Paying More for Primary Care: Can It Help Bend the Medicare Cost Curve?

Estimates how a permanent 10 percent increase in Medicare fees for primary care ambulatory visits would affect the number and cost of visits and spending for inpatient and post-acute care. Considers primary care's role in bending the Medicare cost curve

Managing projects for change: Contextualised project management

This paper will detail three projects which focussed on enhancing online learning at a large Australian distance education University within a School of Business,School of Health and School of Education. Each project had special funding and took quite distinctive project management approaches, which reflect the desire to embed innovation and ownership at the instructor and student interface. By responding to the stakeholder requirements these three projects provide insight into a) how integrated professional development serves to enable change in practice; b) why leadership at both junior and senior levels of the organisation is an important driver to support instructor engagement for real change; c) what role external private contractors can play; and, d) how instructors were integrated through the varied project management approaches. The integrating theme of the paper is instructor engagement for real change. Each project will be detailed as mini-cases and key lessons drawn out that describe and explain the challenges, opportunities and scope of varied project management approaches to suit the distinct four contexts. This paper builds on and brings together considerable investigation into how we can support and enhance dissemination of a variety of project-based models that respond to contextual needs and issues. The multiple school case study methodology serves to provide an approach that is both robust and cognisant of current trends in increased university investment through shortterm project funding. The final recommendations will highlight how different approaches to project management are both desirable and essential for successfully embedding change of instructor practices for enhancing student learning in distance education modes

ETSU Social Work Policy Podcast with Stewart Clifton: Policy Environment (14:59 min)

In this podcast highlights of the full podcast with Stewart Clifton is shared. Stewart discusses the factors that shape political environment; implications of demographic changes in a state that heavily leans in one direction; and how social workers impact the policymaking process

Introduction

Deserted Villages: Perspectives from the Eastern Mediterranean is a collection of case studies examining the abandonment of rural settlements over the past millennium and a half, focusing on modern-day Greece with contributions from Turkey and the United States. Unlike other parts of the world, where deserted villages have benefited from decades of meticulous archaeological research, in the eastern Mediterranean better-known ancient sites have often overshadowed the nearby remains of more recently abandoned settlements. Yet as the papers in this volume show, the tide is finally turning toward a more engaged, multidisciplinary, and anthropologically informed archaeology of medieval and post-medieval rural landscapes. The inspiration for this volume was a two-part colloquium organized for the 2016 Annual Meeting of the Archaeological Institute of America in San Francisco. The sessions were sponsored by the Medieval and Post-Medieval Archaeology Interest Group, a rag-tag team of archaeologists who set out in 2005 with the dual goals of promoting the study of later material and cultural heritage and opening publication venues to the fruits of this research. The introduction to the volume reviews the state of the field and contextualizes the archaeological understanding of abandonment and post-abandonment as ongoing processes. The nine, peer reviewed chapters, which have been substantially revised and expanded since the colloquium, offer unparalleled glimpses into how this process has played out in different places. In the first half, the studies focus on long-abandoned sites that have now entered the archaeological record. In the second half, the studies incorporate archival analysis and ethnographic interviews—alongside the archaeologists’ hyper-attention to material culture—to examine the processes of abandonment and post-abandonment in real time

“Once Again, From the Beginning:” Re-inventing the Museum Library at the University of Pennsylvania

As university museums and academic programs struggle with issues of relevancy and harmful legacies, the libraries that are embedded within these institutions must reckon with similar challenging issues because of their own histories, collections content, museum-adjacent programs, and assumed authority in the supported disciplines. Such departmental libraries already occupy uncomfortable positions within complex institutions, often functioning as minor players in the university’s library systems, but only tenuously linked through location or subject matter expertise to the university’s museums and affiliated departments. Offered as an instructive example is the Museum Library at the University of Pennsylvania, affiliated with the sometimes embattled Penn Museum. This “Report from the Field” essay describes the Museum Library’s methods for participating in a rapidly evolving museum’s strategic initiatives and supporting the sincere investment of its dedicated staff in making meaningful changes. I also discuss the Museum Library’s own complicated history and our reflections as we remake the library in the face of local and global challenges

Use of Most Bothersome Symptom as a Coprimary Endpoint in Migraine Clinical Trials: A Post-Hoc Analysis of the Pivotal ZOTRIP Randomized, Controlled Trial.

ObjectiveTo better understand the utility of using pain freedom and most bothersome headache-associated symptom (MBS) freedom as co-primary endpoints in clinical trials of acute migraine interventions.BackgroundAdhesive dermally applied microarray (ADAM) is an investigational system for intracutaneous drug administration. The recently completed pivotal Phase 2b/3 study (ZOTRIP), evaluating ADAM zolmitriptan for the treatment of acute moderate to severe migraine, was one of the first large studies to incorporate MBS freedom and pain freedom as co-primary endpoints per recently issued guidance by the US Food and Drug Administration. In this trial, the proportion of patients treated with ADAM zolmitriptan 3.8 mg, who were pain-free and MBS-free at 2 hours post-dose, was significantly higher than for placebo.MethodsWe undertook a post-hoc analysis of data from the ZOTRIP trial to examine how the outcomes from this trial compare to what might have been achieved using the conventional co-primary endpoints of pain relief, nausea, photophobia, and phonophobia.ResultsOf the 159 patients treated with ADAM zolmitriptan 3.8 mg or placebo, prospectively designated MBS were photophobia (n = 79), phonophobia (n = 43), and nausea (n = 37). Two-hour pain free rates in those with photophobia as the MBS were 36% for ADAM zolmitriptan 3.8 mg and 14% for placebo (P = .02). Corresponding rates for those with phonophobia as the MBS were 14% and 41% (P = .05). For those whose MBS was nausea, corresponding values were 56% and 16%, respectively (P = .01). Two-hour freedom from the MBS for active drug vs placebo were 67% vs 35% (P < .01) for photophobia, 55% vs 43% (P = .45) for phonophobia, and 89% vs 58% for nausea (P = .04). MBS freedom but not pain freedom was achieved in 28%. Only 1 patient (1%) achieved pain freedom, but not MBS freedom. The proportion with both pain and MBS freedom was highest (56%) among those whose MBS was nausea.ConclusionIn this study, the use of MBS was feasible and seemed to compare favorably to the previously required 4 co-primary endpoints