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 …

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 …

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 …

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 …

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 …

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 …

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 …

Ethnic Differences In Medicinal Plant Use Among University Students: A Cross-Sectional Survey Of Self-Reported Medicinal Plant Use At Two Midwest Universities, Rachel Craft, Katrina C. Mcclure, Steven Corbett, Maria Pontes Ferreira, Ashley M. Stiffarm, Kelly Kindscher

Wayne State University Associated BioMed Central Scholarship

Background: Numerous surveys of medicinal plant use among college students abound, but none compare use between students enrolled in two different Universities with significantly different ethnic compositions. The objective of this study is to compare medicinal plant use between two different ethnic college populations and explore differences between student medicinal plant users and non-users for comparison with previous research.

Methods: Students (n = 721) at a large research university (n = 498) and a Pan-Tribal University for Native Americans (n = 233) completed surveys in October 2011 to assess past year medicinal plant use. The Mann-Whitney U test, Chi Square …

Allowing Patients To Waive The Right To Sue For Medical Malpractice: A Response To Thaler And Sunstein, Tom Baker, Timothy D. Lytton

Timothy D. Lytton

This essay critically evaluates Richard Thaler and Cass Sunstein’s proposal to allow patients to prospectively waive their rights to bring a malpractice claim, presented in their recent, much acclaimed book, Nudge: Improving Decisions about Health, Wealth and Happiness. We show that the behavioral insights that undergird Nudge do not support the waiver proposal. In addition, we demonstrate that Thaler and Sunstein have not provided a persuasive cost-benefit justification for the proposal. Finally, we argue that their liberty-based defense of waivers rests on misleading analogies and polemical rhetoric that ignore the liberty and other interests served by patients’ tort law rights. …

Factors Associated With Belief In Conspiracies About Hiv/Aids Among Hiv-Positive African-American Patients, Andrew A. Zekeri, Youssouf Diabate

Professional Agricultural Workers Journal

Abstract

The purpose of this study is to examine factors associated with belief in conspiracies about HIV/AIDS among HIV-Positive African American patients. Survey data were collected from 256 African American patients living with HIV/AIDS attending two HIV clinics in Montgomery and Dothan, Alabama. The study used multiple regression analysis to examine how sociodemographic factors contribute to belief in conspiracies about HIV/AIDS. Education and age were significantly related to belief in conspiracies about HIV/AIDS among men and women. Beliefs in conspiracies about HIV/AIDS may be a barrier to HIV prevention among African Americans. Public health officials should work toward obtaining the …

Health-Related Beliefs, Practices, And Experiences Of Migrant Dominicans In The Northeastern United States, Constance Sobon Sensor

Seton Hall University Dissertations and Theses (ETDs)

Purpose: This study aimed to discover and describe migrant Dominican cultural beliefs and practices related to health, the ways that migrant Dominicans take care of their health in their new environment, and their experience with professional health care in the Northeastern United States.

Design: This descriptive qualitative study was guided by Leininger’s Theory of Culture Care Diversity and Universality and four-phase analysis method. The health-related beliefs, practices and experiences of a convenience sample of 15 self-identified adult Dominicans living in the United States for six months or more were explored in three focus groups, assisted by trained culturally appropriate interpreters. …

"A Doula Can Only Do So Much": Birth Doulas And Stratification In United States Maternity Care, Kaylee S. Wolfe

Honors Projects

No abstract provided.

The Deaf Cyborg: Analyzing Technoscience, Gender, And Ability, Callahan Roan

Georgia State Undergraduate Research Conference

Gsurc 2015

“Can You Hear Me Now?”: Insurance Coverage For Hearing Benefits In The United States, Reegan Whipple

Annual Undergraduate Conference on Health and Society

Public and private insurance coverage for hearing benefits underscores the gaps in coverage for treating hearing loss in the U.S. The commodification of the hearing benefits sector of healthcare in this country has detrimental consequences for personal health. Using three personal anecdotes to frame the issue, my paper explores the complex worlds of both public and private insurance as well as the implications of each type of insurance for both adults and children. Current regulations and laws for hearing benefits leave many people to suffer financially, physically, and emotionally. After reviewing the current regulations I propose changes to rectify some …

The Impact Of Vaccine Hesitancy On The Polio Vaccine In South Asia, Leah Everist

Independent Study Project (ISP) Collection

A disease that paralyzes hundreds of children each year, polio is incurable but also entirely preventable through vaccination. Though part of the reason some children are not reached for immunization is that they are in areas too volatile for healthcare workers to access, vaccine hesitancy is increasingly being recognized as an important player. The objective of this study is to ascertain the degree to which vaccine hesitancy affects polio vaccine campaigns in Afghanistan and Pakistan, the countries in South Asia where polio continues to be endemic, to assess the drivers behind hesitancy in this region, and to present recommendations for …

Analysis Of Traditional Medicine In Zanzibar, Tanzania, Jessica Baylor

Independent Study Project (ISP) Collection

Traditional medicine is used as a major source of health care in developing countries. A small island off the coast of Tanzania, Zanzibar has traditional medicine embedded in its culture. Informal interviews of community members and healers in four different villages as well as interviews with the Department of Forestry and the Traditional and Alternative Medicine Unit were conducted over a four week study. This study found that community members of four villages in Zanzibar supported the idea of a regulation of traditional medicine by the government. It also found that the majority of traditional medicine users have noticed a …

Perceptions Of Potable Water In Rajasthan’S Jodhpur And Barmer Districts, Melissa Spross

Independent Study Project (ISP) Collection

This paper looks at differences and similarities in various populations’ perceptions of safe drinking water (SDW) within Rajasthan (RJ), India, developing suggestions for future initiatives addressing the movement for safe drinking water for all. For this study, surveys were used; the survey was conducted in RJ, India, both in urban Jodhpur and in surrounding rural villages. To analyze the data, all the responses were entered into Excel format to discover patterns, themes and trends within four subtopics: access, storage, quality and cultural significance. The responses indicate that while a distinct water culture spans the geographic area, each different population retains …

Confronting Cultural Challenges For Migrant Healthcare In Switzerland, Rebecca Weiss

Independent Study Project (ISP) Collection

Switzerland is home to many migrants, and migration exacerbates health risks. In addition to physical health problems, migrants are more likely than Swiss nationals to face mental health challenges and cultural barriers, which complicate their experiences seeking healthcare. Similarly, clinicians encounter numerous challenges related to the special circumstances of migrant patients. As a response to the specific health needs of migrants, hospital networks and migrant support organizations promote the migrant health situation. However, these services are not ubiquitous in Switzerland, partly due to the partial freedoms of each canton to create its own health policy. This paper explores the barriers …

Fighting The Obesity Epidemic: Challenges And Ethics, Grace Brown

Independent Study Project (ISP) Collection

In recent decades, a double burden of disease has emerged that requires public health workers to fight both hunger and obesity. The obesity epidemic is unlike other epidemics in that it is largely man-made and dependent on social factors and industry influences, making it difficult to fight. The high global prevalence of obesity is partially a result of globalization, which has encouraged development and the liberalizing of economies all around the world, which in turn has increased the marketing and consumption of obesogenic products. Policy solutions have been proposed and implemented in some countries, but an international solution has yet …

Accessing Healthcare: The Experience Of Individuals With Asd In Maine Report Summary, Alan Kurtz, Nancy Cronin

Health and Well-Being

A summary of report findings from the published research report, Accessing Healthcare: The Experience of Individuals with Autism Spectrum Disorders in Maine (2014).

Postcolonial Disability In Mohesen Makhmalbaf’S Kandahar, Sukshma Vedere

Ray Browne Conference on Cultural and Critical Studies

Kandahar (2001), an Iranian film directed by Mohsen Makhmalbaf, details the journey of the protagonist, Nafas, to Kandahar to save her sister from committing suicide on the day of the solar eclipse. The film has gained recent attention by disability studies scholars for the representation of disability in Afghanistan; scholars have discussed the significance of prosthetics and international aid for the disabled in post-war zones of the Third World, but little has been said about disability as a postcolonial embodiment. I argue that Kandahar represents the postcolonial state as a disabled space both literally and metaphorically. It projects the veil …

Law, Ethics, And Public Health In The Vaccination Debates: Politics Of The Measles Outbreak, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The measles outbreak of early 2015 is symptomatic of a larger societal problem–the growing number of parents who decide against vaccinating their children. This failure is causing the resurgence of childhood diseases once eliminated from the United States.

This article explores the legal and ethical landscape of vaccine exemptions. While all states require childhood vaccinations, they differ significantly in the types of religious and/or philosophical exemptions permitted, the rigor of the application process, and available review mechanisms. States with relaxed exemption policies disproportionately experience more outbreaks of vaccine-preventable disease.

Vaccine exemptions are an illustration of the “tragedy of the commons,” …

A Protocol For Eliciting Nonmaterial Values Through A Cultural Ecosystem Services Frame, Rachelle K. Gould, Sarah C. Klain, Nicole M. Ardoin, Terre Satterfield, Ulalia Woodside, Neil Hannahs, Gretchen C. Daily, Kai M. Chan

Rubenstein School of Environment and Natural Resources Faculty Publications

Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology. Stakeholders' nonmaterial desires, needs, and values often critically influence the success of conservation projects. These considerations are challenging to articulate and characterize, resulting in their limited uptake in management and policy. We devised an interview protocol designed to enhance understanding of cultural ecosystem services (CES). The protocol begins with discussion of ecosystem-related activities (e.g., recreation, hunting) and management and then addresses CES, prompting for values encompassing concepts identified in the Millennium Ecosystem Assessment (2005) and explored in other CES research. We piloted the protocol in Hawaii …

Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) are at increased risk of developing active tuberculosis (TB) and dying from TB. Isoniazid preventive therapy (IPT) can prevent this, but only a small fraction of HIV-positive individuals are on IPT. Previous research suggests that clinical decision support systems (CDSS)—electronic systems that use existing patient data and established algorithms to generate alerts, reminders, or recommendations intended to aid clinical decision-making—have the potential to improve provider adherence to diagnostic and treatment guidelines. Researchers conducted a cluster randomized controlled trial of a new CDSS intervention for TB screening, prevention, and treatment in a high HIV and TB …

A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman

HIV and AIDS

There is global consensus that transmission of HIV from mother to child can be eliminated. The Global Task Team, co-chaired by UNAIDS and the US Office of the Global AIDS Coordinator, has developed a global framework with the goal of eliminating new HIV infections among children (transmission rate of less than 5 percent) by 2015. Reaching the goal depends on optimal execution of each step in a complex cascade of activities, including testing and counseling for HIV, early attendance for antenatal care to optimize antiretroviral prophylaxis for prevention of mother-to-child transmission (PMTCT), adherence to the drugs, CD4 count testing, and, …

Uncovering Meanings Of Death, Trauma, And Loss As Experienced By Hospice Bereavement Coordinators: A Phenomenological Study, Rochelle S. Clarke

Department of Family Therapy Dissertations and Applied Clinical Projects

This study examined the experiences of Hospice Bereavement Coordinators (HBCs) and Hospice Chaplains working with grief narratives from patient-family units exhibiting signs of anticipatory or complicated grief. While a significant amount of research has been conducted on Hospice employees, no qualitative studies have examined the interpretation of meaning from employees whose primary role focused on the psychosocial-spiritual aspects of clients exhibiting anticipatory or complicated grief. The researcher identified shared meaning of death, trauma, and loss from six participants in the context of a high stress and high loss environment. This study‘s findings revealed ten central themes: Death is an earthly …

Understanding Factors Influencing Adverse Sex Ratios At Birth In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Md. Irfan Hossain, Forhana Rahman Noor

Poverty, Gender, and Youth

Nationally, the sex ratio at birth has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. However, at the regional level, Bangladesh is characterized by an east-west divide in sex ratios at birth. While the western region shows normal sex ratios at birth, the eastern region displays distorted sex ratios. To understand the factors that contribute to regional variations, a household survey was conducted among married women aged 18–49 years who had at least two living children. Views of health-care providers on gender-biased sex selection and of program implementers on …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

Um Só Currículo: Directrizes Para Uma Educação Integrada Em Sexualidade, Género, Hiv E Direitos Humanos, International Sexuality And Hiv Curriculum Working Group, Nicole Haberland, Deborah Rogow

Poverty, Gender, and Youth

Education on sexuality and HIV can help adolescents develop the capacity for healthy, respectful relationships and protect themselves from unwanted and unsafe sex, unintended pregnancy, and sexually transmitted infections. A 2015 Population Council study found that sexuality and HIV education programs that address gender and power in intimate relationships are five times more likely to be effective than programs that do not. However, most curricula still do not address these issues. “It’s All One Curriculum” provides a rationale, content, and sample activities for placing gender and rights at the center of sexuality and HIV curricula—both as stand-alone modules and integrated …