The differential diagnosis of caring

Psychiatric Services, 2008

BOOK REVIEWS P erhaps only a political and policy enthusiast like me would really enjoy this book. It is a 400-page history of the federal and state Medicaid program since its inception in 1965. Medicaid has grown unevenly, often uncontrollably, and sometimes unpredictably in many different program areas and states without much direction or corrective action on the part of the federal government. It began as an add-on to public assistance and is essentially a program of "welfare medicine." The underlying theme of the book is that Medicaid is a "weak entitlement," both morally and institutionally. It is weak on moral grounds because of its close association with public welfare; it reflects our cultural attitudes toward poor people, women, and people from racial minority groups. Medicaid recipients have not paid into an account like Social Security beneficiaries have; and unlike veterans, they are not owed anything by our country at large. It is weak institutionally because it has neither a trust fund nor an administrative equivalent of the Social Security Administration with its large bureaucracy and political defenses. The major strength of Medicaid has been the program's flexibility to take care of a wide range of medical and associated social services, but because of the tendency to expand, a steady growing enrollment, greater benefits coverage, and higher total expenditures, it has consumed increasing proportions of state budgets and federal expenditures. As a result, the Medicaid program today is under siege. This book describes the great divide in the Medicaid program between the frail elderly population, people with chronic illnesses (includ

Neurology, 2015

Journal of Social Work in End-of-Life & Palliative Care, 2015

Journal of Clinical Nursing, 2006

Aim. To illuminate the experience of being a patient and cared for in an acute care ward.Background. Patients may be the best source of information for assessing the quality of care in acute care wards. Studies often show that patients’ satisfaction with their hospital stay is interpreted by managers and care providers as a measure for quality of care.Design. Ten patients were interviewed as part of a comprehensive investigation by four researchers into the narratives of five enrolled nurses (study No. 1 – published in Nursing Ethics 2004), five Registered Nurses (study No. 2 published in Nursing Ethics 2005) and 10 patients (study No. 3) about their experiences from an acute care ward at one university hospital in Sweden.Method. A phenomenological hermeneutical method (inspired by the French philosopher Paul Ricoeur) was conducted in all three studies.Findings. The patients are very satisfied with their treatment and care. They also tell about factors that they do not consider as optimal, but which they explain as compromises, which must be accepted as a necessary part of their stay in the ward. This study demonstrates a close connection between patient satisfaction and vulnerability.Conclusions. It is important for all health care providers not to be complacent and satisfied when patients express their satisfaction with their treatment and care. This can result in losing the focus on the patients’ vulnerability and existential thoughts and reflections which are difficult for them, and which need to be addressed.Relevance to clinical practice. The findings can be seen as a challenge for the health care providers as well as the organization to provide quality of care to patients in acute care ward. When listening to the patients’ voice it makes it easier to be aware of the content of their vulnerability.

2021

This paper investigates the existence of peer effects in academic outcomes by exploring specificities in the student's admission process of a Brazilian federal university, which works as a natural experiment. Individuals who are comparable in terms of previous academic achievement end up having classmates with better or worse performance in college because of the assignment rule of students to classrooms. Thus, our identification strategy for estimating peer effects on academic outcomes eliminates the endogenous selfselection into groups that would otherwise undermine the causal inference of peer effects. Overall, our findings showed that joining a class with high-ability students damages academic achievements of the lowestability students at UFMG. Although male and female students are both negatively affected by being in the first (better) class, we found gender differences. Specifically, being at the bottom of the better class make females take less radical decisions compared to male students in the sense that female students continue to study even though with lower performance (reduced GPA and credits earned) while male students seem to be more prone towards dropping out (increased number of subjects-or even University registration-cancelled and reduced attendance in classroom). We have also found other heterogeneities in peer effects in college in terms of class shift, period of admission, area of study and parents' education. This study is a necessary step before investigating the impact of peer quality on after-graduating decisions using the same natural experiment. This will allow us to deepen our understanding of how peer effects can also have long-lasting impacts.

Cahiers de Fontenay, 1994

MANUAL PRÁTICO PARA MANUTENÇÃO E RECUPERAÇÃO DE IMÓVEIS , 2006

Definem as atividades para que os edifícios construidos conservem suas condições semelhantes de seu estado inicial.

This essay explores how books and letters functioned as complementary media in the early modern scholarly information order, using Athanasius Kircher as a case study. In opposition to recent claims that Kircher was a marginal figure in the “Republic of Letters,” I show that Kircher developed a sophisticated system for disseminating knowledge to an international, multi- confessional audience, which depended on the coordinated use of private letters and publication. While many studies of the Republic of Letters assume that the reciprocal exchange of information with a diverse group of correspondents was a uniquely effective method for facilitating the circulation of knowledge, the example of Kircher shows the important role played by "boundary spanners," who linked groups that would otherwise have been isolated. The essay offers a corrective to a tendency in recent scholarship that overemphasizes correspondence at the expense of printed books, and sounds a note of caution about the limitations of new digital methods of visualizing correspondence networks.