Medicine and Health Commons^™

Disparities In Oral Health: Socioeconomic Status And Policies To Increase Access To Primary Dental Care, Mckenzie Nutter

Theses/Capstones/Creative Projects

Primary dental care is a patient-centered service consisting of routine dental checkups. The oral cavity is the first point of entrance to the body for many harmful pathogens. Therefore, primary dental care is essential to not only prevent and treat conditions in the mouth, but to also reduce the number of systemic diseases in the rest of the body. However, people with higher incomes or wealth have increased access to primary dental care. People with low socioeconomic status have decreased access to primary dental care, at least in part due to difficulties in paying for separate dental insurance. Disparities in …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Seroprevalence Of Novel Coronavirus Sars-Cov-2 At A Community Hospital Emergency Department And Outpatient Laboratory In Northern Orange County, California, Jason Yamaki, Harry Peled, Sajen Mathews, David Park, Mina Firoozi, Kim Smith, Lee Nguyen

Pharmacy Faculty Articles and Research

Introduction

The severe acute respiratory syndrome related coronavirus 2 (SARS-CoV-2) has infected more than 20 million people worldwide, and the spread is most prevalent in the USA, where California had accounted over 240,000 cases in the initial 5 months of the pandemic. To estimate the number of infected persons in our community, we conducted a cross-sectional study to estimate seroprevalence of SARS-CoV-2 infection.

Methods

This cross-sectional study evaluated the presence of immunoglobulin G, antibody for SARS-CoV-2 during the time period of July 15, 2020, to July 27, 2020. Testing was done on serum samples from patients who had visited affiliated …

Rurality Of Medical Provider And Race Of Patient As Risk Factors For Overdose In Opioid Use Disorder Populations, Christopher Vance, Colleen Mulligan, David Von Nordheim, Jodi Heaps-Woodruff Ph.D.

Undergraduate Research Symposium

Title: Rurality of medical provider and race of patient as risk factors for overdose in opioid use disorder populations

Background

This study examines the outcomes of medication assisted treatment (MAT) for opioid use disorders (OUD) based on location of treatment and race of the individual seeking treatment. Opioid use in the United States has been disproportionately rising in the last decade and there is evidence of unequal treatment based on different social disparities, namely rurality and race. Discriminatory distribution of medication and treatment for individuals seeking OUD along the lines of race and rurality is an issue of grave importance …

Clinical Decision Science: Proof Of Concept, James Peter Meza Md, Phd, Nicholus Yee Md, Bennett Riddering Md, Ali Nasrallah Md, Urtė Zableckas Ms, Mbbs

Clinical Research in Practice: The Journal of Team Hippocrates

Clinical decision science, a newly identified area of scholarship, describes how clinical research is used for a patient, within the context of their unique social conditions. We hypothesize that physicians use sociocultural context as an important input to their decision making. We performed a prospective, randomized, double-blind mixed methods study. Family medicine faculty and residents at a community hospital family medicine residency were included in the study. After academic journal club discussing a primary research paper, physicians were asked if they would prescribe medication for a patient who was similar to the subjects in a research paper. However, social and …

Why Can't Homeless Addicts Get Help Too, Rachael D. Causland

English Department: Research for Change - Wicked Problems in Our World

Homeless people today struggle more with addiction than people who have stability in their life. Whether it’s due to financial issues, or not having a support system, homeless people struggle to get the help they need for both their addiction and their homelessness. A high number of homeless people report to have started an addiction since being homeless, and they do so to stay alive, in turn people are continuing to stay homeless and many of these people are dying of overdoses or just staying stuck in the situation they are forced to deal with alone. There are some states …

Discordance In Perceptions Of Barriers To Breast Cancer Treatment Between Hispanic Women And Their Providers, Swapna Reddy, Mary Saxon, Nina Patel, Matthew Speer, Tiffany Ziegler, Nirali Patel, Madison Ziegler, Stephany Esquivel, Andrea Daniella Mata, Asha Devineni, Pooja Paode, Nitika Thawani, Subhakar Mutyala

Journal of Patient-Centered Research and Reviews

Despite comparable screening and incidence rates that are 26% below that of non-Hispanic Whites, Hispanic women present with breast cancer at more advanced stages of disease, representing a continuing and troubling health disparity for this population. Reducing these disparities warrant more innovative research approaches to better understand perspectives of Hispanic patients regarding barriers to treatment and how these perspectives compare to those of their providers. A pilot qualitative study was conducted at a major urban cancer center in Arizona that measured both patient and provider perspectives regarding barriers to treatment. Through a multimethod qualitative analysis, researchers surveyed patients and providers …

Covid-19 Treatment Resource Disparities And Social Disadvantage In New York City, Jason A. Douglas, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

Black and Hispanic communities in the U.S. have endured a disproportionate burden of COVID-19-related morbidity and mortality. Racial and ethnic health disparities such as these are frequently aggravated by inequitable access to healthcare resources in disadvantaged communities. Yet, no known studies have investigated disadvantaged communities' access to COVID-19-related healthcare resources. The current study accordingly examined racial and ethnic differences in (1) April 2020 COVID-19 total and positive viral test rates across 177 New York City (NYC) ZIP Code Tabulation Areas (ZCTA); and (2) November 2019–April 2020 licensed and intensive care unit (ICU) hospital bed access across 194 NYC ZCTAs. Pairwise …

Stutzman, Kelsi - Covid-19 Journal, Kelsi Stutzman

Personal Journals

Personal journal of Kelsi Stutzman, a student in Dr. Laughlin-Schultz's HIS3810 History of Illinois course during Fall, 2020

Growth Mindset Messaging In Stigma-Relevant Contexts: Harnessing Benefits Without Costs, Crystal L. Hoyt, Jeni L. Burnette

Jepson School of Leadership Studies articles, book chapters and other publications

Growth mindsets are increasingly used to promote learning, development, and health. The increased popularity resulted in scrutiny and disputes about utility. The current work reviews a perspective critical to the debate. Namely, we focus on emerging research that examines both the favorable and potentially adverse consequences of growth mindset messaging in stigma-relevant contexts. This double-edged sword model merges the mindset perspective with attribution theory and the psychological essentialism literature. In stigmatizing contexts and in isolation, growth mindsets can indirectly predict less positive outcomes, via personal responsibility for the problem, but more positive outcomes, via expectations for the potential to manage …

Race, Ethnicity, And Insurance: The Association With Opioid Use In A Pediatric Hospital Setting, Louis Ehwerhemuepha, Candice D. Donaldson, Zeev N. Kain, Vivian Luong, Michelle A. Fortier, William Feaster, Michael Weiss, Daniel Tomaszewski, Sun Yang, Michael Phan, Brooke N. Jenkins

Psychology Faculty Articles and Research

Background

This study examined the association between race/ethnicity and health insurance payer type with pediatric opioid and non-opioid ordering in an inpatient hospital setting.

Methods

Cross-sectional inpatient encounter data from June 2013 to June 2018 was retrieved from a pediatric children’s hospital in Southern California (N = 55,944), and statistical analyses were performed to determine associations with opioid ordering.

Results

There was a significant main effect of race/ethnicity on opioid and non-opioid orders. Physicians ordered significantly fewer opioid medications, but a greater number of non-opioid medications, for non-Hispanic African American children than non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic White pediatric …

Availability Of Over-The-Counter Antibiotics In Guatemalan Corner Stores, Purificación Moreno, Alejandro Cerón, Karen Sosa, Marinees Morales, Laura M. Grajeda, Maria Renee Lopez, John P. Mccraken, Celia Cordón-Rosales, Guy H. Palmer, Douglas R. Call, Brooke M. Ramay

Anthropology: Faculty Scholarship

Widespread availability of antibiotics without prescription potentially facilitates overuse and contributes to selection pressure for antimicrobial resistant bacteria. Prior to this study, anecdotal observations in Guatemala identified corner stores as primary antibiotic dispensaries, where people purchase antibiotics without prescriptions. We carried out a cross sectional study to document the number and types of antibiotics available in corner stores, in four study areas in Guatemala. A total of 443 corner stores were surveyed, of which 295 (67%) sold antibiotics. The most commonly available antibiotics were amoxicillin, found in 246/295 (83%) stores, and tetracycline, found in 195/295 (66%) stores. Over the counter …

Parent Responses To Pediatric Pain: The Differential Effects Of Ethnicity On Opioid Consumption, Candice D. Donaldson, Brooke N. Jenkins, Michelle A. Fortier, Michael T. Phan, Daniel M. Tomaszewski, Sun Yang, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

Within the context of the United States opioid epidemic, some parents often fear the use of opioids to help manage their children's postoperative pain. As a possible consequence, parents often do not dispense optimal analgesic medications to their children after surgery, putting their children at risk of suffering from postsurgical pain. The objective of this research was to assess ethnicity as a predictor of both pain and opioid consumption, and to examine how Hispanic/Latinx and Non-Hispanic White parents alter their child's opioid consumption in response to significant postsurgical pain.

Methods

Participants were 254 children undergoing outpatient tonsillectomy and/or adenoidectomy …

Practice-Based Learning: Establishing Simple Monitoring Systems To Support Sgbv Programming In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Michael Gaitho, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

Implementers of sexual and gender-based violence programs in refugee settings are typically eager to learn about the extent to which their programs are making a difference in the lives of those they serve. Basic monitoring information can help address this imperative without unduly burdening program implementers with time-consuming evaluations. The Sauti/VOICE project is guiding adaptation and implementation of evidence-based SGBV interventions in refugee contexts. These interventions are implemented by UNHCR partners in eight countries in the East, Horn, and Great Lakes region of Africa. Although Sauti/VOICE is primarily focused on integrating tested SGBV interventions into refugee contexts, monitoring the implementation …

Practice-Based Learning: Medico-Legal Evidence Collection As Part Of Post-Rape Care In Refugee Contexts, Michael Gaitho, Ronald Kotut, Anne Ngunjiri, Jane T. Thiomi, Josephine Ngebeh, Chi-Chi Undie

Reproductive Health

Health care providers collect an array of documentation and specimens to support criminal investigations. Such documentation and specimens are referred to as “medico-legal” or “forensic” evidence, and in the case of rape, include a survivor’s documented injuries and emotional state at the time of examination, as well as samples and specimens from the survivor’s body or clothing. For survivors of rape and defilement who want to obtain legal justice, medico-legal evidence is critical. In African countries, health providers and the police are depended upon to ensure such evidence is collected, but medico-legal evidence collection can present challenges. Evidence-based interventions are …

Racial Justice And The Image Of Public Health, Marilyn Fischer

Philosophy Faculty Publications

The City Commission in my hometown of Dayton, Ohio recently adopted a resolution declaring racism a public health crisis. In doing so, Dayton joins municipalities around the country, as the global pandemic of coronavirus COVID19 swirls around us. The Commission gave compelling reasons for their action, citing the disparate rates of poor health outcomes in African American communities, as well as disproportionately high rates of poverty, unemployment, economic distress, homelessness, incarceration, and inadequate education.1 The Commission’s commitment to remedy these inequities is welcome. Others have laid out this evidence in much detail; I want to focus here on public health …

Con Confianza: Using Community-Based Participatory Research Principles To Inform Community-Academic Partnership Practices And Build Trust In Hispanic Communities, Sharon Tafolla

Master's Projects and Capstones

Hispanic communities are at disproportionate risk for chronic diseases and researchers have cited the need for further community and culturally informed studies to improve research outcomes to either make treatments and interventions more generalizable or modify them to the needs of Hispanic communities. However, many of the same linguistic and cultural barriers to health care access and utilization also impact the ability for Hispanic groups to participate in research studies. Community Academic Partnerships (CAPs) are positioned to conduct culturally and linguistically competent research in Hispanic communities. For research in Hispanic communities to be effective, CAPs must prioritize practices that build …

Mechanisms Study: Using Game Theory To Assess The Effects Of Social Norms And Social Networks On Adolescent Smoking In Schools—Study Protocol, Ruth F. Hunter, Felipe Montes, Jennifer M. Murray, Sharon C. Sanchez-Franco, Shannon C. Montgomery, Joaquín Jaramillo, Christopher Tate, Rajnish Kumar, Laura Dunne, Abhijit Ramalingam, Erik O. Kimbrough, Erin Krupka, Huiyu Zhou, Laurence Moore, Linda Bauld, Blanca Llorente, Olga L. Sarmiento, Frank Kee

Economics Faculty Articles and Research

This proof of concept study harnesses novel transdisciplinary insights to contrast two school-based smoking prevention interventions among adolescents in the UK and Colombia. We compare schools in these locations because smoking rates and norms are different, in order to better understand social norms based mechanisms of action related to smoking. We aim to: (1) improve the measurement of social norms for smoking behaviors in adolescents and reveal how they spread in schools; (2) to better characterize the mechanisms of action of smoking prevention interventions in schools, learning lessons for future intervention research. The A Stop Smoking in Schools Trial (ASSIST) …

Support Clubs For Children And Youth In Haiti Living With Hiv: A Case Study, Susan Settergren, Robert Philippe, Joanne St. Louis, Nathaniel Segaren, Sylvie Boisson, Tessa Lewis, Olbeg Désinor, Kesner François

HIV and AIDS

In Haiti, where an estimated 3,000 children and youth are receiving antiretroviral therapy (ART), Caris Foundation, with funding from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID), provides hospital-linked psychosocial support groups, known as Kids Clubs, for young people ages nine and older. The clubs are intended to help ensure that HIV-positive children and adolescents stay in contact with health services, and serve as a conduit for delivery of other services, including health messages and health products. In 2019, Project SOAR conducted a study to describe the Kids Club …

Creatively Exploring Self: Applying Organic Inquiry, A Transpersonal And Intuitive Methodology, Larisa J. Bardsley Phd

The Qualitative Report

This article explores the merit of using Organic Inquiry, a qualitative research approach that is most effectively applied to areas of psychological and spiritual growth. Organic Inquiry is a research approach where the psyche of the researcher becomes the instrument of the research, working in partnership with the experiences of participants and guided by liminal and spiritual influences. Organic Inquiry is presented as a unique methodology that can incorporate other non-traditional research methods, including intuitive, autoethnographic and creative techniques. The validity and application of Organic Inquiry, as well as its strengths and limitations are discussed in the light of the …

Lessons From A Five-Year Research Programme On Fgm/C And Their Relevance For Policy And Programmes In Kenya, Dennis Matanda, Agnes K. Meroka-Mutua, Samuel Kimani

Reproductive Health

The Sustainable Development Goals target the elimination of all forms of harmful practices, including female genital mutilation/cutting (FGM/C) by 2030. Kenya has made progress in addressing the elimination of FGM/C through ratification of global instruments and enactment of the Prohibition of FGM Act in 2011 and other supportive laws. The Act created the foundation for the establishment of the Anti-FGM Board, which provides policy leadership and coordination of anti-FGM/C programs in Kenya. More recently, the President of Kenya issued a decree for accelerated elimination of FGM/C by 2022. This synthesis report highlights how evidence generated over the last five years …

Important Lessons On Fgm/C Abandonment From Four Research Studies In Egypt, Nada Wahba, Nahla G. Abdel-Tawab, Abeer Salem

Reproductive Health

Female genital mutilation/cutting (FGM/C) continues to be a widespread practice in Egypt. According to the 2014 Egypt Demographic and Health Survey, the prevalence of FGM/C was 92 percent among ever-married women aged 15–49. However, Egypt continues to witness a drastic surge in the medicalization of FGM/C, with 74 percent of women aged 19 years and younger circumcised by medical practitioners, compared to 55 percent in 1995. This policy brief provides key results and recommendations of four studies conducted by the Population Council/ Egypt under the Evidence to End FGM/C project, in coordination with Egypt’s National Population Council. The four studies …

Commentary: Using Law More Effectively Towards Abandonment Of Fgm/C In Kenya, Agnes K. Meroka-Mutua

Reproductive Health

Female genital mutilation/cutting (FGM/C) is considered a harmful cultural practice and a form of violence against women. Kenya has an FGM/C prevalence rate of 21 percent, but levels vary by ethnic group. Kenya has adopted a robust legal framework for the prohibition of FGM/C, including passage of the Prohibition of FGM Act in 2011, a detailed law that criminalizes carrying out FGM/C and associated offenses. Kenya relies on the human rights–based approach and criminalization in its legal framework for the prohibition of this practice. Despite extensive legal provisions, Kenya has prosecuted fewer than 100 cases, raising concerns with the law’s …

Knowledge Of Breast Cancer And Screening Methods Among Rural Women In Southwest Nigeria, Rowland Edet, Oluwayimika Ekundina

Department of Sociology: Faculty Publications

The objective of this study was to assess the awareness of rural women on breast cancer and its screening methods in Southwest Nigeria. Descriptive cross-sectional survey design with the aid of a semi-structured questionnaire was used to generate data among 422 rural women in selected communities in Egbeda local government area of Ibadan. The qualitative data was generated through in-depth interviews among rural women and key informant interviews among health workers in the communities. The study revealed that only 63.7% were aware of breast cancer screening methods compared to 31.6% who were not aware. The commonly known screening method among …

Variability In The Analysis Of A Single Neuroimaging Dataset By Many Teams, Rotem Botvinik-Nezer, Tom Schonberg, Russell A. Poldrack, Zachary J. Cole, Matthew R. Johnson, Phui Cheng Lim, Evan N. Linz, Douglas H. Schultz, Joshua E. Zosky, Narps Management Team, Jean M. Vettel, More Than 100 Other Co-Authors

Department of Psychology: Faculty Publications

Data analysis workflows in many scientific domains have become increasingly complex and flexible. To assess the impact of this flexibility on functional magnetic resonance imaging (fMRI) results, the same dataset was independently analyzed by 70 teams, testing nine ex-ante hypotheses. The flexibility of analytic approaches is exemplified by the fact that no two teams chose identical workflows to analyze the data. This flexibility resulted in sizeable variation in hypothesis test results, even for teams whose statistical maps were highly correlated at intermediate stages of their analysis pipeline. Variation in reported results was related to several aspects of analysis methodology. Importantly, …

An Investigation Of Stress-Related Factors And Injury Occurrence In Division Iii Ice Hockey Athletes 2020., Christian Kiesel

Master's Theses

Many variables can factor into a student athlete sustaining an injury, but one of the most interesting is stress. The Stress and Injury Model is excellent in explaining how exactly history of stressors, personality, and coping mechanisms play a pivotal role in the stress response. If these three factors cause a negative stress response, then that will lead to an athlete becoming more likely to become injured. This study used 40 ice hockey players from a Division III NCAA institution. Each participant completed the Inventory of College Students’ Recent Life Experiences (ICSRLE) and Pittsburgh Sleep Quality Index (PSQI) every month …

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 …

La Determinación Social De La Enfermedad Renal Crónica De Causas No Tradicionales (Ercnt) En Guatemala / The Social Determination Of Chronic Kidney Disease Of Non-Traditional Causes (Ckdnt) In Guatemala, Alejandro Cerón

Anthropology: Faculty Scholarship

La Enfermedad Renal Crónica de Causas no Tradicionales (ERCnT) ha aumentado en los últimos 20 años, convirtiéndose en un problema de salud pública importante que se observa principalmente en países de Centroamérica y Asia, afectando especialmente a trabajadores agrícolas jóvenes. La presencia de factores de riesgo relacionados con toxinas, medio ambiente y condiciones laborales sugiere una causa multifactorial, la cual puede que involucre la exposición a agroquímicos, contaminantes ambientales, y episodios repetidos de deshidratación. La comprensión de las condiciones sociales que unen estos factores en grupos específicos de población es fundamental para el desarrollo de programas de salud pública tendientes …

Developing An Online Health Community For Autoimmune Disease Patients Through Self-Managed Diet, Rachel Greene

Critical and Creative Thinking Capstones Collection

Part I, Autoimmune Disease Management and the Need for Intervention, discusses current and standard Autoimmune Disease- (AI/AID) management and the shortcomings within. Typical AID-management led by healthcare professionals lacks a holistic, symptom-based approach, thus further contributing to the daily chronic pain of the afflicted. This analysis indicates the need to connect those suffering with AID’s to scientific research that has determined strict dieting can significantly reduce symptoms associated with AID’s. Part II, Synthesizing A Model For Online Health Community Engagement, examines the website prototype of Greenebean, which is an online community developed via user-centric design, in a theoretical, physical, and …

Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods

Dissertations

Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …