Medicine and Health Commons^™

Factors In Primary Care Use Among Young Adult Refugees From Burma And Bhutan In Early Resettlement: Findings From Colorado, Sarah Brewer, Jini Puma

Journal of Refugee & Global Health

Background: Young adult refugees have suboptimal primary care use in early resettlement—domains of integration influence primary care engagement during this time.

Methods: Adjusted logistic regression models were used to estimate odds of (1) having a primary care exam and (2) identification of a primary care provider (PCP) as predicted by domains of integration among young adult refugees (n=154) from Burma and Bhutan across four years following resettlement.

Results: Overall integration and predisposing factors, such as language and cultural knowledge, were lower odds of having a primary care provider. Enabling factors such as having insurance and knowing how to make an …

Mommy, Me, And We: Why Black Mothers Have Turned To Doulas, Janessa Harris

Crossings: Swarthmore Undergraduate Feminist Research Journal

Maternal mortality rates have disproportionately affected black mothers for far too long due to the lack of value that black bodies hold in medical spaces. Because of this concerns voiced by black people are often disregarded and ignored until the very last minute. But what if this was changed? This paper will focus on how black mothers have worked against Western medical systems that silence our voices, but instead turn to doulas who work to make these mothers feel seen, heard, and cared for. Through this, we make birthing a careful and collective effort to turn Mommy&Me to Mommy&We.

Skin Stories And Family Feelings: The Contradictions Of Skin Picking In Mother And Daughter, Katrina Jacinto

Crossings: Swarthmore Undergraduate Feminist Research Journal

Skin picking, otherwise known as dermatillomania, is considered to be a medical disorder by the DSM-5. However, the embodied experiences of skin picking in myself and my mother do not align with the neat definitions offered by psychiatry. Through autoethnographic material and an ethnographic interview with my mother, I argue that skin picking is a bodily technique that is pathologized through stigma. In particular, I suggest that skin picking reveals the body as a polyvalent entity, in which the same features and practices take on different meanings in different bodies. This frames the discrepancies between mine, and my mother's, experiences. …

Comparing Substance Use Social Issues In Appalachian And Non-Appalachian Regions In Kentucky, Erica C. Bellamy, James N. Maples

Kentucky Journal of Undergraduate Scholarship

Substance use and abuse is not a uniquely Appalachian problem, but it remains a prevalent social problem for the geographical region. Kentucky has been one of the central states experiencing generations of substance abuse, ranging from methamphetamines to OxyContin to heroin. Eastern Kentucky, which includes a portion of Central Appalachia, has been a focal point for the proposed war against substance use. What remains undemonstrated in studies is exactly how substance abuse differs between the Central Appalachian counties of Eastern Kentucky and the remainder of the state, if any difference exists at all. In this study, the researchers examine how …

Ivermectin On Twitter: Investigating Early Advocacy For Covid-19 Vaccine Alternatives, Daniel Gabriel

Honors Undergraduate Theses

An emerging pattern of public doubt in scientific and political authorities has been seen during the COVID-19 pandemic, where numerous alternatives to vaccinations have gone viral. Ivermectin's growth from a relatively known specialist drug to a political controversy is a striking example of the amplification that social media can provide. Doubt in the dangers of illness has occurred in regard to previous diseases with limited impact, including the Zika virus, Ebola, and H1N1. However, the COVID-19 pandemic's impact in the United States is a much larger example of the gaps in current risk assessments and methods of public health authorities. …

An Analysis Of The Role Of Fentanyl In Fatal Overdoses In Orange County, Logan Michalski

Honors Undergraduate Theses

Fentanyl is a potent narcotic analgesic that leads to countless overdoses each year. Past studies have shown that fentanyl use has been growing substantially in counties within Florida. However, little research has been done to quantify and analyze rates of fentanyl overdose within Orange County, particularly over multiple year periods of time. The goal of this study is to provide information and analysis on the rates of fentanyl overdose within Orange County, Florida from 2019 to 2021, and to explore demographic factors that correlate with fentanyl overdose. It is hypothesized that the rate of fentanyl overdoses will have significantly increased …

Provider Perceptions On The Usage Of Psychedelic-Assisted Therapy To Influence Behavior Change In Individuals With Substance Use Disorders, Leia T. Rausch

Honors Undergraduate Theses

Recent research studies and clinical trials have suggested that psychedelic therapy with psychological support can offer beneficial and synergistic effects in reducing or eliminating substance use disorder (SUD) patterns and symptoms. However, very little is known about SUD healthcare providers' perceptions of the usage of psychedelic-assisted therapy in SUD treatment. The present study assesses biomedical SUD healthcare providers' perceptions and concerns to better understand potential barriers to the effective implementation of psychedelic-based therapies and formulate further recommendations for research efforts surrounding them. This study collected data through a short survey and qualitative semi-structured interviews from nine participants involved in SUD …

Advocacy With Context: The Role Of Pediatricians In Breastfeeding Success, Sanya Bansal

Honors Undergraduate Theses

Although the importance of breastfeeding is almost universally accepted, the rates of breastfeeding are improving very slowly. The current literature provides much insight as to how medical professionals such as obstetricians and lactation specialists could improve the rates of breastfeeding. The pediatrician could encourage breastfeeding at a prime opportunity: during post-natal visits. Unfortunately, there is limited research on what role the pediatrician plays in breastfeeding success. This study used in-depth, qualitative interviews from four pediatricians to gather data on the true role of the pediatrician in breastfeeding. These pediatricians were selected based on the diverse patient population they serve, considering …

Addressing Medical Mistrust Within The Black Community To Improve Their Health Ourcomes, Jillian Weathington

Honors Undergraduate Theses

Mistrust of the healthcare system is increased among the Black population compared to other race/ethnicity groups. Medical mistrust can lead to intensified health inequities and negative health outcomes among this population. Currently, there is limited research that explores ways to address medical mistrust, especially among the Black population. This study investigated medical mistrust to find ways to improve the quality of life amongst the Black population. Twenty-one participants in this study completed a Group Based Medical Mistrust Survey and five of those participants participated in a semi-structured interview. Descriptive and correlation analyses were conducted. The GBMMS was separated into three …

Gendered And Racialized Bodies In Dobbs V. Jackson Women's Health Organization, Saphronia Carson

Electronic Theses and Dissertations, 2020-2023

In June 2022 the US Supreme Court overturned Roe v. Wade, abandoning nearly 50 years of precedent, and removing federal protections for abortion access. In doing so, the Court drew on a lineage of explicit and implicit discourses that have constructed abortions, abortion providers, and pregnant and fetal bodies in ways that make overturning Roe seem inevitable. This thesis takes a reproductive justice perspective while conducting a feminist critical discourse analysis of the majority and concurring opinions in Dobbs. Two main findings stand out. First, the decision relies on originalist constructions of abortions, abortion providers, pregnant people, and fetuses to …

Exploring Anterior Cruciate Ligament Tears And Athletic Identity As Predictors Of Disordered Eating Behaviors In Female Collegiate Soccer Players, Niondina M. Nyström

Masters Theses

Research has consistently established the relationship between injury occurrence and subsequent mental health concerns within the athletic population (Brown et al., 2014; NCAA, 2021). Specifically, negative mental health outcomes such as anxiety, depression, and social isolation have followed the occurrence of an anterior cruciate ligament (ACL) tear (McGinley et al., 2022; Töyrä & Bergström, 2017). Similarly, because of high levels of athletic identity (AI), the inability to participate in a sport due to injury has been associated with disordered eating (DE) (Gusfa et al., 2022). Despite this, no studies have examined disordered eating and the role of athletic identity after …

Comparison Of Self-Reported Depression And Anxiety Scores Between U.S. Households With And Without Children At Early And Later Stages Of The Covid-19 Pandemic, Hanan Mohammed Eissa Jamali

Electronic Theses and Dissertations

Parents in particular, are disproportionately affected by the 2019 coronavirus pandemic and the lockdowns that followed. Parents had to find a way to balance work, teaching, and taking care of their kids when schools were forced to close for safety reasons. While changes in parents' mental health have been the subject of a number of studies, there have been no studies comparing the level of depression and anxiety experienced by parents with and without children below the age of 18 years in the United States. Data for this study came from Households Pulse Survey (HPS) (week 2 N = 41,996; …

Addiction And Liberty, Matthew B. Lawrence

Faculty Articles

This Article explores the interaction between addiction and liberty and identifies a firm legal basis for recognition of a fundamental constitutional right to freedom from addiction. Government interferes with freedom from addiction when it causes addiction or restricts addiction treatment, and government may protect freedom from addiction through legislation empowering individuals against private actors’ efforts to addict them without their consent. This Article motivates and tests the boundaries of this right through case studies of emergent threats to liberty made possible or exacerbated by new technologies and scientific understandings. These include certain state lottery programs, addiction treatment restrictions, and smartphone …

Fostering Inclusivity And Resilience: Challenges To Community-Based Empowerment For Trans Elders In Roanoke, Virginia, Summer Skye Allison

Undergraduate Honors Theses

As popular media disseminates harmful “culture war” rhetoric regarding trans folk it has become increasingly necessary to amplify their voices to give them power over how they are perceived by society. Though political discourse regarding trans children has become a hot-button topic, this paper seeks to explore the overlooked experiences of trans elders as they contend with intersecting instances of ageism and transphobia from individuals and institutions in Roanoke, Virginia. Since community-based organizations like the Roanoke Diversity Center and Ladies and Gents of the Blue Ridge have been instrumental to strengthening the LGBTQ+ community in Roanoke, this research focuses on …

Health Behavior And Outlooks In An Altered Microbial Diversity: Changes In Parental Attitudes On ‘Building Immunity’ Throughout The Covid-19 Pandemic, Jennifer Vidal

Pitzer Senior Theses

The Covid-19 Pandemic in a short amount of time put into action disease control measures. Current literature has sought to address the long-term effects of sanitization efforts and social isolation on the diversity of the microbiome and the future of infectious diseases. Microbes – microorganisms such as bacteria, protozoa, algae, fungi, and viruses – inhabit the natural environment and human microbiome with our immune system, playing an essential role in immune regulation. The interplay between humans and microbes forms early immune development that has impacted parents’ attitudes toward microbes shown through their participation in Covid-19 preventative health practices. Using the …

Living Alone During Old Age And The Risk Of Dementia: Assessing The Cumulative Risk Of Living Alone, Benjamin A. Shaw, Tse-Chuan Yang, Seulki Kim

Department of Sociology: Faculty Publications

Objectives: This study examines the association between living alone during old age and dementia. Whereas most previous studies on this topic utilize measures of living alone status that were obtained at a single point in time, we compare this typical approach to one that measures long-term exposure to living alone among older adults and assesses whether dementia is more likely to occur within individuals with more accumulated time living alone. Methods: Data come from the Health and Retirement Study, with a follow-up period of 2000–2018. A total of 18,171 older adults were followed during this period, resulting in 78,490 person-waves …

Emoting In Context: Lived Narratives Of Filipino Health-Care Frontliners During The Early Days Of The Covid-19 Pandemic, John Martin Bernard Gappy

Sociology & Anthropology Department Faculty Publications

The current SARS-CoV-2 pandemic has placed the entire world in a liminal position whereby our well-rehearsed and predictive practices have been deeply shaken. Within this context of liminality, studies point to potential distress among healthcare workers who are taking care of COVID-19 patients. Most studies focus on emotional distress of frontline healthcare workers as fixed entities. The current approach perceives emotion as a type of connection with social worlds. This article focuses on contextual acts of emoting and is organized around personal, situational, and cultural features of nine frontline medical doctors affiliated with ten hospitals in Metro-Manila who were taking …

Parenthood, Mental Health, And Intergenerational Adversity: Exploring Gender Role Ideologies, Household Composition And Work-Family Conflict, Ashley Vowels

Theses and Dissertations--Sociology

To date, research at the intersections of parenting, stress, gender, and mental health has yielded complicated and inconsistent results. The objective of this dissertation was to deepen our understanding of how parenting stress contributes to the mental health of both parents and their children, especially within the context of balancing work and family responsibilities. A three-study approach was used to assess differences by sex, gender role ideology, and household composition. Additionally, it explored the impact of parents’ characteristics on their children’s well-being in adulthood.

This project utilized secondary data from the Panel Study of Income Dynamics (PSID). Multivariate regression analyses …

Revisiting The Rainbow: Culturally Responsive Updates To A Standard Clinical Resource, Angela M. Dietsch, Richard Mocarski, Debra A. Hope, Nathan Woodruff, Miechelle Mckelvey

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

Cultural responsivity is essential for efficacious and affirming clinical relationships. This may be especially important with historically marginalized clients, such as transgender and gender-diverse (TGD) people seeking behaviorally based affirming communication services. We recommend modifications to standard tools for diagnostics and training that otherwise might undermine our efforts to create an inclusive and affirming environment.

Method

Modifications to the Rainbow Passage, a standardized paragraph utilized for eliciting speech samples in clinical settings, focused on nongendered terminology and the elimination of content with religious connotations.

Results

The recommended edits to the Rainbow Passage maintain similar length, cadence, and phonetic balance …

Understanding The Implications Of Under-Reporting, Vaccine Efficiency And Social Behavior On The Post-Pandemic Spread Using Physics Informed Neural Networks: A Case Study Of China, Samiran Ghosh, Alonso Ogueda-Oliva, Aditi Ghosh, Malay Banerjee, Padmanabhan Seshaiyer

Faculty, Staff and Student Publications

In late 2019, the emergence of COVID-19 in Wuhan, China, led to the implementation of stringent measures forming the zero-COVID policy aimed at eliminating transmission. Zero-COVID policy basically aimed at completely eliminating the transmission of COVID-19. However, the relaxation of this policy in late 2022 reportedly resulted in a rapid surge of COVID-19 cases. The aim of this work is to investigate the factors contributing to this outbreak using a new SEIR-type epidemic model with time-dependent level of immunity. Our model incorporates a time-dependent level of immunity considering vaccine doses administered and time-post-vaccination dependent vaccine efficacy. We find that vaccine …

Age And Sex-Specific Stroke Epidemiology In Covid-19, Youngran Kim, Maria A Parekh, Xiaojin Li, Yan Huang, Guo-Qiang Zhang, Bharti Manwani

Faculty, Staff and Student Publications

BACKGROUND: COVID-19 has emerged as an independent risk factor for stroke. We aimed to determine age and sex-specific stroke incidence and risk factors with COVID-19 in the US using a large electronic health record (EHR) that included both inpatients and outpatients.

METHODS: A retrospective cohort study was conducted using individual-level data from Optum

RESULTS: Of 387,330 COVID-19 patients, 2,752 patients (0.71%, 95% CI 0.68-0.74) developed stroke during the 180-day follow-up, AIS in 0.65% (95% CI 0.62-0.67), and ICH in 0.11% (95% CI 0.10-0.12). Of strokes among COVID-19 patients, 57% occurred within 3 days. Advanced age was associated with a substantially …

Healthcare Access And Experiences Among Transgender University Students, Micah Reisner

Honors Undergraduate Theses

Background

As transgender identification rises in younger generations, it is imperative that colleges and universities account for the health and wellbeing of this growing subset of the student body. Previous research indicates that transgender populations experience unique barriers to accessing healthcare, including socioeconomic barriers and a lack of healthcare providers experienced in transgender medicine. These barriers contribute to low rates of healthcare utilization and significant health disparities in transgender populations.

Methods

A community health assessment of transgender and gender-nonconforming (TGNC) students at the University of Central Florida was conducted in order to assess: (1) students' access to and experiences with …

Uncovering The Connection Between Mental Health Service Availability And Violent Crime: A Test Of Macrolevel Theory, Tatianna R. Pugmire

Graduate Student Theses, Dissertations, & Professional Papers

Since the decline of mental health service funding and availability, the relationship between untreated (or improperly treated) serious mental illness and violent crime is increasingly critical to examine. Rooted in a social support and institutional anomie theory (IAT) perspective, the purpose of this quantitative study is to analyze the relationship between mental health service availability and violent crime rates across the United States for the year 2016. It was hypothesized that findings would suggest an inverse relationship between mental health service availability and rates of violent crime. Results revealed the opposite, however, indicating that the more psychiatric hospitals in an …

Quality Care Is Equitable Care: A Call To Action To Link Quality To Achieving Health Equity Within Acute Care Surgery, Lisa M Knowlton, Tanya Zakrison, Lillian S Kao, Marta L Mccrum, Suresh Agarwal, Brandon Bruns, Kathie-Ann Joseph, Cherisse Berry

Faculty, Staff and Student Publications

Health equity is defined as the sixth domain of healthcare quality. Understanding health disparities in acute care surgery (defined as trauma surgery, emergency general surgery and surgical critical care) is key to identifying targets that will improve outcomes and ensure delivery of high-quality care within healthcare organizations. Implementing a health equity framework within institutions such that local acute care surgeons can ensure equity is a component of quality is imperative. Recognizing this need, the AAST (American Association for the Surgery of Trauma) Diversity, Equity and Inclusion Committee convened an expert panel entitled 'Quality Care is Equitable Care' at the 81st …

Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason

Theses and Dissertations

Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …

Ethnic And Racial Differences In Self-Reported Symptoms, Health Status, Activity Level, And Missed Work At 3 And 6 Months Following Sars-Cov-2 Infection, Kelli N O'Laughlin, Robin E Klabbers, Imtiaz Ebna Mannan, Nicole L Gentile, Rachel E Geyer, Zihan Zheng, Huihui Yu, Shu-Xia Li, Kwun C G Chan, Erica S Spatz, Ralph C Wang, Michelle L'Hommedieu, Robert A Weinstein, Ian D Plumb, Michael Gottlieb, Ryan M Huebinger, Melissa Hagen, Joann G Elmore, Mandy J Hill, Morgan Kelly, Samuel Mcdonald, Kristin L Rising, Robert M Rodriguez, Arjun Venkatesh, Ahamed H Idris, Michelle Santangelo, Katherine Koo, Sharon Saydah, Graham Nichol, Kari A Stephens

Faculty, Staff and Student Publications

INTRODUCTION: Data on ethnic and racial differences in symptoms and health-related impacts following SARS-CoV-2 infection are limited. We aimed to estimate the ethnic and racial differences in symptoms and health-related impacts 3 and 6 months after the first SARS-CoV-2 infection.

METHODS: Participants included adults with SARS-CoV-2 infection enrolled in a prospective multicenter US study between 12/11/2020 and 7/4/2022 as the primary cohort of interest, as well as a SARS-CoV-2-negative cohort to account for non-SARS-CoV-2-infection impacts, who completed enrollment and 3-month surveys (

RESULTS: Following SARS-CoV-2 infection, the majority of symptoms were similar over time between ethnic and racial groups. At …

Social Vulnerability And The Prevalence Of Opioid Use Disorder Among Older Medicare Beneficiaries In U.S. Counties, Tse-Chuan Yang, Seulki Kim, Stephen A. Matthews, Carla Shoff

Department of Sociology: Faculty Publications

Objectives: Recent research has investigated the factors associated with the prevalence of opioid use disorder (OUD) among older adults (65+), which has rapidly increased in the past decade. However, little is known about the relationship between social vulnerability and the prevalence of OUD, and even less about whether the correlates of the prevalence of OUD vary across the social vulnerability spectrum. This study aims to fill these gaps. Methods: We assemble a county-level data set in the contiguous United States (U.S.) by merging 2021 Medicare claims with the CDC’s social vulnerability index and other covariates. Using the total number of …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Deadly Divisions: Class And Stigma As Fundamental Social Causes Of Spatial Health Inequalities, Misty Lee Harris

Graduate Theses, Dissertations, and Problem Reports (ETD)

The objective of this dissertation is to investigate how class and stigma influence spatial inequalities in health across the US, from the structural to the individual level. Class, stigma, and subsequent access to capital resources are not equally distributed across the US. Women, poor, and minority populations continue to have unequal access to capital resources across the country, though this is spatially determined. Similarly, while there are health inequalities along the same social cleavages at the national level, they differ significantly across localities. Research has not paid enough attention to the fundamental social causes of inequities, resulting in the inability …

Integrating Feminist Approaches In Counseling Work With Adult Women, Kristen M. Toole

Adultspan Journal

The scope of ‘women’s issues’ in counseling is an ever-evolving landscape. Recent events such as the reversal of Roe v. Wade and the disproportionate impact of COVID-19 on women serve as powerful reminders of the necessity of this focus while underscoring a deep-rooted history of oppressive patriarchal structures. Therefore, counselors must remain informed of the unique considerations surrounding adult women in counseling and acquire proficiency in versatile techniques to meet this population’s nuanced needs. This article examines the complexity of contemporary womanhood and explores the fundamentals of Feminist Counseling Theory (FCT), a holistic, multiculturally conscious, social justice theory in counseling. …