Digital Commons Network^™

Buprenorphine Use For Analgesia In Palliative Care, Leanne K Jackson, Ivy O Poon, Mary A Garcia, Syed Imam, Ursula K Braun

Center for Medical Ethics and Health Policy Staff Publications

Buprenorphine is a semi-synthetic long-acting partial µ-opioid receptor (MOR) agonist that can be used for chronic pain as a sublingual tablet, transdermal patch (Butrans®), or a buccal film (Belbuca®). Buprenorphine’s unique high receptor binding affinity and slow dissociation at the MOR allow for effective analgesia while offering less adverse effects compared to a full agonist opioid, in particular, less concern for respiratory depression and constipation. It is underused in chronic pain and palliative care due to misconceptions and stigma from its use in opioid use disorder (OUD). This case report discusses the unique pharmacology of buprenorphine, including its advantages, disadvantages, …

Exploring Social Workers Potential Role In Mitigating Maternal Mortality Through Coordinated Care, Jena Brown-Talib

Honors Theses

Maternal health disparities persist as a significant challenge in Mississippi, particularly for African American women. This thesis explores the intersection of coordinated care models and social work interventions in addressing maternal mortality. Coordinated care involves collaboration among physicians, nurses, practitioners, social workers, community health workers, and other support services, aiming to maximize pregnant patients' overall health outcomes.

Analyzing strategies of social workers within coordinated care models is important for improving maternal health outcomes within this study. A qualitative approach was chosen to delve beyond statistics and illuminate the reality of maternal health disparities and the efforts to resolve them. Data …

Your Money Or Your Life: A Study Of Medical Debt In The Southeastern United States, Grace Barrett

Honors Theses

A major issue has emerged from the U.S. healthcare system: medical debt. Medical debt is a serious problem in the U.S. that often cripples those who received healthcare services, but are unable to pay the bill. The most common scenario is when an unexpected major medical issue occurs, e.g. a heart attack, an automobile accident, cancer or anything requiring an emergency room visit. These hospital visits often result in very large, very unexpected expenses. These expenses are ultimately owed to the healthcare provider by the patient (or the patient's insurance policy) and increasingly, cause lifelong financial stress to those who …

Exploring Hypertension Prevalence Among Ill-Housed Individuals In Urban Environments, Lia Summer Goldberg, Sameer Shah, Nikhila Archakam, Murod Khikmatov, Kesha Choksi, Anddee White

Rowan-Virtua Research Day

This study explores the interrelations of hypertension, homelessness, and access to healthcare in urban ill-housed populations. It was found that conditions such as heart disease and diabetes significantly exacerbate hypertension, which remains highly prevalent due to the population's limited access to consistent medical care. Homelessness further complicates the management of hypertension due to unstable living conditions, making adherence to treatment and follow-up with healthcare providers challenging. Additionally, factors like higher rates of substance abuse and malnutrition among homeless populations contribute to worsening hypertension, which, if untreated, can lead to severe health crises including heart attacks and strokes.

The research underscores …

A Geospatial Analysis Of Patterns In Neighborhood Characteristics And United States Professional Sports Stadium Relocations From 1922-2022, Kara Logan

Master's Theses

In the United States of America, 135 stadiums for new or relocating teams have been constructed between 1970 and 2020 (Bradbury et al., 2022, p. 3). Within those years, researchers, journalists, and community members have examined the impact of those new stadiums on local communities, including economic, environmental, and residential impacts. However, the current scope of literature consists of a considerable number of case studies that examine a single stadium or mega-event, such as the Olympics.

This study will determine what patterns, if any, exist between the demographic and housing characteristics between the stadiums that major league United States professional …

Reaping What You Subsidize: A Comprehensive Review Of Outcomes From Crop Subsidies In The United States, Sawyer J. Knox

Economics Undergraduate Honors Theses

The motivation for researching this topic comes from an interest in public policy and public health. In this paper, we will examine the impact of farm subsidies on the health of citizens, look at who benefits financially and economically from these subsidies, and examine the environmental impact of these programs. The paper will be structured as follows: Section II, the wealth distribution results from farm subsidies; Section III, the disproportionate impacts on health from farm subsidies; Section IV, the impact on global economies from farm subsidies; Section V, the environmental impact from farm subsidies; and Section VI, conclusions and policy …

Examining Policy Diffusion Mechanisms In The Contemporary Local Government Landscape Of A Politically Polarized United States, Jacob Mccauley

All Dissertations

This dissertation explores the nuanced relationship between political polarization and policy diffusion within local governments in the United States, a topic of considerable relevance given the country’s increasing political divide. By examining the diffusion of COVID-19 policies, historical marker modifications, and the implementation of eGovernment services, this research identifies a novel mechanism of policy diffusion that is significantly influenced by political party lines. The study employs a comprehensive methodological approach, incorporating case studies and quantitative analysis to examine policy implementation across politically diverse local governments. The findings reveal that political affiliation profoundly impacts policy choices, with distinct patterns of policy …

Child Maltreatment Primary Prevention Methods In The U.S.: A Systematic Review Of Recent Studies, Maria Godoy-Murillo

Electronic Theses, Projects, and Dissertations

Background: Child maltreatment remains a widespread issue in the United States of America, (U.S.). Identifying effective methods of preventing child maltreatment is key to reducing the prevalence of this issue. Objective: This systematic review provides an overview of contemporary primary child maltreatment prevention methods in the U.S. to investigate their effectiveness. Methods: Using the OneSearch database, the following keywords were included: (“prevention methods” and “child maltreatment”), (“parental leave” and “child maltreatment”), (“primary prevention” and “child maltreatment”), (WIC and “child maltreatment”), (“home visit” and “child maltreatment”), (“child abuse and neglect” and “primary prevention”), (“affordable housing” and prevention and “child maltreatment”), (“early …

Well-Being Behaviors And Outcomes In Arkansas Teachers: A Qualitative Analysis Of Teachers In Arkansas During The Covid-19 Pandemic, Ashton Elizabeth Human

Graduate Theses and Dissertations

Introduction: The COVID-19 pandemic introduced new challenges to teachers and emphasized those already existing in the education system. The increased reliance upon technology and lack of administrative support perceived during distance learning led to lower levels of commitment to teaching and increased levels of teacher burnout. Burnout risk is associated with an increased workload, exhaustion from job demands, cynicism toward the professional community and has been shown to have a negative relationship with well-being. Teachers experiencing burnout are unable to establish positive relationships with students, understand students’ needs, stay in contact with trends in the education field, or provide pedagogically …

Welfare-Based Human Rights Diffusion In Global Social Policy: Examining An Extended Spiral Model To Survey Welfare Norms, Kendra L. Duran

Doctoral Dissertations and Projects

This study addresses a gap in research concerning welfare-based human rights diffusion, rights that are also referred to as Economic, Social, and Cultural Rights (ESCR). This project finds that when states ratify the International Covenant on Economic, Social, and Cultural Rights (ICESCR), global social policies are created, grow worldwide, and receive greater attention from advocacy organizations. Even so, it is not understood how global social policies affect a state’s compliance with its ICESCR commitment, nor how global social policies affect welfare-based human rights diffusion. Seeking to address this gap in theory and praxis, this research utilizes an extended case study …

Financial Exclusion, Gender, And The Lure Of Boko Haram (Chapter From Gender-Responsive Budgeting In Africa: Access And Future Measures), Vesna Markovic, Sven Botha

Justice, Law, and Public Safety Studies Department Faculty Books/Book Chapters

There is a large disparity in financial inclusiveness for those people living in northern Nigeria in contrast to those living in southern Nigeria. According to a 2019 report by the Central Bank of Nigeria and Enhancing Financial Innovation and Access (EFInA), Nigeria has more people living in extreme poverty than any other country in the world. Access to education and lower levels of income all contribute to the lack of financial inclusion for both men and women in the North, but particularly for women. These gender barriers have acted as an enabler for the recruitment of women into the Boko …

Family Medicine’S Role In Addressing The Intersections Of Redlining And Climate Change, Daryl O. Traylor, Eboni E. Anderson, Brianna Clark, Alex M. Smith, Cooper K. Allenbrand

Journal of Sustainable Social Impact

Redlining, the practice of discriminating against specific neighborhoods based on race and socioeconomic status, leads to persistent environmental hazards and socioeconomic inequalities that have lasting adverse health effects on their populations. Health disparities are further exacerbated through the concentration of environmental hazards, as well as the escalating impact of climate change, which poses an increased risk of respiratory illness, cardiovascular disease, mental health issues, heat-related illness, infectious diseases, food insecurity, and socioeconomic difficulties in redline neighborhoods.

This paper examines the interplay of redlining, climate change, and health disparities, with an emphasis on the enduring consequences for these marginalized communities. Through …

Early Childhood Practitioners' Beliefs Regarding Children's Development And Learning Based On The Curriculum, Karlene Gloria Degrasse-Deslandes

Walden Dissertations and Doctoral Studies

The Early Childhood Commission (ECC) is an agency of the Ministry of Education and Youth in Jamaica responsible for early childhood development. It has been proposed that Early Childhood Practitioners (ECPs) should engage in more child friendly and age-appropriate teaching practices. This is especially critical as they use the Jamaica Early Childhood Curriculum (JECC). This basic qualitative research was conducted to explore ECPs’ beliefs regarding children’s development and learning and the influence on the implementation of the JECC. The research questions that guided the study address the beliefs of Jamaican ECPs regarding children’s development and learning and the influence of …

Sustaining And Increasing Participation Of Rural Seniors In A Senior Center, Michelle L. Fontaine

Walden Dissertations and Doctoral Studies

This case study’s objective was to sustain and increase senior participation in senior center activities by examining the rural senior perception of environmental needs and support of a local senior center. Senior centers assist with aging in place well and aid seniors to be socially active within their communities. Much of the literature around senior centers has focused on urban environments and not on the specific needs of the rural senior. In this study, 24 individuals were interviewed. The questions examined the seniors’ perception about the functionality and accessibility of the senior center to meet their physical and social needs …

Adopting The Standard Medical Deduction Increased State Snap Enrollment And Benefits, Yuwei Zhang, Jun Li, Dongmei Zhu, Colleen Heflin

Population Health Research Brief Series

The Supplemental Nutrition Assistance Program (SNAP) is a critical safety net program that helps reduce food insecurity among low-income households in the United States. However, many eligible households do not participate in SNAP due to burdensome administrative requirements. To make it easier for more older adults and people with disabilities to participate in SNAP, many states have adopted the Standard Medical Deduction (SMD) to simplify administrative requirements. This brief summarizes findings from a study that examined the associations between state SMD adoption and SNAP participation and benefits from 2004 to 2019.

Inequities In Chronic Stress Exposure At The Intersection Of Race, Gender, And Sexual Identity In A Nationally Representative Sample Of U.S. Adults, Jordan M. Lancaster, Efrain H. Chavez Martinez

OHSU-PSU School of Public Health Annual Conference

Background

Social inequity rooted in systemic oppression is robustly associated with mental and physical health; chronic stress is highlighted as a key mechanism. Limited research examining the association between sexual identity alone and C-reactive protein (CRP) – an upstream biological marker of chronic stress exposure – has yielded mixed results.

Purpose

To examine whether race/ethnicity, gender, and sexual identity interact to produce unequal levels of CRP.

Methods

Using cross-sectional data from the 2003-2010 waves of the National Health and Nutrition Examination Survey, we examined intersectional (self-reported race*gender*sexual identity) patterns in log-transformed CRP levels using a multivariable linear model among 10,885 …

Navigating Murky Waters: State-Level Strategies For Wetland Preservation And Tile Drainage Regulation After Sackett V. Epa, Caleb M. Swanson

Honors Thesis

Wetlands are some of the world’s most valuable ecosystems, serving as provisioners of species habitat, carbon sequestration, flood mitigation, water quality purification, and other ecosystem services. Human development has resulted in substantial wetland loss the world over. In the 1970s, the United States Congress passed the Clean Water Act, giving the EPA broad authority over wetland protection. However, in the summer of 2023, the United States Supreme Court decided Sackett v. EPA, limiting the EPA’s jurisdiction over wetlands to those indistinguishably connected to generally recognized “Waters of the United States” and removing federal protection for millions of acres of wetlands, …

Adolescent Girls Initiative–Kenya: Testing For Scale—Recommendations Report, Karen Austrian, Eva Ireri Muluve, Ruth Nanjekho, John A. Maluccio, Erica Soler-Hampejsek

Adolescents and Young People

The Adolescent Girls Initiative-Kenya, a randomized trial implemented between 2015 and 2021, was designed to test the short- and longer-term effects of two-year multisectoral and multilevel “cash plus” programs for adolescent girls aged 11–14 years. It was implemented in two marginalized areas of Kenya: Kibera, an urban informal settlement in Nairobi, and Wajir, a pastoralist rural county. Results showed that a multisectoral approach was an effective way to create positive change across a range of well-being factors for young adolescent girls, including education, health, and economic outcomes. The program had long-term sustainable effects. Throughout the testing for scale phase, PC-Kenya …

Wellness As A Predictor Of Turnover Intention In The Active Duty Military, Thomas Clifford Seguin

Counseling & Human Services Theses & Dissertations

Due to the unique nature of military service compared to civilian professions, military attrition is difficult to predict using methods derived from career development theories, so turnover remains an ongoing concern for the active duty military. For this reason, military attrition, through turnover intention, should be investigated through a novel lens with the intention of capturing an essence of military service which previous methods may have overlooked, namely the holistic construct of perceived wellness. Previous studies have shown how wellness-related factors affect turnover intention, but none has studied the relationship between perceived wellness and turnover intention. The main hypothesis of …

The Increase Of Allergies In Developed Countries: A Comparison Of The Quality Of Life And Psychosocial Burden Of Individuals With Food Allergies In Switzerland And The United States Of America, Adrienne Ell

Independent Study Project (ISP) Collection

The Hygiene Hypothesis suggests that as societies become increasingly sterile and there is less exposure to microorganisms early in life; consequently, there is an increase in inflammatory autoimmune disorders and allergies due to a maladapted immune system to the new sterile environment. This hypothesis can offer a possible explanation for the observed increase in allergies, specifically food allergies, in developed countries. To explore the psychosocial burden of allergies and evaluate the quality of life this paper will explore the food allergen labeling policies for prepackaged foods, the regulation of allergen information for non-prepackaged foods, and the psychosocial burden food allergies …

From Collaboration To Continuity: Exploring Stakeholder Engagement For Sustainable Global Health Partnerships, Annabelle Falconer

Independent Study Project (ISP) Collection

Global health partnerships have been identified as crucial to achieving the Sustainable Development Goals and targets related to health and wellbeing. Specifically, the Global Fund, UNAIDS Joint Programme, and the World Food Programme are examples of some of the relevant partners currently engaged in this work, filling roles in global health financing, governance, and delivery. Current literature has identified that the effective engagement of stakeholders in partnerships can be crucial in effective project implementation and that global health partnerships during the era of the Millennium Development Goals did impact health outcomes. This research aims to investigate the current strategies for …

Nutri-Score, Warning Signs, And Facts Up Front – In Theory And In Practice A Comparative Analysis Of The Effectiveness Of Front-Of-Package Labeling Systems, Muskaan Makkar

Independent Study Project (ISP) Collection

Suboptimal diets contribute significantly to poor health and chronic diseases, with excessive sodium intake and low consumption of whole grains, fruits, and vegetables being major risk factors. To address this global nutrition burden, various countries have implemented front-of-package labeling (FOPL) systems such as the Nutri-Score, Warning Signs, and Facts Up Front.

This paper aims to analyze the effectiveness of these systems – which vary in development, design, content, and implementation – in both theory and practice. The methodology involves a comparative analysis of three FOPL systems, assessing their theoretical effectiveness with international guidelines and practical effectiveness through expert interviews and …

The Organizational Socialization Of K–12 Classified Employees, Steven Dunlap

Dissertations

Purpose: The purpose of this mixed methods study was to identify to what extent newly employed classified staff in K–12 school districts in Southern California experienced organizational tactics (content, context, and social) to support their socialization process during the 1st year of employment (G. R. Jones, 1986). In addition, it was the purpose of this study to identify and describe the degree to which newly employed classified staff saw these tactics as effective in supporting their socialization to their new role (role clarity, social acceptance, and task mastery).

Methodology: This study used a sequential explanatory mixed methods design to engage …

Waiving Snap Interviews During The Covid-19 Pandemic Increased Snap Caseloads, Colleen Heflin, William Fannin, Leonard M. Lopoo, Siobhan O'Keefe

Population Health Research Brief Series

Food insecurity in the United States reached historically high rates during the COVID-19 pandemic, thus substantially increasing demand for the Supplemental Nutrition Assistance Program (SNAP). To facilitate access to SNAP during the pandemic, the federal government granted state SNAP offices the option to waive the interview requirement – an administrative burden associated with the SNAP certification process. This brief summarizes findings from a recent study that used data from SNAP offices across 10 states to examine the impact of SNAP interview waivers on SNAP caseloads from January 5th to April 30th of 2021. Findings reveal that counties that implemented the …

Urban-Rural Differences In School Districts' Local Wellness Policies And Policy Implementation Environments, Swati Iyer, Timothy J Walker, Alexandra L Macmillan Uribe, Chad D Rethorst, Rebecca A Seguin-Fowler, Jacob Szeszulski

Faculty, Staff and Student Publications

Higher rates of obesity in rural compared to urban districts suggest environmental differences that affect student health. This study examined urban-rural differences in districts' local wellness policies (LWPs) and LWP implementation environments. Cross-sectional data from two assessments in Texas were analyzed. In assessment one, each district's LWP was reviewed to see if 16 goals were included. In assessment two, an audit was conducted to identify the presence of a wellness plan (a document with recommendations for implementing LWPs), triennial LWP assessment, and school health advisory councils (SHACs) on the district website. Rural districts' LWPs had a smaller number of total …

Rational Prescribing Of Pancreatic Enzymes For Patients With Pancreatic Cancer, Mary Acelle G Garcia, Syed Imam, Ursula K Braun, Leanne K Jackson

Center for Medical Ethics and Health Policy Staff Publications

Most patients with pancreatic cancer at some point present with symptoms related to exocrine pancreatic insufficiency (EPI). These include diarrhea, abdominal bloating, indigestion, steatorrhea, weight loss, and anorexia. Even though up to 80% of pancreatic cancer patients eventually present with symptoms related to exocrine pancreatic insufficiency, only 21% are prescribed pancreatic enzyme replacement therapy (PERT). Its effectiveness is also highly dependent on its proper timing of administration, and patients must be thoroughly educated about this. The impact of symptoms of EPI can lead to poorer overall well-being. Pharmacists play a crucial role in properly educating patients on the correct use …

Aging In The City Of Melrose: A Community Needs Assessment, Caitlin E. Coyle, Katherine Burnes, Mark Krebs, Ceara Somerville

Center for Social and Demographic Research on Aging Publications

This report describes research undertaken by the Center for Social & Demographic Research on Aging (CSDRA) within the Gerontology Institute at the University of Massachusetts Boston, on behalf of the City of Melrose. The goals of this project were to investigate the interests, preferences, and opinions of Melrose’s residents aged 55 or older by engaging the community regarding their experiences and needs relevant to the Council on Aging’s (COA’s) objective to identify and serve the needs of all Melrose citizens 55 and older. The contents of this report are meant to inform the City of Melrose, the Melrose COA, Milano …

Grievance Politics And Technocracy In A Developmental State, Ijlal Naqvi, Federico M. Rossi, Rayner Kay Jin Tan

Research Collection School of Social Sciences

This article uses a process-tracing approach to understand changes in Singapore’s health sector from the start of self-rule in 1959 to the end of the COVID-19 pandemic in 2022. Singapore is a developmental state recognized for its effective management of healthcare costs and its lack of political freedom. In both respects, the ‘Singapore model’ is of interest to other cities and nations. The standard narrative is one of technocratic proficiency in a context in which civic freedoms are heavily constrained, but this article identifies the surprisingly important role of social voices at key moments. It finds episodes in which effective …

Special Insert: Guideline For Delegation Of Duties For Allied Dental Personnel In Michigan, David Foe Ma

The Journal of the Michigan Dental Association

Dental assistants, registered dental assistants, and registered dental hygienists have specific duties they can perform for patients as outlined by the Michigan Public Health Code and the Michigan Board of Dentistry General Rules. Permitted delegated services vary based on a team member’s level of training, licensure, and available supervision by a licensed dentist.

The Journal of Michigan Dental Association provides this pullout insert to guide the dental team. This easy-to-read chart quickly identifies recent changes to the duties each dental auxiliary can legally perform.

Implementation Of National Movement For The Acceleration Of Nutrition Improvement Policy For The First 1,000 Days Of Life In Indonesia, Muhammad Ryman Napirah, Vidyanto Vidyanto, Nurdin Rahman, Arum Sekar Ningrum, Asmawati Asmawati, Meita Veruswati

Kesmas

The national movement for accelerating nutrition improvement in the first 1,000 days of life is an effort to strengthen the Indonesian Government's commitment to the national strategic agenda and tackling stunting. This study aimed to determine communication, resources, disposition, and bureaucratic structure in implementing the movement at the Biromaru Primary Health Care (PHC) and Loru Village, Sigi District, Indonesia. The mixed method approach was carried out with informants consisting of several parties from the PHC, health cadres, and the local community through triangulation and questionnaires. The results showed poor communication was inhibited by a lack of community outreach, the attitude …