Medicine and Health Sciences Commons^™

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Race, Gender, Physical Activity, And Cancer: A Quantitative Investigation, Shawna A. Townsend

Dissertations, Theses, and Capstone Projects

Black women are more likely to die from cancer than any other population in the United States. Physical activity is known to be associated with preventing and reducing cancer burden. However, Black women are less physically active than their White counterparts and have a higher prevalence of diseases related to lack of physical activity than any other female group. To better understand these issues, this study employed the self-and-family management framework and intersectionality as theoretical frameworks through a secondary analysis of the Health Information National Trends Survey (HINTS) dataset and hierarchical regression modeling to examine the relative impact of (a.) …

Factors Associated With Technology Adoption By Community-Dwelling Older Adults During The Covid-19 Pandemic, Elizabeth A. Sutton

Dissertations, Theses, and Capstone Projects

The COVID-19 pandemic brought to the forefront the disparity between older and younger Americans in the utilization of information and communication technologies (ICT) when measures such as the COVID vaccine rollout were dependent on technology use. Technology adoption has implications for overall health and the continuation of disparities in technology adoption is associated with poor aging outcomes. The aim of this study was to understand factors associated with technology adoption by community-dwelling older adults during the COVID-19 pandemic. A nationally representative sample of 2,954 community-dwelling older adults who completed the National Health and Aging Trends Study (NHATS) COVID-19 Questionnaire was …

Incidence And Factors Related To Nonmotorized Scooter Injuries In New York State And New York City, 2005–2020, Peter Tuckel

Publications and Research

Background: This study provides an analysis of contemporary trends and demographics of patients treated for injuries from nonmotorized scooters in emergency departments in New York state excluding New York City (NYS) and New York City (NYC).

Methods: The study tracks the incidence of nonmotorized scooter injuries in NYS and NYC from 2005 to 2020 and furnishes a detailed profile of the injured patients using patient-level records from the Statewide Planning and Research Cooperative System (SPARCS). A negative binomial regression analysis is performed on the SPARCS data to measure the simultaneous effects of demographic variables on scooter injuries for NYS and …

Artificial Intelligence And The Situational Rationality Of Diagnosis: Human Problem-Solving And The Artifacts Of Health And Medicine, Michael W. Raphael

Publications and Research

What is the problem-solving capacity of artificial intelligence (AI) for health and medicine? This paper draws out the cognitive sociological context of diagnostic problem-solving for medical sociology regarding the limits of automation for decision-based medical tasks. Specifically, it presents a practical way of evaluating the artificiality of symptoms and signs in medical encounters, with an emphasis on the visualization of the problem-solving process in doctor-patient relationships. In doing so, the paper details the logical differences underlying diagnostic task performance between man and machine problem-solving: its principle of rationality, the priorities of its means of adaptation to abstraction, and the effects …

Lactating Justice: Constructing A Society Economically Focused On Optimizing Health Through Human Lactation, Shadley Hobour

Dissertations, Theses, and Capstone Projects

This paper uses a qualitative research method to answer if a Universal Base Income would be a good economic policy to adopt to optimize Black chestfeeding. The key idea this thesis aims to clarify is how anti Blackness is killing Black people and how one economic policy could improve health. In this essay, I will break down the significance and importance of human lactation for lifelong better health, and investment in a UBI would especially work as a preventative measure for several health issues Black people experiences.

Four Corners: A Values Clarification Exercise, Montsine Nshom

Open Educational Resources

Four Corners is a values clarification activity that asks participants to stand/show whether they strongly agree to strongly disagree with a specific statement, and reflect on their position during and after the activity. This four corners activity is designed to help students think about and discuss topics that are pertinent to urban community health and public health.

No prior reading or coursework is required; it is a good option for the first day of class to introduce key themes that will be covered during the course as well as practice ground rules and class discussion norms.

Maternal Wellness: Self, Matrescence, Obstetric Violence, And Self-Care, Vanessa V. Vales-Lewis

Dissertations, Theses, and Capstone Projects

In this dissertation, I engage in a self-study through an examination of my experience of matrescence (i.e., the transition to motherhood). I discuss my praxis in the development of a self-study on maternal wellness as it applies to my well-being as both a researcher and the researched. In Chapter 1, I preface this study by highlighting critical scholars and the bricoleurs who have been foundational in my undertaking of this work on a narrative study on maternal wellness. Using bricolage as part of a research methodological framework that involved key scholarly methodologies of authentic inquiry, emergence and contingence, and narratology, …

The Nature Of Anti-Asian American Xenophobia During The Coronavirus Pandemic: A Preliminary Exploration Into Envy As A Key Motivator Of Hate, Daisuke Akiba

Publications and Research

Background. The current Coronavirus pandemic has been linked to a dramatic increase in anti-Asian American and Pacific Islander (AAPI) hate incidents in the United States. At the time of writing, there does not appear to be any published empirical research examining the mechanisms underlying Asiaphobia during the current pandemic. Based on the stereotype content model, we investigated the idea that ambivalent attitudes toward AAPIs, marked primarily with envy, may be contributing to anti-AAPI xenophobia. Methods. Study 1 (N = 140) explored, through a survey, the link between envious stereotypes toward AAPIs and Asiaphobia. Study 2 (N = 167), …

Addressing Structural Racism In The Health Workforce, Randl B. Dent, Anushree Vichare, Jaileessa Casimir

Publications and Research

One of the greatest challenges facing the United States are health inequities among racial/ethnic and other marginalized populations. The deep-rooted structural racism embedded in our social systems, including our health care system and health workforce, is a core cause of racial health inequities. 1 Among many definitions of institutionalized or structural racism, Dr Jones 2 best defines it as: “Differential access to goods, services and opportunities of society by race ... It is structural, having been codified in our institutions of custom, practice, and law, so there need not be an identifiable perpetrator.” Dr Jones further explains that to set …

Food-As-Medicine: An Everyday Strategy Of Health, Rachel Rebecca Bogan

Dissertations, Theses, and Capstone Projects

Using food-as-medicine, a valuable strategy of health, as its focus, this dissertation examines why and how New Yorkers use food to negotiate their health. I argue that while using food medicinally is a common health practice, food-as-medicine operates unequally among different groups of New Yorkers. I attribute this inequity, in part, to how those in power, including public health experts, biomedical doctors, and the food industry, operationalize food-as-medicine as a health remedy and to a neoliberal, healthist context that ties people’s morally “correct” uses of food-as-medicine to their abilities to access “good” citizenship and optimal health.

I chose to write …

Exploring Social Determinants Of Covid-19 Related Sickness And Suffering In The Bronx, Hamida Chumpa

Student Theses and Dissertations

Through a positivistic and phenomenological approach, the study examines social determinants of COVID-19 related sickness and suffering in the Bronx, New York City, New York, ZIP codes 10462, 10472, 10467, 10458, 10474, and 10464. I utilize a violence paradigm (structural and everyday violence) to describe the social determinants of risk and sickness-related suffering and deploy an assemblage framework to shed light on how these determinants create negative synergies that undermine wellbeing and render certain communities vulnerable to extreme suffering. The mixed methods include 64 surveys and eight interviews. Analysis methods include a descriptive analysis of survey results and a thematic …

Intangible Cultural Heritage: A Benefit To Climate-Displaced And Host Communities, Gül Aktürk, Martha B. Lerski

Publications and Research

Climate change is borderless, and its impacts are not shared equally by all communities. It causes an imbalance between people by creating a more desirable living environment for some societies while erasing settlements and shelters of some others. Due to floods, sea level rise, destructive storms, drought, and slow-onset factors such as salinization of water and soil, people lose their lands, homes, and natural resources. Catastrophic events force people to move voluntarily or involuntarily. The relocation of communities is a debatable climate adaptation measure which requires utmost care with human rights, ethics, and psychological well-being of individuals upon the issues …

When Is A Sandwich Too Much? A Critical Look At Teenage Parenthood And Its Impact On The Lives Of Their Parents, Shirley P. Grant

Dissertations, Theses, and Capstone Projects

The transition into early parenthood also implies a shift to early grandparenthood for the parents of teenage parents. The stigmas and stereotypes associated with teenage pregnancy and parenthood are also experienced by their parents for the decisions their children have made. Furthermore, some of these grandparents are caregivers to aging parents while also parenting their younger children. These people, recently called, “the club sandwiched” generation, appear to be experiencing physical, social, economic, and psychological impacts because of their responsibilities of caring for three generations but have not yet received much attention in academic literature. Teenage pregnancy can affect any family. …

Reflections On The Bgj Anti-Racism Seminar, Michelle Billies

Publications and Research

In this Letter to the Editor, Billies (2021) responds to critical and supportive opinion pieces in the British Gestalt Journal (BGJ) following their plenary presentation at BGJ’s 2018 annual seminar (see Asherson Bartram, 2019; O’Malley, 2019). As author of the companion article "How/ Can Gestalt Therapy Promote Liberation from Anti-Black Racism?” (Billies, 2021), Billies, who identifies as white, discusses the intent at the seminar to support white people to increase accountability and reduce harm in dialogue with people of color, while supporting the work and needs of people of color on their terms from a Gestalt perspective. Describing a fishbowl …

Hips That Harm: When Medical Devices Fail Women, Sophie N. Putka

Capstones

Medical devices that save the lives of thousands of Americans each year advance at a rapid pace - but some of them consistently leave women behind. When it comes to joint replacements and even heart devices, women have worse health outcomes. Behind this preventable problem is a system that overlooks women from start to finish. Female bodies are different from male bodies, but women are often underrepresented in medical trials for device approval. Women’s participation in clinical testing for devices has increased, but there’s rarely a detailed analysis of performance by sex, and even less information on women by race …

An Examination Of Hiv Risk, Testing And Prevention Intervention Participation Among Vulnerable Youth, Bianca V. Lopez

Dissertations and Theses

Background: Young gay, bisexual and other men who have sex with men (YGBM) of color are disproportionately affected by HIV and bear the burden of the disease in the United States. Gay and bisexual men – referred to in surveillance systems as men who have sex with men (MSM) – continue to be the risk group most severely affected by HIV in the United States. The dissertation study explored factors related on HIV prevention intervention participation, HIV testing and sexual risk behaviors among YGBM ages 13-29 in the Bronx. Additionally, this dissertation endeavored to study the concept of “intervention fatigue”, …

Shadow Standards And The Logic Of Costs: Care, Stewardship, And Data In U.S. Community Health, Margarite J. Whitten

Dissertations, Theses, and Capstone Projects

This dissertation examines the delegation of responsibility for providing health care to particular categories of marginalized populations in the United States in the absence of a uniform and universal health care system. It explores how the U.S. federal government governs patient populations at a distance by mandating that healthcare providers collect, produce, and report on patient data. Drawing from eighteen months of ethnographic research in Massachusetts clinics for the homeless and the frail elderly between 2014-2015, I argue that when marginalized patients are unable to satisfy the neoliberal ideal of self-governance to maintain their health in cost-effective ways, providers are …

Factors Predicting Sustainability: A Correlational Study Of One Multi-Site Program, Meredith L. King Jensen

Dissertations, Theses, and Capstone Projects

Healthcare organizations invest significant economic, physical, and human resources to implement changes and expect sustained benefits for their investments in the long term. Yet, few studies have examined long-term sustainability and factors contributingto sustainability. The primary aim of the study was to gain a better understanding of sustainability and five factors (champions, leadership support, policy, resources, and training and education) that might predict long-term sustainability within the context of one Safe Patient Handling and Mobility (SPHM) program implemented in a large, nationwide system more than 7 years ago. The secondary aim was to examine the number of nursing staff injuries, …

Greater Social Cohesion Is Associated With Lower Body Mass Index Among African American Adults, Adolfo G. Cuevas, Ichiro Kawachi, Kasim Ortiz, Mariam Pena, Lorraine R. Reitzel, Lorna H. Mcneill

Publications and Research

Obesity remains a public health issue, especially for Blacks (or African Americans). Obesity is thought to reflect a complex interaction of socioenvironmental, biological, and cognitive factors. Yet, insufficient attention has been given to psychosocial factors like social cohesion within the African American community. Using multivariable linear regression, we examined the association between social cohesion, measured by the Social Cohesion and Trust scale, and body mass index (BMI) with cross-sectional data (n = 1467) from a cohort study (2008–2009). Greater social cohesion was associated with lower BMI (b = -0.88; 95% CI: −1.45, −0.32) in an unadjusted model. The association was …

Leveraging Technology To Blend Large-Scale Epidemiologic Surveillance With Social And Behavioral Science Methods: Successes, Challenges, And Lessons Learned Implementing The Unite Longitudinal Cohort Study Of Hiv Risk Factors Among Sexual Minority Men In The United States, H. Jonathon Rendina, Ali J. Talan, Nicola F. Tavella, Jonathan Lopez Matos, Ruben H. Jimenez, S. Scott Jones, Brian Salfas, Drew Westmoreland

Publications and Research

The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a …

Community-Based Responses To Negative Health Impacts Of Sexual Humanitarian Anti-Trafficking Policies And The Criminalization Of Sex Work And Migration In The Us, Heidi Hoefinger, Jennifer Musto, P.G. Macioti, Anne E. Fehrenbacher, Nicola Mai, Calum Bennachie, Calogero Giametta

Publications and Research

System-involvement resulting from anti-trafficking interventions and the criminalization of sex work and migration results in negative health impacts on sex workers, migrants, and people with trafficking experiences. Due to their stigmatized status, sex workers and people with trafficking experiences often struggle to access affordable, unbiased, and supportive health care. This paper will use thematic analysis of qualitative data from in-depth interviews and ethnographic fieldwork with 50 migrant sex workers and trafficked persons, as well as 20 key informants from legal and social services, in New York and Los Angeles. It will highlight the work of trans-specific and sex worker-led initiatives …

The Never-Ending Lap, Ennica D. Jacob, Alexis Reese

Capstones

This personal film documents the journey of a Haitian-American woman dealing with sexual trauma in a culture that doesn’t speak candidly on the topic. How can women of the African- American diaspora break the cycle of sexual trauma and what are coping mechanisms to navigate their life choices with awareness?

The Never-Ending Lap will follow Ennica’s own healing process, delving delve into the cycles of sexual trauma. The film will explore past experiences through journal entries, therapy sessions and her love for track and field as she is on the road to search for coping mechanisms and healing.

Link: https://ennicajacob.myportfolio.com/videos

Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez

Dissertations, Theses, and Capstone Projects

Previous research suggests ethnic identity, a sense of belonging to a particular cultural group, may be protective against symptoms of post-traumatic stress disorder (PTSD). However, the role of ethnic identity, in-group preference (i.e., an individual’s preference for interactions with members of their own ethnic group) and acculturation (i.e., the level of comfort with the mainstream culture) have not been investigated as protective factors for Latinas with a history of interpersonal and sexual trauma. In this study, ethnic identity, in-group preference and acculturation were assessed via self-report on the Scale of Ethnic Experience in two samples of undergraduate Latina and non-Latina …

Illness And The American Workplace: Issues And Implications For Employers And Employees, Victoria R. Dolan

Student Theses and Dissertations

This project aims to identify American employee experiences and existing workplace policies and cultures surrounding illness, disability, and sick leave. This approach was taken in order to closely examine what looks to be working well for companies and workers, and what could benefit from a more human centric approach in regards to workplace policy and employee support programs. The study of employee experiences in particular represents a gap in the current scholarly literature regarding illness and illness policy in the American workplace, and more accurately represents the experiences for both employees and employers. Furthermore, it assists with distinguishing the types …

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.

Nurse Practitioner Knowledge, Attitudes, And Beliefs When Caring For Transgender People, Catherine Paradiso, Robin M. Lally

Publications and Research

Purpose: The aim of this study was to explore Nurse Practitioner (NP) knowledge, attitudes, and beliefs when working with transgender people and to inform about Practitioner education needs.

Methods: A qualitative descriptive design was used to explore (NP) experiences. Focused semistructured interviews were conducted in 2016 with 11 (N = 11) NPs in the northeastern United States who represent various years of experience and encounters with transgender patients. The interviews explored NP knowledge attitudes and beliefs when caring for transgender patients and described their overall experiences in rendering care in the clinical setting. The interviews were professionally transcribed and analyzed …

Climate Grief Hits The Self-Care Generation, Avichai Scher

Capstones

As the effects of climate change intensify, emotional anguish over the future of the planet is emerging. This piece looks at a 10-step program to deal with climate grief "Good Grief."

At Uplift Climate, a conference on climate change for people under 30 held annually, the creators of Good Grief presented their program. The conference focused on climate justice for Native Americans, who have been dealing with climate grief for a long time.

The setting highlighted the class divide of who is affected by climate change. The effects of climate change are now so strong, that climate grief is hitting …

Dios, Drogas, Dinero: ¿QuiéN Gana Con El Traslado De Adictos De Puerto Rico A Ee.Uu.?, Claudia E. Irizarry Aponte, Eliana Y. Perez

Capstones

For the last 25 years, evangelical leaders have been shipping off opioid addicts in Puerto Rico to cities in the mainland US, mainly New York City, Chicago and Philadelphia--under the promise they’ll receive state-of-the-art rehabilitation treatment, only to end up in unregulated transitional homes and flophouses where they don’t receive proper medical care or psychotherapy. In turn, many of these unregulated transitional homes, also run by evangelical leaders, may charge Medicaid kickbacks from their “patients.”

While this so-called “air bridge” from Puerto Rico to the U.S. goes back decades, it gained momentum from 2005 to 2014, when evangelical leaders joined …

Depression, Anxiety, Post-Traumatic Stress Disorder And A History Of Pervasive Gender-Based Violence Among Women Asylum Seekers Who Have Undergone Female Genital Mutilation/Cutting: A Retrospective Case Review, Hazel Lever, Deborah Ottenheimer, Jimmitti Teysir, Elizabeth Singer, Holly G. Atkinson

Publications and Research

We sought to evaluate the frequency of anxiety, depression, PTSD, and any experiences of violence in women who had undergone Female Genital Mutilation/Cutting (FGM/C) and were seeking asylum in the United States. We undertook a retrospective qualitative descriptive study of FGM/C cases seen in an asylum clinic over a 2-year period. Standardized questionnaires provided quantitative scores for anxiety, depression and PTSD. Clients’ personal and physician medical affidavits were analyzed for experiences of violence. Of the 13 cases, anxiety and depression were exhibited by 92 and 100% of women, while all seven women screened for PTSD had symptoms. Qualitative analysis revealed …