the end of life whose care plans still require antimicrobial management.

2024 Adult Foster Home: Resident And Community Characteristics Report On Adult Foster Homes, Ozcan Tunalilar, Sarah Dys, Diana Jacoby, Wafi Albalawi, Minju Kim, Yuliana Levchenko, Paula C. Carder

Institute on Aging Publications

This year marks the 10th anniversary of the Resident and Community Characteristics Report on Adult Foster Homes as part of the Oregon Community Based Care project. The first of these reports was published in 2014 and looking back, one gets a sense of both stability and change. In this year’s report, we describe the results based on data we collected from AFHs licensed and monitored by the Aging and People with Disabilities program of the Oregon Department of Human Services (ODHS/APD). These are small residential settings that provide personal and health-related services for up to five residents. They are primarily …

Deactivation Of Left Ventricular Assist Devices At The End Of Life: Narrative Review And Ethical Framework, Danish Zaidi, James N Kirkpatrick, Savitri E Fedson, Sarah C Hull

Center for Medical Ethics and Health Policy Staff Publications

Left ventricular assist devices (LVADs) have become an increasingly common advanced therapy in patients with severe symptomatic heart failure. Their unique nature in prolonging life through incorporation into the circulatory system raises ethical questions regarding patient identity and values, device ontology, and treatment categorization; approaching requests for LVAD deactivation requires consideration of these factors, among others. To that end, clinicians would benefit from a deeper understanding of: 1) the history and nature of LVADs; 2) the wider context of device deactivation and associated ethical considerations; and 3) an introductory framework incorporating best practices in requests for LVAD deactivation (specifically in …

Do Space Tech Pack Program Evaluation: Improving Digital Access And Equity, Josie Gatti Schafer, Morgan Vogel, Tara Grell, Dan Hayes, Felipe Blanco

Publications

The Do Space Library received funding from the Emergency Connectivity Fund from the Federal Communications Commission to conduct the Teck Pack Program in Omaha, Nebraska, between June 30, 2022 to June 29, 2023. As part of the Tech Pack Program, 945 Omaha residents received a computing device and free internet access for one year. Along with this infrastructure, they received computer basics training and technology tutoring. This innovative program directly addresses the challenges experienced by those without access. In the city of Omaha, Nebraska, according to data from the U.S. Census Bureau’s American Community Survey for 2021, over 9,000 households …

2023 September, Morehead State University. Office Of Communications & Marketing.

Morehead State Press Release Archive, 1961 to the Present

Press releases for September of 2023.

Co-Creating A Responsive, Sustainable, And Equitable Community Health Model For Older Adults With Chronic Diseases, Rachel M. Gallo Mph

Children, Youth, & Families

In 2022, the Bangor YMCA received a grant from the Maine Health Access Foundation’s (MeHAF) Systems Improvement and Innovation Responsive Grants Program for their “Co-Create Responsive, Sustainable, and Equitable Community Health Models for Older Adults with Chronic Diseases” project. This project aimed to “engage older adults with chronic disease conditions and their care partners to collectively identify new ways to connect people to community resources and to co-create community-based continuum of care systems to support the physical, emotional, and mental well-being of people in [their] communities of focus”.

The University of Southern Maine’s Data Innovation Project (DIP) at the Catherine …

Conducting Oral History: Background And Methods, Katrine Barber

History Faculty Publications and Presentations

This chapter-length essay describes the practice of oral history through real world examples: the steps to conducting oral history interviews, things to consider when developing a project or an interview plan, and ethical considerations. How oral history has enlarged the historical record and changed scholarly interpretation of the past are highlighted.

Implementation Of The "Indonesian Jamu Ritual" Concept As A Club Lounge Attraction At The Ritz Carlton Pacific Place, Maha Dewi

Journal of Indonesian Tourism and Policy Studies

The purpose of this research is to investigate the implementation of the concept of applying 'Indonesian Jamu Ritual' as a Club Lounge attraction at The Ritz Carlton Pacific Place. The concept is based on the use of traditional Indonesian herbal concoctions that have been used for centuries for health and beauty purposes. The research method used is a qualitative - descriptive approach using data collection techniques through observation, interviews, and documentation. The results showed that the use of the 'Indonesian Jamu Ritual' concept at the Club Lounge The Ritz Carlton Pacific Place can increase hotel guest satisfaction and provide an …

Use Of Advance Directives In Us Veterans And Non-Veterans: Findings From The Decedents Of The Health And Retirement Study 1992–2014, Ho-Jui Tung, Ming-Chin Yeh

Health Policy & Community Health: Faculty Publications

Evidence shows that older patients with advance directives such as a living will, or durable power of attorney for healthcare, are more likely to receive care consistent with their preferences at the end of life. Less is known about the use of advance directives between veteran and non-veteran older Americans. Using data from the decedents of a longitudinal survey, we explore whether there is a difference in having an established advance directive between the veteran and non-veteran decedents. Data were taken from the Harmonized End of Life data sets, a linked collection of variables derived from the Health and Retirement …

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Divergent Clinical Presentations And Outcomes Among Children And Adolescents With Kaposi Sarcoma In Malawi And Tanzania, Liane R Campbell, Allison Silverstein, Erin Peckham-Gregory, William Kamiyango, Jimmy Villiera, Casey L Mcatee, Jason M Bacha, Carrie L Kovarik, Parth S Mehta, Toni Chanroo, Asulwisye Kapesa, Beatrice Malingoti, Rizine Mzikamanda, Nmazuo W Ozuah, Carl E Allen, Michael E Scheurer, Nader K El-Mallawany

Center for Medical Ethics and Health Policy Staff Publications

Objectives: The Kaposi sarcoma (KS) T0 versus T1 staging classification does not address the unique clinical features of paediatric KS in human gammaherpesvirus 8 (HHV-8) endemic regions of Africa. This study seeks to define patterns of childhood KS using a paediatric-specific approach.

Methods: The Lilongwe paediatric KS staging classification categorizes disease based on clinical phenotype: stage 1 = mild/moderate KS limited to cutaneous/oral involvement, stage 2 = primarily lymphadenopathic disease, stage 3 = woody edema KS, stage 4 = visceral and/or severe/disseminated mucocutaneous disease. Characteristics and outcomes were evaluated from paediatric referral centres in Lilongwe, Malawi, and Mbeya, Tanzania.

Results: …

Reluctancy In Monterey County To Get Covid-19 Vaccine, Kyle Silim

Capstone Projects and Master's Theses

The agency is Central Coast Visiting Nurses Association & Hospice. The Clinic department of the agency would be implementing the project. The communities served are Monterey, San Benito, and Santa Cruz counties. The problem related to my project is the vaccine hesitancy within Monterey County. The project’s purpose is to address the issue of vaccine hesitancy in Monterey County. The implementation method would be to do outreach within the county about upcoming vaccine clinics. The expected outcomes would be that more people would attend said vaccine clinics. The most important finding is that more people participated when there was outreach …

National Cancer Control Plan Of The Korea: Current Status And The Fourth Plan (2021-2025), Kyu-Tae Han, Jae Kwan Jun, Jeong-Soo Im

Faculty, Staff and Student Publications

Cancer management has become a major policy goal for the government of the Korea. As such, the government introduced the National Cancer Control Plan (NCCP) to reduce the individual and social burdens caused by cancer and to promote national health. During the past 25 years, 3 phases of the NCCP have been completed. During this time, the NCCP has changed significantly in all aspects of cancer control from prevention to survival. The targets for cancer control are increasing, and although some blind spots remain, new demands are emerging. The government initiated the fourth NCCP in March 2021, with the vision …

Increasing Access To Doulas In Oregon: A Delphi Study, Courtney Elizabeth Crane

Dissertations and Theses

Doulas are trained, nonmedical support professionals that provide continuous emotional, informational, physical, and practical support before, during, and after childbirth. Doula care has been shown to reduce the cost of birth-related healthcare, reduce adverse birth outcomes, and increase patient satisfaction and positive birth experience. In 2011 Oregon became the first state to authorize payment expenditures of doula care through Medicaid as a strategy to reduce birth-related health disparities and increase culturally and linguistically appropriate healthcare delivery. The intention of the set of policies and administrative rules was to mandate access to doulas and other types of Traditional Health Workers (THWs) …

2023 February, Morehead State University. Office Of Communications & Marketing.

Morehead State Press Release Archive, 1961 to the Present

Press releases for February of 2023.

Deep Community Partnerships: The Future Of Community-Based Senior Care In A Value-Driven Era, Diana Wilcox

DSW Capstone Projects

This capstone reviews three scholarly products that examine how chronically ill older adults interact with healthcare systems and senior service delivery systems in the United States. The systematic literature review examines how community-based senior programs that are funded by the Older Americans Act (OAA) positively impact health outcomes and promote health and wellness among the older adult population. The conceptual paper examines how Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs), Area Agencies on Aging (AAA) interact with the patient and with one another using the lens of Systems Theory. The practice application paper examines best practices regarding care coordination …

2023 Adult Foster Home: Resident And Community Characteristics Report On Adult Foster Homes, Ozcan Tunalilar, Sarah Dys, Paula Carder, Diana Jacoby, Sheryl Elliott, Minju Kim, Nathan Finch Parsons, Wafi Albalawi

Institute on Aging Publications

This report is the ninth installment of the Oregon Community-Based Care Study: Resident and Community Characteristics Report on Adult Foster Homes. Each year, the Institute on Aging at Portland State University (IOA/PSU) collects and reports information that can inform and advise policymakers, state and county agency staff, advocates for older adults and people with physical disabilities, and AFH owners and providers about the AFH landscape in Oregon. The results covered in this report include home and owner characteristics, staff positions, wages, and hiring challenges, consumer payer sources, additional fees and services, resident demographics, health conditions, personal care, health services use, …

2023 Community Based Care: Resident And Community Characteristics Report On Assisted Living, Residential Care, And Memory Care Communities, Ozcan Tunalilar, Paula Carder, Sarah Dys, Diana Jacoby, Sheryl Elliott, Minju Kim, Nathan Finch Parsons, Wafi Albalawi, Christine Wolf

Institute on Aging Publications

The Institute on Aging at Portland State University (IOA/PSU) presents findings from the ninth annual study of Oregon community-based care: assisted living and residential care facilities (AL/RC) with and without memory care endorsement (MC). In this year’s study, we included information about various resident, community, and staff characteristics, including: 1) Residents: sociodemographic characteristics (e.g., age, sex, race, ethnicity), length of stay, personal assistance, health conditions, status, service use, medications, and advanced care planning/legal documentation; 2) Communities: capacity, occupancy rates, resident move-in and move-out locations, private pay charges, Medicaid reimbursement to facilities, staffing, resident transportation use, COVID-19 impacts; and 3) Staff: …

Improving Access For Medicare Inpatient Psychiatric Patients: A Health Policy Analysis, Malinda B. Whitfield

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The Medicare Inpatient Psychiatric Services (IPS) policy, originally developed in the 1960s and without any significant or meaningful updates since the 1980’s, is physician specific, does not reflect the current model of care for psychiatric inpatients, and is restrictive for psychiatric mental health nurse practitioner (PMHNP) practice. The policy is complex, consists of outdated regulations, and results in millions of dollars in compliance costs for Inpatient Psychiatric Facilities (IPFs) annually (NABH, 2019). Although clearly an important part of the inpatient psychiatric services team, PMHNPs are not identified or defined in the policy (Center for Medicare and Medicaid Services [CMS], 2019). …

Death And Dignity: Approaches To Medical Aid-In-Dying And Recommendations For Nevada, Cecilia Winchell

Student Research

Advancements in medicine, surgery, and treatment have prolonged life spans in a way that presents new considerations for death and dying. When it comes to terminal illnesses, all of these innovations increase life expectancy but cannot do the same for a patient’s quality of life. In fact, many people with terminal illnesses lose their autonomy and dignity, leading to the emergence of assisted dying as a way to provide terminally ill patients with an alternative to palliative care. This report takes a look at how assisted dying has developed within the US over the past two and a half decades, …

Financial Well-Being Of Frontline Healthcare Workers: The Importance Of Employer Benefits, Mathieu Despard, Sophia Fox-Dichter, Haotian Zheng, Grace Anderson, Olivia Borland, Kourtney Gilbert

Social Policy Institute Research

Frontline healthcare workers – especially direct care workers (DCWs), such as home health aides, struggle due to low pay, lack of benefits, and difficult working conditions. The need for these workers is growing. Unless frontline healthcare jobs improve, positions may be difficult to fill, and care for vulnerable members of society may be compromised.

In this study, we surveyed 2,321 frontline healthcare workers and conducted in-depth interviews with 30 of these workers concerning pay, benefits, work conditions, and financial well-being. Key survey findings included:

• Only 39% of workers were eligible for at least four out of five major benefits (e.g., …

Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph

Access / Insurance

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:

1. socioeconomic and health characteristics that may inform health care use;
2. trends in health care use, including use of inpatient and emergency department (ED) care; …

A Comparison Of Us Medicare Expenditures For Hemodialysis And Peritoneal Dialysis, Jennifer M Kaplan, Jingbo Niu, Vivian Ho, Wolfgang C Winkelmayer, Kevin F Erickson

Center for Medical Ethics and Health Policy Staff Publications

Background: Observations that peritoneal dialysis (PD) may be an effective, lower-cost alternative to hemodialysis for the treatment of ESKD have led to policies encouraging PD and subsequent increases in its use in the United States.

Methods: In a retrospective cohort analysis of Medicare beneficiaries who started dialysis between 2008 and 2015, we ascertained average annual expenditures (for up to 3 years after initiation of dialysis) for patients ≥67 years receiving in-center hemodialysis or PD. We also determined whether differences in Medicare expenditures across dialysis modalities persisted as more patients were placed on PD. We used propensity scores to match 8305 …

2022 Community-Based Care: Resident And Community Characteristics Report On Assisted Living, Residential Care, And Memory Care Communities, Ozcan Tunalilar, Paula Carder, Jaclyn Winfree, Sheryl Elliott, Minju Kim, Diana Jacoby, Wafi Albalawi, Portland State University Institute On Aging

Institute on Aging Publications

This report summarizes findings from the 8th annual study of Oregon community-based care settings, including assisted living and residential care facilities, and memory care communities. This study was conducted during fall 2021 and winter 2022.