Health Policy Commons^™

Inclusión Cultural En Fonasa: Parto Aymara Como Un Estudio De Caso, Madison Singleton

Independent Study Project (ISP) Collection

Los primeros años de la década de 2000s sirven como un período legal transformador en Chile, debido al auge de los grupos de representación indígena y la introducción de la ley 20.584 que asegura un modelo de interculturalidad en los servicios de salud. El objetivo de esta investigación es comprender los factores que impactaron en la priorización de la inclusión cultural en el sistema público de salud (FONASA), utilizando el parto aymara en Arica como un estudio de caso. Esta investigación toma forma en un diseño de investigación cualitativa y exploratoria utilizando 5 entrevistas y 5 observaciones, así como las …

Medicina Tradicional En La Urbe: El Funcionamiento Del Sistema De Salud Mapuche En Santiago, Mariko Yatsuhashi

Independent Study Project (ISP) Collection

En Santiago, Chile, una ciudad con más de 5 millones de personas, el pueblo originario Mapuche ha logrado la reconstrucción de su sistema tradicional de salud para servir la comunidad urbana de la comunidad mapuche. Hoy en día, la mayoría de gente mapuche viven en ambientes urbanos debido a una migración masiva desde su territorio ancestral en el sur, que creó una población distinta de gente mapuche llamada warriache, o gente de la ciudad. Después de una expansión nacional de los derechos básicos de pueblos originarios en los años ‘90, el pueblo originario Mapuche, junto con otros pueblos originarios, podía …

Doj Withdraws Healthcare Antitrust Protections, Lance Plunkett Jd, Llm

The New York State Dental Journal

DOJ has withdrawn longstanding antitrust guidance that provided safe harbors for specific conduct in the healthcare marketplace.

Things That Make You Go Hmm: Myths And Misconceptions Within Cognitive-Behavioral Treatment Of Obsessive-Compulsive Disorder, Samuel D Spencer, Jordan T Stiede, Andrew D Wiese, Andrew G Guzick, Matti Cervin, Dean Mckay, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

The past four decades have yielded a robust body of evidence supporting the efficacy and effectiveness of cognitive-behavioral therapy (CBT) as a gold-standard treatment for obsessive-compulsive disorder (OCD) across the lifespan. Exposure and response prevention (E/RP) has been identified as a key component of this approach. Despite robust research support for CBT with E/RP, several myths and misconceptions continue to proliferate in both research and practice settings. Such myths and misconceptions are concerning, as they lack empirical basis, may hinder widespread dissemination and implementation of CBT for OCD, and run contrary to the practice of evidence-based psychological medicine. Focusing on …

Key Drivers Of Family-Level Utility Of Pediatric Genomic Sequencing: A Qualitative Analysis To Support Preference Research, Hadley Stevens Smith, Emily S Bonkowski, Raymond Belanger Deloge, Amanda M Gutierrez, Alva M Recinos, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Given that pediatric genomic sequencing (GS) may have implications for the health and well-being of both the child and family, a clearer understanding of the key drivers of the utility of GS from the family perspective is needed. The purpose of this study is to explore what is important to caregivers of pediatric patients regarding clinical GS, with a focus on family-level considerations. We conducted semi-structured interviews with caregivers (n = 41) of pediatric patients who had been recommended for or completed GS that explored the scope of factors caregivers considered when deciding whether to pursue GS for their child. …

International Society For Prenatal Diagnosis 2022 Debate 3-Fetal Genome Sequencing Should Be Offered To All Pregnant Patients, Ignatia B Van Den Veyver, Yuval Yaron, Zandra C Deans

Center for Medical Ethics and Health Policy Staff Publications

Prenatal trio exome sequencing (ES) has become integrated into the care for pregnant women when the fetus has structural anomalies. Details regarding optimizing indications for prenatal exome sequencing, its detection rates with different categories of fetal anomalies, and principles of interpretation of pathogenicity of sequence variants are still under investigation. However, there is now growing consensus about its benefits for finding the cause of fetal structural anomalies. What is not established, is whether exome or genome sequencing (GS) has a place in the care of all pregnant women. This report is a summary of the debate on this topic at …

Development And Pilot Testing Of Internet-Delivered, Family-Based Cognitive Behavioral Therapy For Anxiety And Obsessive-Compulsive Disorders In Autistic Youth, Andrew G Guzick, Sophie C Schneider, Amanda B Perozo Garcia, Minjee Kook, Rebecca L Greenberg, David Riddle, Morgan Mcneel, Servando Rodriguez-Barajas, Michelle Yang, Blake Upshaw, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Cognitive behavioral therapy adapted for autistic youth with anxiety and/or OCD has a strong evidence base, but few have access. A 12-week family-based, Internet-delivered cognitive behavioral therapy (iCBT) program for 7-15 year-old autistic youth with anxiety and/or OCD was developed as a potential method to address this problem. Quantitative and qualitative feedback from stakeholders (parents, youth, clinicians) was gathered on an initial draft of content before conducting a pilot trial. This feedback suggested high quality, engagement, usability, and informativeness of the material. Suggestions were incorporated into the treatment program that was tested in a pilot trial. Eight families were randomized …

Physician Workforce In The Mountain West, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

Using data from the Association of American Medical College’s State Physician Workforce Data Report, this fact sheet synthesizes Mountain West data on the numbers of active physicians and active physician demographics in Arizona, Colorado, Nevada, New Mexico, and Utah. This fact sheet focuses on active physicians in the Mountain West region by gender, race and ethnicity, as well as the number of students pursuing medical and premedical education.

Rural Working-Age Adults Report More Cost Barriers To Health Care, Erika C. Ziller Phd, Carly Milkowski Mph, Amanda Burgess Mppm, Mph

Access / Insurance

Using the 2019-2020 National Health Insurance Survey, researchers at the Maine Rural Health Research Center examined rural-urban differences in affordability of care and cost-saving strategies among working-age adults. Rural adults (18-64) were more likely than their urban counterparts to report problems paying, or being unable to pay, their medical bills. They were also more likely to delay or go without needed care because of the cost. Compared with urban adults, those in rural areas were more likely to engage in prescription drug cost-saving measures such as skipping doses, delaying refills, or taking less medication than prescribed. For all affordability measures, …

Congenital Lobar Overinflation, Dr Sudha Kiran Das Dr, Vikram Patil Dr

Radiology Teaching Files

1 year old girl with history of recurrent respiratory infections associated with wheeze.

Gender And Financial Implications Of Parental Leave Utilization At A Major Us Academic Institution, Maurgan Lee, Lucki Word, Mayra Shafique, Julie Crego, Leah Robinson Phd, Anil Aranha Phd, Beena Sood

Medical Student Research Symposium

Background and Purpose: In the United States, women on average are paid $0.83 for every dollar earned by male counterparts. Creating a family can promote heightened obligations for both parents, however, women tend to take on amplified responsibility associated with childrearing. Studies show females are more likely to utilize parental leave (PL) compared to men. Our study aims to evaluate the impact of PL usage on financial and earning potential based on gender.

Methods: Analysis of retrospective human resources data of WSU employees was conducted. Data parameters included: demographics, length, usage, and number of parental leaves. Data was analyzed using …

How Has The Opioid Overdose Crisis Affected Child Maltreatment In The U.S.?, Alexander Chapman

Population Health Research Brief Series

This brief summarizes results from a study examining the association between U.S. county-level opioid mortality rates and child maltreatment rates from 2007 to 2017. Places with higher opioid overdose mortality rates have higher rates of child maltreatment. Poverty makes this problem worse - where the proportion of families in poverty increases, the association between fatal opioid overdose rates and child maltreatment also increases. Findings suggest that intervening in opioid use by reducing poverty has the potential to markedly decrease the incidence of child maltreatment.

The Oxycontin® Reformulation In 2010 Increased States’ Food Insecurity Rates, Colleen Heflin, Xiaohan Sun

Population Health Research Brief Series

The massive surge in opioid misuse and overdose over the past three decades has led to major family, economic, and social disruptions in the United States. OxyContin® - a highly potent, extended-release opioid was among the most commonly-abused narcotics throughout the 2000s. After reformulating OxyContin® to make it more difficult to inhale or inject, many people with opioid use disorders switched to using street drugs. The reformulation had many other unanticipated consequences. This brief shows that states with higher initial OxyContin® misuse rates had an increase in food insecurity after OxyContin® reformulation. The authors argue that public policies must consider …

Federal Medication-Assisted Treatment Expansion Grants Do Not Reduce Homelessness, Andrew Sullivan, Changwe Park

Population Health Research Brief Series

Medication-assisted treatment (MAT) is an evidence-based intervention that, combined with counseling and behavioral therapies, can effectively treat opioid use disorders. However, MAT is underused due to multiple barriers. To increase access to MAT, the U.S. government awarded grants to local governments and nonprofit organizations to increase and retain the number of people receiving MAT. This brief examined differences in homelessness and employment outcomes between places that received a MAT grant and those that did not. They found that these grants did not reduce homelessness or unemployment rates in the places that received funding and concluded that their effectiveness may have …

How Has The Opioid Crisis Affected Health, Health Care Use, And Crime In The United States?, Johanna Catherine Maclean, Justine Mallatt, Christopher J. Ruhm, Kosali Simon

Population Health Research Brief Series

The U.S. opioid crisis is the deadliest drug crisis in the nation’s history and is not abating. This brief summarizes what is known about the relationships between opioid misuse, health, healthcare use, and crime. The authors show that the opioid crisis has led to worsening health, increased mortality, increased healthcare use, and modest increases in crime. In addition, the policies designed to curb opioid misuse and its associated harms have had only limited success.

Editorial: Assessing And Addressing Health Inequities And Disparities: The Role Of Health Informatics, Gulzar H. Shah, Anjum Khurshid, Joanne Chopak-Foss

Health Policy & Community Health: Faculty Publications

No abstract provided.

Expanded Child Tax Credit Payments Supported Families Raising Children With Disabilities, Allyson Baughman, Laura Brugger, Meg Comeau, Leah Hamilton, Candace Jarzombek, Caroline Parker, Stephen Roll

Social Policy Institute Research

The 2021 expanded Child Tax Credit (CTC) provided temporary enhancements to the existing CTC for the tax years 2021 and 2022. Under the expanded credit, families with children under the age of 18 were eligible to receive a credit of up to $3,000 per child ($3,600 for children under the age of 6).

In addition, half the credit was paid out on a monthly basis rather than as a one-time payment at tax time. This provision was designed to provide more immediate financial support to families with children during the COVID-19 pandemic. However, it also supported families who were at …

Hervs And Cancer-A Comprehensive Review Of The Relationship Of Human Endogenous Retroviruses And Human Cancers, Erik Stricker, Erin C Peckham-Gregory, Michael E Scheurer

Center for Medical Ethics and Health Policy Staff Publications

Genomic instability and genetic mutations can lead to exhibition of several cancer hallmarks in affected cells such as sustained proliferative signaling, evasion of growth suppression, activated invasion, deregulation of cellular energetics, and avoidance of immune destruction. Similar biological changes have been observed to be a result of pathogenic viruses and, in some cases, have been linked to virus-induced cancers. Human endogenous retroviruses (HERVs), once external pathogens, now occupy more than 8% of the human genome, representing the merge of genomic and external factors. In this review, we outline all reported effects of HERVs on cancer development and discuss the HERV …

How Have Researchers Defined Institutions, Politics, Organizations And Governance In Research Related To Epidemic And Pandemic Response? A Scoping Review To Map Current Concepts, Austin Wu, Shivangi Khanna, Shelly Keidar, Peter Berman, Laura Jane Brubacher

Faculty, Staff and Student Publications

In recent years, the literature on public health interventions and health outcomes in the context of epidemic and pandemic response has grown immensely. However, relatively few of these studies have situated their findings within the institutional, political, organizational and governmental (IPOG) context in which interventions and outcomes exist. This conceptual mapping scoping study synthesized the published literature on the impact of IPOG factors on epidemic and pandemic response and critically examined definitions and uses of the terms IPOG in this literature. This research involved a comprehensive search of four databases across the social, health and biomedical sciences as well as …

A Nationwide Study Of The “July Effect” Concerning Postpartum Hemorrhage And Its Risk Factors At Teaching Hospitals Across The United States, Zahra Shahin, Gulzar H. Shah, Bettye Apenteng, Kristie Cason Waterfield, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The International Classification of Diseases, Tenth Revision (ICD-10) from the American Academy of Professional Coders (AAPC) medical coding was used to identify PPH and other study variables. Multivariable logistic regression models were used to compare the adjusted odds of PPH risk in the first and second quarters of the academic year vs. …