152 research outputs found

    Progress Enrolling Children in Medicaid/CHIP: Who Is Left and What Are the Prospects for Covering More Children?

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    Outlines the resources and tools in the Children's Health Insurance Program Reauthorization Act of 2009 for data-driven enrollment and retention processes in Medicaid and CHIP, remaining barriers, and the need to tailor outreach efforts to specific needs

    Medicaid Managed Care and Infant Health: A National Evaluation

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    In this study, we examine the effects of Medicaid managed care (MMC) on prenatal care utilization and infant health. We obtain separate estimates of the effect of primary care case management (PCCM) managed care programs and HMO managed care plans on prenatal care utilization, birth weight, and cesarean section. The results suggest the following: MMC was associated with a small, clinically unimportant decrease in the number of prenatal care visits; MMC had no statistically significant relationship to the APNCU index of the adequacy of prenatal care; MMC was associated with a significant increase in the incidence of low-birth weight and pre-term birth; and MMC had no association with the incidence of cesarean section. We argue that a causal interpretation of the first and third findings is unsupported by a careful reading of the evidence, and we conclude that Medicaid managed care had virtually no causal effect on, prenatal care use, birth outcomes, and cesarean section.

    Health Insurance in Nonstandard Jobs and Small Firms: Differences for Parents by Race and Ethnicity

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    Focuses on the higher rates of small-firm and nonstandard employment and of uninsurance regardless of job type among Latino/Hispanic and African-American parents. Considers healthcare reform provisions' effects on their insurance costs and coverage rates

    Savior of Rural Landscapes or Solomon\u27s Choice? Colorado\u27s Experiment with Alternative Water Transfer Methods for Water (ATMs)

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    This article focuses on the emerging landscape for Alternative Transfer Methods (ATMs) in Colorado, USA. ATMs are developing within a legal landscape of water rights governed by prior appropriation law, growing demand for water in urban centers driven by population growth, and an aging rural farm population whose most valuable asset may include senior water rights. Rural-urban water transfers in the past have been linked to the collapse of rural economies if pursued to the extreme extent of “buy-and-dry,” where water rights were purchased outright and permanently removed from agricultural land (e.g. Crowley County). This article focuses on the emerging innovations of ATMs, which seek to accomplish the same purpose of providing additional water to growing cities but through more flexible mechanisms, such as rotational fallowing, interruptible supplies, and water banks, that aim to preserve rural economies as well. We review the history and context for water allocation in Colorado, the history of rural-urban transfers, and focus on ATMs and their pros and cons. We conclude with implications of ATMs for water governance and providing flexibility and sustainability in a changing climate

    The Status of Women at the University of Dayton: 2019-2020 Report Card

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    In this second iteration, the Status of Women at the University of Dayton: 2019 -20 Report Card continues the effort of the inaugural report card in measuring the representation of women across the UD workforce and in leadership roles, with a focus on highlighting changes from year to year. Our goal in generating this report card is to annually evaluate progress toward increasing institutional diversity and promoting equity for women-identified staff and faculty. In doing so, the report identifies areas where progress is being made and areas where more work is needed. The report card is also a space to share progress on gender equity initiatives led by the Women\u27s Center and other units across campus. Data presented in this report card was provided by the university’s Institutional Research Office and represents data collected in fall 2019; all gender and racial categories are self-reported. This year\u27s report card has some notable changes from the previous academic year, including: a focus on disciplinary differences among faculty by rank; and a breakdown of job categories within both exempt and nonexempt staff. We believe these changes add to our understanding of the gendered division of labor within the institution and its connection to pay, job security, and advancement. As with the previous iteration of the report card, we disaggregated the data to more clearly show the differences between and among women (and men) by examining both gender and race

    "Women's rights, the European Court and Supranational Constitutionalism"

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    This analysis examines supranational constitutionalism in the European Union. In particular, the study focuses on the role of the European Court of Justice in the creation of women’s rights. I examine the interaction between the Court and member state governments in legal integration, and also the integral role that women’s advocates – both individual activists and groups – have played in the development of EU social provisions. The findings suggest that this litigation dynamic can have the effect of fueling the integration process by creating new rights that may empower social actors and EU organizations, with the ultimate effect of diminishing member state government control over the scope and direction of EU law. This study focuses specifically on gender equality law, yet provides a general framework for examining the case law in subsequent legal domains, with the purpose of providing a more nuanced understanding of supranational governance and constitutionalism

    Recommendations for gonadotoxicity surveillance in male childhood, adolescent, and young adult cancer survivors : a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium

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    Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors. The recommendations were developed by an international multidisciplinary panel including 25 experts in relevant medical specialties, using a consistent and transparent process. Recommendations were graded according to the strength of underlying evidence and potential benefit gained by early detection and appropriate management. The aim of the recommendations is to enhance evidence-based care for male CAYA cancer survivors. The guidelines reveal the paucity of high-quality evidence, highlighting the need for further targeted research.Peer reviewe

    Fertility preservation for male patients with childhood, adolescent, and young adult cancer:recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group

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    Item does not contain fulltextMale patients with childhood, adolescent, and young adult cancer are at an increased risk for infertility if their treatment adversely affects reproductive organ function. Future fertility is a primary concern of patients and their families. Variations in clinical practice are barriers to the timely implementation of interventions that preserve fertility. As part of the PanCareLIFE Consortium, in collaboration with the International Late Effects of Childhood Cancer Guideline Harmonization Group, we reviewed the current literature and developed a clinical practice guideline for fertility preservation in male patients who are diagnosed with childhood, adolescent, and young adult cancer at age 25 years or younger, including guidance on risk assessment and available methods for fertility preservation. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to grade the available evidence and to form the recommendations. Recognising the need for global consensus, this clinical practice guideline used existing evidence and international expertise to rigorously develop transparent recommendations that are easy to use to facilitate the care of male patients with childhood, adolescent, and young adult cancer who are at high risk of fertility impairment and to enhance their quality of life

    Fertility preservation for female patients with childhood, adolescent, and young adult cancer:recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group

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    Female patients with childhood, adolescent, and young adult cancer are at increased risk for fertility impairment when treatment adversely affects the function of reproductive organs. Patients and their families desire biological children but substantial variations in clinical practice guidelines reduce consistent and timely implementation of effective interventions for fertility preservation across institutions. As part of the PanCareLIFE Consortium, and in collaboration with the International Late Effects of Childhood Cancer Guideline Harmonization Group, we reviewed the current literature and developed a clinical practice guideline for fertility preservation in female patients who were diagnosed with childhood, adolescent, and young adult cancer at age 25 years or younger, including guidance on risk assessment and available methods for fertility preservation. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to grade the available evidence and to form the recommendations. This clinical practice guideline leverages existing evidence and international expertise to develop transparent recommendations that are easy to use to facilitate the care of female patients with childhood, adolescent, and young adult cancer who are at high risk for fertility impairment. A complete review of the existing evidence, including a quality assessment, transparent reporting of the guideline panel's decisions, and achievement of global interdisciplinary consensus, is an important result of this intensive collaboration.info:eu-repo/semantics/publishe

    Fertility preservation in children, adolescents, and young adults with cancer:Quality of clinical practice guidelines and variations in recommendations

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    BACKGROUNDFertility preservation care for children, adolescents, and young adults (CAYAs) with cancer is not uniform among practitioners. To ensure high-quality care, evidence-based clinical practice guidelines (CPGs) are essential. The authors identified existing CPGs for fertility preservation in CAYAs with cancer, evaluated their quality, and explored differences in recommendations. METHODSA systematic search in PubMed (January 2000-October 2014); guideline databases; and Web sites of oncology, pediatric, and fertility organizations was performed. Two reviewers evaluated the quality of the identified CPGs using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). From high-quality CPGs, the authors evaluated concordant and discordant areas among the recommendations. RESULTSA total of 25 CPGs regarding fertility preservation were identified. The average AGREE II domain scores (scale of 0%-100%) varied from 15% on applicability to 100% on clarity of presentation. The authors considered 8 CPGs (32%) to be of high quality, which was defined as scores 60% in any 4 domains. Large variations in the recommendations of the high-quality CPGs were observed, with 87.2% and 88.6%, respectively, of discordant guideline areas among the fertility preservation recommendations for female and male patients with cancer. CONCLUSIONSOnly approximately one-third of the identified CPGs were found to be of sufficient quality. Of these CPGs, the fertility preservation recommendations varied substantially, which can be a reflection of inadequate evidence for specific recommendations, thereby hindering the ability of providers to deliver high-quality care. CPGs including a transparent decision process for fertility preservation can help health care providers to deliver optimal and uniform care, thus improving the quality of life of CAYAs with cancer and cancer survivors. Cancer 2016;122:2216-23. (c) 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Only approximately one-third of the identified clinical practice guidelines for fertility preservation in children, adolescents, and young adults with cancer were found to be of sufficient quality, and among these, the recommendations varied substantially. This finding supports the need for well-developed and transparent harmonized clinical practice guidelines for children and young adults diagnosed with cancer who are at risk of fertility impairment
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