Medicine and Health Commons^™

Government Roles In Regulating Medical Tourism: Evidence From Guatemala, Ronald Labonté, Valorie A. Crooks, Alejandro Cerón, Vivien Runnels, Jeremy Snyder

Anthropology: Faculty Scholarship

Background: Regulation of the medical tourism and public health sectors overlap in many instances, raising questions of how patient safety, economic growth, and health equity can be protected. The case of Guatemala is used to explore how the regulatory challenges posed by medical tourism should be dealt with in countries seeking to grow this sector.

Methods: We conducted a qualitative case study of the medical tourism sector in Guatemala, through reviews and analyses of policy documents and media reports, key informant interviews (n = 50), and facility site-visits.

Results: Key informants were critical of the absence of effective public regulation …

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 …

Lovie: The Story Of A Southern Midwife And An Unlikely Friendship By Lisa Yarger (Review), Rebecca Adkins Fletcher

Rebecca Adkins Fletcher

No abstract provided.

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 …

A Longitudinal Examination Of Factors Associated With Network Bridging Among Ymsm: Implications For Hiv Prevention, Dexter R. Voisin

Faculty Scholarship

Social-environmental factors may be associated with social network stability, which has implications for HIV acquisition. However, the link between social-environmental factors, network composition and HIV risk has not been examined previously among a city-population based sample of young Black men who have sex with Men (YBMSM). Respondent driven sampling was used to recruit a cohort of 618 YMBSM. Respondents were evaluated at baseline, 9 and 18 months beginning June 2013. A logistic regression model was used to assess the relationship between bridging (i.e. having non-redundant contacts in one’s network, indicating network instability) and social-environmental factors and HIV risk factors between …

Impacts Of Forests On Children’S Diet In Rural Areas Across 27 Developing Countries, Ranaivo A. Rasolofoson, Merlin M. Hanauer, Ari Pappinen, Brendan Fisher, Taylor H. Ricketts

Rubenstein School of Environment and Natural Resources Faculty Publications

Micronutrient deficiency affects about a third of the world’s population. Children in developing countries are particularly vulnerable. Consequences include impaired cognitive and physical development and increased childhood morbidity and mortality. Recent studies suggest that forests help alleviate micronutrient deficiency by increasing dietary diversity. However, evidence is mostly based on weakly designed local case studies of limited relevance to global policies. Furthermore, impacts of forests on diet vary among communities, and understanding this variation can help target actions to enhance impact. We compile data on children’s diets in over 43,000 households across 27 developing countries to examine the impacts of forests …

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 …

Influence Of Physicians’ Beliefs On Propensity To Include Religion/Spirituality In Patient Interactions, Aaron B. Franzen

Faculty Publications

This study examines physicians’ beliefs, their perceptions of whether religion impacts health outcomes, and their propensity to discuss religion/spirituality with patients. It is not uncommon for patients to want religious/spiritual conversations, but the occurrence is infrequent. This study adds to knowledge regarding which physicians include these topics. Using a nationally representative sample of physicians and a mediated bi-factor structural equation model, the author finds that “religious and spiritual” physicians connect religion and patient health more than other religious/spiritual orientations. As a result, “religious and spiritual” physicians include religion/spirituality most often (indirect path). After this variation is accounted for, “spiritual but …

A Military Chronic Pain Interdisciplinary Outpatient Program’S (Iop) Approach To Reducing Pain And Disability And Increasing Functional Ability, Paris N. Mcdonald

USC Aiken Psychology Theses

The present study employed self-report measures to assess pain intensity, self-report perception of disability, and patient activation, and objective functional measures to explore the outcomes of a military interdisciplinary chronic pain intensive outpatient program. Seventy-three Active Duty Service Members (SM) with chronic pain completed baseline measures (pre-IOP) and graduation day measures, 60 SMs completed one-month follow-up measures, and 28 completed three-month follow-up measures. Results indicated that self-report pain levels decreased from pre-IOP to graduation day. The decrease was maintained; however, no additional significant decrease in pain occurred following program completion. Further, participant’s self-reported perception of disability due to back pain …

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

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

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 vaccination …

Doctors As Migration Brokers In The Mandatory Medical Screenings Of Immigrants To The United States, Sofya Aptekar

Publications and Research

Applicants for legal permanent residency in the United States are required to pass a medical screening. Most of these applicants are already living in the United States on non-immigrant and temporary visas and are screened by civil surgeons, physicians designated by the government to look for infectious diseases, incomplete immunization records, and signs that the immigrant will pose a threat or become a public charge. Little is known about the work of these 4000+ physicians, who play a key role as migration brokers in a context where migration control has devolved to non-state actors. I present quantitative analysis of a …

Continuum Rich-Get-Richer Processes: Mean Field Analysis With An Application To Firm Size, David Rushing Dewhurst, Christopher M. Danforth, Peter Sheridan Dodds

College of Engineering and Mathematical Sciences Faculty Publications

Classical rich-get-richer models have found much success in being able to broadly reproduce the statistics and dynamics of diverse real complex systems. These rich-get-richer models are based on classical urn models and unfold step by step in discrete time. Here, we consider a natural variation acting on a temporal continuum in the form of a partial differential equation (PDE). We first show that the continuum version of Simon's canonical preferential attachment model exhibits an identical size distribution. In relaxing Simon's assumption of a linear growth mechanism, we consider the case of an arbitrary growth kernel and find the general solution …

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 …

Mandatory Labels Can Improve Attitudes Toward Genetically Engineered Food, Jane Kolodinsky, Jayson L. Lusk

College of Agriculture and Life Sciences Faculty Publications

The prospect of state and federal laws mandating labeling of genetically engineered (GE) food has prompted vigorous debate about the consequences of the policy on consumer attitudes toward these technologies. There has been substantial debate over whether mandated labels might increase or decrease consumer aversion toward genetic engineering. This research aims to help resolve this issue using a data set containing more than 7800 observations that measures levels of opposition in a national control group compared to levels in Vermont, the only U.S. state to have implemented mandatory labeling of GE foods. Difference-in-difference estimates of opposition to GE food before …

Gaining And Maintaining A Competitive Edge: Evidence From Csa Members And Farmers On Local Food Marketing Strategies, Emily H. Morgan, Michelle M. Severs, Karla L. Hanson, Jared Mcguirt, Florence Becot, Weiwei Wang, Jane Kolodinsky, Marilyn Sitaker, Stephanie B.Jilcott Pitts, Alice Ammerman, Rebecca A. Seguin

College of Agriculture and Life Sciences Faculty Publications

Community-supported agriculture (CSA) is a widely-used approach for farmers to sell directly to consumers. We used the product, place, price, and promotion (4P) marketing mix framework to examine characteristics that help farms offering CSA maintain member satisfaction and thus competitiveness. We conducted semi-structured interviews with 20 CSA members and 24 CSA farmers in four states. CSA members additionally completed a modified choice experiment. Qualitative data were coded iteratively, and choice experiment data were summarized and compared across scenarios. CSA members and farmers were motivated by a range of personal, social, environmental, and economic objectives. Members favored high-quality staple vegetables (e.g., …

The Social Provision Of Healthcare To Migrants In The Us And In China, Van C. Tran, Katharine M. Donato

Publications and Research

This article develops a comparative analysis of healthcare provision to migrants in the US and in China. It proceeds in three parts. First, we begin by describing the growth of the unauthorized population and trace the evolution of social provision of healthcare to immigrants, highlighting the restrictive nature of federal social provisions and greater autonomy of state and local governments in redefining eligibility criteria in the US. Second, we examine the impact of legal status on healthcare access and utilization among Mexicans, using original data from the 2007 Hispanic Healthcare Survey and the Mexican Migration Project. We find that unauthorized …

Measuring Women's Empowerment In Sub-Saharan Africa: Exploratory And Confirmatory Factor Analyses Of The Demographic And Health Surveys, Ibitola O. Asaolu, Halimatou Alaofè, Jayleen K. L. Gunn, Akosua K. Adu, Amanda J. Monroy, John E. Ehiri, Mary H. Hayden, Kacey C. Ernst

Epidemiology and Environmental Health Faculty Publications

Background: Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA.

Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, …

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 …

Long-Term Care Needs In The Context Of Poverty And Population Aging: The Case Of Older Persons In Myanmar, Bussarawan Teerawichitchainan, John Knodel

Research Collection School of Social Sciences

Myanmar is one of the poorest and least healthy countries in Southeast Asia. As elsewhere in the region, population aging is occurring. Yet the government welfare and health systems have done little to address the long-term care (LTC) needs of the increasing number of older persons thus leaving families to cope on their own. Our study, based on the 2012 Myanmar Aging Survey, documents the LTC needs of persons aged 60 and older and how they are met within the context of the family. Nearly 40% of persons in their early 60s and 90% of those 80 and older reported …

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 creativo) …