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Why We Must Provide Better Support For Pakistan's Female Frontline Health Workers, Svea Closser, Rashid Jooma

Section of Neurosurgery

Svea Closser and Rashid Jooma argue that achieving polio eradication and strengthening Pakistan's health system must focus not just on international engagement but also on local partnerships with Lady Health Workers and other ground-level staff. Please see later in the article for the Editors' Summary.

Prevention Of Type 2 Diabetes In Urban American Indian/Alaskan Native Communities: The Life In Balance Pilot Study, Daniel C. Benyshek, Michelle Chino, Carolee Dodge-Francis, Toricellas O. Begay, Hongbin Jin, Celeste Giordano

Environmental & Global Health Faculty Research

Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years; BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) < 6.4 percent (46 mmol/mol) participated in the program between April and December, 2011. Study participants completed a 16 week intensive lifestyle coaching intervention. In addition to obtaining qualitative data regarding opportunities and challenges of applying the lifestyle intervention for AI/AN participants in an urban setting, clinical data, including BMI, waist circumference, blood pres- sure, fasting blood glucose, and blood lipids (HDL, LDL and Triglycerides), were collected. Results: Only 12 of the 22 participants remained in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was ob- served in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.

El Estigma De La Depresión Y Cómo Está Influenciado Por La Percepción De La Enfermedad En Santiago, Chile, Elena Michaels

Independent Study Project (ISP) Collection

Over the past century, as a greater understanding has been developed regarding the brain and mental health disorders, a stigma surrounding the field of mental health has emerged. The goal of this study was to analyze how the public perception of depression relates to the stigma surrounding mental illness and define the relationship between the two. This investigation took place at the Pontifical Catholic University of Chile in Santiago.

In Chile, one of the consequences of the stigma regarding mental health disorders is usage of the mental health services offered. Not uncommonly, a medic would give a mental health evaluation …

Illuminating Rlung: The Vital Energy Of Tibetan Medicine, Alma Rominger

Independent Study Project (ISP) Collection

According to Tibetan Medicine, rlung is one of the three principal energies of the human body; rlung can be translated loosely as “wind” because its predominate element is air. It is responsible for all movement internal and external to the body, from the circulation of blood to the movement of limbs. rLung is the “vehicle” of consciousness, the force which holds and moves the mind. According to the rGyud-bZhi, the traditional Tibetan medical text, rlung is the beginning and end of disease because of its pervasive nature and its close relationship with the mind; it has the power to spread …

Los Determinantes De La Diferencia En La Tasa De Fecundidad Adolescente Entre Comunidades Pobres Y Ricas En Buenos Aires, Emily Turner

Independent Study Project (ISP) Collection

The city of Buenos Aires has some of the lowest rates of teenage fertility in Argentina (Gogna, Binstock, Fernández, Ibarlucía, & Zamberlin, 2008). However, this aggregated number obscures the huge variance within the city. In the most current available data (2010/2012) from the government of the city of Buenos Aires (GCBA) broken down by comunas (areas) highest fertility rate for 15-19 year olds was 81.6 births (per 1000) versus the lowest fertility rate which was only 6.2 (D. d. e. d. GCBA). This discrepancy is huge and reflects the incredible economic disparity in Buenos Aires. The comunas with the three …

Ndank-Ndank: How Governmental Health Organizations Can Take Their First Step To Help Other’S Take Their First Step: A Case Study Of A Prosthetics And Orthotics Rehabilitation Center In Dakar, Senegal, Sarah Jacobi

Independent Study Project (ISP) Collection

The number of people with disability in the world is very large, however; what having a disability means for each person is even more alarming. In a developing country, it is extremely difficult for people with disabilities to receive the health care they need. The organizations that offer health care to people with disabilities are faced with a number of challenges; but they continue to do the best they can. This study was done at a prosthetics and orthotics rehabilitation center in Dakar, Senegal. It is a case study that examines the difficulties the workers face, the motivations the workers …

Public Perceptions On Family Planning And Birth Spacing In The Cultural And Religious Context Of Senegal: A Case Study In Dakar, Senegal, Heidi Kahle

Independent Study Project (ISP) Collection

Much prior research has examined the prevalence rates of family planning and contraceptive use in Senegal, as well as the importance of family planning for reducing maternal and infant mortality, improving the well being of families, and improving the national economy. Few studies, though, have captured the perspectives of Senegalese persons and their attitudes and beliefs toward family planning, rumors and stigmas that surround it, and how different actors can work together to dispel rumors and encourage the use of family planning. I conducted my research in Dakar, Senegal, where I interviewed a variety of persons – two gynecologists, a …

Jordanian University Student’S Attitudes And Perceptions On Mental Health, Amira Khablein

Independent Study Project (ISP) Collection

The present study examines the attitudes and perceptions of students at a private, Jordanian University to examine, through surveys, interviews and a focus group whether the stigma commonly associated with mental health in the Middle East and North African region persists for students and the reasons behind this stigma. It was also investigated what kind of disorders came to mind when asked to name specifics to see if students focused on the illness of psychological disorders when weighing mental health. It was found that the stigma does not necessarily exist for students, though it is perpetuated throughout the community and …

Jordanian Ethical Perceptions Of Preimplantation Genetic Diagnosis, Sarah C. Miller

Independent Study Project (ISP) Collection

Preimplantation Genetic Diagnosis (PGD) is a procedure that can be done during In Vitro Fertilization (IVF), involving genetic and chromosomal screening of fertilized embryos prior to implantation into a woman’s uterus. After PGD, only the embryos possessing the desired characteristics are implanted, while the other embryos are frozen for future use, or discarded. PGD is used for family balancing (gender selection for balancing the gender dynamic within a family), gender selection to screen out sex-linked diseases, or a broader genetic screening for diseases known to be present in the patient’s family history.

Many ethical questions have been raised about PGD, …

Hiv/Aids In Yunnan Province: A Study Of Stigma And Support, Sofia Haile

Independent Study Project (ISP) Collection

I conducted a qualitative study on the ability of peer-HIV-support groups in Kunming, China to lessen the effects stigma. There is a lack of quantitative studies of stigma in Yunnan, and no studies that address the ability of Kunming peer-groups to lessen the effects of stigma. Over the course of one month, I collected data via questionnaire, individual interviews, group interviews, and scholarly research. My study had sixteen participants (five female sex workers, seven former intravenous drug users, and four men who have sex with men).

My scholarly research revealed that peer-groups are an effective way to: disseminate knowledge to …

Nurturing The Whole Body: The Benefits Of Supplementing Tuberculosis Chemotherapy With Traditional Chinese Medical Practices, Rachel Levine

Independent Study Project (ISP) Collection

Although modern medicine has found a cure for Tuberculosis (TB), it remains a worldwide health threat. Due to poor adherence to TB chemotherapya multi-drug resistant strain of the TB bacteria (MDR-TB) has been created.It has been found that poor adherence is caused by many factors, two of which include the high cost of treatment and the many uncomfortable side effects. Through a month of research based in Kunming, China including interviews, observations and surveys,this project hoped to compare Western biomedicine and Traditional Chinese Medicine (TCM) to determine the potential benefits TCM holds for TB patients. TCM improves a TB patient’s …

Adolescents And Parents' Perceptions Of Best Time For Sex And Sexual Communications From Two Communities In The Eastern And Volta Regions Of Ghana: Implications For Hiv And Aids Education, Emmanuel Asampong, Joseph Osafo, Jeffrey Bingenheimer, Clement Ahiadeke

Prevention and Community Health Faculty Publications

Background

Adolescents and parents’ differ in their perceptions regarding engaging in sexual activity and protecting themselves from pregnancy and sexually transmitted infections (STIs). The views of adolescents and parents from two south-eastern communities in Ghana regarding best time for sex and sexual communications were examined.

Methods

Focus Group interviews were conducted with parents and adolescents (both In-school and Out-of school) from two communities (Somanya and Adidome) in the Eastern and Volta regions of Ghana with epidemiological differentials in HIV infection.

Results

Findings showed parents and adolescents agree that the best timing for sexual activity amongst adolescents is determined by socioeconomic …

Parental Height And Child Growth From Birth To 2 Years In The Who Multicentre Growth Reference Study, Cutberto Garza, Elaine Borghi, Adelheid W. Onyango, Mercedes De Onis, Edward A. Frongillo Jr.

Faculty Publications

inear growth from birth to 2 years of children enrolled in the World Health Organization Multicentre Growth Reference Study was similar despite substantial parental height differences among the six study sites. Within-site variability in child length attributable to parental height was estimated by repeated measures analysis of variance using generalized linear models. This approach was also used to examine relationships among selected traits (e.g. breastfeeding duration and child morbidity) and linear growth between 6 and 24 months of age. Differences in intergenerational adult heights were evaluated within sites by comparing mid-parental heights (average of the mother's and father's heights) to …

Study Of Brief Single Session Medical Family Therapy With Low-Income Patients, Mayuri Pandit

Loma Linda University Electronic Theses, Dissertations & Projects

Medical Family Therapy (MedFT) has been promoted as beneficial for vulnerable patient populations. However, there is a need for MedFT effectiveness studies with longitudinal randomized control trials. Thus, this pilot study investigated the results of a brief single session of MedFT over a one-week period with low-income primary care patients. Effectiveness in this study was defined as increasing a sense agency and communion and decreasing psychological distress. Results suggested that over time, MedFT may increase some sense of agency for lower-income patients, increase patient satisfaction with care, increase family support for patients with higher education, and decrease depression symptoms for …

Parasitism Of The Zweeloo Woman: Dicrocoeliasis Evidenced In A Roman Period Bog Mummy, Nicole Searcey, Karl Reinhard, Eduard Egarter-Vigl, Frank Maixner, Dario Piombino-Mascali, Albert R. Zink, Wijnand Van Der Sanden, Scott Gardner, Raffaella Bianucci

School of Natural Resources: Faculty Publications

We undertook the analysis of Zweeloo Woman, a bog mummy from the Netherlands, to assess her parasitic state. Evidence of infection came from two areas: (1) liver paraffin sections and (2) microfossils washed from an intestinal section. Although the liver had shrunken considerably, objects consistent with operculated trematode eggs were found. After evaluating the range of trematode species that produce eggs in liver tissue, we arrived at the diagnosis of Dicrocoelium dendriticum. Although only 0.1 ml of sediment was recovered from an intestinal section, eggs of Ascaris lumbricoides and Trichuris trichiura were also identified. No eggs of D. dendriticum were …

Deficiencies: Mental Disability And The Imagination In Scott's Waverley Novels, Colin Carman

Studies in Scottish Literature

Argues that Walter Scott's novels, especially Waverley and The Heart of Midlothian, represent a shift in Anglo-scottish attitudes towards the mentally ill, and that mental disability, operating in Scott's novels under the guises of idiocy and insanity, was integral to Scott’s articulations of the romantic imagination.

Shared Learning In An Interconnected World: Innovations To Advance Global Health Equity, Agnes Binagwaho, Cameron T. Nutt, Vincent Mutabazi, Corine Karema

Dartmouth Scholarship

The notion of "reverse innovation"--that some insights from low-income countries might offer transferable lessons for wealthier contexts--is increasingly common in the global health and business strategy literature. Yet the perspectives of researchers and policymakers in settings where these innovations are developed have been largely absent from the discussion to date. In this Commentary, we present examples of programmatic, technological, and research-based innovations from Rwanda, and offer reflections on how the global health community might leverage innovative partnerships for shared learning and improved health outcomes in all countries.

Health Disparity And Structural Violence: How Fear Undermines Health Among Immigrants At Risk For Diabetes, Janet Page-Reeves, Joshua D. Niforatos, Shiraz Mishra, Lidia Regino, Andrew Gingerich, Robert Bulten

Journal of Health Disparities Research and Practice

Diabetes is a national health problem, and the burden of the disease and its consequences particularly affect Hispanics. While social determinants of health models have improved our conceptualization of how certain contexts and environments influence an individual's ability to make healthy choices, a structural violence framework transcends traditional uni-dimensional analysis. Thus, a structural violence approach is capable of revealing dynamics of social practices that operate across multiple dimensions of people’s lives in ways that may not immediately appear related to health. Working with a Hispanic immigrant community in Albuquerque, New Mexico, we demonstrate how structural forces simultaneously directly inhibit access …

Resilience And Syndemic Risk Factors Among African-American Female Sex Workers, Mance E. Buttram, Hilary L. Surratt, Steven P. Kurtz

CAHSS Faculty Articles

Research on street-based female sex workers documents a multitude of problems faced by these women, such as substance use, HIV risk, mental health problems, victimization, and homelessness. The presence of problems such as these is understood as a syndemic, or co-occurrence of two or more risk factors that act synergistically to create an excess burden of disease. However, the syndemic framework has not previously incorporated the examination of resilience to understand what protective factors enable female sex workers to cope with syndemic risk. Using 562 baseline interviews from street-based African-American female sex workers enrolled in a randomized intervention trial, this …

The Stress Revolution: An Examination Of Acculturative Stress And An Emerging Modern Human Stress Response, Jeffrey Nicklas

Social Sciences

In a world that is so fast pace and always changing, the human biological systems have need to adapt just as swiftly. WIth the dependence on culture that humans all share has led to the building of societies with complex rules, ideals, and accepted roles and ways of life. In these complex societies, great cities and governments have arisen but so too have unnoticed changes to human biology. One of these changes is with environmental stressors and the effects it has on the nervous system. The human body, in these modern times, still responds to perceived stressors with the release …

The Effects Of A Moisture-Wicking Fabric Shirt On The Physiological Responses During Acute Exercise In The Heat, Kimberly Wigboldy

Masters Theses

The purpose of this study is to investigate the effects that a form fitted, moisture-wicking fabric shirt, promoted to have improved evaporative and ventilation properties, has on the thermoregulatory, physiological and perceptual response during moderate intensity exercise in the heat for an extended duration of exercise of 90 minutes. Ten healthy subjects (7 males, 3 females), completed two heat stress tests consisting of 20 minute seated rest in a neutral environment (24°C, 60% RH), 30 minute seated rest in a hot environment (33°C, 60% RH), and 90 minutes of exercise(50% V0_{2 peak}) on a magnetically-braked cycle ergometerin a …

Barriers To Depression Treatment Among Low-Income, Latino Emergency Department Patients, Anjanette A. Wells, Isabel T. Lagomasino M.D., Lawrence A. Palinkas, Jennifer Green, Diana Gonzalez Msw

Brown School Faculty Publications

Objectives. Low-income and Latinos use the emergency department (ED) as a primary source of care. Also, the depression prevalence in ED patients is high, making the ED a compelling venue for depression screening and intervention. This study examined barriers and facilitators to depression treatment among low-income, predominantly Latino ED patients. Methods. We conducted telephone interviews with 24 ED patients (18-62 years of age, 79% female) who dropped out of a depression treatment intervention. Using grounded theory, we analyzed perceptions of depression and treatment, and barriers and facilitators to mental health treatment. Results. Although most patients acknowledged signs of depression, there …

Is Health Diplomacy Keeping Pace With Global Health Developments? Implications For Access To Medicines Strategies In The Post-2015 Mdg Framework, Samantha Ski, Rachel Kiddell-Monroe, James M. Sherry

Global Health Faculty Publications

As the 2015 deadline to achieve the Millennium Development Goals (MDGs) draws near, efforts to ensure access to essential medicines face new challenges in light of new resource constraints. To help assess those challenges, a summary analysis of published data was undertaken to examine the increasing discontinuity between the geographic focus of donor-country programs on low-income countries (LICs) and the geographic location of the increasing majority of the poor and the global burden of preventable disease within middle-income countries (MICs). This disconnect has put new pressure on both donor and government resources for essential medicines, prompting greater consideration of strategies …

Humanitarianism And The Anthropology Of Hunger, Kate Klein

Undergraduate Theses—Unrestricted

While the early view of hunger as the product of a world population too large to sustain has largely been eliminated, and the mainstream international community has come to accept that food insecurity results from issues of distribution rather than an insufficient global food supply, the emphasis on biotechnology in agriculture, humanitarianism in international aid, and social justice in international human rights law in the contemporary era has contributed to other barriers that prevent hunger alleviation.

In this thesis, I argue that these previous contemporary developments have had the capacity to hide hunger. My analysis of technology and humanitarian aid …

Preventative Care And Culture, Anna Wagman

Independent Study Project (ISP) Collection

This paper explores the intersection between culture and health. The similarities and differences between methods for preventative medicine employed by traditional and allopathic systems are discussed. These ostensibly disparate systems, in reality, display many parallels in regards to their delivery. The effects of industrial progress, and therefore cultural change, on the health of the inhabitants of rapidly urbanizing African cities are examined. Historical information from studies of Great Britain, the first area to undergo a full industrial revolution is also drawn on. These analyses essentially predict the societal issues that come with urbanization, such as the amalgamation of preexisting pollutants …

Christian Villanueva - Trauma Exposure Reported By Women Recently Deported From The U.S. To Mexico, Christian Villanueva

Ronald E. McNair Scholars Program 2013

In 2012 the U.S. deported approximately 200,000 individuals to Mexico; a significant proportion of these individuals were women. The combined effect of previous traumatic experiences with that of being deported to Mexico is detrimental to women’s health. The trauma suffered through this process results in high levels of stress that lead to a variety of mental and physical health problems for Mexican women, disproportionally compared to men, who entered into and are deported from the U.S. The purpose of this study is to describe the life history of trauma exposure of women who have recently been deported from the U.S. …

Alcohol In The Life Narratives Of Women: Commonalities And Differences By Sexual Orientation, Laurie A. Drabble, K. Trocki

Faculty Publications

Aim: The aim of this study was to explore social representations of alcohol use among women, with a focus on possible differences between sexual minority and heterosexual women. Methods: This qualitative study was part of a larger study examining mediators of heavier drinking among sexual minority women (lesbian identified, bisexual identified, and heterosexual identified with same sex partners) compared to heterosexual women based on the National Alcohol Survey. Qualitative in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey, including respondents representing different sexual orientation groups. Questions explored the …

I'M A Patient, Not A Problem: An Exploration Into The Roles Assigned In The Doctor-Patient Relationship, Monica C. Stewart

Honors Theses and Capstones

No abstract provided.

Visual Activity Evoked By Infrared In Humans After Dark Adaptation, Leslie Olivia Hopkins

Biomedical Sciences ETDs

We evaluated the visual response to infrared (IR) in humans after dark adaptation. In seven adult participants, visual perception, visual sensitivity, and the visual response to IR after light adaptation were tested. Over the course of dark adaptation, we found visual perception and sensitivity to our experimental IR stimulus increased, while the relative IR intensity necessary for perception decreased. Visual perception of the IR stimulus was abolished during a transient light exposure; however, when turned back off, perception to the IR stimulus returned for all participants. These novel findings may be relevant for both pre-clinical and clinical visual research.

Treatment Of Psychiatric Inpatients With Relationship Dysfunction Using A Short Term Cognitive Interpersonal Intervention: A Pilot Study, Tamra Rasberry

Doctoral Dissertations and Projects

Relationship conflict for the psychiatric patient can have significant detrimental effects. There are specific types of interactions that can increase conflict and predict the potential for relapse; these have been identified by research and designated as components of Expressed Emotion (EE). Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have been very effective when targeting specific psychiatric diagnoses, but less effective when addressing relationship conflict. The majority of studies addressing relationship conflict have taken place in an outpatient, long-term setting. There is limited research that utilizes an inpatient short-term intensive therapy with relationship conflict as its sole focus, targeting areas …