Health Policy Commons^™

Whistleblowing As An Anti-Corruption Strategy In Health And Pharmaceutical Organizations: A Scoping Review Protocol., Taryn Vian, Brianna Agnew Mph, Keith Mcinnes Jr

Nursing and Health Professions Faculty Research and Publications

Background

Whistleblowing can bring suspected wrongdoing to the attention of someone who is in the position to rectify the problem. Whistleblowing research can help improve effectiveness of anti-corruption efforts in the health sector.

Objective

The objective of this scoping review is to understand the extent and type of evidence on whistleblowing as an anti-corruption strategy in health and pharmaceutical organizations in low- and middle-income countries (LMICs).

Methods

This scoping review searched the PubMed, Scopus, and EMBASE databases from 2005 to 2020, limited to English language. We also searched websites of multilateral agencies or international non-governmental organizations for policy documents, guidance …

Uthealth Quality Symposium 2022 Abstracts-2

Teaching in Clinics

No abstract

Impact Of A Multifaceted Intervention On Physicians' Knowledge, Attitudes And Practices In Relation To Pharmaceutical Incentivisation: Protocol For A Randomised Control Trial, Muhammad Naveed Noor, Mishal Khan, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Sabeen Sharif Khan, Iqbal Azam, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Introduction: In settings where the private sector constitutes a larger part of the health system, profit-gathering can take primacy over patients' well-being. In their interactions with pharmaceutical companies, private general practitioners (GPs) can experience the conflict of interest (COI), a situation whereby the impartiality of GPs' professional decision making may be influenced by secondary interests such as financial gains from prescribing specific pharmaceutical brands.
Methods and analysis: This study is a randomised controlled trial to assess the impact of a multifaceted intervention on GPs' medical practice. The study sample consists of 419 registered GPs who own/work in private clinics and …

Proteogenomic Markers Of Chemotherapy Resistance And Response In Triple-Negative Breast Cancer, Meenakshi Anurag, Eric J Jaehnig, Karsten Krug, Jonathan T Lei, Erik J Bergstrom, Beom-Jun Kim, Tanmayi D Vashist, Anh Minh Tran Huynh, Yongchao Dou, Xuxu Gou, Chen Huang, Zhiao Shi, Bo Wen, Viktoriya Korchina, Richard A Gibbs, Donna M Muzny, Harshavardhan Doddapaneni, Lacey E Dobrolecki, Henry Rodriguez, Ana I Robles, Tara Hiltke, Michael T Lewis, Julie R Nangia, Maryam Nemati Shafaee, Shunqiang Li, Ian S Hagemann, Jeremy Hoog, Bora Lim, C Kent Osborne, D R Mani, Michael A Gillette, Bing Zhang, Gloria V Echeverria, George Miles, Mothaffar F Rimawi, Steven A Carr, Foluso O Ademuyiwa, Shankha Satpathy, Matthew J Ellis

Center for Medical Ethics and Health Policy Staff Publications

Microscaled proteogenomics was deployed to probe the molecular basis for differential response to neoadjuvant carboplatin and docetaxel combination chemotherapy for triple-negative breast cancer (TNBC). Proteomic analyses of pretreatment patient biopsies uniquely revealed metabolic pathways, including oxidative phosphorylation, adipogenesis, and fatty acid metabolism, that were associated with resistance. Both proteomics and transcriptomics revealed that sensitivity was marked by elevation of DNA repair, E2F targets, G2-M checkpoint, interferon-gamma signaling, and immune-checkpoint components. Proteogenomic analyses of somatic copy-number aberrations identified a resistance-associated 19q13.31-33 deletion where LIG1, POLD1, and XRCC1 are located. In orthogonal datasets, LIG1 (DNA ligase I) gene deletion and/or low mRNA …

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; …

The Erasure Of Sex: The Global Capture Of Policies On Sex By Gender Identity Activists And The Effects On The Rights Of Women And Girls, Feminists From Europe, Asia, North America, Latin America, And Africa

Dignity: A Journal of Analysis of Exploitation and Violence

This article reviews the goals, history, and impact of the new gender identity politics. Based on the Yogyakarta Principles, these new ideas and policies will profoundly affect the rights of women and girls worldwide. The Principles are a document from an international meeting about sexual orientation and gender identity in 2006. In 2017, the document was updated to the Yogyakarta Principles Plus 10. The Principles recommend legal changes by states worldwide, resulting in the erasure of sex as a legal and cultural category. These principles have been widely used to lobby for legal changes resulting in profound structural …

Incidence Trends Of Kaposi Sarcoma Among Young Non-Hispanic Black Men By Us Regions, 2001-2018, Ryan Suk, Donna L White, Sheena Knights, Ank Nijhawan, Ashish A Deshmukh, Elizabeth Y Chiao

Center for Medical Ethics and Health Policy Staff Publications

Despite the overall national decline in Kaposi sarcoma (KS) incidence in the United States among persons living with HIV, previous studies suggest there might be specific subgroups of the US population that are associated with higher KS incidence rates than others. Using the 2001-2018 National Program of Cancer Registries and Surveillance, Epidemiology, and End Results Program database, we assessed KS incidence trends among young men aged 20-34 years by race and ethnicity and geographic region. Statistical significance is 2-sided. The KS incidence rate increased nationally by 1.5% per year in non-Hispanic Black men, whereas the rate decreased statistically significantly by …

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 …

Challenges And Lessons Learned From The Rapid Operationalization Of A Prospective Cohort To Study The Natural History And Neurodevelopmental Outcomes Of Postnatal Zika Virus Infection Among Infants And Children In Rural Guatemala, Alejandra Paniagua-Avila, Daniel Olson, Amy Connery, D Mirella Calvimontes, Guillermo A Bolanos, Molly M Lamb, Desiree Bauer, Aida Ralda, Neudy Rojop, Eduardo Barrios, Andrea Chacon, Melissa Gomez, Paola Arroyave, Sara Hernandez, Maria Alejandra Martinez, Saskia Bunge-Montes, Alison Colbert, Kareen Arias, Garret Brazeale, Andrea Holliday, Kay M Tomashek, Hana M El Sahly, Wendy Keitel, Flor M Munoz, Edwin J Asturias

Center for Medical Ethics and Health Policy Staff Publications

During the course of the 2015-2017 outbreak of Zika virus (ZIKV) in the Americas, the emerging virus was recognized as a congenital infection that could damage the developing brain. As the Latin American ZIKV outbreak advanced, the scientific and public health community questioned if this newly recognized neurotropic flavivirus could affect the developing brain of infants and young children infected after birth. We report here the study design, methods and the challenges and lessons learned from the rapid operationalization of a prospective natural history cohort study aimed at evaluating the potential neurological and neurodevelopmental effects of postnatal ZIKV infection in …

Medicaid Expansion And Veterans' Reliance On The Va For Depression Care, Daniel Liaou, Patrick N O'Mahen, Laura A Petersen

Center for Medical Ethics and Health Policy Staff Publications

Background: In 2001, before the Affordable Care Act (ACA), some states expanded Medicaid coverage to include an array of mental health services, changing veterans' reliance on US Department of Veterans Affairs (VA) services.

Methods: Using Medicaid and VA administrative data from 1999 to 2006, we used a difference-in-difference design to calculate shifts in veterans' reliance on the VA for depression care in New York and Arizona after the 2 states expanded Medicaid coverage to adults in 2001. Demographically matched, neighbor states Pennsylvania and New Mexico/Nevada were used as paired comparisons, respectively. Fractional logit was used to capture the distribution of …

Safety Analysis Of High-Dose Methotrexate In Pediatric Non-Hodgkin Lymphomas, M Brooke Bernhardt, Austin L Brown, Austyn T Grim, Michael E Scheurer, Nader Kim El-Mallawany, Nmazuo W Ozuah

Center for Medical Ethics and Health Policy Staff Publications

High-dose methotrexate (HD-MTX) with rigorous supportive care is essential to the treatment of pediatric non-Hodgkin lymphomas (NHL). We describe the safety and tolerability of HD-MTX in patients with NHL treated at our center. In our cohort of 46 patients, the majority had at least one course of delayed clearance and/or creatinine elevation. Additionally, more than one-third of patients experienced an episode of grade ≥3 mucositis. Creatinine elevations and delayed clearance were independently associated with subsequent grade ≥3 mucositis. We advocate for greater availability of methotrexate monitoring to allow dose escalation of this essential modality around the world.

Two Specialists, Two Recommendations: Discordance Between Urologists' & Radiation Oncologists' Prostate Cancer Treatment Recommendations, Rebecca K Delaney, Brittany L Sisco-Taylor, Xuechen Wang, Karen Scherr, Peter A Ubel, Benjamin Haaland, Valerie C Kahn, Daniel Hamstra, John T Wei, Farrah Madanay, J Kelly Davis, Taylor U Greeno, Angela Fagerlin

Center for Medical Ethics and Health Policy Staff Publications

Objective: To examine the treatment recommendation patterns among urologists and radiation oncologists, the level of concordance or discordance between physician recommendations, and the association between physician recommendations and the treatment that patients received.

Method: The study was a secondary analysis of data from a randomized clinical trial conducted November 2010 to April 2014 (NCT02053389). Eligible participants were patients from the trial who saw both specialists. The primary outcome was physician recommendations that were scored using an adapted version of the validated PhyReCS coding system. Secondary outcomes included concordance between physician recommendations and the treatment patients received.

Results: Participants …

Perceptions Of Various Treatment Approaches For Adults And Children With Misophonia, Eleanor E A Smith, Andrew G Guzick, Isabel A Draper, Jane Clinger, Sophie C Schneider, Wayne K Goodman, Jennifer J Brout, Marjin Lijffijt, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Objective: Misophonia is a complex disorder characterized by a heightened reaction to certain sounds and associated stimuli. While there is no uniformly accepted treatment to date, different intervention approaches are being investigated. Individual's perceptions of different misophonia treatment methods may affect compliance and satisfaction with treatment options. We sought to gather data on patient perceptions of currently available misophonia treatments.

Methods: Using an online survey, we collected data about treatment preferences, treatment usage, and diagnosis history from parents of children with misophonia (N = 141) and adults with misophonia (N = 252).

Results: Most respondents were not satisfied with misophonia …

Extracorporeal Membrane Oxygenation Outcomes In Children With Preexisting Neurologic Disorders Or Neurofunctional Disability, Siddhartha A Dante, Megan K Carroll, Derek K Ng, Ankur Patel, Philip C Spinella, Marie E Steiner, Laura L Loftis, Melania M Bembea

Center for Medical Ethics and Health Policy Staff Publications

Objective: Patient selection for pediatric extracorporeal membrane oxygenation (ECMO) support has broadened over the years to include children with pre-existing neurologic morbidities. We aimed to determine the prevalence and nature of pre-ECMO neurologic disorders or disability and investigate the association between pre-ECMO neurologic disorders or disability and mortality and unfavorable neurologic outcome.

Design: Multicenter retrospective observational cohort study.

Setting: Eight hospitals reporting to the Pediatric ECMO Outcomes Registry between October 2011 and June 2019.

Patients: Children younger than 18 years supported with venoarterial or venovenous ECMO.

Interventions: The primary exposure was presence of pre-ECMO neurologic disorders or moderate-to-severe disability, defined …

Primary Outcomes For Adults Receiving The Unified Protocol After Hurricane Harvey In An Integrated Healthcare Setting, Saira A Weinzimmer, Amy R Goetz, Andrew G Guzick, Lynn M Hana, Sandra L Cepeda, Sophie C Schneider, Sarah M Kennedy, Gifty N Amos Nwankwo, Catherine C Christian, Ashley M Shaw, Alison Salloum, Asim A Shah, Wayne K Goodman, Jill Ehrenreich-May, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated efficacy for treating anxiety and depression. However, there are limited effectiveness data when conducted in real-world settings with diverse populations, including those with trauma. We evaluated treatment outcomes in a naturalistic, community setting among 279 adults who received UP following Hurricane Harvey. We examined change in overall clinical severity, depression and anxiety symptoms, functional impairment, and baseline outcome predictors (i.e., demographic characteristics, impact from Hurricane Harvey, co-occurrence of depression and anxiety symptoms). Global clinical severity, depression and anxiety symptoms, and functional impairment decreased by end-of-treatment. Participants experienced global …

A Multinational Delphi Consensus To End The Covid-19 Public Health Threat, Jeffrey V Lazarus, Diana Romero, Christopher J Kopka, Salim Abdool Karim, Laith J Abu-Raddad, Gisele Almeida, Ricardo Baptista-Leite, Joshua A Barocas, Mauricio L Barreto, Yaneer Bar-Yam, Quique Bassat, Carolina Batista, Morgan Bazilian, Shu-Ti Chiou, Carlos Del Rio, Gregory J Dore, George F Gao, Lawrence O Gostin, Margaret Hellard, Jose L Jimenez, Gagandeep Kang, Nancy Lee, Mojca Matičič, Martin Mckee, Sabin Nsanzimana, Miquel Oliu-Barton, Bary Pradelski, Oksana Pyzik, Kenneth Rabin, Sunil Raina, Sabina Faiz Rashid, Magdalena Rathe, Rocio Saenz, Sudhvir Singh, Malene Trock-Hempler, Sonia Villapol, Peiling Yap, Agnes Binagwaho, Adeeba Kamarulzaman, Ayman El-Mohandes

Faculty, Staff and Students Publications

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and …

The Risks Of Birth Defects And Childhood Cancer With Conception By Assisted Reproductive Technology, Barbara Luke, Morton B Brown, Ethan Wantman, Maria J Schymura, Marilyn L Browne, Sarah C Fisher, Nina E Forestieri, Chandrika Rao, Hazel B Nichols, Mahsa M Yazdy, Susan T Gershman, Caitlin R Sacha, Melanie Williams, Mary K Ethen, Mark A Canfield, Kevin J Doody, Michael L Eisenberg, Valerie L Baker, Carrie Williams, Alastair G Sutcliffe, Melissa A Richard, Philip J Lupo

Center for Medical Ethics and Health Policy Staff Publications

Study question: Is there an association between fertility status, method of conception and the risks of birth defects and childhood cancer?

Summary answer: The risk of childhood cancer had two independent components: (i) method of conception and (ii) presence, type and number of birth defects.

What is known already: The rarity of the co-occurrence of birth defects, cancer and ART makes studying their association challenging. Prior studies have indicated that infertility and ART are associated with an increased risk of birth defects or cancer but have been limited by small sample size and inadequate statistical power, failure to adjust for …

The Pandemic : Impact On Imo Member State Audit On The Pacific Island Member States, Shaleen Lata

World Maritime University Dissertations

No abstract provided.

Uthealth Quality Symposium 2022 Abstracts

Teaching in Clinics

No abstract

Characteristics Of Academic Anesthesiologist’S Elected To An Institutional Academy Of Master Educators, Evan G. Pivalizza, Sara Guzman-Reyes, Christopher Stephens, Rhashedah A. Ekeoduru, Omonele O. Nwokolo, Katherine C. Normand, Srikanth Sridhar, Travis H. Markham, Johanna B. Dehaan, George Williams, Gary C. Rosenfeld

Teaching in Clinics

Background. The educational experience and success of academic anesthesiologists may be elusive to quantify. We wished to examine the characteristics of a cohort of anesthesiology faculty who were inducted into a medical school master educator academy over the last decade.

Methods. After IRB approval with waiver of consent, all 10 anesthesiology faculty inductees into the academy supplied relevant data for their accomplishments at the time of induction in multiple educational domains, including teaching and assessment, mentoring and advising, evidence of scholarship and production of enduring materials, and educational leadership. These were deidentified and analyzed.

Results. The cohort had evidence of …