“They Didn’t Ask.” Rural Women With Disabilities and Experiences of Violence Describe Interactions With the Healthcare System

2022 ◽  
pp. 104973232110591
Author(s):  
Kimberly Aguillard ◽  
Rosemary Hughes ◽  
Gretchen L. Gemeinhardt ◽  
Vanessa Schick ◽  
Sheryl McCurdy
Keyword(s):  
Healthcare System ◽  
Rural Women ◽  
Healthcare Delivery ◽  
The United States ◽  
Screening Tools ◽  
Policy And Practice ◽  
Women With Disabilities ◽  
Practice Recommendations ◽  
Depth Interviews ◽  
Missed Opportunity

Women with disabilities are at risk of experiencing multiple forms of severe and prolonged violence, yet guidelines for screening this population are unclear, screening rates are historically low, and screening tools may be inadequate to capture disability-related aspects of abuse. We conducted qualitative in-depth interviews with 33 rural women in the United States with diverse disabilities and experiences of violence. They described overarching healthcare provider and system factors that influenced their trust and confidence in healthcare delivery as an avenue to support their safety. Women described interactions with the healthcare system during their experience of violence as a missed opportunity for identifying and responding to their abuse and connecting them with resources. We conclude with policy and practice recommendations based on women with disabilities’ perspectives and insights.

Adult Pornography and Violence Against Women in the Heartland: Results From a Rural Southeast Ohio Study

2016 ◽  
Vol 23 (7) ◽  
pp. 830-849 ◽  
Author(s):  
Walter S. DeKeseredy ◽  
Amanda Hall-Sanchez
Keyword(s):  
United States ◽  
Violence Against Women ◽  
Rural Women ◽  
Empirical Work ◽  
The United States ◽  
Intimate Violence ◽  
Woman Abuse ◽  
Future Directions ◽  
Quantitative Evidence ◽  
Depth Interviews

Many rural parts of the United States are now “pornified.” There is growing quantitative evidence revealing that rural women are at higher risk of being victimized by intimate violence than their urban and suburban counterparts. In-depth interviews with 55 rural southeast Ohio women who wanted to leave, were trying to leave, or were in the process of leaving, or who have left their male marital/cohabiting partners reveal that pornography is a major component of the problem of rural woman abuse. The main objective of this article is twofold: (a) to present the results of our qualitative study, and (b) to suggest future directions in theoretical and empirical work.

The Ethical Neutrality of Prospective Payments: Justice Issues

1996 ◽  
Vol 5 (4) ◽  
pp. 570-578
Author(s):  
Jean McDowell
Keyword(s):  
United States ◽  
Healthcare System ◽  
West Coast ◽  
Healthcare Delivery ◽  
The United States ◽  
Fee For Service ◽  
Reimbursement Mechanisms ◽  
The West ◽  
The Past ◽  
The U.S

The U.S. healthcare system has been subject to unprecedented scrutiny over the past three years; one of the results of this scrutiny has been recognition of the serious problems that exist in both healthcare delivery and reimbursement mechanisms. While the verbal debate in Washington has essentially ceased, within the healthcare community a historic shift has taken place in the way healthcare reimbursement is structured: increasingly, traditional fee-for-service reimbursement methods are being replaced with capitation reimbursement methods. While this phenomenon originated on the West Coast, it has spread to all geographic sectors of the United States in varying degrees and can be expected to dominate the funding patterns of healthcare over the next decade.

scholarly journals Data-driven decision making in early education: Evidence From North Carolina’s Pre-K program

2019 ◽  
Vol 27 ◽  
pp. 18
Author(s):  
Michael Harris Little ◽  
Lora Cohen-Vogel ◽  
James Sadler ◽  
Becca Merrill
Keyword(s):  
Decision Making ◽  
Data Sharing ◽  
Early Education ◽  
Screening Tools ◽  
Data Driven ◽  
Policy And Practice ◽  
Data Driven Decision Making ◽  
Use Of Data ◽  
Depth Interviews ◽  
Shed Light

The purpose of this study is to shed light on the use of data in early education settings—specifically, North Carolina’s Pre-K program. In this mixed-methods study, we draw upon in-depth interviews and survey data to examine (1) the types of data available to educators in Pre-K, (2) the ways in which data are intended to be used, (3) how data are reportedly used, and (4) the facilitators and inhibitors of effective data-driven decision making. Our findings reveal that Pre-K settings are data-rich environments, often with informal data collected through developmental screening tools and formative assessment systems. We find that engagement with and use of these data for instruction is variable. Finally, we find data sharing between grades is inconsistent, but an important factor predicting data sharing is co-location of Pre-K programs within elementary school buildings. We consider our findings in the context of existing academic literature and discuss the implications for policy and practice. 

scholarly journals Cultivating Collaborative Resilience to Social and Ecological Change: An Assessment of Adaptive Capacity, Actions, and Barriers Among Collaborative Forest Restoration Groups in the United States

2022 ◽  
Author(s):  
Tyler A Beeton ◽  
Antony S Cheng ◽  
Melanie M Colavito
Keyword(s):  
United States ◽  
Forest Restoration ◽  
National Level ◽  
Public Lands ◽  
Collaborative Governance ◽  
The United States ◽  
Policy And Practice ◽  
Practice Recommendations ◽  
Public Lands Management ◽  
Adaptation Options

Abstract Collaboration is increasingly emphasized as a tool to realize national-level policy goals in public lands management. Yet, collaborative governance regimes (CGRs) are nested within traditional bureaucracies and are affected by internal and external disruptions. The extent to which CGRs adapt and remain resilient to these disruptions remains under-explored. Here, we distill insights from an assessment of the Collaborative Forest Landscape Restoration Program (CFLRP) projects and other CGRs. We asked (1) how do CGRs adapt to disruptions? and (2) what barriers constrained CGR resilience? Our analysis is informed by a synthesis of the literature, case examples and exemplars from focus groups, and a national CFLRP survey. CGRs demonstrated the ability to mobilize social capital, learning, resources, and flexibility to respond to disruptions. Yet authority, accountability, and capacity complicated collaborative resilience. We conclude with policy and practice recommendations to cultivate collaborative resilience moving forward. Study Implications Collaborative approaches between public lands management agencies and nongovernment organizations have become common in forest restoration. Yet collaborative progress may be affected by turnover, wildfire disturbances, or legal or policy changes. We assessed how forest collaboratives in the United States adapted to changes that affected their performance and documented the factors that constrained response. We found that forest collaboratives developed myriad strategies to adapt to these changes, although limited authority, capacity, and accountability constrain adaptation options. We offer policy and practice recommendations to overcome these constraints, increase adaptation options, and enhance the sustainability of forest collaboratives.

scholarly journals Impact of COVID-19 Pandemic on Cancer Screening in the United States

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 3-4
Author(s):  
Sonikpreet Aulakh ◽  
Asher Chanan Khan
Keyword(s):  
United States ◽  
Cancer Screening ◽  
Healthcare System ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
The United States ◽  
Healthcare Systems ◽  
Systematic Evaluation ◽  
The Us

COVID-19 pandemic has exposed vulnerabilities all across the global healthcare systems including those within the United States. A systematic evaluation of these soft spots has been crucial in order to reengineer the healthcare system for enhanced competences and superior quality of care. One area that has been undoubtedly affected is the diagnosis and management of neoplastic diseases. The healthcare system in the US witnessed an instantaneous implementation of a “social distancing” strategy, which was implemented in an effort to flatten the infectivity “curve”. This required an urgent modification in the general administration of healthcare delivery, independent of COVID-19 infection status of a patient. For the non-COVID patients, it meant a shift from in-person to a virtual administration platform.''(Royce et al., 2020) Neither the healthcare providers, nor the patients, or the hospital management were adequately prepared for this sudden transition. Various healthcare services offered through these healthcare systems were required to be triaged based upon patients' assessment of needs into either emergent, urgent or routine/non- urgent. Patients seeking services that fell in the non- urgent/routine clinical visits were encouraged to stay home until the pandemic simmered down/resolved. This strategy was erroneously predicated on a rather short anticipated duration of the pandemic. As expected, cancer screening visits were deemed non- urgent and thus most healthcare facilities in and outside the US suspended these services, inadvertently compromising the timely diagnosis of neoplastic disorders.

Clinical Characteristics of Patients Diagnosed with Strongyloidiasis in a United States Urban Outpatient Dermatology Department: A Case Series

2017 ◽  
Vol 1 (3) ◽  
pp. 156-160
Author(s):  
Jacqueline Watchmaker ◽  
Sean Legler ◽  
Dianne De Leon ◽  
Vanessa Pascoe ◽  
Robert Stavert
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Screening Tools ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Serologic Testing ◽  
Patient Reported ◽  
History Of ◽  
Endemic Areas

Background: Although considered a tropical disease, strongyloidiasis may be encountered in non-endemic regions, primarily amongst immigrants and travelers from endemic areas.  Chronic strongyloides infection may be under-detected owing to its non-specific cutaneous presentation and the low sensitivity of commonly used screening tools. Methods: 18 consecutive patients with serologic evidence of strongyloides infestation who presented to a single urban, academic dermatology clinic between September 2013 and October 2016 were retrospectively included.  Patient age, sex, country of origin, strongyloides serology titer, absolute eosinophil count, presenting cutaneous manifestations, and patient reported subjective outcome of pruritus after treatment were obtained via chart review.  Results: Of the 18 patients, all had non-specific pruritic dermatoses, 36% had documented eosinophila and none were originally from the United States. A majority reported subjective improvement in their symptoms after treatment. Conclusion:  Strongyloides infection and serologic testing should be considered in patients living in non-endemic regions presenting with pruritic dermatoses and with a history of exposure to an endemic area.Key Points:Chronic strongyloidiasis can be encountered in non-endemic areas and clinical manifestations are variableEosinophilia was not a reliable indicator of chronic infection in this case series Dermatologists should consider serologic testing for strongyloidiasis in patients with a history of exposure and unexplained pruritus

Early Psychosis: Diagnosis and Treatment

2020 ◽  
Vol 09 ◽  
Author(s):  
Nataly S. Beck ◽  
Melanie L. Lean ◽  
Kate V. Hardy ◽  
Jacob S. Ballon
Keyword(s):  
United States ◽  
Early Identification ◽  
Mental Health Problems ◽  
The United States ◽  
Early Psychosis ◽  
Screening Tools ◽  
Diagnosis And Treatment ◽  
First Episode ◽  
Psychotic Episode ◽  
First Onset

Background: The typical age of onset for psychotic disorders is concurrent with the typical age of enrollment in higher education. College and graduate students often experience new academic and social demands that may leave them vulnerable to substance use and mental health problems, including the initial onset of a psychotic episode. Objective: To provide a current overview of the guidelines and literature for the diagnosis and treatment of first-onset psychosis with special consideration for the college and graduate student population in the United States. To highlight areas of need and provide recommendations for clinicians who work at educational institutions and their health services, along with general psychiatrists and psychologists who work with post-secondary education populations, to help close the treatment gap. Method: A review of interventions and best practice for the treatment of early psychosis in college students was conducted, informed by the authors’ current experience as clinicians with this population at a United States university. Results: Thorough psychiatric interviews and screening tools can help in the early identification of individuals at clinical high risk for and at first onset of psychosis. Coordinated specialty care services are the gold standard for early psychosis services, including psychotherapy (such as cognitive behavioral therapy and individual resiliency training), as well as support for a student to return to school or work. Individuals experiencing a first episode of psychosis in general respond better to lower doses of antipsychotics and may also experience more adverse effects. Conclusion: Return to a high level of functioning is possible in many cases of first onset of psychosis, and early identification and treatment is essential.

Mobilized by Injustice

2020 ◽  
Author(s):  
Hannah L. Walker
Keyword(s):  
New York ◽  
Criminal Justice ◽  
Civil Rights ◽  
Political Action ◽  
Negative Impact ◽  
The United States ◽  
Personal Contact ◽  
Racial Boundaries ◽  
Material Resources ◽  
Depth Interviews

Springing from decades of abuse by law enforcement and an excessive criminal justice system, members of over-policed communities lead the current movement for civil rights in the United States. Activated by injustice, individuals protested police brutality in Ferguson, campaigned to end stop-and-frisk in New York City, and advocated for restorative justice in Washington, D.C. Yet, scholars focused on the negative impact of punitive policy on material resources, and trust in government did not predict these pockets of resistance, arguing instead that marginalizing and demeaning policy teaches individuals to acquiesce and withdraw. Mobilized by Injustice excavates conditions under which, despite otherwise negative outcomes, negative criminal justice experiences catalyze political action. This book argues that when understood as resulting from a system that targets people based on race, class, or other group identifiers, contact can politically mobilize. Negative experiences with democratic institutions predicated on equality under the law, when connected to a larger, group-based struggle, can provoke action from anger. Evidence from several surveys and in-depth interviews reveals that mobilization as result of negative criminal justice experiences is broad, crosses racial boundaries, and extends to the loved ones of custodial citizens. When over half of Blacks and Latinos and a plurality of Whites know someone with personal contact, the mobilizing effect of a sense of injustice promises to have important consequences for American politics.

Persons with Disabilities and Public Health Ethics

2019 ◽  
pp. 218-231
Author(s):  
Monika Mitra ◽  
Linda Long-Bellil ◽  
Robyn Powell
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Ethical Issues ◽  
The United States ◽  
Policy And Practice ◽  
Persons With Disabilities ◽  
Public Health Decision ◽  
Health Decision ◽  
Health Policy And Practice

This chapter draws on medical, social, and legal perspectives to identify and highlight ethical issues pertaining to the treatment, representation, and inclusion of persons with disabilities in public health policy and practice. A brief history of disability in the United States is provided as a context for examining the key ethical issues related to public health policy and practice. Conceptual frameworks and approaches to disability are then described and applied. The chapter then discusses the imperativeness of expanding access to public health programs by persons with disabilities, the need to address implicit and structural biases, and the importance of including persons with disabilities in public health decision-making.

The Interplay of Developing Morality and Gender Attitudes

2020 ◽  
pp. 724-745
Author(s):  
Rebecca S. Bigler ◽  
Lynn S. Liben
Keyword(s):  
Psychological Theory ◽  
The United States ◽  
Gender Nonconformity ◽  
Gender Attitudes ◽  
Future Research ◽  
Policy And Practice ◽  
Ethical Policy ◽  
History Of ◽  
And Gender ◽  
And Behavior

Morality and gender are intersecting realms of human thought and behavior. Reasoning and action at their intersection (e.g., views of women’s rights legislation) carry important consequences for societies, communities, and individual lives. In this chapter, the authors argue that children’s developing views of morality and gender reciprocally shape one another in important and underexplored ways. The chapter begins with a brief history of psychological theory and research at the intersection of morality and gender and suggests reasons for the historical failure to view gender attitudes through moral lenses. The authors then describe reasons for expecting morality to play an important role in shaping children’s developing gender attitudes and, reciprocally, for gender attitudes to play an important role in shaping children’s developing moral values. The authors next illustrate the importance and relevance of these ideas by discussing two topics at the center of contentious debate in the United States concerning ethical policy and practice: treatment of gender nonconformity and gender-segregated schooling. The chapter concludes with suggestions for future research.

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