Health professionals' perceptions of maggot debridement therapy

2021 ◽  
Vol 30 (Sup9a) ◽  
pp. VIIi-VIIxi
Author(s):  
Carmen Pajarillo ◽  
Ronald A Sherman ◽  
Robert Sheridan ◽  
Lewis E Kazis
Keyword(s):  
Wound Healing ◽  
Qualitative Analysis ◽  
Health Professionals ◽  
Insurance Coverage ◽  
Maggot Debridement Therapy ◽  
Insurance Reimbursement ◽  
Tissue Removal ◽  
The Us ◽  
Dead Tissue ◽  
Theory Framework

Background: Maggot debridement therapy (MDT), or the use of maggots in dead tissue removal, has been shown to be beneficial in wound healing. Yet MDT in the US is often only used once conventional debridement methods have failed. Method: In this study, nine health professionals, experienced in MDT, were interviewed in order to identify and analyse the perceived societal barriers to MDT acceptance and usage in the US. Results: Through qualitative analysis, using the grounded theory framework, this study found that among those interviewed, insurance reimbursement restrictions and stigmatisation of medicinal maggots were the factors driving resistance to MDT use. Conclusion: Specifically, the ‘yuck’ factor and the perception of MDT as an ‘ancient’ modality contributed towards MDT stigma; in addition, lack of outpatient insurance coverage deterred MDT use. These findings provide useful information regarding the perceptual and systemic barriers that prevent greater acceptance of MDT. Ultimately, these barriers must be understood if we are to facilitate MDT implementation and improve MDT usage in the future.

La evaluación del interprofesionalismo en la educación basada en simulación

2019 ◽  
Vol 62 (0) ◽  
pp. 56-63
Author(s):  
Laura Silvia Hernández Gutiérrez ◽  
Angélica García-Gómez ◽  
Argimira Vianey Barona Nuñez ◽  
Erick López Léon
Keyword(s):  
Health Professionals ◽  
Interprofessional Education ◽  
Collaborative Work ◽  
Educational Process ◽  
Educational Institutions ◽  
Controlled Environment ◽  
Study Group ◽  
The Us ◽  
Improvement Strategies

The education based on simulation is an educationalstrategy where students learn from their errors, developing skills, knowledge, competences,etc. in a controlled environment. During the process of teaching by simulation, it is necessaryto execute various types of assessments (diagnostic, summative, formative) in order tomake adjustments or changes in the educational process of the students, therefore identifying areas of opportunity for improvement. With the simulation, different processes can be taught, like interprofessionalism and collaborative work. Nowadays, there is a major concern for added safety and the quality of care for the patients and their families. Therefore, a WHO study group determined the basic interprofessional competences, and has been given the task of disseminating and promoting interprofessional education. Some educational institutions in the US, Canada and Europe have integrated interprofessional and collaborative work in simulation practices. All the activity by simulation must be evaluated in order to provide feedback to the participants and establish improvement strategies. The assessment of the interprofessional work focuses on the evaluation of common skills and competencies among various health professionals.

scholarly journals Regulating health professional scopes of practice: comparing institutional arrangements and approaches in the US, Canada, Australia and the UK

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kathleen Leslie ◽  
Jean Moore ◽  
Chris Robertson ◽  
Douglas Bilton ◽  
Kristine Hirschkorn ◽  
...  
Keyword(s):  
Health Professional ◽  
Health Professionals ◽  
Swot Analysis ◽  
Institutional Arrangements ◽  
Scope Of Practice ◽  
Comparative Case Study ◽  
Specific Reference ◽  
The Public ◽  
The Us ◽  
The Uk

Abstract Background Fundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals. Methods Using a comparative case study approach and similar systems policy analysis design, we present and discuss four different regulatory approaches from the US, Canada, Australia and the UK. For each case, we highlight the jurisdictional differences in how these countries regulate health professional scopes of practice in the interest of the public. Our comparative Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis is based on archival research carried out by the authors wherein we describe the evolution of the institutional arrangements for form of regulatory approach, with specific reference to scope of practice. Results/conclusions Our comparative examination finds that the different regulatory approaches in these countries have emerged in response to similar challenges. In some cases, ‘tasks’ or ‘activities’ are the basis of regulation, whereas in other contexts protected ‘titles’ are regulated, and in some cases both. From our results and the jurisdiction-specific SWOT analyses, we have conceptualized a synthesized table of leading practices related to regulating scopes of practice mapped to specific regulatory principles. We discuss the implications for how these different approaches achieve positive outcomes for the public, but also for health professionals and the system more broadly in terms of workforce optimization.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

Did Medicaid Expansion Mitigate Disparities in Post-mastectomy Reconstruction Rates?

2022 ◽  
pp. 000313482110604
Author(s):  
Alison R. Goldenberg ◽  
Lauren M. Willcox ◽  
Daria M. Abolghasemi ◽  
Renjian Jiang ◽  
Zheng Z. Wei ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Insurance Coverage ◽  
Complex Problem ◽  
Cancer Disparities ◽  
Multivariate Model ◽  
Medicaid Expansion ◽  
The Us ◽  
Caucasian Women ◽  
Breast Cancer Disparities ◽  
To Receive

Background Patient and socioeconomic factors both contribute to disparities in post-mastectomy reconstruction (PMR) rates. We sought to explore PMR patterns across the US and to determine if PMR rates were associated with Medicaid expansion. Methods The NCDB was used to identify women who underwent PMR between 2004-2016. The data was stratified by race, state Medicaid expansion status, and region. A multivariate model was fit to determine the association between Medicaid expansion and receipt of PMR. Results In comparison to Caucasian women receiving PMR in Medicaid expansion states, African American (AA) women in Medicaid expansion states were less likely to receive PMR (OR .96 [.92-1.00] P < .001). Patients in the Northeast (NE) had better PMR rates vs any other region in the US, for both Caucasian and AA women (Caucasian NE ref, Caucasian-South .80 [.77-.83] vs AA NE 1.11 [1.04-1.19], AA-South (.60 [.58-.63], P < .001). Interestingly, AA patients residing in the NE had the highest receipt of PMR 1.11 (1.04-1.19), even higher than their Caucasian counterparts residing in the same region (ref). Rural AA women had the lowest rates of PMR vs rural Caucasian women (.40 [.28-.58] vs .79 [.73-.85], P < .001]. Discussion Racial disparities in PMR rates persisted despite Medicaid expansion. When stratified by region, however, AA patients in the NE had higher rates of PMR than AA women in other regions. The largest disparities were seen in AA women in the rural US. Breast cancer disparities continue to be a complex problem that was not entirely mitigated by improved insurance coverage.

Recent perspectives of nanotechnology in burn wounds management: a review

2021 ◽  
Vol 30 (5) ◽  
pp. 350-370
Author(s):  
Ruan Na ◽  
Tian Wei
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Healing Process ◽  
Skin Barrier ◽  
Active Role ◽  
Qualitative Studies ◽  
Future Directions ◽  
Burn Wounds ◽  
The Us ◽  
Efficacious Drug

Objective: The burden of the management of problematic skin wounds characterised by a compromised skin barrier is growing rapidly. Almost six million patients are affected in the US alone, with an estimated market of $25 billion annually. There is an urgent requirement for efficient mechanism-based treatments and more efficacious drug delivery systems. Novel strategies are needed for faster healing by reducing infection, moisturising the wound, stimulating the healing mechanisms, speeding up wound closure and reducing scar formation. Methods: A systematic review of qualitative studies was conducted on the recent perspectives of nanotechnology in burn wounds management. Pubmed, Scopus, EMBASE, CINAHL and PsychINFO databases were all systematically searched. Authors independently rated the reporting of the qualitative studies included. A comprehensive literature search was conducted covering various resources up to 2018–2019. Traditional techniques aim to simply cover the wound without playing any active role in wound healing. However, nanotechnology-based solutions are being used to create multipurpose biomaterials, not only for regeneration and repair, but also for on-demand delivery of specific molecules. The chronic nature and associated complications of nonhealing wounds have led to the emergence of nanotechnology-based therapies that aim at facilitating the healing process and ultimately repairing the injured tissue. Conclusion: Nanotechnology-based therapy is in the forefront of next-generation therapy that is able to advance wound healing of hard-to-heal wounds. In this review, we will highlight the developed nanotechnology-based therapeutic agents and assess the viability and efficacy of each treatment. Herein we will explore the unmet needs and future directions of current technologies, while discussing promising strategies that can advance the wound-healing field

scholarly journals Healthcare Access and Utilization among Korean Americans: The Mediating Role of English Use and Proficiency

2016 ◽  
Vol 4 (1) ◽  
pp. 83 ◽  
Author(s):  
Jiang Li ◽  
Annette E. Maxwell ◽  
Beth A. Glenn ◽  
Alison K. Herrmann ◽  
L Cindy Chang ◽  
...  
Keyword(s):  
Health Insurance ◽  
Length Of Stay ◽  
Health Services ◽  
Insurance Coverage ◽  
Korean Americans ◽  
Usual Source Of Care ◽  
Mediating Role ◽  
Usual Source ◽  
The Us ◽  
Source Of Care

The literature suggests that Korean Americans underutilize health services. Cultural factors and language barriers appear to influence this pattern of low utilization but studies on the relationships among length of stay in the US, English use and proficiency, and utilization of health services among Korean Americans have yielded inconsistent results. This study examines whether English language use and proficiency plays a mediating role in the relationships between length of stay in the US and health insurance coverage, access to and use of care. Structural equation modeling was used for mediation analysis with multiple dependent variables among Korean Americans (N= 555) using baseline data from a large trial designed to increase Hepatitis B testing. The results show 36% of the total effect of proportion of lifetime in the US on having health insurance was significantly mediated by English use and proficiency (indirect effect =0.166, SE= 0.07, p<.05; direct effect=0.296, SE= 0.13, p<.05). Proportion of lifetime in the US was not associated with usual source of care and health service utilization. Instead, health care utilization was primarily driven by having health insurance and a usual source of care, further underscoring the importance of these factors. A focus on increasing English use and proficiency and insurance coverage among older, female, less educated Korean Americans has the potential to mitigate health disparities associated with reduced access to health services in this population.

scholarly journals International Approaches to Management of CFTR-Related Metabolic Syndrome/Cystic Fibrosis Screen Positive, Inconclusive Diagnosis

2022 ◽  
Vol 8 (1) ◽  
pp. 5
Author(s):  
Jane Chudleigh ◽  
Jürg Barben ◽  
Clement L. Ren ◽  
Kevin W. Southern
Keyword(s):  
Metabolic Syndrome ◽  
Cystic Fibrosis ◽  
Health Professionals ◽  
Online Survey ◽  
Transmembrane Conductance Regulator ◽  
Transmembrane Conductance ◽  
Online Questionnaire ◽  
The Us ◽  
The Uk ◽  
Cystic Fibrosis Transmembrane

The main aim of the present study was to explore health professionals’ reported experiences and approaches to managing children who receive a designation of cystic fibrosis transmembrane conductance regulator-related metabolic syndrome/cystic fibrosis screen positive inconclusive diagnosis following a positive NBS result for cystic fibrosis. An online questionnaire was distributed via Qualtrics Survey Software and circulated to a purposive, international sample of health professionals involved in managing children with this designation. In total, 101 clinicians completed the online survey: 39 from the US, six from Canada, and 56 from Europe (including the UK). Results indicated that while respondents reported minor deviations in practice, they were cognizant of recommendations in the updated guidance and for the most part, attempted to implement these into practice consistently internationally. Where variation was reported, the purpose of this appeared to be to enable clinicians to respond to either clinical assessments or parental anxiety in order to improve outcomes for the child and family. Further research is needed to determine if these findings are reflective of both a wider audience of clinicians and actual (rather than reported) practice.

Modelling identity types through agency: part 2, personal identity and mindsets

Kybernetes ◽  
2017 ◽  
Vol 46 (7) ◽  
pp. 1112-1130
Author(s):  
Davide Di Fatta ◽  
Maurice Yolles
Keyword(s):  
Content Analysis ◽  
Agency Theory ◽  
Personal Identity ◽  
Qualitative Evaluation ◽  
Public Identity ◽  
Content Type ◽  
Behavioural Patterns ◽  
Self Interest ◽  
The Us ◽  
Theory Framework

Purpose The purpose of this paper is to evaluate the personal identity of Donald Trump in the US presidential election using the mindset agency theory framework and content analysis. Design/methodology/approach The qualitative evaluation of identity type is determined by the personality mindset agency theory (PMAT). This measures qualitatively by assigning a type to the personal identity. The methods being adopted are content analysis, and a coding frame is constructed that arises from the key words defined in PMAT. Findings Using PMAT, the authors determine that Trump’s personal identity is of the type hierarchical popularism (HP), from which behavioural patterns are derived, supposing that this is consistent with his public identity type measured using agency MAT (AMAT), which will be assessed in part 3 of this paper. Originality/value Appropriate image management can be used in an attempt to hide problematic purely self-interest aspects of a personality. This paper shows that it is possible to evaluate personality mindsets using content analysis. In a later paper, exploration of agency mindsets will occur that is indicative of the potential for behaviour.

scholarly journals Defensive medicine in neurosurgery: the Canadian experience

2016 ◽  
Vol 124 (5) ◽  
pp. 1524-1530 ◽  
Author(s):  
Timothy R. Smith ◽  
M. Maher Hulou ◽  
Sandra C. Yan ◽  
David J. Cote ◽  
Brian V. Nahed ◽  
...  
Keyword(s):  
Online Survey ◽  
Insurance Coverage ◽  
Patient Characteristics ◽  
Defensive Medicine ◽  
Published Data ◽  
Risk Environment ◽  
Malpractice Insurance ◽  
The Us ◽  
Survey Responses ◽  
The Impact

OBJECT Recent studies have examined the impact of perceived medicolegal risk and compared how this perception impacts defensive practices within the US. To date, there have been no published data on the practice of defensive medicine among neurosurgeons in Canada. METHODS An online survey containing 44 questions was sent to 170 Canadian neurosurgeons and used to measure Canadian neurosurgeons’ perception of liability risk and their practice of defensive medicine. The survey included questions on the following domains: surgeon demographics, patient characteristics, type of physician practice, surgeon liability profile, policy coverage, defensive behaviors, and perception of the liability environment. Survey responses were analyzed and summarized using counts and percentages. RESULTS A total of 75 neurosurgeons completed the survey, achieving an overall response rate of 44.1%. Over one-third (36.5%) of Canadian neurosurgeons paid less than $5000 for insurance annually. The majority (87%) of Canadian neurosurgeons felt confident with their insurance coverage, and 60% reported that they rarely felt the need to practice defensive medicine. The majority of the respondents reported that the perceived medicolegal risk environment has no bearing on their preferred practice location. Only 1 in 5 respondent Canadian neurosurgeons (21.8%) reported viewing patients as a potential lawsuit. Only 4.9% of respondents would have selected a different career based on current medicolegal risk factors, and only 4.1% view the cost of annual malpractice insurance as a major burden. CONCLUSIONS Canadian neurosurgeons perceive their medicolegal risk environment as more favorable and their patients as less likely to sue than their counterparts in the US do. Overall, Canadian neurosurgeons engage in fewer defensive medical behaviors than previously reported in the US.

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