Digital Commons Network^™

Broken Promises: Prolonged Diminished Quality-Of-Life Among Liberian Ebola Survivors Half A Decade After The 2014-16 West African Outbreak, Jessi Hanson-Defusco, Decontee Davis, Meghana Bommareddy, Zainab Olaniyan

Journal of Social, Behavioral, and Health Sciences

The 2014–2016 Ebola outbreak left thousands of Liberian survivors with severely diminished quality of life. Applying a social determinants framework, this mixed method study investigates to what extent Ebola virus disease (EVD) survivors suffer long-haul psychosocial stress, diminished quality-of-life factors, and the impact of EVD-related service provisions on their ongoing healing. We present the results of a quantitative analysis survey of data collected from 19 Liberian EVD survivors in 2022 using snowball sampling. Additionally, a qualitative analysis of survivor statements helps triangulate key statistical findings and inform causal mechanisms. Survivors report experiencing 5.25 of a total of 7 ongoing stressors …

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

The Paradox Of Child Poverty And Welfare, Tirna Purkait

Department of Nutrition and Health Sciences: Faculty Publications

The United States confronts persistent child welfare issues rooted in poverty. The age-old debate vacillates between advocating personal responsibility and bolstering social safety nets. Current welfare programs, aiming to mitigate child poverty, often fall short given the deep nexus of poverty and child maltreatment. This paper probes the intricate ties between child poverty and welfare, emphasizing state legislative variances, inherent system paradoxes, and potential policy enhancements. Exploring historical contexts, existing societal frameworks, and future reforms, this research emphasizes the urgency for all-encompassing solutions. These should tackle poverty’s core while fortifying child welfare, safeguarding the well-being of forthcoming American generations.

Nursing Abroad: A Comparison Of Healthcare In Italy, Sweden, And The Us, Sadie Stark

The Eleanor Mann School of Nursing Undergraduate Honors Theses

No healthcare system is perfect, nor does one system work for all populations. History and culture have dictated the mindset of people for generations. It is the ever-changing mindset of patients and providers that will continue to expand and improve international healthcare by first changing daily practices. Nursing in Italy, Sweden, and the United States look very similar but also have a number of differences. Each country’s healthcare system works for its population, but efforts for international collaboration could still prove beneficial. Whether it be universal or private, centralized or localized, a patient centered focus is the driving force behind …

Understanding Costa Rica's Response To The Covid-19 Pandemic: Competing Explanations, Lise Charles

The Journal of International Relations, Peace Studies, and Development

As the COVID-19 pandemic continues to have major impacts on the world, careful study of successful health systems is essential. Costa Rica has been identified as a country that has responded well to the pandemic with the proportion of death rates compared to infection rates being the lowest in comparison to other countries in Central America. This paper examines Costa Rica’s relatively successful response to the COVID-19 pandemic as a case study in good public healthcare management. This study also highlights the importance of theory for addressing urgent, practical development challenges to explore what theoretical frameworks can best explain the …

Structural Violence & Small Victories: Political Epidemiology Of Hiv Among Msm In Nigeria, 2000-2010, Debbie A. Dada

Harvey M. Applebaum ’59 Award

No abstract provided.

Small-Family Mindset: An Analysis Of The Impact Of China's Family Planning Policies On Family Culture, Sarah Ansley Croft

Honors Theses

This thesis examines the impact of China’s family planning policies on women’s attitudes towards family culture and the implications on China today. The family planning policies began in the 1970s as an emergency measure intended to create a short-term voluntary small-family culture by decreasing fertility rates. My research, comprised primarily of primary and secondary qualitative sources, discusses the development and implementation of the policies, the economic reforms beginning in the 1980s, and their joint effects on fertility rates, sex ratio at birth, women’s liberation, and changes in family culture, particularly in rural areas. This study found that the family planning …

Constructing Curriculum: Centering Identities In Sex Education, Jozette Belmont

Dissertations, Theses, and Capstone Projects

Sex education (sex ed) is a state-by-state and school-by-school issue, and there are no federal laws which mandate medically accurate education. In New York, schools only offer one semester of health education which often happens in the last semester of twelfth grade. Further, LGBTQIA+ people’s sexual health and identities are rarely mentioned. Therefore, this project asks: What are the ways sex ed curricula and policies in New York address the needs of LGBTQIA+ youth? To answer this question, I use a critical policy analysis to compare curriculum from the New York City Department of Education (NYCDOE) and Peer Health Exchange …

Consumer-Directed Healthcare And The Physician-Patient Relationship, Chase Floyd

Senior Theses

The physician-patient relationship is the most fundamental unit of medicine itself - and yet currently faces great peril, increasingly encroached upon by a number of different threats. Consumer-directed healthcare, an innovative new form of healthcare financing, empowers indi- viduals to make their own decisions regarding their healthcare, holds providers accountable to their patients, and theoretically establishes a robust working relationship that benefits both par- ties. Could this be what is needed to save and strengthen the physician-patient relationship? This paper studies this question, namely the effect of consumer-directed healthcare on the physi- cian-patient relationship, in-depth through a synthesis of existing …

Prenatal Care For Undocumented Immigrants: Implications For Policy, Practice, And Ethics, Rachel Fabi

Population Health Research Brief Series

Nearly 250,000 babies are born each year to undocumented immigrant parents in the U.S. These babies are U.S. citizens, but undocumented immigrants are ineligible for most public insurance, making it difficult for them to access prenatal care. This research brief describes restrictive policies related to prenatal care for undocumented immigrants and discusses how these policies affect health care providers and the care they are able to offer pregnant immigrant women.

Impact Of The Affordable Care Act On The Cooper Women’S Care Center, Amanda Malik, Natali Franzblau

Cooper Rowan Medical Journal

Background: The Affordable Care Act (ACA) increased access to women’s health care by expanding Medicaid eligibility and requiring that insurance plans cover many gynecologic preventive services at no cost to patients. Before implementation of the ACA, pregnant women with low incomes qualified for Medicaid but childless adults of the same income did not, and though prenatal obstetrical visits were covered by plans at no or low cost to patients, most gynecologic services required out of pocket payments.

Objective: This study aimed to identify changes in the types of visits (gynecologic or obstetric) and patient demographics (including age, race, …

Structural Justice: A Critical Feminist Framework Exploring The Intersection Between Justice, Equity And Structural Reconciliation., Camille Burnett, Michael Swanberg, Ashley Hudson, Donna Schminkey

Journal of Health Disparities Research and Practice

Violence against women is a human rights violation (UN, 2006). It affects the health of women globally (UN, 2009) and its elimination is at the heart of many international and national goals. Intimate partner violence (IPV), one of the most common forms of gender-based violence, affects one in three women worldwide (WHO, 2013). The consequences of IPV create negative health outcomes for women that diminish their quality of life and their overall well-being. Abused women access community supports such as shelters to seek safe refuge from the abuse and restore their lives. While shelters play an extensive role in helping …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

Discursive Constructions Of Professional Identity In Policy And Regulatory Discourse, Gerard Fealy, Josephine Mary Hegarty, Martin Mcnamara, Mary Casey, Denise O'Leary, Catriona Kennedy, Pauline O’Reilly, Rhona O’Connell, Anne-Marie Brady, Emma Nicholson

Articles

Aim

To examine and describe disciplinary discourses conducted through professional policy and regulatory documents in nursing and midwifery in Ireland.

Background

A key tenet of discourse theory is that group identities are constructed in public discourses and these discursively constructed identities become social realities. Professional identities can be extracted from both the explicit and latent content of discourse. Studies of nursing's disciplinary discourse have drawn attention to a dominant discourse that confers nursing with particular identities, which privilege the relational and affective aspects of nursing and, in the process, marginalize scientific knowledge and the technical and body work of nursing. …

Financial Exploitation Of Maine's Older Adults: An Analysis Of Maine Adult Protective Services And Legal Services For The Elderly Case Records, State Fiscal Years 2010-2016, Eileen Griffin Jd, Catherine Mcguire Bs, Kimberly I. Snow Mhsa, Ba

Disability & Aging

The goal of this study was to capture information about the amount of money Maine’s older adults have lost to financial exploitation, along with information about those exploited, the perpetrators of financial exploitation, the type of loss, and amount of money lost. This report summarizes key findings emerging from this analysis. In particular, we found that, when compared to Maine’s general population of adults age 60 and older, the victims of financial exploitation served by Maine's Adult Protective Services (APS) and Legal Services for the Elderly (LSE) are more likely to be age 80 and older, female; and widowed, single, …

The First Special Issue Of Dignity, Donna M. Hughes

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Social Isolation And Loneliness In Older People: A Closer Look At Definitions, Mary Lou Ciolfi, Frances Jimenez Ba

Disability & Aging

Social isolation and loneliness are related and the terms are often used interchangeably, but they are distinct concepts with different definitions, health impacts, and interventions. Our population is aging and older people are at increased risk for both social isolation and loneliness and the associated negative health consequences. Understanding the important differences between social isolation and loneliness will help us recognize them earlier in vulnerable populations, engage in more meaningful conversations with older adults about their own risks, and will inform the development and delivery of more individualized, meaningful, and cost-effective interventions.

Acknowledging Individual Responsibility While Emphasizing Social Determinants In Narratives To Promote Obesity-Reducing Public Policy: A Randomized Experiment, Jeff Niederdeppe, Sungjong Roh, Michael A. Shapiro

Research Collection Lee Kong Chian School Of Business

This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity’s social determinants were less likely to engage in counterargument and felt more empathy for the story’s main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and …

Policymakers Identify Priorities For Phssr, Katherine Froeb Papa

Frontiers in Public Health Services and Systems Research

A major goal for the health services research community is to provide evidence policymakers can use to improve the public’s health. However, it can be difficult to know what evidence policymakers want and how they decide what research to fund.

In order to understand where policymakers turn for evidence and how they make funding decisions amid fiscal and political constraints, AcademyHealth conducted a 3-part Fireside Chat series in the spring of 2014. This editorial summarizes the evidence gaps identified, and provides strategies for communicating with decision makers.

Political Determinants Of Health: Lessons For Pakistan, Rashid Jooma, Guido Sabatinelli

Section of Neurosurgery

There is much concern about the capacity of the health system of Pakistan to meet its goals and obligations. Historically, the political thrust has been absent from the health policy formulation and this is reflected in the low and stagnant public allocations to health. Successive political leaderships have averred from considering healthcare is a common good rather than a market commodity and health has not been recognized as a constitutional right. Over 120 of world's nation states have accepted health as a constitutional right but the 1973 Constitution of Pakistan does not mandate health or education as a fundamental right …

Perceptions Of The Counseling Profession: From Health Science Graduate Faculty And Students, Kaprea F. Johnson, Christianne Fowler, Karen Kott, Margaret Lemaster

Nursing Faculty Publications

Counseling is considered a newer healthcare profession and possibly unknown to others. This study uses a post-positivist phenomenological approach exploring healthcare faculty and students' perceptions of counseling professionals after participating in a semester long interprofessional health promotions and maintenance course. Results indicated most professions are unaware of counselors, their scope of practice, and their benefit to interprofessional teams. Participants showed growth in their knowledge. Results indicate the importance of interprofessional education and need for advocacy awareness.

Diffusion Of Innovation Across A National Local Health Department Network: A Simulation Approach To Policy Development Using Agent-Based Modeling, Mark Orr, Jacqueline Merrill

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues is sparsely connected, which may limit the spread of innovative practices. We used agent-based simulation modeling to find out if a policy to promote more connections improved the network’s capability to diffuse innovation. We found that unanticipated effects could result, depending on the requirements of the policy and the proportion of health officials involved. With carefully crafted assumptions and reliable data it is possible to untangle complex processes using simulation modeling. The results represent how the world might actually work which may provide useful decision support for policymakers …

Cross-System Profile Of Maine's Long Term Support System: A New View Of Maine's Long Term Services And Supports And The People Served, Eileen Griffin Jd, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Stuart Bratesman Mpp, Kathy Bubar, Romaine Turyn

Disability & Aging

This document provides a new way of looking at Maine's long term services and supports, with an emphasis on developing a common approach for describing and analyzing long term services and supports across programs. A conscious effort was made to organize this profile around the populations served rather than the programs serving them. For that reason, the profile captures information on all of the services accessed by each population group, not only those services administered by a particular program. This broader view provides important information about the full range of service utilization for each population group.

Tracing The History Of Medicare Home Health Care: The Impact Of Policy On Benefit Use, Joan K. Davitt, Sunha Choi

The Journal of Sociology & Social Welfare

We trace key policy changes that affected use of the Medicare home health benefit from the 1980s through the prospective payment system implemented in 2000, analyzing the impact on three measures of home care use: expenditures, users and visits. We demonstrate the impact of policies generated in the legislative, the judicial, and the executive branches of government and the gaming behavior of home health agencies in response to policy changes. Our analysis suggests that the policy itself and the implementation process are critical to understanding benefit use. The incentives in the policies and agency reactions had the potential to generate …

Women Of Talent: Gender And Government Appointments In Massachusetts, 2002–2007, Carol Hardy-Fanta, Kacie Kelly

Publications from the Center for Women in Politics and Public Policy

Despite the high educational and occupational attainment—and considerable talent—of women in Massachusetts, the state ranks just 22nd in the nation on women's overall share of top executive, legislative, and judicial posts, compared to their share of the population. The goals of this study were to (1) calculate the percentage of women holding senior-level positions in state government at these four points in time; (2) analyze the distribution of appointments by type of position and executive office; (3) provide possible explanations for the status of women’s representation in these positions; and (4) offer recommendations that will serve to promote the appointment …

Access To Housing For Persons With Disabilities: Lessons Learned From Three Demonstration Projects, Cutler, Disability And Aging, Eileen Griffin Jd

Disability & Aging

The Quality Choices for Maine project was conducted from 2001-2004. This report focuses on Access to Services, one part of the three-year RCSC Quality Grant. The specific housing related goal was “to improve access to community housing for people with disabilities of all types.” Project activities were overseen by the Access to Services Technical Assistance Group and a variety of stakeholders. Read the activity summaries, lessons learned and recommendations on how to sustain the work.

The Citizens Health Prescription: Coping With Rising Drug Costs, Shannon Cadres

New England Journal of Public Policy

Prescription drug prices have climbed to unaffordable levels in recent years, creating a serious public policy problem for lawmakers at both the state and federal levels. The U.S. Medicare program only covers the costs of inpatient prescription drugs, and only seventy-five percent of beneficiaries are receiving coverage through some other means. But because of the tremendous power of the pharmaceutical industry on Capitol Hill, lawmakers in Washington have been unable to agree upon a workable solution. As a result, many states are experimenting with different strategies to provide some relief. Massachusetts has attempted to solve the problem through the Prescription …