Medicine and Health Commons^™

Assessment Of Maine's Long-Term Care Needs Baseline Report: Demographics And Use Of Long Term Care Services In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Karen Mauney, Catherine Mcguire Bs, Louise Olsen, Jasper Ziller

Disability & Aging

In 2006, the Office of Elder Services requested the assistance of the Muskie School in developing an assessment of long term care service use in Maine. This report provides baseline information on the demographic characteristics, participant characteristics and service use trends for people accessing long term care services in this State.

For purposes of this report, we have excluded people with MR/DD. Long term care services do not include community support services for people with mental illness.

In this report, long term care services include:

• Nursing Facility Services
• Private Non-medical Institutions
• Consumer Directed Attendant Services
• Day Health Services
• Elder and …

Face To Face With “It”: And Other Neglected Contexts Of Health Privacy, Anita L. Allen

All Faculty Scholarship

“Illness has recently emerged from the obscurity of medical treatises and private diaries to acquire something like celebrity status,” Professor David Morris astutely observes. Great plagues and epidemics throughout history have won notoriety as collective disasters; and the Western world has made curiosities of an occasional “Elephant Man,” “Wild Boy,” or pair of enterprising “Siamese Twins.” People now reveal their illnesses and medical procedures in conversation, at work and on the internet. This paper explores the reasons why, despite the celebrity of disease and a new openness about health problems, privacy and confidentiality are still values in medicine.

Lead-Contaminated Candies In Southern Nevada, Shawn Gerstenberger, Glenn Savage, Clayton Sellers, Keith Zupnik, Emmanuel C. Gorospe

Environmental & Occupational Health Faculty Publications

Lead-contaminated candies from Latin America are beginning to gain attention in the public media1,2 and in the medical literature.3–5 These candies come from a number of sources and are manufactured outside Food and Drug Administration regulatory control. In 2005, we sampled 50 imported Latin American candies sold in Southern Nevada. A total of 20 (40%) tested positive with an average lead content of 1.46  0.27 mg/kg in the candies’ wrappers and straws, based on standard Graphite Furnace Atomic Absorption Spectrophotometry methodology. Given these results, the Southern Nevada Health District issued a cease-and-desist order on February 13, 2006, to local …

Diabetes Treatments And Moral Hazard, Jonathan Klick, Thomas Stratmann

All Faculty Scholarship

In the face of rising rates of diabetes, many states have passed laws requiring health insurance plans to cover medical treatments for the disease. Although supporters of the mandates expect them to improve the health of diabetics, the mandates have the potential to generate a moral hazard to the extent that medical treatments might displace individual behavioral improvements. Another possibility is that the mandates do little to improve insurance coverage for most individuals, as previous research on benefit mandates has suggested that mandates often duplicate what plans already cover. To examine the effects of these mandates, we employ a triple-differences …

Interdisciplinary Education In Emergency Preparedness: Assuring The Safety Of Aging Populations, Linda L. Strong, Dori Taylor Sullivan

Nursing Faculty Publications

Aging is a global phenomenon. It impacts unequally, with this inequality attributable to such factors as gender, culture, education, socioeconomic status and access to primary and preventive care. Access to care and the quality of that care are significantly impacted by governmental support and regulations. Most elderly live in developed countries; however, for a significant number life is not free of stress and struggle to meet basic needs. Elders in developing countries face even more challenges. Natural and man-made disasters increase the vulnerability of these populations through potential disruption of critical services. Currently there is a paucity of health and …

Super Size Me And The Conundrum Of Race/Ethnicity, Gender, And Class For The Contemporary Law-Genre Documentary Filmmaker, Regina Austin

All Faculty Scholarship

According to director Morgan Spurlock, the idea for "Super Size Me," the hugely popular documentary that explored the health impact of fast food, originated from a news report about Pelman v. McDonald’s, one of the fast food obesity cases. Over the course of his month-long McDonald’s binge, Spurlock became the literal embodiment of fast-food’s ill-effects on the seemingly generic American adult physique. Spurlock’s take on the subject, however, ignores the circumstances that contributed to the overweight conditions of the Pelman plaintiffs who were two black adolescent females who ate their fast food in the Bronx. One of them was homeless …

Medical Malpractice Reform And Physicians In High-Risk Specialties, Jonathan Klick, Thomas Stratmann

All Faculty Scholarship

If medical malpractice reform affects the supply of physicians, the effects will be concentrated in specialties facing high liability exposure. Many doctors are likely to be indifferent regarding reform, because their likelihood of being sued is low. This difference can be exploited to isolate the causal effect of medical malpractice reform on the supply of doctors in high-risk specialties, by using doctors in low-risk specialties as a contemporaneous within-state control group. Using this triple-differences design to control for unobserved effects that correlate with the passage of medical malpractice reform, we show that only caps on noneconomic damages have a statistically …

Rural Children Increasingly Rely On Medicaid And State Child Health Insurance Programs For Medical Care, William P. O'Hare

The Carsey School of Public Policy at the Scholars' Repository

Despite a flurry of reports on health insurance coverage for children, virtually none of them have examined the unique situation of rural families where one-fifth of all the nation's poor children live. This brief takes an in-depth look at the health insurance programs, such as SCHIP and Medicaid, which rural children rely on for medical care.

Tattoo World, Agnieszka Marczak

Honors Projects

Presents a holistic look at the world of tattoo. Covers the history of the practice of tattooing in Europe, Asia, and the Pacific. Discusses such major issues as tattooing in relation to the body, authenticity, commodification and meaning, functions, medical and legal concerns, the impact of technological developments on the practice, and the increase in popularity of tattooing in recent decades.

Aborto Legal Para No Morir: Un Análisis De Los Discursos De La Lucha Por Los Derechos Reproductivos En Argentina, Jessica Scruggs

Independent Study Project (ISP) Collection

No abstract provided.

Stress And Occupation: Summer Research On The Road, Lindsey Wetteland

Inquiry Journal 2007

No abstract provided.

Children's Health Insurance In New Hampshire: An Analysis Of New Hampshire Healthy Kids, Sally Ward, Sarah Savage, Nena F. Stracuzzi

The Carsey School of Public Policy at the Scholars' Repository

New Hampshire has been successful in achieving one of the lowest uninsurance rates for children in the country - 6 percent in 2005 (U.S. Census Bureau). The extent to which New Hampshire Healthy Kids has contributed to the state's success in achieving this low rate is the focus of this brief.

Resisting Peer Pressure: Characteristics Associated With Other-Self Discrepancies In College Students’ Levels Of Alcohol Consumption, Lizabeth A. Crawford, Katherine B. Novak

Scholarship and Professional Work - LAS

Since college undergraduates tend to increase their use of alcohol to match what they perceive to be normative, the assumption has been that students who believe that others on campus drink more than they do (a common misperception) are in a vulnerable position. Taking a different perspective, we consider large other-self discrepancies in levels of alcohol consumption as indicative of a capacity to resist situational pressures that favor drinking. OLS regression was used to assess the relationship between student background characteristics, self-presentational tendencies, and a gender-specific other-self gap measure. Overall, those individuals who drank closest to what they regarded as …

Addressing Gupt Rog: Narrative Prevention Counselling For Sti/Hiv Prevention—A Guide To Ayush And Allopathic Practitioners, Bonnie K. Nastasi, Niranjan Saggurti, Stephen L. Schensul, Ravi K. Verma, Meena Gandhi

HIV and AIDS

Although India has over 600,000 registered AYUSH practitioners who are engaged in homeopathic, Ayurvedic, and Unani systems of medicine, they have not been integrated into the country’s national health system. While practitioners of these systems of medicine treat all illnesses, they have a special niche in providing services to address men’s sexual health concerns (Gupt Rog). A project on Research and Intervention in Sexual Health: Theory to Action was undertaken by the International Institute for Population Sciences/Mumbai, the Population Council/New Delhi, and partners, in three slum communities in Mumbai, from 2001–07. The objective was to control the spread of sexually …

Health And Aging: A Roadmap For Maine’S Older Adults And Their Families, Lenard W. Kaye, Dyan M. Villeneuve

Maine Center on Aging Research and Evaluation

The rapid aging of Maine’s population has created a range of challenges associated with maximizing the health and well-being of our older citizens. This issue brief considers a series of policy and programmatic approaches to promoting healthy aging lifestyles in the state while ensuring the continued involvement of relatives and other informal supports in all such efforts. Much of the current legislation that governs policy decisions regarding social service delivery and allocation of funds for Maine’s elders is funneled through the Older Americans Act, but this has not kept pace over the past 20 years. One key factor that is …

Moving From Place To Place Northern Maine Edition: A Consumer Navigation Guide For Seniors Involved In Health Care Transitions, University Of Maine Center On Aging, Eastern Area Agency On Aging

Maine Center on Aging Service and Consultation

The University of Maine Center on Aging and the Eastern Area Agency on Aging published a guide for older adults transitioning from one living situation to another. Topics discussed include transitioning from hospital to home, home to nursing home, moving from a hospital or nursing home to rehabilitation, and keeping track of medications at home.

Social Support And Thriving Health: A New Approach To Understanding The Health Of Indigenous Canadians, Chantelle A.M. Richmond, Nancy A. Ross, Grace E. Egeland

Aboriginal Policy Research Consortium International (APRCi)

Objectives. We examined the importance of social support in promoting thriv- ing health among indigenous Canadians, a disadvantaged population.

Methods. We categorized the self-reported health status of 31 625 adult indig- enous Canadians as thriving (excellent, very good) or nonthriving (good, fair, poor). We measured social support with indices of positive interaction, emotional support, tangible support, and affection and intimacy. We used multivariable lo- gistic regression analyses to estimate odds of reporting thriving health, using social support as the key independent variable, and we controlled for educational attainment and labor force status.

Results. Compared with women reporting low levels of …

Supporting Volunteer Mentors: Insights From A Mentorship Program For Youth-Headed Households In Rwanda, Lisanne Brown, Tonya R. Thurman, Edward Kalisa, Janet C. Rice, Jean De Dieu Bizimana, Neil W. Boris, Leslie M. Snider, Joseph Ntaganira

HIV and AIDS

In 2004, World Vision Rwanda (WVR), in collaboration with Tulane University and the Rwanda School of Public Health, implemented a program to provide support through regular visits by an adult mentor to youth living without adult care. After completion of baseline quantitative and qualitative research, WVR implemented the program in two areas of a province in southwestern Rwanda. Over an 18-month period, 156 trained adult mentors visited and supported 441 youth-headed households. The mentor training covered key aspects of child development and skills for addressing key psychosocial issues that were identified through the baseline research. Specifically, the training addressed how …

Reaching Truckers In Brazil With Non-Stigmatizing And Effective Hiv/Sti Services, Magda Chinaglia, Sheri A. Lippman, Julie Pulerwitz, Maeve De Mello, Rick Homan, Juan Diaz

HIV and AIDS

A study conducted by the Population Council in 2001 found that truckers crossing Brazil’s southern border had easy access to commercial sex and extremely limited access to health services, condoms, HIV testing and counseling, and HIV/STI prevention messages. In response, the Population Council’s Horizons Program conducted an intervention study from 2002 to 2005. The study examined the feasibility, acceptability, and impact of providing a range of health services to truckers at a health post inside a customs station, where truckers wait anywhere from one day to a week for documents and cargo to clear customs. As noted in this brief, …

Building The Capacity Of Faith-Based Organizations To Promote Mutual Monogamy In South Africa, Waimar Tun, Nathi Sohaba, Unathi Malinzi, Matthew Nqono, Osborne Mzilikazi, Bonisiwa Mgujulwa, Moses Madywabe, Mbulelo Fatyeni, Christine Fontecchio

HIV and AIDS

In South Africa, where sex partnerships outside primary relationships are common even among church members, HIV-prevention programs focusing on mutual monogamy (MM) are needed. Church leaders, highly regarded by the community, may be effective in reaching congregation members with HIV-prevention messages. However, implementing programs that promote faithfulness pose several challenges. In response to a lack of research on effective strategies to promote MM, the Horizons Program, in partnership with the Eastern Cape Provincial Council of Churches and the South African Council of Churches, piloted an intervention to promote MM. A curriculum was developed covering topics including HIV transmission, personal relationships, …

Intergenerational Communication On Sexuality And Hiv/Aids: Exploring Feasibility Of Building Effective Youth-Adult Partnerships To Reduce Young People's Hiv Vulnerabilities, Vaishali Sharma Mahendra, Sarat Chandra Pradhan, Saraswati Swain, Aradhana Nanda, Sanjit Patnayak, Sucheta Panda, Rajendra Prasad

HIV and AIDS

In India, over one-third of all reported AIDS cases occur among people aged 15–24 years. Young people need competencies to navigate daily-life situations and engage in productive activities, and the relationships they form with adults and peers are the source of support and guidance critical to the development of their competencies. The peer-based approach is integral to sexual health and HIV-prevention programs for youth. However, in some settings, program and policy directions have been hampered by adult beliefs of what young people should be permitted to know. Recent projects show that working on changing the norms and beliefs of adults …

Identifying Areas For Linkages Between Hiv And Srh For Vulnerable Populations: An Exploratory Study To Assess Female Sex Workers' Sexual And Reproductive Health Needs, Vaishali Sharma Mahendra, Sushma Mehrotra, B. Srikanthi, Sucheta Panda, Avina Sarna, A.K. Jayasree, Rajendra Prasad, Naomi Rutenberg

HIV and AIDS

Sexual and reproductive ill-health and HIV/AIDS share root causes, including poverty, gender inequality, and social marginalization of the most vulnerable populations. This has prompted the international community to call for policy and program approaches to strengthen the linkages between SRH and HIV/AIDS programs. However, most integration efforts have given priority to family planning, maternal and child health, and STI treatment and to addressing the needs of married women from the general population. Female sex workers have been targeted for HIV prevention efforts but little attention has been given to SRH-related care. To bring sex workers into the focus for SRH-HIV …

Mainstreaming Emergency Contraception In Ethiopia's Public Sector: Final Project Report, Jill Keesbury, Hailegiorgis Aytenfisu, Spike Bradford

Reproductive Health

The Ethiopian Ministry of Health, the Ethiopian Society of Obstetricians and Gynecologists, and ECafrique launched a two-year project in 2004 to mainstream emergency contraception (EC) in the country’s public sector. The project aimed at improving reproductive health care among young women and reducing the country’s abortion rate by expanding access to EC. Overall, its goal was to demonstrate the feasibility of integrating EC within the public sector’s broader contraceptive mix and was guided by the following objectives: to scale-up and promote public sector EC services in five of Ethiopia’s most populated regions; to document the characteristics and use patterns of …

Grandir En Harmonie: Curriculum D'Animation Des Pairs-Éducateurs Et Des Aides-Ados Ou Jeunes Écoutant, Population Council

Reproductive Health

« Grandir en harmonie » est un curriculum d’animation en santé de la reproduction a l’intention des pair éducateurs et des aides-adolescent(e)s, principalement, pour préparer les adolescent(e)s à aborder la sexualité en connaisance de cause, de manière responsable et dans le respect des valeurs de leur milieu. Son contenu peut aussi être utilisé par les jeunes de 20 à 24 ans, mais avec des méthodes appropriées (panel, thé-débat, etc.). D’autre types d’utilisateurs l’ont expérimenté et ont trouvé que c’était une ressource utile pour la conduite de leurs activités: aides-adolescent(e)s, enseignants, prestataires de santé et autres encadreurs de jeunes. Leurs remarques …

Kenya: Mobilize Health Care Providers To Advocate Against Fgm/C, Frontiers In Reproductive Health

Reproductive Health

Female genital mutilation/cutting (FGM/C) is illegal in Kenya. The practice has declined slightly, yet it is nearly universal among the Abagusii, a relatively affluent ethnic group residing in the Nyanza province in western Kenya. Half of cut women reported that they had been cut by a health worker, however providers express willingness to advocate against the practice. This study, launched in 2004 by the Population Council’s FRONTIERS Program, examined the role of health providers in FGM/C in Kenya’s Abagusii community. As noted in this brief, the objectives were to understand the motivations behind the medicalization of FGM/C and determine the …

South Africa: Improve Facility Management To Increase Nurse Retention, Frontiers In Reproductive Health

Reproductive Health

South Africa’s medical infrastructure is relatively well developed, but its maternal mortality rate remains high and numerous studies document poor maternal care. Shortages in nursing staff are a major factor in quality-of-care problems on maternity wards. A Population Council FRONTIERS study of antenatal care in rural clinics in Kwa-Zulu Natal showed that between one-third and one-half of providers interviewed had worked at their clinics for less than a year. In 2004, FRONTIERS followed up on the Kwa-Zulu Natal study to document factors affecting the tenure, motivations, and working conditions of maternal-health nursing staff in three South African provinces. The study …

Mainstreaming And Scaling Up The Kenya Adolescent Reproductive Health Project, Ian Askew, Humphres Evelia

Reproductive Health

From 1999–2003, FRONTIERS implemented a Global Agenda program of operations research (OR) projects to address the reproductive health (RH) needs of adolescents in four countries—Bangladesh, Kenya, Mexico, and Senegal. The project was implemented in two districts of Western Province in Kenya and was known as the Kenya Adolescent Reproductive Health Project (KARHP). The project supported a public sector, multisectoral intervention to enhance young people’s knowledge and behavior regarding HIV prevention and RH. Implemented jointly with PATH, this OR project demonstrated that such an intervention could be implemented by the public sector, that it was acceptable to communities, that its influence …

Achieving Synergies In Prevention Through Linking Sexual And Reproductive Health And Hiv Services, Ian Askew

Reproductive Health

Integration, linkages, and synergies are widely used terms among those interested in strengthening the relationship between sexual and reproductive health services and HIV prevention. These conference proceedings explore the terms conceptually and review the wide range of combinations of SRH and HIV prevention services that have been linked or integrated. Several different combinations have proven feasible and acceptable in pilot situations, but there remains a lack of evidence as to their effectiveness in changing behaviors, including preventing HIV transmission. There is also limited experience with scaling up successful models and a need to move beyond a focus on services to …

Hiv/Aids Programming And Sexuality Of Young People Perinatally Infected With Hiv, Harriet Birungi

Reproductive Health

These conference proceedings draw on preliminary data from an ongoing project implemented by TASO Uganda and the Population Council that contributes to the promotion of sexual and reproductive health rights of young people aged 10–19 years perinatally infected with HIV. The key argument is that HIV/AIDS programming in Uganda and elsewhere in Africa will need to acknowledge that the population of young people perinatally infected with HIV is growing and to specifically target that population. HIV/AIDS programming will also address the sexual desires of young people perinatally infected with HIV by providing them with information and practical support to understand …

Assessment: Frontiers Small Grants Program, Koli Banik

Reproductive Health

This report reviews the Small Grants Program (SGP) implemented by FRONTIERS. It assesses the SGP’s areas of achievements and challenges, and explores the feasibility of using this approach to build capacity in operations research. The report provides ideas for implementing a successful SGP that can deliver high-quality, relevant, and timely information for program design. Although capacity building was not an objective in the FRONTIERS SGP, it did produce some increased capacity after two years. As was found with other small grants programs, the FRONTIERS experience suggests that considerable resources are required to produce good quality research and final products. Program …