Keeping Track of Care: Quality and Technology at LifeBridge Health System (Baltimore)

This one-day site visit focused on quality and technology in acute, post-acute and long-term care at Sinai Hospital and Levindale Hebrew Geriatric Center and Hospital, both components of LifeBridge Health System in Baltimore. Participants traced the treatment paths of hypothetical cardiac and cancer patients through the hospital and explored the range of home- and community-based as well as institutional care available through the geriatric center. The role of clinical information technology was highlighted in both settings

Selection, inheritance, and the evolution of parent-offspring interactions

Very few studies have examined parent-offspring interactions from a quantitative genetic perspective. We used a cross-fostering design and measured genetic correlations and components of social selection arising from two parental and two offspring behaviors in the burying beetle Nicrophorus vespilloides. Genetic correlations were assessed by examining behavior of relatives independent of common social influences. We found positive genetic correlations between all pairs of behaviors, including between parent and offspring behaviors. Patterns of selection were assessed by standardized performance and selection gradients. Parental provisioning had positive effects on offspring performance and fitness, while remaining near the larvae without feeding them had negative effects. Begging had positive effects on offspring performance and fitness, while increased competition among siblings had negative effects. Coadaptations between parenting and offspring behavior appear to be maintained by genetic correlations and functional trade-offs; parents that feed their offspring more also spend more time in the area where they can forage for themselves. Families with high levels of begging have high levels of sibling competition. Integrating information from genetics and selection thus provides a general explanation for why variation persists in seemingly beneficial traits expressed in parent-offspring interactions and illustrates why it is important to measure functionally related suites of behaviors

SCHIP in the Formative Years: An Update

This issue brief examines the status of the State Children\u27s Health Insurance Program (SCHIP) three years after authorizing legislation was enacted. Topics addressed include enrollment and retention of children in new programs, funding allotments and expenditures, evaluation activities planned and underway, the interaction of Medicaid and SCHIP, and problems common across many states

A Report from the Forum Session Implementing the New Medicare Drug Benefit: Challenges and Opportunities for States

The National Health Policy Forum convened a meeting on July 22, 2004 to discuss state-based challenges associated with implementing the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). The meeting brought together an extremely insightful and experienced group of current and former state officials and other experts to discuss key issues. In keeping with its tradition of promoting a frank, off-the-record exchange on health policy issues, NHPF does not normally prepare written summaries or reports of meetings. However, because this meeting provided vivid illustrations of the importance of state-federal collaboration for the successful implementation of the new Medicare drug benefit, participants agreed that the information should be shared more widely. Thus, this report is intended to provide a candid montage of the July 22 meeting and supply additional information and insights into state issues surrounding MMA implementation. Though the MMA offers a huge number and range of potential subjects, the discussion was focused around four primary areas affecting states: eligibility, enrollment, and outreach; the transition for dual eligibles; financing challenges; and administrative and systems issues

Welfare Reform and Its Impact on Medicaid: An Update

Welfare reform, enacted in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), had a profound impact on the Medicaid program, delinking Medicaid from the new TANF program and for the first time allowing Medicaid eligibility to be divorced from welfare status. This paper reviews the national impact of this decoupling, describing research, implementation activities, and the impact of new state welfare programs on health programs in general

Creativity, or, Holding on to aroha : exploring, exemplifying and encouraging creativity in adulthood : a thesis presented in partial fulfilment of the requirements for the degree of Master of Education (Adult), Massey University

"Creativity is the sixth sense, transporting us to dreamed of places which the other five cannot reach," to paraphrase the Prime Minister, the Right Honourable Helen Clark. It was the task of this thesis to 'catch' creativity, scrutinise it and make sense of it. Accordingly, it was necessary to: Define creativity as the catalyst for effective innovation Determine who manifests it; major and minor exemplars Discover where it occurs; personal and public sites Detect how it can be effectively encouraged Delve into reasons for esteeming it; philosophical and pragmatic Answers to the above alliterative list's demands, were found in three places: The first was a global location, specifically the international literature on creativity, with particular reference to that written over the past fifty years The second was a New Zealand venue for the encouragement of creativity, The Leaming Connexion, Wellington, evidenced in the story of its founder The third was in the personal perspective of five people who are convinced that creativity is central to shaping how they live. They agreed to be identified as a signature, witnessing the role that creativity has in their lives. Throughout, the theoretical and actual informed each other, as well as the thesis author. Soon universal evidence of creativity's relevance became apparent. On a poetic note, the study concluded that creativity is worth holding onto since it is at the heart of what makes us take nothing for granted. In so doing, its breath grants humanity meaning. More prosaically, the thesis ends with five practical recommendations as to how some of the insights gained might be implemented to help make living and learning more meaningful in an increasingly complex world

CHIP and Medicaid Outreach and Enrollment: A Hands-on Look at Marketing and Applications

The State Children\u27s Health Insurance Program (SCHIP or CHIP), enacted as part of the Balanced Budget Act (BBA) in 1997, has enrolled eligible low-income children in innovative ways and tackled a variety of challenges to make sure that families know about the new program. This issue brief describes the outreach, application, and enrollment process for both SCHIP and Medicaid, analyzing the difficulty in simplifying applications, and noting problems that states must solve around systems design, immigration issues, and the stigma sometimes associated with government programs

Will Coaching Improve One\u27s Math Score on the Scholastic Aptitude Test?

The Scholastic Aptitude Test (SAT) has long been a determining factor for admission into most of the nation\u27s colleges and universities. Numerous studies have been conducted to question the reliability and predictive validity of SAT scores, yet they are still widely used. The widespread use of these scores in determining college admission is an indication that the SAT will be around for quite some time. For this reason and for personal reasons, I posed the following research question: Will coaching improve one\u27s math score on the Scholastic Aptitude Test

Introduction to 'Counselling and Psychotherapy in Organisational Settings'

This is the introduction to a book entitled 'Counselling and Psychotherapy in Organisational Settings', co-edited with Ruth Roberts

Quality Improvement in Maryland: Partnerships and Progress

This one-and-a-half-day site visit to Easton, Maryland, explored the activities of the Delmarva Foundation, the Quality Improvement Organization (QIO) for Maryland and the District of Columbia. The program reviewed Delmarva’s responsibilities under their Medicare contract and the initiatives they have undertaken with hospitals and other providers to improve health care outcomes and to define, collect, and report quality data. Local hospital officials added their perspective on quality programs and working with Delmarva. Topics of particular interest were health information technology, patient safety, and quality reporting both to government agencies and to consumers