The Graphic Journalism genre is emerging with influences from war reportage with authors like Joe Sacco. I would like to address and report the “War on Drugs” from small first hand experiences, personal connections, and a genuine deep desire to see the healthcare and justice system change. The war on Drugs started in the 1970s during Richard Nixon’s term in the U.S. Presidency. Nixon’s influence to launch the “War on Drugs'' campaign began shortly after two congressmen released a report on the growing heroin epidemic that affected hundreds to thousands of servicemen who fought in the Vietnam War, who used heroin to treat PTSD. Nixon launched unfair disconnected political policy and passed laws that disproportionately targeted those against him and his values (minorities, specifically African Americans and anyone belonging to the counterculture “subwhite”). The War on Drugs movement started as a way to outcast and control minorities through unrealistic and systemically racist and oppressive laws. As the movement evolved so did its focus, the War on Drugs eventually metamorphosed into the “War on Class”, or a war against the economically disadvantaged. The War on Drugs has done way more harm than good and immediate action needs to be taken to begin to restart drug policy in America and within the World. The incomparable Billie Holiday, world renowned jazz singer and creator of “Strange Fruit” once said “I need help. Not jail time.” Shortly after her arrest for heroin possession in 1947. In my opinion, these famous words that Billie Holiday shared during the day of her arrest should be the leading quote in the much needed movement against the criminalization of drug abuse victims. Not only does the War on Drugs disproportionately disenfranchise black and brown communities, it makes researching the benefits of any type of narcotic that was not fully understood nearly impossible. My goal is to reverse the taboos that currently exist throughout our society with a graphic novel/ zine aimed at high school students. I believe that future generations can benefit from natural hallucinogens and other forms of holistic medicines in a safe way that doesn’t involve them having to access illegal avenues of receiving narcotics in order to remedy their pain. Afterall, there is a far greater risk in taking street narcotics due to one’s ability to use an incorrect dosage according to their size and bodily chemistry which can ultimately lead to an overdose and street narcotics may include an unknown amount of ingredients, some of which include fentanyl, a synthetic product of prohibition that is cheaper than heroin, but far more powerful. Fentanyl is used pharmacologically in anesthesia and neuroleptanalgesia and can be extremely harmful to the mind and body. I believe extremely deadly drugs like fentanyl would never exist if it wasn’t for the War on Drugs and its consistent agenda to demonize the usage of all narcotics without exploring the benefits of holistic medicines like hallucinogens and regulating the usage of these medicines through legalization, supervision, FDA regulation, and accessibility within the U.S, Healthcare System.

The aim of this thesis is to map regional variability in the intensity of mortality using methods avoidable mortality and a few selected characteristics of health care. The thesis describes the development of the concept of avoidable mortality, which is then used for the Czech Republic for the period 2006-2010 and to individual districts for the period 2006-2010. Furthermore, this thesis focuses on the relationship between expenditures of General Health Insurance Company and the level of mortality in the regions. For showing regional differences depending on the health care intensity of mortality from ischemic heart disease (both acute and chronic forms) was also selected, depending on the distance of specialized medical care. The last chapter focuses on National screening programs and cancer mortality, which are integrated in a comparison of the percentage of people examine in this program for districts. The relationship between spending per insured and intensity of mortality and outcomes related to the intensity of mortality, depending on the availability of specialized health care has been confirmed by statistical methods - correlation (Pearson correlation coefficient). Relationship between the intensity of mortality in cancer within screening programs and the percentage of people who passed...

This master thesis deals with the field of postgraduate medical education. The main goal of this thesis is deeper understanding of problems in the educational system. By means of a qualitative research the thesis explores the problems and causes of current postgraduate educational system from the perspective of young physicians. The research is based on a series of semi-structured interviews with physicians who are currently passing through a phase of postgraduate medical education. Results of the survey show the most questionable fact, according to participants, is the lack of the educational leadership which is supposed to be secured by the assigned supervisor. Despite the formal rules, this role is often ensured merely formally or is missing at all. Participants also mentioned difficulties related to accomplishing of specialized practical training and required procedures. Both of them are frequently subordinated to informal rules. The main findings are based on revealing the causes of problems mentioned above. The reasons of ascertained discrepancy are introduced with the theoretical help of the theory of informal institutions by G. Helmke and S. Levitsky. Through the lense of chosen theory the issue is that there is insufficient efficiency of formal institutions. Therefore, prospective solution should...

Background: The COVID-19 pandemic calls attention to the importance of sustainable healthcare systems. Frail healthcare systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Significant work has been done to describe the general attribute of sustainability and resilience in healthcare systems during crises. The next step would be to identify the research domains that has been highlighted during COVID-19 pandemic in order to reflect and achieve further sustainability in healthcare systems.  Methods: A scoping review of the literature was conducted to identify recurring themes, research domains and capacities needed to maintain healthcare systems’ sustainability in COVID-19 outbreak. Until 13 December 2020, six electronic databases were searched using specific keywords such as ‘sustainability,’ ‘resilience,’ and ‘surge capacity’ in ‘healthcare systems.’ Peer-reviewed articles went through a scientometric analysis mapping research fields, domains, study destinations and keywords.  Results: 104 studies met the inclusion criteria – majority (75%) focused on medical research followed by interdisciplinary (12%), social science (5%), and environment studies (5%). Originally identified domains of healthcare systems’ sustainability research included ‘capacity calculation,’ ‘telehealth,’ ‘environment,’ ‘inequity,’ ‘data,’ ‘holistic nexus planning,’ ‘social & environmental risk factor,’ ‘transport connectivity,’ and ‘vulnerability.’  Conclusion: This scoping review represents a systematic assessment of the research domains of healthcare systems’ sustainability during COVID-19 pandemic. Further refined and broadened sustainability framework is required so that healthcare systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

[pt] A gamificação de sistemas visa engajar usuários com as principais funcionalidades de sistemas. Tal engajamento é alcançado via um modelo conceitual de gamificação que associa elementos do jogo (pontos, etc.) e regras (políticas de classificação, etc.) às funcionalidades. Vários sistemas existentes, isto é, que não foram originalmente projetados com gamificação em mente, precisam ser gamificados. Porém, o apoio prático às atividades de desenvolvimento necessárias para gamificar sistemas existentes é precário. Gamificar um sistema existente requer: (i) a definição do modelo de gamificação que guia a incorporação de elementos de jogos e regras ao sistema; e (ii) um conhecimento das atividades necessárias à gamificação desse sistema. Infelizmente, há poucos modelos de gamificação bem definidos, menos ainda focados no apoio à saúde pública, especialmente na prevenção de doenças transmitidas por mosquitos. Também não há método sistemático que guie as atividades específicas da gamificação de sistemas existentes. Esta dissertação de mestrado endereça as limitações mencionadas acima com base na experiência prática de se gamificar o sistema VazaZika. VazaZika é um sistema que encoraja a prevenção a doenças transmitidas por mosquito como Zika e Dengue. Primeiro, nós refinamos um método da literatura para lidar com a gamificação de sistemas existentes. Segundo, nós introduzimos um modelo de gamificação com 12 elementos e 16 regras de jogos para gamificar sistemas de prevenção das doenças acima. O nosso modelo foi avaliado com 20 usuários em termos de facilidade de uso, interface, diversão, motivação, potencial de uso constante e potencial de disseminação do sistema. Nossos resultados são promissores: (i) após refinamentos baseados em experiência, o método foi aplicado com sucesso na gamificação do VazaZika; (ii) identificamos 22 atividades de desenvolvimento que se tornaram desafiadoras para os desenvolvedores durante a gamificação; e (iii) nosso modelo de gamificação apoiou a construção de um sistema fácil de usar e capaz de engajar usuários em funcionalidades essenciais à saúde, como o relato de criadouros de mosquito. Esta dissertação provê guias adicionais à gamificação de sistemas existentes e realça oportunidades para trabalhos futuros. / [en] Software gamification aims to leverage the user engagement with key features of software systems. Engagement is promoted by a conceptual gamification model that associates game elements (e.g., points) and rules (e.g., ranking policy) with features. It is quite common to gamify existing systems that were not originally designed with gamification in mind. Unfortunately, the development activities required to gamify a system are barely supported in practice. Gamifying an existing system requires: (i) the definition of a gamification model for guiding the incorporation of game elements and rules into an existing system; and (ii) the knowledge about key development activities to gamify this existing system. However, there are only a few models aimed to support the gamification of existing systems, and none is specific to software domains such as the prevention of mosquito-borne diseases. More critically, there is no systematic method aimed to guide the activities of gamifying existing systems. This Master s dissertation addressed the aforementioned limitations based on our experience with gamifying the VazaZika system. VazaZika is a system that encourages the prevention of mosquitoborne diseases such as Zika, Dengue, and Chikungunya. We introduce a gamification method that supports key activities during the gamification of existing systems, plus a gamification model composed of 12 game elements and 16 rules. Second, we evaluate our model with 20 users by means of ease of use, user interface, user fun, user motivation, and the potential for both constant system use and system dissemination. Our results are promising: (i) after some experience-based refinements, our method was successfully applied in the VazaZika gamification; (ii) we have identified 22 development activities that became challenging for developers to perform along the VazaZika gamification; these activities helped us to shape our method; and (iii) our gamification model has resulted in an easy-to-use system that is able to improve user engagement with critical healthcare-related features, such as the report of mosquito breeding sites. In summary, this dissertation contributed with additional guidance for supporting gamification of existing systems while shedding light on opportunities for future work.

<p dir="ltr">The adoption of Electronic Health Records (EHR) and Health Information Technology (HIT) is essential for creating a more integrated, efficient, and patient-centered healthcare system. Despite progress, the issue of interoperability—the seamless exchange and use of information across EHR systems—remains a significant challenge. These barriers limit healthcare providers' access to comprehensive patient data, impacting care quality and operational efficiency. This dissertation investigated the role of policy interventions in addressing EHR interoperability challenges within the U.S. healthcare system. It examined how administrative and financial policies have hindered or supported progress toward seamless data exchange, focusing on legislation like the HITECH Act and the implementation of Fast Healthcare Interoperability Resources (FHIR) standards. Using a qualitative meta-synthesis approach, the study systematically reviewed peer-reviewed articles, policy documents, and reports from the past 15 years, identifying three primary barriers: inconsistent policy enforcement, financial constraints, and leadership challenges. The study proposed policy modifications to address these barriers, including stronger enforcement, sustained financial support, and leadership training. This dissertation contributes to the discourse on healthcare technology and policy, offering actionable recommendations to improve EHR interoperability, enhance patient care, and influence future policymaking in the U.S. healthcare system. The study concludes that addressing the identified barriers—through stronger policy enforcement, sustained financial support, and leadership development—is essential for achieving EHR interoperability.</p><p><br></p><p dir="ltr"><i>Keywords</i>: EHR interoperability, policy interventions, HITECH Act, healthcare technology, U.S. healthcare system</p>

In 1993, the last health reform “Law 100” was introduced in Colombia. It has been over 30 years since its implementation, and there have been many changes to the healthcare system in Colombia ever since. The policy increased health insurance coverage to almost 95% of the population, providing better and more affordable patient care. However, increasing the availability of resources does not necessarily make them accessible to all of Colombia’s residents. This study aims to analyze the outcomes of “Law 100” to the system and studies critical obstacles that halt healthcare equity in Colombia, particularly for those in rural and low-income populations. Disparities in access to quality healthcare, a shortage of healthcare professionals, and insufficient preventative measures are persisting problems that have challenged the Colombian healthcare system. In addition, this study explores models from Brazil, Thailand, and Finland, which have healthcare systems similar to Colombia's and have faced and overcome comparable concerns. Based on these successful models, policy recommendations adapted to fit the Colombian healthcare system include implementing community-based healthcare teams, creating educational incentives for healthcare workers in underserved areas, and launching public health prevention campaigns. This study offers actionable improvements for Colombian policymakers to reduce healthcare disparities and develop a fairer system for all citizens.

Thesis (MBA (Business Management))--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: The democratic government of South Africa inherited a healthcare system that was fragmented and inequitable. The Department of Health was mandated by the Constitution and the Bill of Rights to implement a system whereby quality, affordable healthcare could become available to all citizens of the country within the constraints of the available resources. The objective of government, through reform legislation, is to establish a social health insurance (SHI) system for the country which will ultimately lead to the implementation of a national health insurance (NHI) system in order to achieve universal coverage. Medical schemes have been identified as an important component of this transformation process. The private healthcare industry, represented largely by medical schemes, acknowledges that SHI is the ideal pathway chosen by government to achieve universal coverage, but is concerned with the process being used to achieve this aim, the pace at which transformation is occurring, and the effect of this on medical schemes. The movement towards an equitable healthcare system required the introduction of reform legislation necessary for the establishment of an enabling environment. The implementation of community rating, open enrolment and prescribed minimum benefits (PMBs) reforms, succeeded in ending the risk-rating of those medical schemes that were excluding members who were considered vulnerable. However, these legislations were not followed by a risk equalisation mechanism in the form of a proposed risk equalisation fund (REF) for the South African environment. The main purpose of this fund is to ensure that equity within the medical schemes industry is maintained through the equalisation of the risks that had resulted from the implementation of the first components of reform legislation. The research into the experiences of other countries shows that South Africa is the only country in the world that has implemented the above legislation without a system of risk equalisation. All indications are that the proposed implementation of the REF has been delayed to beyond 2009. In addition, the reform legislation regarding the statutory solvency ratio requires medical schemes to maintain this ratio at 25 percent. This, together with the delay in REF is placing financial pressure on medical schemes. Low income medical schemes (LIMS) legislation is pending implementation. Its purpose is to provide basic medical cover to the lower income market until such time that the components of SHI have been fully negotiated; it is thus an interim measure, but no indication to implement LIMS has yet been given. The average number of years for a country to implement SHI is 70. The South African situation is only 13 years old and though some success has been achieved during this relatively short period, much more still needs to be accomplished. The research shows that, the approximate timelines and intended sequence of implementing the reform legislation were perhaps too ambitious. This has caused the industry stakeholders to be disillusioned about the current state of affairs. Given the time that has elapsed, and considering the progress that has been made thus far, it is recommended that the existing plan be revised or even replaced with a more realistically timed one. This will restore some of the confidence into the “future healthcare vision of universal coverage” for South Africa intended by the government, through a system of social health insurance. / AFRIKAANSE OPSOMMING: Die demokratiese regering van Suid-Afrika het ‘n gesondheidsorgstelsel geërf wat gefragmenteerd en onregverdig was. Die Departement van Gesondheid het in die Grondwet en die Handves van Menseregte die mandaat gekry om ‘n stelsel te implementeer waarvolgens bekostigbare gesondheidsorg van goeie gehalte vir alle landsburgers beskikbaar kon word binne die beperkinge van die beskikbare hulpbronne. Die regering se doelwit met hervormingswetgewing is om ‘n maatskaplike gesondheidsversekeringstelsel (SHI) vir die land daar te stel wat uiteindelik sal lei tot die implementering van ‘n nasionale gesondheidstelsel (NHI) met die oog op universele dekking. Mediese skemas is geïdentifiseer as ‘n sleutelkomponent van hierdie transformasieproses. Die privategesondheidsorgindustrie, wat grotendeels deur mediese skemas verteenwoordig word, erken dat SHI die ideale weg is wat deur die regering gekies is om universele dekking te bereik, maar is besorg oor die proses wat gebruik word om hierdie doelwit te bereik, die pas waarteen transformasie geskied, en die uitwerking hiervan op mediese skemas. Die beweging na ‘n regverdige gesondheidsorgstelstel het vereis dat hervormingsgswetgewing ingestel word soos nodig vir die daarstelling van ‘n omgewing wat dit moontlik maak. Die implementering van gemeenskapsevaluering, oop lidmaatskap en hervorming van voorgeskrewe minimum voordele (PMB’s) was suksesvol vir die beëindiging van die risikoevaluering van daardie skemas wat lede uitgesluit het wat as kwesbaar beskou is. Maar hierdie wetgewing is nie opgevolg deur ‘n risikogelykstellingsmeganisme in die vorm van ‘n voorgestelde risikogelykstellingsfonds (REF) vir die Suid-Afrikaanse omgewing nie. Die hoofdoelwit van hierdie fonds is om te verseker dat gelykheid binne die mediesefondsindustrie gehandhaaf word deur die gelykstelling van risiko’s wat die gevolg was van die implementering van die aanvanklike hervormingswetgewing. Navorsing oor die ondervinding in ander lande toon dat Suid-Afrika die enigste land in die wêreld is wat sodanige wetgewing geïmplementeer het sonder ‘n stelsel van risikogelykstelling. Alle tekens dui daarop dat die voorgestelde implementering van die REF uitgestel is tot na 2009. Daarbenewens vereis die hervormingswetgewing ten opsigte van die statutêre solvensieverhouding dat mediese skemas hierdie verhouding op 25% handhaaf. Tesame met die vertraging in REF plaas dit finansiële druk op mediese skemas. Lae-inkomstemedieseskemas (LIMS) is verdere hervormingswetgewing wat wag op implementering. Die doel daarvan is om basiese mediese dekking te voorsien aan die laer-inkomstemark totdat die komponente van SHI ten volle onderhandel is. Dit is dus ‘n oorgangsmaatreël, maar daar is nog geen aanduiding gegee van die implementering van LIMS nie. Die gemiddelde tyd wat dit neem vir ‘n land om SHI te implementeer, is 70 jaar. Die Suid-Afrikaanse situasie is net 13 jaar oud, en hoewel daar heelwat sukses behaal is in hierdie relatief kort tydperk, moet daar nog baie meer bereik word. Navorsing toon dat die geskatte tydperk en voorgenome opeenvolging van die implementering van die hervormingswetgewing dalk te ambisieus was. Dit het veroorsaak dat die belanghebbers in die industrie ontnugter is oor die huidige stand van sake. Met inagneming van die tyd wat verloop het en die vordering wat tot dusver gemaak is, word daar aanbeveel dat die bestaande plan hersien word of selfs vervang word deur een met ‘n meer realistiese tydsbeperking. Dit sal ‘n mate van vertroue herstel in die Suid-Afrikaanse Regering se “toekomsvisie van universele gesondheidsdekking” deur ‘n stelsel van maatskaplike gesondheidsversekering.

This research on healthcare strategies of home-based, low-wage, immigrant careworkers contributes to the ways medical anthropology, migration studies and social science understand human-economy-family care relationships and health and carework as commodities in today's global economy. It reveals the consequences for workers as they defray the costs of care for the Italian government and contribute to their home economies. This research was conducted in Genoa, Italy, which has the largest percentage of people over the age of 70 in any city of its size in the world and a tradition of sending and receiving immigrant workers. The main question was: Under the circumstances of providing labor-intensive, in-home supportive services, how do immigrant workers respond to their own health needs? The researcher collected data from interviews with 50 careworkers, 25 professionals who provide services to the careworkers, and 23 administrators in the health system, government agencies, labor unions, and the Catholic Church. The careworkers interviewed were women from South America, as they do most of the carework jobs in this city. Long-term participant observation and interview data were analyzed to: 1) produce empirical data on health concerns of and healthcare resource use by migrant careworkers; and 2) investigate the relationships between health concerns, living/working conditions, and healthcare resource use of transnational immigrants in the informal economy. The data showed that the Catholic Church promoted immigrants as able workers, aided their elderly parishioners, and provided necessary mental health support to careworkers who experienced stress. The data also revealed that the health care system of Italy functioned well to address the physical health concerns of immigrant careworkers. The relationship between the client and the worker was important for the general well-being of the worker and her ability to maintain her general health, have time for medical appointments, socialize outside of the workplace, and attend community events. This study examined: strategies for using health resources; responses of the Italian medical system personnel to anti-immigrant legislation; use of non-State resources to meet health needs; the health consequences of caring for an elderly person in the private home; and ways to address these health consequences.

Les changements qui ont marqué le monde industriel pendant les dernières décennies ont eu un impact significatif sur la réorganisation du travail. La fragmentation de l'organisation à intégration verticale ne peut plus être contestée. L’organisation en réseau se profile désormais comme un modèle capable de répondre au nouveau contexte socio-économique. Avec une structure à frontières irrégulières, à l'intérieur desquelles les organisations et les actions apparaissent moins ordonnées, cette nouvelle forme organisationnelle demeure toutefois objet à exploration, afin d'identifier notamment les règles qui déterminent autant sa structure que les comportements des acteurs qui ont un impact direct sur son fonctionnement. Bien que le secteur privé ait été le premier à subir les effets de ces changements, le secteur public n'en fait pas exception. Le domaine de la santé s'inscrit aujourd'hui dans le paradigme de l'organisation en réseau. L’objectif de cette recherche est de comprendre les mécanismes qui assurent le maintien de cette structure organisationnelle et favorisent sa régulation et son institutionnalisation. Il s’agit plus précisément d’étudier les facteurs qui permettent son fonctionnement interne, soit les mécanismes qui assurent une coordination des services et la collaboration des acteurs. À cette fin, nous avons réalisé une étude de cas qui porte sur un programme de santé, le programme cible santé – maladies chroniques, au sein d’un CISSS du Québec, un réseau local de services de santé. Notre recherche nous a permis d’analyser en profondeur la nature de ce CISSS qui se profile comme un réseau fortement régulé et institutionnalisé et de mettre en évidence l’importance qu’occupent les acteurs dans son fonctionnement réel. Si la définition de l’objectif commun, aligné à la stratégie organisationnelle, permet la planification de l’intégration des ressources et l’adaptabilité aux besoins des usagers, c’est l’équilibre entre ces facteurs qui assure la performance du réseau. La collaboration entre les acteurs, fondée sur la confiance, favorise un tel équilibre et permet la naissance de solutions qui répondent à l’objectif commun, par l’innovation fondée sur le partage ouvert des connaissances. Cela assure une coordination efficace des services de santé. Par ailleurs, si la structure cadre l’action des acteurs, par la définition de règles, ces derniers, par leur implication volontaire au fonctionnement du système, le redéfinissent également. / The changes that have shaped the industry over the past decades had a significant impact on work reorganisation. The break-up of the vertically integrated organisation cannot be questioned any more. The network organisation currently stands out as the model that addresses the new socioeconomic context. With irregular borders, inside which departments and actions appear less orderly, this new organisation structure remains an area of exploration aimed to identify the rules that determine both its design and the behaviours of the players that have direct impact on its operations. Although the private sector was the first to carry the effects of these changes, the public sector was impacted as well. Health care is governed today by the network organisation structure paradigm. The objective of this research is to understand the mechanisms that support this organizational structure, favouring its regulation and its establishment. More precisely it is focused on the analysis of the factors that allow its internal functioning, the coordination of services and the collaboration between different players. To this aim we performed a case study on the chronic disease healthcare target program within a Quebec medical services network (CISSS). Our inquiry allowed us to deep dive into the functioning of this CISSS that stands out as a strongly regulated and institutionalised network and to bring into the spotlight the importance of different players to its operations. The definition of the common objective, aligned with the organizational strategy, allows for the resource integration planning and adaptability to customer needs but it is the harmonisation of these factors that ensures the network’s performance. The stakeholders collaboration based on mutual confidence favours such harmonisation and allows for the identification of solutions that address the common objective, through innovation based on a wide information sharing. This ensures an efficient coordination of the healthcare services. Otherwise, while the structure frames the stakeholders’ actions by defining rules, the stakeholders also reshape the system through their deliberate involvement.