Medicine and Health Commons^™

Addressing The Persistence Of Tuberculosis Among The Canadian Inuit Population: The Need For A Social Determinants Of Health Framework, Kassandra C. Kulmann Ma Candidate, Chantelle Am Richmond Professor

Chantelle Richmond

Canadian Aboriginal people have poorer levels of health than the general population. A serious issue is the high rate of tuberculosis (TB) among the Inuit population; rates are much higher than those of the general Canadian population. Several social determinants of health (SDOH), including household crowding and poverty, are strongly correlated with TB prevalence. In this paper, we describe the medical and social determinants of TB, and critically examine the TB literature specific to the Inuit population. The majority of studies recommend biomedical interventions for the treatment of TB. Few researchers have employed the social determinants of health theory to …

Exploring The Effects Of Multi-Level Protective And Risk Factors On Child And Parenting Outcomes In Families Participating In Healthy Start/Healthy Families Oregon (Hs/Hfo), Peggy Nygren

Dissertations and Theses

While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy …

Reimagining My Body, Center For Public Service

SURGE

I stood there, shoulders slouched, elbows locked, hands glued to the side of the toilet. My body convulsing, I told myself, “this is the last time, just one more time and you’ll get back on track tomorrow.” It wasn’t the last time. I had been forcing myself to purge for months at this point, and each time I hated myself for it.

It was something I couldn’t control. It wasn’t out of a need for attention as so commonly thought, but a pure need to be the unreachable level of thin that I thought would make me beautiful. I was …

Structure Matters: Examining Illness Behavior Using Parsons's Sick Role, Angela D. Byrd

Masters Theses & Specialist Projects

Although Talcott Parsons’s sick role theory, as described in 1951 in The Social System, has been severely criticized for its inapplicability to chronic illnesses, a portion of the theory is still a relevant and necessary factor in terms of understanding and treating chronic illness today. Using data from the 2012 National Health Interview Survey, this study looks at the individual effects of sex, age, race, cohabitation, education and region of residence on the likelihood of chronically ill patients considering themselves limited in their amount or kind of work as an indicator of sick role adaptation. Results show statistically significant relationships …

Food Sovereignty: An Alternative Paradigm For Poverty Reduction And Biodiversity Conservation In Latin America, M. Jahi Chappell, Hannah Wittman, Christopher M. Bacon, Bruce G. Ferguson, Luis García Barrios, Raúl García Barrios, Daniel Jaffee, Jefferson Lima, V. Ernesto Méndez, Helda Morales, Lorena Soto-Pinto, John Vandermeer, Ivette Perfecto

College of Agriculture and Life Sciences Faculty Publications

Strong feedback between global biodiversity loss and persistent, extreme rural poverty are major challenges in the face of concurrent food, energy, and environmental crises. This paper examines the role of industrial agricultural intensification and market integration as exogenous socio-ecological drivers of biodiversity loss and poverty traps in Latin America. We then analyze the potential of a food sovereignty framework, based on protecting the viability of a diverse agroecological matrix while supporting rural livelihoods and global food production. We review several successful examples of this approach, including ecological land reform in Brazil, agroforestry, milpa, and the uses of wild varieties in …

Prenatal Development: Annotated Bibliography, Victoria J. Molfese, Amanda Prokasky, Kathleen Moritz Rudasill, Ibrahim H. Acar, Xiaoqing Tu, Kate Sirota, Brian Keiser

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

For decades, researchers have investigated how events in the prenatal period impact women and their infants. These studies, particularly by researchers in the medical, neuroscience, and behavioral science fields, led to discoveries of important information regarding the prenatal events that were strongly associated with mortality (or death) and morbidity (or incidences of injury, pathology and abnormalities/anomalies, and neurobehavioral sequelae) in the neonatal and infancy periods. Among the many common findings from early research studies, two are particularly noteworthy. First, maternal and fetal risk conditions arising in the prenatal period do not do so in isolation. Sameroff and Chandler characterized this …

The Role Of Culture In Making Psychiatric Diagnosis: Hwabyung (火病) And Neurasthenia (神經衰弱), Jonghyun Lee

2013 New England Association for Asian Studies Conference

The Role of Culture in Making Psychiatric Diagnosis: Hwabyung (火病) and Neurasthenia (神經衰弱)

My paper looks at two psychiatric illnesses and discusses their social and cultural dimensions. The two illnesses to be compared are the Korean affliction called hwabyung, and the once-popular Western malady labeled neurasthenia, a common ailment in 19th century America.

Neurasthenia was defined as “a disorder characterized by feelings of fatigue and lassitude,” which is caused by the nervous system. That definition could fit most people at some time or another. Hwabyung, on the other hand, means “fire illness.” Koreans believe that chronic distress can …

The Association Between Insurance Status And Cervical Cancer Screening In Community Health Centers: Exploring The Potential Of Electronic Health Records For Population-Level Surveillance, 2008-2010, Stuart Cowburn, Matthew J. Carlson, Jodi A. Lapidus, Jennifer E. Devoe

Sociology Faculty Publications and Presentations

Introduction: Cervical cancer incidence and mortality rates in the United States have decreased 67% over the past 3 decades, a reduction mainly attributed to widespread use of the Papanicolaou (Pap) test for cervical cancer screening. In the general population, receipt of cervical cancer screening is positively associated with having health insurance. Less is known about the role insurance plays among women seeking care in community health centers, where screening services are available regardless of insurance status. The objective of our study was to assess the association between cervical cancer screening and insurance status in Oregon and California community health centers …

Gender Disparities In Access To Hiv Testing And Antiretroviral Treatment Services, Wyatt Lombard Smith

Independent Study Project (ISP) Collection

Throughout a six-week practicum period at TASO Mulago in Kampala, Uganda and St. Francis Naggalama Hospital in Naggalama, Uganda, the researcher aimed to find methods to increase male engagement in all facets of comprehensive HIV/AIDS care. Women and children generally receive most global attention on the issue of HIV/AIDS in Uganda but men are beginning to demand more attention. Antiretroviral treatment has been critical in allowing countless people to live functionally with HIV but many research projects have hypothesized that delayed access to HIV/AIDS treatment and prevention methods has resulted in men exhibiting higher mortality rates upon initiation of this …

Risk Factors For Diabetes Mellitus: A Comparative Analysis Of Subpopulation Differences In A Large Canadian Sample, Michael James Taylor

Electronic Thesis and Dissertation Repository

Objectives: Certain Canadian subpopulations observe numerous modifiable and non-modifiable risk factors for diabetes. This study compares immigrants and Aboriginals (First Nations, Inuit, and Métis) with Canada-born individuals at higher risks for diabetes, and deciphers the determinant differences between them.

Methods: Pooled Canadian Community Health Survey data (2001-2010) were used. Time trends for diabetes within each subsample were calculated using individual survey year prevalence rates; diabetes diagnoses were self-reported (N=33,565). Various risk factors were also examined using logistic regression.

Results: Diabetes prevalence rates significantly increased from 2001 to 2010 for each subpopulation, as well as the total sample: Canada-Born individuals (3.9% …

Out Of The Night, Riley Gryc

SURGE

I did not graduate.

After four years of college, waiting for the day I could shake President Riggs’ hand, receive my diploma, and depart our campus with pride and honor, that day never came. One of the hardest things I’ve ever had to do was watch from the back row of the audience as everyone I had attended school with for the last four years, my classmates, my friends, all received their diplomas and moved on without me. The stares from teachers I knew, the surprised looks from underclassmen, the careful tact with which everyone avoided the subject of not …

Factors Influencing Access To Healthcare Services, Melissa Delia

Independent Study Project (ISP) Collection

Following several political upheavals, the country of Madagascar has become one of the poorest countries in the world. This level of poverty affects many aspects of life, especially access to healthcare services. The availability of both allopathic and traditional healthcare to the impoverished citizens of Madagascar was examined through discussions, interviews, and journal articles. It was found that although both the allopathic and traditional medicinal systems do not charge their patients for general consultations and care, there is a high cost for pharmaceutical medications in the allopathic system. These medications are sometimes too expensive for many Malagasy patients to afford. …

Preventative Care And Culture, Anna Wagman

Independent Study Project (ISP) Collection

This paper explores the intersection between culture and health. The similarities and differences between methods for preventative medicine employed by traditional and allopathic systems are discussed. These ostensibly disparate systems, in reality, display many parallels in regards to their delivery. The effects of industrial progress, and therefore cultural change, on the health of the inhabitants of rapidly urbanizing African cities are examined. Historical information from studies of Great Britain, the first area to undergo a full industrial revolution is also drawn on. These analyses essentially predict the societal issues that come with urbanization, such as the amalgamation of preexisting pollutants …

I'M A Patient, Not A Problem: An Exploration Into The Roles Assigned In The Doctor-Patient Relationship, Monica C. Stewart

Honors Theses and Capstones

No abstract provided.

Cardiovascular Health: Associations With Race-Ethnicity, Nativity, And Education In A Diverse, Population-Based Sample Of Californians, Georgiana Bostean, Christian K. Roberts, Catherine M. Crespi, Michael Prelip, Anne Peters, Thomas R. Belin, William J. Mccarthy

Sociology Faculty Articles and Research

Purpose—This study examined how race-ethnicity, nativity, and education interact to influence disparities in cardiovascular (CV) health, a new concept defined by the American Heart Association (AHA). We assessed whether race-ethnicity and nativity disparities in CV health vary by education, and whether the foreign-born differ in CV health from their US-born race-ethnic counterparts with comparable education.

Methods—We used data from the 2009 California Health Interview Survey to determine the prevalence of optimal CV health metrics (based on selected AHA guidelines) among adults ages 25 and over (n = 42,014). We examined the interaction between education and ethnicity-nativity, comparing predicted …

Kawasaki Syndrome In Texas, Alberto Coustasse, Julius J. Larry, Witold Migala, Cody Arvidson, Karan P. Singh

Alberto Coustasse, DrPH, MD, MBA, MPH

The authors examined hospitalization rates of Kawasaki Syndrome (KS) among Texas children to isolate clusters, identify demographic disparities, and suggest possible causative factors. Using a retrospective cross-sectional study design, they studied 330 KS cases from 2,818,460 hospital discharges. The majority of the cases (61.5%) occurred within the 1-4-years-old category, representing the highest hospitalization rate (14.3 per 100,000 children). Almost 75% of the KS population was less than 5 years old, with hospitalization rates approximately 8 times higher than that of all other children (p < .05). KS diagnosis occurred for only 49.4% of all KS cases upon admission. Along with high-density …

Exploring Parental Experiences And Decision-Making Processes Following A Fetal Anomaly Diagnosis, Ramona L. Fernandez

Electronic Thesis and Dissertation Repository

Often the first indication that something may be wrong in a seemingly normal pregnancy occurs during the first detailed ultrasound appointment between 16 and 20 weeks gestation. Even the most tentative suspicions of fetal anomalies is jarring. Parent’s default reality of a normal pregnancy and a ‘perfect child’ changes to one of risk factors and the possibility of an ‘unhealthy child’. This study begins with the realization of this first loss in a series of losses that follow for parents as they grapple with diagnostic information to be able to make informed medical decisions regarding their fetus and pregnancy. The …

Medicalization Of Mental Disorders: 1970- To The Present, W. Joseph Wyatt

Psychology Faculty Research

A thirty-five year escalation of emphasis on biological causation has rendered, for many, medications as the treatment of choice for mental disorders. Non-drug treatment may be cast aside, as a result.

History And Hope: The International Humanitarian Reader, Kevin M. Cahill, M.D.

Institute of International Humanitarian Affairs

History and Hope: The International Humanitarian Reader provides a better understanding—both within and outside academia—of the multifaceted demands posed by humanitarian assistance programs. The Reader is a compilation of the most important chapters in the twelve-volume International Humanitarian Affairs book series published by Fordham University Press. Each selected chapter has been edited and updated. In addition, the series editor, Kevin M. Cahill, M.D., has written, among other chapters, an introductory essay explaining the academic evolution of the discipline of humanitarian assistance. It focuses on the “Fordham Experience”: its Institute of International Humanitarian Affairs (IIHA) has developed practical programs for training …

An Ehealth System Supporting Palliative Care For Patients With Non-Small Cell Lung Cancer: A Randomized Trial, David H. Gustafson, Lori L. Dubenske, Kang Namkoong, Robert Hawkins, Ming-Yuan Chih, Amy K. Atwood, Roberta Johnson, Abhik Bhattacharya, Cindy L. Carmack, Anne M. Traynor, Toby C. Campbell, Mary K. Buss, Ramaswamy Govindan, Joan H. Schiller, James F. Cleary

Community & Leadership Development Faculty Publications

BACKGROUND: In this study, the authors examined the effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus the Internet in relieving physical symptom distress in patients with non-small cell lung cancer (NSCLC).

METHODS: In total, 285 informal caregiver-patient dyads were assigned randomly to receive, for up to 25 months, standard care plus training on and access to either use of the Internet and a list of Internet sites about lung cancer (the Internet arm) or CHESS (the CHESS arm). Caregivers agreed to use CHESS or the Internet and to complete bimonthly surveys; for patients, these tasks …

Perceptions Of Workplace Bullying Among Practicing Registered Nurses, Crystal Regina Threadgill

Dissertations

Workplace bullying (WPB) is a social and organizational problem. Within the health care arena, employees, particularly registered nurses, are at risk. WPB has several adverse effects and has been cited in the literature as closely associated with burnout and nurses leaving their positions. This quantitative study examined workplace bullying among practicing registered and its relationship with burnout and nurses’ intent to leave their current position.

The surveys utilized were the Negative Acts Questionnaires-Revised (NAQ-R), Maslach Burnout Inventory Survey, Intention to Turnover Scale and a demographic survey. Of the surveys distributed, a total of 185 were returned from one selected hospital …

Global Budgets, Payment Reform And Single Payer: Understanding Vemont's Health Reform, Trish Riley

Population Health & Health Policy

The Muskie School of Public Service hosted two health policy colloquia this April to promote informed discussion throughout the state regarding MaineCare coverage options under the ACA and the implications of Vermont’s move toward a single-payer system.The series, sponsored by the Muskie School Board of Visitors, offers community conversations in which experts from various disciplines and perspectives inform and engage the broader public to explore and debate critical policy issues. On April 22, community and sector leaders joined for Global Budgets, Payment Reform, and Single Payer: Understanding Vermont's Health Reform. Participants discussed Vermont's recent movie toward single payer health …

Sweetened Drink And Snacking Cues In Adolescents. A Study Using Ecological Momentary Assessment, Jerry L. Grenard, Alan W. Stacy, Saul Shiffman, Amanda N. Baraldi, David P. Mackinnon, Ginger Lockhart, Yasemin Kisbu-Sakarya, Sarah Boyle Abd, Yuliyana Beleva Abd, Carol Koprowski, Susan L. Ames, Kim D. Reynolds

CGU Faculty Publications and Research

The objective of this study was to identify physical, social, and intrapersonal cues that were associated with the consumption of sweetened beverages and sweet and salty snacks among adolescents from lower SES neighborhoods. Students were recruited from high schools with a minimum level of 25% free or reduced cost lunches. Using ecological momentary assessment, participants (N=158) were trained to answer brief questionnaires on handheld PDA devices: (a) each time they ate or drank, (b) when prompted randomly, and (c) once each evening. Data were collected over 7days for each participant. Participants reported their location (e.g., school grounds, home), mood, social …

The Characteristics Of Women Seeking Funding From The Dc Abortion Fund, Karin Elizabeth Bleeg

GW Research Days 2013

Objectives: To determine whether the population DCAF serves, based on current research, are those most in need of its financial services. Describe the population that DCAF is supports by age, race and ethnicity, poverty, educational attainment, union status, contraceptive method used, referral source, and number of prior pregnancies.

Methods: An adapted version of The Guttmacher Institute's National Patient Survey will be used to collect data from women who contact DCAF for financial assistance for their abortion (n=150). The data will be collected for one month and then analyzed in SPSS.

Results: Between January and March 2013 approximately 400 women contacted …

Risk Factors Associated With Clinical Malaria Episodes In Bangladesh: A Longitudinal Study, Ubydul Haque, Gregory E. Glass, Arne Bomblies, Masahiro Hashizume, Dipak Mitra, Nawajish Noman, Waziul Haque, M. Moktadir Kabir, Taro Yamamoto, Hans J. Overgaard

College of Engineering and Mathematical Sciences Faculty Publications

Malaria is endemic to Bangladesh. In this longitudinal study, we used hydrologic, topographic, and socioeconomic risk factors to explain single and multiple malaria infections at individual and household levels. Malaria incidence was determined for 1,634 households in 54 villages in 2009 and 2010. During the entire study period 21.8% of households accounted for all (n = 497) malaria cases detected; 15.4% of households had 1 case and 6.4% had ≥2 cases. The greatest risk factors for malaria infection were low bed net ratio per household, house construction materials (wall), and high density of houses. Hydrologic and topographic factors were not …

The Impact Of The Chinese Rural Healthcare System On Infectious Disease: A Study Of The History And Reform Of Chinese Healthcare, And The Global Implications Of Infectious Disease Control In China, John Barbadoro

Independent Study Project (ISP) Collection

China’s healthcare system has gone through significant changes in the 20^th and 21^st centuries. These changes have mirrored not only the political focus of the time, but also the social issues facing China. The NRCMCS for rural residents is a cheap annual fee that covers a percentage of medical costs. There are two urban equivalents, the BMIUE and BMIUR for urban employees through their job, and residency respectively. Despite the focus on cheaper healthcare for rural residents, the problems of income inequality and mistrust in the medical system are major problems that affect the health of this large …

Adding Injustice To Injury - Health Perceptions, Plurality, And Power In The Ongoing Bhopal Disaster, Ruth Markwardt

Independent Study Project (ISP) Collection

Standards of health, human rights, and development are typically defined and dictated by policymakers instead of the populations directly affected by so-called development efforts. This paper seeks to contextualize global development efforts by highlighting specific local realities among the community of Bhopal Disaster survivors in Madhya Pradesh, India. As the site of the world’s largest industrial disaster, a disaster which is not over but ongoing, Bhopal represents an important population to highlight as the disaster continues. The Political Ecology of Health model was used to highlight political and environmental influences on community health. Within Political Ecology, this study takes a …

Health As A Human Right: An Analysis Of Healthcare Delivery To Bidonvilles, Juliana Saracino

Independent Study Project (ISP) Collection

Morocco is often characterized by its diverse geographical elements such as deserts, waterfalls, mountains, and beachfronts, but an element that Morocco may not be as proud of yet can be found throughout the country is the bidonville. These small communities that tend to compose sub-sections of major cities host an astonishing number of the urban poor who are forced to live in compromised health and social stigma. Through an investigation of the bidonville dwellers’ experiences with the heath care services, this paper attempts to assess the relationship between the Moroccan healthcare system and the marginalized people it endeavors to, but …

Examining Mainecare’S Coverage Options Under The Affordable Care Act, Erika C. Ziller Phd, Trish Riley

Population Health & Health Policy

The Affordable Care Act (ACA) was designed to achieve nearly universal access to health coverage in the United States—in part by standardizing Medicaid eligibility across the country so that each state’s program would cover individuals with incomes below 138% of the federal poverty level (FPL), or $15,856 for an individual and $32,499 for a family of four in 2013 (see Figure 1).i However, in June 2012, the U.S. Supreme Court determined that states could not be required to broaden Medicaid and retained the decision as a state option. States that choose to participate may do so by amending their state …

The Doctor-Patient Relationship Revisited. An Analysis Of The Placebo Effect., Herbert M. Adler, Md, Van B. Hammett. Md

Herbert M. Adler

An overview of prescientific medicine, evolution, and individual human development is presented in an attempt to discover the generic factors operating in all interpersonal therapies. We hypothesize that the placebo effect rests on the universal human need for a group and, by symbolic extension, a system.