Medicine and Health Commons^™

The Cultural And Systemic Influence On Substance Use Disorder, Christina Seery

Independent Study Project (ISP) Collection

The opioid epidemic is an extensive global problem, but it is not random that it is most severe in the United Sates. It is commonly believed that the individuals with substance use disorder and the health care system are at fault, however many people disregard the impact culture and systems have on substance use disorder. I tackled this gap by conducting formal qualitative interviews with experts in the field of addiction and dissecting academic work. After this research it is apparent that the American culture and institutions has made individuals vulnerable to become addicted to opioids while other similar European …

Reflections On The Effects Of Federalism On Opioid Policy, Matthew B. Lawrence

Dickinson Law Review (2017-Present)

No abstract provided.

Mhpaea & Marble Cake: Parity & The Forgotten Frame Of Federalism, Taleed El-Sabawi

Dickinson Law Review (2017-Present)

No abstract provided.

State Regulatory Responses To The Prescription Opioid Crisis: Too Much To Bear?, Lars Noah

Dickinson Law Review (2017-Present)

In order to prevent further overuse of prescription opioids, states have adopted a variety of strategies. This article summarizes the growing use of prescription drug monitoring programs, crackdowns on “pill mills,” prohibitions on the use of particularly hazardous opioids, limitations on the duration and dosage of prescribed opioids, excise taxes, physician education and patient disclosure requirements, public awareness campaigns, and drug take-back programs. Although occasionally challenged on constitutional grounds, including claims of federal preemption under the Supremacy Clause, discrimination against out-of-state businesses under the dormant Commerce Clause doctrine, and interference with rights of commercial free speech, this article evaluates the …

Safe Consumption Sites And The Perverse Dynamics Of Federalism In The Aftermath Of The War On Drugs, Deborah Ahrens

Dickinson Law Review (2017-Present)

In this Article, I explore the complicated regulatory and federalism issues posed by creating safe consumption sites for drug users—an effort which would regulate drugs through use of a public health paradigm. This Article details the difficulties that localities pursuing such sites and other non-criminal-law responses have faced as a result of both federal and state interference. It contrasts those difficulties with the carte blanche local and state officials typically receive from federal regulators when creatively adopting new punitive policies to combat drugs. In so doing, this Article identifies systemic asymmetries of federalism that threaten drug policy reform. While traditional …

Medical Trust In Pediatric Care In The United States, Talia Feldscher

Independent Study Project (ISP) Collection

Trust is a critical aspect of the patient-provider dynamic, but in the U.S., its importance is overlooked in many medical settings, especially among those from low socio-economic groups. As the disparities in American healthcare are being recognized on a larger scale, it is necessary to further uncover why this is the case, and how to begin to remedy this disparity. This study presents an original qualitative data set of perspectives from four current health/mental health practitioners, based on their experiences with their pediatric patients, and how the concept of trust is critical to their service provision. Supported by literature, this …

“En Defensa Por La Salud”: Los Actores Sociales En La Construcción Del Movimiento Social En Chile, Karina Martinez

Independent Study Project (ISP) Collection

This investigation aimed to describe the construction of the social movement for health demands in the frame of the social outbreak in Chile in October 2019. In addition to identifying the main health demands of this movement, it also had a focus on understanding the role of social organizations in the construction of the movement and placing it within the broader socio-political movement that arises from the social outbreak. The research design was qualitative and descriptive. Having been a remote investigation, it was largely based on literature review with the support of information from a semi-structured interview. Regarding the results, …

El Rol Del Gobierno En Las Campañas Sanitarias De Vih, Covid-19 E Influenza, Sydney Reyes

Independent Study Project (ISP) Collection

Research Question: What are the differences and similarities between the three health campaigns — the flu, HIV, and COVID-19 — that the Chilean government has spread to population?

Objectives: The primary objective of this study was to describe and compare the three public health campaigns — the flu, HIV, and COVID-19 — to examine the role that the Chilean government has in health education and heath promotion. The secondary objectives were to identify the differences in national health campaigns and regional campaigns as well as to show the interactions between health campaigns and indigenous people. Overall, the research project looked …

The Current State Of Migrant Health In Morocco: Pre-And Peri-Covid-19 Pandemic, Layla Babahaji

Independent Study Project (ISP) Collection

In the early 21st century, Morocco transitioned from being a predominantly transit migration country into both a transit and destination country for migrants. In 2013, the Moroccan government took significant steps to adapt the healthcare system in better integrating migrants in its policies. The government implemented the National Strategy on Immigration and Asylum that improved access to public health care for migrants. Recently, in March of 2020, Morocco declared a state of medical emergency due to the current COVID-19 pandemic that continues today. This paper addresses the effects of the COVID-19 pandemic on the current state of migrant health in …

Cleveland, Alex - Covid-19 Journal, Alex Cleveland

Personal Journals

In this journal, EIU student Alex Cleveland in the Spring 2020 History of Illinois (HIS 3810) documents the beginning period of the pandemic, including initial reactions to the shelter in place order.

Two Implementation Models Of Workers' Health Education Programs In Egypt: What Works? What Doesn't Work?, Nahla G. Abdel-Tawab, Norhan Bader, Elizabeth Tobey, Aparna Jain

Reproductive Health

This brief presents findings from two models of workers’ health education programs implemented by the Evidence Project/Population Council in Egypt. The two interventions aimed to increase family planning (FP) service demand among young people aged 18–35 in Port Said and urban Souhag. In Port Said, male and female factory workers who were trained as peer educators shared family planning/reproductive health (FP/RH) information with fellow factory workers, distributed communication materials, and provided referrals to infirmary nurses trained in FP counseling. In Souhag, male and female peer educators were trained to provide integrated FP/RH and livelihood workshops to job seekers. Results of …

Evaluation Of The Impact Of Social Collaborations On Sexual And Reproductive Health Knowledge, Lucki Word, Jaila Campbell, Manar T. Edriss, Destiny Stroman, Jewel Evans, Melanie Hanna-Johnson, Md, Anil N. F. Aranha, Phd

Medical Student Research Symposium

Introduction: Developments in technology, such as the popularity of mobile devices and social media outlets, have enhanced the ability of individuals to communicate. Currently, search engines allow for easy exploration of information related to every topic of interest. Our study purpose was to evaluate the impact of technological and social collaborations on sexual and reproductive health knowledge (SRHK).

Methods: A 50-item survey instrument, integrating factors of sociodemographics, number/type of social collaborations, technological communication use, and SRHK, was developed to assess familiarity with sexual and reproductive health perceptions. The survey was provided to consenting patients in an ambulatory, primary care setting. …

The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh

Medical Student Research Symposium

Objective: To understand the current landscape of urine drug testing (UDT) guidelines as part of risk assessment for opioid abuse, and to offer recommendations towards adopting universal screening guidelines.

Background: There has been an opioid epidemic within the United States, and the role of prescription opioids has been well established. Despite proposed recommendations, there has yet to be a published universal screening guideline on the use of UDT in the setting of opioid abuse risk stratification as well as postoperative drug monitoring.

Methods: We explored current guidelines for UDT on two levels. First, we explore general indications for UDT within …

Abriendo Futuros: A Program For Rural Indigenous Girls In Yucatan, Mexico, Fabiola Romero, Ludivine Cicolella, Silvana Larrea, A. Fallone, Isabel Vieitez Martínez

Poverty, Gender, and Youth

The Abriendo Futuros (AF) program builds on the Council’s global experience of designing and implementing successful girl-centered programs in Africa, Asia, the Middle East, and Latin America and the Caribbean. AF aims to improve the living conditions of Mayan girls (10–18 years) and contribute to the achievement of gender equity in the Yucatan. The program’s community-focused strategy seeks to empower girls through interpersonal communication and participatory workshops. Girls in selected communities are divided into age groups (10–14 and 15–18) that meet weekly with a mentor in safe spaces. The program’s mentors are young women aged 20–30 from the communities, who …

The Community Health System In Bangladesh: An Overview, Frontline Health Project

Reproductive Health

This brief provides an overview of the community health system in Bangladesh. Bangladesh is divided into eight administrative divisions, 64 districts, and 545 subdistricts, known as upazilas. Each rural area within an upazila is divided into union parishads and mouzas, which are further divided into villages. The Ministry of Health and Family Welfare has an extensive health infrastructure that is pluralistic and follows the country’s administrative pattern. Union parishads are the smallest administrative unit in rural areas. At the lowest administrative level, traditional healers, nonqualified allopathic practitioners, and community health workers (CHWs) are typically the only providers available. This brief …

Implementation Process Brief: Integrated Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Charlotte E. Warren, Aparna Jain, Melsa Lutomia, Jane Loech, Elizabeth Washika

Reproductive Health

Enabling women living with HIV to use contraception effectively can decrease unintended pregnancies and in turn reduce maternal mortality and vertical transmission of HIV. This brief describes the implementation process and intervention tested under the Evidence Project for delivering integrated FP and HIV services at the community level in Kenya. It outlines the implementation steps, best practices, and lessons learned of an intervention that was tested within the existing community health structure. Community health volunteers were trained to offer FP as part of their routine services to women living with HIV, and community health units were prepared to sustain those …

The Community Health System In Haiti: An Overview, Frontline Health Project

Reproductive Health

This brief provides an overview of the community health system in Haiti. In Haiti, the health system is overseen at the national level by the Ministry of Public Health and Population (Ministère de la Santé Publique et de la Population-MSPP) which provides policies and standards for service delivery at all levels, including the community level. Health service delivery is managed and coordinated across three levels: national (level III), health department (level II), and district and community levels (level I). The national level is guided by the MSPP and provides policy guidance for community-level service delivery. The Health Department level is …

Comparing Individual Perceptions Of Food Desert With Quantitative Measures In Omaha, Nebraska., Hector N. Samani, Bradley Bereitschaft

UNO Student Research and Creative Activity Fair

Food deserts have been linked to an increase in chronic diseases such as obesity and diabetes, due to lower access to affordable and healthy foods. The United States Department of Agriculture (USDA) outlines various methods and variables for defining food deserts, in attempts to standardize what constitutes a food desert or their characteristics. The USDA identifies the state of Nebraska as having both rural and urban food deserts, with an increase of food insecurity from 1.1% – 3.0% between 2007 and 2012 and warns of further increase of food deserts and its impact if measures are not taken. However, there …

Arjun Kukreja - Covid-19 Journal, Arjun Kukreja

Personal Journals

EIU History of Illinois (HIS 3810) student outlines personal impressions of the early months of the Covid-19 pandemic.

Evidence To Support Hiv Prevention For Adolescent Girls And Young Women (Agyw) And Their Male Partners: Results From Malawi Dreams Studies With Agyw, Male Partners Of Agyw, Men Living With Hiv, And Program Implementing Partners, Nanlesta Pilgrim, Victor Mwapasa, Effie Chipeta, Wanangwa Chimwaza Manda, Nrupa Jani, Tracy Mcclair, Lyson Tenthani, Sanyukta Mathur

HIV and AIDS

Project SOAR, led by the Population Council, in partnership with the Center of Reproductive Health at the University of Malawi College of Medicine, conducted a research portfolio to generate evidence to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. The objectives of this implementation research were to generate evidence for describing HIV-related risk factors among AGYW; assess the extent to which the overall DREAMS project contributed toward the goal of reducing HIV risk among AGYW; and understand the characteristics of male partners and how to link them to HIV services, as well as retain …

Community-Based Hiv Treatment Service Delivery Model For Female Sex Workers In Tanzania: Evaluation Findings, Lung Vu, Waimar Tun, Louis Apicella, Jeremiah Kidola, Caterina Casalini, Gasper Mbita, Neema Makyao, Todd Koppenhaver, Erick Mlanga

HIV and AIDS

Project SOAR in collaboration with the National AIDS Control Program of the Government of Tanzania, National Institute of Medical Research, and Jhpiego’s Sauti Program, conducted an implementation science study to investigate the delivery of community-based antiretroviral treatment (ART) services to female sex workers (FSWs) in Tanzania. Studies from sub-Saharan Africa have shown improved HIV treatment outcomes, such as uptake of HIV services, retention in care, and increased dignity and quality of life, by using community-based delivery of HIV services. As detailed in this Project SOAR final report, the study assessed the effectiveness of the community-based ART delivery intervention in improving …

Strengthening Capacity For Assessment Of Hiv-Related Data Needs Among Key Populations To Inform Evidence-Based Responses, Amrita Rao, Nikita Viswasam, Stefan Baral

HIV and AIDS

Defining the HIV prevention and treatment needs of key populations who have disproportionate HIV acquisition and transmission risks has been particularly difficult in the context of generalized HIV epidemics where less attention has historically been placed on the HIV prevention and treatment needs of these groups. There is a gap in our understanding of the specific needs of—and ultimately the investment case for the added value of supporting—disproportionately burdened key populations in these settings. In response to this gap, Johns Hopkins University under the United States Agency for International Development (USAID)-funded Project SOAR implemented a project in partnership with collaborators, …

Considerations For Collecting And Documenting Fgm/C Data By Health Care Providers, Dennis Matanda

Reproductive Health

Data on female genital mutilation/cutting (FGM/C) are rarely collected in health facilities, yet routine collection of facility-based data through other health-seeking visits (e.g., during antenatal care) is considered good medical practice and can be an important source of data. Clinical exams provide an opportunity to identify women and girls who have undergone FGM/C, which is an important step in aiding the prevention of chronic complications that can be difficult to manage later in life. These exams also make it possible to refer those with FGM/C-related complications for specialized treatment. Clinical visits also present an opportunity to discuss prevention of the …

Female Genital Mutilation/Cutting In Senegal: Is The Practice Declining? Descriptive Analysis Of Demographic And Health Surveys, 2005–2017, Dennis Matanda, Glory Atilola, Zhuzhi Moore, Paul Komba, Lubanzadio Mavatikua, Chibuzor Christopher Nnanatu, Ngianga-Bakwin Kandala

Reproductive Health

To achieve the Sustainable Development Goals, female genital mutilation/cutting (FGM/C) is one of the most prominent issues world leaders and governments must address. In Senegal, estimates from the 2017 Senegal Demographic and Health Survey show that almost a quarter of women aged 15–49 have undergone FGM/C, while 14 percent of girls aged 0–14 years have been cut. Given the many interventions that have been implemented in Senegal with the intention of scaling down FGM/C rates, the key question is: To what extent has the practice declined? The aim of this study, as presented in this working paper, was to generate …

Understanding Female Genital Mutilation/Cutting Abandonment In Egypt, Nada Wahba, Hania El Banhawi, Amira El Ayouti

Reproductive Health

Although the prevalence of female genital mutilation/cutting (FGM/C) in Egypt among married women aged 15–49 years is high (92 percent), in the most recent (2014) Demographic and Health Survey, prevalence rates appear to be declining among younger cohorts of girls and women. Support for the discontinuation of the practice is more widespread in younger generations, among females, and among those living in urban areas. Variations in attitudes toward FGM/C by education level and wealth status are also documented. While numerous studies have examined the reasons why people practice FGM/C, few studies have examined the characteristics of the individuals who have …

Health Care Providers' And Mothers' Perceptions About The Medicalization Of Female Genital Mutilation Or Cutting In Egypt: A Cross-Sectional Qualitative Study [Arabic], Omaima El-Gibaly, Mirette Aziz

Reproductive Health

The medicalization of FGM/C has been increasing significantly in Egypt making it the country with the highest rate of medicalization. In this qualitative study, we explore the drivers and motives behind why health-care professionals perform FGM/C and why mothers rely on them to perform the practice on their daughters.

No To Circumcision’: The Road To Effective Social Marketing Campaigns In Egypt [Arabic], Salma Abou Hussein, Sarah Ghattass

Reproductive Health

This study sought to understand how, where, and why social marketing campaigns (SMCs) supporting abandonment of female genital mutilation/cutting (FGM/C) are working, and with what impact, to inform design and scale-up of campaigns that can foster new perspectives, expectations, and behaviors.

A Diagnostic Assessment Of The Health System's Response To Fgm/C Management And Prevention In Nigeria—Brief, Osasuyi Dirisu, Adetayo Adetunji, Mayokun Adediran, Otibho Obianwu

Reproductive Health

Globally, over 200 million women have been cut and are living with FGM/C-related consequences. In Africa, an estimated 27 million, 24 million, and 20 million girls/women have undergone FGM/C in Egypt, Ethiopia, and Nigeria respectively, the countries with the highest prevalence of FGM/C on the continent. In Nigeria, although the practice is considered widespread, national surveys suggest a gradual decline of FGM/C prevalence among women aged 15–49 years from 30 percent in 2008 to 20 percent in 2018. While these statistics suggest progress, the prevalence is still as high as 67 percent in some states. Nigeria’s National Strategic Health Development …

A Diagnostic Assessment Of The Health System's Response To Female Genital Mutilation/Cutting Management And Prevention In Kenya: A Case Study Of West Pokot County, Samuel Kimani

Reproductive Health

Female genital mutilation/cutting (FGM/C), a pervasive cultural practice in some contexts, is associated with negative impacts on women’s and girls’ health and rights. The health sector is well positioned to respond to the prevention of FGM/C and the management of its complications because of its primary role in disease prevention, health promotion, and curative services. In Kenya, the health sector’s role is anchored in national and county legal and policy instruments and guidelines that are adopted or customized from global or regional frameworks as well as skills support tools approved by the World Health Organization. This brief highlights findings from …

Improving The Documentation Of Female Genital Mutilation Or Cutting (Fgm/C) Abandonment Interventions And Their Evaluations, Caroline W. Kabiru

Reproductive Health

Female genital mutilation/cutting (FGM/C) is internationally recognized as a violation of human rights. Consequently, there have been extensive efforts to promote the abandonment of the practice. There is limited evidence on the impact of many of the efforts, in part because many interventions are implemented by small organizations with inadequate resources to document and evaluate their activities. The complex nature of FGM/C interventions, as with other interventions aimed at addressing violence against women and girls, also makes it difficult to adequately document what is done, how, when, and with what results. Nonetheless, it is important that implementing organizations make every …