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At least 307 records · Page 17Linked to original sources

PubMed1997

Political identification and perceptions of homelessness: attributed causality and attitudes on public policy.

The study investigated relationships between political orientation, causal perceptions of poverty, and attitudes toward government programs for the poor. The test sample of 200 women and 200 men were recruited from introductory psychology classes. In support of hypotheses based on previous research and Weiner's attribution-emotion-action theory, when compared with self-identified Democrats, self-identified Republicans (a) were significantly more inclined to attribute homelessness to internal vs external factors and (b) expressed significantly less favorable attitudes toward publically funded programs for the homeless. Sex differences were nonsignificant. Conceptual-empirical and methodological implications are discussed. Limitations on inferences from these data and directions for inquiry into the development of individual difference in political cognitions and public policy attitudes are considered.

Adult↗

PubMed2026

Swimming Upstream to Understand Congenital Anomalies of the Kidney and Urinary Tract: Zebrafish Models for Developmental Biology, Disease Mechanisms, and Functional Interpretation of Genetic Variation.

Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of pediatric chronic kidney disease (CKD) and comprise a heterogeneous group of developmental disorders with a substantial genetic contribution. Advances in next-generation sequencing have facilitated the identification of numerous candidate genes and rare variants associated with CAKUT. However, establishing causality and defining the biological functions of implicated genes remain major challenges. Functional validation is therefore essential to bridge the gap between gene discovery and mechanistic understanding, enabling the interpretation of genetic variation within the context of kidney development and disease. The zebrafish (Danio rerio) has emerged as a powerful in vivo model for studying renal development and interrogating the function of CAKUT-associated genes. Its utility stems from a high degree of genetic and developmental conservation with humans, conserved nephrogenic pathways, optical transparency during embryogenesis, and the relative ease of genetic manipulation. In this review, we provide an overview of zebrafish kidney development within the broader context of vertebrate nephrogenesis, highlighting the key genetic programs governing intermediate mesoderm specification, nephron segmentation, and pronephric morphogenesis. We then systematically examine CAKUT-associated genes that have been modeled in zebrafish, focusing on studies that have linked genetic perturbations to renal development and structural phenotypes. Finally, we discuss the strengths and limitations of zebrafish models for functional genomics and variant interpretation and consider their emerging role in bridging genetic discovery with mechanistic insights into CAKUT pathogenesis.

Animals↗

PubMed2004

From respect to rights to entitlement, blocked aspirations and suicidal behavior.

Dr. Bill Richards was a noted psychiatrist who worked with Alaska Native people for many years. This paper was taken from notes he used for a slide presentation at a conference. In it, he discussed the possible relationship between rapid social change and the increasing rates of suicide among northern people. He summarized the limitations in the existing suicide data, including its essentially descriptive nature, the short time periods of study, small numbers of observations and lack of complete health service use information which could help anticipate a suicidal event. Richards noted the importance of suicide as an indicator condition that could be used to link social survey and health information data bases. He closed his paper with a discussion of the transition from an era of "rights" to one of "entitlements," and described his observations of growing overt anger and hostile dependency upon government programs. Last, Richards related his concerns over the collection of health service use and epidemiological data associated with a suicidal event.

Alaska↗

PubMed2004

Academic nursing centers: the road from the past, the bridge to the future.

This article explores the development of academic nursing centers within an environment of evolving health policy and changing priorities and resources within nursing education during the past 3 decades. Etheredge's framework for this discussion identifies three health policy eras: the Age of Traditional Health Insurance (1965-1982); the Age of Regulated Prices for Government Programs (1983-1992); and the Age of Markets, Purchasing, and Managed Care (1993-2000). In this article, I suggest the current era is the Age of Uncertainty and Opportunity. Within each era, health policy changes are summarized, and changes in nursing education that influenced the evolution of academic nursing centers are identified. The uncertainty and opportunity of the current era is explored within the context of the Institute of Medicine (IOM) reports issued in 2000 and 2001. The new vision for clinical education in the health professions described in the 2001 report provides new opportunities for academic nursing centers. To take advantage of these opportunities, these centers must focus on quality issues as they continue to maintain a precarious balance between meeting the service needs of their clients and the academic needs of the nursing programs that own them. Centers that maintain this balance will be a bridge to the future for quality health professions education.

Community Health Centers↗

PubMed2006

Task transfer: another pressure for evolution of the medical profession.

Since the 1960s, Australian society and the medical profession have undergone enormous change. Our society has moved from a relatively homogeneous and conservative community, supported by limited government services, to one that is multicultural, focused on the individual and consumerism, and supported by extensive government programs, with health care a top public and political priority. A defining feature of contemporary society is its mistrust of institutions, professionals, public servants and politicians. The medical profession has changed from a cohesive entity, valuing generalism and with limited specialisation, to one splintered by ultra-specialisation and competing professional agendas. The medical workforce shortage and efforts to maintain the safety and quality of health services are putting acute pressure on the profession. Task transfer or role substitution of medical services is mooted as a potential solution to this pressure. This has the potential to drastically transform the profession. How task transfer will evolve and change medicine depends on the vision and leadership of the profession and a flexible pragmatism that safeguards quality and safety and places patient priorities above those of the profession.

Australia↗

PubMed2007

Nutrition-related disorders in Indigenous Australians: how things have changed.

Awareness of a serious Indigenous health problem in Australia did not emerge until the 1960s and 1970s. Much attention was focused at the time on poor pregnancy outcomes, high infant and young child mortality rates, and childhood malnutrition and impaired growth, often associated with high infectious disease burdens. Although that situation has improved somewhat, Indigenous infant and child health is still poor compared with that of other Australian children. Over recent decades, there has been a rapid rise among Indigenous people of nutrition-related "lifestyle" disorders such as obesity, cardiovascular disease, type 2 diabetes mellitus and chronic renal disease and their complications. This epidemic of disabling and often fatal chronic diseases in Indigenous Australians is also occurring in disadvantaged groups in many other countries. Control of this potentially disastrous epidemic must become a much higher priority in Indigenous health programs. Governments must commit to this task in cooperation and collaboration with Indigenous organisations and communities.

Australia↗

PubMedDate not supplied

Point/counterpoint: national health insurance.

In early November at the annual Board of Directors meeting of the Federation of American Health Systems, Chrysler Corporation's Walter B. Maher spoke for health care reform, stressing a need for a strong government solution. Humana Inc.'s George Atkins rose to the defense of the health care industry and countered Maher's ideas with his case for expansion of existing government programs coupled with a larger share of cost responsibility falling to employees.

Costs and Cost Analysis↗

PubMed1993

Retooling for community benefit.

Healthcare providers today must have a mission of service both to the individual and to the community. In 1990 the Hospital Community Benefit Standards Program (HCBSP) was launched as a demonstration project to begin the process of defining the elements that constitute community benefit. The HCBSP standards are that a hospital (1) evince a significant organizational and operational commitment to a community benefit process, (2) plan and implement projects and activities that address specific community public health needs, (3) cultivate and maintain relationships with other organizations to foster community benefit, and (4) foster an internal environment that encourages everyone in the organization to participate in community benefit programs. The following elements are important to an effective community benefit program: Governing board involvement CEO understanding and commitment A key senior manager to coordinate An explicit commitment of human and financial resources An epidemiologic data base describing a defined community or population A mechanism for bringing together people in the organization interested in community benefit A mechanism for facilitating dialogue between hospital leaders and representatives from the community A method of linking community benefit processes to outcomes

Chief Executive Officers, Hospital↗

PubMedDate not supplied

Pharmaceuticals in Australia: priorities in a teaching hospital.

In spite of rigorous government programs for control of the pricing and dissemination of pharmaceutical products in Australia, the list of new drugs continues to grow and prices to increase. To regain control over drug usage at Royal Adelaide Hospital, the Hospital Drug Committee developed a rating method that judged drugs on the basis of their cost-benefit to patients. The ratio of a total quality score to a total cost score becomes the determinant of additions to the hospital formulary. The background for the Australian approach to pharmaceuticals and the new evaluation technique at the teaching hospital are described in this report.

Australia↗

PubMed1995

PPOs diversify, accept some risk to ensure survival.

A Modern Healthcare survey of provider-owned managed-care organizations finds PPOs outpacing HMOs. PPOs are proving experts who predicted their decline wrong. They're diversifying, accepting risk, and lobbying for inclusion in government programs.

Community Participation↗

PubMed1997

Provider specialty choice among Medicare beneficiaries treated for psychiatric disorders.

This study estimates the probability of mental health specialist use among elderly and disabled Medicare beneficiaries treated for a primary psychiatric diagnosis, based on the 1991 Medicare Current Beneficiary Survey (MCBS) and physician claims. Beneficiaries with psychotic and affective disorders or multiple psychiatric diagnoses had a higher probability of specialty use, as did beneficiaries in counties with greater psychiatrist density. Elderly in counties with greater general practitioner density and disabled in counties with greater psychologist density were less likely to see a specialist, suggesting possible provider substitution. Government programs to recruit and retain mental health professionals in underserved areas may change provider specialty choices among Medicare beneficiaries treated for psychiatric disorders.

Aged↗

PubMedDate not supplied

Consumer-centered vs. job-centered health insurance.

Most employees and their dependents in the United States have health insurance provided by the employer or labor-management health and welfare fund. In this system, employees and their families lose their health insurance when the breadwinner loses his or her job while, at the same time, a Medicaid beneficiary can lose Medicaid eligibility by getting a job, even a poorly paid one. Most health insurance pays the doctor on the basis of fee-for-service and the hospital on the basis of cost-reimbursement, rewarding both with more revenue for providing more and more costly services. The insured employee has little or no incentive to seek out a less costly provider. There are no rewards for economy in this system. It should be little wonder, then, that health care costs are out of control. There are alternative financing and delivery systems with built-in incentives to use resources economically, but, the author of this article asserts, their ability to compete and attract patients with their superior economic efficiency is blocked by many laws and government programs. The author believes that the most effective and acceptable way to get costs under control, and at the same time achieve universal coverage, would be through a system of fair economic competition. He discusses his Consumer Choice Health Plan proposal and describes how one of the main barriers to competition is today's system of job-linked health insurance.

Commerce↗

PubMed1987

Community-based national health proposals, 1914-1917 and 1974-1977.

Over the years health activists sought radical reform of the health system they knew. The recurring vision was a government program open to all people, free of profit incentives, accountable to the users and with an emphasis on prevention by cooperative groups of practitioners working in harmony. Some health activists believed such a system was not possible without radical societal change. More commonly, as is the case with these two proposals, the existing economic and political order is assumed.

History, 20th Century↗

PubMed1999

Organizing hospital laboratories for efficiency and quality.

Decreasing revenues from price controls in government programs and discounted fees and below-cost capitation contracts from private insurance companies have made cost control the main factor in laboratory decisions. Consolidation, which is already extensive in Independent Laboratories, is now coming to hospital laboratories. An Integrated Regional Laboratory is an effective way to adapt to these changes. This structure makes possible both cost savings and improved service quality, but significant time, work, and investment are required to establish one.

Cost Savings↗

PubMed2001

Medicare. Can its benefits be sustained as cost of coverage grows?

By many measures Medicare is one of the most successful government programs ever instituted, and its benefit to the health of older citizens is unquestioned. Yet it is not without chronic problems and challenges, including the cost of administering the program, limited insurance coverage for certain services and conditions, lack of standardization, and fraud. Moreover, new challenges arise as societal circumstances change and political demands fluctuate. Chief among the concerns are the imminent influx of baby boomers into the system and the debate over expanding the limited scope of Medicare coverage.

Aged↗

PubMed2001

Fortification challenges and needs.

Experience in many parts of the developing world has shown that food fortification offers a cost-effective and sustainable solution to the problem of micronutrient malnutrition. Building on the advances in science and technology and backed by studies on the economic benefits of fortification programs, governments and industry are beginning to respond positively to the call of nutrition advocates to adopt fortification as a long-term strategy. On the other hand, formidable challenges still remain in many countries in Asia, constraining the widespread adoption of this strategy. The science and technology community needs to provide adequate scientific and technological information as basis for planning and decision making. The government faces the challenge of providing the enabling environment for all stakeholders to cooperate in the fortification effort. Industry faces the challenge of adapting its production system to the requirements of fortification in order that they can contribute to social objectives while pursuing their economic objectives. The international and bilateral aid agencies need to seek tried and innovative ways to support the multiple players of food fortification, as these players in turn face the challenges that confront them.

Asia↗

PubMed2002

Business associates: a HIPAA compliance challenge.

The final rule implementing the privacy standards mandated by the Health Insurance Portability and Accountability Act (HIPAA) of 1996 imposes substantial requirements on covered entities with respect to their business associates--those parties providing certain services to, or on behalf of, the covered entities. A covered entity must develop a contract with each of its business associates that sets forth the conditions under which the business associate may use or disclose the protected health information it receives from the covered entity. The contract also must delineate the covered entity's obligations with respect to the business associate, which include ensuring individuals' access to their protected health information and taking certain steps to respond to a breach of the privacy standards by the business associate. The business associate requirements do not apply to the covered entity's workforce, disclosures to providers for treatment purposes, certain financial transactions, certain jointly administered government programs, and, provided that certain other restrictions are met, disclosures made by group health plans to plan sponsors.

Commerce↗

PubMedDate not supplied

Tunisia WFS [World Fertility Survey].

Tunisia, the smallest North African country in size, has recently published the results of its part of the World Fertility Survey (WFS) taken in 1978. About 1/2 of this Missouri-sized country consists of arid and semiarid desert, with well-irrigated fertile areas in the north. The country, which has a population of about 7 million, must import large quantities of food each year and also suffers from widespread unemployment. In 1964, the government was among the earliest to announce a policy to reduce the rate of population growth and Tunisia now has 1 of the lowest birth rates of the African continent (33 births/1000 population) although it is still moderately high. Part of the reason for the birth rate decline has been a risking age at marriage; the legal minimum was fixed at 17 years for women and 20 for men by a 1964 law. The Tunisia WFS indicates that, of women 20-24 in 1978, 56% had not yet married, a large increase from the 27% of 1966. The mean age at 1st marriage for females was 24 in 1978, very high by less developed country standards. It may be that the fertility-lowering impetus from rising age at marriage has been spent (this measure cannot rise indefinitely): Tunisia's total fertility rate (TFR), the average number of children/woman, dropped from 7.1 children in 1966 to 5.7 in 1976, but the decrease has tapered off somewhat since. The TFR appears to have dropped to 5.2 as of 1981. When asked how many children they would like to have, the women surveyed gave 4.2 children, on average, as their "ideal" number. This number is, of course, considerably above that needed to ultimately stop population growth (about 2.1-2.5 children/woman). Contraceptive use in Tunisia is quite high by developing country standards; much of this is due to the efficient network of government-sponsored clinics. About 44% of the women exposed to pregnancy were practicing an efficient form of family planning with the pill or sterilization accounting for most of that number (22 and 20% respectively). Nonetheless, traditions which still favor 3-5 children and some possible loss of momentum from a rising age at marriage may cause future fertility declines to be slower than in the recent past. Tunisia does present an interesting case of a country maintaining a government program to reduce population growth as an overall part of the country's development efforts.

Africa↗