Medicine and Health Sciences Commons^™

When Curiosity Kills More Than The Cat: The Perils Of Unchecked Scientific Inquiry, Jamie Shannon

Pomona Senior Theses

This work analyzes the ecological, physical, emotional and health impacts of the US nuclear testing done in the Marshall Islands in the mid-20th century.

The Affordable Care Act, Medical Homes, And Childhood Asthma: A Key Opportunity For Progress, Meagan Lyon, Anne Rossier Markus, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The medical homes provisions of the Affordable Care Act offer a major opportunity to advance high quality, cost-efficient health care for children with asthma. This policy brief examines evolving national medical homes policy in a childhood asthma context. Following a brief background that examines childhood asthma and explores the origins and evolution of medical homes policy (a concept developed with children in mind), the brief then describes how the Affordable Care Act can advance the implementation of medical homes policies to improve health outcomes for children with asthma.

Roundtable On The National Health Security Strategy And At‐Risk Individuals, Behavioral Health, And Community Resilience, Daniel B. Fagbuyi, +Conference Participants

GW mHealth Collaborative

No abstract provided.

Public Health Insurance Utilization In New York City, 2008, Rachael Varra

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines demographic and socioeconomic factors of racial/ethnic groups in New York City between as of 2008 – particularly the utilization of public health insurance (PHI) benefits.

Methods: Data on Latinos and other racial/ethnic groups were obtained from the U.S. Census Bureau American Community Survey, reorganized for public use by the Minnesota Population Center, University of Minnesota, IPUMSusa. Cases in the dataset were weighted and analyzed to produce population estimates.

Results: Of the 25% of New Yorkers receiving PHI in 2008, the absolute number of whites, blacks and Latinos receiving PHI was similar. However, greater proportions of Latinos …

A Case Study Of Appendicitis At Antanimalandy Lutheran Hospital, Jennifer Gemmell

Independent Study Project (ISP) Collection

From the introduction:

The island of Madagascar houses a total of 19,159,000 people who spend only $34 per person per year on health care (“Madagascar,” 2008). The government claims to have “committed itself to the principle that good health is a right of each Malagasy citizen, and has made significant studies in the area of health care,” according to the country study for the Library of Congress. However, with political corruption, political crisis after political crisis, and lack of international support, the government does not dispense the funds necessary to support this commitment (Metz, 1994). For example, in 1976 the …

Finding The Right Fit: Unique Challenges Faced By Health Ngos In The Health System Of Lamu District, Lauren Hartel

Independent Study Project (ISP) Collection

This study examines how nongovernmental organizations and community-based organizations in Lamu District interact with the governmentally structured health care system at the district level. This is done through participatory observation, interviews and removed observation of NGOs, CBOs and government officials. From these observations, this study then identifies major challenges faced by health NGOs that inhibit them from performing to the best of their ability, and at times even compromise the health of the people they are trying to help. The results of this study show that in Lamu District, the most relevant challenges are continuity of care, dissemination of information, …

Data Segmentation In Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein, Melissa M. Heesters, Penelope P. Hughes, Benjamin Williams, Scott A. Weinstein

Health Policy and Management Faculty Publications

The issue of whether and, if so, to what extent patients should have control over the sharing or withholding of their health information represents one of the foremost policy challenges related to electronic health information exchange. It is widely acknowledged that patients' health information should flow where and when it is needed to support the provision of appropriate and high-quality care. Equally significant, however, is the notion that patients want their needs and preferences to be considered in the determination of what information is shared with other parties, for what purposes, and under what conditions. Some patients may prefer to …

Renewing Health Services Management Research: Redrawing The Citizen-Client In Irish Health Care Policy, Vivienne Byers

Conference Papers

Ireland has a history of health policy which is not explicit as to its aims and objectives. In light of this fact, this paper examines the position and direction of the Irish Health Services, five years on from the advent of the setting up of the Health Services Executive (HSE) and the restructuring of the health services. The Irish health system policy is guided by the Health Strategy of 2001; in that there should be equitable distribution of health services focused on the need of the citizen-client, and also by the Primary Care Strategy (2001:7); in that there should be …

Women’S Health Disparities And Midwifery Care, Adeola Oni-Orisan, Dorothy Hiersteiner, Althea Swett

Publications from the Center for Women in Politics and Public Policy

This fact sheet was developed for the roundtables project “Midwifery Care in New England: Addressing the Needs of Underserved and Diverse Communities of Women.” Sponsored by the U.S. Department of Health and Human Services (HHS) Office on Women’s Health (Region I), this initiative addresses the challenges and opportunities related to the provision of midwifery care to underserved and vulnerable populations of women. The project aims to increase our understanding of regional midwifery workforce needs in the context of ensuring that all women living in New England have access to timely, affordable, and high-quality health care.

The September 2010 roundtables were …

Women’S Health Disparities And Midwifery Care: Spotlight On Connecticut, Dorothy Hiersteiner, Kaye Inandan

Publications from the Center for Women in Politics and Public Policy

Although Connecticut’s Medicaid programs, Husky A and B, are essential providers of coverage for maternity care, there are still major racial and ethnic disparities in access to, use of, and quality of prenatal care in Connecticut. The cesarean birth rate in the state is almost 9% higher than the US average. African American/black and Hispanic mothers experience comparatively high rates of low birth weight births. Furthermore, Connecticut is home to a substantial rural population which experiences unique challenges to accessing adequate health care. While 75% of the Connecticut population is non-Hispanic white, 9% is African American/black, 12% is Hispanic and …

Women’S Health Disparities And Midwifery Care: Spotlight On Maine, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

With a large percentage of its population living in rural areas, Maine faces obstacles to providing adequate prenatal and maternity care to many women. The vast majority (96.2%) of Maine residents are non-Hispanic white, 1.2% are African American/black, 1.4% are Hispanic and 1.2% have other racial/ethnic backgrounds.

Women’S Health Disparities And Midwifery Care: Spotlight On Massachusetts, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

As a result of Massachusetts’ 2006 health insurance coverage law, there has been a significant decrease in the uninsurance rate for women of color. Access to and use of health care for all women in the Commonwealth has also increased. Despite these coverage and access gains, major racial/ethnic disparities in health conditions and outcomes still exist among women, especially in the use and quality of prenatal care, the occurrence of preterm and low birth weight births, and infant mortality rates. The proportion of Massachusetts births that were cesarean deliveries in 2007 was 8% higher than the national rate. Compared to …

Women’S Health Disparities And Midwifery Care: Spotlight On New Hampshire, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

New Hampshire faces significant obstacles to serving the nearly 6% of the population living in medically underserved areas. In addition, many residents of New Hampshire are uninsured, limiting their access to vital medical care. According to 2007-8 data, the racial/ethnic breakdown of New Hampshire residents is: 1% African American/black, 2% Hispanic, 94% non-Hispanic white and 3% Other. In 2005, 5.9% of the total New Hampshire population was foreign born.1 Since 1996, New Hampshire has seen increases in low birth weight births, cesarean births2, and infant mortality with racial/ethnic disparities reflected in most maternal and infant indicators.

Women’S Health Disparities And Midwifery Care: Spotlight On Vermont, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

In Vermont, racial and ethnic dispariti es in low birth weight and preterm birth rates exist alongside racial and ethnic disparities in health insurance coverage and use of preventative care. As of 2005, the percentage of racial and ethnic minorities in Vermont was approximately 3.3%, compared to 25% for the nation as a whole. In 2005, 3.4% of the Vermont population was foreign born.

Envisioning Nevada’S Future: Goals & Strategies For Advancing Our Quality Of Life, Nevada Vision Stakeholder Group, Moody’S Analytics

Brookings Mountain West Publications

Nevada’s severe downturn has brought to light many of the long-term challenges facing the state. Not only is its economy subject to painful swings, but Nevada’s primary drivers— consumer services (primarily gaming, hospitality and housing) and resource extraction—will provide less support than they have in past business cycles. Less economic vitality will make it harder to offer Nevadans the quality of life they expect.

The importance of the economy to quality of life is equally clear—quality of life is a hollow promise without a healthy and supportive economy. Similarly, a proper fiscal structure—both in terms of spending and revenues—is critical …

Women’S Health Disparities And Midwifery Care: Spotlight On Rhode Island, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

Rhode Islanders face unique health disparities based on race, ethnicity and location. Just over six percent (6.3%) of the Rhode Island population is living in Primary Care Health Professional Shortage Areas (HPSAs), according to 2008 data. Native American and African American/black communities face particular health disparities, specifically in the areas of reproductive and infant health. In 2008, 79% of the Rhode Island population was non-Hispanic white, while 5% was African-American/black, 11% was Hispanic and 5% had other racial/ethnic backgrounds. In 2005, 12.4% of the total Rhode Island population was foreign born.

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Drive Alive: Teen Seat Belt Survey Program, Katie M. Burkett, Steve Davidson, Carol Cotton, James Barlament, Laurel Loftin, James H. Stephens, Martin Dunbar, Ryan Butterfield

Health Policy and Management Faculty Publications

Objective: To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.

Methods: The first component of the program was 20 observational teen seat belt surveys conducted by volunteer students in a high school parking lot over a 38-month period before and after the month-long intervention. The survey results were published in the newspaper. The second component was the use of incentives, such as gift cards, to promote teen seat belt use. The third component involved disincentives, such as increased police …

Strengthening Primary Care To Bend The Cost Curve: The Expansion Of Community Health Centers Through Health Reform, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The recent enactment of health reform sets into motion important changes that will expand health insurance coverage, increase funding for community health centers and alter the way that health centers are paid. These reforms will have a major impact on two major challenges of health reform: bolstering the capacity of the nation's primary care system and reducing the long term growth in health care costs.

Our analyses examine the impact of the new health reform law on the number of patients who will receive primary care services at community health centers and the effect of the service expansions on overall …

Barriers And Facilitators To Prenatal Care For Pregnant Latina Women In Cobb County, Georgia, Carol Holtz, Annette Bairan

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This research study seeks to identify factors that serve as barriers and/or facilitators to prenatal care for Latina women and to provide data to assist health care providers, health care agencies, and policy makers in developing programs that maximize access to prenatal care for Latina women. In addition, other groups may also find this data useful, such as scholars in Latin American studies, immigration, cultural diversity, minority health care, and health care in general. The research questions consist of the following: (1) What do indigent pregnant (or recently delivered) Latina women believe about prenatal care? (2) What are the barriers …

Early Childhood Care And Education For All In 2015: Is This A Mirage In Nigeria?, Esther A. Oduolowu

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This paper examines the possibility of the provision of Early Childhood Care and Education (ECCE) for all children from birth to age five in Nigeria by 2015. In the paper are the history of preschool education in Nigeria) situation of ECCE worldwide in the 1980s) and the, global trends in basic education in the 1990s. The paper also examines the limitations of the attempt and offers probable solutions.

Forced Migration And The Survival Needs Of The Nigerian Child, Ngozi Diwunma Obidike

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This article identifies the survival needs of the forced migrant Nigerian child as well as the extent to which the identified needs are satisfied. The population consisted of 600 forced migrant children and 10 emergency workers who were chosen based on their experiences being forced migrants. A questionnaire was used for the study. The result showed) among other things, that although the need for food, clean water, education, peace, and shelter were identified as the five most essential needs, other needs were also identified as necessary for the children's survival. Based on the results, recommendations were made.

Medical-Legal Partnerships: Addressing The Unmet Legal Needs Of Health Center Patients, Peter Shin, Fraser Rothenberg Byrne, Emily Jones, Joel B. Teitelbaum, Lee Repasch, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Medical-legal partnerships (MLPs), now available at over 180 hospitals and health centers across 38 states, are an important option for addressing the legal needs affecting low-income and vulnerable patients, and thereby improving their overall health. We estimate that each year, anywhere between 50 and 85 percent of health centers users - or between ten and 17 million people - experience unmet legal needs, many of which negatively impact their health. In a medical-legal partnership, health care staff at hospitals, clinics, and other sites are trained to screen for health-related legal issues, refer the patient to an affiliated lawyer or legal …

Archetypal Energies, "Psychic Politics", And The Transformative Potential Of The Health Care Debate, Carroy U. Ferguson

Carroy U "Cuf" Ferguson, Ph.D.

In a previous message, I spoke of “Archetypal Energies, The Emergence of Obama As A Practical Idealist, and Global Transformation” (February/March 2009). I suggested that at issue is what I called “psychic politics for global transformation, nurtured by practical idealism and the Archetypal Energies.” To reiterate, I have described Archetypal Energies as Higher Vibrational Energies, operating deep within our individual and collective psyches, which have their own transcendent value, purpose, quality, and “voice” unique to the individual. We experience them as “creative urges” to move us toward our Highest Good or Optimal Realities. I use easily recognized terms to evoke …

Safe Medicine Disposal For Me A Handbook And Summary Report, Lenard W. Kaye, Jennifer Crittenden, Stevan Gressitt

Maine Center on Aging Service and Consultation

The Safe Medicine Disposal for ME (SMDME) program is a statewide model for the disposal of unused household medications using a mail-back return envelope system. Established through state legislation and implemented in 2007 with a grant from the U.S. Environmental Protection Program’s Aging Initiative, the program is authorized to handle both controlled and non-controlled medications This handbook describes the program components, as well as the outcomes and lessons learned from Phases I & II of the program. The handbook is designed as a guide to organizations that are implementing similar programs in other states. Maine, which has a combination of …

Standardized Performance Measurement And Reporting In Emergency Departments (Eds), Gw Urgent Matters Learning Network Ii

Health Workforce Research Center Publications

The drive to maximize emergency department (ED) efficiency while also ensuring the quality of care they deliver has been the focus of experts in the United States for decades. Access to patient-centered and equitable emergency care is critical to a community, and EDs are the safety net that must provide that care whenever it is needed, to whomever needs it. A wellmanaged ED increases the quality and safety of patient care and strengthens the health care infrastructure.

Consumer Consent Options For Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein

Health Policy and Management Faculty Publications

The issue of whether, to what extent, and how individuals should have the ability to exercise control over their health information represents one of the foremost policy challenges related to the electronic exchange of health information. The current landscape of possible consent models is varied, and the factors involved in choosing among them are complex. States and other entities engaged in facilitating the exchange of electronic health information are struggling with a host of challenges, chief among them the establishment of policies and procedures for patient participation in their exchange efforts. While some have adopted policies enabling patients to exercise …

Changing Po2licy: The Elements For Improving Childhood Asthma Outcomes, Anne Rossier Markus, Meagan Lyon, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and chronic health issue that affects one in seven U.S. children and their families, compromising their health and quality of life and placing a heavy financial burden on families as well as an enormous strain on the health care system. Treating, managing, and ultimately preventing and reducing the burden of asthma represents a critical test of the ability of the U.S. health system – health insurers, clinical care providers, and public health agencies – to work together. Our investigation found that, as a country, we already know enough to act and improve life for the …

Conceptions Regarding Children’S Health: An Examination Of Ethnotheories In A Sending And Receiving Community, Maria Rosario De Guzman, Jennifer Deleon, Gloria Gonzalez-Kruger, Rodrigo Cantarero

Department of Child, Youth, and Family Studies: Faculty Publications

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty-four Mexican adults in six focus groups discussed well-being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components …

The President's Emergency Plan For Aids Relief (Pepfar): A Social Work Ethical Analysis And Recommendations, Robert J. Barney, Stephan L. Buckingham, Judith M. Friedrich, Lisa M. Johnson, Michael A. Robinson, Bibhuti K. Sar

The Journal of Sociology & Social Welfare

The President's Emergency Plan for AIDS Relief (PEPFAR) is the most recent international social program instituted by the U.S. Government to combat HIV/AIDS. Since its inception in 2003, this foreign policy initiative has dedicated $63 billion for HIV/AIDS prevention and treatment in foreign countries. Despite PEPFAR's many accomplishments, it continues to promote controversial prevention strategies. This paper analyzes these prevention strategies, utilizing social work values as described in the NASW Code of Ethics. Policy, practice, and research implications are discussed.