Medicine and Health Commons^™

Higher Quality At Lower Cost: Community Health Worker Interventions In The Health Care Innovation Awards, Caitlin Cross-Barnet, Sarah Ruiz, Megan Skillman, Rina Dhopeshwarkar, Rachel Singer, Rachel Carpenter, Suzanne Campanella, Maysoun Freij, Lynne Snyder, Erin Colligan

Journal of Health Disparities Research and Practice

Background: Published evidence regarding cost savings, reduced utilization, and improved quality associated with employing community health workers (CHWs) is largely lacking. This paper presents findings from the Centers for Medicare & Medicaid Services Health Care Innovation Awards (HCIA), with a focus on six diverse programs that employ CHWs. We examine outcomes associated with programs incorporating CHWs into care teams for a broad age range of patients with various health issues such as cancer, asthma, and complex conditions.

Methods: This mixed-methods study used data from claims and site visits to assess the effectiveness of CHW programs. In difference-in-differences analyses of Medicare fee-for-service ...

A Modern Plague: U.S. Racial And Ethnic Vaccination Disparities During The 2009 H1n1 Influenza Pandemic, Andrew E. Burger

All Graduate Theses and Dissertations

On June 11, 2009 the World Health Organization announced that a novel strain of H1N1 influenza was being classified a Phase 6 pandemic, the highest level of alarm indicating that the disease was present worldwide and its spread was inevitable. While seasonal influenza epidemics occur annually, the 2009 H1N1 strain was the first novel pandemic influenza since the 1968 Hong Kong flu. The 2009 H1N1 pandemic provides a case study of how the U.S. population responded to an emergent and potentially lethal infectious disease. The richness and variety of public health data presents an opportunity to examine predictors of ...

Chinese Enclave Protections Among Married Chinese American Women: Exploratory Secondary Analysis Of Colon Cancer Survival, Luisa Kcomt, Kevin Gorey

Social Work Publications

Objective: Like the barrio advantage theory related to Mexican Americans, a theory about the protective effects of Chinese American enclaves is developing. Such protections were examined among socioeconomically vulnerable people with colon cancer.

Design: A colon cancer cohort established in California between 1995 and 2000, and followed until the enactment of the Affordable Care Act was utilized in this study. Secondary analysis was conducted on the 5-year survival among 127 Chinese Americans and 4524 other Americans (3810 non-Hispanic white and 714 Hispanic people). A third of the original cohort was selected from high poverty neighborhoods. Chinese American enclaves were neighborhoods ...

The "Give And Take" Of Medical Morality, Caitlyn Tabor

Honors Theses

Doctors face situations within the medical arena in which their conscience -- as a person and as a professional -- conflicts with patient autonomy. Consider the terminally ill patient who wishes to end all treatment and elect to receive assisted suicide, and his physician who believes that aiding in death is a moral wrong. This creates a conflict of interests between physician and patient.

Historically, a paternalistic model of physician-patient interaction was employed to deal with dilemmas, contributing to infringement of patient’s rights and a lack of understanding of ethics on the part of the physician. This manifests as the physician ...

El Impacto De Las Artes Visuales En Personas Afectadas Por Cáncer, Bettina Ingham

ICOT 18 - International Conference on Thinking - Cultivating Mindsets for Global Citizens

El impacto de las artes visuales en el bienestar y la mejora de la calidad de vida de personas afectadas por cáncer.

Un programa diseñado para poner en práctica e investigar el alcance que tienen las artes visuales y el método de Estrategias de Pensamiento Visual para el desarrollo de habilidades de pensamiento que promueven la identificación y expresión verbal de las emociones, minimizando, en el caso de las personas convalecientes, el sufrimiento que va desde el dolor de la enfermedad hasta el miedo a la muerte.

Los efectos que la contemplación (percepción estética), el análisis y la práctica(proceso ...

The Role Of Race And Economic Characteristics In The Presentation And Survival Of Patients With Surgically Resected Non-Small Cell Lung Cancer, John M. Varlotto, Kerrie Mckie, Rickie P. Voland, John C. Flickinger, Malcolm M. Decamp, Debra Maddox, Paul Rava, Thomas J. Fitzgerald, William Walsh, Paulo Oliveira, Negar Rassaei, Jennifer Baima, Karl Uy

Open Access Articles

Background: Little is understood regarding the inter-relation between economic, marital, and racial/ethnic differences in presentation and survival of surgically resected lung cancer patients. Our investigation will assess these differences in addition to known therapeutic, patient, and histopathologic factors.

Methods: A retrospective review of the Surveillance Epidemiology and End Reporting database was conducted through the years 2007-2012. The population was split into nine different ethnic groups. Population differences were assessed via chi-square testing. Multivariable analysis (MVA) were used to detect overall survival (OS) differences in the total surgical population (TS, N = 35,689) in an ear (T1-T2 < 4 cm N0) surgical population [early-stage resectable (ESR), N = 17,931]. Lung cancer-specific survival (LCSS) was assessed in the ESR.

Results: In the ...

Just Wrestle: How We Evolved Through Rough And Tumble Play, Rafe Kelley, Beth Kelley

Journal of Evolution and Health

No abstract provided.

Military Factors Associated With Smoking In Veterans, Sara E. Golden, Sujata Thakurta, Christopher G. Slatore, Hyeyoung Woo, Donald R. Sullivan

Sociology Faculty Publications and Presentations

Introduction: Given the high prevalence of smoking among Veterans and the economic, social, and clinical implications, it is important to understand the factors that contribute to smoking in order to focus efforts to mitigate these factors and improve smoking cessation efforts among Veterans. The availability of research on smoking in Veterans compared with civilians is limited given the military-specific differences in their life course. We aimed to identify military-specific factors combined with sociodemographic factors for ever smoking and current smoking among Veterans to inform future interventions. Materials and Methods: We used data from the 2010 National Survey of Veterans, the ...

Book Review: Surrogacy: A Human Rights Violation By Renate Klein, Sheela Saravanan

Dignity: A Journal on Sexual Exploitation and Violence

No abstract provided.

"I Was Not Sick And I Didn't Need To Recover": Methadone Maintenance Treatment (Mmt) As A Refuge From Criminalization, David Frank

All Dissertations, Theses, and Capstone Projects

Methadone Maintenance Treatment (MMT) has been undergoing a cultural and epistemological shift away from an approach that emphasized client stabilization and a reduction of social harms towards one grounded in values associated with the recovery movement. These changes include promoting a view of addiction grounded in the disease model as well as efforts to make abstinence and ancillary services such as recovery coaching/counseling, programs emphasizing proper citizenship, and concern for clients’ spirituality necessary parts of the program. As such, the increasing use of recovery as the dominant conceptual framework for MMT represents a change in how methadone, MMT, and ...

Pornography As A Public Health Issue: Promoting Violence And Exploitation Of Children, Youth, And Adults, Elisabeth Taylor

Dignity: A Journal on Sexual Exploitation and Violence

The pornography industry is expanding exponentially as a result of ongoing technological advances. The ability to stream videos over the internet and the ubiquity of the smart phone have meant that pornography producers are able to use algorithms to target potential consumers, to cultivate new sexual tastes and to deliver content to a more diverse audience over mobile devices. The advent of virtual reality pornography with interactive sex toys and sex robots imbued with artificial intelligence promises to unleash a further step-change in the extent to which pornography influences ‘real-world’ sexual culture. The critical analysis of pornography undertaken over decades ...

Constructing Illness: How Society Effects Physical And Mental Illness, Madeline Marks

Honors Theses

The social construction of illness has become one of the central themes in medical sociology over the last fifty years. This field of research focuses on how society and an individual’s knowledge and experiences shape the way they understand and view certain physical and mental illnesses. Prior research has found that many people hold stigmatized views towards individuals who suffer from mental illnesses and tend to feel more sympathetic and supportive towards those who have physical illnesses. These previous studies have found that gender, age, race, education and socioeconomic status are factors that influence how a person perceives physical ...

Policy Of Current Hospital Translation Services And Recommendations For Future Adjustments For Spanish-Speaking Patients, Isidora Rose Beach

University of Tennessee Honors Thesis Projects

No abstract provided.

Original Parts: Aging And Reckoning With Cystic Fibrosis Related Kidney Disease, Alexandra Ch Nowakowski

Patient Experience Journal

Kidney disease increasingly impacts people with cystic fibrosis (CF) as adult patients continue to survive longer. Yet the literature on CF related kidney disease focuses little on amplifying the voices of people aging with the condition. This article presents perspectives on CF related kidney disease from a medical sociologist who is themselves managing these issues. It (1) gives an overview of relevant literature and trends in epidemiological data on kidney disease and CF, (2) details the author’s own process of adjusting to progressive changes in renal function, and (3) outlines opportunities for clinicians to make a positive impact for ...

Where Trying To Conceive Becomes A Community Effort: A Digital Ethnography Of Online Infertility Forums, Megan Burns

Sociology Honors Papers

Online forums for women using in vitro fertilization (IVF), or similar assisted reproductive technologies (ARTs), provide a useful setting to further evaluate and understand women’s expectations of motherhood, the relationship infertile women have with physicians and biomedicine, and their interactions on the forums. Some critics of ARTs consider them a tool of oppression in a pronatalist state. The pressure and desire to become a biological mother leads the women with access to these technologies to use them regardless. Through digital ethnographic research on four online ART forums, this research examines the intersection of altruism and self-interest in the ways ...

The Experience Of Managing Type Ii Diabetes Among Indigenous Maya In The Western Highlands Of Guatemala, Nubia Ortega

Anthropology Senior Theses

As part of the Guatemala Health Initiative program, I spent ten weeks in the Western Highlands of Guatemala in one of the towns surrounding the lake region: Santiago Atitlan. My research question was among indigenous Maya who have been diagnosed with type II diabetes in the Western highlands of Guatemala, what is their experience with diagnosis, treatment, and management of type II diabetes?

With assistance from the Hospitalito Atitlan, the primary referral hospital in the region, I conducted semi-structured interviews with a purposive sample of 41 people with diabetes. Patients were recruited from diabetes clubs at different health centers and ...

Grief Off-The-Clock: Supporting Hospice Professionals Through Personal Loss, Rachel A. Guimond

Scholar Week 2016 - present

Working with clients who die can have a major impact on the way professionals address their own grief. Daily exposure to the possibility of death alters the process of mourning and can leave professionals feeling disconnected from family and friends during times of grief. This presentation will look at the challenges that hospice workers, clergy members, social workers and other professionals face when they experience grief in their own lives. Evidence-based strategies for supporting professionals in their grief will also be explored.

The Impact Of Prosthetics On Amputee Quality Of Life, Courtney Tabor

Liberal Arts Capstones

After someone has a limb amputated, their lifestyle must be rearranged to accommodate for the loss of the limb. This can include adjusting to an inability to do tasks that used to come easily and a drastic reduction in mobility. They may now require assistance with caring for themselves. As a side effect, amputees often experience a significant level of depression and anxiety related to their situation. A selection of literature was analyzed for the physiological, psychological, and sociological effects of losing a limb, and then for the ways in which a prosthetic limb would alleviate some of these issues ...

Allopathic Medicine’S Influence On Indigenous Peoples In The Kumaon Region Of India, Eliana M. Blum

Butler Journal of Undergraduate Research

This paper focuses on the use of western medicine in the Kumaon region of Uttarakhand, India. The goal of this research is to understand which healing practices are preferable in rural villages. Semi-structured interviews were conducted with 53 participants, including two spiritual healers, two doctors, and one pharmacist. Results indicate that allopathic medicine, otherwise known as modern medicine or western medicine, has become the go-to remedy for even the most remote people in India. Nearly all participants use allopathic medicine, but less than half of the participants experiment with other forms of healing, such as Ayurveda, homeopathy, meditation, and yoga ...

Accessing Healthcare In Ontario: Influences On Utilization Among Asian Immigrant Women, Gwynne Ng

Electronic Thesis and Dissertation Repository

Previous research on immigrant integration has tended to focus on economic and social integration. As such, the factors shaping health integration are less understood. At the same time, health researchers suggest that immigrants in Canada may underutilize certain health services. For instance, studies have documented the low participation rates of cervical cancer screening among Asian immigrant women in Canada (Xiong, Murphy, Matthews, Gadag, & Wang, 2010; McDonald & Kennedy, 2007; Woltman & Newbold, 2007). This study sheds light on immigrant integration by exploring the experiences of Asian immigrant women with cervical cancer screening and Canadian healthcare services more broadly. Through in-depth interviews, Asian immigrant women share their ...