Medicine and Health Commons^™

Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke

Journal of Health Disparities Research and Practice

ABSTRACT

This study attempts to clarify the associations between macro-social and social network factors and continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL. The data included census-derived macro-social context, self-reported social network, self-reported demographic and medically abstracted health measures. Mortality data from the National Death Index (NDI) were used to determine 5-year survival ...

Disentangling The Effects Of Acculturation And Duration In The United States On Latina Immigrant Maternal Overweight And Macrosomia, Miguel Ceballos, Andrea Cantarero, Shanell Sanchez

Journal of Health Disparities Research and Practice

A significant body of research on minority health shows that while Latina immigrants experience unexpectedly favorable outcomes in maternal and infant health in the United States, this advantage deteriorates with increased duration of residency. This study assesses the relationship between excessively high birth weight (macrosomia), maternal weight, and length of residency in the United States. A sample of Mexican immigrant women living in two Midwestern communities in the United States is used to analyze the effects of duration in the United States, acculturation on birth outcomes, and maternal overweight once controlling for social, behavioral, and environmental mediators of health status ...

Allostatic Load Biomarker Associations With Depressive Symptoms Vary Among Us Black And White Women And Men, Ganga Bey, William M. Jesdale, Christine M. Ulbricht, Eric O. Mick, Sharina D. Person

Open Access Articles

The prevalence and severity of depression differ in women and men and across racial groups. Psychosocial factors such as chronic stress have been proposed as contributors, but causes of this variation are not fully understood. Allostatic load, a measure of the physiological burden of chronic stress, is known to be associated with depression. Using data from the National Health and Nutrition Examination Survey 2005(-)2010, we examined the associations of nine allostatic load biomarkers with depression among US black and white adults aged 18(-)64 years (n = 6431). Depressive symptoms were assessed using the Patient Health Questionaire-9; logistic models estimated ...

The Micro-Politics Of A New Mental Condition: Legitimization In Maladaptive Daydreamers' Discourse, Orit Bershtling Ph.D., Eli Somer Ph.D.

The Qualitative Report

This study illuminates legitimization efforts in the discourse of individuals who suffer from excessive, uncontrolled daydreaming: a contested mental condition that has not yet been recognized by the medical establishment. It aims to explore the rhetorical maneuvers employed by these “Maladaptive Daydreamers” in 35 email exchanges with the second author and two petitions, submitted to the American Psychiatric Association and to the UK Parliament, with a demand for recognition. Our analysis, anchored theoretically and methodologically in Critical Discourse Analysis, identified several verbal strategies employed by the participants to persuade their interlocutors about the realness of their suffering. The main strategies ...

Cumulative Childhood Adversity And Disparities In Adult Psychological Distress And Educational Attainment, Loanna Heidinger

Electronic Thesis and Dissertation Repository

Exposure to childhood adversity often does not occur as an isolated experience; rather, adverse childhood circumstances tend to co-occur, resulting in a climate of disadvantage that has detrimental consequences, and contributes to disparities in adult outcomes. Although the enduring impacts of cumulative childhood adversity on adult mental health and attainment outcomes are well documented in the literature, studies have not accounted for the long-term impact of cumulative childhood adversity on trajectories of adult psychological distress. Furthermore, measures of adversity used to predict selection into higher education consistently focus on childhood economic hardship as the sole indicator of adversity and overlook ...

The Role Of Primary Care Nurses In Addressing Unmet Social Needs, Susan Natale

Graduate School of Nursing Dissertations

PURPOSE

The purpose of this study was to explore how primary care registered nurses address unmet social needs in patients.

SPECIFIC AIMS

• Explore how RNs in a safety-net, primary care setting develop an awareness of and address patient's unmet social needs.
• Describe how information about unmet social needs are integrated into nursing assessment and intervention activities, and are shared with other members of the health care team.
• Describe the challenges primary care RNs face when addressing unmet social needs.

FRAMEWORK

Critical caring theory provided the framework for this study.

DESIGN

This study used a descriptive, qualitative design. Semi-structured interviews ...

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.

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.

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 ...

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 ...

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

Dignity: A Journal on Sexual Exploitation and Violence

No abstract provided.

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 ...

"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 ...

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 ...