The Population Health Management PolicyMap Project (PHM/PMP)

The Population Health Management/ PolicyMap Project links together the academic focus on population health management and the adoption of the PolicyMap technology to develop essential analytical skills applicable to real-time health industry decision-making. This Project helps prepare students to identify populations at risk, develop risk segmentation characteristics and criteria and to complete risk stratification in order to complete integrated care plans and management. The map representation will help students further engage in determining risk factors and treatment options/availabilities that will be crucial in planning, preventing and managing any of the at-risk health conditions. The PolicyMap learning assignment will be integrated within a designated unit of the HCAD 7518 – Managing Community and Population Health course offered during the Fall 2016 semester to two separate sections (online and on-campus). Within each course, students will be divided into task forces focusing on a specific population health topic. These topics will be based on immediate health issues that have major impacts on quality of life and health costs. Potential topics will be very diverse from focusing on emerging contagious diseases (Zika) to substance abuse (Opoid epidemic), HIV/AIDs persistence in rural populations and behavioral health management for at-risk populations. The actual assignment will require the students to identify the population health issues, research the characteristics and criteria of the condition and to define the population at-risk. The key skill development revolves around the student\u27s capacity to find the most appropriate data sources and to select those data indicators that best represent the needs of the population at-risk. The PolicyMap tool will allow the student to link together not only clinical conditions, but social determinants as well. The summary reports and presentations will allow students to demonstrate critical thinking as they design their management responses to the various healthcare challenges

The elimination of undifferentiated human embryonic stem cells in vitro

Stem cells have been a focus of growing scientific interest both as a tool for studying early development and as a potential source of transplantable cells for regenerative medicine. Since their derivation in 1998, human embryonic stem (ES) cells have received much of this attention principally because of their ability to proliferate seemingly indefinitely in vitro and to differentiate along multiple lineages, essentially giving rise to every cell in the body (Reubinoff et ai, 2000; Thomson et al., 1998). However, before human ES-derived transplantation becomes a reality for patients, problems associated with prolonged and functional engraftment, histocompatability, homogeneous cell populations, and the risk of tumours arising from the accidental transplantation of undifferentiated human ES cells, must first be addressed.Despite the risk of malignancy associated with undifferentiated human ES cells, their indefinite growth in culture has provided an opportunity to manipulate their fate. This thesis has investigated the possibility of using the exogenous cell surface markers; the Galal-3Galpl-4GlcNAc-R (a-gal) epitope and the murine major histocompatibility complex (MHC) class I molecule H2-Kk, under the transcription control of the human telomerase reverse transcriptase (hTERT) promoter to selectively identify undifferentiated human ES cells for selective elimination. Provided within is evidence to show the successful genetic manipulation of undifferentiated human ES cells with al,3galactosyltransferase (al,3Gal) gene, providing comparable cell surface expression of the a-gal epitope with endogenous a-gal expression on the ovine foetal fibroblast cell line (PDFF). However, the use of the H2-Kk gene as a potential lysis epitope was not so successful. Despite successful integration and transcription of the H2-Kk gene, cell surface expression of the H2-Kk epitope was not achieved, and proof of protein translation could not be found.Expression of the a-gal epitope on undifferentiated human ES cells elicits a severe, yet highly specific cytolytic response; on average 95% of the transgenic human ES cells were lysed compared with just 8-12% of wild type non-expressing H9 cells, when exposed to human serum containing active-complement. In addition, when transgenic human ES cells were differentiated the a-gal epitope was down regulated, in the same manner as established markers of undifferentiated human ES cells (TRA1-81 and SSEA-4). Following differentiation the transgenic a-gal expressing cell line (M2) survived exposure to active serum-complement.This novel system for selective ablation could potentially provide natural immune protection, through the presence of circulating antibodies to a-gal that would protect graft-recipients against the presence of, or de-differentiation of, human ES-cell derivatives following engraftment

Working the Nexus: Teaching students to think, read and problem-solve like a lawyer

Despite a clear case for thinking skills in legal education, the approach to teaching these skills often appears to be implied in law curricula rather than identified explicitly. Thinking skills could be taught as part of reading law and legal problem solving. However, learning the full suite of thinking skills requires active teaching strategies which go beyond exposing students to the text of the law, and training them in its application by solving problem scenarios. The challenge for law teachers is to articulate how to learn legal thinking skills, and to do so at each level of the degree. This article outlines how the nexus between three component skills: critical legal thinking, reading law, and legal problem solving, can be put to work to provide a cohesive and scaffolded approach to the teaching of legal thinking. Although the approach in this article arises from the Smart Casual project, producing discipline-specific professional development resources directed at sessional teachers in law, we suggest that its application is relevant to all law teachers

Teaching Population Health: Innovations in the integration of the healthcare and public health systems

Population health is a critical concept in healthcare delivery today. Many healthcare administrators are struggling to adapt their organization from fee-for-service to value delivery. Payers and patients expect healthcare leaders to understand how to deliver care under this new model. Health administration programs play a critical role in training future leaders of healthcare organizations to be adaptable and effective in this dynamic environment. The purpose of this research was to: (a) engage current educators of health administration students in a dialogue about the best practices of integrating the healthcare and public health systems; (b) identify the content and pedagogy for population health in the undergraduate and graduate curricula; and (c) discuss exemplar population health curriculum models, available course materials, and curriculum integration options. Authors conducted focus groups of participants attending this educational session at the 2017 annual AUPHA meeting. Qualitative analysis of the focus group discussions was performed and themes identified by a consensus process. Study findings provide validated recommendations for population health in the health administration curriculum. The identification of key content areas and pedagogical approaches serves to inform health educators as they prepare future health administrators to practice in this new era of population health

Critical legal reading: The elements, strategies and dispositions needed to master this essential skill

Alex Steel, Kate Galloway, Mary Heath, Natalie Skead, Mark Israel, Anne Hewit

Pedagogy: How to best teach population health to future healthcare leaders

Our healthcare system is moving from a fee-for-service reimbursement model to one that provides payment for improvements in three areas related to care: quality, coordination, and cost. Healthcare organizations must use a population health approach when delivering care under this new paradigm. Health administration programs play a critical role in training future leaders of healthcare organizations to be adaptable and effective in this dynamic environment. The purpose of this research was to: (1) engage health administration educators in a dialogue about population health and its relevance to healthcare administration education; (2) describe pedagogical methods appropriate for teaching population health skills and abilities needed for successful careers in our healthcare environment; and (3) identify current student learning outcomes that participants can tailor to utilize in their undergraduate and graduate health management courses. Authors conducted focus groups of participants attending this educational session at the 2018 annual AUPHA meeting. Qualitative analysis of the focus group discussions identified themes by a consensus process. Study findings provide validated recommendations for population health in the health administration curriculum. The identification of pedagogical approaches serves to inform educators as they prepare future health administrators to practice in this new era of healthcare delivery

Older care-home residents as collaborators or advisors in research: a systematic review

Background: patient and public involvement (PPI) in research can enhance its relevance. Older care-home residents are often not involved in research processes even when studies are care-home focused. Objective: to conduct a systematic review to find out to what extent and how older care-home residents have been involved in research as collaborators or advisors. Methods: a systematic literature search of 12 databases, covering the period from 1990-September 2014 was conducted. A lateral search was also carried out. Standardised inclusion criteria were used and checked independently by two researchers. Results: 19 reports and papers were identified relating to 11 different studies. Care-home residents had been involved in the research process in multiple ways. Two key themes were identified: (i) the differences in residents’ involvement in small-scale and large-scale studies, (ii) the barriers to and facilitators of involvement. Conclusions: small-scale studies involved residents as collaborators in participatory action research, whereas larger studies involved residents as consultants in advisory roles. There are multiple facilitators of and barriers to involving residents as PPI members. The reporting of PPI varies. While it is difficult to evaluate the impact of involving care-home residents on the research outcomes, impact has been demonstrated from more inclusive research processes with care-home residents. The review shows that older care-home residents can be successfully involved in the research process

The development of a British assessment of inferential and idiom comprehension for 5:00 to 9:11 year-old typically-developing children

Understanding of inferences and non-literal language, such as idioms, is critical for successful communication and academic learning. Assessment of inferential and idiom comprehension is essential for children who are showing difficulties in these areas so that appropriate intervention and support can be provided. There is very little information on the typical development of these specific areas of verbal comprehension in the literature and there are very few current assessments of inferential and idiom comprehension for British school-aged children. While many assessments that do exist have face validity, very few are standardised. Some children with comprehension difficulties do well on existing picture-based assessments of verbal comprehension but they demonstrate significant difficulties with more abstract language comprehension. There is a gap in the current battery of assessments available to paediatric speech and language therapists for assessing inferential and idiom comprehension in detail. The primary aims of this thesis were to develop a robust standardised British assessment of inferential and idiom comprehension for 5:00 to 9:11 year-old children, to provide supporting validity and reliability data for the newly devised assessment, to provide normative and statistically significant data for inferential and idiom comprehension in typically developing children aged 5:00 to 9:11, to provide qualitative information on the typical development of these areas of verbal comprehension and to carry out exploratory studies using the new assessment with children with communication impairments. Secondary aims of the study were to examine if there was any relationship between gender and test performance and between socio-economic status and test performance. A new assessment, the Hewitt Inferential Comprehension and Idioms Test (HICIT) was created following a review of the literature and of the existing assessments in these areas of verbal comprehension. A pilot study was carried out with sixty-two 4:06 to 10:06 year-old children in two primary schools in the North West of England. The fourteen section, 210 item pilot test was reduced to the twelve section, 140 item final version of the HICIT. This was then trialled with a further 200 children, aged 5:00 to 9:11, making an overall standardisation sample of 250 children. Normative data were provided from the application of descriptive and inferential statistics to the results. A two-way ANOVA examined the effects of age group and gender on test scores and a one-way ANOVA and post-hoc independent T tests looked at the relationship between socio-economic status and test performance. The construct validity of the test was examined with exploratory and confirmatory factor analyses. These demonstrated a single factor loading and good model fit measurements. The reliability of the test, as assessed by Cronbach’s Alpha was moderate, similar to an existing published British standardised verbal language assessment. Rasch analysis indicated that the internal consistency of the test was good. The inter-rater reliability of 98.6% was excellent. The descriptive and inferential statistics demonstrated that there was a developmental progression between the age groups for inferential and idiom comprehension but that there was no effect for gender. The idioms sub-section was the only section not to reach ceiling scores by 9:11. The results for the relationship between socio-economic status and test scores were inconclusive. Quantitative analysis of the HICIT data demonstrated that the test is a robust assessment of inferential and idiom comprehension. Some sub-tests of the test are more robust with different age groups so different versions of the test could be used with different age groups. Qualitative analysis of the test responses, exploratory case studies using the HICIT to assess four children with communication impairments and feedback from practising speech and language therapists produced useful information on the possible applications of the test and suggested that it could be very useful to assist in differential diagnosis of different types of communication impairments