Health Policy Commons^™

Hope And Optimism In Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives, Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A Storch, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective: This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and methods: Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, …

Rural-Urban Disparities In Video Telehealth Use During Rapid Mental Health Care Virtualization Among American Indian/Alaska Native Veterans, Isabelle S Kusters, Amber B Amspoker, Kristen Frosio, Stephanie C Day, Giselle Day, Anthony Ecker, Julianna Hogan, Jan A Lindsay, Jay Shore

Center for Medical Ethics and Health Policy Staff Publications

Importance: American Indian/Alaska Native veterans experience a high risk for health inequities, including mental health (MH) care access. Rapid virtualization of MH care in response to the COVID-19 pandemic facilitated care continuity across the Veterans Health Administration (VHA), but the association between virtualization of care and health inequities among American Indian/Alaska Native veterans is unknown.

Objective: To examine differences in video telehealth (VTH) use for MH care between American Indian/Alaska Native and non-American Indian/Alaska Native veterans by rurality and urbanicity.

Design, setting, and participants: In this cohort study, VHA administrative data on VTH use among a veteran cohort that received …

Factors Associated With Internalizing And Externalizing Symptoms In A Clinical Sample Of Youth With Misophonia, Gabrielle M Armstrong, Rebecca L Greenberg, Orri Smárason, Renee M Frederick, Andrew G Guzick, Sophie C Schneider, Samuel D Spencer, Matti Cervin, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia …

Clinician Perspectives On Levels Of Evidence And Oversight For Deep Brain Stimulation For Treatment-Resistant Childhood Ocd, Michelle T Pham, Tiffany A Campbell, Natalie Dorfman, Laura Torgerson, Kristin Kostick-Quenet, Jennifer Blumenthal-Barby, Eric A Storch, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Approximately 10-20% of children with obsessive-compulsive disorder (OCD) have treatment-resistant presentations, and there is likely interest in developing interventions for this patient group, which may include deep brain stimulation (DBS). The World Society for Stereotactic and Functional Neurosurgery has argued that at least two successful randomized controlled trials should be available before DBS treatment for a psychiatric disorder is considered "established." The FDA approved DBS for adults with treatment-resistant OCD under a humanitarian device exemption (HDE) in 2009, which requires that a device be used to manage or treat a condition impacting 8,000 or fewer patients annually in the United …

Hope And Optimism In Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives, Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A Storch, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective: This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and methods: Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, …

Ethics Education For Healthcare Professionals In The Era Of Chatgpt And Other Large Language Models: Do We Still Need It?, Vasiliki Rahimzadeh, Kristin Kostick-Quenet, Jennifer Blumenthal Barby, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

In this paper, we contend with whether we still need traditional ethics education as part of healthcare professional training given the abilities of chatGPT (generative pre-trained transformer) and other large language models (LLM). We reflect on common programmatic goals to assess the current strengths and limitations of LLMs in helping to build ethics competencies among future clinicians. Through an actual case analysis, we highlight areas in which chatGPT and other LLMs are conducive to common bioethics education goals. We also comment on where such technologies remain an imperfect substitute for human-led ethics teaching and learning. Finally, we conclude that the …

Feminization Of Sri Lankan Doctors And Key Specialties: 2000 To 2020, Dileep De Silva, Pamila Adikari, Mihiri S. Rubasinghe, Udeni L. Seneviratne

Journal of Indonesian Health Policy and Administration

The study focused on the feminization of Sri Lankan generalist doctors in all major and selected minor specialties between 2000 and 2020. The study analyzed all relevant documents by exploring Sri Lanka's male-to-female doctor and specialist ratio over 20 years. This was determined by analyzing state medical faculty records from 1990 to 2020. For better clarity, the researchers analyzed the gender ratio changes in every five-year block from 1990 to 2020. Focus groups filled PGIM's gender data fields. Five-year medical students surged from 43% to 63% between 1990 and 2020. Linear trend analysis predicts 68% of female medical students by …

Sensitive Intervention Policy Recommendations To Reduce Stunting Rates Based On Spatial Analysis Of Sanitary Factors In Dki Jakarta Province 2021, Septiria Irawati, Ema Hermawati

Journal of Indonesian Health Policy and Administration

The purpose of this study was to describe the prevalence of stunting in children under five and the percentage of proper sanitation, as well as recommendations for priority areas for stunting control interventions in the Province of the Special Capital Region of Jakarta in 2021. This study used a descriptive approach to present an overview of the percentage of sanitation and prevalence of stunting in children under five by sub-district in 38 districts in DKI Jakarta. Data is displayed as a map to show distribution areas based on high, medium, and low categories. An overlay was made between the distribution …

Health Policy Reform Through Strengthening Indonesia's Health Resilience System, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

The National Health System in Indonesia is developing and being discussed more seriously after entering the COVID-19 pandemic. With a national health system and several existing tools, Indonesia needed more time to be ready to face the challenges of that time. Upstream health policies should be optimized to mobilize resources and increase the nation's efforts to build a national resilience system. This paper was built using selected policy documents up-to-date and reliable literature. By reviewing empirical evidence, the author believes and shows the role of strengthening health policies in building a robust national health resilience system. Indonesia has several policies …

The Effects Of Vaccination Against Covid-19 Incidence: Is The Current Age-Priorities Appropriate?, Dian Ip Nugrahari, Nurhanifah Hamdah

Journal of Indonesian Health Policy and Administration

Age is an independent risk factor for COVID-19. Thus, the government of Indonesia prioritizes the elderly and adults with significant comorbidities for COVID-19 vaccination. To discover whether this policy is still appropriate, we evaluated the effects of vaccination against the COVID-19 incidence and infection risk.It was a retrospective cohort study of the NAR COVID-19 and Dashboard KPCPEN COVID-19 of the Depok City Health Department. The tests used to analyze the data were the chi-square and logistic regression tests. We discovered that there was a 92.7% total reduction in the COVID-19 infection rate with vaccination. The infection risk for COVID-19 in …

Policy Implementation Analysis Of Spm Health Sector For Hypertension Sufferers In South Kalimantan Province, Indonesia In 2022, Anggi Asri Rusliana Dewi, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

Hypertension is a major cardiovascular risk factor that causes disability throughout the world and among those who are not aware of their health condition, it is often referred to as the silent killer . The prevalence rate of hypertension in Indonesia is quite high. Based on Riskesdas (2018), South Kalimantan Province shows the highest prevalence of hypertension, but the percentage of hypertension sufferers who receive health services is still low. Banjarbaru City has the lowest percentage, namely 11.3% of the target of 100%. Health services for hypertension sufferers are included in the Minimum Service Standards (SPM) for the Health Sector …

Building On The Health Policy Analysis Triangle: Elucidation Of The Elements, Aysha Zahidie, Saima Asif, Meesha Iqbal

Community Health Sciences

The health policy triangle first presented in the 20th century by Walt and Gilson has been extensively used at local, national, regional, and international levels to assess health policies related to communicable and non-communicable diseases, physical and mental health, antenatal and postnatal care, and human resources, services, and systems. However, the framework lacks intricate details for the four pillars in the triangle viz: 'content,' 'context', 'actors', and 'processes. We propose a checklist of elements to be considered for each pillar; to ease and enhance the process of policy analyses for researchers and policymakers across the globe, including low- and middle-income …

Researching The Future: Scenarios To Explore The Future Of Human Genome Editing, Cynthia Selin, Lauren Lambert, Stephanie Morain, John P Nelson, Dorit Barlevy, Mahmud Farooque, Haley Manley, Christopher T Scott

Center for Medical Ethics and Health Policy Staff Publications

Background: Forward-looking, democratically oriented governance is needed to ensure that human genome editing serves rather than undercuts public values. Scientific, policy, and ethics communities have recognized this necessity but have demonstrated limited understanding of how to fulfill it. The field of bioethics has long attempted to grapple with the unintended consequences of emerging technologies, but too often such foresight has lacked adequate scientific grounding, overemphasized regulation to the exclusion of examining underlying values, and failed to adequately engage the public.

Methods: This research investigates the application of scenario planning, a tool developed in the high-stakes, uncertainty-ridden world of corporate strategy, …

Progress Reimagined: A Generation Z Perspective On Belfast In Relation To The Unsdgs., Lucy Love Haman, Rebecca F. Macleod, Emilee E. Ernster, Camryn Moore, Erin Miller, Daron Baltazar, Ricardo Jackson

[Archive] Belmont University Research Symposium (BURS)

This research explores a contemporary outsider view of Belfast, through the eyes of Generation Z visiting college students, in relation to how three United Nations Sustainable Development Goals are carried out (Good Health and Well-Being, Climate Action, and Peace, Justice, and Strong Institutions). To learn through firsthand accounts, the researchers utilized ethnographic and phenomenological methods, as interacting with locals to gather community inputs, surveying different groups in the city, Abstract: recording quotes said by citizens and displayed at billboards, and For Peer Review applying personal sensory experiences. It was found that a political deadlock plays a major role in the …

Park Access And Quality In Mountain West Cities, 2023, Maryam Raja, Julia Salangsang, Vanessa M. Booth, Caitlin J. Saladino, William E. Brown Jr.

Environment

This fact sheet presents data from a 2023 publication from The Trust for Public Land ParkScore® Index1 which provides data on public parks for the 100 largest cities in the United States. The fact sheet includes park scores for the cities in the Mountain West states of Nevada, Arizona, Colorado, and New Mexico. This fact sheet expands upon a previously published fact sheet on park access and quality from 2020.

Nevada Medical Residencies, 2023, Annie J. Vong, Emily J. Daclan, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet highlights medical residency data for the 2021, 2022, 2023 graduating classes of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) and the University of Nevada, Reno (UNR) School of Medicine. This fact sheet presents the number of residency program matches at the Kirk Kerkorian School of Medicine at UNLV and the UNR School of Medicine and reveals where Nevada medical school students pursue their residencies, and updates findings from a 2022 fact sheet exploring 2021 and 2022 graduating class data.

Firearm Deaths In The Mountain West, 2020, Lana Kojoian, Annie Vong, Caitlin J. Saladino, William E. Brown Jr.

Criminal Justice

This fact sheet examines data from the RAND Corporation report “Understanding Firearm Deaths by State—and How to Reduce Them,” which provides data on state and national rates of firearm related deaths, including suicides and homicides for 2020 This fact sheet includes firearm death data for five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah.

Poverty And Commercial Surrogacy In India: An Intersectional Analytical Approach, Sheela Suryanarayanan

Dignity: A Journal of Analysis of Exploitation and Violence

The destination and source countries for commercial surrogacy match world patterns of inequality. India, Nepal, Thailand, Mexico, and Cambodia banned commercial surrogacy, moving the market to other less-developed countries in South Africa and South America. India had a commercial surrogacy boom until exploitative factors led to the passage of the Surrogacy (Regulation) Bill in 2019, which banned the practice. This paper examines surrogacy's monetary, health, and emotional effects on 45 surrogate mothers in Gujarat State, India. The study revealed that a majority (63%) of the very poor women remained very poor post-surgery. Surrogate mothers in poor households had to do …

The Promise Of Universalism Deferred: Political Economy Of Social Policy In 21st Century Latin America, Juan C. Ferre

Dissertations, Theses, and Capstone Projects

In the first decade and half of the 21st century, most Latin American countries experienced a long-overdue reduction in income inequalities and significant social policy expansion. While this welfare expansion has been widely documented, scholars have paid less attention to the persistent or increasing segmentation: inequalities in transfers and in the quality of services across population groups continued unabated. This dissertation employs mixed-methods to respond to the following questions: have governments in Latin America, and Left governments in particular, made significant progress toward universal social policy?

For 17 Latin American countries in the period 2000-2020, I measure three dimensions …

Women’S Leadership And Covid-19 Pandemic: Navigating Crises Through The Application Of Connective Leadership, Chris Taylor Cartwright, Maura Harrington, Sarah Smith Orr, Tessa Sutton

International & Global Studies Faculty Publications and Presentations

International and national crises often highlight behavioral patterns in the labor market that illustrate women’s courage and adaptability in challenging times. The COVID-19 pandemic and resulting changes in the workplace due to social distancing, remote work, and tele-communications protocols showcased women’s power of authenticity and accessibility (interpersonal and personalized experiences) to engage with their constituents effectively. The catalyzed this research was our desire to underscore the importance of studying the impact of COVID-19 on women leaders. The COVID-19 pandemic brought to light specific challenges and disparities women faced in the workplace. It has been asserted that women leaders substantially benefit …