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HealthcarePapers Jul 2023Despite notions of colour-blindness and denials of widespread systemic racism, anti-Black racism remains inherent in the political, economic, educational and healthcare...
Despite notions of colour-blindness and denials of widespread systemic racism, anti-Black racism remains inherent in the political, economic, educational and healthcare systems in Europe. We use the Netherlands as a case study to explore some of these mechanisms. Here, we discuss how a focus on cultural deficiency and the denial of racism allows the bearers of inequality and inequity to be blamed for their own disenfranchisement. Nonetheless, scholars in the Netherlands continue to show how everyday racism is negatively impacting marginalized people's lives and their access to the social determinants of health and well-being in society.
Topics: Humans; Racism; Antiracism; Delivery of Health Care
PubMed: 37887166
DOI: 10.12927/hcpap.2023.27195 -
Memory (Hove, England) Oct 2022False denials are sometimes used to cope with traumatic experiences. We examined whether false denials can affect true and false memory production for a traumatic event...
False denials are sometimes used to cope with traumatic experiences. We examined whether false denials can affect true and false memory production for a traumatic event and conversations surrounding the trauma. One hundred and twenty-six participants watched a trauma analogue video of a car crash before being randomly asked in a discussion with the experimenter to (1) respond honestly or (2) falsely deny that certain details happened in the video. After one week, all participants received misinformation about the discussion with the experimenter and the car crash. Finally, all participants were instructed to respond truthfully in a source memory task. Participants who falsely denied information during the first session were statistically significantly more prone than honest participants to omit details they denied and to report misinformation about what was discussed in the first session. Our work suggests that false denials of a traumatic experience might lead to both forgetting and increased false memory levels for earlier conversations about the event.
Topics: Adaptation, Psychological; Communication; Humans; Memory
PubMed: 35786402
DOI: 10.1080/09658211.2022.2094964 -
Consciousness and Cognition Aug 2020Approximation involves representing things in ways that might be close to the truth but are nevertheless false. Given the widespread reliance on approximations in...
Approximation involves representing things in ways that might be close to the truth but are nevertheless false. Given the widespread reliance on approximations in science and everyday life, here we ask whether it is conceptually possible for false approximations to qualify as knowledge. According to the factivity account, it is impossible to know false approximations, because knowledge requires truth. According to the representational adequacy account, it is possible to know false approximations, if they are close enough to the truth for present purposes. In this paper, we adopt an experimental methodology to begin testing these two theories. When an agent provides a false and practically inadequate answer, both theories predict that people will deny knowledge. But the theories disagree about an agent who provides a false but practically adequate answer: the factivity hypothesis again predicts knowledge denial, whereas the representational adequacy hypothesis predicts knowledge attribution. Across two experiments, our principal finding was that people tended to attribute knowledge for false but practically adequate answers, which supports the representational adequacy account. We propose an interpretation of existing findings that preserves a conceptual link between knowledge and truth. According to this proposal, truth is not necessary for knowledge, but it is a feature of prototypical knowledge.
Topics: Adolescent; Adult; Aged; Female; Humans; Judgment; Male; Middle Aged; Psychological Theory; Theory of Mind; Young Adult
PubMed: 32474214
DOI: 10.1016/j.concog.2020.102950 -
Rhode Island Medical Journal (2013) Jun 2020To determine the health and socioeconomic consequences of comprehensive abortion denial in Rhode Island.
OBJECTIVES
To determine the health and socioeconomic consequences of comprehensive abortion denial in Rhode Island.
METHODS
Using Turnaway Study findings and RI abortion data from 2013-2016, we project the burden of negative outcomes for women and their families under 100% abortion denial conditions.
RESULTS
Findings suggest negative impacts on the health and socioeconomic well-being of RI women and their families. 982 and 910 women, who would have otherwise received an abortion, will report anxiety and depression, respectively, at one-week post abortion denial, and 1,499 will report receiving Temporary Assistance for Needy Families funding at six months post denial.
CONCLUSIONS
If women who would seek a safe and legal abortion in RI are denied one, clear and undue burden will exist for those who carry to term and raise the child, as well as affecting existing children.
Topics: Abortion Applicants; Abortion, Induced; Abortion, Legal; Adaptation, Psychological; Adolescent; Adult; Anxiety; Depression; Female; Health Impact Assessment; Humans; Poverty; Pregnancy; Rhode Island; State Government; Young Adult
PubMed: 32481788
DOI: No ID Found -
Neuropsychological Rehabilitation 2016Historically, anosognosia referred to under-report of striking symptoms of acquired brain injury (e.g., hemiplegia) with debilitating functional consequences and was... (Review)
Review
Historically, anosognosia referred to under-report of striking symptoms of acquired brain injury (e.g., hemiplegia) with debilitating functional consequences and was linked with anosodiaphoria, an emotional reaction of indifference. It was later extended to include under-report of all manner of symptoms of acquired brain injury by the patient compared to clinicians, family members, or functional performance. Anosognosia is related to time since onset of brain injury but not consistently to demographic variables, lesion location (except that it is more common after unilateral right than left hemispheric injury), or specific neuropsychological test scores. This review considers all manifestations of anosognosia as a unitary phenomenon with differing clinical characteristics dictated by variability in linked cognitive impairments. It is concluded that anosognosia has three chief contributing factors: (1) procedural: measurement differences across studies in terms of symptom selection and the designation of a "gold standard" of patient symptomatology; (2) psychological: a tendency towards positive self-evaluation and the avoidance of adverse information, that also occurs in neurologically intact individuals; and (3) neuropathological: an increased likelihood of error recognition failure from disconnections that disrupt feedback between injured brain regions governing specific behaviours (symptoms) and anterior cingulate/insular cortex. Anosodiaphoria is considered as an associated symptom, resulting from the same psychological and neuropathological factors.
Topics: Agnosia; Brain; Brain Injuries; Cognition Disorders; Emotions; Humans
PubMed: 25686381
DOI: 10.1080/09602011.2015.1011665 -
Behavioral Sciences & the Law May 2022Victims of abuse might deny their traumatic experiences. We studied mnemonic effects of simulating false denial of a child sexual abuse narrative. Participants...
Victims of abuse might deny their traumatic experiences. We studied mnemonic effects of simulating false denial of a child sexual abuse narrative. Participants (N = 127) read and empathized with the main character of this narrative. Next, half were instructed to falsely deny abuse-related information while others responded honestly in an interview. One week later, participants received misinformation for the narrative and interview. In a final source memory task, participants' memory for the narrative and interview was tested. Participants who falsely denied abuse-related information endorsed more abuse-unrelated misinformation about the event than honest participants. Abuse-related false memory rates did not statistically differ between the groups, and false denials were not related to omission errors about (1) the interview and (2) narrative. Hence, victim's memory for abuse-related information related to their experience might not be affected by a false denial, and inconsistencies surrounding the abuse-unrelated information are more likely to take place.
Topics: Child; Child Abuse, Sexual; Communication; Humans; Memory; Mental Recall; Narration
PubMed: 35194828
DOI: 10.1002/bsl.2566 -
Supportive Care in Cancer : Official... Feb 2024The American Society of Clinical Oncology Cancer Survivorship Committee established a task force to determine which survivorship care services were being denied by...
PURPOSE
The American Society of Clinical Oncology Cancer Survivorship Committee established a task force to determine which survivorship care services were being denied by public and private payers for coverage and reimbursement.
METHODS
A quantitative survey instrument was developed to determine the clinical practice-reported rates of coverage denials for evidence-based cancer survivorship care services. Additionally, qualitative interviews were conducted to understand whether coverage denials were based on payer policies, cost-sharing, or prior authorization.
RESULTS
Of 122 respondents from 50 states, respondents reported that coverage denials were common ("always," "most of the time," or "some of the time") for maintenance therapies, screening for new primary cancers or cancer recurrence. Respondents reported that denials in coverage for maintenance therapies were highest for immunotherapy (41.74%) and maintenance chemotherapy (40.17%). Coverage denials for new primary cancer screenings were highest for Hodgkin lymphoma survivors needing a PET/CT scan (49.04%) and breast cancer survivors at a high risk of recurrence who needed an MRI (63.46%), respectively. More than half of survey respondents reported denials for symptom management and supportive care services. Fertility services, dental services when indicated, and mental health services were denied "always" or "most of the time" 23.1%, 22.5%, and 12.8%, respectively. Respondents reported they often had a process in place to automatically appeal denials for evidence-based services. The denial process, however, resulted in greater stress for the patient and provider.
CONCLUSION
Our study demonstrates that additional advocacy with payers is needed to ensure that reimbursement policies are consistent with evidence-based survivorship care services.
Topics: Humans; Survivorship; Cancer Survivors; Positron Emission Tomography Computed Tomography; Neoplasm Recurrence, Local; Breast; Insurance Coverage
PubMed: 38368466
DOI: 10.1007/s00520-024-08359-9 -
Journal of Pediatric Gastroenterology... Oct 2022Increasingly, in the United States, the prescribing of high-cost drugs has become a challenge for physicians and other practitioners. Such drugs are highly regulated by... (Review)
Review
Increasingly, in the United States, the prescribing of high-cost drugs has become a challenge for physicians and other practitioners. Such drugs are highly regulated by third-party payers (aka insurance), as well as pharmacy benefit managers. Not infrequently, a clinician prescribing a medication will have the payment for the prescription denied by the third-party payer, with the end result being a delay in getting a medically necessary medication to a patient. This article highlights the challenges involved in the prior authorization and denial process, with a focus on pediatric inflammatory bowel disease. The article reviews the role of pharmacy benefits managers in restricting access to drugs, and the reasons why denials of medically necessary medications may occur. The article also provides information on how to appeal denials, how to write a letters of medical necessity, and how to conduct a proper peer-to-peer review. Advocacy from patients and clinicians will be important, as we want to reform the process in the future.
Topics: Child; Humans; Inflammatory Bowel Diseases; Insurance, Health, Reimbursement; United States
PubMed: 35836325
DOI: 10.1097/MPG.0000000000003564 -
British Journal of Community Nursing Jun 2015This clinical focus and literature review describe the effect of psychosocial factors on coping and living with a venous leg ulcer (VLU). The associated stressors of... (Review)
Review
This clinical focus and literature review describe the effect of psychosocial factors on coping and living with a venous leg ulcer (VLU). The associated stressors of living with a VLU include: pain, loss of self-esteem, and social isolation, with subsequent negative emotions that could potentially lead to anxiety and depression. The ability to cope with a VLU depends upon the individual, with some patients employing negative coping strategies such as denial, depending on the stage of the illness and level of acceptance reached (Husband, 2001; Brown, 2014). Psychosocial interventions by health professionals have been shown to reduce the stress of living with a VLU, to improve a patient's coping ability, and subsequently enhance wound healing. This article highlights the importance of holistic assessment and joint treatment planning, to incorporate patients' psychosocial needs and individual coping methods in order to reduce the associated stress of living with a VLU.
Topics: Adaptation, Psychological; Anxiety; Chronic Disease; Depression; Humans; Leg Ulcer; Pain Management; Pain Measurement; Patient Education as Topic; Quality of Life; Self Concept; Social Isolation; Social Support
PubMed: 26052991
DOI: 10.12968/bjcn.2015.20.Sup6.S21 -
Professional Case Management 2016This article reviews the various types of technical and clinical denials that are usually "written off" and proposes strategies to prevent this loss. For purposes of...
PURPOSE/OBJECTIVES
This article reviews the various types of technical and clinical denials that are usually "written off" and proposes strategies to prevent this loss. For purposes of this writing, avoidable technical and clinical denial write-offs are defined as revenue lost from "first-pass" denials rejections. For example, a procedure that requires an authorization is performed without having had an authorization obtained. After appeals and attempts to recoup the revenue, often unsuccessful, the organization ultimately "writes off" the revenue as not collectable. The question to ask is: Are these claims really not collectable or can actionable steps be taken to conserve these dollars and improve the bottom line?
PRIMARY PRACTICE SETTING
Acute care hospitals, physician offices, and clinics.
FINDINGS AND CONCLUSIONS
In today's environment, the need to manage costs is ubiquitous. Cost management is on the priority list of all savvy health care executives, even if margins are healthy, revenue is under pressure, and the magnitude of cost reduction needed is greater than what past efforts have achieved. As hospitals and physician clinics prioritize areas for improvement, reduction in lost revenue-especially avoidable lost revenue-should be at the top of the list. Attentively managing claim denial write-offs will significantly reduce lost revenue.
IMPLICATIONS FOR CASE MANAGEMENT
There is significant interface between case management and the revenue cycle. Developing core competencies for reducing clinical and technical denials should be a critical imperative in overall cost management strategy. Case managers are well placed to prevent these unnecessary losses through accurate status determination and clinical documentation review. These clinical professionals can also provide insight into work flow and other processes inherent in the preauthorization process.
Topics: Ambulatory Care Facilities; Economics, Hospital; Education, Continuing; Insurance, Health, Reimbursement; Physicians' Offices
PubMed: 26844714
DOI: 10.1097/NCM.0000000000000117