A qualitative analysis of health care provider perceptions of depression and suicidality in Mozambique

Thesis (Master's)--University of Washington, 2016-06

“Dismissingness always matters”: An examination of tobacco smoking, frequency of visits to healthcare providers, and trust in the provider as potential mediators between attachment style dismissingness and diabetes health status

Thesis (Master's)--University of Washington, 2016-06

Emergency Provider Use of Plain Radiographs in the Evaluation of Pediatric Constipation

Thesis (Master's)--University of Washington, 2016-06

Logics of marginalisation in health and social care reform:integration, choice, and provider-blind provision

The period 2010–2013 was a time of far-reaching structural reforms of the National Health Service in England. Of particular interest in this paper is the way in which radical critiques of the reform process were marginalised by pragmatic concerns about how to maintain the market-competition thrust of the reforms while avoiding potential fragmentation. We draw on the Essex school of political discourse theory and develop a ‘nodal’ analytical framework to argue that widespread and repeated appeals to a narrative of choice-based integrated care served to take the fragmentation ‘sting’ out of radical critiques of the pro-competition reform process. This served to marginalise alternative visions of health and social care, and to pre-empt the contestation of a key norm in the provision of health care that is closely associated with the notions of ‘any willing provider’ and ‘any qualified provider’: provider-blind provision.

A lean kultúra értelmezése és mérése egy egészségügyi szolgáltatónál (The interpretation and measurement of the lean culture – in case of a healthcare service provider)

A lean menedzsment egészségügyi szolgáltatásokra való alkalmazásával elérhető eredmények egyre inkább nyilvánvalóvá válnak. Ennek köszönhetően a szektorban dinamikus növekedés tapasztalható ezen a téren. A kutatások azonban arra hívják fel a figyelmet, hogy a lean menedzsment alkalmazásával elért eredmények csak akkor lesznek fenntarthatóak, ha az eszközök alkalmazását a kultúra átalakulása is követi. A kultúra változásának követéséhez annak folyamatos értékelésére van szükség. A szervezeti kultúra lean-specifikus méréséhez azonban – a szerzők tudomása szerint – még nincs kidolgozott eszköz. Ezért cikkükben a kapcsolódó szakirodalom áttekintése után kidolgoztak egy lean kultúra kérdőívet, majd bemutatják a kérdőív tesztelését és annak eredményeit. Összegzésként elmondható, hogy az itt bemutatott kérdőív az első tesztelés alapján további fejlesztésre szorul. / === / The results that can be obtained by applying lean management in healthcare services become more and more clear. This generates a dynamic increase of lean applications in healthcare. However, researches are warning that the res ults obtained by lean applications can only be sustained, if next to the use of the lean tools cultural change will also take place. In order to track changes in culture its constant evaluation is necessary. According to the authors’ knowledge today does not exist any lean-specific culture evaluation tool. In this paper they elaborate a lean culture questionnaire based on the review of relevant literature. Than they describe its test and the results of the test. The authors conclude that the questionnaire as introduced here needs further improvement.

Justified assessments of service provider reputation

Abstract Reputation, influenced by ratings from past clients, is crucial for providers competing for custom. For new providers with less track record, a few negative ratings can harm their chances of growing. In the JASPR project, we aim to look at how to ensure automated reputation assessments are justified and informative. Even an honest balanced review of a service provision may still be an unreliable predictor of future performance if the circumstances differ. For example, a service may have previously relied on different sub-providers to now, or been affected by season-specific weather events. A common way to ameliorate the ratings that may not reflect future performance is by weighting by recency. We argue that better results are obtained by querying provenance records on how services are provided for the circumstances of provision, to determine the significance of past interactions. Informed by case studies in global logistics, taxi hire, and courtesy car leasing, we are going on to explore the generation of explanations for reputation assessments, which can be valuable both for clients and for providers wishing to improve their match to the market, and applying machine learning to predict aspects of service provision which may influence decisions on the appropriateness of a provider. In this talk, I will give an overview of the research conducted and planned on JASPR. Speaker Biography Dr Simon Miles Simon Miles is a Reader in Computer Science at King's College London, UK, and head of the Agents and Intelligent Systems group. He conducts research in the areas of normative systems, data provenance, and medical informatics at King's, and has published widely and manages a number of research projects in these areas. He was previously a researcher at the University of Southampton after graduating from his PhD at Warwick. He has twice been an organising committee member for the Autonomous Agents and Multi-Agent Systems conference series, and was a member of the W3C working group which published standards on interoperable provenance data in 2013.

Die Rolle der Internet Service Provider im deutschen und US-amerikanischen Recht - Verantwortlichkeit und Privilegierung für Urheberrechtsverletzungen im Internet

Die Dissertation befasst sich mit der Verantwortlichkeit und der Haftungsprivilegierung von Internet Service Providern (ISP) für Urheberrechtsverletzungen Dritter im deutschen und US-amerikanischen Recht. Internet Service Provider (das sind Host-Provider, Cache-Provider, Access-Provider sowie Suchmaschinen-Anbieter bzw. sonstige Linksetzende) nehmen eine wichtige Rolle im Internet ein. In Deutschland sehen sich die ISP jedoch trotz gesetzlicher Haftungsprivilegien erheblichen Rechtsunsicherheiten ausgesetzt. Der Dissertation liegt die Hypothese zugrunde, dass durch die Ausweitung der Verantwortlichkeit der ISP durch die Rechtsprechung die gesetzlich stipulierte Haftungsprivilegierung faktisch entwertet wird. Insbesondere stehen die Nichtanwendung der Privilegien auf Unterlassungsansprüche sowie die im Rahmen der Störerhaftung begründeten Prüfpflichten der Intention des Gesetzgebers (auch auf europäischer Ebene) entgegen. Eine gerechte Balance der Interessen der Akteure durch die Rechtsprechung wurde nicht erreicht. Die gesetzliche Ausgestaltung der US-amerikanischen Privilegierung verspricht hingegen eine den Interessen der ISP gerechtere Lösung. Auch die Rechtsanwendung der US-amerikanischen Gerichte liegt hiermit auf einer Linie.

MEDICAL SERVICES PROVIDER MANUAL for 2010

This brochure describes the 2010 Medical services provider manual, how to order one and how much it costs. The 2010 edition is a complete revision to the fee schedule with new maximum allowable payments based on 2010 CPT® coding. The manual covers services for physicians of all specialties, chiropractors, psychologists, physician assistants, nurse practitioners, clinical social workers and physical therapists. This edition provides more detailed procedure descriptions as well as further clarification of payment policies. It also serves as an excellent reference for price comparisons with other payers.

Review of Abuse, Neglect, and Exploitation Allegations Involving SC Mentor, a Private Provider for the South Carolina Department of Disabilities and Special Needs

This review was requested by the Department of Disabilities and Special Needs for an independent review of allegations of abuse, neglect, and exploitation at SC Mentor, a private provider of residential services for DDSN consumers. An analysis of incidents did not indicate systemic abuse towards consumers inasmuch as the majority of the ANE reporting system contained allegations more akin to staff/facility performance issues and the vast majority of all allegations were unsustained by independent investigations. In the future, DDSN should expand the level of detail in its ANE reporting, which currently only reports total allegations and sustained criminal incidents.

Propylthiouracil Quantification In Human Plasma By High-performance Liquid Chromatography Coupled With Electrospray Tandem Mass Spectrometry: Application In A Bioequivalence Study.

A rapid, sensitive and specific method for quantifying propylthiouracil in human plasma using methylthiouracil as the internal standard (IS) is described. The analyte and the IS were extracted from plasma by liquid-liquid extraction using an organic solvent (ethyl acetate). The extracts were analyzed by high performance liquid chromatography coupled with electrospray tandem mass spectrometry (HPLC-MS/MS) in negative mode (ES-). Chromatography was performed using a Phenomenex Gemini C18 5μm analytical column (4.6mm×150mm i.d.) and a mobile phase consisting of methanol/water/acetonitrile (40/40/20, v/v/v)+0.1% of formic acid. For propylthiouracil and I.S., the optimized parameters of the declustering potential, collision energy and collision exit potential were -60 (V), -26 (eV) and -5 (V), respectively. The method had a chromatographic run time of 2.5min and a linear calibration curve over the range 20-5000ng/mL. The limit of quantification was 20ng/mL. The stability tests indicated no significant degradation. This HPLC-MS/MS procedure was used to assess the bioequivalence of two propylthiouracil 100mg tablet formulations in healthy volunteers of both sexes in fasted and fed state. The geometric mean and 90% confidence interval CI of Test/Reference percent ratios were, without and with food, respectively: 109.28% (103.63-115.25%) and 115.60% (109.03-122.58%) for Cmax, 103.31% (100.74-105.96%) and 103.40% (101.03-105.84) for AUClast. This method offers advantages over those previously reported, in terms of both a simple liquid-liquid extraction without clean-up procedures, as well as a faster run time (2.5min). The LOQ of 20ng/mL is well suited for pharmacokinetic studies. The assay performance results indicate that the method is precise and accurate enough for the routine determination of the propylthiouracil in human plasma. The test formulation with and without food was bioequivalent to reference formulation. Food administration increased the Tmax and decreased the bioavailability (Cmax and AUC).

Effect Of Aloe Vera Application On The Content And Molecular Arrangement Of Glycosaminoglycans During Calcaneal Tendon Healing.

Although several treatments for tendon lesions have been proposed, successful tendon repair remains a great challenge for orthopedics, especially considering the high incidence of re-rupture of injured tendons. Our aim was to evaluate the pharmacological potential of Aloe vera on the content and arrangement of glycosaminoglycans (GAGs) during tendon healing, which was based on the effectiveness of A. vera on collagen organization previously observed by our group. In rats, a partial calcaneal tendon transection was performed with subsequent topical A. vera application at the injury site. The tendons were treated with A. vera ointment for 7 days and excised on the 7(th) , 14(th) , or 21(st) day post-surgery. Control rats received ointment without A. vera. A higher content of GAGs and a lower amount of dermatan sulfate were detected in the A. vera-treated group on the 14(th) day compared with the control. Also at 14 days post-surgery, a lower dichroic ratio in toluidine blue stained sections was observed in A. vera-treated tendons compared with the control. No differences were observed in the chondroitin-6-sulfate and TGF-β1 levels between the groups, and higher amount of non-collagenous proteins was detected in the A. vera-treated group on the 21(st) day, compared with the control group. No differences were observed in the number of fibroblasts, inflammatory cells and blood vessels between the groups. The application of A. vera during tendon healing modified the arrangement of GAGs and increased the content of GAGs and non-collagenous proteins.

Chemo-, Regio- And Stereoselective Heck Arylation Of Allylated Malonates: Mechanistic Insights By Esi-ms And Synthetic Application Toward 5-arylmethyl-γ-lactones.

We describe herein a general method for the controlled Heck arylation of allylated malonates. Both electron-rich and electron-poor aryldiazonium salts were readily employed as the aryl-transfer agents in good yields and in high chemo-, regio-, and stereoselectivity without formation of decarboxylated byproducts. Reaction monitoring via ESI-MS was used to support the formation of chelated Pd species through the catalytic cycle. Additionally, some Heck adducts were successfully used in the total synthesis of pharmacologically active γ-lactones.

Recolonization Of Mutans Streptococci After Application Of Chlorhexidine Gel.

Streptococcus mutans is specifically suppressed by intensive treatment with chlorhexidine gel, but the time for recolonization and the effect on other oral bacteria are not totally clear. In this study, recolonization of mutans streptococci was evaluated in nine healthy adult volunteers, who were highly colonized with this microorganism. Stimulated saliva was collected before (baseline) and at 1, 7, 14, 21 and 28 days after application of 1% chlorhexidine gel on volunteers' teeth for two consecutive days. On each day, the gel was applied using disposable trays for 3 x 5 min with intervals of 5 min between each application. Saliva was plated on blood agar to determine total microorganisms (TM); on mitis salivarius agar to determine total streptococci (TS) and on mitis salivarius agar plus bacitracin to determine mutans streptococci (MS). Chlorhexidine was capable of reducing the counts of MS and the proportion of MS with regard to total microorganisms (%MS/TM) (p<0.05), but these values did not differ statistically from baseline (p>0.05) after 14 days for MS and 21 days for %MS/TM. The counts of TM and TS and the proportion of MS to total streptococci did not differ statistically from baseline (p>0.05) after chlorhexidine treatment. The results suggest that the effect of chlorhexidine gel treatment on suppression of mutans streptococci is limited to less than a month in highly colonized individuals.

Application Of A Semi-empirical Model For The Evaluation Of Transmission Properties Of Barite Mortar.

The aim of this study was to estimate barite mortar attenuation curves using X-ray spectra weighted by a workload distribution. A semi-empirical model was used for the evaluation of transmission properties of this material. Since ambient dose equivalent, H(⁎)(10), is the radiation quantity adopted by IAEA for dose assessment, the variation of the H(⁎)(10) as a function of barite mortar thickness was calculated using primary experimental spectra. A CdTe detector was used for the measurement of these spectra. The resulting spectra were adopted for estimating the optimized thickness of protective barrier needed for shielding an area in an X-ray imaging facility.

Application Of Tactile/kinesthetic Stimulation In Preterm Infants: A Systematic Review.

To verify the methods used by the clinical trials that assessed the effect of tactile/kinesthetic stimulation on weight gain in preterm infants and highlight the similarities and differences among such studies. This review collected studies from two databases, PEDro and PubMed, in July of 2014, in addition to bibliographies. Two researchers assessed the relevant titles independently, and then chose which studies to read in full and include in this review by consensus. Clinical trials that studied tactile stimulation or massage therapy whether or not associated with kinesthetic stimulation of preterm infants; that assessed weight gain after the intervention; that had a control group and were composed in English, Portuguese, or Spanish were included. A total of 520 titles were found and 108 were selected for manuscript reading. Repeated studies were excluded, resulting in 40 different studies. Of these, 31 met all the inclusion criteria. There were many differences in the application of tactile/kinesthetic stimulation techniques among studies, which hindered the accurate reproduction of the procedure. Also, many studies did not describe the adverse events that occurred during stimulation, the course of action taken when such events occurred, and their effect on the outcome. These studies made a relevant contribution towards indicating tactile/kinesthetic stimulation as a promising tool. Nevertheless, there was no standard for application among them. Future studies should raise the level of methodological rigor and describe the adverse events. This may permit other researchers to be more aware of expected outcomes, and a standard technique could be established.