Medicine and Health Sciences Commons^™

Impact Of A Community-Based, Hiv Intervention On Antiretroviral Treatment Retention And Adherence In Tanzania, Project Soar

HIV and AIDS

Project SOAR is contributing to the evidence base on community-based care models by conducting implementation research in Tanzania, a country where 1.5 million people are in need of HIV care services, and where clients eligible for antiretroviral therapy (ART) often drop out or are lost to follow up. While the country has a cadre of community-based HIV service (CBHS) providers, they remain largely informal. Project SOAR and its partners are evaluating a coordinated, integrated model in which CBHS providers deliver an enhanced service package to HIV-positive clients. The evaluation will advance understanding of the value of CBHS providers in improving …

Project Soar's Voluntary Medical Male Circumcision Portfolio, Project Soar

HIV and AIDS

Project SOAR has developed an extensive voluntary medical male circumcision (VMMC) portfolio to support multiple countries with data to make informed policy and programmatic decisions about VMMC that address their specific needs and environments. A critical component of this portfolio is research utilization. At the country level, Project SOAR seeks to generate data to support planning, implementing, and monitoring VMMC programs and increase access to and use of this data through user-friendly interfaces and dissemination strategies. Simultaneously, SOAR aims to advance VMMC as a vital prevention strategy by filling important data gaps in the global discourse around VMMC. This brief …

Bullying In Senior Living Facilities: A Qualitative Study, Felicia Jo Vandenest

All Graduate Theses, Dissertations, and Other Capstone Projects

Resident-to resident bullying has attracted some attention in the popular press and is well-known to many who work with seniors in long-term care facilities. However, this is very little empirical literature that has address the topic of "senior bullying". The aim of the proposed qualitative study is to better understand the phenomenon of resident-to-resident bullying from the perspective of staff who work in long-term care facilities. Staff members (n=45) responded to a combination of open- and close-ended interview questions regarding their observations of senior-to-senior bullying. Results indicate that the majority of staff members (98%) have observed resident-to-resident bullying within senior …

Vitamin D Clinical Relevance In The Recovery From Traumatic Brain Injury Among The Military Population, Yuisa M. Colón

Honors Undergraduate Theses

Background: Traumatic brain injury (TBI) still remains a difficult disorder to treat. TBI has been associated to chronic neuroinflammation and a high risk for neurodegenerative disorders. Since 2001 between ten to twenty percent of all deployed military members have suffered a combat-related TBI. Nearly twenty to thirty percent of those will experience chronic cognitive, behavioral and somatic symptoms after suffering a TBI.
Methods: The objective of this review is to evaluate current literature examining vitamin D as a neurosteroid with protective properties and its clinical relevance after traumatic brain injury. Vitamin D is known to participate in neurobiological …

Organizing For Women And Children: Advocating For The ‘Reach Every Mother And Child’ Campaign, Laura E. Leslie

Capstone Collection

Every day families are left without mothers and children. Not only does this affect the family but it can have ramifications on the community. There is a link between the wellbeing of moms and that of their children, yet we lose thousands of women to maternal complications each year. Moreover, each day, thousands of children die before reaching their fifth birthday. The most tragic part is that most of these deaths are preventable. While these deaths have been halved in the last 15 years, there is still a lot of work to be done. There have been several initiatives which …

Chronic Pancreatitis, Pain, And Anxiety In An Alcohol And High Fat Mouse Model, Tiffanie Clinkinbeard

Theses and Dissertations--Gerontology

Homeodynamic space (HDS) shrinks as vulnerability increases with aging and repeated damage to the cells. HDS is lost in alcoholic pancreatitis patients due to overconsumption of alcohol, smoking, and high fat diets. Etiologically relevant animal models for study of chronic pancreatitis (CP) are needed. In order to begin filling this gap a central purpose of this dissertation research was to examine relationships between the alcohol and high fat diet (AHF) and pancreatitis with attention to hypersensitivity and anxiety-like behaviors. The AHF diet induced pancreatitis described here etiologically mimics human risk factors of AHF consumption for advancement to alcoholic CP.

In …

Veterans Treatment Courts: Pure Pretextualism Or A Venue For Veterans' Needs?, John William Erickson Jr.

School of Criminal Justice Theses and Dissertations

The intended goals of Veterans Treatment Courts (VTCs) are consistent with what drove the establishment of Drug Courts and Mental Health Courts in the ‘90s. That is, a recognition that the traditional criminal justice system is geared toward punitive court dispositions; not the unique characteristics of addicts and/or mental health defendants (G. Lerner-Wren, personal communication, January 12, 2015). For example, In Dade County, Florida, a former U.S. Attorney, then the Dade County State Attorney, recognized that reform was necessary to avoid the criminalization of drug addiction; given the high prevalence of cocaine abuse. Today, U.S. Military Veterans returning from Iraq …

Potentially Traumatic Experiences And Sexual Health Among Orphaned And Separated Adolescents In Five Low- And Middle-Income Countries, Christine L. Gray, Kathryn Whetten, Lynne C. Messer, Rachel A. Whetten, Jan Ostermann, Karen O'Donnell, Nathan M. Thielman, Brian W. Pence

Community Health Faculty Publications and Presentations

Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in sub-Saharan Africa and Asia. Over 153 million children worldwide have lost one or both parents, including 17 million orphaned by AIDS, and millions more have been separated from their parents. As younger orphans enter adolescence, their sexual health and HIV-related risk behaviors become key considerations for their overall health. Importantly, their high prevalence of exposure to potentially traumatic events (PTEs) may put OSC at additional risk for adverse sexual health outcomes. The Positive Outcomes for Orphans study followed OSC randomly sampled from institution-based care and …

Improvement Of Under-Represented Minority Individuals In The Healthcare Field Of Communication Sciences And Disorders, Allison Webb

Lewis Honors College Capstone Collection

Individuals from under-represented minority backgrounds are scarce within healthcare careers. Former research has suggested that this lack of diversity begins at the undergraduate level. This proposal discusses a potential solution to this problem occurring at the University of Kentucky and other colleges across the United States. Suggested intervention targeted diverse populations, connected students with faculty and staff, and provided shadowing resources for individuals from under-represented minority backgrounds. Based on research and current diversity statistics, populations of individuals from diverse backgrounds are expected to increase within the Communication Sciences and Disorders program. Demographic information for the fall 2016 semester will become …

Barriers To Fistula Repair In Nigeria: A Formative Study, Population Council

Reproductive Health

A formative research study was conducted in Nigeria to better understand the barriers and enabling factors for fistula repair care delivery and access. This brief presents results from a literature review conducted to identify and understand the delays in accessing and receiving treatment and corresponding barriers, to document interventions that help to overcome barriers, and to specify gaps in the literature that require further research. The report concludes that women’s concern over healing and reintegration reflects their expectation that the holistic approach of hospitals will bring them back to normal life incorporating physical, sexual, psychosocial, and economic rehabilitation. Awareness, financial, …

Strengthening Factory Health Systems Under Levi Strauss & Co.'S Worker Well-Being Initiative In Egypt, Population Council, The Evidence Project

Reproductive Health

The pilot intervention described in this brief took place at an apparel manufacturing company, Lotus, located in Port Said, Egypt as part of the Worker Well-being Initiative. Worker Well-being is an initiative of Levi Strauss & Co. and the Levi Strauss Foundation that seeks to move beyond a “do no harm” compliance model of labor rights in its global supply chain. The interventions in Egypt have contributed to the overall development of a health system–strengthening approach to private workplaces, which is a new concept for management. The work in Egypt contributed to a collaboration between the Evidence Project/RAISE Health and …

North Minneapolis Residents' Knowledge And Awareness Of Indoor Air Quality In Older Residences, Blisse Marie Cajacob

All Graduate Theses, Dissertations, and Other Capstone Projects

Older housing stock is one suspected cause of poor indoor air quality and poor indoor air quality can cause many negative health conditions. Four hazardous conditions related to indoor air quality were examined for this study: lead, asbestos, dampness causing mold and radon. North Minneapolis residents, specifically low-income, disproportionately live in older stock houses and have higher rates of asthma compared to other parts of the state. In this study, data was collected to understand North Minneapolis residents' knowledge and awareness of indoor air quality in older residences. Fifteen minute interviews followed by a brief sociodemographic questionnaire were used to …

Perceptions Of Female Sexual Pathology: The Role Of Racial Biases In Clinical Decision Making, Jerusha Sanjeevi

All Graduate Theses, Dissertations, and Other Capstone Projects

Diversity issues such as multicultural competence and sexual health competence have received increased but separate academic attention in recent years. Although empirical support has been found for the presence of racial biases in the diagnoses of mental health disorders, there is no evidence to date regarding the role of racial biases in the diagnoses of female sexual pathology. In the present study, 101 pre-doctoral psychology interns across the United States assessed the symptom severity of a fictional client via online vignettes in which client race was experimentally manipulated. Participants did not report significantly different symptom severity ratings between the vignettes …

Does Shifting Gender Norms On The Community Level Lead To Increased Hiv Services Uptake?, Project Soar

HIV and AIDS

Project SOAR and partners are building on an ongoing National Institute of Mental Health–funded randomized controlled trial being conducted in South Africa—Community Mobilization for Treatment as Prevention. Specifically, the study aims to strengthen and expand the gender content of the intervention to engage both women and men in critically examining gender norms and power inequalities. This brief presents the particularly timely study that will address a key question in the field as to how gender norms may operate to affect HIV service utilization. Building the evidence base in this area is vital for improving care outcomes as well as creating …

Estimating The Costs Of Providing Voluntary Medical Male Circumcision In South Africa, Project Soar

HIV and AIDS

The South African government introduced voluntary medical male circumcision (VMMC) as an HIV-prevention intervention in 2010, based on the compelling evidence that VMMC reduces men’s risk of becoming HIV infected by approximately 60 percent. To inform strategic planning for continued scale-up of its VMMC program and better understand cost drivers and cost variances across provinces, the South African National Department of Health in 2014 requested estimates of the unit cost of VMMC and the level of current spending for VMMC demand creation. The results of this study provide a comprehensive analysis of the unit cost of providing VMMC in South …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Multan, Population Council

Reproductive Health

This district profile of Multan is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of antenatal and delivery care services; use of family planning; other socioeconomic indicators; availability of health facilities and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning and a chart listing district-specific donors, projects, and implementing partners. The analysis, conducted by …

Landscape Analysis Of The Family Planning Situation In Pakistan—District Profile: Sukkur, Population Council

Reproductive Health

This district profile of Sukkur is part of the Landscape Analysis of the Family Planning Situation in Pakistan. The factsheet provides a detailed picture of use of antenatal and delivery care services; use of family planning; other socioeconomic indicators; availability of health facilities, pharmacies, and lady health workers; distribution of public static and private facilities by cadre; provision of specific family planning methods by sector; and presence and provision of family planning services/products. The factsheet concludes with a review of consumers’ perspectives on barriers to use of family planning and a chart listing district-specific donors, projects, and implementing partners. The …

Comt And Oprm1 Genotype Associations With Daily Knee Pain Variability And Activity Induced Pain, Lynn M. Martire, Stephanie J. Wilson, Brent J. Small, Yvette P. Conley, Piotr K. Janicki, Martin J. Sliwinski

Aging Studies Faculty Publications

Background: Osteoarthritis (OA) of the knee is a common and increasingly prevalent condition that is one of the primary causes of chronic pain. Staying physically active protects against disability from knee OA but is also very challenging. A critical but unexamined question is whether patients at greatest risk for becoming less active are those with a genetic predisposition for greater sensitivity to daily pain.

Aims: We examined day-to-day variability in knee OA pain for patients with different variants of catechol-O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) single nucleotide polymorphisms (SNPs), and whether patients with a specific genotype experience more pain following …

Walking-Induced Fatigue Leads To Increased Risk In Older Adults, S. Morrison, S. R. Colberg, H. K. Parson, S. Neumann, R. Handel, E. J. Vinik, J. Paulson, A. I. Vinik

Rehabilitation Sciences Faculty Publications

Background- For older adults, falls are a serious health problem, with more than 30% of people older than 65 suffering a fall at least once a year. One element often overlooked in the assessment of falls is whether a person's balance, walking ability, and overall falls risk is affected by performing activities of daily living such as walking.

Objective- This study assessed the immediate impact of incline walking at a moderate pace on falls risk, leg strength, reaction time, gait, and balance in 75 healthy adults from 30 to 79 years of age. Subjects were subdivided into 5 equal groups …

An Exploration Of Home-Based Therapists’ Supervisory Experiences: A Phenomenological Inquiry, Cherre Camper

Department of Family Therapy Dissertations and Applied Clinical Projects

In-home family therapy has become one of the most common options of treatment for providing services to families who do not typically utilize a private clinic (Lawson, 2005; Reiter, 2000; Yorgason, McWey, & Felts, 2005). Researchers have given some attention to the topic of home-based therapy and to general supervision, but little attention has focused on the actual supervision experiences of home-based therapy providers. This phenomenological study explored the supervision experiences of seven past and current in-home therapists: marriage and family therapists (MFTs) and social workers (MSWs). Semi-structured interviews were conducted with the participants, and data was analyzed to develop …

The Art Of Solution-Focused Brief Therapy: Experiential Training For Novice Therapists In Creative Collaborative Language, Lori Ann Pantaleao

Department of Family Therapy Dissertations and Applied Clinical Projects

Novice solution-focused brief therapists often have difficulty delivering scaling questions within the languaging of their clients. To help beginning Solution-Focused Brief Therapy (SFBT) trainees, this researcher has created the metaphorically enhanced scaling question (MESQ) training program. By incorporating a meaning making system such as the metaphor, the scaling question becomes expressive and symbolic to the client and his or her own story. The MESQ objective is to assist novice therapists in facilitating the SFBT scaling question creatively through the use of metaphor. A metaphor is a created meaning isomorphic to its original meaning or experience. The metaphor will be co-constructed …

Social Grief: A Grounded Theory Of Utilizing Status Updates On Facebook As A Contemporary Ritual, Celese Catania-Opris

Department of Family Therapy Dissertations and Applied Clinical Projects

The popular Social Networking Site, Facebook, offers its users the ability tocommunicate with others from all over the globe. Individuals can create a virtual identity for themselves enabling members to call, message, and locate others in a matter of seconds. The number of Facebook users appears to increase; yet, the number of members who die daily is not normally accounted. Facebook now permits the memorialization ofthe deceased’s profile. This allows members to continue commenting, sharing photos and videos, and visiting the deceased’s Facebook page. This trend led to the central question of this study, “What benefits, if any, are individuals …

Health Care Agency: Statewide Awareness Of Patient-Centered Care In Maine’S Mental Health Care Facilities, Holly Hogan A

Honors Theses

This research project focuses on patient-centered care (PCC) in the context of inpatient acute psychiatric units. Hospitals have been claiming their renewed outlooks on health-care via PCC. It has become an increasingly popular term to use on hospital websites and in presidential statements. The technologies and practices surrounding psychiatric care have evolved in such a way that patients are more welcomed to have an input in their care. This project discusses the discourse around PCC at Mental Health Care Facilities in Maine. There is no consensus on the definition; the meanings ascribed to it are derived from the individual institutions. …

Sexual And Reproductive Health Knowledge, Attitudes, And Practices Among Early Adolescents And Young Adults In Uganda: Findings From A Link Up Exploratory Study, Population Council

HIV and AIDS

The Population Council collaborated with Makerere University’s Child Health and Development Centre to conduct a study of males and females ages 10–24 to help inform future programs and policies affecting these young people. This study was conducted as part of the Link Up project, a global consortium led by the International HIV/AIDS Alliance that aims to improve the sexual and reproductive health and rights (SRHR) of young vulnerable people. Results indicate that adolescents and young adults have broad gaps in their knowledge about HIV and SRHR; early adolescents fared significantly worse in these areas than their older counterparts, suggesting that …

Identity Theory And Women’S Choice Of Medical Specialty, Kelli A. Rolfsmeyer

Electronic Theses and Dissertations

The purpose of this study was to answer the research question: Does a self theory of social action account for female physicians’ perceptions of past choice of specialty? Perceptions of self changed as she prepared herself to become a physician. During her medical training, a medical student gains a better sense of who she is as a person who will become a doctor. The ability to act back on one’s self, called selfreflexivity, is the mechanism involved in the transitions of a physician’s biographical self. The data for this study was collected through interviews centered on questions chosen from the …

Electronic Medical Records (Emr): An Empirical Testing Of Factors Contributing To Healthcare Professionals’ Resistance To Use Emr Systems, Emmanuel Patrick Bazile

CCAC Theses and Dissertations

The benefits of using electronic medical records (EMRs) have been well documented; however, despite numerous financial benefits and cost reductions being offered by the federal government, some healthcare professionals have been reluctant to implement EMR systems. In fact, prior research provides evidence of failed EMR implementations due to resistance on the part of physicians, nurses, and clinical administrators. In 2010, only 25% of office-based physicians have basic EMR systems and only 10% have fully functional systems. One of the hindrances believed to be responsible for the slow implementation rates of EMR systems is resistance from healthcare professionals not truly convinced …

Addressing Racial Disparities In Breast Cancer Treatment Delays: An Application Of Group Model Building (Gmb), Faustine Williams, Nancy Zoellner, Maisha Flannel, L. Noel, J. Habif, P. Hovmand, Sarah Gehlert

ETSU Faculty Works

No abstract provided.

Youth In Pakistan: Priorities, Realities And Policy Responses, Zeba Sathar, Iram Kamran, Maqsood Sadiq, Sabahat Hussain

Poverty, Gender, and Youth

Youth is a pivotal stage during which the right policies and interventions in the health, social, educational, and economic sectors can protect young people against risks, and turn the trajectories of their lives toward a safe and productive path of growth. This report explores some of the key issues facing youth in Pakistan, in the main spheres marking their transition to adult roles. It also presents the results of an age-based segmentation analysis capturing where youth in Pakistan stand in terms of school enrollment, work force participation, and marriage, with a view to identifying the broad developmental priorities for each …

The Africa Regional Sgbv Network Learning Brief Series: Learning Updates From Uganda (Brief #6), Population Council

Reproductive Health

Sexual and gender-based violence (SGBV) in humanitarian contexts is recognized by the UN Refugee Agency as a global concern and as a priority in its programming. Crisis-affected populations often face multiple forms of SGBV at multiple time periods (during conflict, during flight from conflict, and within post-conflict settings). The Africa Regional SGBV Network, set up in 2006, is addressing SGBV in humanitarian contexts in East and Southern Africa. This Learning Brief is one in a series of two that share critical findings on effective responses to the issue in Uganda. This brief notes that relatively higher screening, disclosure, referral, and …

The Africa Regional Sgbv Network Learning Brief Series: Learning Updates From Swaziland (Brief #3), Population Council

Reproductive Health

Nearly half of girls aged 13–24 in Swaziland suffer some form of sexual violence, according to the country’s 2007 Violence Against Children (VAC) survey. About 10 percent of girls reported experiencing sexual and gender-based violence (SGBV) in school in particular. The Swaziland Action Group Against Abuse (SWAGAA) is recognized as Swaziland’s leading SGBV prevention, response, and advocacy organization. This Learning Brief describes how SWAGAA is tackling SGBV in schools in three different ways: 1) helping girls take more control of their school experience through a new self-efficacy module in the Girls’ Empowerment Clubs; 2) encouraging girls, and giving them the …