Local County Research Articles

Patriotism, Nation, and Masculinity in the Official Propaganda of the Hungarian Insurrectio during the War of the Fifth Coalition (1809)

During the War of the Fifth Coalition (1809), the idea of “national war” was put into practice in the Austrian Empire. Not only the Habsburg military system was reformed, but the war was accompanied by an extensive propaganda campaign, implemented by intellectuals in the service of the Viennese Court. In Hungary, the palatine, Archduke Joseph was responsible for harmonizing the military innovations with the constitutional traditions of the country. The mobilization was carried out mainly by the partly modernized insurrectio, which obliged the masses of nobility to do personal military service in exchange for their privileges. This anachronistic means of defense tried to satisfy, lopsidedly, the demand of manpower in an age of mass warfare. Consequently, the imperial propaganda also had to be adapted to the particular Hungarian situation. This paper investigates this unique Hungarian situation, through analysing the relationship between the military mobilization of the nobility by the insurrectio and the efforts of the official propaganda to construct a valorous and patriotic self-image of the Hungarian nation. First, the study analyses the limited reforms concerning the traditional system of defence of the estates. Second, it presents how the official propaganda of the insurrectio shaped the ideal image of the “noble warrior” on national level in the periods of mobilization, war and demobilization. Third, it discusses the cult of heroes and the fallen of the insurrectio both on national and local (county) level. It argues that this cult proved short-lived in the long run because of the defeat of Austria, the shortness of the war, the uneven involvement of the counties in fighting, and so forth. The paper concludes that the insurrectio of 1809, which was the last great moment of the military mobilization and the valorous patriotic-national ideology of the nobility, did not fit the modern nation-building process and therefore has never incorporated into the Hungarian nationalism as a true “national war.”

The Labor Market Effects of State and Local Expansions of the Earned Income Tax Credit

This study analyzes the labor market impact of state and local supplements to the federal Earned Income Tax Credit (EITC) program. Using Current Population Survey data from 1984 to 2020, I examine the differential impact of the state and local government supplements of the EITC on the labor force participation rates of married women. I examine whether the substantial expansions in the EITC program created by these supplements are an effective means of providing work incentives. In particular, do states and local counties with an EITC supplement witness higher female labor force participation rates? Exploiting variation in the policy over time both across states and within states between different demographic groups, I analyze whether the EITC supplements have raised labor supply among single women, and whether such differences exist in the labor supply of married women.

The effect of COVID-19 on Influenza treatment: a comparative analysis using synthetic and real data

Stay-at-home mandates to minimize the spread of COVID-19 may affect the spread of other respiratory viruses including influenza. We sought to compare rates of Oseltamivir administration, a surrogate for severe influenza, amongst pregnant individuals before and after March 23, 2020 when our local County enacted stay-at-home orders.

Frontline Reporting from the Epicenter of a Global Pandemic: A Survey of the Impact of COVID-19 on Plastic Surgery Training in New York and New Jersey.

Since the first documented case of coronavirus disease of 2019 (COVID-19), the greater New York City area quickly became the epicenter of the global pandemic, with over 500,000 cases and 50,000 deaths. This unprecedented crisis affected all aspects of health care, including plastic surgery residency training. The purpose of this study was to understand the specific impact of the COVID-19 pandemic on plastic surgery residencies. A survey of all plastic surgery residency training programs in the greater New York City area was conducted. The impact to training during the peak months of infection (March and April of 2020) was evaluated using resident education as measured by case numbers, need for redeployment, and staff wellness as primary outcome variables. A total of 11 programs were identified in the region, and seven programs completed the survey, with a response rate 63.6 percent. When comparing productivity in March and April of 2019 to March and April of 2020, a total decrease in surgical volume of 64.8 percent (range, 19.7 to 84.8 percent) and an average of 940 (range, 50 to 1287) cancelled clinic visits per month were observed. These decreases directly correlated with the local county's COVID-19 incidence rates (p = 0.70). A total of 83 percent of programs required redeployment to areas of need, and correlation between local incidence of COVID-19 and the percentage of residents redeployed to non-plastic surgical clinical environments by a given program (ρ = 0.97) was observed. As the first COVID-19 wave passes the greater New York area and spreads to the rest of the country, the authors hope their experience will shed light on the effects of the ongoing COVID-19 pandemic, and inform other programs on what to expect and how they can try and prepare for future public health crises.

Environmental governance capability and water quality: A quasi-natural experiment based on the Ten-point Water Plan

Sustainable utilization of water resource is an era task for China to transform its economic development model and enhance its capability of environmental governance. Based on the panel data of 267 prefecture level cities in China from 2011 to 2017, this study takes the Ten-point Water Plan as a quasi-natural experiment. Then, the difference-in-difference (DID) approach is conducted to evaluate the environmental governance capability of Ten-point Water Plan. The study proposes that water quality will be improved when incorporating environmental performance is introduced into the local officials' performance evaluation system by this policy. Taking into account the regional heterogeneity, the results reveal that the Ten-point Water Plan policy have a stronger effect in the eastern and western regions of China. Furthermore, the regulation effect is better in small and medium-sized cities among provincial capital cities. Additionally, the older local officials and smaller number of local counties display the better implementation of regional environmental governance. This research not only provides logical support for the promotion of the “Ten-point Water” policy, but also raise a new idea for solving the problem of low efficiency in water pollution prevention.

Improving Care for Individuals Living With Intellectual Developmental Disabilities and Dementia

Ultimately, transformation of communities can only occur through educational efforts delivered to specific community sectors. Although the portion of people with Intellectual Developmental Disabilities who develop dementia as they age is equal to that of the general population, individuals with Down syndrome are at a much higher risk. This symposium will describe how a county health department partnered with the local County Board of Developmental Disabilities to systematically incorporate Dementia Friends for Intellectual Developmental Disabilities with Alzheimer’s disease training to their staff and provider network. We will describe who to get on board with the idea, how to organize, and how to deliver specific trainings. Outcomes related to increase in participant knowledge, increases in service provision and outcomes related to staff mentoring will be discussed.

A seven-year analysis of the role and impact of a free community eye clinic

BackgroundThe Indiana University Student Outreach Clinic (IUSOC) Eye Clinic is a monthly student-run eye clinic that provides free visual screening to the Near East Side community of Indianapolis, IN, USA. Screening includes assessments of visual acuity, intraocular pressure, peripheral visual fields, refraction, and non-mydriatic fundus photography.MethodsThis is a retrospective chart review of 875 patients seen at the IUSOC Eye Clinic from October 2013 to February 2020. Data on demographics, insurance coverage, ocular history, physical examination, suspected diagnosis, referral status, and glasses provided were collected and analyzed.Results875 patients were seen at the IUSOC Eye Clinic from October 2013 to February 2020. 39.2% of the patients seen at the clinic reported being uninsured. 61.4% of patients were found to have visual acuity of 20/40 or worse, while 51.3% of patients were found to have a near visual acuity of 20/40 or worse. 20.3% of patients were referred to the local county hospital for further evaluation by an ophthalmologist, 14.4% of patients received free glasses prescriptions, and 27.9% of patients received free reading glasses. Common reasons for referral for further ophthalmology evaluation included glaucoma, decreased visual acuity, and diabetic retinopathy. An estimated value of services provided over the seven years of the clinic was 1271 relative value units.ConclusionThe IUSOC Eye Clinic fills an important role in advancing ocular health and preventing irreversible blindness in an underserved Indianapolis community. Additionally, the clinic demonstrates an educational model for involving medical student volunteers.

Let Confucianism and Islam work together: bargaining for a distinct Muslim identity in local propaganda literature

ABSTRACT In recent years, propaganda authorities in the Xinjiang Uyghur Autonomous Region of China have orchestrated the production of posters, banners, books, news reports, and literary magazines calling for the Sinicisation of Islam. What role is played by local Hui (Chinese Muslim) writers in the production of this propaganda? This article is based on a close reading of propaganda literature from a local county between 2010 and 2017. I show that Hui writers bargain for the preservation Hui ideological and cultural particularities. While contributing to the propaganda apparatus, they bargain to find a balance between the national call for the Sinicisation of religion and their own goal of the preservation of a Hui identity distinct from Han-Chinese culture. They argue that Sinicisation in the sense of value integration benefits the propaganda goals of the Chinese Party-State in a way that is not possible with Sinicisation in the sense of cultural and ideological assimilation.

Empowerment, love, and connection: Lessons learned from the Farmacy Project, a food-is-medicine program in Rutland, Vermont

Senior high school student volunteer Tyler Carroll walks out to the car that has pulled up along the back of the renovated former iron works building, the site of the Vermont Farmers Food Center, in downtown Rutland, Vermont. Tyler says, “Hi! Can I get your name, please?” Tyler then takes one bag from the table covered with bagged farm shares and puts one in the customer’s back seat, thanking them as they drive off with their local goods. The members are here to receive their produce prescription through the Farmacy Project, a program that provides 150 individuals in the county with 15 weeks of fresh produce grown exclusively by local Rutland county farms. Finishing up its sixth year in 2021, the program has become a standard in the area, working with healthcare providers who identify individuals with chronic diet-related health conditions who could benefit from a “food as medicine” produce share. This project intersects community health and local agriculture. Many, although not all, members may be food insecure as well, as reflected in the 68% of members this year who were food insecure based on the results of the two-item food insecurity questionnaire of the U.S. Household Food Security Survey.

Kinship Ties to Government Staff and Local Political Trust: Evidence from Rural China

Drawing on the Rural Socioeconomic Survey in China, we for the first time present descriptive information about Chinese citizens’ kinship ties to local government staff in rural areas, where around 40 percent of the respondents have at least one close relative in the family working in the local government. On average, such kinship ties have a significant but negative correlation with both the trust in staff of local township and county governments, and the trust in staff of judicial, legislative, and public security agencies. This negative effect, however, is not linearly additive with the number of kinship ties. Taken together, these findings lend support to the negative association between local kinship embeddedness and confidence in local official staff, highlighting a relational approach to understanding political trust in Chinese society.

CPESN California Update

CPESN California has been busy these past few months. Our local network has increased to over 100 independent pharmacies that have delivered on clinical services from COVID vaccine to Point of Care testing. Many of our independent pharmacies have collaborated with their local county health departments, fire departments, schools, employer groups, and long-term care facilities to vaccinate thousands of patients against COVID-19.CPESN California pharmacies have worked tirelessly to ensure that all those that wished to get vaccinated did. Haller’s Pharmacy in Fremont, California, under the direction of Dr. Sanjay Patel, partnered with local fire departments to host many clinics. Pucci’s Pharmacy in Sacramento, California, led by Dr. Clint Hopkins, partnered with Sacramento Public Health Departments to host onsite high school clinics. San Joaquin Drug in Planada owned by Dr. Katie Bass not only worked with her public health department to secure vaccines early but also held clinics every weekend to ensure their community had the opportunity to get vaccinated. Manor Drug and Barr Pharmacy in Fresno California held an onsite COVID clinic in Sanger, California to promote wellness through vaccination. Dr. Michael Ohashi led this effort with strong collaboration from Pam Yoshikawa both are owners of CPESN pharmacies. In Southern California, Western University School of Pharmacy has been working with college students and the underserved in their community. Dr. Bruno Tching at Inland Pharmacy has been collaborating with both local providers and Riverside County Public Health to identify patients with access disparities, such as home bound patients in need of vaccinations, and to provide remote clinics in HPI quartile 1 and 2 areas of the county. They have also been working with local advocacy organizations like the NAACP to promote vaccinations and help tackle disparity issues in low vaccination areas.However, delivering COVID vaccine was not the only thing our CPESN California Networks did. Our Flip the Pharmacy teams led by Dr. Karl Hess from Chapman University transformed their traditional dispensing pharmacy to one that integrates clinical services as part of their daily workload. They began to offer services that centered around diabetes care and social determinants of health. Each providing necessary education and screening to prevent any mishaps in care.It is through these partnerships, community relationships, and focus on providing outstanding individualized care that our CPESN California stores are breaking boundaries to elevate the care they give. Being a part of this community of forward-thinking pharmacists who are willing to think beyond the bottle and focusing on the patient allows our network to be highly successful in delivering exceptional care. If you are interested in learning more about how CPESN California can improve your practice and your relationships with community leaders contact us at www.cpesn.com.

Ensuring buprenorphine access in rural community pharmacies to prevent overdoses

BackgroundOpioid-related drug overdoses have been rapidly increasing in the United States, especially in rural Southern and Appalachian regions. The use of buprenorphine-containing medications to treat opioid use disorder (OUD) is an evidence-based approach proven to reduce overdose death risks. Access to such treatment is uneven, with less access in parts of the United States where overdose rates are higher. Pharmacy dispensing of buprenorphine is a key component of access, yet barriers related to perceived and actual regulatory constraints, training gaps, stigma, and challenges to prescriber-pharmacist communication limit dispensing of this life-saving medication. ObjectivesThe objectives of this study were to explore the experiences of rural patients with OUD filling prescriptions for buprenorphine-containing medications at community pharmacies. Practice DescriptionRural community pharmacies, both commercial chain and independent, in 2 rural South-Central Appalachian counties where the local health departments prescribe buprenorphine-containing medications. Practice InnovationThe local county health departments each entered into dedicated dispensing arrangements with a local independent community pharmacy to ensure a stable supply of medication for their patients with OUD who were prescribed buprenorphine. Evaluation MethodsQualitative interviews (n =16) with patients prescribed buprenorphine from their county health department; county health department staff, local harm reduction program staff, and harm reduction program participants prescribed buprenorphine. Transcripts were analyzed using thematic analysis. ResultsParticipants reported problems with buprenorphine dispensing at rural community pharmacies, dispensing delays that resulted in experiencing withdrawal symptoms and hesitation to continue in treatment, high medication costs, and stigmatizing treatment by some pharmacists. Participants also reported that access improved after dedicated dispensing arrangements began. ConclusionAgreements between prescribing health departments and community pharmacies could increase access to buprenorphine, especially in rural areas.

Decarceration from Local County Jails during the COVID-19 Pandemic: A Closer Look

ABSTRACT The COVID-19 pandemic initially compelled population reductions at local county jails. This study uses daily population counts at 970 jail facilities in 43 different U.S. states to; assess changes in jail population levels during 2020; relate those changes to the demographic, economic, and political characteristics of the counties where they took place; and examine the relationships between jail population levels and COVID-19 cases and deaths. Jail population data was gathered by the Jail Data Initiative at New York University and linked to other publicly accessible data collections. Through descriptive analyses and latent growth curve modeling, our findings indicate that while jail population levels generally fell in the early stages of the pandemic, they remained higher in areas with larger proportions of minoritized populations, and returned more rapidly to pre-pandemic levels in areas with larger proportions of Black and Republican-leaning residents. Larger pre-pandemic jail population rates were associated with elevated COVID-19 case and death rates during 2020, and changes in local jail population rates predicted case and death rates over a following three-month period. Specifically, each percentage increase in jail populations was associated with between 80.4 and 101.9 additional cases and 1.2 to 1.4 additional deaths per 10 K county residents.

COVID-19 and Local Emergency Management Operations

As the COVID-19 pandemic spread across the globe, local (county and municipal) emergency management departments in the United States were thrust to the forefront in addressing the needs of its citizenry. Doing so likely involved the use of Comprehensive Emergency Management (CEM) principles and planning efforts to address the pandemic. This paper outlines how respondents to a May/June 2020 survey of lead local emergency management department professionals nationwide used a variety of tools to address the evolving demands of the pandemic. The results suggest that a majority of local departments report having preparation and response means designed to address a pandemic in place prior to the outbreak of COVID- 19, but the use of specific efforts to confront the virus varied from place to place, as do attitudes regarding the impact of the pandemic on the daily operations of the local emergency management agency.

IS ANONYMITY GONE? DIRECT-TO-CONSUMER ANCESTRY TESTING REVEALS OLD SECRETS IN FERTILITY CARE: LEGAL CASE REVIEW

To heighten awareness of potential ethical and legal pitfalls when providing fertility care in the age of direct-to-consumer (DTC) ancestry tests. Legal issues and court cases against fertility clinics due to DTC ancestry testing were queried using the Nexis Uni (legal search engine of state and federal cases) and Google search engines. Local county courts were queried for court documents pertaining to specific cases. The following search terms were used: IVF, fertility, 23andMe, and Ancestry.com. Many DTC ancestry tests utilize microarray chips and look at hundreds of thousands of single nucleotide polymorphisms (snp’s) as a measure of genetic similarity, thus mapping customers to others in their database. Six legal cases were found filed between years 2018-2021. In 2019, a physician brought charges against a University IVF facility for misuse of sperm he had donated when he was a medical student. He donated sperm with the conditions that it would be used by women living outside the state and to father only five children. Through DTC ancestry testing, he later identified 19 individuals were conceived with his donated sperm and several of these individuals live in his community. This resulted in a high-profile case for breach of consent, and he sued the clinic for $5.25 million. The case is still ongoing. Another case resulted after a mother found a relative of her daughter’s sperm donor through a 23andMe DNA test. The mother made unwelcome contact to a relative of the anonymous sperm donor. The sperm bank sent the recipient a “cease-and-desist” letter stating she had violated the terms of their contract by contacting the family of the sperm donor and seized the remaining vials of the sperm she had purchased. The recipient sued the sperm bank, however in January 2020, the judge dismissed the woman’s claims and sided in favor of protecting the anonymity and rights of gamete donors. DTC ancestry testing has also revealed cases where reproductive endocrinologists have acted unethically and used their own sperm to inseminate patients without disclosure and informed consent. A woman brought eight causes of action against her parents’ fertility doctor in 2018 after using Ancestry.com DNA kit and finding out their doctor was her biological father. The charges include medical malpractice, lack of informed consent, fraud, battery, intentional infliction of emotional distress, negligent infliction of emotional distress, breach of contract, and violation of Idaho's Consumer Protection Act. The reproductive endocrinologist admitted that he breached the applicable standard of care when he inseminated his patient with his own semen. The trial is anticipated to begin May 17, 2021. With the rapid growth in popularity for DTC, donor anonymity can no longer be reasonably presumed. Individuals who are donor-conceived can more easily identify their biologic oocyte or sperm donors who intended to be anonymous.

A look at the gynecologic oncologist workforce – Are we meeting patient demand?

Objectiveto examine the geographic distribution of gynecologic oncologists (GO) and assess if the GO workforce is meeting the demand for oncology services for patients with gynecologic cancers. MethodsWe identified GO by National Provider Identifiers (NPI) and calculated county-level density of GO. County-level gynecologic cancer rates were derived from the U.S. Cancer Statistics to represent demand for GO services. A spatial data plot compared GO workforce to gynecologic cancer service demand. U.S. census county-level demographic information was collected and compared. ResultsIn 2019, 1527 GO had a registered NPI. Of 3142 counties in the US, 2864 (91.2%) counties had no GO in their local county and 1943 (61.8%) counties had no GO in local or adjacent (neighboring) counties. As the gynecologic cancer rate increases (described in quintiles) in counties, there are fewer counties without a GO or adjacent GO. However, county-level GO density (number of GO per 100,000 women) did not significantly increase as the county-level incidence of gynecologic cancer increased (r = −0.12, p = 0.06)… Women living in counties with the highest gynecologic cancer rates and without access to a GO were more likely to reside in a rural area where residents had a lower median income and were predominately of White race.. ConclusionThere are a significant number of counties in the U.S. without a GO. As county-level gynecologic cancer incidence increased, the proportion of counties without a GO decreased; GO density did not increase with increasing cancer rates. Rural counties with high gynecologic incidence rates are underserved by GO. This information can inform initiatives to improve outreach and collaboration to better meet the needs of patients in different geographic areas.

A national inventory and analysis of US transfer of development rights programs

Transfer of development rights (TDR) programs shift development intensity between land parcels. Jurisdictions, most commonly local municipal or county governments, employ TDR to protect resources such as farmland or historical properties and to encourage infill and redevelopment where deemed appropriate. However, while championed by economists and others seeking to reduce conflicts between land development and preservation, TDR program adoption has varied widely across the US. What demographic, economic, or environmental factors are associated with TDR program establishment? This paper describes a census of 375 TDR programs in the United States, documenting primary program attributes and adoption year and categorizing their functions and typology. Using logistic regression, we analyze program spatial patterns and factors predicting program implementation. We find that areas that are coastal, more liberal, have higher home values, in home-rule states, and in states with state-wide growth management programs, are all significantly more likely to implement TDR programs.

Exploring Race and Ethnicity Representational Inequities in Illinois Medical Schools.

Purpose: Efforts to increase U.S. medical school student diversity have lagged behind the continued growth of racial/ethnic minorities in the population. A targeted, local approach may catalyze actionable change that holds schools accountable for addressing community needs through representation. The aims of our study are to (1) analyze the student racial/ethnic profiles of allopathic and osteopathic medical schools in the diverse state of Illinois and (2) compare student race/ethnicity with that of schools' local county and primary teaching hospital patient populations.Methods: Data from the Association of American Medical Colleges and American Association of College of Osteopathic Medicine were used to gather matriculated student race/ethnicity from the eight allopathic schools and one osteopathic medical school in Illinois. Representational inequity quotients (RIQs) were calculated to determine the proportion of Hispanic/Latinx, black/African American, and total underrepresented in medicine (UIM) individuals in three reference populations (U.S., county, and primary teaching hospital patient populations) relative to each medical school's student racial/ethnic profile.Results: Across Illinois schools, mean RIQs were highest (showed greater inequity) when county demographics were used as the reference population as opposed to U.S. or hospital populations. For all schools individually, Hispanic county-student RIQs were higher than RIQs based on hospital population. For a majority of schools with primary teaching hospital in Cook County, hospital-student RIQs magnified representational inequity for the black population.Conclusions: Using county data to evaluate medical school representation inequities may better reflect UIM representation goals than the U.S. population. Examining hospital demographics may further reveal other structural inequities relevant to medical education, such as primary teaching hospitals that are not adequately serving their surrounding communities. By evaluating RIQs on a local and hospital-population level, schools can periodically assess to what degree their student body and hospital populations represent their communities and adjust recruitment, retention, and service efforts.

"TRUST IN PUBLIC INSTITUTIONS AND COMPLIANCE WITH MEASURES AGAINST COVID-19 PANDEMIC. CASE STUDY ON METROPOLITAN AREA OF CLUJ, ROMANIA"

The goal of this article is to analyze the level of citizens’ trust in different public institutions during the second wave of COVID-19 pandemic, and the influence of citizens’ trust on their compliance with the measures adopted to prevent the spread of the virus. The research was conducted between November and December 2020 on a sample of 700 residents of Metropolitan Area of Cluj, Romania. During the time of data collection, Romania registered the largest number of daily COVID-19 cases, therefore, citizens’ compliance with preventive measures was crucial to contain the spread of the virus. Citizens reported high levels of compliance with preventive measures. However, even though people were recommended to avoid meetings with relatives and friends, and participation to private events with large number of people, respondents reported that did not fully comply with social distancing requirements. Citizens have highest level of trust in the public institutions at local level, medical institutions and County Committees for Emergency Situations. The research found that trust in public institutions influences the compliance with preventive measures; however, the influence is weak and the trust in different institutions influences differently policy compliance.

Using a SLX Model to Examine the Impact of the Great Recession on Poverty in South Carolina

ABSTRACT In this paper, we employ a model using spatially lagged explanatory variables (SLX) to model poverty in the rural South – a region with large pockets of counties with persistent and high poverty. The SLX model allows for separation of spillovers from non-metro counties versus those from metro counties, something missing from the existing literature. We employ various economic and demographic variables to model poverty rates pre- and post-Great Recession. We also estimate separate models for non-metro counties and metro counties. There were no significant impacts from the local metro county before the recession and no significant local impacts in non-metro counties after the recession. Before the recession, factors from surrounding metro counties contributed greater impact on both non-metro and metro poverty. After the recession, there were more significant factors from surrounding non-metro counties that displayed a greater impact. The results suggest that poverty is unique across space and time. Poverty reduction programs should not only adopt a discretionary strategy that accounts for geographical variation, but also consider the timing of business cycles. Our research suggests a universal, all-encompassing strategy toward poverty may be less than ideal in the rural south.