Rationalizing Noneconomic Damages: A Health-Utilities Approach

Studdert et al examine why making compensation of noneconomic damages in personal-injury litigation more rational and predictable is socially valuable. Noneconomic-damages schedules as an alternative to caps are discussed, several potential approaches to construction of schedules are reviewed, and the use of a health-utilities approach as the most promising model is argued. An empirical analysis that combines health-utilities data created in a previous study with original empirical work is used to demonstrate how key steps in construction of a health-utilities-based schedule for noneconomic damages might proceed

Partnering with Medicaid to Advance and Sustain the Goals of the Child Welfare System

The purpose of this paper is to serve as a practical guide for child welfare directors who are looking to expand or sustain services for the children and families that they serve. This paper focuses on ways to partner with Medicaid to leverage opportunities to provide high quality services for children in child welfare who have behavioral health needs. It also includes information that will provide a foundational understanding of the behavioral health needs of children involved with the child welfare system, with an emphasis on describing child behavior through the lens of child development, adaptive functioning, and trauma; the services that can effectively address those behavioral and trauma related responses that can disrupt a child's skills and abilities; and, examples from states and counties who are providing these services and supports

Incorporating climate change into invasive species management: insights from managers

Invasive alien species are likely to interact with climate change, thus necessitating management that proactively addresses both global changes. However, invasive species managers’ concerns about the effects of climate change, the degree to which they incorporate climate change into their management, and what stops them from doing so remain unknown. Therefore, we surveyed natural resource managers addressing invasive species across the U.S. about their priorities, concerns, and management strategies in a changing climate. Of the 211 managers we surveyed, most were very concerned about the influence of climate change on invasive species management, but their organizations were significantly less so. Managers reported that lack of funding and personnel limited their ability to effectively manage invasive species, while lack of information limited their consideration of climate change in decision-making. Additionally, managers prioritized research that identifies range-shifting invasive species and native communities resilient to invasions and climate change. Managers also reported that this information would be most effectively communicated through conversations, research summaries, and meetings/symposia. Despite the need for more information, 65% of managers incorporate climate change into their invasive species management through strategic planning, preventative management, changing treatment and control, and increasing education and outreach. These results show the potential for incorporating climate change into management, but also highlight a clear and pressing need for more targeted research, accessible science communication, and two-way dialogue between researchers and managers focused on invasive species and climate change

Use of the Montreal Cognitive Assessment (MoCA) in a Rural Outreach Program for Military Veterans

The Montreal Cognitive Assessment (MoCA) is a free, easily accessible screener ideal for rural areas where resources are limited. We examined administration and scoring by Veteran Community Outreach Health Workers (VCOHWs); compared positive screening rates using two cutoff scores; and examined predictors of education-adjusted scores in N = 168 rural military Veterans from the Alabama Veteran Rural Health Initiative. Accuracy of administration (95 percent) and scoring (68 percent) was calculated and recommendations are offered. Higher than expected rates of positive screens were observed (40 percent using 24/30 cutoff) in this relatively young (M = 55 years) community-dwelling sample. Age, education, and race but not subjective health predicted differences in domain and total education-adjusted scores on multivariate and univariate tests. This study advances social science research in rural communities by being the first to: (1) examine MoCA scores in a rural, Deep South U.S. sample; and (2) report fidelity administration data for VCOHWs

Further improvement of warming-equivalent emissions calculation

GWP* was recently proposed1 as a simple metric for calculating warming-equivalent emissions by equating a change in the rate of emission of a short-lived climate pollutant (SLCP) to a pulse emission of carbon dioxide. Other metrics aiming to account for the time-dependent impact of SLCP emissions, such as CGWP, have also been proposed2. In 2019 an improvement to GWP* was proposed by Cain et al.3, hereafter CLA, combining both the rate and change in rate of SLCP emission, justified by the rate of forcing decline required to stabilise temperatures following a recent multi-decade emissions increase. Here we provide a more direct justification of the coefficients used in this definition of GWP*, with a small revision to their absolute values, by equating CO2 and SLCP forcing directly, without reference to the temperature response. This provides a more direct link to the impulse-response model used to calculate GWP values and improves consistency with CGWP values

Regional Invasive Species & Climate Change Management Challenge: Why Native? Benefits of planting native species in a changing climate

Yards host a variety of native and non-native plants. It is easy to assume all plants play a similar role in supporting wildlife, but native plants dramatically increase the diversity of bees, butterflies, birds and other native animals. Additionally, non-native plants can become invasive or support invasive pests. Native plants increase biodiversity and reduce risks associated with invasive species, which supports resilient ecosystems in the face of climate change

Social Determinants of Health in People Living with Psychiatric Disorders: The Role of Pharmacists.

INTRODUCTION: Social determinants of health (SDOH) affect outcomes of people living with psychiatric disorders, including substance use disorders. As experts in medication optimization, pharmacists play a vital role in identifying and addressing medication-related problems associated with SDOH. However, there is a paucity of literature on how pharmacists can be part of the solution. OBJECTIVE: The purpose of this article is to provide a narrative review and commentary on the intersection between SDOH, medication-related outcomes in people living with psychiatric disorders, and the role of pharmacists in addressing them. METHOD: The American Association of Psychiatric Pharmacists appointed an expert panel to research the issue, identify barriers, and develop a framework for including pharmacists in addressing medication therapy problems associated with SDOH in people with psychiatric disorders. The panel used Healthy People 2030 as the framework and sought input from public health officials to propose solutions for their commentary. RESULTS: We identified potential connections between SDOH and their impact on medication use in people with psychiatric disorders. We provide examples of how comprehensive medication management can afford opportunities for pharmacists to mitigate medication-related problems associated with SDOH. CONCLUSION: Public health officials should be aware of the vital role that pharmacists play in addressing medication therapy problems associated with SDOH to improve health outcomes and to incorporate them in health promotion programs

Is the pharmacy profession innovative enough?: meeting the needs of Australian residents with chronic conditions and their carers using the nominal group technique

Background Community pharmacies are ideally located as a source of support for people with chronic conditions. Yet, we have limited insight into what innovative pharmacy services would support this consumer group to manage their condition/s. The aim of this study was to identify what innovations people with chronic conditions and their carers want from their ideal community pharmacy, and compare with what pharmacists and pharmacy support staff think consumers want. Methods We elicited ideas using the nominal group technique. Participants included people with chronic conditions, unpaid carers, pharmacists and pharmacy support staff, in four regions of Australia. Themes were identified via thematic analysis using the constant comparison method. Results Fifteen consumer/carer, four pharmacist and two pharmacy support staff groups were conducted. Two overarching themes were identified: extended scope of practice for the pharmacist and new or improved pharmacy services. The most innovative role for Australian pharmacists was medication continuance, within a limited time-frame. Consumers and carers wanted improved access to pharmacists, but this did not necessarily align with a faster or automated dispensing service. Other ideas included streamlined access to prescriptions via medication reminders, electronic prescriptions and a chronic illness card. Conclusions This study provides further support for extending the pharmacist’s role in medication continuance, particularly as it represents the consumer’s voice. How this is done, or the methods used, needs to optimise patient safety. A range of innovative strategies were proposed and Australian community pharmacies should advocate for and implement innovative approaches to improve access and ensure continuity of care