Birth Empowerment: Integrating Doula Services into Our Healthcare System

This law review article explores the role of doulas in improving maternal and infant outcomes and the challenges of integrating doula services into our healthcare system. Part I provides an overview of maternal and infant mortality rates in the United States, highlighting the disparities faced by women of color and low-income women. Part II discusses the benefits of doula services, including reduced rates of cesarean delivery, preterm birth, and other complications. Part III reviews current coverage of doula services in various states, both in the public and private sector. Part IV critiques the current regulatory scheme for doula services and proposes a state-run board to review doula conduct and services to ensure quality care. The article concludes that integrating doula services into our healthcare system is essential for improving maternal and infant outcomes, but requires addressing structural barriers such as reimbursement policies and regulatory frameworks. [AI generated abstract

Evaluation Design and Technical Assistance Opportunities: Early Findings From the Beacon Community Program Evaluation Teams

Examines study designs, evaluation approaches, outcome measures, data sources, challenges, and technical assistance needs among sites in a project under the American Recovery and Reinvestment Act to strengthen health information technology capabilities

Resilience Among Sexual Minority Youth: The Role of Natural Mentors in Improving Mental Health and Substance Abuse Outcomes

Thesis advisor: Stephanie BerzinA growing body of evidence shows that sexual minority youth disproportionately suffer from poor mental health and substance abuse outcomes in comparison to their heterosexual peers. Parental support has been found to be a strong protective factor for these youth. There is a lack of research, however, that examines the role of non-parental adult support, such as natural mentors (e.g., teachers, grandparents, and coaches). Guided by minority stress and resiliency theories, the current study aims to deepen our understanding of whether natural mentors act as a resilience resource for sexual minority youth. The current study uses the National Longitudinal Study of Adolescent to Adult Health (Add Health) restricted-use dataset. This is a large, nationally representative sample of both heterosexual (n=12,667) and sexual minority youth (n=1,413), ages 18 to 26. Variable-centered (i.e., multiple regression analysis with moderation) and person-centered (latent class analysis) statistical techniques were utilized to explore the effect of the presence and characteristics of natural mentoring relationships on a range of mental health and substance abuse outcomes. Results show that natural mentors have a similar relationship with health outcomes, regardless of sexual orientation. Perceived closeness is a critical characteristic of the mentoring relationship, exhibiting significant associations with depression, suicide ideation, self-esteem, life satisfaction, and binge drinking. Furthermore, those who have lifelong, close relationships with non-parental adult family members receive the most benefit. It is noteworthy that sexual minority youth are significantly less likely to have a permanent family mentor. Rather, they are more likely to have mentors from high school with whom they lack closeness as they transition into adulthood. Several suggestions for individual and school-based interventions to assist sexual minority youth in developing and maintaining long-term relationships with non-parental adult family members are discussed. The current study emphasizes the importance of supporting and advocating for greater policy change that will directly address minority stressors that sexual minority youth face. Findings from the current study make a significant contribution to the social work field by extending our knowledge regarding resiliency among sexual minority youth and offering concrete avenues for intervention.Thesis (PhD) — Boston College, 2015.Submitted to: Boston College. Graduate School of Social Work.Discipline: Social Work

District Science Leaders: Beliefs and Pedagogical Content Knowledge for Scientific Argumentation

Thesis advisor: Katherine L. McNeillThe Next Generation Science Standards (NGSS) represent a significant shift in the goals of U.S. science education. Instead of a focus solely on content acquisition, the NGSS aim to engage students in the practices of science. Teachers will require substantial support, in large part from science leaders at the district level, to change their instruction to accomplish this vision. However, little is known about how these leaders conceptualize the NGSS. Therefore, this dissertation utilizes a sensemaking theoretical framework to explore the beliefs and pedagogical content knowledge (PCK) of district science leaders about one of the NGSS science practices, scientific argumentation. Greater understandings of these constructs can aid in designing appropriate supports for district leaders and meeting the challenges of implementing the NGSS. Fifty-three district leaders from states that have adopted the NGSS participated in a survey focused on their beliefs and PCK for argumentation. After the administration of the survey, 10 district leaders who represented a range of states and beliefs were selected for follow-up interviews. These interviews were semi-structured and focused on the same areas of belief as in the survey. The findings from the surveys and interviews indicate that most district science leaders are supporters of the NGSS and believe that scientific argumentation offers important benefits for students. Many leaders referenced one or more of the NGSS science practices in their descriptions of effective science education and asserted that they believe that the NGSS will require teachers in their districts to make substantial changes in their current instruction. However, some leaders also maintained their beliefs in the effectiveness of traditional instructional methods that are not compatible with the NGSS, and few leaders mentioned critique as an essential component of argumentation. In addition, many leaders demonstrated challenges in their PCK for argumentation, specifically related to evidence and reasoning in scientific arguments and the role of critique in dialogical interactions. Therefore, supporting leaders to develop more accurate conceptions and knowledge of the NGSS and argumentation should be a priority for districts nationwide.Thesis (PhD) — Boston College, 2016.Submitted to: Boston College. Lynch School of Education.Discipline: Teacher Education, Special Education, Curriculum and Instruction

Ode to positive constructive daydreaming

Nearly 60 years ago, Jerome L. Singer launched a groundbreaking research program into daydreaming (Singer, 1955, 1975, 2009) that presaged and laid the foundation for virtually every major strand of mind wandering research active today (Antrobus, 1999; Klinger, 1999, 2009). Here we review Singer’s enormous contribution to the field, which includes insights, methodologies, and tools still in use today, and trace his enduring legacy as revealed in the recent proliferation of mind wandering studies. We then turn to the central theme in Singer’s work, the adaptive nature of positive constructive daydreaming, which was a revolutionary idea when Singer began his work in the 1950s and remains underreported today. Last, we propose a new approach to answering the enduring question: Why does mind wandering persist and occupy so much of our time, as much as 50% of our waking time according to some estimates, if it is as costly as most studies suggest

Understanding Maternity Care Coordination for Women Veterans Using an Integrated Care Model Approach

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits. METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among a sample of postpartum veterans who had utilized VA maternity benefits for their pregnancies (n = 276). We assessed relationships between perceptions of six domains of patient-reported integrated care, indicating how well-integrated patients perceived the care received from VA and non-VA clinicians, and utilization of mental healthcare following pregnancy. RESULTS: Domain scores were highest for items focused on VA care, including test result communication and VA provider\u27s knowledge of patient\u27s medical conditions. Scores were lower for obstetrician\u27s knowledge of patient\u27s medical history. Women with depressive symptom scores indicative of depression rated test result communication as highly integrated, while women who received mental healthcare following pregnancy had low integrated care ratings for the Support for Medication and Home Health Management domain, indicating a lack of support for mental health conditions following pregnancy. DISCUSSION: Among a group of postpartum veterans, poor ratings of integrated care across some domains were associated with higher rates of mental healthcare use following pregnancy. Further assessment of integrated care by patients may assist VA providers and policymakers in developing systems to ensure integrated care for veterans who receive care outside the VA