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https://www.readbyqxmd.com/read/28930761/factors-associated-with-medical-school-graduates-intention-to-work-with-underserved-populations-policy-implications-for-advancing-workforce-diversity
#1
Andrea N Garcia, Tony Kuo, Lisa Arangua, Eliseo J Pérez-Stable
PURPOSE: Given projected U.S. physician shortages across all specialties that will likely impact underserved areas disproportionately, the authors sought to explore factors most correlated with medical school graduates' intention to work with underserved populations (IWUP). METHOD: Data from the 2010-2012 Association of American Medical Colleges Medical School Graduation Questionnaire (n = 40,846) were analyzed. Variables (demographics, career preference, debt burden, intention to enter loan forgiveness programs) were examined using chi-square tests and logistic regression models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#2
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28930714/vaccine-exemptions-and-the-church-state-problem
#3
Dena S Davis
All of the 50 states of the United States have laws governing childhood vaccinations; 48 allow for religious exemptions, while 19 also offer exemptions based on some sort of personal philosophy. Recent disease outbreaks have caused these states to reconsider philosophical exemptions. However, we cannot, consistent with the U.S. Constitution, give preference to religion by creating religious exemptions only. The Constitution requires states to put religious and nonreligious claims on equal footing. Given the ubiquity of nonreligious objections to vaccination, I conclude that the best response is to remove all exemptions, as two states have already done...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28929875/using-structured-incentives-to-increase-value-for-money-in-an-academic-health-sciences-centre
#4
Guy J Hébert, Connie Colasante, Renate G Ilse, Alan J Forster
As healthcare continues to consume more and more of provincial government spending, there is a continuing pressure to improve efficiency and cut overall costs. In this increasingly constrained healthcare system, value for money is a growing focus of discussions around accountability and system sustainability; healthcare leaders are required to find ways of measuring, enforcing, and reporting on that value. In 2014, our organization began implementing an innovative system of structured incentives, linking distribution of Ministry of Health and Long-Term Care academic physician funding to quality and performance goals...
July 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929731/stabilizing-individual-health-insurance-markets-with-subsidized-reinsurance
#5
Scott E Harrington
Subsidized reinsurance represents a potentially important tool to help stabilize individual health insurance markets. This brief describes alternative forms of subsidized reinsurance and the mechanisms by which they spread risk and reduce premiums. It summarizes specific state initiatives and Congressional proposals that include subsidized reinsurance. It compares approaches to each other and to more direct subsidies of individual market enrollment. For a given amount of funding, a particular program’s efficacy will depend on how it affects insurers' risk and the risk margins built into premiums, incentives for selecting or avoiding risks, incentives for coordinating and managing care, and the costs and complexity of administration...
September 2017: LDI Issue Brief
https://www.readbyqxmd.com/read/28929402/characteristics-of-laws-requiring-physicians-to-report-patient-information-for-public-health-surveillance-notable-patterns-from-a-nevada-case-study
#6
Maxim Gakh, Brian Labus, Brittany Walker
Laws across the globe require healthcare providers to disclose patient health information to public health entities for surveillance and intervention purposes. Physicians play a unique role in such mandatory reporting regimes. However, research reveals consistent under-reporting and points to limited knowledge of mandates, perceived burdens of reporting, misaligned incentives and penalties, and a lack of streamlined processes as significant reporting barriers. These barriers suggest that how legal mandates are structured may impact compliance; yet little research systematically examines their characteristics...
September 19, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28927321/do-current-and-former-cigarette-smokers-have-an-attentional-bias-for-e-cigarette-cues
#7
Kirsten Lochbuehler, E Paul Wileyto, Kathy Z Tang, Melissa Mercincavage, Joseph N Cappella, Andrew A Strasser
The similarity of e-cigarettes to tobacco cigarettes with regard to shape and usage raises the question of whether e-cigarette cues have the same incentive motivational properties as tobacco cigarette cues. The objective of the present study was to examine whether e-cigarette cues capture and hold smokers' and former smokers' attention and whether the attentional focus is associated with subsequent craving for tobacco cigarettes. It was also examined whether device type (cigalike or mod) moderated this relationship...
September 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28926499/sharing-clinical-notes-with-patients
#8
Catherine T Fant, Deborah S Adelman
Patient portals are access points to patient information, meeting Centers for Medicare and Medicaid Services incentives. Providing patients with access to clinical notes has garnered positive feedback with few concerns. This article addresses the latest literature on patient access to clinical notes and offers suggestions for NPs in their use.
October 18, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28926033/working-towards-consensus-the-need-for-coordinated-policies-to-assist-control-of-foot-and-mouth-disease-and-emerging-disease-threats-in-south-east-asia
#9
I W Patrick, S Sovann, S Socheat
Foot and mouth disease (FMD) is an important transboundary disease in South-East Asia. Its control has been a priority in the region for at least 20 years, with extensive institutional support and capacity-building being provided by the international community through the World Organisation for Animal Health. This paper describes the FMD control and eradication programme in the Mekong region (Myanmar, Thailand, the Lao People's Democratic Republic, Cambodia and Vietnam) of South-East Asia and evaluates the FMD control programme in one of the region's countries, namely Cambodia...
April 2017: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/28926030/the-allocation-of-resources-for-animal-health
#10
K S Howe
Economics is too important to be left to the experts. This paper is therefore mainly for animal health policy-makers who are not economists but want a better appreciation of how economics can contribute to resource allocation decisions. First, the methodology of economic analysis is outlined with the objective of dispelling criticisms of its simplifying assumption of rationality. Then, unusual in economics but more familiar to biological and veterinary scientists, the technical aspects of transforming resources into products are discussed...
April 2017: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/28926027/using-institutional-and-behavioural-economics-to-examine-animal-health-systems
#11
C A Wolf
Economics provides a framework for understanding management decisions and their policy implications for the animal health system. While the neoclassical economic model is useful for framing animal health decisions on the farm, some of its assumptions and prescriptive results may be unrealistic. Institutional and behavioural economics address some of these potential shortcomings by considering the role of information, psychology and social factors in decisions. Framing such decisions under contract theory allows us to consider asymmetric information between policy-makers and farmers...
April 2017: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/28926026/conceptual-models-underlying-economic-analysis-of-animal-health-and-welfare-with-the-inclusion-of-three-components-people-products-and-resources
#12
D A Hennessy
Infectious animal diseases can spill across farm boundaries, so effective management requires coordinated responses. Costs and benefits from the management of infectious diseases are such that those who make the decisions have weak incentives to act, the levels of goods and services produced from animal agriculture are probably smaller than is socially optimal and resources are likely wasted. This work provides an overview of the existing literature on conceptual economic models in animal disease management, paying particular attention to inadequate incentives to make the required biosecurity efforts...
April 2017: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/28926004/where-to-next-with-animal-health-in-latin-america-the-transition-from-endemic-to-disease-free-status
#13
H Rojas, J R Romero
The Latin American and Caribbean region (LAC) is a leading global producer and exporter of animal products. Its livestock production systems are diverse, ranging from large-scale commercial enterprises to family farms. Countries in this region have sought to improve their animal health status through both public and private efforts. Despite significant advances in eradicating such diseases as foot and mouth disease and classical swine fever, other animal health challenges remain; constraining exports, causing negative economic impacts and threatening food security...
April 2017: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/28925976/shiga-toxin-therapeutics-beyond-neutralization
#14
REVIEW
Gregory Hall, Shinichiro Kurosawa, Deborah J Stearns-Kurosawa
Ribotoxic Shiga toxins are the primary cause of hemolytic uremic syndrome (HUS) in patients infected with Shiga toxin-producing enterohemorrhagic Escherichia coli (STEC), a pathogen class responsible for epidemic outbreaks of gastrointestinal disease around the globe. HUS is a leading cause of pediatric renal failure in otherwise healthy children, resulting in a mortality rate of 10% and a chronic morbidity rate near 25%. There are currently no available therapeutics to prevent or treat HUS in STEC patients despite decades of work elucidating the mechanisms of Shiga toxicity in sensitive cells...
September 19, 2017: Toxins
https://www.readbyqxmd.com/read/28922907/organ-vouchers-and-barter-markets-saving-lives-reducing-suffering-and-trading-in-human-organs
#15
Mark J Cherry
The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: (1) What are the direct and indirect health care costs and benefits of such a voucher system in human organs? (2) Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? (3) Do vouchers contribute to the inappropriate commodification of human body parts? (4) Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges (e...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922903/banking-on-living-kidney-donors-a-new-way-to-facilitate-donation-without-compromising-on-ethical-values
#16
Dominique E Martin, Gabriel M Danovitch
Public surveys conducted in many countries report widespread willingness of individuals to donate a kidney while alive to a family member or close friend, yet thousands suffer and many die each year while waiting for a kidney transplant. Advocates of financial incentive programs or "regulated markets" in kidneys present the problem of the kidney shortage as one of insufficient public motivation to donate, arguing that incentives will increase the number of donors. Others believe the solutions lie-at least in part-in facilitating so-called "altruistic donation;" harnessing the willingness of relatives and friends to donate by addressing the many barriers which serve as disincentives to living donation...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922902/from-directed-donation-to-kidney-sale-does-the-argument-hold-up
#17
James Stacey Taylor
The UCLA Medical Center has initiated a "voucher program" under which a person who donated a kidney would receive a voucher that she could provide to someone of her choosing who could then use it to move to the top of the renal transplantation waiting list. If the use of such vouchers as incentives for donors is morally permissible, then cash payments for kidneys are also morally permissible. But, that argument faces five objections. First, there are some goods whose nature allows them to be exchanged for similar goods but renders them monetarily inalienable...
October 1, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28922385/metabolomics-analyses-identify-platelet-activating-factors-and-heme-breakdown-products-as-lassa-fever-biomarkers
#18
Trevor V Gale, Timothy M Horton, Donald S Grant, Robert F Garry
Lassa fever afflicts tens of thousands of people in West Africa annually. The rapid progression of patients from febrile illness to fulminant syndrome and death provides incentive for development of clinical prognostic markers that can guide case management. The small molecule profile of serum from febrile patients triaged to the Viral Hemorrhagic Fever Ward at Kenema Government Hospital in Sierra Leone was assessed using untargeted Ultra High Performance Liquid Chromatography Mass Spectrometry. Physiological dysregulation resulting from Lassa virus (LASV) infection occurs at the small molecule level...
September 18, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28921604/stress-testing-the-affect-misattribution-procedure-heterogeneous-control-of-affect-misattribution-procedure-effects-under-incentives
#19
Chad J Hazlett, Adam J Berinsky
The affect misattribution procedure (AMP) is widely used to measure sensitive attitudes towards classes of stimuli, by estimating the effect that affectively charged prime images have on subsequent judgements of neutral target images. We test its resistance to efforts to conceal one's attitudes, by replicating the standard AMP design while offering small incentives to conceal attitudes towards the prime images. We find that although the average AMP effect remains positive, it decreases significantly in magnitude...
September 16, 2017: British Journal of Social Psychology
https://www.readbyqxmd.com/read/28921477/out-of-pocket-expenditure-and-catastrophic-health-spending-on-maternal-care-in-public-and-private-health-centres-in-india-a-comparative-study-of-pre-and-post-national-health-mission-period
#20
Sanjay K Mohanty, Anshul Kastor
BACKGROUND: The National Health Mission (NHM), one of the largest publicly funded maternal health programs worldwide was initiated in 2005 to reduce maternal, neo-natal and infant mortality and out-of-pocket expenditure (OOPE) on maternal care in India. Though evidence suggests improvement in maternal and child health, little is known on the change in OOPE and catastrophic health spending (CHS) since the launch of NHM. AIM: The aim of this paper is to provide a comprehensive estimate of OOPE and CHS on maternal care by public and private health providers in pre and post NHM periods...
September 18, 2017: Health Economics Review
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