Medicine and Health Commons^™

Moral Injury, Identity Dissonance, And Reintegration: A Compendium Of Reintegration And Survey Of United States Military Veterans, Thomas Hodges

Doctor of International Conflict Management Dissertations

How do military moral injuries affect reintegration? All service members leave the military eventually, but reintegration can be challenging, bringing changes in career, family life, and friendships, potentially prompting a loss of purpose, drive, and connection. Service members may also struggle with a crisis of identity upon separating from the military, feeling their military identity is incompatible with civilian life. While these difficulties are common for service members in reintegration, they may be worsened by moral injury, the adverse biological, social, psychological, and spiritual effects of experiencing an event that deeply offends a person’s sense of right and wrong. People …

The Public Performativity Of Trust, Lynette Hammond Gerido

Faculty Scholarship

Building trust between academic medical centers and certain communities they depend on in the research process is hard, particularly when those communities consist of minoritized or historically marginalized populations. Some believe that engagement activities like the creation of advisory boards, town halls, or a research workforce that looks more like community members will establish or reestablish trust between academic medical centers and racialized communities. However, without systematic approaches to dismantle racism, those well-intended actions become public performativity, and trust building will fail. In this essay, we draw upon foundational ethical principles of trust, distrust, and trust building; apply the concept …

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.

Insights From Obstetric Providers And Emergency Medical Technicians On Determinants Of Maternal Morbidity And Mortality Among Underserved, Rural Patients In The United States, Anna Hansen, Nancy Schoenberg, Carrie B. Oser

UK CARES Faculty Publications

Over the past two decades, individuals in the United States (US) have faced a steadily increasing risk of experiencing severe morbidities attributable to pregnancy and dying from pregnancy-related causes. The prevalence of severe maternal morbidity (SMM), defined as the occurrence of end-organ damage in the mother encompassing unexpected outcomes of labor and delivery, has nearly tripled since the turn of the 21st century (Creanga et al., 2014; Neggers, 2016). The prevalence of pregnancy related mortality (PRM), defined as the death of a woman during or within one year of pregnancy due to pregnancy-related complications or aggravated preexisting conditions, has nearly …

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

Capstone Experience: Master of Public Health

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 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 …

High School Flash Sexual Health Education Curriculum: Lgbtq Inclusivity Strategies Reduce Homophobia And Transphobia, Kari Kesler, Andrea Gerber, B A Laris, Pamela Anderson, Elizabeth Baumler, Karin Coyle

Faculty, Staff and Student Publications

Homophobic and transphobic beliefs that lead to bias-based harassment remain a critical concern for young people in the USA. The aim of the present study was to examine the impact of an inclusive comprehensive sex education program (High School FLASH) on homophobic and transphobic beliefs. Data from this study come from a randomized controlled trial that evaluated the impact of High School FLASH on students' sexual behaviors and related outcomes with 20 schools in two U.S. regions (Midwest and South). Following the baseline survey, the 20 schools were randomly assigned to receive FLASH or a comparison curriculum. Ninth and 10th …

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 …

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 …

Association Of Social Vulnerability And Covid-19 Mortality Rates In Texas Between 15 March 2020, And 21 July 2022: An Ecological Analysis, Dennis Ogeto Nyachoti, Nalini Ranjit, Ryan Ramphul, Leah D Whigham, Andrew E Springer

Faculty, Staff and Student Publications

BACKGROUND: Despite the key role of social vulnerability such as economic disadvantage in health outcomes, research is limited on the impact of social vulnerabilities on COVID-19-related deaths, especially at the state and county level in the USA.

METHODS: We conducted a cross-sectional ecologic analysis of COVID-19 mortality by the county-level Minority Health Social Vulnerability Index (MH SVI) and each of its components in Texas. Negative binomial regression (NBR) analyses were used to estimate the association between the composite MH SVI (and its components) and COVID-19 mortality.

RESULTS: A 0.1-unit increase in the overall MH SVI (IRR, 1.27; 95% CI, 1.04-1.55; …

The Puerto Rico Children Vulnerability Index, 2021, Jennifer Hinojosa, Laura Colon-Melendez, Jorge Soldevilla-Irizarry, Damayra I. Figueroa-Lazu

CUNY Centro, The Center for Puerto Rican Studies

Recent natural hazards and resulting disasters in Puerto Rico have drawn attention to the social vulnerability of children in the archipelago. We created the Child Vulnerability Index (CVI) to identify the scale and patterns of child vulnerability in the archipelago, and provide insights to mitigate the effects that hazardous events may cause. The index was created using 2017-2021 American Community Survey (ACS) data pertaining to three broad themes: Personal characteristics of children, Characteristics of households with children, and Overall household characteristics for all Municipios, Barrios, and Census Tracts in Puerto Rico. The CVI is a two-pronged tool consisting of an …

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, East Africa

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 …

Examination Of Disparities In Prehospital Encounters For Pediatric Asthma Exacerbations, Lauren Riney, Sam Palmer, Erik Finlay, Andrew Bertrand, Shannon Burcham, Phyllis Hendry, Manish Shah, Kathryn Kothari, David W Ashby, Daniel Ostermayer, Olga Semenova, Benjamin N Abo, Benjamin Abes, Nichole Shimko, Emily Myers, Marshall Frank, Tim Turner, Mac Kemp, Kim Landry, Greg Roland, Jennifer N Fishe

Faculty, Staff and Student Publications

INTRODUCTION: There are disparities in multiple aspects of pediatric asthma care; however, prehospital care disparities are largely undescribed. This study's objective was to examine racial and geographic disparities in emergency medical services (EMS) medication administration to pediatric patients with asthma.

METHODS: This is a substudy of the Early Administration of Steroids in the Ambulance Setting: An Observational Design Trial, which includes data from pediatric asthma patients ages 2-18 years. We examined rates of EMS administration of systemic corticosteroids and inhaled bronchodilators by patient race. We geocoded EMS scene addresses, characterized the locations' neighborhood-based conditions and resources relevant to children using …

Universal Health Coverage: A Basis For Pandemic Preparedness?, Merline Feero

Independent Study Project (ISP) Collection

Amid extensive research and reporting on the effects of COVID-19 on Universal Health Coverage (UHC) progress, this study explores an often neglected topic: the potential of UHC to contribute to the foundations of pandemic preparedness. Herein, quantitative analysis reveals that countries with higher UHC coverage tend to exhibit greater pandemic preparedness (as determined by the UHC Service Coverage Index and the Global Health Security Index). Complementary qualitative analysis is used to further illustrate and explain the correlation between UHC and pandemic preparedness using four case study countries, integrating literature reviews and relevant expert interviews. Through these methods, a clear tie …

Hidden Hurdles: Evaluating Informal Barriers To Primary Healthcare Access Among Undocumented Migrants In Switzerland, Arantxa Bonifaz Rosas

Independent Study Project (ISP) Collection

Undocumented migrants face heightened difficulties in accessing healthcare due to a combination of legal, financial, and social challenges. Informal barriers to accessing healthcare further exacerbate poor health outcomes among undocumented migrants. In Switzerland, where undocumented migrants have the right to health insurance, barriers to receiving healthcare continue to restrict their access to essential services, such as primary healthcare (PHC). Employing a meta-analysis approach, this qualitative study aimed to broaden existing research on informal barriers hindering access to PHC for undocumented migrants, with a particular focus on the Swiss context. The identified informal barriers centered around health insurance, fear of deportation, …

Social Vulnerability Of The People Exposed To Wildfires In Us West Coast States, Arash Modaresi Rad, John T Abatzoglou, Erica Fleishman, Miranda H Mockrin, Volker C Radeloff, Yavar Pourmohamad, Megan Cattau, J Michael Johnson, Philip Higuera, Nicholas J Nauslar, Mojtaba Sadegh

Faculty, Staff and Student Publications

Understanding of the vulnerability of populations exposed to wildfires is limited. We used an index from the U.S. Centers for Disease Control and Prevention to assess the social vulnerability of populations exposed to wildfire from 2000-2021 in California, Oregon, and Washington, which accounted for 90% of exposures in the western United States. The number of people exposed to fire from 2000-2010 to 2011-2021 increased substantially, with the largest increase, nearly 250%, for people with high social vulnerability. In Oregon and Washington, a higher percentage of exposed people were highly vulnerable (>40%) than in California (~8%). Increased social vulnerability of …

Colonial Geographies Of Gendered Violence And Mental Health In The United States And Puerto Rico, Lorraine Lizbeth L. Torres Colon

Dissertations, Theses, and Capstone Projects

As of January 2021, after years of community organizing and protests, the Puerto Rican island government announced a state of emergency due to the high rates of gendered violence on the island. At the same time, within the field of psychiatric epidemiology, consistent findings have indicated higher frequencies of mood disorders and substance abuse disorders among Puerto Ricans both on and off the island, relative to all other US Latinx ethnic groups. This dissertation frames Puerto Ricans experiences with psychological distress and gendered violence as public health issues nested within differing geographies of colonial divestment. I explore the relationships between …

Confronting The Doppelganger: Mapping The Ontological Terrain Of An Afro-Caribbean Woman As She Rebrands Diasporic, Feminine Identity Politics: An Autoethnography, Aysha E. Todd-Stone

Dissertations, Theses, and Capstone Projects

This thesis seeks to interrogate the intricacies governing the intra-racial\ intra-gendered relationship of an Afro-Trinidadian woman as she commandeers professional spaces in North America. The intent is to challenge the instrument of Black sisterhood deeming it as an incomplete, social instrument, and to prove using an auto-ethnographic approach how Diasporic, feminine trauma leads to psychically induced, episodic violence that is highly suggestive but subtle to the naked eye which in turn irretrievably damages intra-interpersonal relations. Quantitative studies have produced a composite from the white\black perspective (Goosby et al., 2015, Sims et al., 2012) and others dealing with gender (Braithwaite., 1981, …

A Statewide Study Of Disparities In Local Policies And Tobacco, Vape, And Cannabis Retail Environments, Georgiana Bostean, William R. Ponicki, Alisa A. Padon, William J. Mccarthy, Jennifer B. Unger

Sociology Faculty Articles and Research

The current study: (1) assesses sociodemographic disparities in local policies related to tobacco and cannabis retail, and (2) examines the cross-sectional association between policy strength and retailer densities of tobacco, e-cigarette (vape), and cannabis retailers within California cities and county unincorporated areas (N = 539). We combined (a) American Community Survey data (2019 5-year estimates), (b) 2018 tobacco, vape, and cannabis retailer locations from a commercial data provider, (c) 2017 tobacco and vape retail environment policy data from American Lung Association, and (d) 2018 cannabis policy data from California Cannabis Local Laws Database. Conditional autoregressive models examined policy strength associations …

Aca Medicaid Expansions Did Not Significantly Improve Maternal Morbidity, Pinka Chatterji, Hanna Glenn, Sara Markowitz, Jennifer Karas Montez

Population Health Research Brief Series

Rising rates of severe maternal morbidity in the U.S. highlight the unmet need for continuous and comprehensive health care for women before, during, and after pregnancy. This data slice summarizes findings from a study that tested whether ACA Medicaid expansions helped reduce severe maternal morbidity, including transfusion, ruptured uterus, unplanned hysterectomy, eclampsia, and the need for intensive care. Results show little evidence that the ACA expansions improved maternal morbidity, other than reducing the need for blood transfusions.

Responding To Disproportionate Skin Cancer Rates Affecting Adult Men Aged 18-60, Aaron Thompson

Capstone Collection

Skin cancer is a deadly disease that kills significantly more men than women every year. At the same time, women are more than twice as likely to apply daily sun protection factor (SPF) than men. This research study explores how key stakeholders within the skin care industry have responded to the data showing increasing disparities between male and female skin cancer rates. To fulfill the objectives of this research study, qualitative data was collected from six semi-structured interviews with adult males between the ages of 18 and 60. The interviews were intentionally designed to engage with the American, adult male’s …

An Sms Text Message-Based Type 2 Diabetes Prevention Program For Hispanic Adolescents With Obesity: Qualitative Co-Design Process, Erica Soltero, Callie Lopez, Sandra Mihail, Ayleen Hernandez, Salma M Musaad, Teresia M O'Connor, Debbe Thompson

Faculty, Staff and Students Publications

BACKGROUND: SMS text message-based interventions are a promising approach for reaching and engaging high-risk youths, such as Hispanic adolescents with obesity, in health promotion and disease prevention opportunities. This is particularly relevant, given that SMS text messaging is widely accessible and available and that adolescents are frequent texters. Including youths in the development of SMS text message content can lead to more acceptable and relevant messaging; however, few studies include this group as cocollaborators.

OBJECTIVE: This study aimed to use a co-design process to inform the development of SMS text messages that promote healthy physical activity (PA) and sleep behaviors …

A Call To Action: Person-Centered Care Aligned With Reproductive Justice For Incarcerated Pregnant People With Substance Use Disorder, Essence Hairston, Aunchalee El Palmquist, Andrea K. Knittel, Kevin Mensah-Biney, Crystal M. Hayes, Amelia Mack, Hendrée E. Jones

School of Social Work Faculty Publications

Although research has proven that jails and prisons are ineffective in preventing or reducing substance use among pregnant people, the USA continues to rely heavily on the criminal legal system as its intervention. Pregnant people with an opioid use disorder are more likely to experience incarceration than pregnant people without an opioid use disorder. In some states, pregnant people are transported from jail to prison through the process of safekeeping in order to receive physical or mental health care that the jail does not provide, despite conviction status. When pregnant and postpartum safekeepers with an opioid use disorder experience incarceration, …

Services Provided To Aging Individuals With Intellectual Disabilities: Survey Of Speech Language Pathologists, Claire H. Gatewood

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Purpose: The present study explored current speech-language pathology service provision for aging individuals with intellectual disabilities in the United States, including areas and domains of services, factors restricting service provision, and reported knowledge and confidence of individuals within the field of speech-language pathology in providing services, to identify possible gaps of service and needed improvement.

Methods: Participants (n = 272) from across the United States completed an online survey to gather descriptive information about current speech-language pathology service provision for aging individuals with intellectual disabilities. Participants were recruited through state speech-language hearing associations and universities with speech-language pathology clinics …

Trends Of Azole Antifungal Prescription In The United States: Medicare Part D Provider Utilization And Payment Data Analysis, Mohanad M Al-Obaidi, Luis Ostrosky-Zeichner, David E Nix

Faculty, Staff and Student Publications

BACKGROUND: Invasive fungal infections carry a substantial risk of mortality and morbidity. Azole antifungals are used in the treatment of such infections; however, their extensive use can lead to the emergence of antifungal resistance and increased costs to patients and healthcare systems. The aim of this study is to evaluate trends in these antifungals use and costs.

METHODS: The secular and regional trends of outpatient azole antifungals were analyzed using Medicare Part D Prescriber Public Use Files for the years 2013-2020. The total days supply (TDS), total drug cost (TDC) per 100 000 enrollees, and cost per day (CPD) were …

The Dilemma Of Socrates’ Position: Interview Methods And Feminist Empirical Bioethics, Michiel De Proost

The Qualitative Report

There is a growing body of bioethics research that addresses the importance of adapting empirical, predominantly qualitative, methods to generate debate on ethical arguments. However, there is an absence of illustrative work examining how this could be realised from a feminist perspective. This article, seeking to address the research gap, examines interview methods through a reflexive lens. Drawing on the doctoral research I conducted through interviews with women who were interested in social egg freezing (i.e., healthy women freezing their eggs in anticipation of future infertility), I describe how I encountered a dilemma because of my gendered positionality and the …

Unintentional Fatal Overdose Analysis In Orange County, Fl Yearly Trends 2018-2022, Alexandria Mcclarty, Amy Donley Phd

Institute for Social and Behavioral Science (ISBS)

This report aims to analyze yearly trends in unintentional fatal overdoses in Orange County, FL. Like many other parts of the country, the Central Florida area continues to suffer from a high number of overdose mortalities. As such, this report analyzes unintentional fatal overdoses across the years 2018-2022, focusing on the variables of sex, race, age, drug toxicology, victim residency information, and death location to draw conclusions on Orange County’s overdose climate and identify any changes over time. Additionally, we analyze quarterly trends within each calendar year, and estimate overdose rates in regard to county population by using publicly available …