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      • A structure by no means complete: A comparison of the path and processes surrounding successful passage of Medicare and Medicaid under Lyndon Baines Johnson and the failure to pass national health care reform under William Jefferson Clinton

        Johnson, David Howard The University of Texas at Austin 2009 해외박사(DDOD)

        RANK : 247711

        In this comparative policy development analysis, I utilize path-dependence theory and presidential records to analyze President Lyndon Johnson's success in passing Medicare and Medicaid and President Bill Clinton's failure to pass national health care reform. Findings support four major themes from the Johnson administration: (1) President Johnson had a keen understanding of the importance of language in framing debate; (2) He placed control of the legislative process in the hands of a small, select group of seasoned political operatives and career policymaking professionals; (3) He paid considerable attention to the details of negotiations and the policy consequences; and (4) He had a highly developed sense of the political and legislative processes involved in passing major legislation. The case study of the Clinton administration reveals five major themes: (1) There is a lack of evidence that President Clinton remained actively engaged throughout the policy development and legislative processes, instead choosing to delegate the process to the First Lady; (2) There was a naivete on the part of the Clintons and many administration staff members with regard to the legal and political ramifications of their decisions; (3) The Clintons tried to make the plan fully their own, sharing little credit for its development with Congress; (4) Their attempts to incorporate existing corporate health care delivery structures with their vision for universal coverage proved unworkable; and (5) The extended time from task force launch to bill delivery gave opponents ample time to marshal their opposition forces. I conclude that in developing health care legislation, Johnson had the advantages of: (1) a small group of key policymakers; (2) multiple, simultaneous legislative initiatives which diffused the attention of a more limited media; and, (3) national crises which promoted an environment conducive to sweeping policy change. I suggest that major, national health care reform will not occur until: (1) an economic or geopolitical crisis sets the stage for change; (2) business interests and progressive interests find common ground; and, (3) Americans achieve a new cultural understanding of universal health care as both economically just and economically necessary.

      • Quantifying the effects of community health center access on health for medically-vulnerable populations

        Johnson, Danielle N Temple University 2016 해외박사(DDOD)

        RANK : 247631

        Established in 1965 as a part of President Johnson's War on Poverty effort, the federal community health center (CHC) program is a primary source of federally-subsidized quality health care services for medically-vulnerable populations in the United States. Despite its current role as a medical safety-net for the nation's health care system, the CHC program did not begin as a public health program, but rather as a social justice program. Since its formalization, the CHC program has enjoyed relatively consistent Congressional support as a cost-effective means of providing primary healthcare to indigent populations; however, the narrative of the program has shifted overtime from a focus of empowerment and lifting communities out of poverty, to the fortification of the national health care system as a cost-effective provider of quality healthcare care for all. In this manuscript, I argue that this transition from community empowerment and the mitigation of fundamental causes of disease to a more risk-based emphasis on the issue of access, has diminished the urgency around the engagement of the structural effects of poverty on health in favor of a "one size fits all" approach to the provision of basic health care. In an effort to objectively quantify the effects of geographic access on health as a means for evaluating the success of the contemporary program, this research project explores the extent to which proximal access to a CHC is significantly associated with various self-reported indicators of positive health outcomes. My primary research method is multivariable regression utilizing secondary data from the 2012 Southeastern Pennsylvania Household Health Survey, the 2008-2012 5-year American Community Survey Estimate, and the Health Resources and Services Administration Data Warehouse. Using statistical modeling, I test the effect of CHC access on three distinct measures of individual health: (1) self-reported health status, (2) the likelihood of having pain lasting 6 months or more, and (3) the likelihood of having a usual source of health care. Within each model, I also test a series of interaction terms through nested sub-models to uncover any conditional effects of access for selected social groups. This statistical design offers the opportunity to explore whether the main association between access to a CHC and health varies based on the social characteristics and/or social environment of the individual. The findings of my analysis suggest that the effect of CHC access varies for different social groups, with less disadvantaged groups, such as poor non-Hispanic whites with high social capital, and poor individuals living in areas of low disadvantage, receiving the greatest benefit from proximal CHC access. However, individuals at the extremes of social disadvantage benefit least from CHC access alone. I argue that while the provision of CHC access is a noble and necessary tactic for fighting the persistence of health disparities in our medically-vulnerable communities, focusing on access alone is insufficient to solve the problem. The pendulum must switch back to community empowerment and the eradication of structural threats to health to initiate real change for medically-vulnerable populations.

      • Explaining Racial Disparity in Bipolar Disorder Treatment: How Do Providers Contribute?

        McMaster, Kaja Johnson University of California, Berkeley ProQuest Disser 2017 해외박사(DDOD)

        RANK : 247630

        Bipolar disorder is a serious mental illness that goes untreated more often among blacks than whites in the U.S. In the current study, I identified and tested a proposed mechanism underlying differential treatment in bipolar disorder, namely how treatment providers' racial biases contribute to the inadequate care of black patients with bipolar disorder. Findings from research in general and mental healthcare show that providers' clinical decisions may be related to racial biases based on stereotypes that providers hold. Moreover, general healthcare research has demonstrated the presence of implicit racial biases (defined as unconscious preferences for one race over another) among providers that are linked to the differential treatment of blacks and whites. Unfortunately, much less work has been done to show the presence and effects of implicit racial biases among mental healthcare providers. The hypothesized model in the current study proposes that implicit racial biases held by mental healthcare providers bias diagnostic and prognostic assessments as well as treatment recommendations in bipolar disorder and result in the observed treatment disparities between black and white patients. The Implicit Association Test was used to measure general racial biases in a sample of 82 mental healthcare providers. Clinical decision-making was simulated using clinical vignettes about theoretical black and white patients with psychotic and non-psychotic bipolar disorder. Three-way ANOVAs were used to test for racial disparities in decision-making, and structural equation modeling was used to determine whether providers' implicit racial biases were associated with decision-making outcomes. Results showed that providers held moderate pro-white/anti-black racial biases and neutral explicit attitudes, also known as an "aversive racism" profile. Racial disparity was observed, but confounded by a mismatch in the severity of symptoms of the hypothetical patients. Composite scores for the vignettes were used to overcome this issue in the SEM analyses. These results revealed that there was no link between racial bias and decision-making. Suggestions for future research are given to improve modeling of the relationship between racial bias and patient care. Despite limitations, findings provide some of the first evidence establishing the presence or implicit racial biases in mental healthcare.

      • Expanding the power of literature: African-American literary theory and young adult literature

        Hinton-Johnson, KaaVonia Mechelle The Ohio State University 2003 해외박사(DDOD)

        RANK : 247630

        This study examines the intertexual relationship between select young adult (YA) African American women's literature and literature within the broader African American women's literary tradition. Given that many secondary teachers are committed to teaching works by and about African American women, particularly those written for an adult audience, it is necessary that scholars discuss the connection that exists between African American women's literature written for adults and literature classified as YA literature. One of the goals of this study was to contribute to this discussion. The study examined select works by Angela Johnson, Rita Williams-Garcia, and Jacqueline Woodson from a black feminist perspective in an effort to situate the novels within the already established African American women's literary tradition. The following six novels, two by each author, were analyzed: Angela Johnson's <italic> Toning the Sweep</italic> (1994) and <italic>Heaven</italic> (1998), Rita Williams-Garcia's <italic>Blue Tights</italic> (1988) and <italic>Like Sisters on the Homefront</italic> (1995) and Jacqueline Woodson's <italic>The Dear One</italic> (1991) and <italic>I Hadn't Meant to Tell You This</italic> (1994). The novels were analyzed to see if the works illustrate any of the tenets of black feminist thought, with emphasis on tenets related to individual or cultural identity (i.e., multiple oppressions of race, class, and gender in the lives of young African American women, cultivating sisterhood, discovering voice and subjectivity, etc.). The data gathered for this study included: six YA novels, published interviews, book reviews, biographical sketches of each author, and articles written by and about authors of the books in this study. The data were analyzed through content analysis. Literary analysis revealed that there were indeed thematic connections between the novels listed above and select literature within the African American women's literary tradition. Literary analysis demonstrated that three themes, in particular, are shared: family, African American expressive culture and sexuality. Finally, literary analysis also indicated that key tenets of black feminism, as defined by the researcher, were found in each of the six novels.

      • Probing the structure and function of biopolymer-carbon nanotube hybrids with molecular dynamics

        Johnson, Robert R University of Pennsylvania 2009 해외박사(DDOD)

        RANK : 247615

        Nanoscience deals with the characterization and manipulation of matter on the atomic/molecular size scale in order to deepen our understanding of condensed matter and develop revolutionary technology. Meeting the demands of the rapidly advancing nanotechnological frontier requires novel, multifunctional nanoscale materials. Among the most promising nanomaterials to fulfill this need are biopolymer-carbon nanotube hybrids (Bio-CNT). Bio-CNT consists of a single-walled carbon nanotube (CNT) coated with a self-assembled layer of biopolymers such as DNA or protein. Experiments have demonstrated that these nanomaterials possess a wide range of technologically useful properties with applications in nanoelectronics, medicine, homeland security, environmental safety and microbiology. However, a fundamental understanding of the self-assembly mechanics, structure and energetics of Bio-CNT is lacking. The objective of this thesis is to address this deficiency through molecular dynamics (MD) simulation, which provides an atomic-scale window into the behavior of this unique nanomaterial. MD shows that Bio-CNT composed of single-stranded DNA (ssDNA) self-assembles via the formation of high affinity contacts between DNA bases and the CNT sidewall. Calculation of the base-CNT binding free energy by thermodynamic integration reveals that these contacts result from the attractive pi--pi stacking interaction. Binding affinities follow the trend G > A > T > C. MD reveals that long ssDNA sequences are driven into a helical wrapping about CNT with a sub-10 nm pitch by electrostatic and torsional interactions in the backbone. A large-scale replica exchange molecular dynamics simulation reveals that ssDNA-CNT hybrids are disordered. At room temperature, ssDNA can reside in several low-energy conformations that contain a sequence-specific arrangement of bases detached from CNT surface. MD demonstrates that protein-CNT hybrids composed of the Coxsackie-adenovirus receptor are biologically active and function as a nanobiosensor with specific recognition of Knob proteins from the adenovirus capsid. Simulation also shows that the rigid CNT damps structural fluctuations in bound proteins, which may have important ramifications for biosensing devices composed of protein-CNT hybrids. These results expand current knowledge of Bio-CNT and demonstrate the effectiveness of MD for investigations of nanobiomolecular systems.

      • Sex scenes and naked apes: Sexual-technological experimentation and the sexual revolution

        Johnson, Eithne Emer The University of Texas at Austin 1999 해외박사(DDOD)

        RANK : 247615

        Addressing the period popularly marked by both the sexual revolution and the communications revolution, this dissertation argues that key sexual-technological experiments were organized around the figure of the “naked ape.” These experiments linked imaging technologies and performing bodies in the following domains: the sexology laboratory, the sex therapy clinic, the multimedia Sexarama, and the clinic or home for genital self-examination. By taking this approach, this dissertation investigates the significance of sexual science and pornography during this period, as both were invested in producing new sexualized signs and sexual performativities. The laboratory's coloscopic film makes sense in relation to the beaver film, the first pornographic genre to go public; both were invested in a masturbatory female orgasmic performativity. The “sensate focus” sex therapy program makes sense in relation to the rise of semiotics in the sciences, which considered touch important to interpreting animal behavior. As Masters and Johnson's sex therapy articulated a sexual semiotics for the naked ape that privilege touch, the marriage manual film promised to reveal how humans do it, claiming that visual media made it possible to see sex acts better. The multimedia Sexarama was an approach to sex education designed to appeal to youth of the television age, already bombarded by the media. This sexual-technological experiment was organized to expose audiences to porn movies in order to desensitize them to sex, then to resensitize them by showing them documentaries demonstrating people's actual sexual patterns. Concerned for women's lower rates of masturbation and sexual satisfaction, sex therapists and sex educators crafted a sexual-technological experiment around the hand mirror to help women see their genitals and improve their orgasmic performativity. This dissertation argues that this technique resulted in the female-identified “mirror shot,” which had its parallel in the male-identified “money shot” of pornography. In sum, this project synthesizes research in media and culture studies to demonstrate how graphic, filmic, and catoptric (mirror) imaging techniques served to bring naked, sexually active bodies “on/scene” during the sexual and communications revolutions.

      • Thoughtful wanderings: A study of the collected compositions of Douglas Hill

        Johnson, Katie Marguerite The University of Wisconsin - Madison 2012 해외박사(DDOD)

        RANK : 247375

        The Doctoral Performance and Research submitted by Katie Marguerite Johnson, under the direction of Emeritus Professor Douglas Hill and Professor Daniel Grabois at the University of Wisconsin-Madison, in the fulfillment of the requirements for the degree Doctor of Musical Arts consists of the following. I. Chamber Recital, 10/30/2010, Auf Dem Strom, Op. 119 by Franz Schubert; The Heart of the Matter by Benjamin Britten; The Glorious Privilege of Being for voice, horn and piano by Douglas Hill; Serenade Op. 31 by Benjamin Britten; Prologue; Pastoral; Nocturne; Elegy; Dirge; Hymn; Sonnet; Epilogue. II. Chamber/Solo Recital, 2/27/2011, Morphy Hall; Sonata for alto horn and piano in E-flat by Paul Hindemith; Ruhig Bewegt; Lebhaft; Sehr Langsam; Dialogue: The Posthorn - Lebhaft; Parable VIII for Solo Horn, Op. 120 by Vincent Persichetti; Elegy for violin and horn by Douglas Hill; Trio for violin, horn and piano in E-flat, Op. 40 by Johannes Brahms. III. Concerto Recital, 4/5/2011, Mills Concert Hall; Concerto for Horn and Wind Ensemble by Dana Wilson; I. Plaintively II. With great energy. IV. Solo Recital, 5/1/2011, Morphy Hall; Scherzo Concertante by Vaclav Nelhybel; Appel Interstellaire by Olivier Messiaen; Sonata No. 2 in E-flat major, BWV 1031 by J.S. Bach; Andante, Op. Posth., by Richard Strauss; Oddities for Solo Horn by Douglas Hill; Fives; Threes; Nines; Andante e Polacca by Karl Czerny; Andante Allegro alla Polacca. V. Lecture Recital, 4/24/2012, Mosse Humanities Building, Rm. 2441, Technology and the Horn: How technological advancements, from hand stopping to digital technology, impacted composition for the horn. VI. Written Dissertation, Thoughtful Wanderings: A Study of the Collected Compositions of Douglas Hill Project includes: Composer biography as it pertains to this research, a survey and study of the five major categories of Hill's composition, perspectives of several professional performers of Hill's works and an annotated catalogue of Hill's compositions for horn.

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