Medicine and Health Sciences Commons^™

Adversity And Academic Performance Among Adolescent Youth: A Community-Based Participatory Research Study, Sukhdip Purewal Boparai, Tiffani Marie, Eduardo Aguayo, Jordan Brooks, Estefany Juarez, Sheana Soriano, Alasia Waters, Jaquez Donaldson, Joseph Reagans, Gracee Anguiano, Allison Ipsen

Journal of Adolescent and Family Health

Researchers and youth stakeholders devised a survey on 27 adversities based on youth expertise, clinical practice, and adversity literature. The aim of the study was to understand the prevalence of individual and cumulative adversities, and association of adversities to age, gender, race/ethnicity and academic performance among a community sample of urban high school students. All participants experienced two or more adversities and experienced greater overall adversity than youth in population-based studies. Youth-proposed stressors were among the most prevalent, and females, older youth, and African American youth reported disproportionately greater number of adversities. Specific types of adversities were endorsed differentially based …

A Social Network Study To Improve Collaborative Partnerships Among The Southeastern Health Equity Council (Shec), Candace Forbes Bright, Hannah Scott, Braden Bagley, Jonathan Dennis

Faculty Publications

This report presents research conducted on the relationships among and attributes of members of the Southeastern Health Equity Council (SHEC, herein Council) to provide recommendations for partnerships, collaboration, and the recruitment of new members. The background, methods, results, and recommendations are outlined in detail throughout this report. Social networks are measured and defined as connections among people, organization, and/or other units. SNA is a valuable and innovative tool for recognizing strengths and weaknesses in collaborative partnerships. The evaluative study presented herein can be replicated in other councils within the Regional Health Equity Councils to improve collaborations not only among SHEC …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty and Staff Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Opportunities And Challenges For Self-Monitoring Technologies For Healthy Aging: An In-Situ Study, Mirana Randriambelonoro, Yu Chen, Onur Yuruten, Pearl Pu

Faculty Publications, Information Systems & Technology

The current need to adopt a healthy lifestyle opens the way for researchers to investigate the efficiency of using technology to motivate a change towards such behavior. Senior people’s technology adoption barriers have been largely investigated in previous research but remain unclear to design efficient solution to promote behavior change in the long term. In this paper, we present the findings of an experiment with 20 older adults using pervasive sensors for 6 weeks at their homes. In particular, we present their attitudes for physical activities and self-monitoring technologies before and after the actual usage. We then discuss the opportunities …

Pololeo Y Protección: Las Barreras De Acceso A Métodos Anticonceptivos Para Adolescentes Vulnerables En La Comuna De Macul, Santiago De Chile / Pololeo Y Protección: Barriers To Access Contraceptive Methods For Vulnerable Adolescents In The District Of Macul, Santiago De Chile, Louisa Boswell

Independent Study Project (ISP) Collection

El embarazo adolescente sigue siendo un problema de salud pública al nivel nacional en Chile. Aunque por ley, todos tienen el derecho a una educación sexual y a elegir un método de control de fecundidad, todavía existen casos de embarazos no planificados, particularmente entre adolescentes. Este estudio investigó las barreras que limitan el acceso a métodos anticonceptivos para adolescentes, enfocando primariamente en el sistema público en la Región Metropolitana. Específicamente, la investigación consideró las adolescentes de la comuna de Macul, utilizando muestras de un colegio local y dos centros de salud familiar para hacer conclusiones. La investigadora entrevistó a matronas …

Women Of Leh Town, Ladakh: An Overview Of Perceptions Of Health, Health-Seeking Behaviors, And Access To Health Care, Sophia Marion

Independent Study Project (ISP) Collection

The following study seeks to investigate access to health care services and perceptions of health care among women residing in traditional farming communities around the Ladakh region, and to analyze perspectives on health, health-seeking behavior, and access to health care. This project was prompted by the fact that health care in this region is understudied. This study also focuses on marginalized communities including local women and immigrant women. Methods used for the collection of data were qualitative interviews conducted with 24 women, as well as an amchi worker, doctors, and informal and formal conversations with people from different nongovernmental Organizations …

When Knowledge Flows: A Case Study Of Village Health Workers’ Motivations In Jamkhed, Selaem Hadera

Independent Study Project (ISP) Collection

Across the field of global health, there have been many attempts to cater to the health needs of the most marginalized populations. Community health workers (CHWs) are individuals that live in the communities they serve and are typically low-­‐income women with little to no formal education. After a period of training by their program, they enter their communities equipped as a bridge between the community and the health system. Although CHWs do play a substantial role in health delivery and education, the structure of CHW programs varies widely, but a common characteristic of these programs is that the CHWs are …

Sex Work And Compromised Health: Health Conditions And The Barriers To Accessing Treatment Services In Pelourinho, Salvador, Amelia Fox

Independent Study Project (ISP) Collection

Sex workers remain one of the most marginalized populations in Brazilian society, both coming from and living within realities defined by poverty and poor health. Through partnership with Força Feminina – an organization located in Salvador, dedicated to aiding local sex workers– I explored the day-to-day health complications sex workers encounter and the impact these problems have on quality of life. I then questioned how discrimination and stigma impact a woman’s willingness to prioritize her health and seek out healthcare services. To pursue these questions, I utilized participant observation, interviews with 4 staff members – a pastoral educator, financial coordinator, …

Tibetan Women’S Experiences With Childbirth: A Comparative Study Of Present-Day Shangri-La And Previous Studies In Tibetan Communities, Billie Dunn-Mcmartin

Independent Study Project (ISP) Collection

What are the experiences of Tibetan women living in and around Shangri-La with pregnancy, childbirth, and motherhood? In order to explore this topic, one must first understand the context in which this topic exists: Tibetan Buddhism and culture. This paper gives a short background on women and the female body in Tibetan Buddhism, the Tibetan Medical system, and the current accessibility and regulation of hospitals, before entering into the topic of Tibetan women’s experiences with childbirth. The experiences and traditional practices of childbirth are important, as birth is universally significant as well as particularly religiously significant in Tibetan Buddhism, and …

Caring For Caregivers: Challenges Facing Informal Palliative Caregivers In Western Kenya, Hartlee Johnston

Independent Study Project (ISP) Collection

Chronic illnesses like cancer, HIV, and other non-communicable disease are increasing globally, especially in developing countries, necessitating development of palliative care and symptom management systems. In Kenya, the burden of care for chronically ill patients often falls to unpaid, informal caregivers like family members or friends. Thirty-five current or past informal caregivers from Kisumu, Kenya were interviewed about their experience, challenges they faced, and interventions they felt would be helpful. Major challenges identified included lack of finances for treatment and other living expenses; inadequate, unaffordable, or interrupted medical care; emotional stress exacerbated by juggling many responsibilities, pressure to emotionally support …

Hiv Harm Reduction Methods: A Comparison Between Switzerland And The United States, Erin Major

Independent Study Project (ISP) Collection

This paper explores the connections between harm reduction methods and the prevalence of HIV/AIDS in Switzerland and the United States of America, focusing primarily on the harm reduction methods of needle exchange programs, safe drug consumption spaces, and sex education. While these two countries are largely similar in their culture and geopolitical approaches, there are some key differences in how HIV is approached in each. Switzerland’s somewhat unique approach with relaxed drug policies and more pragmatic, harm reduction based response to the AIDS epidemic sets a model framework for other countries to follow, with comparatively widespread use of needle exchange …

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

Understanding Sanitation Preferences: An Exploratory Study In The Sirohi District Of Rajasthan, Karen Mac

Independent Study Project (ISP) Collection

Of all the countries in the world, India has the highest number of people practicing open defecation, causing adverse health outcomes from the unconfined spread of faecal matter. The Government of India is ambitiously aiming to end this practice through the construction of 12 million toilets by 2019, but historically, many toilets across India have gone unused. This study focused on understanding: (1) the reasons why people continue to openly defecate despite having toilets and (2) the requirements of a toilet that rural households would be willing to use. Along with 36 observations of household toilets, semi-structured group (n=8) and …

Service Provider Promising Practice: Flexible Scheduling And Creative Staffing - Kfi’S Support Solutions, Heike Boeltzig, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Headquartered in a small rural town in northern Maine, Katahdin Friends, Inc. (KFI) provides community employment and life engagement supports, as well as home supports, to individuals with intellectual and developmental disabilities (IDD). KFI’s services extend throughout northern and southern Maine, including the cities of Portland and Bangor. A flexible approach to staffing and support scheduling helps KFI ensure customized daily support schedules that meet individual goals. This approach also allows individuals to interact with a variety of direct support professionals, which is important for having a more engaged and meaningful life in the community. As of July 2016, KFI …

Service Provider Promising Practice: Braiding Community Employment And Life Engagement Services - Transcen’S Worklink Program, Heike Boeltzig, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

WorkLink is a program that braids community employment and life engagement services. The goal is to enable individuals with intellectual and developmental disabilities (IDD) to work while receiving wrap-around day supports, as needed. Started in 1996, WorkLink is a program of TransCen, Inc. and is based in San Francisco. WorkLink clients do not have to give up day supports when deciding to pursue work. In addition to helping individuals establish and maintain meaningful community relationships, day supports are used to discover and explore vocational goals and job options. This information then helps guide individuals’ employment planning process. At WorkLink clients …

Service Provider Promising Practice: Avenues Supported Living Services: A Staffing Approach Based On Client Relationships, Heike Boeltzig, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Avenues Supported Living Services of Valencia, California was founded in 1997 by a husband- andwife team, Scott and Lori Shepard. The agency provides supported living and community life engagement (CLE) services to individuals with intellectual and developmental disabilities (IDD). Key to Avenues’ success is a staffing approach that is grounded in client relationships. The agency limits staff hours to two shifts per week with the same individual. This is done to facilitate clientstaff matching and relationship building, but also to prevent potential burnout and frustration by ensuring both the clients they support and their staff have variety in their schedules. …

Service Provider Promising Practice - Transcen’S Worklink Program: Helping Individuals Gain Work Skills Through Targeted Volunteering And Other Community Life Engagement Activities, Heike Boeltzig, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

WorkLink is a program that enables individuals with intellectual and developmental disabilities (IDD) to work while receiving wrap-around day services. Having access to both types of supports -- community employment and Community Life Engagement (CLE) -- is particularly important for individuals with significant IDD, who often work fewer hours and need additional support to lead active and meaningful lives. The program was started in 1996 by TransCen, Inc., and is based in San Francisco, California. Day services not only help individuals establish and maintain meaningful community relationships, but also let them build important skills as they explore vocational goals and …

The Opioid Epidemic: A Practice And Policy Perspective, Gail D'Onofrio

Center for Policy Research

I will be talking about the escalating opioid epidemic and some innovative solutions my colleagues and I at Yale University and throughout the state of Connecticut, are working on to mitigate the consequences of this public health crisis.

International Black-Market Organ Trade, Marni E. Granzow

Student Publications

The human organ trade is a global epidemic as citizens of developed-countries look to developing-countries to find organ donors, specifically exploiting the poor for their own personal gain. The impoverished organ donors are treated in an inhumane manner, as they are often left with serious medical complications and are not treated equally in the transaction.

Responding To Infertility: Lessons From A Growing Body Of Research And Suggested Guidelines For Practice, Karina M. Shreffler, Arthur L. Greil, Julia Mcquillan

Department of Sociology: Faculty Publications

Infertility is a common, yet often misunderstood, experience. Infertility is an important topic for family scientists because of its effects on families; its relevance to research in related areas, such as fertility trends and reproductive health; and its implications for practitioners who work with individuals and couples experiencing infertility. In this review, we focus on common misperceptions in knowledge and treatment of infertility and highlight insights from recent research that includes men, couples, and people with infertility who are not in treatment. The meaning of parenthood, childlessness, awareness of a fertility problem, and access to resources are particularly relevant for …

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …

Una Investigación Sobre La Prevalencia De La Lactancia Materna / 62/5000 An Investigation On The Prevalence Of Breastfeeding, Madeline Ferone

Independent Study Project (ISP) Collection

El propósito de la investigación es estudiar la realidad de las prácticas y la prevalencia de la lactancia materna en Chile, y cómo las características demográficas distintas de las mujeres influyen en la alimentación de sus bebés. La lactancia materna es crucial para el crecimiento y desarrollo saludable de un bebé, y también tiene beneficios para la salud de la madre. Sin embargo, las madres a menudo no siguen las pautas de la Organización Mundial de Salud y UNICEF. Los métodos de recolección de datos son una revisión de una Encuesta del Ministerio de Salud de 2013 de 9604 madres …

Bridging The Gap From Policy To Practice: Diabetes In Rural Morocco, Zoe H. Robbin

Independent Study Project (ISP) Collection

Morocco is in the midst of an epidemiologic transition ushered in by reduced fertility rates and extended life expectancy. Unlike two decades ago, today’s leading cause of death is chronic disease. In 2006, Moroccan officials launched Vision 2020, a comprehensive plan that seeks to expand access to healthcare and reign back the prevalence of noncommunicable disease, among other goals related to development. Through qualitative interviews with the residents of Tarmilat and Oulmes, a rural community south of Khamissat, this paper represents the first assessment of Vision 2020’s performance thus far to combat the spread of type 2 diabetes among rural …

The Latex Journey: A Narrative Approach To Exploring Condom Use, Stigma, And Education From The Perspective Of Women In Masxha, Kylie Yocum

Independent Study Project (ISP) Collection

Although the South African National Department of Health (NDOH) is spending increasing amounts of money on improving their HIV programs (including the rollout of new, scented condoms for their condom distribution program), the rates of condom use at last sexual encounter are declining. This inquiry focused on young women in the neighborhood of Masxha, Cato Manor, and their opinions surrounding how condoms are being used or misused, as well as the gender norms that perpetrate this (mis)use. This inquiry demonstrated the narratives of these young women on factors such as condom acquisition, gendered stigma, and condom education, including the Life …

The Perceived Mental Health Effects Of China’S One-Child Policy, Avery Rasmussen

Independent Study Project (ISP) Collection

This study looked at the perceived impacts of China’s 30 year One-Child Policy (OCP). Previous studies suggested the OCP affected Chinese culture and society in a number of ways, however no studies (to the knowledge of the principal investigator) had looked at perceptions of the effects of the OCP on anxiety levels and other mental health issues of students in China. This study sought to fill the aforementioned knowledge gap and aimed to determine perceptions about the mental health effects of the OCP on students. Specifically, this study endeavored to gain a better understanding of perceptions of the effects of …

Managing Health In All The Helpers: A Survey Of Mental Health Services For Humanitarian Aid Workers, Erin Mercado

Independent Study Project (ISP) Collection

Humanitarianism has been a long-standing principle of helping those in need. However, the work of providing such assistance is not an easy feat. Humanitarian work is mentally taxing because of the high daily demands of the job as well as the potential for exposure to direct and secondary traumatization. These mental health risks can manifest into the mental health disorders if the stressors of the job are not well managed by individual aid workers and by the humanitarian organizations. The most common mental health disorders experienced by aid workers are depression, anxiety, burnout, and PTSD. Research into mental health and …

Health-Related Quality Of Life Variations By Sociodemographic Factors And Chronic Conditions In Three Metropolitan Cities Of South Asia: The Carrs Study, Kavita Singh, Dimple Kondal, Roopa Shivashankar, Mohammed K. Ali, Rajendra Pradeepa, Vamadevan S. Ajay, Viswanathan Mohan, Muhammad Masood Kadir, Mark Daniel Sullivan, Nikhil Tandon, K M Venkat Narayan, Dorairaj Prabhakaran

Community Health Sciences

Objectives: Health-related quality of life (HRQOL) is a key indicator of health. However, HRQOL data from representative populations in South Asia are lacking. This study aims to describe HRQOL overall, by age, gender and socioeconomic status, and examine the associations between selected chronic conditions and HRQOL in adults from three urban cities in South Asia.
Methods: We used data from 16 287 adults aged ≥20 years from the baseline survey of the Centre for Cardiometabolic Risk Reduction in South Asia cohort (2010-2011). HRQOL was measured using the European Quality of Life Five Dimension-Visual Analogue Scale (EQ5D-VAS), which measures health status …

The Mediating Effects Of Positive Thinking And Social Support On Suicide Resilience Among Undergraduate Students, Denise Marie Matel-Anderson

Dissertations (1934 -)

Suicide has been the 2nd leading cause of death for 18-24-year-olds in the US since 2011. The stress experienced by undergraduate college students has the potential to increase ones’ risk for suicide. Resilience theory was used as a theoretical framework to examine the interplay between risk and protective factors. A cross-sectional and correlational design was used to assess the mediating effects of positive thinking and/or social support on suicide resilience in 131 college students 18-24 years old who completed an online survey. An indirect effect of self-esteem on suicide resilience was found through positive thinking and social support indicating that …

Evaluating The Term ‘Disorders Of Sex Development’: A Multidisciplinary Debate, Natalie Delimata Phd, Margaret Simmonds Phd, Michelle O'Brien Msc, Georgiann Davis Phd, Richard Auchus Md, Phd, Karen Lin-Su Md

Sociology Faculty Research

In 2014, almost 10 years after the 2005 International Consensus Conference on Intersex in Chicago,1 one of the conference co-organisers, under the auspices of a number of international paediatric endocrinology societies, launched the Global DSD Update to assess progress. A consortium of fourteen work groups conducted online/email discussions to explore each of the fourteen key topics, one of which was use of the controversial medical umbrella term ‘Disorders of Sex Development (DSD)’. The initial key question for Work Group 1 (referred to hereafter as WG1) was to reconsider the nomenclature. Nineteen individuals from a variety of professional backgrounds, including medical …

Age Drives Distortion Of Brain Metabolic, Vascular And Cognitive Functions, And The Gut Microbiome, Jared D. Hoffman, Ishita Parikh, Stefan J. Green, George Chlipala, Robert P. Mohney, Mignon Keaton, Bjoern Bauer, Anika M. S. Hartz, Ai-Ling Lin

Sanders-Brown Center on Aging Faculty Publications

Advancing age is the top risk factor for the development of neurodegenerative disorders, including Alzheimer’s disease (AD). However, the contribution of aging processes to AD etiology remains unclear. Emerging evidence shows that reduced brain metabolic and vascular functions occur decades before the onset of cognitive impairments, and these reductions are highly associated with low-grade, chronic inflammation developed in the brain over time. Interestingly, recent findings suggest that the gut microbiota may also play a critical role in modulating immune responses in the brain via the brain-gut axis. In this study, our goal was to identify associations between deleterious changes in …