Medicine and Health Commons^™

Competency To Stand Trial Evaluations: Using Vignettes With Patients Who Lack Insight, Katelyn Fuller

James Madison Undergraduate Research Journal (JMURJ)

In the United States, an attorney may request a competency to stand trial evaluation if they are concerned that their client is not mentally fit to adequately participate in their case and defense. Patients found incompetent must undergo treatment for restoration of competency, regardless of their willingness. Clinicians and psychiatrists may use vignettes, or hypothetical scenarios, to help restore competency if the patient lacks insight into their mental illness. While vignettes have been well documented in studying attitudes and awareness, decision making, and identifying mental illness, there is little to no research into their use in psychiatric hospitals due to …

Exploring The Experience Of Healthcare-Related Epistemic Injustice Among People With Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, Joanne Hunt, Jessica Runacres, Daniel Herron, David Sheffield

The Qualitative Report

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a chronic, disabling yet clinically “contested” condition, previously theorised through a lens of epistemic injustice. Phenomena conceptually close to epistemic injustice, including stigma, are known to have deleterious consequences on a person’s health and life-world. Yet, no known primary studies have explored how people with ME/CFS experience healthcare through a lens of epistemic injustice, whilst a dearth of research explicitly exploring healthcare-related injustice from a patient perspective has been noted. This qualitative study seeks to address this gap. Semi-structured interviews and interpretative phenomenological analysis (IPA) were used to explore the experiences of …

Inter-Institutional Analysis Of Skin Of Color Representation In Dermatological Lecture Content At Md And Do Medical Schools, Oluwafunke Oluwatosin Ogunremi, Blake Fredericksen, John Komas, Sana Ismail, Siri Knutsen-Larson Md, Valeriy Kozmenko Md, Afia Albin Do

Aesculapius Journal (Health Sciences & Medicine)

The purpose of this study was to analyze the lecture materials provided in medical schools through a diversity lens. Skin pathologies manifest distinctively on various shades of skin and physicians must be equipped with the proper knowledge to identify and diagnose these conditions accurately and promptly. For most medical students, images in prominent textbooks and lecture slides are their first encounter with disease presentations. Therefore, it is important to analyze the diversity of skin tones in the content that is being delivered. Specifically, the use of images featuring darker skin tones compared to those depicting lighter skin tones. This study …

Experiences Of Working Sandwich Generation Caregivers, Kimberly Ben, Susan Macdermott

Spring 2024 Virtual OTD Capstone Symposium

This poster presents an insightful exploration into the lives of Working Sandwich Generation Caregivers (WSCs), a group defined as individuals aged 30-65 who simultaneously provide care for both aging adults (over 65 years old) and younger dependents (29 years old or younger), while also managing their careers. The study delves deep into the unique challenges and experiences faced by WSCs, aiming to highlight the occupational, emotional, and physical demands inherent in their roles. Through qualitative research methods, including interviews and occupational therapy assessments, the manuscript offers a comprehensive look at the balancing act WSCs perform daily. It seeks to inform …

Broken Promises: Prolonged Diminished Quality-Of-Life Among Liberian Ebola Survivors Half A Decade After The 2014-16 West African Outbreak, Jessi Hanson-Defusco, Decontee Davis, Meghana Bommareddy, Zainab Olaniyan

Journal of Social, Behavioral, and Health Sciences

The 2014–2016 Ebola outbreak left thousands of Liberian survivors with severely diminished quality of life. Applying a social determinants framework, this mixed method study investigates to what extent Ebola virus disease (EVD) survivors suffer long-haul psychosocial stress, diminished quality-of-life factors, and the impact of EVD-related service provisions on their ongoing healing. We present the results of a quantitative analysis survey of data collected from 19 Liberian EVD survivors in 2022 using snowball sampling. Additionally, a qualitative analysis of survivor statements helps triangulate key statistical findings and inform causal mechanisms. Survivors report experiencing 5.25 of a total of 7 ongoing stressors …

Foster Inclusivity And Equity:Strategiesfor Retaining Racialized Workers In Ontario’S Healthcare Sector, Kiannah Kerr-Mccarthy, Natasha Bonnick

Capstone Research Posters

This research endeavors to explore the factors influencing the retention of racialized workers within Ontario's long-term care sector, recognizing the imperative of fostering an inclusive and supportive workplace environment. Employing a mixed-methods approach, survey data was collected to unravel the unique challenges faced by racialized workers and discern the determinants influencing their decision to remain in the sector or seek employment elsewhere. The study delves into various facets such as workplace culture, organizational policies, and interpersonal dynamics, elucidating their pivotal role in retention. Furthermore, the research evaluates the potential impact of mentorship programs, diversity training initiatives, and career development opportunities …

Health Care Use Experiences Of Ethnoculturally Diverse Immigrant Older Adults: A Meta-Ethnography, Lorna De Witt, Kathryn A. Pfaff, Roger Reka, Noeman Ahmad Mirza

Nursing Publications

Purpose

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health care services?

Design/methodology/approach

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, …

Impact Of Social Determinants Of Health On Healthcare Disparities In Florida, Kayla L. Haydon, Catarina Jim, Joel J. Mantilla, Noel C. Barengo

American Journal of Non-Communicable Diseases

Objective

Healthcare disparities disproportionately affect underserved and marginalized communities due to social determinants of health (SDoH), contributing to significant differences in health outcomes and life expectancy within different communities in Florida. This observational study aimed to understand the impact of SDoH, such as race/ethnicity, income level, and education attainment on healthcare access in Florida.

Methods

Self-reported data from the 2020 Behavioral Risk Factor Surveillance System were pooled to evaluate disparities in healthcare access by race/ethnicity, income, and education level in Florida.

Results

Health status and healthcare access vary based on characteristics related to SDoH, including race/ethnicity, income level, and educational …

Close Contacts Of Xenograft Recipients: Ethical Considerations Due To Risk Of Xenozoonosis, Daniel J Hurst, Luz Padilla, Daniel Rodger, Tamar Schiff, David K C Cooper

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

With decades of pre-clinical studies culminating in the recent clinical application of xenotransplantation, it would appear timely to provide recommendations for operationalizing oversight of xenotransplantation clinical trials. Ethical issues with clinical xenotransplantation have been described for decades, largely centering on animal welfare, the risks posed to the recipient, and public health risks posed by potential spread of xenozoonosis. Much less attention has been given to considerations relating to potentially elevated risks faced by those who may care for or otherwise have close contact with xenograft recipients. This paper examines the ethical and logistical issues raised by the potential exposure to …

Intersectional Model Of Service Use: Understanding Transgender And Nonbinary Healthcare Access, Jarrod Call, Brendon Holloway

Journal of Social, Behavioral, and Health Sciences

Transgender and nonbinary (TNB) people often have difficulty accessing healthcare services because of the systemic forces of transphobia and cisgenderism. Despite this, there is little theory specifically designed to examine healthcare access among TNB people. We conducted a literature review to identify studies examining TNB healthcare access. We screened a total of 2,050 unique articles for inclusion, resulting in a final sample of 46 articles that met the review criteria. Theories used and key findings were coded to inform the development of the Intersectional Model of Service Use (IMSU) for TNB people. The IMSU builds upon current theoretical frameworks including …

Cultura Y (Ataque De) Corazón: A Training For Health Professionals Needing Medical Interpretation Services, Elizabeth Dudek, Shelby Edwards

11th National Symposium on Spanish as a Heritage Language

Limited English proficiency is a known barrier to quality health care outcomes (Green 2017, Helmi 2021). Inclusion of a certified language interpreter during health care encounters improves outcomes among ESL (English as a Second Language) patients (Karliner, Jacobs, Chen, and Mutha 2007). Interpretation with a certified interpreter promotes understanding between patients and their medical providers, and advances both health and race equity (Foiles Sifuentes, Robledo Cornejo, Castaneda-Avila, Tija, and Lapane 2020). Most health care workers receive no formal training in how to use an interpreter with limited English-proficiency patients. Located in the Hispanic Heritage District of an increasingly Latine mid-sized …

What Factors Increase Risk Of Alzheimer's Disease And Related Dementia?, Elizabeth Vásquez, Kai Zhang

Population Health Research Brief Series

Alzheimer’s disease is the most common form of dementia and ranks 7th in the leading causes of death in the United States (U.S.). This data slice uses nationwide data from 3,155 counties in the U.S. to identify the factors that best predict county-level rates of Alzheimer’s Disease and Related Dementias (ADRDs) in 2018. The results indicate that insufficient sleep, consuming less than one serving of fruits and vegetables per day, having no high school diploma, Black population percentage, and social vulnerability were among the leading factors predicting county-level ADRD prevalence.

Calming The Body, Calming The Mind: A Pilot Study On The Use Of Zero Balancing To Reduce Anxiety, Misty L. Rhoads, Mary Murphy

Journal of Transformative Touch

Background: The predominance of anxiety is currently at record levels, and the need for non-pharmaceutical approaches to help alleviate and decrease the harmful effects of anxiety on an individual and collective level is necessary. This study explored how Zero Balancing supports individuals with anxiety to manage their physical, mental, and emotional health more effectively. Researchers hypothesized that Zero Balancing would lower the perceived severity of general anxiety and lower perceived anxiety symptoms.

Methods: To honor the holistic nature of bodywork and the participants' lived experiences, the researchers utilized a concurrent mixed-methods phenomenological research design. Each participant received one Zero Balancing …

Beyond ‘Heightism’ And ‘Height Premium’: An Anthropology And Sociology Of Human Stature, Gideon Lasco

Development Studies Faculty Publications

This review article examines the meanings and materialities of human stature, from serving as a marker of human difference to shaping the socio-spatial experiences of individuals. I introduce existing perspectives on height from various disciplines, including biomedical discourses on the factors (e.g. nutrition, genetics) that determine height, economic discourses on how the average heights of populations have changed over time, sociobiological and psychological discourses that assume a pre-cultural, evolutionary “height premium”, and popular discourses on heightism and height discrimination. Drawing from a diverse range of scholarship since Saul Feldman called for a “sociology of stature” in the 1970s, I then …

Human Zoo Healthcare At The 1904 World’S Fair, Angel Blake

Undergraduate Research Symposium

Human Zoo Healthcare at the 1904 World’s Fair

Were precautions taken or put into place for the Human Zoo performers at the 1904 World’s Fair? This topic has been overlooked and understudied by historians, there are few articles written and we do not know the true death toll which shows the racism towards these indigenous peoples. The research for this project was conducted at the State Historical Society of Missouri, the St. Louis Mercantile Library, Newspapers.com, Archives.com, St. Louis Public Library, and the Missouri Historical Society, including research on primary sources such as official World’s Fair committee meeting minutes, hospital …

Pain Limits Family Caregivers’ Daily Activities, Shelbie G. Turner, Karl A. Pillemer, Jamie Robinson, M. Cary Reid

Population Health Research Brief Series

Family caregivers are the main providers of home care to older adults, especially as the prevalence of Alzheimer’s disease and related dementia rises. Caregiving can take a toll on caregivers’ physical and mental health, which impacts both their own well-being and their care recipients’ health outcomes. This brief summarizes findings from a study that used data from the 2017 National Study on Caregiving (NSOC) to estimate the prevalence of arthritis and activity-limiting pain among 1,930 family caregivers to older adults. Over half of all caregivers reported bothersome pain in the previous month, 24% of whom had pain that limited their …

Perceived Neighborhood Disorder And Type 2 Diabetes Disparities In Hispanic, Black, And White Americans, Min Ying Yu, Alfredo J. Velasquez, Belinda Campos, Jennifer W. Robinette

Psychology Faculty Articles and Research

Introduction: Approximately 32 million Americans have type 2 diabetes, and that number continues to grow. Higher prevalence rates are observed among certain subgroups, including members of marginalized racial/ethnic groups as well as residents of disordered neighborhoods (i.e., those with more trash and vandalism). Institutionalized discriminatory practices have resulted in disproportionate representation of marginalized racial/ethnic groups in disordered neighborhoods compared to non-Hispanic Whites. These neighborhood disparities may partially contribute to health disparities, given that signs of neighborhood disorder often relate to a general withdrawal from the neighborhood, minimizing opportunities for both physical and social engagement. Yet, research suggests variability across …

“Your Brain Isn’T All Backwards”: Asexual Young Women’S Narratives Of Sexual Healthism, Anna Sheppard, Emily S. Mann, Carla A. Pfeffer

The Qualitative Report

Scholarship on asexuality is a growing but underexplored area in the social sciences. In the U.S., asexual people (i.e., individuals who do not experience sexual attraction) navigate a society in which being a sexual person is regarded as a normal and even compulsory aspect of human health and subjectivity. Utilizing an asexual subsample from a broader study of queer young women, this article integrates Foucault’s theorizing around sexuality and repression with scholarship on healthism to examine how discourses of sexual healthism operate among asexual young women in the U.S. South. We argue that in rejecting theories of sexual repression and …

Collateral Effects Of Covid-19 Stay-At-Home Orders On Violence Against Women In The United States, January 2019 To December 2020, Patricia C. Lewis, Yuk F. Cheong, Nadine J. Kaslow, Kathryn M. Yount

Health Science Faculty Publications

Background: The necessary execution of non-pharmaceutical risk-mitigation (NPRM) strategies to reduce the transmission of COVID-19 has created an unprecedented natural experiment to ascertain whether pandemic-induced social-policy interventions may elevate collateral health risks. Here, we assess the efects on violence against women (VAW) of the duration of NPRM measures that were executed through jurisdictional-level orders in the United States. We expect that stay-at-home orders, by reducing mobility and disrupting non-coresident social ties, are associated with higher incident reporting of VAW.

Methods: We used aggregate data from the Murder Accountability Project from January 2019 through December 2020, to estimate count models examining …

Demographic Profile Of Accidental Drug Overdoses In 2020, Jacquelyn Reiss Phd, Amy Donley Phd, Alexandria Mcclarty Ba

Institute for Social and Behavioral Science (ISBS)

This white paper presents a demographic profile of accidental drug overdoses in Orange County, Florida for the year 2020.

The Impact Of The Covid-19 Pandemic On The Well-Being Of People Incarcerated In United States Prisons, Kimberly Rivera

Department of Sociology: Dissertations, Theses, and Student Research

The COVID-19 pandemic has negatively impacted the population as a whole. However, the incarcerated population (which also experiences a variety of health disparities) has been disproportionately affected by the pandemic. Due to overcrowding, poor ventilation, and lack of resources, the incarcerated population already is at a heightened risk for negative health outcomes, made worse by the recent pandemic. To adapt to the rapidly changing conditions during the pandemic in 2020 and into 2022, new safety measures were implemented, but the unintended consequences associated with the implementation of these procedures have yet to be examined empirically. I conducted a qualitative content …

How Does Parents’ Social Support Impact Children’S Health Practice? Examining A Mediating Role Of Health Knowledge, Paulin Tay Straughan, Chengwei Xu

Research Collection School of Social Sciences

Background: Family environmental factors play a vital role in shaping children’s health practices (e.g., obesity prevention). It is still unclear how parents’ social support affects children’s obesity-related health practices. The present study argues that whether parents’ social support positively associates with children’s obesity-related health practice depends on if it could promote parents’ obesity-related health knowledge. Thus, we hypothesize that health knowledge mediates the relationship between parents’ social support and children’s health practice regarding weight management. Methods: To test the hypothesis, we conducted a questionnaire survey and collected a nationally representative sample of 1488 household responses in Singapore. The survey included …

An Exploration Into Health Equity Discourse In Mississippi: Organizational Commitments And Practitioner Perspectives, Thuy-Vy Lillian Pham

Honors Theses

This thesis takes a sociological approach to examine healthcare workers' beliefs and medical organizations’ solidarity statements related to diversity and equity and how these discourses aligned and/or diverged. Through interviews with healthcare providers in Mississippi and content analysis of solidarity statements, the study finds that discussions on health disparities more frequently addressed socioeconomic inequality rather than systemic racism, diverging from organizational statements. This emphasis may partly stem from the demographics of the study participants, who were predominantly White—which also reflected the staff where they worked. Additionally, while healthcare workers recognized structural issues related to health disparities, they often showed hesitancy …

La Exploración Del Acceso Equitativo A La Atención Médica Para Los Hispanohablantes, Lauren Elizabeth Mcreynolds

Chancellor’s Honors Program Projects

No abstract provided.

Economic Analysis Of Population-Based Next Generation Sequencing For Breast Cancer, Sapphire Curelaru

University Honors Theses

Breast cancer develops due to accumulated DNA replication insults which causes cancer to uncontrollably proliferate. An individual's predisposition to developing cancer, as well as the composition of a tumor, can be sequenced using genetic tests. Myriad's BRACAnalysis CDx^® seems to be the most utilized genetic test. However, Next Generation Sequencing (NGS) seems to be a better genetic test for breast cancer when compared to Myriad's BRACAnalysisCDx^® in terms of return-time, accuracy, efficiency, and healthcare cost. By using Next Generation Sequencing tests, stakeholders can save money on genetic testing which can be invested in more genetic tests. Payers can …

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …

The Associations Of Parental Smoking, Quitting And Habitus With Teenager E-Cigarette, Smoking, Alcohol And Other Drug Use In Gui Cohort ’98, Salome Sunday, Luke Clancy, Joan Hanafin

Articles

We analyse parental smoking and cessation (quitting) associations with teenager e-cigarette, alcohol, tobacco smoking and other drug use, and explore parental smoking as a mechanism for social reproduction. We use data from Waves 1–3 of Growing Up in Ireland (Cohort ’98). Our analytic sample consisted of n = 6,039 participants reporting in all 3 Waves. Data were collected in Waves 1 and 2 when the children were 9 and 13 years old and in Wave 3 at age 17/18 years. Generalized Estimating Equations (GEE) models were used to analyse teenage substance use at Wave 3. Parental smoking was associated with …

Social Determinants Of Health And Lung Cancer Surgery: A Qualitative Study, Dede K. Teteh, Betty Ferrell, Oluwatimilehin Okunowo, Aidea Downie, Loretta Erhunmwunsee, Susanne B. Montgomery, Dan J. Raz, Rick Kittles, Jae Y. Kim, Virginia Sun

Health Sciences and Kinesiology Faculty Articles

Introduction: Social determinants of health (SDOH) are non-clinical factors that may affect the outcomes of cancer patients. The purpose of this study was to describe the influence of SDOH factors on quality of life (QOL)-related outcomes for lung cancer surgery patients.

Methods: Thirteen patients enrolled in a randomized trial of a dyadic self-management intervention were invited and agreed to participate in semi-structured key informant interviews at study completion (3 months post-discharge). A conventional content analysis approach was used to identify codes and themes that were derived from the interviews. Independent investigators coded the qualitative data, which were subsequently …

Mothers Get Really Exhausted!” The Lived Experience Of Pregnancy In Extreme Heat: Qualitative Findings From Kilifi, Kenya, Fiona Scorgie, Adelaide Lusambili, S. Luchters, Peter. Khaemba, Veronique Filippi, B. Nakstad, Jeremy Hess, Cathryn Birch, S. Kovats, M.F. Chersich

Institute for Human Development

Background: Palliative care (PC) can reduce symptom distress and improve quality of life for patients and their families experiencing life-threatening illness. While the need for PC in Kenya is high, PC service delivery and research is limited. Qualitative research is needed to explore potential areas for PC research and support needed to enable that research. This insight is critical for informing a national PC research agenda and mobilizing limited resources for conducting rigorous PC research in Kenya.

Objectives: To explore perceptions of priority areas for PC research and support needed to facilitate rigorous research from the perspective of Kenyan PC …

Analyzing African American College Student Willingness To Participate In Clinical Trials, Caitlin B. Ulmer

Senior Theses

Previous studies regarding African American participation in clinical trials have found that African Americans participate at a significantly lower rate than other ethnic/racial groups. Scholars argue that this lack of participation in clinical trials is a direct result of historical trauma linked to unethical experiments and African American distrust in the healthcare system. However, there is a gap in the literature because these studies focus on African American individuals above the age of 30. This study aimed to fill the gap by examining clinical trial participation among African American college students within the ages 18 to 23. This study also …