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1 – 10 of over 144000Several emergency public health issues have a tremendous impact on and rely upon close coordination with law enforcement officials. Most interactions involve law enforcement…
Abstract
Several emergency public health issues have a tremendous impact on and rely upon close coordination with law enforcement officials. Most interactions involve law enforcement personnel providing security, crowd control, and/or traffic control during public health related incidents. However, as varied chemical and biological threats have emerged over the years, this interaction has increased to include joint investigations between the two disciplines. Certain biological threats, such as pandemics, pose direct threats to the law enforcement agency operations. Understanding the role of public health in emergencies, the overlapping missions, and the threats at all levels allows law enforcement professionals to better prepare themselves and their organizations for coordinating operations and maintaining continuity of law enforcement services.
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Xiaodong Tan, Jing Qiu, Guanjun Liu and Kehong Lv
The purpose of this paper is to evaluate the health‐states of unit under test (UUT) in aerospace systems by means of unreliable test outcomes, and the evaluation results can…
Abstract
Purpose
The purpose of this paper is to evaluate the health‐states of unit under test (UUT) in aerospace systems by means of unreliable test outcomes, and the evaluation results can provide a guide for engineers to carry out proper maintenance prior to total failure.
Design/methodology/approach
In this paper, the authors formulate the health‐state evaluation (HSE) problem with unreliable test outcomes based on Bayes rule, and develop the Lagrangian relaxation and adaptive genetic algorithm (LRAGA) to solve it. The solution scheme can be viewed as a two‐level coordinated solution framework for the HSE problem. At the top level, the Lagrange multipliers are updated by using AGA. At the bottom level, each of the sub‐problems is solved by using AGA.
Findings
The experimental results show that the HSE model appears promising and the LRAGA can obtain the higher quality solution and converge to it at a faster rate than conventional methods (i.e. Lagrangian relaxation (LR), genetic algorithm (GA), simulated annealing (SA) and Lagrangian relaxation and genetic algorithm (LRGA).
Research limitations/implications
The proposed method for the HSE problem of large‐scale systems which include thousands of faults and tests needs to be verified further.
Practical implications
The HSE results for aerospace systems can help engineers to carry out a schedule for prompt maintenance prior to UUTs' failure, to avoid the consequences of total failure. It is important to improve aerospace systems' safety, reliability, maintainability, affordability, and reduce life cycle cost.
Originality/value
This paper constructs the HSE model with unreliable test outcomes based on the Bayes rule and proposes a method based on LRAGA to solve the HSE problem.
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This paper aims to examine the issue of quality of care in the US managed care system and to compare state‐level policies and programs. Specifically, it aims to describe five…
Abstract
Purpose
This paper aims to examine the issue of quality of care in the US managed care system and to compare state‐level policies and programs. Specifically, it aims to describe five states which are making the most quality of care improvements.
Design/methodology/approach
This study examines the literature to identify states' care quality rankings. Additionally, five state case studies are presented to illustrate various programs approach to quality.
Findings
The paper finds that some states are better than others in their strategies to enhance quality of care. California, Florida, Maryland, Minnesota and Rhode Island are considered among the best. Thus, their programs are described.
Research limitations/implications
From a research perspective the study brings a renewed focus on various methods in which states invest to improve residents' quality of care.
Practical implications
From a practical standpoint, since quality of care is an important topic and interesting to all stakeholders in health care – policymakers, consumers, providers, and payers – readers can use the study's results to compare states' strategies and develop new ways to increase quality.
Originality/value
This study's value lies in the way it helps states to compare their performance over time and against other states as they make improvements to enhance quality.
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This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise…
Abstract
This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non‐binding or so‐called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.
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Vincent L. Marando and Alan C. Melchior
Contrary to the popular view of mandates as rigid and dictatorial mechanisms, this article advances a view of mandates as mechanisms for cooperation and negotiation. The…
Abstract
Contrary to the popular view of mandates as rigid and dictatorial mechanisms, this article advances a view of mandates as mechanisms for cooperation and negotiation. The relationship between several state and local actors is investigated in Maryland, particularly within the context of the development of a "loosely" mandated public health program, the Targeted Funding Program (TFP). An analysis of the TFP and the actors involved in the program's development demonstrates how this program is designed to achieve much more than increased fiscal responsibility. The TFP is designed, and continues to be redesigned, to meet the political and professional objectives of various elected and appointed officials at the state and local levels.
L. Warshawsky-Livne, L. Novack, A. B. Rosen, S. M. Downs, J. Shkolnik-Inbar and J. S. Pliskin
A rich literature has documented gender-based differences in health care utilization and outcomes. The role of risk attitude in explaining the variations is limited at best. This…
Abstract
Purpose
A rich literature has documented gender-based differences in health care utilization and outcomes. The role of risk attitude in explaining the variations is limited at best. This study examines gender differences in health utilities and risk attitudes.
Methodology
Data on 13 health states were collected from 629 students via questionnaires at the Ben-Gurion University of the Negev in 2005. From each respondent, we assessed utilities for a subset of health states, using Time Trade-Off and Standard Gamble. A risk attitude coefficient was calculated for each respondent as a function of their utilities for all outcomes assessed. The risk coefficient derived from a closed-form utility model for men was compared to that of women using the t-statistic.
Findings
There was a statistically significant difference in the risk attitudes of men and women. Men had a concave utility function, representing risk aversion, while women had a near linear utility function, suggesting that women are risk neutral.
Practical/social implications
Differences in risk attitude may be an important contributor to gender-based disparities in health services utilization. More research is needed to assess its full impact on decision-making in health care.
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Laura Senier, Matthew Kearney and Jason Orne
This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.
Abstract
Purpose
This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.
Methodology/approach
We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.
Findings
Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.
Research/Policy Implications
Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.
Originality/Value
There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.
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Mohammad Azhar Ud Din, Muzffar Hussain Dar and Shaukat Haseen
The study aims to compare India's public health expenditure at the international and state levels. The paper also empirically examines the regional disparities in NRHM spending…
Abstract
Purpose
The study aims to compare India's public health expenditure at the international and state levels. The paper also empirically examines the regional disparities in NRHM spending across the 21 selected states of India.
Design/methodology/approach
The tools of absolute β-and σ-convergence are used in the analysis to test the regional convergence. The average annual growth rate across the states is the dependent variable for β-convergence, and time is the second dependent variable but is used for s-convergence. In contrast, the initial value of NRHM expenditure and the coefficient of variation of NRHM expenditure are used as independent variables, respectively. Descriptive statistics are also used for the study. The data are annual and cover the panel from 2007 to 2020.
Findings
The study attests to the hypothesis of β-and σ-convergence for the selected states in the period mentioned. The observed convergence in NRHM expenditure is due to the shift in the government's attention from the non-high focus high focus states to high states through the national rural health mission policy. The coefficient of variation across the states also shows a declining trend and provides the robustness of the σ-convergence.
Originality/value
As far as the literature is concerned, none of the existing studies examines the convergence of a public health expenditure scheme like the National Rural Health Mission across the Indian states by applying the techniques of β-and σ-convergence. The novelty of the study is using the newly updated dataset and validating the convergence hypotheses in the National Rural Health Mission expenditure case.
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Amarendu Nandy, Chhavi Tiwari and Sayantan Kundu
The COVID-19 pandemic educed extraordinary policy responses globally, including in India, to flatten the infection-growth curve. The trajectories of infections, recovery, and…
Abstract
Purpose
The COVID-19 pandemic educed extraordinary policy responses globally, including in India, to flatten the infection-growth curve. The trajectories of infections, recovery, and deaths vastly differed across Indian states. The purpose of this study is to investigate whether persistent investments by states in critical social sectors, such as health and education, explain their preparedness and hence better management of the pandemic.
Design/methodology/approach
This study uses secondary data on the number of infected, recovered and deceased due to COVID-19, along with data on population and income across 302 districts in 11 major states in India. Data on health and education indices are collected at the state-level. Linear regression models that also control for heteroskedasticity are applied.
Findings
This study finds that higher investments in health care and education reduce the propensity of the infection spread. Further, states with persistent investments in health care and education exhibit a higher rate of recovery. This study also finds that death rates are significantly lower in states with higher investments in education.
Research limitations/implications
The findings support the conjecture that states that have consistently invested in social sectors benefited from the associated positive externalities during the crisis that helped them manage the pandemic better.
Originality/value
This study will help policymakers understand the underlying social forces critical to the success in the fight against pandemics. Apart from improving preparedness for future pandemics, the evidence provided in the paper may help give better direction and purpose to tax-financed public spending in states where social sector development has hitherto received low priority.
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