Digital Commons Network^™

Public Mental Health During And After The Sars-Cov-2 Pandemic: Opportunities For Intervention, Melissa M Karnaze, Brent M Kious, Lindsay Z Feuerman, Sarah Classen, Jill O Robinson, Cinnamon S Bloss, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Importance: During the pandemic, the number of United States adults reporting clinically significant symptoms of anxiety and depression sky-rocketed, up from 11% in 2020 to more than 40% in 2021. Our current mental healthcare system cannot adequately accommodate the current crisis; it is therefore important to identify opportunities for public mental health interventions.

Objective: Assess whether modifiable emotional factors may offer a point of intervention for the mental health crisis.

Design setting and participants: From January 13 to 15, 2022, adults living in the United States were recruited via Amazon Mechanical Turk to complete an anonymous survey.

Main outcomes and …

Renewed Calls For Abortion-Related Research In The Post-Roe Era, Sophie L Schott, April Adams, Ryan J Dougherty, Taylor Montgomery, Folasade C Lapite, Faith E Fletcher

Center for Medical Ethics and Health Policy Staff Publications

Nearly 50 years after Roe versus Wade, the United States Supreme Court's decision in Dobbs versus Jackson Women's Health Organization unraveled the constitutional right to abortion, allowing individual states to severely restrict or ban the procedure. In response, leading medical, public health, and community organizations have renewed calls for research to elucidate and address the burgeoning social and medical consequences of new abortion restrictions. Abortion research not only includes studies that establish the safety, quality, and efficacy of evidence-based abortion care protocols, but also encompasses studies on the availability of abortion care, the consequences of being denied an abortion, and …

Payer Reimbursement Practices And Incentives For Improving Interpretation Of Germline Genetic Testing, Patricia Deverka, Janis Geary, Charles Mathews, Matan Cohen, Gillian Hooker, Mary Majumder, Zuzana Skvarkova, Robert Cook-Deegan

Center for Medical Ethics and Health Policy Staff Publications

Germline genetic testing for inherited cancer risk has shifted to multi-gene panel tests (MGPTs). While MGPTs detect more pathogenic variants, they also detect more variants of uncertain significance (VUSs) that increase the possibility of harms such as unnecessary surgery. Data sharing by laboratories is critical to addressing the VUS problem. However, barriers to sharing and an absence of incentives have limited laboratory contributions to the ClinVar database. Payers can play a crucial role in the expansion of knowledge and effectiveness of genetic testing. Current policies affecting MGPT reimbursement are complex and create perverse incentives. Trends in utilization and coverage for …

Researcher Views On Changes In Personality, Mood, And Behavior In Next-Generation Deep Brain Stimulation, Peter Zuk, Clarissa E Sanchez, Kristin Kostick-Quenet, Katrina A Muñoz, Lavina Kalwani, Richa Lavingia, Laura Torgerson, Demetrio Sierra-Mercado, Jill O Robinson, Stacey Pereira, Simon Outram, Barbara A Koenig, Amy L Mcguire, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

The literature on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises concerns that these technologies may affect personality, mood, and behavior. We conducted semi-structured interviews with researchers (

Policy Options To Facilitate Cancer Genomic Variant Data Sharing: Outcomes Of A Modified Policy Delphi, Jill O Robinson, Amira Daoud, Janis Geary, Vasiliki Rahimzadeh, Juli Bollinger, Christi J Guerrini, Robert Cook-Deegan, Amy L Mcguire, Mary A Majumder

Center for Medical Ethics and Health Policy Staff Publications

Sharing cancer gene variant and relevant clinical data could accelerate progress in cancer genomics. However, data sharing is currently impeded by issues related to financial sustainability, equity, incentives, privacy and security, and data quality. Evidence-based policy options to facilitate data sharing in these domains, and ultimately improve interpretation of cancer-associated genomic variants, are therefore needed. We conducted a modified policy Delphi with expert stakeholders that involved generating, evaluating, and ranking potential policy options to address these issues, with a focus on the US context. We found policy options in the financial sustainability domain were highly ranked, particularly stable funding for …

Using Visual Arts Education And Reflective Practice To Increase Empathy And Perspective Taking In Medical Students, Sina Rezaei, Andrew Childress, Bhavika Kaul, Kelly Magill Rosales, Alana Newell, Stacey Rose

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Empathy is a critical competency for health care providers. However, empathy levels in medical students and residents have been shown to paradoxically decrease during training. Arts and humanities education and reflective practice may reduce burnout and promote empathy during medical school.

Methods: We developed and implemented an art education elective for medical students focusing on observation and reflective practice and measured its impact on empathy. Between 2017 and 2022, first-year medical students were offered an annual, 4-week elective led by art educators that featured visualization exercises and discussions on the role of bias and perspective in art interpretation. Curriculum …

Payer Reimbursement Practices And Incentives For Improving Interpretation Of Germline Genetic Testing, Patricia Deverka, Janis Geary, Charles Mathews, Matan Cohen, Gillian Hooker, Mary Majumder, Zuzana Skvarkova, Robert Cook-Deegan

Center for Medical Ethics and Health Policy Staff Publications

Germline genetic testing for inherited cancer risk has shifted to multi-gene panel tests (MGPTs). While MGPTs detect more pathogenic variants, they also detect more variants of uncertain significance (VUSs) that increase the possibility of harms such as unnecessary surgery. Data sharing by laboratories is critical to addressing the VUS problem. However, barriers to sharing and an absence of incentives have limited laboratory contributions to the ClinVar database. Payers can play a crucial role in the expansion of knowledge and effectiveness of genetic testing. Current policies affecting MGPT reimbursement are complex and create perverse incentives. Trends in utilization and coverage for …

Clinician Perceptions Of Passport For Care, A Web-Based Clinical Decision Support Tool For Survivorship Care Plan Delivery, Jason E King, Michael C O'Connor, Ellen Shohet, Susan M Krause, Michael E Scheurer, Marc E Horowitz, David G Poplack, C Michael Fordis, Maria M Gramatges

Center for Medical Ethics and Health Policy Staff Publications

Background: The Children's Oncology Group Long-Term Follow-Up Guidelines provide exposure-based risks and recommendations for late effects screening of survivors of childhood cancer. Passport for Care (PFC) is a web-based clinical decision support tool for generating a personalized survivorship care plan (SCP) derived from the Guidelines and user-entered exposures. We assessed PFC clinician user practices and perceptions of PFC impact on clinic workflow, guidelines application, and survivor shared decision-making.

Procedure: A 35-item REDCap survey was emailed to all PFC users (n = 936) in 146 current and former PFC user clinics. Anonymous responses were permitted. Results were summarized and compared with …

Treatment And Life Goals Among Veterans With Gulf War Illness, Nicole Sullivan, Hannah Schorpp, Sarah Crosky, Scott Thien, Drew A Helmer, David R Litke, Wilfred R Pigeon, Karen S Quigley, Lisa M Mcandrew

Center for Medical Ethics and Health Policy Staff Publications

Medically unexplained syndromes (MUS), also termed persistent physical symptoms, are both prevalent and disabling. Yet treatments for MUS are marked by high rates of patient dissatisfaction, as well as disagreement between patients and providers on the management of persistent physical symptoms. A better understanding of patient-generated goals could increase collaborative goal setting and promote person-centered care, a critical component of MUS treatment; yet research in this area is lacking. This paper aimed to develop a typology of treatment and life goals among Gulf War veterans with a medically unexplained syndrome (Gulf War Illness). We examined participants’ responses to open-ended questions …

Cannabis-Assisted Psychotherapy For Complex Dissociative Posttraumatic Stress Disorder: A Case Report, Anya Ragnhildstveit, Miriam Kaiyo, Matthew Brian Snyder, Laura Kate Jackson, Alex Lopez, Chasity Mayo, Alyssa Claire Miranda, River Jude August, Paul Seli, Reid Robison, Lynnette Astrid Averill

Center for Medical Ethics and Health Policy Staff Publications

Background: A dissociative subtype of posttraumatic stress disorder, known as "D-PTSD", has been included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. In addition to meeting criteria for PTSD, patients endorse prominent dissociative symptoms, namely depersonalization and derealization, or detachment from one's self and surroundings. At present, this population is supported by a highly heterogeneous and undeveloped literature. Targeted interventions are therefore lacking, and those indicated for PTSD are limited by poor efficacy, delayed onset of action, and low patient engagement. Here, we introduce cannabis-assisted psychotherapy (CAP) as a novel treatment for D-PTSD, drawing parallels to psychedelic …

Deep Brain Stimulation For Pediatric Dystonia: Clinicians' Perspectives On The Most Pressing Ethical Challenges, Kristin M Kostick-Quenet, Lavina Kalwani, Laura N Torgerson, Katrina Munoz, Clarissa Sanchez, Eric A Storch, J S Blumenthal-Barby, Gabriel Lazáro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Pediatric deep brain stimulation (pDBS) is commonly used to manage treatment-resistant primary dystonias with favorable results and more frequently used for secondary dystonia to improve quality of life. There has been little systematic empirical neuroethics research to identify ethical challenges and potential solutions to ensure responsible use of DBS in pediatric populations.

Methods: Clinicians (n = 29) who care for minors with treatment-resistant dystonia were interviewed for their perspectives on the most pressing ethical issues in pDBS.

Results: Using thematic content analysis to explore salient themes, clinicians identified four pressing concerns: (1) uncertainty about risks and benefits of pDBS …

Critical Space Infrastructure: A Complex System Governance Perspective, Adrian V. Gheorghe, James C. Pyne, Joseph Sisti, Charles B. Keating, Polinpapilinho F. Katina, William Edmonson

Engineering Management & Systems Engineering Faculty Publications

This paper examines the applicability of Complex System Governance (CSG) to advance the Critical Space Infrastructure field (CSI). CSI encompasses space related hardware, workforce, environment, facilities, and businesses that are necessary for societal well-being. CSI is increasing in importance as more societal serving systems are becoming dependent on CSI to operate. Given this increasing dependence on CSI, societal sectors are increasingly at risk should something go wrong with CSI upon which they depend. CSI has been developing is a fragmented way and lacks coherent organization. CSG is focused on design, execution, and evolution of system functions that provide for communications, …

Strengthening Urban Resilience: Understanding The Interdependencies Of Outer Space And Strategic Planning For Sustainable Smart Environments, Ulpia-Elena Botezatu, Olga Bucovetchi, Adrian V. Gheorghe, Radu D. Stanciu

Engineering Management & Systems Engineering Faculty Publications

The conventional approach to urban planning has predominantly focused on horizontal dimensions, disregarding the potential risks originating from outer space. This paper aims to initiate a discourse on the vertical dimension of cities, which is influenced by outer space, as an essential element of strategic urban planning. Through an examination of a highly disruptive incident in outer space involving a collision between the Iridium 33 and Cosmos 2251 satellites, this article elucidates the intricate interdependencies between urban areas and outer space infrastructure and services. Leveraging the principles of critical infrastructure protection, which bridge the urban and outer space domains, and …

Fighting For The Public’S Health: Challenges And Opportunities To Reinvigorate Public Health Advocacy, Madeleine S. Frey

Georgia Public Health Association Annual Meeting & Conference

Background

Covid-19 shed a painful light on racial health disparities. As health officials asserted their public health authority to stop the pandemic and promote health equity, elected officials moved to limit their ability to do so. Without strong advocacy infrastructure, public health has struggled to defend its legal public health authority, support the workforce, and ensure equitable health outcomes for everyone.

Methods

Fighting for Public Health, a 2022 Feasibility Study from the Network for Public Health Law, assessed what’s happening in public health advocacy, and what’s needed to strengthen it on state and national levels. With funding from Healthcare …

Covid-19, Health Inequities, And Behavioral Health Issues Facing Children, Gulzar H. Shah

Health Policy & Community Health: Faculty Publications

No abstract provided.

An Evaluation Of The Psychosocial Benefits For Children Experiencing Homelessness Arising From The Introduction Of An Integrated Community Care Project Across The City Of Cork, Traolach O' Callaghan

Theses

The purpose of the research is to evaluate an intervention within a new model of family support being delivered in Cork City, on addressing child and family homelessness. This new model is being delivered for the first time in Ireland during ‘Youth Club’ and strives to act as an intervention to assist children experiencing homelessness. The model was first developed by Tusla Springboard Child and Family service and Good Shepherd Services Cork in 2016 in response to the alarming rise in child and family homelessness in Cork city, and the resulting impact of same. The research investigates the model and …

A Different Perspective: An Exploration Towards The Emancipation Of Practice Within Social Care, Jonathan Condon

Theses

In Ireland today, it is recognized that the Reflexive Practitioner is the dominant paradigm within the district of Social Care and the approach of professionals is obtained through the traditional ways; whilst Social Pedagogy is still a relatively new import with only a couple of organizations operating across the country. Both disciplines work with the same general clientele and have similar goals for the clients with whom they work (Lalor and Share, 2013). The professional approach of both disciplines was unfastened and discovered throughout this study. Social care professionals focus on the protection of those in their care. Along with …

Desalination And Development: Locating The Missing Masses In Dakar’S Water Network, Marina Riad

Scripps Senior Theses

The introduction of desalination technology to the water network in Dakar, Senegal marks a monumental change in how state and commercial interests aim to solve systemic problems using novel technologies. Desalination aims to transform the ocean surrounding Dakar into potable water, a vital resource in the growing metropolis. However, this desalination project must integrate itself within a network of social, historical, political, commercial, and ecological influences shaping the role of desalination in urban Dakar. With millions of dollars and an entire ocean mobilized towards solving Dakar’s water problems, it may come as a surprise that this project will only provide …

Model Legal Processes For Court Ordered Mental Health Treatment - A Modern Approach, Brian D. Shannon

FIU Law Review

The United States Conference of Chief Justices and Conference of State Court Administrators established the National Judicial Task Force to Examine State Courts’ Response to Mental Illness in 2019. As part of its overall efforts, the National Judicial Task Force then partnered with the Equitas Project of Mental Health Colorado to appoint a select workgroup to develop model statutory language for court-ordered mental health treatment, emergency psychiatric intervention, medication over objection, and criminal matters involving persons with mental illness. This Model Legal Processes Workgroup included judges, psychiatrists, medical school professors, law professors, and others whose goal was to draft model …

Policy Innovation As The Cornerstone Of Energy Transition: An Analysis Of Energy Policy In The Shipping Economy And Operations, Peyman Ghaforian Masodzadeh

World Maritime University Ph.D. Dissertations

Despite being excluded from most climate change treaties, the maritime sector is expected to manage and reduce carbon emissions in line with global decarbonization goals. Although the IMO's effort has been evident by the adoption of energy regulations and the GHG strategy during the past decade, however, the effectiveness and adequacy of the adopted energy policy remain questionable. This thesis aims to identify problems associated with energy policy in the shipping industry and propose appropriate solutions. Initially, this study was premised on the hypothesis that “energy policy in the shipping industry involves problems associated with policy design, policy implementation, and …

A New Era Of Policing: Uncovering Ways Officers Believe Community Relations Can Be Restored, Bradi Kai Kooyman

University of the Pacific Theses and Dissertations

The present study qualitatively investigated law enforcement officers’ opinions on creating more positive relationships with community members and how news media can play a role in deteriorating community attitudes and perceptions of law enforcement officers. A total of six participants were selected to participate in a forty-five-minute interview. Participants were asked questions regarding positive and negative factors in their relationship with their communities, local and national law enforcement portrayals in news media, reforms needed within law enforcement, beliefs toward community policing, and factors that lead to success in their relationships with citizens. This study discovered that building trust, implementing community …

The Space In Between: An Exploration Of The Transition From Military Service To Life As A Homeless Female Veteran, Dana M. Howard

University of the Pacific Theses and Dissertations

The Space in Between: An Exploration of the Transition From Military Service to Life as a Homeless Female Veteran

Abstract

By Dana M. Howard

University of the Pacific

2023

There are 18.2 million U.S. military veterans (U.S. Department of Commerce, 2021) and approximately 200,000 active-duty, reserve, and National Guard service members will become veterans each year (U.S. Department of Labor, n.d.). Before becoming veterans, these military members were performing duties in service to their country (Duty Periods Defined, n.d.). Due to a planned or unplanned event, military personnel must transition from uniformed members to civilian citizens. This transition process can …

A Qualitative Study Of Understanding Female Navy Veterans’ Experiences With Representation And Inclusion In The U.S. Military, Antwanisha K. Williamson

University of the Pacific Theses and Dissertations

Research about women in the military helps to address the ongoing concerns about the lack of inclusion of female perspectives, which contributes to oppressive power dynamics and lack of women’s representation in practice, policy, and procedures. The problem this dissertation addressed is the lack of representation and inclusion of female perspectives regarding power and privilege that affect military practices, policies, and procedures. The purpose of this qualitative study was to understand female Navy veterans’ experiences with representation and inclusion in military practices, policies, and procedures. Applying a larger conceptual framing using radical feminism, liberal feminism, and critical theory helped to …

Fostering Electricity Access In Cameroon: Impeding Factors And Cost-Effective Model, Jean-Jacques A. Enow

Walden Dissertations and Doctoral Studies

Abstract Due to irregularities and shortages in electricity generation and distribution, 95% of Cameroon’s population suffers from debilitating effects on national economic security, public health, education, safety, and quality of life. Cameroon needs a sustainable, efficient, and innovative electricity source and policy system. Failure to meet this demand forestalls the much-needed socio-economic and political development of the country. The purpose of the present study was to explore inadequacies of the current hydroelectric supply system in Cameroon, putting into perspective factors that impeded the development of a sustainable electricity supply system, strategies to alleviate these impediments, and the most cost-effective framework …

Impact Of Resilience On Quality Of Life In Spinal Cord Injured Clients, Crystal D. Glover

Walden Dissertations and Doctoral Studies

Abstract Impact of Resilience on Quality of Life in Spinal Cord Injured Clients by Crystal D. Glover

MSM, Troy University, 2006BSN, University of North Carolina at Greensboro, 1995

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health

Walden University August 2023

Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon

Walden Dissertations and Doctoral Studies

AbstractWhether from natural or human causes, every global community is at risk for overwhelming, destabilizing incidents. Hurricanes Irma and Maria devastated the U.S. Virgin Islands in late August and early September 2017, necessitating the urgent evacuation of hemodialysis patients over 1000 miles to the U.S. mainland. Because the damage and response to the U.S. territory were unprecedented, the public health implications of the government’s strategies on the evacuated population subset were unexplored. However, available information suggested that some evacuees sustained avoidable harm while in the protracted care and custody of the government. This qualitative case study, conceptually framed by Bronfenbrenner’s …

Exploring Educators' Perception Of Remote Instructional Collaboration In Liberian Higher Education Classrooms, George Wah Williams

Walden Dissertations and Doctoral Studies

Public higher education institutions in Liberia have employed various mitigating measures to improve instruction quality and increase learning outcomes; however, little was known about remote instructional collaboration as a strategic approach in Liberian higher education classrooms. This qualitative study, based on Everett Rogers’ Diffusion of Innovation theory, explored the Liberian educators’ perceptions of and disposition to RIC in public tertiary classrooms in Liberia. Seeking Liberian educators’ perception of and disposition to remote instructional collaboration in public tertiary classrooms drove this investigation. Two groups of 17 educators based in the United States and Liberia were interviewed using a semi-structured protocol facilitated …

Perceptions Of Female Naval Officers On Combat Role Policy And Career Advancement, Cheryl Dudley

Walden Dissertations and Doctoral Studies

Women were officially allowed to serve in combat positions when the 1993 Combat Exclusion Policy was lifted in 2013. There was little research to date on how these changes may have influenced the recruitment, retention, and promotion of female naval officers. The purpose of this study was to explore female naval officers' perceptions on how lifting the combat exclusion policy impacted the factors of recruitment, retention, and promotion within the military. A generic qualitative study supported exploring perceptions of female naval officers who experienced combat duty regarding these issues. Using feminist security studies as the conceptual framework, this study focused …

Homophobia In Jamaica And Its Impact On The Victimization Of Homosexual Adult Males In Montego Bay, St. James, Dr. Shahila D. Edwards-Grey

Walden Dissertations and Doctoral Studies

AbstractJamaica has been listed among the most unfriendly nations for homosexual males. Previous research indicated that due to the biopolitical and sociocultural norms of the Jamaican society, homosexual males continued to be targets of various forms of discrimination based on their sexual orientation. However, research reflecting the lived experiences of homosexual males in Jamaica is sparse. The purpose of this phenomenological qualitative study was to provide details on the encounters of victimization due to homophobia of adult homosexual males in the parish of St. James, Jamaica. Data were collected through observations and in-depth interviews with eight men who identified as …

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

AbstractFor the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …