Policy Framework for Outreach, Enrollment, Retention and Utilization for Health Care Coverage in California

Defines a framework that counties in California can use to structure outreach, enrollment, retention, and utilization systems and strategies. Provides specific recommendations, based on local successes, for improving access to health care by children

“Dear You”: Witnessing Trauma in the World of The Handmaid’s Tale

This project explores the relationships between memory, intimacy, and witnessing trauma in the world of Margaret Atwood’s The Handmaid’s Tale. Chapter One looks into Atwood’s novel itself, tracing Gilead’s abuse of memory, both individual and collective. I argue that Offred turns to intimate memories and new intimate encounters to hold onto her memories, and thus to her sense of self. In Chapter Two, I examine Hulu’s series adaptation of Atwood’s story and the way the show develops its titular character beyond the novel by turning her tale into a revenge tragedy. I contend that June’s Gileadean life warped her perspective of power, which causes her to rely on an addiction to revenge in order to express and validate her trauma. Chapter Three then tackles how the woman Offred/June became in Gilead impacted her children in Atwood’s sequel novel, The Testaments. The subconscious behaviors and desires exhibited by June’s daughters suggest that the longing and hopelessness June endured were passed down to her children. However, for the very first time in The Handmaid’s Tale universe, The Testaments also illustrates how witnessing for one another enables Agnes and Nicole to begin processing their trauma. Ultimately, these messages urge audiences to consider the value of their own memories and relationships in order to recognize how their traumatic experiences will shape the next generation

An effective Chebotarev density theorem for families of number fields, with an application to ℓ\ell-torsion in class groups

We prove a new effective Chebotarev density theorem for Galois extensions $L/\mathbb{Q}$ that allows one to count small primes (even as small as an arbitrarily small power of the discriminant of $L$); this theorem holds for the Galois closures of "almost all" number fields that lie in an appropriate family of field extensions. Previously, applying Chebotarev in such small ranges required assuming the Generalized Riemann Hypothesis. The error term in this new Chebotarev density theorem also avoids the effect of an exceptional zero of the Dedekind zeta function of $L$, without assuming GRH. We give many different "appropriate families," including families of arbitrarily large degree. To do this, we first prove a new effective Chebotarev density theorem that requires a zero-free region of the Dedekind zeta function. Then we prove that almost all number fields in our families yield such a zero-free region. The innovation that allows us to achieve this is a delicate new method for controlling zeroes of certain families of non-cuspidal $L$-functions. This builds on, and greatly generalizes the applicability of, work of Kowalski and Michel on the average density of zeroes of a family of cuspidal $L$-functions. A surprising feature of this new method, which we expect will have independent interest, is that we control the number of zeroes in the family of $L$-functions by bounding the number of certain associated fields with fixed discriminant. As an application of the new Chebotarev density theorem, we prove the first nontrivial upper bounds for $\ell$-torsion in class groups, for all integers $\ell \geq 1$, applicable to infinite families of fields of arbitrarily large degree.Comment: 52 pages. This shorter version aligns with the published paper. Note that portions of Section 8 of the longer v1 have been developed as a separate paper with identifier arXiv:1902.0200

Inferring Causation from Cross-Sectional Data: Examination of the Causal Relationship between Hyperactivity–Impulsivity and Novelty Seeking

Previous research suggests an association between hyperactivity–impulsivity – one of the two behavioral dimensions that form attention deficit hyperactivity disorder – and the temperament characteristic of novelty seeking. We aimed to examine etiological links underlying the co-occurrence between these behaviors using a general population sample of 668 twin pairs, ages 7–10, for whom we obtained parent ratings in middle childhood; and pilot longitudinal data on 76 children. Structural equation modeling confirmed a shared genetic etiology (genetic correlation, rD = 0.81; 95% confidence intervals = 0.34–1.00) and showed that much (64%) of the covariation can be accounted for by shared genetic effects. In addition, causal paths were modeled between the two behaviors; 12% of the variance in novelty seeking at age 7 was accounted for by hyperactive–impulsive behaviors at the same age. The causal effects model fits with the current characterization of hyperactive–impulsive behaviors reflecting a heightened need for stimulation. This has important implications for the management of hyperactive–impulsive behaviors in clinical settings

Vaccine hesitancy and behavior change theory-based social media interventions: a systematic review

It is widely acknowledged that vaccine hesitancy is a multifaceted problem that cannot be addressed by a single strategy. Behavior change theories and social media tools may together help to guide the design of interventions aimed at improving vaccination uptake. This systematic review aims to identify the breadth and effectiveness of such theories and tools. The systematic review search was performed in PubMed, Scopus, ACM, Cochrane Library, ProQuest, and Web of Science databases for studies between January 2011 and January 2021 that applied social media tools to increase vaccine confidence or improve vaccination uptake. The literature search yielded a total of 3,065 publications. Twenty articles met the eligibility criteria, 12 of which were theory-based interventions. The result shows that the Health Belief Model was the most frequently deployed theory, and the most common social media tool was educational posts, followed by dialogue-based groups, interactive websites, and personal reminders. Theory-based interventions were generally more measurable and comparable and had more evidence to trigger the positive behavior change. Fifteen studies reported the effectiveness in knowledge gain, intention increase, or behavior change. Educational messages were proved to be effective in increasing knowledge but less helpful in triggering behavior change. Dialogue-based social media intervention performed well in improving people’s intention to vaccinate. Interventions informed by behavior change theory and delivered via social media platforms offer an important opportunity for addressing vaccine hesitancy. This review highlights the need to use a multitheory framework and tailoring social media interventions to the specific circumstances and needs of the target audience in future interventions. The results and insights gained from this review will be of assistance to future studies

A central line care maintenance bundle for the prevention of central line–associated bloodstream infection in non–intensive care unit settings

OBJECTIVE: To evaluate a central line care maintenance bundle to reduce central line-associated bloodstream infection (CLABSI) in non-ICU settings. DESIGN: Before-after trial with 12 month follow-up period. SETTING: 1250-bed teaching hospital. PARTICIPANTS: Patients with central lines on eight general medicine wards. Four wards received the intervention and four served as controls. INTERVENTION: A multifaceted catheter care maintenance bundle consisting of educational programs for nurses, update of hospital policies, visual aids, a competency assessment, process monitoring, regular progress reports, and consolidation of supplies necessary for catheter maintenance. RESULTS: Data were collected for 25,542 catheter-days including 43 CLABSI (rate = 1.68 per 1,000 CL-days) and 4,012 catheter dressing observations. Following the intervention, a 2.5% monthly decrease in the CLABSI incidence density was observed on intervention floors, but this was not statistically significant (95% confidence interval (CI); −5.3 – 0.4). On control floors, there was a smaller, but marginally significant decrease in CLABSI incidence during the study (change in monthly rate = −1.1%; 95% CI, −2.1 - −0.1). Implementation of the bundle was associated with improvement in catheter dressing compliance on intervention wards (78.8% compliance pre-intervention vs. 87.9% during intervention/follow-up; p<0.001) but improvement was also observed on control wards (84.9% compliance pre-intervention vs. 90.9% during intervention/follow-up; P = .001). CONCLUSIONS: A multi-faceted program to improve catheter care was associated with improvement in catheter dressing care, but no change in CLABSI rates. Additional study is needed to determine strategies to prevent CLABSI in non-ICU patients

Understanding the Stigma and Feasibility of Opening a Safe Injection Facility in Baltimore City: A Qualitative Case Study

Supervised injection facilities (SIFs) are medically supervised facilities designed to provide a hygienic environment in which drug users can consume illicit drugs intravenously. SIFs can be cost saving, help to reduce transmission of disease, and decrease drug overdoses. There are no SIFs in the United States. In this study we used a multiple case study design to understand the stigma surrounding the use of a SIF and the feasibility of implementing the drug prevention strategy in Baltimore City by comparing experiences with opening a SIF in Sydney, Australia. We interviewed one healthcare worker at the Sydney SIF and ten community stakeholders in Baltimore City. Interviewees were asked about community stigma of SIFs, drug use, and feasibility of opening a SIF in Baltimore City. Six overarching themes were established including lack of trust, lack of public education, fear of police, concern about efficacy of harm reduction programs, drug user stigma, and concerns about implementation. Findings suggest that stigma surrounding drug use and drug users is the most important aspect in shaping the participant\u27s varied perceptions of SIFs. Participants believed that for any change to occur, there must be multi-tiered collaboration at the level of government, healthcare, community, and law enforcement

Using Interviewing in Public Health Research: Experiences of Novice Researchers

In this article, we provide the experiences of three novice public health researchers conducting studies with several vulnerable populations: women, people with disabilities, and children. We describe all phases of our interview studies including developing data collection guides, planning the interview in an appropriate setting, conducting the interviews, and bringing the interview to a close. Specific components of the interviews that are discussed include establishing rapport and minimizing the power imbalance inherent between interviewer and interviewee, including the added power imbalance that vulnerable populations experience. Issues of maintaining quality and rigor, as well as ethical considerations for working with our specific populations are also discussed

From the 'cinematic' to the 'anime-ic': Issues of movement in anime

This is the author's accepted manuscript. The final published article is available from the link below.This article explores the way that movement is formally depicted in anime. Drawing on Thomas Lamarre's concepts of the `cinematic' and the `anime-ic', the article interrogates further the differences in movement and action in anime from traditional filmic form. While often considered in terms of `flatness', anime offers spectacle, character development and, ironically, depth through the very form of movement put to use in such texts.The article questions whether the modes of address at work in anime are unique to this form of animation.Taking into account how the terms `cinematic' and `anime-ic' can be understood (and by extension the cinematic and animatic apparatus), the article also begins to explore how viewers might identify with such images

“UNDER THE REBEL LASH”: BLACK PRISONERS OF WAR IN THE CONFEDERATE SOUTH

From 1862 to 1865, the Confederate military and private citizens enslaved captured Black US soldiers by various means rather than treating them as legitimate combatants. Confederates saw Black soldiers as slaves, and treated Black POWs as reclaimed property and as a labor corps subject to the demands of military necessity under the laws of war. Black POWs were therefore relatively mobile and usually labored outside of prison walls, beyond the sight of US officials and White POWs. Black POWs could be (and were) sold, reclaimed by former enslavers, and used as laborers on military works, in hospitals, and in prisons. Black POWs’ carceral experiences therefore centered upon their labor rather than their close confinement. Black POWs, navigated these diverse forms of captivity using survival strategies employed by American enslaved people over several generations, such as building personal relationships with one another and whites, using their particular skills while forced to labor, and escape. Their first person testimony, found in hundreds of military pensions, is vital to making sense of their survival and direct action during the war.Doctor of Philosoph