scholarly journals Between Stars and Stripes: Regions for American Healthcare Reform

2019 ◽  
Author(s):  
Brian M Coyle
Keyword(s):  
Healthcare Reform ◽  
Healthcare Delivery ◽  
Political Support ◽  
Government Administration ◽  
Population Sizes ◽  
Equal Population ◽  
Roll Out ◽  
Better Than

Analyzes government administration healthcare reform requires. Defines vast scaling of enterprise to cover the entire US. Reviews management constraints to supervise and learn. Always requires hierarchies. Too many layers pass effectiveness thresholds. Proposed reforms: "Medicare for All," may extend UK NHS-like program to US residents; "Public Option" may extend government insurance to US residents who choose it. Debate thus far about costs. Administrative requirements more critical to success (or failure.) Ignored in some plans. Examine how scale is managed in healthcare delivery, in smaller and some large nations. Administration of major medical reforms across US market will take a decade plus to roll-out. Must be carefully managed, to meet healthcare expectations and maintain political support. Success will exploit regionalisation, seeding new programs in areas with equal population sizes and ethnic compositions. Nationalization of some insurers is better than "putting them out of business," could smooth Public Option surge. But perfection is enemy of good: success will follow Moynihan's rule: show benefits to the privileged to serve the underprivileged.

scholarly journals Location and Survival of Leaf-Associated Bacteria in Relation to Pathogenicity and Potential for Growth within the Leaf

1999 ◽  
Vol 65 (4) ◽  
pp. 1435-1443 ◽  
Author(s):  
M. Wilson ◽  
S. S. Hirano ◽  
S. E. Lindow
Keyword(s):  
Pseudomonas Syringae ◽  
Plant Pathogens ◽  
Vacuum Infiltration ◽  
Associated Bacteria ◽  
Growth And Survival ◽  
Total Leaf ◽  
Spray Inoculation ◽  
Dry Conditions ◽  
Population Sizes ◽  
Better Than

ABSTRACT The growth and survival of pathogenic and nonpathogenicPseudomonas syringae strains and of the nonpathogenic species Pantoea agglomerans, Stenotrophomonas maltophilia, and Methylobacterium organophilum were compared in the phyllosphere of bean. In general, the plant pathogens survived better than the nonpathogens on leaves under environmental stress. The sizes of the total leaf-associated populations of the pathogenic P. syringae strains were greater than the sizes of the total leaf-associated populations of the nonpathogens under dry conditions but not under moist conditions. In these studies the surface sterilants hydrogen peroxide and UV irradiation were used to differentiate cells that were fully exposed on the surface from nonexposed cells that were in “protected sites” that were inaccessible to these agents. In general, the population sizes in protected sites increased with time after inoculation of plants. The proportion of bacteria on leaves that were in protected sites was generally greater for pathogens than for nonpathogens and was greater under dry conditions than under moist conditions. When organisms were vacuum infiltrated into leaves, the sizes of the nonexposed “internal” populations were greater for pathogenic P. syringae strains than for nonpathogenic P. syringaestrains. The sizes of the populations of the nonpathogenic species failed to increase or even decreased. The sizes of nonexposed populations following spray inoculation were correlated with the sizes of nonexposed, internal populations which developed after vacuum infiltration and incubation. While the sizes of the populations of the pathogenic P. syringae strains increased on leaves under dry conditions, the sizes of the populations of the nonpathogenic strains of P. syringae, P. agglomerans, andS. maltophilia decreased when the organisms were applied to plants. The sizes of the populations on dry leaves were also correlated with the sizes of the nonexposed populations that developed following vacuum infiltration. Although pathogenicity was not required for growth in the phyllosphere under high-relative-humidity conditions, pathogenicity apparently was involved in the ability to access and/or multiply in certain protected sites in the phyllosphere and in growth on dry leaves.

scholarly journals Have the Pilot County Hospitals’ Service Capability Been Improved Since the Healthcare Reform? An Analysis of 370 Hospitals in China

2019 ◽  
Author(s):  
Yinhong Dong ◽  
Xingyi YANG ◽  
Pengqian FANG ◽  
Zhengqiong PAN ◽  
Zhenni LUO
Keyword(s):  
Public Hospital ◽  
Healthcare Reform ◽  
Current Situation ◽  
Public Hospitals ◽  
Analysis Method ◽  
Hospital Reform ◽  
Comprehensive Service ◽  
Service Capability ◽  
Public Hospital Reform ◽  
Better Than

Background: County public hospital reform is one of the major tasks proposed in Chinese Healthcare Reform., and the evaluation of hospital reform effectiveness is very important and beneficial since it helps the government to understand the current situation of pilot county public hospitals and smoothly start the reform in all county hospitals. Methods: This study used hospitals data from 2009 to 2012 to evaluate the effectiveness of county public hospital reform through comprehensive service capability. Descriptive analysis method was used, and factor analysis method was used to extract the main factors associated with service capabilities as well as to calculate a composite score. The t-test of two independent-samples methods was used to comparison analyze. Results: The differences of common factor scores (hospital scale and service capacity, treatment quality, service quality, and services efficiency) between pilot and non-pilot hospitals were not statistically significant (P>0.05). The service capability score in 2012 was better than that in 2009 either in pilot or non-pilot group (P<0.05). The pilot hospitals’ service capability score was better than that in non-pilot groups either in 2010 or 2012 (P<0.05). However, the differences from 2009 to 2012 of service capability score between pilot and non-pilot hospitals were not statistically significant. Conclusion: The comprehensive service capability of both pilot and non-pilot group all got improvement. However, county public hospital reform did not significantly play a due good role in improving the service capability in pilot group. The reform was helpful to improve the hospital current situation, but it has not completely achieved policy objectives in the sample hospitals of this study.

scholarly journals Advancing Healthcare Reform: The American Heart Association’s 2020 Statement of Principles for Adequate, Accessible, and Affordable Health Care: A Presidential Advisory From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 141 (10) ◽  
Author(s):  
John J. Warner ◽  
Ivor J. Benjamin ◽  
Keith Churchwell ◽  
Grace Firestone ◽  
Timothy J. Gardner ◽  
...  
Keyword(s):  
Health Care ◽  
Biomedical Research ◽  
American Heart Association ◽  
Healthcare Reform ◽  
American Heart ◽  
Healthcare Delivery ◽  
Heart Association ◽  
The United States ◽  
Delivery Systems ◽  
Healthcare Delivery Systems

The mission of the American Heart Association is to be a relentless force for a world of longer, healthier lives. The American Heart Association has consistently prioritized the needs and perspective of the patient in taking positions on healthcare reform while recognizing the importance of biomedical research, providers, and healthcare delivery systems in advancing the care of patients and the prevention of disease. The American Heart Association’s vision for healthcare reform describes the foundational changes needed for the health system to serve the best interests of patients and to achieve health care and coverage that are adequate, accessible, and affordable for everyone living in the United States. The American Heart Association is committed to advancing the dialogue around healthcare reform and has prepared this updated statement of our principles, placed in the context of the advances in coverage and care that have occurred after the passage of the Affordable Care Act, the rapidly changing landscape of healthcare delivery systems, and our evolving recognition that efforts to prevent cardiovascular disease can have synergistic benefit in preventing other diseases and improving overall well-being. These updated principles focus on expanding access to affordable health care and coverage; enhancing the availability of evidence-based preventive services; eliminating disparities that limit the availability and equitable delivery of health care; strengthening the public health infrastructure to respond to social determinants of health; prioritizing and accelerating investments in biomedical research; and growing a diverse, culturally competent health and healthcare workforce prepared to meet the challenges of delivering high-value health care.

Day Medicine: An Urgent Internal Medicine Clinic and Medical Procedures Suite

2003 ◽  
Vol 16 (1) ◽  
pp. 17-23 ◽  
Author(s):  
H. Jay Biem ◽  
David Cotton ◽  
Shirley McNeil ◽  
Alice Boechler ◽  
Debra Gudmundson
Keyword(s):  
Internal Medicine ◽  
Healthcare Reform ◽  
Healthcare Delivery ◽  
Acute Hospital ◽  
Medical Procedures ◽  
Medical Patients ◽  
District Health ◽  
Number Of Patients ◽  
Hospital Beds ◽  
Internal Medicine Clinic

During Saskatchewan's healthcare reform of the 1990s, the number of acute hospital beds in Saskatoon District Health was cut in half. The emergency room and outpatient facilities were not able to accommodate an increasing number of patients needing urgent assessments and medical procedures. In this article, we describe the development, implementation and utilization of a day medicine program. This description may be useful to others planning healthcare delivery to medical patients, especially in a setting of resource constraint.

scholarly journals Towards universal health coverage: lessons from 10 years of healthcare reform in China

2020 ◽  
Vol 5 (3) ◽  
pp. e002086 ◽  
Author(s):  
Wenjuan Tao ◽  
Zhi Zeng ◽  
Haixia Dang ◽  
Bingqing Lu ◽  
Linh Chuong ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Healthcare Reform ◽  
Service System ◽  
National Policy ◽  
Health Financing ◽  
Universal Coverage ◽  
Political Support ◽  
Chinese Government ◽  
Health Coverage ◽  
Universal Health

Universal health coverage (UHC) is driving the global health agenda. Many countries have embarked on national policy reforms towards this goal, including China. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. The year of 2019 marks the 10th anniversary of China’s most recent healthcare reform. Sharing China’s experience is especially timely for other countries pursuing reforms to achieve UHC. This study describes the social, economic and health context in China, and then reviews the overall progress of healthcare reform (1949 to present), with a focus on the most recent (2009) round of healthcare reform. The study comprehensively analyses key reform initiatives and major achievements according to four aspects: health insurance system, drug supply and security system, medical service system and public health service system. Lessons learnt from China may have important implications for other nations, including continued political support, increased health financing and a strong primary healthcare system as basis.

scholarly journals China’s National Health Guiding Principles: a perspective worthy of healthcare reform

2017 ◽  
Vol 19 (01) ◽  
pp. 99-104 ◽  
Author(s):  
Ping Zhang ◽  
Yuan Liang
Keyword(s):  
National Health ◽  
Western Medicine ◽  
Healthcare Reform ◽  
Healthcare Delivery ◽  
Chinese Traditional Medicine ◽  
The Third ◽  
The Social ◽  
Guiding Principles ◽  
New Perspective ◽  
Priority Population

For countries faced with much talk but little action on healthcare reform, China’s National Health Guiding Principles (CNHGP), with its 60-year history, may provide a new perspective. There are four values of CNHGP for healthcare reform. First, these principles provide an innovative strategic framework for healthcare reform with three levels, from ‘One priority population’ to ‘Four approaches’ and then to ‘Two aims.’ The second is the importance of mass/grassroots participation, which runs through all three levels of CNHGP. The third value is that the CNHGP used nonspecific social approaches, an innovation in healthcare delivery that addressed the social determinants of health. The fourth value is the integration between Chinese traditional medicine and Western medicine.

scholarly journals An Analytical Tool for Constructing and Evaluating Testing Strategic for COVID-19

2021 ◽  
Author(s):  
Richard Kouri ◽  
Donald Warsing ◽  
Nikhil Singh ◽  
Beena Thomas ◽  
Robert B Handfield
Keyword(s):  
The United States ◽  
Critical Parameters ◽  
Term Care ◽  
Public School Systems ◽  
Testing Cost ◽  
Population Sizes ◽  
Public Health Officials ◽  
Antigen Testing ◽  
Roll Out

Abstract Background This paper describes the utilization of a mathematical modeling tool for evaluating alternative testing cadences for the SARS-CoV-2 virus that are applicable to any well-contained congregate setting. These settings include long-term care facilities, and public-school systems. Results Variables analyzed include population sizes, contagion factor, and unique testing objectives that congregate settings might have (e.g., differing susceptibilities, or varying underlying health conditions). The tool helps evaluate cost vs benefit for a range of testing cadences (e.g., daily, every 2 days, every 3 days, every week, every 2 weeks every 3 weeks and every 4 weeks) based on use of a commercially available antigen testing kit that costs $5 per test. Conclusions Critical parameters derived as output of the model include total persons tested, average number in quarantine, average percent positives in quarantine, total testing cost, total infections allowed, cases averted, and cost per case averted. These parameters allow public health officials, site managers and/or on-site healthcare workers to optimize testing plans to align with available resources and support fact-based decision making. We also discuss how this tool can work with vaccine roll-out both in the United States and elsewhere.

scholarly journals Maximum-Likelihood Estimation of Migration Rates and Effective Population Numbers in Two Populations Using a Coalescent Approach

Genetics ◽  
1999 ◽  
Vol 152 (2) ◽  
pp. 763-773 ◽  
Author(s):  
Peter Beerli ◽  
Joseph Felsenstein
Keyword(s):  
Maximum Likelihood ◽  
Mutation Rate ◽  
Likelihood Estimation ◽  
Effective Population ◽  
Migration Rates ◽  
Coalescent Approach ◽  
Population Sizes ◽  
Two Populations ◽  
Better Than ◽  
Population Numbers

Abstract A new method for the estimation of migration rates and effective population sizes is described. It uses a maximum-likelihood framework based on coalescence theory. The parameters are estimated by Metropolis-Hastings importance sampling. In a two-population model this method estimates four parameters: the effective population size and the immigration rate for each population relative to the mutation rate. Summarizing over loci can be done by assuming either that the mutation rate is the same for all loci or that the mutation rates are gamma distributed among loci but the same for all sites of a locus. The estimates are as good as or better than those from an optimized FST-based measure. The program is available on the World Wide Web at http://evolution.genetics.washington.edu/lamarc.html/.

scholarly journals Rhizosphere Competence of Wild-Type and Genetically Engineered Pseudomonas brassicacearum Is Affected by the Crop Species

2016 ◽  
Vol 106 (6) ◽  
pp. 554-561 ◽  
Author(s):  
Stacey Blouin Bankhead ◽  
Linda S. Thomashow ◽  
David M. Weller
Keyword(s):  
Genetically Engineered ◽  
Navy Bean ◽  
Crop Species ◽  
Rhizosphere Population ◽  
Population Sizes ◽  
Rhizosphere Competence ◽  
Pseudomonas Brassicacearum ◽  
The Impact ◽  
Biocontrol Strain ◽  
Better Than

2,4-Diacetylphloroglucinol (2,4-DAPG)-producing Pseudomonas brassicacearum Q8r1-96 is a highly effective biocontrol agent of take-all disease of wheat. Strain Z30-97, a recombinant derivative of Q8r1-96 containing the phzABCDEFG operon from P. synxantha (formerly P. fluorescens) 2-79 inserted into its chromosome, also produces phenazine-1-carboxylic acid. Rhizosphere population sizes of Q8r1-96, Z30-97, and 2-79, introduced into the soil, were assayed during successive growth cycles of barley, navy bean, or pea under controlled conditions as a measure of the impact of crop species on rhizosphere colonization of each strain. In the barley rhizosphere, Z30-96 colonized less that Q8r1-96 when they were introduced separately, and Q8r1-96 out-competed Z30-96 when the strains were introduced together. In the navy bean rhizosphere, Q8r1-96 colonized better than Z30-97 when the strains were introduced separately. However, both strains had similar population densities when introduced together. Strain Q8r1-96 and Z30-97 colonized the pea rhizosphere equally well when each strain was introduced separately, but Z30-97 out-competed Q8r1-96 when they were introduced together. To our knowledge, this is the first report of a recombinant biocontrol strain of Pseudomonas spp. gaining rhizosphere competitiveness on a crop species. When assessing the potential fate of and risk posed by a recombinant Pseudomonas sp. in soil, both the identity of the introduced genes and the crop species colonized by the recombinant strain need to be considered.

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