Alien Registration- Bedrosian, Karon (Portland, Cumberland County)

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Eye Screening in U.S. Adults with Diabetes: Examination of Trends, Racial and Ethnic Differences, and Contribution of Medicaid Expansion, MEPS 2010-2017

Diabetic retinopathy (DR) is a prevalent cause of vision impairment and blindness among adults in the United States. Early diagnosis of DR through dilated eye examinations can reduce the risk of vision impairment or loss. Differences in eye examination rates by race and ethnicity have been suggested by prior studies emphasizing importance of increasing insurance coverage and access to care among minority populations. The Affordable Care Act aimed to expand health insurance coverage and improve access to care. This study examined trends overall and by race and ethnicity in eye examination rates and the contribution of Medicaid expansion on changes in eye examination rates among U.S. adults with diabetes living below 138% of the federal poverty level (FPL). This research utilized data from the 2010-2017 Medical Expenditure Panel Survey. Univariate and multivariable logistic regression models with post-estimation commands were fit to assess changes in eye examination rates overall, by race and ethnicity, and by residence in a state that expanded or did not expand Medicaid, while controlling for predisposing, enabling, and need factors, as conceptualized by the Andersen Healthcare Utilization model. Results: Eye examination rates did not significantly change among non-Hispanic whites, non-Hispanic blacks, and Hispanics from 2010-2017. The fully adjusted model revealed no significant differences in eye examination rates between the three racial and ethnic subgroups and in individuals with diabetes living below 138% of the FPL in expansion vs non-expansion states. Between 2010 and 2017, no significant improvements in eye examination were noted among non-Hispanic whites, non-Hispanic blacks, and Hispanics, and Medicaid expansion was not associated with changes in eye examination rates. Research on public health interventions targeting other factors that influence eye screening is warranted as expanding access to insurance coverage alone did not appear to translate into improvements in eye examinations

Stop the Madness! An Examination of Mental Health Stigma and Proposal to Implement Widespread Efforts for its Reduction

Many people in the United States are affected by mental health conditions. Mental health stigma is a social problem characterized by negative representation in the media, numerous barriers to obtaining treatment, and feelings of shame for those affected by a mental health disorder. While there is evidence of positive outcomes to some anti-stigma campaigns, there has been a failure for these programs to become widespread, covering all parts of American society. This paper has been created to present recommendations for widespread initiatives at the federal and state level. Recommendations for training and sensitivity programs targeting places of employment and schools, along with alteration of perceptions of people with mental illness in the media have been made. This topic and resulting recommendations may pave the path to reduce the severity and madness of mental health stigma in society

How Do You Take Your Multi-State, Class-Action Litigation? One Lump or Two?

The Class Action Fairness Act of 2005, which essentially federalizes all multi-state class-action cases, has introduced the class-action bar, and necessarily the judiciary, to myriad substantive and procedural issues never before envisioned in class-action litigation’s history. While some of these issues have already surfaced, many others haven’t but will as newly federalized multi-state class-action lawsuits move through litigation to the class certification stage. A major and unavoidable issue involves whether federal judges, when deciding multi-state claims’ class certification under Federal Rule 23, may consider well-developed, state class-action jurisprudence applying a single state’s substantive law or whether doing so violates the U.S. Supreme Court’s Erie Doctrine. My Article, after analyzing federal choice-of-law jurisprudence and Erie and its progeny, concludes that federal courts may consider state class-action jurisprudence applying a single state’s substantive law when deciding class certification under Federal Rule 23 and that doing so actually honors Erie’s mandate, albeit in an unanticipated manner. My Article provides guidance to the class-action bar and the judiciary, as they will undoubtedly recognize this issue and its significance when briefing, arguing, and deciding class certification of multi-state, class-action lawsuits