scholarly journals Setting an Agenda for Hospital Medicine Research: Making Sure the Right People Are at the Table

10.12788/3403 ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. 383-384
Author(s):  
Alexander F Glick ◽  
Ramon EA Jacobs-Shaw ◽  
Rebecca E Rosenberg
Keyword(s):  
United States ◽  
Health System ◽  
Patient Engagement ◽  
Outcomes Research ◽  
Hospital Medicine ◽  
The United States ◽  
Service Industries ◽  
Patient Centered ◽  
Medicine Research ◽  
The Right

Unlike other service industries, US healthcare has been slower to adopt an approach of asking users (patients) how to make things better. However, patient engagement in systems of healthcare (eg, Patient and Family Advisory Councils [PFAC]) and health system-­based research (eg, Patient Centered Outcomes Research Institute [PCORI]) are gaining currency in the United States.1,2

scholarly journals The Impact of Comparative Effectiveness Research on Interventional Pain Management: Evolution from Medicare Modernization Act to Patient Protection and Affordable Care Act and the Patient-Centered Outcomes Research Institute

2011 ◽  
Vol 3;14 (3;5) ◽  
pp. E249-E282
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
United States ◽  
Pain Management ◽  
Affordable Care Act ◽  
Comparative Effectiveness Research ◽  
Outcomes Research ◽  
Comparative Effectiveness ◽  
The United States ◽  
Effectiveness Research ◽  
Patient Centered ◽  
Interventional Pain Management

The Patient-Centered Outcomes Research Institute (PCORI) was established by the Affordable Care Act of 2010 to promote comparative effectiveness research (CER) to assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis. The development of PCORI is vested in the Medicare Modernization Act (MMA) and the American Recovery and Reinvestment Act (ARRA). The framework of CER and PCORI describes multiple elements which are vested in all 3 regulations including stakeholder involvement, public participation, and open transparent decision-making process. Overall, PCORI is much more elaborate with significant involvement of stakeholders, transparency, public participation, and open decision-making. However, there are multiple issues concerning the operation of such agencies in the United States including the predecessor of Agency for Healthcare Research and Quality (AHRQ), the Agency for Healthcare Policy and Research (AHCPR), AHRQ Effectiveness Health Care programs, and others. The CER in the United States may be described at cross-roads or at the beginnings of a scientific era of CER and evidence-based medicine (EBM). However the United States suffers as other countries, including the United Kingdom with its National Health Services (NHS) and National Institute for Health and Clinical Excellence (NICE), with major misunderstandings of methodology, an inordinate focus on methodological assessment, lack of understanding of the study design (placebo versus active control), lack of involvement of clinicians, and misinterpretation of the evidence which continues to be disseminated. Consequently, PCORI and CER have been described as government-driven solutions without following the principles of EBM with an extensive focus on costs rather than quality. It also has been stated that the central planning which has been described for PCORI and CER, a term devised to be acceptable, will be used by third party payors to override the physician’s best medical judgement and patient’s best interest. Further, stakeholders in PCORI are not scientists, are not balanced, and will set an agenda with an ultimate problem of comparative effectiveness and PCORI that it is not based on medical science, but rather on political science and not even under congressional authority, leading to unprecedented negative changes to health care. Thus, PCORI is operating in an ad hoc manner that is incompatible with the principles of evidence-based practice. This manuscript describes the framework of PCORI, and the role of CER and its impact on interventional pain management. Key words: Patient-Centered Outcomes Research Institute (PCORI), comparative effectiveness research (CER), National Institute for Health and Clinical Excellence (NICE), Patient Protection and Affordable Care Act (ACA), Medicare Modernization Act (MMA), American Recovery and Reinvestment Act (ARRA), interventional pain management, interventional techniques, evidencebased medicine, systematic reviews.

scholarly journals Facilitators and Barriers to Patient-Centered Outcomes Research Partnership Sustainability in the United States

2021 ◽  
Vol 8 (1) ◽  
pp. 8-19
Author(s):  
Tristen L Hall ◽  
Charlene Barrientos-Ortiz ◽  
Griselda Peña-Jackson ◽  
Courtney Fultineer ◽  
Kevin Werner ◽  
...  
Keyword(s):  
United States ◽  
Outcomes Research ◽  
The United States ◽  
Research Partnership ◽  
Patient Centered ◽  
Facilitators And Barriers

Lending to the Borrower from Hell

2017 ◽  
Author(s):  
Mauricio Drelichman ◽  
Hans-Joachim Voth
Keyword(s):  
United States ◽  
Sixteenth Century ◽  
Sovereign Debt ◽  
Risk Sharing ◽  
The United States ◽  
Philip Ii ◽  
Loan Contracts ◽  
The Right ◽  
Intelligent Model ◽  
New Evidence

Why do lenders time and again loan money to sovereign borrowers who promptly go bankrupt? When can this type of lending work? As the United States and many European nations struggle with mountains of debt, historical precedents can offer valuable insights. This book looks at one famous case—the debts and defaults of Philip II of Spain. Ruling over one of the largest and most powerful empires in history, King Philip defaulted four times. Yet he never lost access to capital markets and could borrow again within a year or two of each default. Exploring the shrewd reasoning of the lenders who continued to offer money, the book analyzes the lessons from this historical example. Using detailed new evidence collected from sixteenth-century archives, the book examines the incentives and returns of lenders. It provides powerful evidence that in the right situations, lenders not only survive despite defaults—they thrive. It also demonstrates that debt markets cope well, despite massive fluctuations in expenditure and revenue, when lending functions like insurance. The book unearths unique sixteenth-century loan contracts that offered highly effective risk sharing between the king and his lenders, with payment obligations reduced in bad times. A fascinating story of finance and empire, this book offers an intelligent model for keeping economies safe in times of sovereign debt crises and defaults.

Law Struggles, Lawmaking, and the Politics of Hegemony in Neoliberal India

2017 ◽  
Author(s):  
Kenneth Bo Nielsen ◽  
Alf Gunvald Nilsen
Keyword(s):  
United States ◽  
The United States ◽  
Land Acquisition ◽  
Ethical Perspective ◽  
Judicial Decisions ◽  
Fair Compensation ◽  
The Right ◽  
Neoliberal India ◽  
Land Question

The chapter examines the fairness claim of the Right to Fair Compensation and Transparency in Land Acquisition, Rehabilitation and Resettlement Act (LARR), 2013. The author uses the utilitarian fairness standard proposed by one of the most influential American constitutional scholars of the twentieth and twenty-first centuries, Frank Michelman, whose study of judicial decisions from an ethical perspective by introducing the concept of “demoralization costs” has shaped the interpretational debate on takings law in the United States. Michelman’s analysis is particularly relevant for the land question in India today since there is a widespread feeling that millions of people have been unfairly deprived of their land and livelihoods. The chapter looks at the role of the Indian judiciary in interpreting the land acquisition legislation since landmark judgments affect the morale of society. It concludes that using Michelman’s standard would help in bringing about greater “fairness” than what the new legislation has achieved.

The Power to be Ethical: Controlling Moral Assemblages in Border Militias

2021 ◽  
pp. 089124162110218
Author(s):  
John R. Parsons
Keyword(s):  
United States ◽  
The United States ◽  
Recent Interest ◽  
Ethical Conflicts ◽  
Moral Landscape ◽  
The Government ◽  
Moral Certainty ◽  
The Right ◽  
Ethical Response

Every year, hundreds of U.S. citizens patrol the Mexican border dressed in camouflage and armed with pistols and assault rifles. Unsanctioned by the government, these militias aim to stop the movement of narcotics into the United States. Recent interest in the anthropology of ethics has focused on how individuals cultivate themselves toward a notion of the ethical. In contrast, within the militias, ethical self-cultivation was absent. I argue the volunteers derived the power to be ethical from the control of the dominant moral assemblage and the construction of an immoral “Other” which provided them the power to define a moral landscape that limited the potential for ethical conflicts. In the article, I discuss two instances Border Watch and its volunteers dismissed disruptions to their moral certainty and confirmed to themselves that their actions were not only the “right” thing to do, but the only ethical response available.

The Three Rs in Research and Education: A Long Road Ahead in the United States

1996 ◽  
Vol 24 (2) ◽  
pp. 151-158 ◽  
Author(s):  
F. Barbara Orlans
Keyword(s):  
United States ◽  
Animal Experiments ◽  
The United States ◽  
Education Student ◽  
Funding Sources ◽  
Research And Education ◽  
The Right ◽  
Student Projects ◽  
Institutional Oversight ◽  
The Three Rs

Attitudes toward the Three Rs concept of refinement, reduction and replacement in the United States in research and education are widely divergent. Positive responses have come from several sources, notably from four centres established to disseminate information about alternatives. Funding sources to support work in the Three Rs have proliferated. The activities of institutional oversight committees have resulted in the nationwide implementation of important refinements. In the field of education, student projects involving pain or death for sentient animals have declined, and the right of students to object to participation in animal experiments on ethical grounds has been widely established. However, there is still a long way to go. Resistance to alternatives is deep-seated within several of the scientific disciplines most closely associated with animal research. The response of the National Institutes of Health to potentially important Congressional directives on the Three Rs has been unsatisfactory. The prestigious National Association of Biology Teachers, which at first endorsed the use of alternatives in education, later rescinded this policy, because of opposition to it. An impediment to progress is the extreme polarisation of viewpoints between the biomedical community and the animal protectionists.

Constitutional Law in 1942–1943: The Constitutional Decisions of the Supreme Court of the United States in the October Term, 1942

1944 ◽  
Vol 38 (2) ◽  
pp. 266-288
Author(s):  
Robert E. Cushman
Keyword(s):  
United States ◽  
Supreme Court ◽  
West Coast ◽  
The United States ◽  
Japanese American ◽  
Circuit Court ◽  
Court Of Appeals ◽  
The Supreme Court ◽  
Set Up ◽  
The Right

On February 15, 1943, Wiley B. Rutledge, Jr., a judge of the United States Circuit Court of Appeals for the District of Columbia, took the seat on the Supreme Court vacated by the resignation in October, 1942, of Mr. Justice Byrnes. There were no other changes in the Court's personnel. Disagreement among the justices abated somewhat. In only a dozen cases of importance did either four or three justices dissent, as against some thirty cases in the last term. The Court overruled two earlier decisions, both recent; and the reversal in each case was made possible by the vote of Mr. Justice Rutledge.A. QUESTIONS OF NATIONAL POWER1. WAR POWER-CIVIL VERSUS MILITARY AUTHORITYWest Coast Curfew Applied to Japanese-American Citizens. In February, 1942, the President issued Executive Order No. 9066, which authorized the creation of military areas from which any or all persons might be excluded and with respect to which the right of persons to enter, remain in, or leave should be subject to such regulations as the military authorities might prescribe. On March 2, the entire West Coast to an average depth of forty miles was set up as Military Area No. 1 by the Commanding General in that area, and the intention was announced to evacuate from it persons of suspected loyalty, alien enemies, and all persons, aliens and citizens alike, of Japanese ancestry.

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