Cultivating Contemplative Mind in the Classroom

In Fall 2019, we showed video interviews of successful (i.e., graduated) alumni to first-year seminar students in the hope that incoming students would be inspired to adopt similar success strategies leading to increased retention and completion of their UNLV degree. The Academic Success Center filmed interviews with ten UNLV graduates who took our first-year seminar, COLA 100E. These COLA 100E Success Stories were then edited into three videos, each focusing on a particular theme, such as the first-year transition, the major selection process, and the key tips for graduation. The goal was that these successfully-graduated students would serve as motivational role models for UNLV’s diverse first-year student population. Though the alumni echoed concepts taught in the class, we imagined these peers would be more relatable than the instructor alone, encouraging students to identify with and potentially adopt new approaches to and perspectives of success early in their college careers.https://digitalscholarship.unlv.edu/btp_expo/1090/thumbnail.jp

Do Health Reforms Impact Cost Consciousness of Health Care Professionals? Results from a Nation-Wide Survey in the Balkans

BACKGROUND: Serbia, as the largest market of the Western Balkans, has entered socioeconomic transition with substantial delay compared to most of Eastern Europe. Its health system reform efforts were bold during the past 15 years, but their results were inconsistent in various areas. The two waves of global recession that hit Balkan economies ultimately reflected to the financial situation of healthcare. Serious difficulties in providing accessible medical care to the citizens became a reality. A large part of the unbearable expenses actually belongs to the overt prescription of pharmaceuticals and various laboratory and imaging diagnostic procedures requested by physicians. Therefore, a broad national survey was conducted at all levels of the healthcare system hierarchy to distinguish the ability of cost containment strategies to reshape clinician\u27s mindsets and decision-making in practice. AIMS: Assessment of healthcare professionals\u27 judgment on economic consequences of prescribed medical interventions and evaluation of responsiveness of healthcare professionals to policy measures targeted at increasing cost-consciousness. STUDY DESIGN: Cross-sectional study. METHODS: A nationwide cross-sectional survey was conducted through a hierarchy of medical facilities across diverse geographical regions before and after policy action, from January 2010 to April 2013. In the middle of the observed period, the National Health Insurance Fund (RFZO) adopted severe cost-containment measures. Independently, pharmacoeconomic guidelines targeted at prescribers were disseminated. Administration in large hospitals and community pharmacies was forced to restrict access to high budget-impact medical care. Economic Awareness of Healthcare Professionals Questionnaire-29 (EAHPQ-29), developed in Serbian language, was used in face-to-face interviews. The questionnaire documented clinician\u27s attitudes on: Clinical-Decision-Making-between-Alternative-Interventions (CDMAI), Quality-of-Health-Care (QHC), and Cost-Containment-Policy (CCP). The authors randomly and anonymously recruited 2000 healthcare experts, with a total of 1487 responding; after eliminating incomplete surveys, 649 participants were considered before and 651 after policy intervention. RESULTS: Dentists (1.195±0.560) had a higher mean CDMAI score compared to physicians (1.017±0.453). The surgical group compared to the internist group had a higher total EAHPQ-29 score, CCP score and CDMAI score. Policy intervention had a statistically significant negative impact on the QHC score (F=4.958; df=1; p=0.027). There was no substantial impact of policy interventions on professional behavior and judgment with regard to the CDMAI, CCP, and total EAHPQ-29 scores. CONCLUSION: Although cost savings were forcibly imposed in practice, the effects on clinical decision-making were modest. Clinicians\u27 perceptions of quality of medical care were explained in a less effective manner due to the severely constrained resources allocated to the providers. This pioneering effort in the Balkans exposes the inefficiency of current policies to expand clinicians\u27 cost consciousness

Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-making Preferences, and Implications for a Public Health Policy

Objectives: The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability. Methodology and data: The methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR), which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly. Results: There exists a complement relationship between the informal home care (IHC) and community-based FHC services, and the elasticity\u27s ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH) services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services. Conclusion: Policy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives

A CONJOINT STUDY OF THE RELATIONSHIP BETWEEN WEBSITE ATTRIBUTES AND CONSUMER PURCHASE INTENTIONS

This paper extends and modifies the Schaupp and Belanger model (2005) to develop and propose a model of on-line shopping intentions. Four on-line websites were designed as the test platforms. Respondents of this study were asked to visit these web-sites that represent differing shopping scenarios before they completed our on-line survey. Findings of this study are as follows. First, on-line contract signing mechanism was ranked as the most desired option in building trust in on-line shopping websites by all respondents. Second, respondents of this study were found able to be categorized into three groups according to the website factors they valued most. The three were logistic/security, security/trust, and convenience/trust. The specific attributes of on-line shopping websites valued most within each of the three groups are discussed in this paper. This study presents findings that support the use of many existing on-line technologies that have been found little used in on-line shopping websites such as digital certificate and on-line contracting. The inclusion of these technologies in on-line shopping websites may increase the cost of building and maintaining them and may create worries about user inconvenience. However, it is important that these technologies increase the attractiveness of the on-line shopping website and web surfers purchase intentions

Urban-Rural Disparity of Generics Prescription in Taiwan: The Example of Dihydropyridine Derivatives

The aim of the current study was to investigate the urban-rural disparity of prescribing generics, which were usually cheaper than branded drugs, within the universal health insurance system in Taiwan. Data sources were the cohort datasets of National Health Insurance Research Database with claims data in 2010. The generic prescribing ratios of dihydropyridine (DHP) derivatives (the proportion of DHP prescribed as generics to all prescribed DHP) of medical facilities were examined against the urbanization levels of the clinic location. Among the total 21,606,914 defined daily doses of DHP, 35.7% belonged to generics. The aggregate generic prescribing ratio rose from 6.7% at academic medical centers to 15.3% at regional hospitals, 29.4% at community hospital, and 66.1% at physician clinics. Among physician clinics, the generic prescribing ratio in urban areas was 63.9 ± 41.0% (mean ± standard deviation), lower than that in suburban (69.6 ± 38.7%) and in rural (74.1% ± 35.3%). After adjusting the related factors in the linear regression model, generic prescribing ratios of suburban and rural clinics were significantly higher than those of urban clinics (β=0.043 and 0.077; P=0.024 and 0.008, resp.). The generic prescribing ratio of the most popular antihypertensive agents at a clinic was reversely associated with the urbanization level