Medicine and Health Commons^™

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …

Gender And Attitudes About Mental Health Help Seeking: Results From National Data, Douglas Wendt, Kevin Shafer

Faculty Publications

Men often express less emotion than women do, are hesitant to express weakness, and seek professional help much less frequently than do their female counterparts. The lack of help seeking is common across characteristics such as age, race, ethnicity, and nationality. Authors used data from the 2006 General Social Surveys mental health module to suggest that the gender gap in help seeking may be rooted in attitudes regarding help-seeking behaviors generally. Using structural equation modeling, we linked vignette type (depression and schizophrenia) to the endorsement of help seeking from informal and formal sources. Men showed similar support for informal help …

The Hidden Epidemic: Mental Health Epidemiology In Post-Conflict Populations And Implications For Conflict Transformation Practices, Jennifer Sato

Capstone Collection

This capstone explores the ramifications of unmitigated mental health illness in conflict populations, paying special attention to refugees and migrants. The intersection between conflict and mental health is explored and analyzed in order to highlight the implications of the findings and to make recommendations to both metal health and conflict transformation practitioners. This capstone depends predominately on secondary resources and personal interviews and is informed by my own practicum experience at a refugee health center. The need to improve mental health outcomes in order to pursue conflict transformation and peace building is a key focus and is supported by the …

Economic Status And Old-Age Health In Poverty-Stricken Myanmar, Bussarawan Teerawichitchainan, John Knodel

Research Collection School of Social Sciences

Objective: We examine the association between poverty, economic inequality, and health among elderly in Myanmar. Method: We analyze 2012 data from Myanmar’s first representative survey of older adults to investigate how health indicators vary across wealth quintiles as measured by household possessions and housing quality. Results: Poverty and poor health are pervasive. Self-assessed health, sensory impairment, and functional limitation consistently improve with higher wealth levels regardless of socio-demographic controls. Differentials in self-rated health and sensory impairment between the bottom and second quintiles are clearly evident, suggesting that relative economic inequality matters even among very poor elders and that a small …

To A Better Understanding Of Professional Practice: Provider Decision-Making When Delivering Hiv Services, Carizma Amila Chapman

Loma Linda University Electronic Theses, Dissertations & Projects

Over the last several decades an abundance of research has been conducted on HIV/AIDS. These studies have focused on the infection, impact of the disease on the health and quality of life of people living with the infection, and on treatment effectiveness. However, limited studies are available that explore the experiences of providers delivering HIV/AIDS services. Research demonstrates that providers have an important impact on treatment, shaping not only patient retention, but also treatment adherence. The critical role HIV/AIDS providers have in shaping treatment makes understanding provider experiences a pertinent area of inquiry to understand HIV/AIDS care. In this study, …

Using A New Evidence-Based Health Workforce Innovation Research Framework To Compare Innovations In Community Health Center And Other Ambulatory Care Settings, Leah E. Masselink, Patricia Pittman, Claire Houterman

Health Workforce Research Center Publications

In the United States, changing demographics, rising costs, and the impact of new regulations and payment models arising from the Affordable Care Act have placed unprecedented pressures on healthcare providers to increase access to care, improve quality and to control costs. To meet these challenges, some providers are forming accountable care organizations (ACOs) while others are pursuing medical homes or other novel payment and care delivery models designed to help meet these challenges. Within established organizations such as federally funded community health centers (CHCs), healthcare leaders are exercising significant latitude in developing innovative solutions for meeting their patients’ needs more …

Assessing The Deployment Of Home Visiting: Learning From A State-Wide Survey Of Home Visiting Programs, Robert L. Fischer, Elizabeth R. Anthony, Nina Lalich, Paul Bakaki, Siran Koroukian-Hajinazarian

Faculty Scholarship

Objectives: Large-scale planning for health and human services programming is required to inform effective public policy as well as deliver services to meet community needs. The present study demonstrates the value of collecting data directly from deliverers of home visiting programs across a state. This study was conducted in response to the Patient Protection and Affordable Care Act, which requires states to conduct a needs assessment of home visiting programs for pregnant women and young children to receive federal funding. In this paper, we provide a descriptive analysis of a needs assessment of home visiting programs in Ohio. Methods: All …

Association Between Childhood Sexual Abuse And Hiv-Related Risk Factors For Hiv-Positive Haitian Women, Marie Sandra Severe

FIU Electronic Theses and Dissertations

Childhood sexual abuse (CSA) is one of the least studied HIV-related risk factors in Haiti although research in the United States and Europe has clearly established the link between childhood trauma and HIV risk behaviors. Understanding the role and impact of CSA on HIV-positive Haitian women is likely to strengthen future HIV prevention and treatment efforts aimed at this vulnerable group.

The current study was a cross-sectional examination of baseline data collected during a randomized trial of a cognitive-behavioral stress management (CBSM) intervention in Haiti. The purpose of this study was to analyze the association between CSA and sexual risk …

Living Arrangements And Psychological Well-Being Of The Elderly After The Economic Transition In Vietnam, Ken Yamada, Bussarawan Teerawichitchainan

Research Collection School of Social Sciences

Objectives: We examine the relationship between living arrangements and psychological well-being of the older adults in Vietnam, where there is an influence of Confucian values and a lack of close substitutes for family care of the older adults, by exploiting a great deal of regional variation in economic development. We also examine the role of living arrangements in well-being differentials across regions. Method: We estimate a triangular simultaneous-equation discrete-response model, which accounts for the simultaneity between living arrangements and psychological well-being (happiness, depression, loneliness, poor appetite, and sleep disorder), using a nationally representative sample of 2,225 adults aged 60 and …

In Search Of Safety, Negotiating Everyday Forms Of Risk: Sex Work, Criminalization, And Hiv/Aids In The Slums Of Kampala, Serena Cruz

FIU Electronic Theses and Dissertations

This dissertation offers an in-depth descriptive account of how women manage daily risks associated with sex work, criminalization, and HIV/AIDS. Primary data collection took place within two slums in Kampala, Uganda over the course of fourteen months. The emphasis was on ethnographic methodologies involving participant observation and informal and unstructured interviewing. Insights then informed document analysis of international and national policies concerning HIV prevention and treatment strategies in the context of Uganda. The dissertation finds social networks and social capital provide the basis for community formation in the sex trade. It holds that these interpersonal processes are necessary components for …

Reproductive Rights In Latin America: A Case Study Of Guatemala And Nicaragua, Katherine W. Bogen

Scholarly Undergraduate Research Journal at Clark (SURJ)

A lack of access to contraceptives and legal abortion for women throughout the nations of Nicaragua and Guatemala creates critical health care problems. Moreover, rural and underprivileged women in Guatemala and Nicaragua are facing greater limitations to birth control access, demonstrating a classist aspect in the global struggle for female reproductive rights. Although some efforts have been made over the past half-century to initiate a dialogue on the failure of medical care in these nations to adequately address issues of maternal mortality and reproductive rights, the women's reproductive health movements of Nicaragua and Guatemala have struggled to reach an effective …

Identifying Missing Dictionary Entries With Frequency-Conserving Context Models, Jake Ryland Williams, Eric M. Clark, James P. Bagrow, Christopher M. Danforth, Peter Sheridan Dodds

College of Engineering and Mathematical Sciences Faculty Publications

In an effort to better understand meaning from natural language texts, we explore methods aimed at organizing lexical objects into contexts. A number of these methods for organization fall into a family defined by word ordering. Unlike demographic or spatial partitions of data, these collocation models are of special importance for their universal applicability. While we are interested here in text and have framed our treatment appropriately, our work is potentially applicable to other areas of research (e.g., speech, genomics, and mobility patterns) where one has ordered categorical data (e.g., sounds, genes, and locations). Our approach focuses on the phrase …

Characterizing The Google Books Corpus: Strong Limits To Inferences Of Socio-Cultural And Linguistic Evolution, Eitan Adam Pechenick, Christopher M. Danforth, Peter Sheridan Dodds

College of Engineering and Mathematical Sciences Faculty Publications

It is tempting to treat frequency trends from the Google Books data sets as indicators of the "true" popularity of various words and phrases. Doing so allows us to draw quantitatively strong conclusions about the evolution of cultural perception of a given topic, such as time or gender. However, the Google Books corpus suffers from a number of limitations which make it an obscure mask of cultural popularity. A primary issue is that the corpus is in effect a library, containing one of each book. A single, prolific author is thereby able to noticeably insert new phrases into the Google …

First Report Of The National Evaluation Of Rsvp Volunteers, Annie Georges, Susan Gabbard, Ashley Wendell Kranjac

Sociology Faculty Articles and Research

"In 2013, the Corporation for National and Community Service (CNCS) initiated a national evaluation of the Retired and Senior Volunteer Program (RSVP). The national evaluation was intended to collect the necessary information to better guide the RSVP program and to address three objectives: 1) describe the characteristics of RSVP volunteers, including how volunteers are distributed across CNCS’s performance measure categories, and how volunteers allocated their time to different service activities across the performance measure categories; 2) measure the relationship between volunteer characteristics, service activities, and volunteers’ psychosocial health; and 3) measure the impact of RSVP national service participation on volunteers’ …

Effects Of Skeletal Streetscape Design On Perceived Safety, Chester Harvey, Lisa Aultman-Hall, Stephanie E. Hurley, Austin Troy

College of Agriculture and Life Sciences Faculty Publications

It is important for planners and urban designers to understand how physical characteristics of urban streetscapes contribute to perceptions of them as safe, comfortable urban spaces. While urban design theory offers numerous suggestions for successful streetscapes there is meager empirical evidence of their effects. We suggest that this is largely due to precision and sample size limitations on audit-based physical design and human perception measurements. This paper overcomes these limitations by identifying a key set of "streetscape skeleton" design variables that can be efficiently measured using a GIS-based method. It then measures these variables on a large and diverse sample …

La Relación Entre El Desamparo Y La Salud: El Caso Del Campamento Japón En Santiago, Chile, Chaveli Concepción

Independent Study Project (ISP) Collection

En esta investigación se busca exponer más a fondo como la desigualdad social afecta la salud de aquellos que han sido menos favorecidos. En esta ocasión se analizó el caso de los habitantes del Campamento Japón, en la comuna de Maipú, de Santiago, Chile, con el objetivo de entender el fenómeno de la desigualdad social y cómo esta afecta la salud de las personas que la sufren. La metodología de este estudio cualitativo se constituyó de investigación bibliográfica previa, y posteriormente visitas y trabajos voluntarios al Campamento Japón para hacer observaciones y entrevistas a los activistas del campamento, a los …

Recursos Y Servicios Disponibles Para Personas Afectadas Por El Uso De Agroquímicos Tóxicos En Avia Terai, Chaco, Argentina / Resources And Services That Are Available To People Who Are Affected By The Use Of Toxic Agrochemicals In Avia Terai, Chaco, Argentina, David Andersen

Independent Study Project (ISP) Collection

Introducción: El Chaco es una provincia del norte de Argentina con los peores indicadores de salud y de menor ingreso. El estudio se desarrolló en Avia Terai, un pueblo que tiene cinco mil habitantes, está rodeado por cultivos que son fumigados con agroquímicos tóxicos y que tiene niveles muy altos de cáncer y de discapacidad. Muchas personas en Avia Terai trabajan con agroquímicos y viven cerca de los campos fumigados. La mayoría de las personas en el pueblo no tienen seguros de salud y usan el sector público. En el pueblo hay un Centro Integrador Comunitario (CIC), un hospital, dos …

From Curing Patients To Healing Society : The Honourable Dr. Edward Che-Hung Leong, Chun Kiu, Tony Lai, Wing Chung, David Chan

Asia Pacific Institute of Ageing Studies Newsletter 亞太老年學研究通訊

Dr. Edward Che-hung Leong, GBM, GBS, OBE, JP, a private medical practitioner specialised in urology, was born into a medical family. Leong is well-known to most Hong Kong people for his surgery skills. He has been praised as the "Golden Surgeon Leong" (金刀梁). He is also named the "Master of Public Office" (公職王). Since 1988, he has been a Legislative Councilor representing the Medical Functional Constituency, as well as many other public service roles of the Government and quangos, including Chairmanship of the Elderly Commission, in which his works were highly appraised. For years Doctor Leung has enthusiastically engaged in …

從「醫人」到「醫國」: 濟世為懷的梁智鴻醫生, Chun Kiu, Tony Lai, Wing Chung, David Chan

Asia Pacific Institute of Ageing Studies Newsletter 亞太老年學研究通訊

梁智鴻醫生 (GBM，GBS，OBE，太平紳士) 出身醫學世家，是醫術高超的私人執業泌尿科醫生。他手術技巧高超，素有「金刀梁」的綽號，是香港家喻戶曉的一位名醫。他同時是一名「公職王」，自1988年起擔任過立法會醫學界功能界別議員以及安老事務委員會主席等多項政府及不同半官方機構的公職，一直深受各界人士好評。梁醫生多年來熱心公益；為肯定其對社會的貢獻，政府先後向他頒授多個勳銜，包括太平紳士、金紫荊星章以及大紫荊勳賢。現時梁醫生的主要公職包括香港大學校務委員會主席以及安老事務委員會長者學院發展基金主席等。有説「醫有三品: 上醫 醫國，中醫醫人，下醫醫病」，梁醫生是如何從「醫人」到「醫國」呢？

Duration Of U.S. Stay And Body Mass Index Among Latino And Asian Immigrants: A Test Of Theoretical Pathways, Annie Ro, Georgiana Bostean

Sociology Faculty Articles and Research

Studies find that longer-term immigrants have higher body mass index (BMI) than their more recently-arrived counterparts. Most interpretations of these health patterns by duration of U.S. residence rely on theories of immigrant integration; they posit that with increasing time in the United States, immigrants incorporate economically, socially, and culturally into aspects of U.S. society, and that these changes impact health. Few studies empirically examine whether these aspects of integration are indeed mediators of the association between duration of U.S. stay and BMI, and if their patterns differ across immigrant subgroups. This study examines data from the National Latino and Asian …

If You've Seen One Worm, Have You Seen Them All? Spatial, Community, And Genetic Variability Of Tubificid Communities In Montana, Nilanjan Lodh, Donna M. Rizzo, Billie L. Kerans, Stephanie Mcginnis, Nikolaos Fytilis, Lori Stevens

College of Engineering and Mathematical Sciences Faculty Publications

Genetic studies are recognized increasingly as important for understanding naturally occurring disease dynamics and are used to predict host genetic diversity and coevolutionary processes and to identify species composition in ecological communities. Tubifex tubifex, the definitive host of the whirling disease parasite Myxobolus cerebralis, comprises 6 known lineages that vary widely in parasite susceptibility. We used 16S ribosomal DNA (16S rDNA) to identify relationships among genetic variability of 3 oligochaete genera (T. tubifex, Rhyacodrilus spp., and Ilyodrilus spp.; Oligochaeta:Tubificidae), oligochaete assemblage composition, and the presence of whirling disease in 9 locations across 4 watersheds in Montana, USA. We assessed genetic …

The Social Costs Of Gender Nonconformity For Transgender Adults: Implications For Discrimination And Health, Lisa R. Miller, Eric Anthony Grollman

Sociology and Anthropology Faculty Publications

Research suggests that transgender people face high levels of discrimination in society, which may contribute to their disproportionate risk for poor health. However, little is known about whether gender nonconformity, as a visible marker of one’s stigmatized status as a transgender individual, heightens trans people’s experiences with discrimination and, in turn, their health. Using data from the largest survey of transgender adults in the United States, the National Transgender Discrimination Survey (N = 4,115), we examine the associations among gender nonconformity, transphobic discrimination, and health-harming behaviors (i.e., attempted suicide, drug/alcohol abuse, and smoking). The results suggest that gender nonconforming trans …

Climate Change Sentiment On Twitter: An Unsolicited Public Opinion Poll, Emily M. Cody, Andrew J. Reagan, Lewis Mitchell, Peter Sheridan Dodds, Christopher M. Danforth

College of Engineering and Mathematical Sciences Faculty Publications

The consequences of anthropogenic climate change are extensively debated through scientific papers, newspaper articles, and blogs. Newspaper articles may lack accuracy, while the severity of findings in scientific papers may be too opaque for the public to understand. Social media, however, is a forum where individuals of diverse backgrounds can share their thoughts and opinions. As consumption shifts from old media to new, Twitter has become a valuable resource for analyzing current events and headline news. In this research, we analyze tweets containing the word "climate" collected between September 2008 and July 2014. Through use of a previously developed sentiment …

Socially Deviant Communities Online: How The Pro-Anorexia Movement Utilizes The Anonymity Provided By The Internet To Thrive, Samantha Thomas

Honors Theses

The creation of the internet has produced an environment in which many communities have been able to develop into strong and thriving societies. A large number of communities that are now predominantly online were unable to exist successfully before the establishment of the internet for a variety of reasons. The internet has made it easier for people from different backgrounds and locations to network, form communities, and share information with one another. Unfortunately the internet has also given harmful underground communities the opportunity to develop and thrive as well. Socially deviant communities, groups that support ideas and behaviors deemed unacceptable …

Zipfs Law Holds For Phrases, Not Words, Jake Ryland Williams, Paul R. Lessard, Suma Desu, Eric M. Clark, James P. Bagrow, Christopher M. Danforth, Peter Sheridan Dodds

College of Engineering and Mathematical Sciences Faculty Publications

With Zipfs law being originally and most famously observed for word frequency, it is surprisingly limited in its applicability to human language, holding over no more than three to four orders of magnitude before hitting a clear break in scaling. Here, building on the simple observation that phrases of one or more words comprise the most coherent units of meaning in language, we show empirically that Zipfs law for phrases extends over as many as nine orders of rank magnitude. In doing so, we develop a principled and scalable statistical mechanical method of random text partitioning, which opens up a …

Children's Mental Health Over The Early Life Course: The Impact Of Economic Resources, Neighborhood Disorder, And Family Processes, Jinette M. Comeau

Electronic Thesis and Dissertation Repository

Drawing upon a stress process and life course framework, and using data from the Child Supplement of the National Longitudinal Survey of Youth, the three papers presented in this dissertation examine the extent to which economic resources, neighborhood disorder, and family processes influence children’s trajectories of mental health.

In the first paper, I empirically construct six categories that represent children with comparable profiles of family income over time: increasing, decreasing, fluctuating, and stability across low-, medium-, and high-income families. The income categories are incorporated in multiple group latent growth curve models to assess the extent to which they initiate and …

Impacts Of Community-Based Natural Resource Management On Wealth, Food Security And Child Health In Tanzania, Sharon Pailler, Robin Naidoo, Neil D. Burgess, Olivia E. Freeman, Brendan Fisher

Rubenstein School of Environment and Natural Resources Faculty Publications

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-indifferences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than …

Many Eligible Children Don’T Participate In School Nutrition Programs; Reauthorization Offers Opportunities To Improve, Jessica A. Carson

The Carsey School of Public Policy at the Scholars' Repository

This brief uses data from the 2013 Current Population Survey’s Food Security Supplement to document levels of participation in two of the largest programs authorized by the Healthy, Hunger-Free Kids Act of 2010—the National School Lunch Program and the School Breakfast Program—by region and place type (rural, suburban, and city), to identify areas where expanding participation may be especially important. Author Jessica Carson reports that only 64 percent of eligible households participate in the National School Lunch Program, and 52 percent participate in the School Breakfast Program. Fifty-nine percent of eligible suburban households and 63 percent of rural households participate …

Notes From The Field: Lessons Learned From Using Ecosystem Service Approaches To Inform Real-World Decisions, Mary Ruckelshaus, Emily Mckenzie, Heather Tallis, Anne Guerry, Gretchen Daily, Peter Kareiva, Stephen Polasky, Taylor Ricketts, Nirmal Bhagabati, Spencer A. Wood, Joanna Bernhardt

Rubenstein School of Environment and Natural Resources Faculty Publications

While there have been rapid advances in assessments of biodiversity and ecosystem services (BES), a critical remaining challenge is how to move from scientific knowledge to real-world decision making. We offer 6 lessons from our experiences applying new approaches and tools for quantifying BES in 20 pilot demonstrations: (1) Applying a BES approach is most effective in leading to policy change as part of an iterative science-policy process; (2) simple ecological production function models have been useful in a diverse set of decision contexts, across a broad range of biophysical, social, and governance systems. Key limitations of simple models arise …

How Do Living Arrangements And Intergenerational Support Matter For Psychological Health Of Elderly Parents? Evidence From Myanmar, Vietnam, And Thailand, Bussarawan Teerawichitchainan, Wiraporn Pothisiri, Giang Thanh Long

Research Collection School of Social Sciences

Living arrangements and family support for older persons have become an increasingly important policy concern in developing and rapidly aging Asia. Formulating a sound elderly care policy for the region will benefit from empirically examining how living arrangements, particularly coresidence, and intergenerational exchanges of financial, instrumental, and emotional support are associated with old-age psychological health. This study analyzes data from nationally representative aging surveys in Myanmar, Vietnam, and Thailand for 2011-2012 to offer a comparative perspective from Southeast Asia where various kinship systems coexist. Results suggest that coresidence with a child of culturally preferred gender significantly improves the emotional health …