Health Policy Commons^™

Analyzing Reproductive Policy: Patriarchal Legitimization And Women In Latin America, Shannon C. Magni

Honors Scholar Theses

This paper examines the way in which gendered violence is carried out as a way for the formal state and the Catholic Church to negotiate power. While examples of a much larger trend, three Latin American countries are discussed in detail. The first case occurred in Nicaragua, where a 9-year-old victim of rape was denied an abortion by both the state and the Church. The second case examined is the use of rape as a torture tactic by the military junta in Argentina during the Dirty War from 1976 to 1983. The final case examined is that of the forced …

Advocacy: A Vital Step In Attaining Full Practice Authority For The Advanced Practice Registered Nurse, Mandi Cafasso

Doctor of Nursing Practice Scholarly Projects

Problem Statement

Recent passage of the Affordable Care Act has made the imminent concern of poor patient/provider ratios a reality. Unfortunately, despite increasing numbers of advanced practice registered nurses graduating annually, the access to healthcare issue continues. Advanced practice registered nurses (APRNs) are limited in the care they can provide as a result of Ohio law.

The Ohio Nurse Practice Act requires APRNs to work in a collaborative relationship with a physician and also requires that prescribing practices be guided by an inclusionary formulary (Nurse Practice Act, 2014). Thus, APRNs in Ohio cannot practice to their fullest scope of education …

Improving Rhode Island’S Health Care System: Lessons From The Cuban Model, Sarah R. Moffitt

Senior Honors Projects

Improving Rhode Island’s health care system: lessons from the Cuban model

Cuba is world renowned for its health care system. In regards to international health crises, Cuba is a leader in sending workers abroad and training doctors from all over the world. Within its own borders, the Cuban model provides free access to all citizens in which every individual has a primary care provider. Cuba boasts high vaccination rates, a long life expectancy, low infant mortality rate, and a population that is one of the healthiest in the western hemisphere.

The purpose of this research project is to evaluate the …

Swords Into Stethoscopes: How The U.S. Military Could Conduct Medical Diplomacy, Oliver Kendall

Political Science Honors Projects

Since the early 1960’s, Cuba and China have won international appreciation by sending doctors abroad to help where they are needed. While there was surprise in some quarters when U.S. military personnel were deployed to combat Ebola in the last months of 2014, the Department of Defense actually has a long history of medical activity. In its current form, DoD medical outreach cannot likely garner soft power in the way that the Chinese and Cuban programs can, but with a few modifications, the U.S. military could be a serious conductor of medical diplomacy that would save countless lives and benefit …

Foodborne Illness Risk Factor Study, Kathi-Anne M. Fortin

Muskie School Capstones and Dissertations

The initial purpose of this capstone was to establish a baseline for the occurrence of the top five foodbome illness risk factors, to write a report on the baseline findings and to develop a plan to repeat this study at least once every 60 months for the Portland Environmental Health & Safety Program. It soon became clear, however, that the scope was too broad. An extensive effort was required to integrate national methodology and comparability principles with the State and local restaurant inspection structure. Subsequently, the focus of the capstone shifted to the development of a comprehensive data collection manual. …

Rush To Judgment: The Sti-Treatment Trials And Hiv In Sub-Saharan Africa, Eileen Stillwaggon, Larry Sawers

Economics Faculty Publications

Introduction: The extraordinarily high incidence of HIV in sub-Saharan Africa led to the search for cofactor infections that could explain the high rates of transmission in the region. Genital inflammation and lesions caused by sexually transmitted infections (STIs) were a probable mechanism, and numerous observational studies indicated several STI cofactors. Nine out of the ten randomized controlled trials (RCTs), however, failed to demonstrate that treating STIs could lower HIV incidence. We evaluate all 10 trials to determine if their design permits the conclusion, widely believed, that STI treatment is ineffective in reducing HIV incidence.

Discussion: Examination of the …

Localizing The International: Examining How Fieldworkers Combat Adolescent Pregnancy In Northern Ghana, Alexandra C. Sloss

Renée Crown University Honors Thesis Projects - All

International aid is often ineffective because it is delivered without an understanding of local ideologies and contexts. My Capstone examined whether or not international aid in northern Ghana could be effective when addressing adolescent pregnancy. The Ghanaian programs I address in my Capstone are six non-governmental organizations, a government sub-district clinic and government junior high schools. The majority of my data was collected through interviews with individuals at all levels of the organizations, including directors, staff members, volunteers and individuals seeking the organization’s services. Alongside interviews I also spent time in the field, participating in youth group discussions, visiting regional …

Adolescent Girls, Human Rights And The Expanding Climate Emergency, Holly G. Atkinson, Judith Bruce

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing.¹ These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent. The authors urge key actors responding to both the threats and opportunities that climate change poses to understand adolescent girls as exceptionally at risk on the one hand, and as exceptionally resilient and …

Complexity Of People's Attitudes Towards Abortion, Lindsey K. Butler

Health, Human Performance and Recreation Undergraduate Honors Theses

In the United States, and in Arkansas specifically, unintended and unplanned pregnancies are a significant public health problem. Induced abortion is a potential outcome of any pregnancy, especially unintended pregnancy. Approximately 43% of unintended pregnancies will be terminated via self-induced abortion (Centers for Disease Control and Prevention [CDC], 2013). However, abortion remains a salient, but contentious, public health issue in the United States. State and federal governments continue to pass legislation restricting access to safe, legal abortion suggesting that public opinion supports more restrictive policies. Research examining abortion attitudes typically utilize dichotomous, Prochoice versus Prolife, outcomes. Research assessing the extent …

An Evaluation Of The Primary Care Providers’ Perspective Of The Effects Of Moderate Alcohol Consumption On Health, Gisele Tchamba

Dissertations

The complexity of health benefits of moderate alcohol consumption (MAC) is well documented. From the World Health Organization recent report, impact of harm from alcohol consumption was 3.3 million deaths or 5.9 percent of all global deaths (WHO, 2014).

Yet, the benefits of MAC for better health and longer life expectancy compared with abstinence are advocated in numerous studies (Nova, Baccan, Zapatera and Marcos, 2012). However, the nature of alcohol, its role on human sufferings has generated disagreements in the scientific community. Analysis of the results of early studies advocating better health for moderate drinkers, reveal discrepancies regarding the influence …

Book Review: Being Mortal: Illness, Medicine And What Matters In The End, Sue Sutton

Patient Experience Journal

In her review of Being Mortal: Illness, Medicine and What Matters in the End written by Atul Gawande, MD, Sue Sutton shares both the insights of Dr. Gawande and their important perspectives for person-centered experience. She reinforces that in this day of increased focus on understanding patient’s expectations and patient-focused care, Dr. Gawande compels us to learn how to have the difficult conversations about what really matters. She closes the review with a compelling quote from the author, "I never expected that among the most meaningful experiences I’d have as a doctor— and, really, as a human being— would come …

Creating And Integrating A New Patient Experience Leadership Role: A Consultative Approach For Partnering With Executive And Clinical Leaders, Denise M. Kennedy

Patient Experience Journal

Many healthcare organizations are creating new leadership roles to add subject matter expertise and structure to their patient experience improvement efforts. The patient experience field is emerging, however, so there are many questions about this role’s function and how best to structure it in the organization for maximal effectiveness.

This article explores the benefits of a consultative approach for improving the patient experience. Previous research on management consulting and the integration of new roles in established organizations is briefly reviewed. Mayo Clinic Arizona’s (MCA) comprehensive, "7-prong" service model is revisited. Developed and implemented in 2008, the model is predicated on …

Health Information Technology: A Key Ingredient Of The Patient Experience, Matthew Werder

Patient Experience Journal

In this exploration to understand the linkages of health information technology (HIT) and patient experience, a comprehensive literature search was conducted using the key words, “information technology, HIT, patient experience, patient satisfaction, and technology”, on the MEDLINE, PubMed, and EMBASE databases resulting in over 1,000 citations. Eventually, 35 of the most relevant articles were reviewed and 11 identified as key references to include in beginning to explore the question, as the transformation of healthcare continues, how can technology enable a positive return on investment to a patients’ perception of their care in an organization and how can technology impact the …

Variations In The Patients’ Hospital Care Experience By States’ Strategy For Medicaid Expansion: 2009-2013, Edmund Becker, Kenton Johnston Phd, Jaeyong Bae, Jason M. Hockenberry Phd, Ariel C. Avgar, Sandra Liu, Ira Wilson, Arnold Milstein Md, Mph

Patient Experience Journal

Our investigation evaluates the extent of differences in the patient’s hospital experience due to variations among state strategies to adopt, or not adopt, their Medicaid plans to the 2010 ACA legislation. Using ten HCAHPS measures, we analyze patient hospital experience data for the 2009 - 2013 period for all 50 states and the District of Columbia grouped by those states that (1) did not expand, (2) expanded Medicaid through Section 1115 waivers, (3) expanders early, and (4) expanded Medicaid concurrent with the new ACA legislation.

Our findings reveal that those states that opted out of Medicaid expansion typically started with …

Building National Consensus On Experiences Of Care, Anna Baranski, Neil Churchill, Sophie Staniszewska

Patient Experience Journal

The NHS in England is measured against specific indicators that focus on ‘ensuring that people have a positive experience of care,’ yet there was a lack of organisational alignment across the new national health and care organisations regarding their understanding of what constitutes a positive experience of care. This represents a major barrier to achieving an aligned and consistent system-wide approach to improving experiences. To address the need to create national alignment in definition and approach, we worked with the Patient Experience Sub-group of the National Quality Board to develop consensus on how national organisations define ‘experience of care’ and …

Cancer Patients’ Experiences Of Error And Consequences During Diagnosis And Treatment, Henriette Lipczak, Liv H. Dørflinger, Christine Enevoldsen, Mette M. Vinter, Jeanne L. Knudsen

Patient Experience Journal

The study objective was to investigate patient experienced error during diagnosis and treatment of cancer. The design included a nationwide patient survey on quality and safety in Danish cancer care. Responses regarding patient experienced error were separately analyzed, quantitative responses using descriptive statistics and qualitative responses using systematic text analysis. Study participants included 6,720 adult patients with a first time diagnosis of cancer registered between May 1st and August 31st 2010. The patients received a questionnaire concerning their experiences of care received by general practitioners, specialist practitioners and at the hospital. A response rate of 65% was achieved. 10 – …

Patient Complaints As Predictors Of Patient Safety Incidents, Helen L. Kroening, Bronwyn Kerr, James Bruce, Iain Yardley

Patient Experience Journal

Patients remain an underused resource in efforts to improve quality and safety in healthcare, despite evidence that they can provide valuable insights into the care they receive. This study aimed to establish whether high-level patient safety incidents (HLIs) were predictable from preceding complaints, enabling complaints to be used to prevent HLIs. For this study complaints received from November 2011 through June 2012 and HLI incident reports from April through September 2012 were examined. Complaints and HLIs were categorised according to location or specialty and the themes they included. Data were analysed to look for correlations between number of complaints and …

Weighting Patient Satisfaction Factors To Inform Health Care Providers Of The Patient Experience In The Age Of Social Media Consumer Sentiment, Blaine Parrish, Amita N. Vyas, Grace Douglass

Patient Experience Journal

The researchers explored the possibility that patients would go beyond simple ranking and could give weight to previously validated and reliable patient satisfaction factors, while also describing their online habits related to the patient experience and health seeking information in order to inform medical providers on what patients say matters most when evaluating satisfaction with their provider. One thousand one hundred and sixty-four adults completed a 13- item web-based quantitative survey, developed by public health researchers, to weight patient satisfaction factors and describe online health seeking habits of patients across the United States. Proportional weights for each of the patient …

Patient Satisfaction Reported By In-Visit And After-Visit Surveys, Rukiya Wongus, Nicholas H. Schluterman, Sharon Feinstein, Nihkolle Mcgirt, Deborah R. Greenberg, David B. Schwartz

Patient Experience Journal

Patient experience measurement has become a basic requirement for every healthcare provider organization. Yet, when the timing and mode of survey administration are considered, there is skepticism about the usefulness of ‘after- visit’ patient experience surveys to measure satisfaction and identify opportunities to improve service or health care quality. The aim of this observational study was to compare patient satisfaction among those who rated the patient experience at the conclusion of their outpatient appointment while still in the office, to that among those who rated the patient experience up to one month after their outpatient appointment via a mailed survey. …

Considering Shared Power And Responsibility: Diabetic Patients’ Experience With The Pcmh Care Model, Olena Mazurenko Md, Phd, Sheila Bock Phd, Catherine Prato, Margarita Bondarenko

Patient Experience Journal

The patient-centered medical home (PCMH), an innovative primary care model that fosters a stronger, more personal patient-doctor relationship than traditional health care models, should be particularly well suited for the treatment of chronic conditions such as diabetes that require ongoing management by both patients and providers. Despite growing research on the effectiveness of PCMHs in diabetes care, relatively little attention has been given to diabetic patients’ experiences. This qualitative study examines diabetic patients’ experiences at one PCMH setting, using in-depth interviews to understand patients’ perspectives of the shared power and responsibility between patient and provider in their diabetes care. Our …