Medicine and Health Commons^™

Assessing Transgender Attitudes Toward Health Care: Can These Attitudes Help Predict Health Outcomes?, Sara M. Shane

PCOM Psychology Dissertations

Research has identified the fact that race/ethnicity, sexual orientation, gender identity, socioeconomic status, education level, geographic location, help seeking behaviors, and experiences of discrimination are associated with health outcomes. In addition, attitudes towards providers can also help determine health outcomes. The transgender community experiences barriers to health care services and therefore their overall health is affected. There is not a sufficient amount of literature that assesses, using standardized measure, the attitudes of the transgender community and their health. The present study will assess the attitudes of the transgender community toward health care (mental and medical health) and, using standardized measures, …

Social Networks, Drug Use, And Drug Abuse Help-Seeking: A Test Of The Network Episode Model Among African American Women, Erin L. Pullen

Theses and Dissertations--Sociology

Untreated substance use disorders are a major public health concern that has costly consequences at both the societal and individual level. Identifying the characteristics and resources of those who seek help for substance abuse problems in order to inform more effective intervention and treatment techniques is therefore an important research objective. Using the Network Episode Model (NEM) as a theoretical framework, this dissertation examines both substance abuse help-seeking (i.e. inpatient/outpatient treatment and 12-Step meeting attendance) and patterns of drug use over time among low-income African American women, with a special focus on the role of the social network system in …

Results From Ireland's 2014 Report Card On Physical Activity In Children And Youth, Deirdre M. Harrington, Sarahjane Belton, Tara Coppinger, Muireann Cullen, Alan Donnelly, Kieran Dowd, Teresa Keating, Richard Layte, Marie Murphy, Niamh Murphy, Elaine Murtagh, Catherine Woods

Publications

Background: Physical activity (PA) levels are a key performance indicator for policy documents in Ireland. The first Ireland Report Card on Physical Activity in Children and Youth aims to set a robust baseline for future surveillance of indicators related to PA in children and youth. Methods: Data collected between 2003-2010 on more than 35,000 7- to 18-year-old children and youth were used and graded using a standardized grading system for 10 indicators. Results: Grades assigned for the indicators were as follows: overall physical activity levels, D-; sedentary behavior (TV viewing), C-; organized sport participation, C-: physical education, D-; active play, …

Making Space For Dying: Portraits Of Living With Dying, Elise Lark

Antioch University Dissertations & Theses

In Making Space for Dying: Portraits of Living with Dying, I describe the everyday lived experience of dying and the care culture within freestanding, community-based, end-of-life residences (CBEOLR) utilizing portraiture and arts-based research. I craft four case studies into “portraits,” based on interviews, on-site visits, up-close observation, and field notes. In the person-centered portraits, I reveal the inner landscape of two terminally ill women, with data represented in poetry. In the place-centered portraits, I “map” the social topography of two CBEOLRs to illustrate how lives and care of the dying are emplaced, from the perspectives of community leaders, …

Lifetime Racism And Blood Pressure Changes During Pregnancy: Implications For Fetal Growth, Clayton J. Hilmert, Tyan Parker Dominguez, Christine Dunkel Schetter, Sindhu K. Srinivas, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth. Methods: African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone …

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 …

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 …

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.

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 …

Explaining Political Activeness And Attitudes Toward Unionization Among Nurses In The United States., Crystal L. Lesmeister

Political Science Theses and Capstones

There is no question; nurses play a key role in healthcare. Nurses provide direct care, coordinate health promotion activities, educate, and provide support and advocacy to patients. Today, there are over two million registered nurses in the United States. My research aims to determine the variables that influence some nurses to be more politically active and more engaged in unionization than their counterparts. I analyze The National Sample Survey of Registered Nurses 2004 looking at a variety of potential explanations for union participation. Findings show a strong regional variation in the percentage of unionization, however, some of the conventional explanations …

A Climate For Swelling: The Social & Biological Impacts Of Lymphatic Filariasis On Males & Females In Developing Countries, Arezoo Nazari '13

Honor Scholar Theses

Neglected tropical diseases (NTD) impair physical and cognitive development. This impairment makes it difficult to earn a living, restricts quality of life, and limits productivity in the work force. As a result, neglected tropical diseases trap the poor in a cycle of disease and poverty. Lymphatic filariasis (LF), also known as elephantiasis, is an NTD. It starts when microscopic, thread-like parasitic worms (Wuchereria bancrofti, Brugia timori, and Brugia malayi) are transmitted by mosquitoes. These worms infect and block the lymph nodes in the body, causing edema. Blockage in the lymphatic system and build-up of tissue and blood flow often occur …

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 …

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 …

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 …

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 …

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 …

Effectiveness Of A Portable, Large-Area Ultraviolet Germicidal Device, Mark P. Buttner, Thomas Yee, Patricia Cruz, Vanessa Stevens

Nevada Journal of Public Health

Effective disinfection of the hospital environment is a key component in the prevention of healthcare-associated infections. The objective of this project was to evaluate the effectiveness of an ultraviolet germicidal device in reducing the concentrations of culturable bacteria on indoor surfaces. The ultraviolet germicidal device was installed and operated in four experimental trials conducted in a microbiology research chamber. Agar plates inoculated with known concentrations of two test microorganisms were placed on benches inside the chamber at two distances, 1.5 meters and 3.0 meters from the machine, for exposure times of 5 minutes, 10 minutes, and 20 minutes. With test …

The State Of The Science Of Health And Wellness For Adults With Intellectual And Developmental Disabilities, Lynda Lahti Anderson, Kathy Humphries, Suzanne Mcdermott, Beth Marks, Jasmina Sisirak, Sheryl Larson

Rural Institute Journal Articles

Historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to several factors including: a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with IDD in public health efforts and other prevention activities. Over the past decade, a greater effort has been made to both identify and begin to address myriad health disparities experienced by people with IDD through a variety of activities including programs that address health lifestyles and greater …

From Problem-Solving To Research Utilization: How Operations Research And Program Evaluation Can Make Programs Better, Karen Foreit

HIV and AIDS

HIV treatment, care, and support, and PMTCT programs are most effective when based on the best available research evidence. This is the fundamental premise of evidence-based medicine. Equally well known is the dilemma of transforming evidence into practice, which is the subject of knowledge translation and implementation science. Even when the findings of clinical trials make their way into international and national program guidelines, they run up against competing priorities within public health and community programs, resource constraints, and institutional and human inertia. Understanding how to effectively change the approach used in program operations requires understanding how programs work in …

Comparing Two-Year Community College And Four-Year University Student Social And Behavioral Sexually Transmitted Infection Risk Factors, Oswald M. Attin

Faculty Dissertations

Sexually transmitted infections (STIs) could cause ectopic, cervical cancer, infertility, and organ damage to the heart, kidneys, and brain. This study compared several behavioral risk factors of STIs (condom use, number of sexual partners, type of sex (anal or vaginal) and drinking habits) between two distinct educational settings and their association with socioeconomic risk factors such as low income and parent’s lower level of education that are known to increase the incidence of STIs among college-aged students. This study was based on the precautionary-health-behavior model, where individuals act regardless of consequences, and the health-behavior-change model, where individual behaviors either increase …

Prevalence Of Hiv, Hepatitis B And C, And Co-Infection In A Cohort Of Male Injection Drug Users In Delhi, Lopamudra Saraswati, Mary Philip Sebastian, Avina Sarna, Vartika Sharma, Ira Madan, Dean Lewis, Ibou Thior, Waimar Tun

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000 nationally with an HIV prevalence of 7.2 percent. Historically, the presence of IDU populations and associated HIV infection was concentrated in the northeastern states of the country. Recent evidence documents IDU populations in other parts of the country. Delhi has an estimated 17,000 IDUs and the second highest HIV prevalence in India at 18.3 percent. The probability of becoming infected with HIV after using an infected syringe ranges from 0.34 percent to 1.4 percent. By comparison, the risk for hepatitis C (HCV) ranges from 1.5 percent to 5 …

Implementing Incentive-Based Hiv Interventions In Zambia: The Compact Model, Sam Kalibala, Waimar Tun, Chabu Kangale, Jill Keesbury, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council received a cooperative agreement from USAID to implement the Community Mobilization for Preventive Action (COMPACT) project, to develop and determine the feasibility of “community compacts” as an innovative approach to prevent HIV in Zambian communities. The aim is to mobilize the communities through a capacity-building process that enables them to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. This study determined baseline levels of key indicators related to HIV, sexual behaviors, gender-based violence, alcohol abuse, and reproductive health. These baseline measures will be compared with midline and endline levels to assess …

Motivations For Entering Volunteer Service And Factors Affecting Productivity: A Mixed Method Survey Of Steps-Ovc Volunteer Hiv Caregivers In Zambia, Jessica Price, Tina Moyo, Stephanie Topp, Drosin Mulenga, Mardieh Dennis, Mathew Ngunga

HIV and AIDS

This study by the Population Council and the Zambia-Led Prevention Initiative was designed to examine the motivations of individuals volunteering as STEPS-OVC caregivers; to explore their experiences in service, including perceived barriers to carrying out their volunteer work and if, and how, their expectations for volunteering had been met or not; to assess individuals’ intent to continue caregiving; and to ascertain factors associated with volunteer productivity. Two main findings stand out from this study: that communitarian and religious helping values were virtually universal in the study population, and that a majority of the volunteers indicated economic and material interests and …

High Hiv Incidence Among Male Injection Drug Users In Delhi, India, Waimar Tun, Lopamudra Saraswati, Mary Philip Sebastian, Vartika Sharma, Amita Yadav, Ira Madan, Ibou Thior, Avina Sarna

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000. The overall national HIV prevalence is around 7.2 percent in this group, the highest among all key populations in the country. There is limited HIV incidence data among IDUs in India. In collaboration with Arise—Enhancing HIV Prevention Programs for At-Risk Populations, the Population Council initiated a prospective cohort study at five centers in Delhi to examine HIV incidence and behavior change both pre-introduction and post-introduction of HIV prevention services among IDUs. HIV transmission risk remains high among IDUs in Delhi despite targeted prevention interventions. Despite the widespread availability …

Situation Analysis Of Programs To Meet The Hiv Prevention, Care, And Treatment Needs Of Persons With Disabilities In Ghana, Uganda, And Zambia, Waimar Tun, Jerry Okal, Katie D. Schenk, Meredith Sheehy, Emmanuel Kuffour, Selina F. Esantsi, Hilary Asiah, Grimond Moono, Felix Mutale, Rita Kyeremaa, Edson Ngirabakunzi, Atwijukire Justus

HIV and AIDS

National HIV strategic plans, HIV-related services, and HIV outreach efforts have tended to overlook persons with disabilities, and persons with disabilities are not reached by general HIV prevention, care, support, and treatment campaigns and services. To increase our understanding of how to make HIV programming more inclusive for persons with disabilities, HIVCore and partners conducted a three-country situation analysis (Uganda, Zambia, and Ghana). The study explored existing HIV services for persons with disabilities and determined the factors affecting their access to and use of HIV/sexual and reproductive health (SRH) services. Key findings: Persons with disabilities experience greater sexual vulnerability to …