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The opioid epidemic has renewed debate about how to structure laws, agency policies and hospital protocols for mandatory reporting of illicit substances during pregnancy. This paper analyzes the ethics of Rhode Island's approach to mandatory reporting - in particular, reporting of positive maternal and newborn drug tests at time of delivery. Given that state intervention is generally perceived by pregnant people as punitive and threatening to their family, we consider how four elements often used to justify punitive action by the state - retribution, deterrence, rehabilitation, and incapacitation (societal protection) - apply to Rhode Island's policy and approach to prenatal substance use. In addition, the paper considers the equity implications of Rhode Island's approach. It concludes that, given the potential for the policy to do more harm than good, investment of resources would be better spent on clinical and community services that support substance using parents and their newborns. [ABSTRACT FROM AUTHOR]

The article discusses the launch of Rhode Island's online medical marijuana card registration system by the Rhode Island Department of Health, replacing the previous paper-based system and offering a user-friendly portal for registration, renewals, and updates.

African immigrants in the United States may experience barriers to health-care access and effectiveness. This mixed-methods study used paper-based surveys of people (N=101) in the target population from Nigeria, Ghana, and Liberia, recruited through convenience and snowball sampling. Semi-structured interviews were conducted with 3 clergy members who pastor churches with large Nigerian, Ghanaian, and Liberian populations, respectively; and five physicians and a clinical pharmacist who serve African immigrants. Results : Length of stay in the United States was associated with the health status of refugee children. Undocumented immigration status was associated with lack of health insurance. Cardiovascular diseases, uterine fibroids and stress-related disorders were the most prevalent reported conditions. Regardless of English fluency, many immigrants are unfamiliar with medical terminology. Conclusion: African immigrants in the state of Rhode Island need more health education and resources to navigate the US health-care system. [ABSTRACT FROM AUTHOR]

In recent years, there has been a surge in the number of global health programs directed by academic institutions. Global health programs take many forms, focusing on different curricular goals such as knowledge attainment of endemic diseases, community service projects, and improved foreign-language skills. This is an expository paper describing the origins and evolution of the medical exchange program between Rhode Island Hospital and Hospital Regional Universitario José María Cabral y Báez. The exchange program is unique because it is trainee- driven and has strived to maintain a bilateral educational exchange over the past 15 years. Future goals for the program include further developing a research curriculum for both institutions and creating a longitudinal relationship with a community-based state-funded clinic in Santiago, Dominican Republic. [ABSTRACT FROM AUTHOR]

Health care transitions are often dangerous for older patients. Interviews with older adults about their health care moves in Rhode Island (RI) were conducted to develop an Internal Medicine (IM) curriculum designed to provide IM interns with insights about the impact of transitions on patients. This paper describes some ways patients talk about their transitional experiences. Following pilot interviews, 10 nursing home residents were interviewed about their care transitions, conversations with physicians, and advice to doctors beginning their careers. The interviews were analyzed to identify themes. Patients described multiple moves, often did not know what to expect, appreciated help from a family member and desired effective communications with physicians. Learning about patient experiences may help new physicians appreciate the experiences of transitions on patients. [ABSTRACT FROM AUTHOR]

The Hospital Association of Rhode Island, in conjunction with the Rhode Island Cancer Registry, received funding for a special project to improve the validity and reliability of race and ethnicity data in hospital inpatient records. In the past year, five hospitals participated in a pilot to improve race/ethnicity data collection. This paper provides an overview of the design and initial implementation of the pilot, and reports on early feedback. Given that the Affordable Care Act strengthens federal data collection efforts, with a new standard issued which adds granularity, these policies can renew efforts to record more accurate and detailed race and ethnicity data. Improved race and ethnicity data will increase our understanding of the health needs of different racial and ethnic groups and health disparities between groups. Better data improves understanding, increases the likelihood of effective actions to address and monitor disparities, and ensure that every American has the opportunity to live the healthiest life possible. [ABSTRACT FROM AUTHOR]

This paper presents a personal look at the changing world of long-term nursing care in one facility over the course of a 38-year nursing career. The paper reviews the ways the role of "nurse" has evolved and expanded due to changes in patient populations, industry standards, and technology advancement. Though the job has changed dramatically over the decades, the most integral parts of successful nursing remain the same: Connection to patients and their families, and a commitment to quality care and patient well-being. [ABSTRACT FROM AUTHOR]