Perceptions of Physician Influence on Healthcare Accessibility

A significant portion of the U.S. population across the country has limited access to quality healthcare; however, this situation is more pronounced in rural areas. One potential solution is for healthcare practitioners to move their services to underserved rural areas to improve healthcare coverage. No previous studies have explored the perceptions of practitioners regarding their influence on healthcare access, particularly the potential impact of moving healthcare services to underserved areas. Thus, the purpose of this research was to address this gap. A qualitative phenomenological approach was adopted. A sample of 24 participants was selected using purposive sampling, from the target population of medical doctors in the southeastern area of the United States. Open-ended interview questions used during data collection, prompted respondents to provide insightful feedback. A deductive coding procedure was used to mirror the 6 dimensions of healthcare access. The results point to 3 major themes: (a) physicians increase healthcare acceptability and awareness through their knowledge and experience; (b) physicians increase accommodation through consideration of patients’ needs and coordination of care, and (c) physicians increase resource availability through use of electronic medical records. This research study affords a clearer understanding of physicians’ perceptions and may guide the development of informational awareness-raising materials for physicians and also alludes to the need to promote positive relationships between physicians and patients to maximize healthcare accessibility in the United States

The prodrome of autism: early behavioral and biological signs, regression, peri- and post-natal development and genetics

Autism is one of the most heritable neurodevelopmental conditions and has an early onset, with symptoms being required to be present in the first 3 years of life in order to meet criteria for the ‘core’ disorder in the classification systems. As such, the focus on identifying a prodrome over the past 20 years has been on pre-clinical signs or indicators that will be present very early in life, certainly in infancy. A number of novel lines of investigation have been used to this end, including retrospective coding of home videos, prospective population screening and ‘high risk’ sibling studies; as well as the investigation of pre- and peri-natal, brain developmental and other biological factors. Whilst no single prodromal sign is expected to be present in all cases, a picture is emerging of indicative prodromal signs in infancy and initial studies are being undertaken to attempt to ameliorate the early presentation and even ‘prevent’ emergence of the full syndrome

Challenging Social Media Threats using Collective Well-being Aware Recommendation Algorithms and an Educational Virtual Companion

Social media (SM) have become an integral part of our lives, expanding our inter-linking capabilities to new levels. There is plenty to be said about their positive effects. On the other hand however, some serious negative implications of SM have repeatedly been highlighted in recent years, pointing at various SM threats for society, and its teenagers in particular: from common issues (e.g. digital addiction and polarization) and manipulative influences of algorithms to teenager-specific issues (e.g. body stereotyping). The full impact of current SM platform design -- both at an individual and societal level -- asks for a comprehensive evaluation and conceptual improvement. We extend measures of Collective Well-Being (CWB) to SM communities. As users' relationships and interactions are a central component of CWB, education is crucial to improve CWB. We thus propose a framework based on an adaptive "social media virtual companion" for educating and supporting the entire students' community to interact with SM. The virtual companion will be powered by a Recommender System (CWB-RS) that will optimize a CWB metric instead of engagement or platform profit, which currently largely drives recommender systems thereby disregarding any societal collateral effect. CWB-RS will optimize CWB both in the short term, by balancing the level of SM threat the students are exposed to, as well as in the long term, by adopting an Intelligent Tutor System role and enabling adaptive and personalized sequencing of playful learning activities. This framework offers an initial step on understanding how to design SM systems and embedded educational interventions that favor a more healthy and positive society

Healing a Broken System: Veterans and the War on Drugs

This report examines the plight of returning veterans who struggle with incarceration and psychological wounds of war such as addiction and post-traumatic stress disorder -- and suggests reforms that could improve the health and preserve the freedom of American soldiers returning from war zones and transitioning back to civilian life. Roughly 30 percent of veterans from Iraq and Afghanistan report symptoms of post-traumatic stress disorder (PTSD), traumatic brain injury, depression, mental illness or other cognitive disability. Left untreated, these medical conditions often contribute to substance misuse and addiction, fatal overdose, homelessness and suicide, as well as violations of the law, particularly nonviolent drug offenses. This report recommends alternatives to incarceration for nonviolent drug offenses, increased access to overdose prevention programs and medication-assisted therapy, and research evaluating innovative treatment modalities such as medical marijuana and MDMA-assisted psychotherapy

Are incentives everything? payment mechanisms for health care providers in developing countries

This paper assesses the extent to which provider payment mechanisms can help developing countries address their leading health care problems. It first identifies four key problems in the health care systems in developing countries: 1) public facilities, which provide the bulk of secondary and tertiary health care services in most countries, offer services of poor quality; 2) providers cannot be enticed to rural and urban marginal areas, leaving large segments of the population without adequate access to health care; 3) the composition of health services offered and consumed is sub-optimal; and 4) coordination in the delivery of care, including referrals, second opinions, and teamwork, is inadequate. The paper examines each problem in turn and assesses the extent to which changes in provider payments might address it.Health Economics&Finance,Health Systems Development&Reform,Public Health Promotion,Health Monitoring&Evaluation,Early Child and Children's Health,Health Monitoring&Evaluation,HealthEconomics&Finance,Health Systems Development&Reform,Environmental Economics&Policies,Housing&Human Habitats

MANAGING POLICY NETWORKS: A SOCIAL MARKETING- AND COLLECTIVE INTELLIGENCE SYSTEMS-DRIVEN VIEW

This research contributes a new view of Policy Networks (PN) management. The research object is a successful PN practice in the Basque Country (BC) over an 8-year period, in relation to Local Agenda 21 (LA21) promotion. The Basque experience is studied using a qualitative and a quantitative approach. PNs are viewed as social marketing-driven collective intelligence systems built to have an effect on municipality commitment to LA21 (in terms of value, satisfaction and loyalty). The research concludes that by fostering the co-development ‘genome’ (a mix of co-decision, co-creation, love, glory and money ‘genes’) a commitment to the new tool is achieved.

How Should We Treat Depression in Patients with Cardiovascular Disease?

Among patients with cardiovascular disease (CVD), depression is highly prevalent and is associated with worse cardiovascular prognosis and lower quality of life. Treatments for depression in CVD patients produce modest, but clinically significant reductions in depressive symptoms and show promise for improving cardiovascular prognosis. While tricyclics should generally be avoided, antidepressants from multiple other classes appear to be safe in cardiac patients. A strategy of engaging patients in choosing medications or psychotherapy and then intensifying treatment to therapeutic goal appears to be more effective at reducing depression than single mode interventions. Recommendations for screening all CVD patients for depression may be premature given increased costs associated with screening and gaps in knowledge about the risk-benefit ratio of depression treatment in mild and moderately depressed patients