The exponential growth in medical pharmaceuticals and related clinical trials have created a need to better understand the decision-making factors in the processes for developing hospital medication formularies. The purpose of the study was to identify, rank, and compare major factors impacting hospital formulary decision-making among three prescriber groups serving on a hospital's pharmacy and therapeutics (P&T) committee. Prescribers were selected from the University of Texas, MD Anderson Cancer Center which is a large, multi-facility, academic oncology hospital. Specifically, the prescriber groups studied were comprised of physicians, midlevel providers, and pharmacists. A self-administered online survey was disseminated to participants. Seven major hospital formulary decision-making factors were identified in the scientific literature. Study participants were asked to respond to questions about each of the hospital formulary decision-making factors and to rank the various formulary decision-making factors from the factor deemed most important to the factor deemed least important. There are five major conclusions drawn from the study including three similarities and two significant differences among the prescriber groups and factors. Similarities include: (1) the factor "pharmacy staff's evaluation of medical evidence including formulary recommendations" was ranked highest for all three prescriber groups; (2) "evaluation of medications by expert physicians" was ranked second for physicians and midlevel providers while pharmacists ranked it third; and (3) the factor, "financial impact of the treatment to the patient" was fifth in terms of hospital formulary decision-making statement and ranking by all three prescriber groups. Two significant differences include: (1) for the hospital-formulary decision making statement, "I consider the number of patients affected by adding, removing, or modifying a drug on the formulary when making hospital medication formulary decisions," midlevel providers considered this factor of significantly greater importance than did physicians; and (2) for the ranked hospital formulary decision-making factor, "financial impact of treatment to the …
This thesis examines the response to the AIDS crisis in Houston and Dallas, two cities in Texas with the most established gay communities highest number of AIDS incidences. Devoting particular attention to the struggles of the Texas’ gay men, this work analyzes the roadblocks to equal and compassionate care for AIDS, including access to affordable treatment, medical insurance, and the closure of the nation’s first AIDS hospital. In addition, this thesis describes the ways in which the peculiar nature of AIDS as an illness transformed the public perception of sickness and infection. This work contributes to the growing study of gay and lesbian history by exploring the transformative effects of AIDS on the gay community in Texas, a location often forgotten within the context of the AIDS epidemic.
Locational decisions based on stigma and low funding have handicapped the efficiency of community based mental healthcare in the United States since 1963. However, the pattern of services in the 21st century American South remains largely unknown. This thesis addresses this gap in knowledge by using a mixed methodology including location allocation, descriptive statistics, and qualitative site visits to explore the geography of community clinics offering both physical and mental health services. The City of Houston has proposed using these facilities to anchor new supportive housing, but introducing more fixed costs to a mismatched system could create more problems than solutions. The findings of this study suggest the presence of an unnecessary concentration of services in the central city and a spatial mismatch between accessible clinics and the poor, sick people in need. Furthermore, this research reveals a new suburban pattern of vulnerability, calling into question long-held assumptions about the vulnerability of the inner city. Building supportive housing around existing community clinics, especially in the central city, may further concentrate vulnerable people thereby contributing to intensifying patterns of service-seeking drift and the continued traumatization of mentally ill homeless persons in Houston.
This study is concerned with the roles and relationships between artists-in-residence, community audiences, and program coordinators/art educators as they engage together in community arts programs. This study takes place at Project Row Houses (PRH), a community arts organization located in Houston, Texas and focuses on the artist-in-residence program, which commissions a group of national and international artists for a 6-month period to create art installations in relation to the community and its African-American heritage. This ethnographic case study is based on the activities and events surrounding the 2008 PRH exhibition, Round 29, Thunderbolt Special: The Great Electric Show and Dance, after Sam Lightnin’ Hopkins and employed qualitative data gathering methods of participant-observation, conducting semi-structured, open-ended, in-depth interviews, and through document collection, and contextual information. Observations were recorded through field notes, photographs, and video. Interviews were conducted with 3 artists-in-residence, 3 community audience members, and 3 program coordinators or staff members involved with the program, regarding their experiences at the site and experiences with each other. My analysis presents the roles of artist, community audience, and program coordinator/art educator through three sections on cultural work. Within these sections I discuss topics related to the power of voice, situatedness, and creativity, as it relates to the artists and community audiences. For the role of program coordinator/art educator, I focus more closely on her role in the process of mediation. Topics of power, social dynamics, identity, and representation are also framed within these discussions.
Miss Kathy is a documentary film that tells the story of Kathy Griffin-Grinan, a lead recovery coach for prostitution and human trafficking with the Harris County Sheriff’s Office. Her non-profit organization —We’ve Been There, Done That – works in conjunction with law-enforcement to offer the survivors of prostitution a chance at rehabilitation. With endless enthusiasm, she mentors survivors as they struggle to escape a destructive lifestyle. This film also explores the relationship between human trafficking and prostitution, while addressing issues of victimization and exploitation.
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