Medicine and Health Sciences Commons^™

Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi

Dissertations

Burnout is a widely researched stress-related phenomenon associated with numerous adverse outcomes for employees and organizations. Unfortunately, burnout is not well understood and research to this point has been flawed due to a lack of consensus on the definition, dimensionality, and context of the construct. Prevalent conceptualizations of burnout have been criticized for being arbitrarily developed without solid theoretical foundation and for failing to clearly distinguish burnout from depression or other work-related conditions such as compassion fatigue, secondary traumatization, and vicarious traumatization. The current project first examines relevant literature to identify commonalities among prevalent burnout conceptualizations. Then relevant stress research …

From The American People: An Autoethnographic Exploration Of South African Ngos' Perceptions Of Pepfar, Antonia Asher

Independent Study Project (ISP) Collection

The aim of this research was to understand what the ideal partnership would be between United States (US) governmental aid agencies and South African non-governmental organizations (NGOs), specifically concerning HIV/AIDS programs funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), from the perspective of NGOs. PEPFAR is the largest relief fund for a single disease; thus, I additionally sought to deeply reflect upon myself as a US citizen in South Africa, a country that has received trillions of dollars from taxpayers such as myself.

To accomplish this, I interviewed NGO staff about the nature of current partnerships, outcomes …

Vaccine Hesitancy In The United States And Switzerland, Anna E. Lunderberg

Independent Study Project (ISP) Collection

Vaccine hesitancy (VH), or the reluctance or refusal to participate in vaccination programs, is a complex phenomenon with far-reaching impacts on society. VH can impact vaccine uptake and facilitate subsequent outbreaks, as seen with the case of measles. Perceptions of vaccination are similar in the United States and Switzerland, and misinformation in each country contributed to VH through impaired parental risk-benefit analysis; parental analysis and subsequent VH is associated with both anti-vaccination messages gaining prominence and a decrease in the public perception of the health risk from vaccine-preventable diseases (VPDs). There are many proposed strategies for addressing VH on both …

Quality Over Quantity: A Comparative Analysis Of The Quality Measures And Performance Between Switzerland And The United States, Lexi Farina

Independent Study Project (ISP) Collection

Even in the best health systems, poor quality of care continues to cause harm to patients and prevent them from receiving the best treatment possible. Thus, it is important to record and report quality of care measures because they can help inform policy changes and improve performance. In this paper, a comparative analysis between the United States and Switzerland is conducted to understand the process for defining and assessing quality indicators in each country as well as compare their quality of care performance results. The methods for this study include a literature review of relevant background information relating to quality …

Understanding Sexual Pleasure And Health: A Study Of Urban Middle-Class Women’S Narratives In New Delhi, India, Solana Chertow

Independent Study Project (ISP) Collection

The following study seeks to explore how urban-middle class women in Delhi understand, value, and access sexual pleasure. Simultaneously, it looks to understand the relationship between ideas of agency, power, and pleasure. This project was prompted by the lack of colloquial conversation happening on these subjects both globally, and in the communities familiar to the researcher. Although sex and pleasure, in both theory and practice, are extremely prominent in the lives of people around the world, discussion remains stigmatized. With these constraints in mind, this study investigates how a certain population of women became knowledgeable, and are still learning about …

My Body, Their Choice: Childbearing Attitudes And Practices In Jamkhed, Maharashtra, Sienna Sewell

Independent Study Project (ISP) Collection

Understanding the beliefs and practices of women and their families during pregnancy and childbirth is fundamental to the creation of successful public health interventions that target maternal and infant mortality. This study explores the childbearing practices of women in rural Jamkhed, as well as the social and economic factors that influence family planning, reproductive health-seeking, and delivery. Interviews and quantitative surveys were conducted with women in villages that have partnered with the Comprehensive Rural Health Project (CRHP) to examine how and why women access prenatal care during pregnancy. The influence of CRHP’s “Jamkhed Model” on healthcare access is considered in …

Exploring Mobility Help-Seeking Behavior Among People With Physical Disabilities: A Case Study Of Jaipur Foot, Alex Podell

Independent Study Project (ISP) Collection

It is estimated that as many as 90 million people living in India experience some sort of disability (The World Bank, 2007). As India’s population keeps growing and aging, not only will the medical aspects, but also the societal impacts of disability need to be brought to the forefront of discussion, developmental strategy, and policy implementation. This study sought to analyze factors influencing the process of seeking help from formal and informal sources for people with physical disabilities. Data was collected from 10 people with physical disabilities receiving a variety of mobility aids from the NGO, Bhagwan Mahaveer Viklang Sahayata …

Sirva Todos Como Un Hermano: Las Filosofías De Los Médicos Tradicionales Mapuches Hacia Los Pacientes Winka, Andrew Turner

Independent Study Project (ISP) Collection

In recent years, the popularity of traditional Mapuche medicine has increased drastically among non-Mapuche, Winka, Chileans. This increase in the soliciting of services as well as an expansion of intercultural health programming exists within the context of the ongoing Mapuche conflict in which Mapuche activists in the Araucunía region are fighting for the territorial and societal rights of their indigenous communities. To ascertain the effects of Winka medical solicitation on Mapuche medical practioners, semi-structured interviews were utilized. 8 Mapuche medical practioners and associated community members such as intercultural hospital directors and Lonkos were interviewed. Participants were questioned about the personal …

Pasantía En Red Oss: Más Que Una Clínica, Saad Ehsan

Independent Study Project (ISP) Collection

RED OSS es una organización en Conchalí, Santiago que provee pruebas rápidas de VIH y actualiza otras pruebas para ETS en una manera gratuita desde 1991. Durante mi pasantía, investigué como una organización disminuye las desigualdades de salud. También aprendí sobre el financiamiento de RED OSS, las pruebas rápidas y el nicho de RED OSS en un país con un sistema pública. Utilicé observaciones y entrevistas para estudiar la clínica. Tuve oportunidades para asistir los talleres para prevenir homofobia y ver las consejerías con un voluntario. También actualicé el sitio web para reflejar los servicios que RED OSS ofrece. En …

Social Support And Discrimination: The Experiences Of Recovering Heroin Addicts In Kunming, China, Phoebe Li

Independent Study Project (ISP) Collection

Opioids have had a long, complex position in Chinese society, dating all the way back to the Ming dynasty. In 1949, 5% of the overall Chinese population and 25% of the population in Yunnan smoked opium regularly, which led to societal collapse and economic downturn. Since then, the Chinese government has used many different methods to attempt to control drug use and trafficking, including registering all users, executing traffickers, and using Compulsory Rehabilitation Centers. Starting in 2008, the government switched to a harm reduction approach and began to invest in methadone clinics, community support groups, and needle exchange programs. Because …

Is Technology The Key To Prevention Of Falls Among The Elderly In Rapidly Aging Societies? A Case Study Of Kunming, China, Phoebe Kiburi

Independent Study Project (ISP) Collection

As the aging society rapidly becomes more dominant in the world, there is a pressing need for different stakeholders to tend to the needs of the aging sufficiently. This is crucial in ensuring the robustness of the healthcare system as a whole; given that it can only be as strong as its weakest link. This study focuses on one of the areas of need of the ageing society: fall prevention.

Numerous studies have been done on interventions by the government, private entities, elderly people and their caregivers to prevent occurrence and recurrence of falls. However, most of these have been …

When Crayons Meet Tibetan Living Room Walls: Early Childhood In Exile, Emma Hart

Independent Study Project (ISP) Collection

This study aims to understand early childhood caregiving among Tibetan refugees living in Nepal. Due to the brain’s enormous developmental plasticity from ages zero to three, children’s experiences during this period are extremely important to explaining their future learnings in school, interactions with people, and engagements with their surroundings. Through interviews and observations, Tibetan parents shared their conceptions of early childhood, parent-child interaction norms, dreams for their children, and how their status as refugees in Nepal affects these. Research was conducted in two Pokhara district Tibetan settlements and one settlement in Mustang. Connected by the flow of children and adults …

Voices Unheard: Women And Their Children In Nepal’S Incarceration System, Aune Nuyttens, Mikayla Rose

Independent Study Project (ISP) Collection

This research project focused on women in Nepal’s incarceration system. Our goal was to hear and share their stories with the hopes of humanize and de-stigmatize perceptions of female prisoners in and outside of Nepal. A central component to these stories, as we learned, was also the story of prisoner’s children and the NGOs who provide assistance to this vulnerable group of women and their children. The researchers travelled to the east and west of Kathmandu to visit rural and urban prisons in Nepal, and visited various children homes, however the research was based out of Kathmandu, where many of …

Reshaping Counselor Education: The Identification Of Influential Factors On Multisystemic Therapy, T'Airra C. Belcher

Counseling & Human Services Theses & Dissertations

Multisystemic therapy (MST) is a form of behavioral health treatment for adolescents which has been identified as one of the leading effective forms of treatment for children and adolescents with severe behavioral and mental health disorders. Since its creation, there have been countless studies exploring if this form of treatment works with a different population in a variety of locations. Additionally, there have been studies which determined that MST is just as effective as or even less effective than other treatment modalities. This dissertation explored the specific aspects of MST and what leads to its effectiveness. A meta-analysis and case …

Career Pathway Through Exercise Science, Renee Cloeter

Honors Projects

College students have many choices for choosing a major that will lead to a profession or post-graduate school following graduation with a Bachelor’s or Associates degree. For many, making this decision can be daunting and time-consuming as it is important to select the right major for future endeavors. Several students change majors multiple times throughout the course of their college careers causing them to remain in school for an extended period of time to complete graduation. Researching and analyzing potential majors as a new student is a part of the process, but some students may skip this step as there …

A Framework To Reveal Clandestine Organ Trafficking In The Dark Web And Beyond, Michael P. Heinl, Bo Yu, Duminda Wijesekera

Journal of Digital Forensics, Security and Law

Due to the scarcity of transplantable organs, patients have to wait on long lists for many years to get a matching kidney. This scarcity has created an illicit market place for wealthy recipients to avoid long waiting times. Brokers arrange such organ transplants and collect most of the payment that is sometimes channeled to fund other illicit activities. In order to collect and disburse payments, they often resort to money laundering-like schemes of money transfers. As the low-cost Internet arrives in some of the affected countries, social media and the dark web are used to illegally trade human organs. This …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Glycine Supplementation Extends Lifespan Of Male And Female Mice, Richard A. Miller, David E. Harrison, C. Michael Astle, Molly A. Bogue, Joel Brind, Elizabeth Fernandez, Kevin Flurkey, Martin Javors, Warren Ladiges, Christiaan Leeuwenburgh, Francesca Macchiarini, James Nelson, Alexey G. Ryazanov, Jessica Snyder, Timothy M. Stearns, Douglas E. Vaughan, Randy Strong

Publications and Research

Diets low in methionine extend lifespan of rodents, though through unknown mechanisms. Glycine can mitigate methionine toxicity, and a small prior study has suggested that supplemental glycine could extend lifespan of Fischer 344 rats. We therefore evaluated the effects of an 8% glycine diet on lifespan and pathology of genetically heterogeneous mice in the context of the Interventions Testing Program. Elevated glycine led to a small (4%–6%) but statistically significant lifespan increase, as well as an increase in maximum lifespan, in both males (p = 0.002) and females (p < 0.001). Pooling across sex, glycine increased lifespan at each of the three independent sites, with significance at p = 0.01, 0.053, and 0.03, respectively. Glycinesupplemented females were lighter than controls, but there was no effect on weight in males. End‐of‐life necropsies suggested that glycine‐treated mice were less likely than controls to die of pulmonary adenocarcinoma (p = 0.03). Of the 40 varieties of incidental pathology evaluated in these mice, none were increased to a significant degree by the glycine‐supplemented diet. In parallel analyses of the same cohort, we found no benefits from TM5441 (an inhibitor of PAI‐1, the primary inhibitor of tissue and urokinase plasminogen activators), inulin (a source of soluble fiber), or aspirin at either of two doses. Our glycine results strengthen the idea that modulation of dietary amino acid levels can increase healthy lifespan in mice, and provide a foundation for further investigation of dietary effects on aging and late‐life diseases.

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

Meeting Point: Partner Dancing As Couple's Therapy, Rami Eckhaus

Expressive Therapies Dissertations

This dissertation research explored the experience of partner dancing as a therapeutic process that reflects upon the dynamics and interactions of couples who are in the process of couple's therapy. The research also aimed to gain insight on the ways in which the experience of partner dancing can support these couples' therapeutic processes. Partner dancing is a dance-form that is based on the interaction between two individuals. Such interaction requires the dancing couples to communicate on many levels that may uncover layers of their relational dynamics. In this research, five couples who were undergoing couple's therapy were asked to participate …

Racial Disparities In A State Based Workers' Compensation System, Caroline Kristine Smith

Dissertations and Theses

Racial, ethnic, and linguistic minority workers suffer higher rates of work-related injuries and illnesses in the United States compared to their White counterparts. Explanations for these higher rates include potential socioeconomic causes (education, income, and wealth) and occupational segregation into more dangerous occupations. What is less studied are the post-injury sequelae for minority workers, which is their experiences in the workers' compensation system, as well as their health and return to paid employment. What is known comes primarily from qualitative literature, which includes themes of racial discrimination (from employers, health care providers, and workers' compensation employees), a lack of information …

Engaging Student Nurses In A Professional Association, Nicholas Craig

Student Engagement Posters

Nicholas Craig discusses student engagement at Linfield College with regard to his involement with the Critical Care Nurses' Club.

Bone Marrow Drive: Will Linfield Be The Match?, Ashley Filler

Student Engagement Posters

Ashley Filler discusses student engagement at Linfield College with regard to organizing a bone marrow registration drive.

Escaping Death: Naloxone's Chemical Nature And Potential To Combat The Opioid Epidemic, Abigale Miller

Honors Program: Senior Projects (Public)

Naloxone is a life-saving drug with the ability to reverse an opioid overdose. As the opioid epidemic’s death toll rises, we can turn to Naloxone as a tool to combat the crisis. The epidemic, born of corruption, has a wide reach among the people of the United States, with especially firm grasps on middle-aged people, sufferers of chronic pain, white Americans and those living in the eastern portion of the country. Naloxone’s elegant design saves lives by effectively competing for a position on an opioid biding receptor in the brain to almost instantly end an overdose and restore normal breathing. …

Feeling Green: The Benefits Of Green Space On Urbanites' Mental Health, Kathryn A. Hoagland

Liberal Arts and Engineering Studies

This investigation intends to determine the best methods for incorporating public green space into dense urban areas, for the betterment of residents' mental health. Data from studies showing differences in the prevalence of anxiety and depression in urban and rural areas are discussed alongside data from studies looking at the effect that certain types of green space might have on mental health. While there is no exact consensus on the extent to which nature has positive effects on mental health there is enough of a correlation to argue for the implementation of public green spaces in urban design, in order …

“Build A Bridge So You Can Cross It:” A Photo-Elicitation Study Of Health And Wellness Among Homeless And Marginally Housed Veterans, Keri L. Rodriguez, Lauren M. Broyles, Michael A. Mitchell, Melissa E. Wieland, Gala True, Adam J. Gordon

The Qualitative Report

As part of a photo-elicitation interview study, we aimed to describe homeless and marginally housed Veterans’ experiences with health and wellness, health decisions, and health-related behaviors. Twenty Veterans receiving Veterans Affairs Homeless Patient-Aligned Care Team care took photographs depicting health and wellness, then used their photographs to discuss the same topics in 30-60 minute audio-recorded, semi-structured photo-elicitation interviews. Transcripts were analyzed using template analysis. Veterans described eight dimensions related to their health and wellness; physical, social, and environmental were most commonly discussed, followed by emotional, intellectual, spiritual, occupational, and financial wellness. Photographs contained literal and metaphorical depictions that were positively-oriented, …

Health Literacy And Type 2 Diabetes In Barbados, Coralene Quimby-Worrell

The Qualitative Report

In this qualitative instrumental single case study, I explored how patients living with Type 2 diabetes (T2D) in Barbados manage the disease and what role health literacy might play. Purposeful sampling aided in selecting the sample for the study. The sample was 23 participants who were 40 years and older, diagnosed with T2D, living in Barbados, and attending the Endocrine Center for treatment. Participants responded to 13 open ended questions used to answer the research questions. Information was coded using NVivo 10 software and the software provided the themes based on the participants’ responses to the interview questions. The themes …

State Roles In Promoting Community Life Engagement: Themes From The State Employment Leadership Network’S Working Group, Jennifer Sullivan Sulewski, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

As states focus on expanding integrated employment opportunities for people with intellectual and developmental disabilities (IDD) and phasing out sheltered work, they are finding a need to concurrently examine Community Life Engagement (CLE) supports as a wrap-around to ensure individuals’ engagement in the community is maintained and they continue to receive sufficient levels of support, despite fluctuations in job status and hours. In January through June of 2017, the State Employment Leadership Network (SELN) hosted a working group of member states to discuss ideas and share strategies for encouraging quality CLE supports while maintaining a focus on Employment First (see …

A Roadmap To Competitive Integrated Employment: Strategies For Provider Transformation, Esther Kamau, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Competitive integrated employment is defined within the Workforce Innovation and Opportunity Act (WIOA, 2014) as full-time or part-time work at minimum wage or higher, with wages and benefits similar to those without disabilities performing the same work, and fully integrated with coworkers without disabilities. The Act requires that states ensure employment is offered as a priority outcome for people with intellectual and developmental disabilities (IDD). As a result, providers who offer employment support to people with IDD have been working to phase out sheltered workshops and transform to offer competitive integrated employment.

A Qualitative Metasynthesis Of Published Research Exploring The Pregnancy And Resettlement Experience Among Refugee Women, Diana M. Kingsbury, Sheryl L. Chatfield

The Qualitative Report

The number of refugees and asylum seekers throughout the world continues to increase, leading to increasing challenges in meeting healthcare needs of these individuals. Women’s antenatal health is of particular concern due to their vulnerability to sexual violence and the substantial proportion of refugees consisting of women and girls of or nearing reproductive age. The purpose of this qualitative metasynthesis was to integrate and interpret findings from previously published research reports in which authors explored aspects of pregnancy among resettled refugee women. Following a systematic search process, we used Dedoose qualitative data analysis software to manage the process of extracting …