Medicine and Health Commons^™

Investigation Of Sandwich Generation Caregiver Perceptions And Factors Of Caregiving Strain, Samantha Marie Young

Masters Theses

The Sandwich Generation caregiver is responsible for caring for their children and parents simultaneously (Miller, 1981). In this study, stressors, burdens, and strains were analyzed in relation to caregiver demographics and the following variables: caregiving relationship quality, caregiving roles, communication, and resources (time and finances). The purpose of this study is to investigate the factors that contribute to perceived strains in Sandwich Generation caregivers. The Sandwich Generation Caregiver Survey was distributed through social media (Facebook, Instagram, Twitter, and LinkedIn), email, listservs, and word of mouth through a nonprobability snowball approach (Creswell, 2012). The researcher used frequency counts, percentages, and mean …

A Systems Approach To Improving Delivery And Update Of Facility-Based Hiv Testing And Linkage To Care In South Africa, Project Soar

HIV and AIDS

Project SOAR is examining the current delivery of HIV testing (HTS) and linkages to care (LTC) services—including barriers, facilitators, and infrastructure—in Ekurhuleni District, South Africa which has the second-highest district-level HIV prevalence in the country. Based on these formative findings, the project will develop and test tailored approaches to increase patients’ uptake of HTS and subsequent LTC, if positive. The project expects to find evidence of HTS coverage outside of antenatal care; document key systems-level barriers to HTS and LTC; assess potentially generalizable clinic-level strategies to increase HTS delivery and assess LTC needs; and identify the added value for implementation …

Effect Of A Family-Centered Model Of Hiv Care On Viral Suppression And Care Retention Among Hiv-Positive Children In Swaziland, Project Soar

HIV and AIDS

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has been supporting the Kingdom of Swaziland since 2003 to prevent mother-to-child transmission and to provide care and treatment services to HIV-positive children and adults. Project SOAR and the Swaziland Ministry of Health are leveraging EGPAF’s establishment of a family-centered care service delivery program (FAM-CARE) and a national rollout of viral load monitoring to assess their implementation and effect on viral suppression and retention in care among children living with HIV. This implementation science study is important because it will provide critical data to national and global policymakers about the model’s feasibility, acceptability, …

Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar

HIV and AIDS

In Malawi, and other resourced-constrained, sub-Saharan African countries with a high HIV burden, several service delivery models have emerged to increase prevention of mother-to-child transmission care retention by strengthening connections between health facilities and their surrounding communities. Yet there has been little documentation of the unique characteristics of each model and their comparative impact on mother-infant pair (MIP) care retention and other health outcomes. This brief describes how Project SOAR is responding to these knowledge gaps by conducting research to identify components of community-based MIP support that are associated with maternal care retention and infant HIV-free survival. This research will …

Evaluation A Depression Treatment Program On Hiv Care And Mental Health Outcomes In Malawi, Project Soar

HIV and AIDS

This brief outlines a Project SOAR study which will provide critical evidence on the feasibility, effectiveness, and cost-effectiveness of an integrated depression treatment model for improving retention in and adherence to HIV care in Malawi. Among people initiating antiretroviral therapy (ART), those with depression are a large and especially vulnerable population. Depression affects 18–30 percent of patients receiving HIV care in Africa and is an important barrier to early ART retention. Evidence revealed by the study will have implications not only for the applicability of the model in Malawi but for other countries in sub-Saharan Africa as well.

Project Yes! Youth Engaging For Success: A Peer Mentoring Program To Transition Youth To Hiv Self-Management In Zambia, Project Soar

HIV and AIDS

This activity brief describes an operational study that responds to challenges and evidence gaps in Zambia about how to support adolescents and young adults living with HIV (YLHIV) in having a greater and more effective role in the management of their own care. The study aimed to refine and test a peer-mentoring strategy in Zambia to strengthen the capacity of health systems and families to support youth as they transition to, and engage in, self-management and adult HIV care and treatment. This approach builds on previous Ministry of Health–approved research at Arthur Davison Children’s Hospital with YLHIV and their families. …

Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar

HIV and AIDS

Project SOAR is conducting implementation science research in Malawi to build needed evidence to inform decisionmaking about effective programming to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. Specifically, SOAR is: examining approaches to identify the most at-risk girls, particularly those out of school, and enroll and retain them in DREAMS programming; assessing HIV-risk and health-seeking behaviors before and after AGYW’s engagement in DREAMS interventions; exploring how to reach AGYW’s male sexual partners and increase their uptake of HIV services; and assessing facilitators and barriers to HIV service uptake by men living with HIV. …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

Consecuencias De La Dictadura: La Salud Mental Transgeneracional En Hijos De Detenidos Desaparecidos / Consequences Of The Dictatorship: Transgenerational Mental Health In Children Of Disappeared Detainees, Catherine Sillari

Independent Study Project (ISP) Collection

Research Question: What are the trends seen in the mental health of the children of the people who were “disappeared” by the Pinochet dictatorship?

Objectives: The general objective of this study is to look for trends in the mental health of children of disappeared people. The specific objectives are to understand the particular stresses that come with disappearances versus other types of deaths, to gage the general opinion of the government’s system of reparation, and to identify common coping methods.

Background: Between the years of 1973-1990, Chile was under the military dictatorship of Augusto Pinochet. During this time, major …

The Importance Of Nature: An Investigation On How Geography Influences Well-Being, Christina Cobb

Independent Study Project (ISP) Collection

The objective of this community service project (CSP) was to study how a community’s location, specifically within nature, influences their well-being. I hoped to see how the community’s location, within Chapada Diamantina national park, influences the many ways health is promoted, and how these ways are affected by their location within nature. This project was built upon a review of the literature, which found that there is a theoretical basis for the notion that contact with nature is beneficial, a term deemed Biophilia. There is a robust body of academic research that highlights the health benefits deriving from contact …

Continuing Efforts To Alleviate "Orange Pain" An Internship With The Da Nang Association Of Victims Of Agent Orange/Dioxin, Loan Heilner

Independent Study Project (ISP) Collection

This year marked the 55th anniversary of Vietnam’s Agent Orange Disaster. Decades after the end of the war, Vietnamese people are still largely being affected by the remnants of the United States’ Agent Orange herbicide sprays. Dioxin chemical has now been confirmed detrimental to human and environmental well-being, but unfortunately it still remains in high concentrations in certain areas of Vietnam. Dioxin chemical is passed on through genetics to new generations, but one of the leading causes of dioxin-related health defects today are due to environmental residue. In Da Nang, Agent Orange was stored and loaded at the local airbase …

Pathways To Positive Change: A People's Perspective Of Healthcare In Humla, Wensday Meyers Berman

Independent Study Project (ISP) Collection

The villagers of Humla have suffered from unreliable health services and unjust indifference from the Nepali government for too long. Many global health initiatives and international NGOs have tried and failed to step in and make an improvement of health within these villages, because they are lacking an understanding of how these villages are run, what villagers prioritize, and how to continue providing reliable, supervised support. Because of the remoteness of the Humla area, it is difficult for allopathic medicine to be sufficiently provided here, and access to emergency medical resources are limited. Global health organizations such as WHO and …

L'Effet De La Sélection De L’Immigrant En Bonne Santé Au Canada: Une Revue Systématique, Zoua Vang, Jennifer Sigouin, Astrid Flenon, Alain Gagnon

Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/ Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail

Au Canada, la politique d'immigration favorise les individus ayant un capital humain élevé (Knowles, 2007). Étant donné les liens étroits entre le capital humain et la santé (Jasso et al., 2004) et le fait que les recherches suggèrent la présence d'un avantage de santé universel au sein de la population immigrante au Canada, nous nous attendions à observer l'effet de la sélection de l’immigrant en bonne santé à tous les stades du parcours de vie et sur des problèmes de santé multiples. Notre examen suggère plutôt un modèle plus complexe qu’envisagé initialement. Cette synthèse indique que les immigrants ont clairement …

“Great Job Cleaning Your Plate Today!” Determinants Of Child-Care Providers’ Use Of Controlling Feeding Practices: An Exploratory Examination, Dipti A. Dev, Brent A. Mcbride, Katherine E. Speirs, Kimberly A. Blitch, Natalie A. Williams

Department of Child, Youth, and Family Studies: Faculty Publications

Background National early childhood obesity prevention policies recommend that child-care providers avoid controlling feeding practices (CFP) (e.g., pressure-to-eat, food as reward, and praising children for cleaning their plates) with children to prevent unhealthy child eating behaviors and childhood obesity. However, evidence suggests that providers frequently use CFP during mealtimes.

Objective Using the Academy of Nutrition and Dietetics (2011) benchmarks for nutrition in child care as a framework, researchers assessed child-care providers’ perspectives regarding their use of mealtime CFP with young children (aged 2 to 5 years).

Design Using a qualitative design, individual, face-to-face, semi-structured interviews were conducted with providers until …

Obesity Over The Life Course: Perspectives In Health And Mortality, Noura E. Insolera

Dissertations, Theses, and Capstone Projects

This dissertation seeks to examine obesity in different contexts throughout the life course. Through empirical analyses, separate stages of the life course are considered: namely childhood through adolescence, young adulthood, and adulthood. By using a life course perspective, it is possible to consider longitudinal and intergenerational approaches to these questions, which will update and inform the current debates surrounding obesity.

Beginning with children, the intergenerational transmission of diet disease knowledge, socioeconomic status, and child health behaviors are considered in their associations with the outcomes of child diet in 2002, and in turn their associations with child obesity in 2007. Information …

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

Dossier De Politique No. 25 - Les Immigrants Sont-Ils En Meilleure Santé Que Les Natifs Du Canada?, Zoua M. Vang, Jennifer Sigouin, Astrid Flenon, Alain Gagnon

Population Change and Lifecourse Strategic Knowledge Cluster Research/Policy Brief

Plusieurs études montrent que les immigrants sont en meilleure santé que leurs concitoyens du pays d’accueil, du moins dans les premiers temps suivant leur arrivée. Le présent travail de synthèse (prenant en considération 77 travaux empiriques sur la question) démontre que si l’effet de « l’immigrant en bonne santé » est souvent avéré chez les immigrants adultes, il en va tout autrement chez les enfants ou les personnes âgées. L’ampleur de l’effet de sélection est aussi nettement plus significative pour les indicateurs de mortalité que de morbidité. Notre analyse suggère que les politiques en matière de santé des immigrants ne …

Dossier De Recherche No. 22 - De Nouvelles Pistes Sur Le Vieillissement Démographique Et Les Coûts Des Soins De Santé Au Québec, Michaël Boissonneault, Jacques Légaré, Yann Décarie

Population Change and Lifecourse Strategic Knowledge Cluster Research/Policy Brief

Cette recherche s'intéresse aux déterminants individuels associés à la variation des coûts publics des soins de santé, chez les Québécois de 65 ans et plus, vivant en ménage privé, avec incapacités. À l'aide de données administratives, la variation des coûts pour la consultation de professionnels de la santé et la consommation de produits pharmaceutiques a été analysée en fonction du nombre d’incapacités ainsi que de la nature de celles-ci. Les résultats montrent que des coûts plus élevés sont associés à un nombre plus élevé d'incapacités ainsi qu'à certains types particuliers d'incapacité, soient celles liées à l’agilité, la mobilité et, plus …

Research Brief No. 13 - The Social And Health Service Needs Of Aboriginal Peoples In Urban Southern Ontario, Martin Cooke, Julia Woodhall, Jennifer Mcwhirter

Population Change and Lifecourse Strategic Knowledge Cluster Research/Policy Brief

The disproportionate needs of urban Aboriginal people make it important for urban social and health service providers to understand the conditions faced by this population. This synthesis paper reviews recent literature on urban Aboriginal populations in order to identify their characteristics and main areas of need. It is meant to inform those who work in health and social service planning and delivery in smaller urban centers, particularly non-Aboriginal service agencies in Southern Ontario. The existing research shows that urbanized First Nations, Métis and Inuit have greater needs for specific health, cultural, justice, financial, and educational services. Further-more, the literature indicates …

Policy Brief No. 10 - The Town With No Poverty: Health Effects Of Guaranteed Annual Income, Evelyn L. Forget

Population Change and Lifecourse Strategic Knowledge Cluster Research/Policy Brief

Guaranteed Annual Income (GAI) has been advocated and opposed in both the United States and Canada as a means to fight poverty since the 1960s, but how does GAI influence specific health and social outcomes? In examining data from a town involved in a Canadian GAI field experiment, we primarily found that a relatively modest GAI can improve population health at the community level. Considering the increasing burden of health care costs in Canada, it is possible that implementing GAI could amount to considerable savings.

Policy Brief No. 5 - The Social And Health Consequences Of Family/Friend Caregiving, Stephanie Fletcher, Janet Fast, Jacquie Eales

Population Change and Lifecourse Strategic Knowledge Cluster Research/Policy Brief

The retrenchment of health care and other public support services coupled with economic and demographic changes have increased demands on family/friend caregivers. Family/friend caregivers are expected to do more with less. Yet the social and health consequences of providing family/friend care can undermine caregivers’ own wellbeing. A better understanding of these non-economic costs is important to preserving this vital resource. Using Statistics Canada’s 2007 General Social Survey (GSS), we describe the impact caregiving has on the health and social well-being of family/friend caregivers aged 45 and older in Canada.

Exploration Of The State Of Mental Healthcare Services For Youth In Nairobi, Rashiidah Richardson

Independent Study Project (ISP) Collection

This paper is formative research concerning the state of mental health care for youth in Nairobi, Kenya. Using a mixed methods design, the objectives of this study were to identify the most prevalent mental health concerns among youth in Kenya, to explore the availability and acceptability of youth friendly mental health care services, and to explore the quality of and challenges to providing youth friendly mental health care services. Results indicate that substance abuse, conduct disorder, and family conflict may be among the most pressing mental health concerns for young people. Furthermore, while young people may be willing to seek …

Marital Quality Buffers The Association Between Socioeconomic Status And Ambulatory Blood Pressure, Wendy C. Birmingham, Jenny M. Cundiff, Bert N. Uchino, Timothy W. Smith

Faculty Publications

Background Socioeconomic status is robustly associated with rates of death and disease. Psychophysiological stress processes are thought to account for a portion of this association. Purpose Although positive and supportive relationships can buffer psychophysiological stress responses, no studies have examined whether the quality of a primary adult relation�ship—marriage—may buffer the negative association be�tween socioeconomic status and stress-related disease processes. Methods The current study examines the interaction between income and marital quality (supportive vs. ambivalent) on individuals’ daily ambulatory blood pressure, a valid and re�liable indicator of cardiovascular risk. Results Results revealed that supportive marital relationships buffered the otherwise higher ambulatory …

Los Médicos No Creen En La Brujería: El Choque Entre La Psicologia Occidental, El Catolicismo Y Las Creencias Ancestrales En La Salud Mental Boliviana, Olivia Legan

Independent Study Project (ISP) Collection

Este ensayo explora el concepto de salud mental en Bolivia y discute cómo las creencias ancestrales y el catolicismo determinan el entendimiento boliviano sobre la salud. También se toma en cuenta el rol de la salud mental en la migración interna y la tensión entre el estilo de vida rural y urbano. En base a mis experiencias en un centro de terapia alternativa y un hospital psiquiátrico católico, voy a comunicar algunas maneras en que se recibe e implementa la psicología occidental en la sociedad boliviana.

This paper explores mental health in Bolivia and discusses how both ancestral beliefs and …

Sex And Sexual Education In China: Traditional Values And Social Implications, Isabella Steinhauer

Independent Study Project (ISP) Collection

In China, the differing views of sex between younger and older generations is the clearest indicator ofthe division of modern and traditional thought in societyand their resulting repercussions. The paper examineswhat specific traditional Chinese norms and values spark many social issues in China, how those traditional values are reflected in the lack of sexual education, and then analyzes how the lack of sexual education impacts those social issues.Formal interviews were conducted in Kunming with seven college students (aged 18-23) from Yunnan Finance and Economics University and other universities, while more casual conversations were held with people of other ages in …

A Qualitative Investigation On The Effects Of The Uttar Pradesh Population Policy On Women Who Undergo Sterilization In Bahraich, Uttar Pradesh, Anna Wadhwani

Independent Study Project (ISP) Collection

The effectiveness of population policies is widely disputed by the international development community and is under constant scrutiny. While these policies have the potential to positively affect reproductive and child health indicators, they often focus too heavily on macro-demographic family planning goals and fail to acknowledge socioeconomic determinants of fertility indicators, often making for ineffective policy. Furthermore, target-based approaches have the potential to negatively impact women’s family planning choices and the quality of care they receive. This study seeks to analyze how the Uttar Pradesh Population Policy affects the decision-making process and experiences of women who undergo sterilization procedures in …

Inégalités En Santé Chez Les Adultes Plus Vieux Dans Les Pays Développés: Réconcilier Théories Et Approches Politiques, Amélie Quesnel-Vallée, Andrea Willson, Sandra Reiter-Campeau

Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/ Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail

Les politiques dont le but est de soutenir les personnes âgées creusent peut-être les inégalités. Des régimes de pensions de plus en plus privatisées et un manque de services de soutien subventionnés profitent de façon disproportionnée à ceux qui ont les moyens sociaux et économiques les plus forts à l’âge avancé. Les gens favorisés sont en meilleure santé que ceux qui sont désavantagés. Le Canada a l’occasion d’éviter un impact si biaisé des programmes pour les aînés, en puisant dans les approches créées par l’Organisation mondiale de la santé, des exemples internationaux et dans la théorie et la recherche sociologique. …

Research Brief: "Aging Well Among Women Veterans Compared With Non-Veterans In The Women’S Health Initiative", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study analyzes a veteran status' effects on aging among women 80 years and older. For policy and practice, this research clearly states that mental health and healthy behaviors are important for aging women, and that the VA should continue research on health needs of aging female veterans. Suggestions for future research include studies to better understand special health risks among older female veterans, how self-resiliency among female veterans affects their health as they age, and how educational attainment relates to older female veterans' health.

A Systematic Review Of The Treatment And Management Of Pre-Eclampsia And Eclampsia In Pakistan, Saleem Shaikh, Ali M. Mir

Reproductive Health

Pakistan is one of the six countries that account for more than 50 percent of the world’s maternal deaths. According to Population Council estimates, each year nearly 8.6 million women become pregnant in the country. Of these, 1.2 million women are likely to face obstetric complications. Each year, there are nearly 14,000 pregnancy-related deaths. Information is lacking on context-specific health-system barriers that prevent optimal use of the lifesaving medicine magnesium sulfate (MgSO4) in Pakistan. Although efforts in Pakistan both at the national and subnational level are ongoing on the prevention and treatment of pre-eclampsia and eclampsia (PE/E), results are generally …

Los Riesgos Sobre La Salud De Los Trabajadores Inmigrantes Bolivianos En Los Talleres Textiles En La Ciudad Autónoma Buenos Aires: Las Experiencias De Los Trabajadores De La Cooperativa La Alameda / The Health Risks Of Bolivian Immigrant Workers In Textile Workshops In The Autonomous City Of Buenos Aires: The Experiences Of Workers At Cooperative La Alameda, Marian Gardner

Independent Study Project (ISP) Collection

Los bolivianos inmigran a Argentina para escapar de la falta de oportunidades laborales y de la pobreza. Sin embargo, una vez en Argentina, su inserción laboral es precaria e informal, principalmente, son contratados en los talleres textiles clandestinos. En éstos , donde la mayoría de ellos también vive, se ven reducidos a condiciones de servidumbre, explotación y son sometidos a condiciones de semi esclavitud, como lo demuestran las 14 a 18 horas de trabajo que realizan los siete días de la semana por sólo alrededor de $ 1300 a $ 3000 pesos argentinos por mes. Además, las condiciones laborales suponen …