Medicine and Health Commons^™

The Health Care Expenditure And Income: A Global Perspective, Badi H. Baltagi, Raffaele Lagravinese, Francesco Moscone, Elisa Tosetti

Center for Policy Research

This paper investigates the long-run economic relationship between health care expenditure and income in the world using data on 167 countries over the period 1995-2012, collected from the World Bank data set. The analysis is carried using panel data methods that allow one to account for unobserved heterogeneity, temporal persistence, and cross-section dependence in the form of either a common factor model or a spatial process. We estimate a global measure of income elasticity using all countries in the sample, and for sub-groups of countries, depending on their geo-political area and income. Our findings suggest that at the global level, …

Fish, Christine Stark

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Results From Ireland North And South's 2016 Report Card On Physical Activity For Children And Youth, Deirdre M. Harrington, Marie Murphy, Angela Carlin, Tara Coppinger, Alan Donnelly, Kieran P. Dowd, Teresa Keating, Niamh Murphy, Elaine Murtagh, Wesley O'Brien, Catherine Woods, Sarahjane Belton

Publications

Background: Physical activity (PA) is a key performance indicator for policy documents in both the Republic of Ireland and Northern Ireland. Building on baseline grades set in 2014, Ireland's second Report Card on Physical Activity for Children and Youth allows for continued surveillance of indicators related to PA in children and youth. Methods: Data and information were extracted and collated for 10 indicators and graded using an international standardized grading system. Results: Overall, 7 grades stayed the same, 2 increased, and 1 decreased. Grades were assigned as follows: Overall PA, D (an increase); Sedentary Behavior (TV), C-; Physical Education, D-; …

Validating A Measure Of Beliefs In Health Prevention Screenings Among Old Adults In China, H. Xu, Paulin Tay Straughan, W. Pan, Z. Zhen, B. Wu

Research Collection School of Social Sciences

We aimed to examine the psychometric properties of a modified 16-item Attitudinal Index (AI), a measure of health beliefs in health prevention screenings among Chinese older adults. We used the 2013 Shanghai Longitudinal Survey of Elderly Life and Opinion data including 3418 respondents aged 60 and above. We examined the validity and reliability of the modified AI. Psychometric evaluation of the modified AI revealed good response patterns. The overall scale had good reliability (Cronbach’s alpha = 0.835) with four distinct dimensions: barriers, fatalism, unnecessary, and detects (Cronbach’s alpha = 0.815 to 0.908). Confirmatory factor analysis of the modified AI’s factor …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Involvement In The Juvenile Justice System For African American Adolescents: Examining Associations With Behavioral Health Problems, Dexter R. Voisin

Faculty Scholarship

While researchers have found that African American youth experience higher levels of juvenile justice involvement at every system level (arrest, sentencing, and incarceration) relative to their other ethnic counterparts, few studies have explored how juvenile justice involvement and number of contacts might be correlated with this broad range of problems. A convenience sample of 638 African American adolescents living in predominantly low-income, urban communities participated in a survey related to juvenile justice involvement. Major findings using logistic regression models indicated that adolescents who reported juvenile justice system involvement versus no involvement were 2.3 times as likely to report mental health …

Actually, Let’S Not Talk About Sex: The Value-Laden Sex Education Received By China’S Young Women, Allyson Tsu

Independent Study Project (ISP) Collection

No abstract provided.

New Measures To Capture End Of Life Concerns In Huntington Disease: Meaning And Purpose And Concern With Death And Dying From Hdqlife (A Patient-Reported Outcomes Measurement System)., N E Carlozzi, N R Downing, M K Mccormack, S G Schilling, J S Perlmutter, E A Hahn, J S Lai, S Frank, K A Quaid, J S Paulsen, D Cella, S M Goodnight, J A Miner, M A Nance

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: Huntington disease (HD) is an incurable terminal disease. Thus, end of life (EOL) concerns are common in these individuals. A quantitative measure of EOL concerns in HD would enable a better understanding of how these concerns impact health-related quality of life. Therefore, we developed new measures of EOL for use in HD.

METHODS: An EOL item pool of 45 items was field tested in 507 individuals with prodromal or manifest HD. Exploratory and confirmatory factor analyses (EFA and CFA, respectively) were conducted to establish unidimensional item pools. Item response theory (IRT) and differential item functioning analyses were applied to …

Hdqlife: Development And Assessment Of Health-Related Quality Of Life In Huntington Disease (Hd), N E Carlozzi, S G Schilling, J-S Lai, J S Paulsen, E A Hahn, J S Perlmutter, C A Ross, N R Downing, A L Kratz, M K Mccormack, M A Nance, K A Quaid, J C Stout, R C Gershon, R E Ready, J A Miner, S K Barton, S L Perlman, S M Rao, S Frank, I Shoulson, H Marin, M D Geschwind, P Dayalu, S M Goodnight, D Cella

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: Huntington disease (HD) is a chronic, debilitating genetic disease that affects physical, emotional, cognitive, and social health. Existing patient-reported outcomes (PROs) of health-related quality of life (HRQOL) used in HD are neither comprehensive, nor do they adequately account for clinically meaningful changes in function. While new PROs examining HRQOL (i.e., Neuro-QoL-Quality of Life in Neurological Disorders and PROMIS-Patient-Reported Outcomes Measurement Information System) offer solutions to many of these shortcomings, they do not include HD-specific content, nor have they been validated in HD. HDQLIFE addresses this by validating 12 PROMIS/Neuro-QoL domains in individuals with HD and by using established PROMIS …

The Costs Of Cancer, Jamie Mosely

Honors Papers and Posters

This poster explores the relationship between more advanced cancer-fighting technologies and the increase in healthcare costs over the last several decades, and the socioeconomic impact this has for patients with less disposable income or no health insurance.

Developing Nations And Disadvantaged Populations: How The 2009 H1n1 Influenza Pandemic Exacerbated Disparities And Inequities, Rebecca Lebeaux

Independent Study Project (ISP) Collection

The 2009 H1N1 influenza pandemic, although not as deadly or long lasting as initially projected, demonstrated that the world was and is ill prepared to handle a mass pandemic. As the first pandemic of the twenty-first century, the pandemic revealed global health insecurities and asymmetrical disease burdens for disadvantaged individuals and countries. This paper will analyze why both developing countries and disadvantaged individuals suffered disproportionately from the pandemic. Using the framework of structural violence, this paper will investigate how socioeconomic and political disparities encountered before and during the pandemic caused differential health, societal, political, and economic outcomes. These preexisting disparities …

Consecuencias De La Dictadura: La Salud Mental Transgeneracional En Hijos De Detenidos Desaparecidos / Consequences Of The Dictatorship: Transgenerational Mental Health In Children Of Disappeared Detainees, Catherine Sillari

Independent Study Project (ISP) Collection

Research Question: What are the trends seen in the mental health of the children of the people who were “disappeared” by the Pinochet dictatorship?

Objectives: The general objective of this study is to look for trends in the mental health of children of disappeared people. The specific objectives are to understand the particular stresses that come with disappearances versus other types of deaths, to gage the general opinion of the government’s system of reparation, and to identify common coping methods.

Background: Between the years of 1973-1990, Chile was under the military dictatorship of Augusto Pinochet. During this time, major …

Estigma Y Discriminación Hacia Hombres Que Tienen Sexo Con Otros Hombres (Hsh) Y Mujeres Trans: El Impacto En La Vulnerabilidad Y Riesgo Frente Al Vih/Sida / Stigma And Discrimination Against Men Who Have Sex With Men (Msm) And Transgender Women: The Impact On Vulnerability And Risk Of Hiv / Aids, Alessandra Scher

Independent Study Project (ISP) Collection

Research Question – How does stigma and discrimination toward men who have sex with men (MSM) and transgender women affect their vulnerability toward HIV/AIDS?

Background – Although there has been progress over the years on improving attitudes towards, and knowledge about, sexual diversity, LGBT persons continue to be harshly discriminated against and stigmatized. The conservative and machista nature of Chilean society, as well as a lack of information about sexual diversity, perpetuates this treatment and marginalization of those who do not conform to the social expectations surrounding sexual relations and strict gender norms, specifically homosexual men and other MSM, as …

The Importance Of Nature: An Investigation On How Geography Influences Well-Being, Christina Cobb

Independent Study Project (ISP) Collection

The objective of this community service project (CSP) was to study how a community’s location, specifically within nature, influences their well-being. I hoped to see how the community’s location, within Chapada Diamantina national park, influences the many ways health is promoted, and how these ways are affected by their location within nature. This project was built upon a review of the literature, which found that there is a theoretical basis for the notion that contact with nature is beneficial, a term deemed Biophilia. There is a robust body of academic research that highlights the health benefits deriving from contact …

Continuing Efforts To Alleviate "Orange Pain" An Internship With The Da Nang Association Of Victims Of Agent Orange/Dioxin, Loan Heilner

Independent Study Project (ISP) Collection

This year marked the 55th anniversary of Vietnam’s Agent Orange Disaster. Decades after the end of the war, Vietnamese people are still largely being affected by the remnants of the United States’ Agent Orange herbicide sprays. Dioxin chemical has now been confirmed detrimental to human and environmental well-being, but unfortunately it still remains in high concentrations in certain areas of Vietnam. Dioxin chemical is passed on through genetics to new generations, but one of the leading causes of dioxin-related health defects today are due to environmental residue. In Da Nang, Agent Orange was stored and loaded at the local airbase …

Pathways To Positive Change: A People's Perspective Of Healthcare In Humla, Wensday Meyers Berman

Independent Study Project (ISP) Collection

The villagers of Humla have suffered from unreliable health services and unjust indifference from the Nepali government for too long. Many global health initiatives and international NGOs have tried and failed to step in and make an improvement of health within these villages, because they are lacking an understanding of how these villages are run, what villagers prioritize, and how to continue providing reliable, supervised support. Because of the remoteness of the Humla area, it is difficult for allopathic medicine to be sufficiently provided here, and access to emergency medical resources are limited. Global health organizations such as WHO and …

Powerful Words: An Exploration Of Linguistic Hierarchy In Moroccan Hospitals, Ellelan Degife

Independent Study Project (ISP) Collection

Morocco is a country of distinct diversity, which exists as a result of the settling of multiple peoples and European colonization. As a result of this diversity, many languages are employed in different settings and spaces, and of these languages, French represents remnants of colonialism and continual elitism in the country. One of the spheres that French commands in Moroccan society is medicine, which creates a dichotomy between the educated health care providers and the underprivileged patients in public hospitals. The aim of this paper is to explore the effect of French on the doctor-patient relationship in urban, public Moroccan …

You Poor Thing: A Retrospective Autoethnography Of Visible Chronic Illness As A Symbolic Vanishing Act, Alexandra Ch Nowakowski

The Qualitative Report

In this autoethnography, I outline a framework for understanding illness as deviance, contextualizing general sociological theory on sick role dynamics to the specific case of chronic conditions that manifest with visible physical differences. I demonstrate two distinct ways in which chronic conditions can foster labeling and stigma. First, I explore how social norms can result in sanctions for showing physical evidence of chronic conditions. I describe sanctions I have experienced for violating conventional ideas about youth and female beauty, and associated behavioral expectations. Second, I explore how double jeopardy can result from failing to meet usual social expectations for sickness. …

The Relationship Between Life Stressors And Drug And Sexual Behaviors Among A Population-Based Sample Of Young Black Men Who Have Sex With Men In Chicago, Dexter R. Voisin

Faculty Scholarship

Younger Black men who have sex with men (YBMSM) have the highest rates of HIV incidence in the U.S. and are also exposed to high life stressors (e.g., unemployment, incarceration, and exposure to communality). This study assessed whether life stressors were related to drug use and sexual risk behaviors among a representative sample of YBMSM. The South Side of Chicago and selected adjacent suburbs represents the most populous contiguous Black community in the U.S. Over 10% of the estimated YBMSM population in this geographic region were sampled. Major findings indicated that higher life stress was significantly associated with greater odds …

Taking One Step At A Time: Understanding Pulmonary Hypertension Through The Voices Of The Patients, Renae J. Mohammed

Sociology Major Research Papers

This paper presents and discusses the findings of a qualitative thematic analysis of interviews with eight Pulmonary Hypertension patients who discussed their illness experiences. This is an important topic to research, as Pulmonary Hypertension is a rare, invisible and potentially terminal illness about which little substantive research in both the medical and social scientific fields has been done. The diagnosis experience, day-today life, and resilience and coping are the three dominant themes found in these interviews. The analysis of these themes indicates that the participants in this study who are living with Pulmonary Hypertension have been able to maintain a …

In The Trenches: Traditional Healers' Understanding Of Health And Healing, Gus Hill

Lyle S. Hallman Social Work Faculty Publications

This study explored understandings of traditional healing from the perspectives of traditional healers and helpers. The sample of sixteen individuals was initially identified by key informants, and then the sample snowballed by word of mouth. Among the sample are healers from a variety of cultures, including Anishnaabe, Mohawk, Oneida, Seneca, Paiute, Inuit, Innu, and Potawatomi. Traditional Indigenous protocols were followed by the researcher during the course of the study. In-depth interviews were conducted with each participant. Interviews were audio-recorded and verbatim transcripts were analyzed qualitatively. These individuals shared their understanding of the work that they do, including ceremonies, use of …

Is This Relevant? Physician Perceptions, Clinical Relevance, And Religious Content In Clinical Interactions, Aaron B. Franzen

Faculty Publications

Despite wide support among physicians for practicing patient-centered care, clinical interactions are primarily driven by physicians’ perception of relevance. While some will perceive a connection between religion and patient health, this relevance will be less apparent for others. I argue that physician responses when religious/spiritual topics come up during clinical interactions will depend on their own religious/spiritual background. The more central religion is for the physician, the greater his or her perception of religion's impact on health outcomes and his or her inclusion of religion/spirituality within clinical interactions. Using a nationally representative sample of physicians in the United States and …

Empty Metal Jacket: The Biopolitical Economy Of War And Medicine, Sandra Lee Trappen

Dissertations, Theses, and Capstone Projects

Empty Metal Jacket: The Biopolitical Economy of War and Medicine undertakes study of how global conflict and violence shape the entire range of social production, from commodities and culture to social goods and social theory. The research presented in this work draws from cutting-edge theories in body and science studies, in addition to theories of affect and biopolitics to address how war became a problem solving paradigm in medicine. Combat casualties are shown to serve as a material nexus for medical knowledge production. Although the focus here is on medicine and medical innovation in particular, these developments are connected to …

L'Effet De La Sélection De L’Immigrant En Bonne Santé Au Canada: Une Revue Systématique, Zoua Vang, Jennifer Sigouin, Astrid Flenon, Alain Gagnon

Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/ Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail

Au Canada, la politique d'immigration favorise les individus ayant un capital humain élevé (Knowles, 2007). Étant donné les liens étroits entre le capital humain et la santé (Jasso et al., 2004) et le fait que les recherches suggèrent la présence d'un avantage de santé universel au sein de la population immigrante au Canada, nous nous attendions à observer l'effet de la sélection de l’immigrant en bonne santé à tous les stades du parcours de vie et sur des problèmes de santé multiples. Notre examen suggère plutôt un modèle plus complexe qu’envisagé initialement. Cette synthèse indique que les immigrants ont clairement …

Decomposing Trends In Adult Body Mass Index, Obesity, And Morbid Obesity, 1971-2012, Ashley Wendell Kranjac, Robert L. Wagmiller

Sociology Faculty Articles and Research

Trends in adult obesity have been used to motivate key public health policies in the United States. While these analyses provide important insights into the broad historical contours of the obesity epidemic in the U.S., they shed less light on the proximate mechanisms that have generated these changes and that will ultimately determine the long-term course and pace of change in obesity rates. We used data from the National Health and Nutrition Examination Survey (NHANES), Glenn Firebaugh's linear decomposition technique, and Kitagawa's algebraic decomposition method to decompose change in body mass index (BMI), obesity, and morbid obesity from 1971 through …

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

‘Project Spraoi’: A Randomized Control Trial To Improve Nutrition And Physical Activity In School Children, Tara Coppinger, Seán Lacey, Cian O'Neill, Con Burns

Publications

Background

Recent evidence predicts that by 2030, Ireland will have the highest rate of obesity in Europe. Consequently, there are concerns that health problems associated with this condition will present in childhood. Studies have shown that interventions based on increasing physical activity (PA) levels, reducing sedentary lifestyles and improving nutritional habits all pose protective mechanisms against obesity and its related disorders in youth. Yet, to date, there are no interventions being delivered in Ireland that concurrently target PA, nutritional habits and sedentary time amongst school children.

Purpose

The purpose of this study is to implement and evaluate an intervention that …

Marijuana Use Among Young Black Men Who Have Sex With Men And The Hiv Care Continuum: Findings From The Uconnect Cohort, Dexter R. Voisin

Faculty Scholarship

Background: Young Black men who have sex with men (YBMSM) are at highest risk for HIV seroconversion in the United States. Successful movement through the HIV care continuum is an important intervention for limiting onwards HIV transmission. Objective: Little data exists on how substances most commonly used by YBMSM, such as marijuana, are related to the HIV continuum, which represents the primary aim of this study. Methods: A cohort of YBMSM (n = 618) was generated through respondent-driven sampling. Frequency of marijuana use and marijuana use as a sex-drug were assessed across the HIV care continuum using weighted logistic regression …

Gender Differences In Social Support, Self-Salience, And Mental Health, Ee Shin (Emily) Hum, Christina Falci

UCARE: Research Products

Men and women tend to manifest distinct mental health outcomes. Specifically, women report higher levels of internalizing symptoms, such as depression and anxiety, whereas men report higher levels externalizing symptoms, such as alcohol abuse (Rosenfield, S., Lennon, M. C., & White, H. R., 2005; Rosenfield, S., & Smith, D., 2010). However, it is unclear what mechanisms shape the gender differences in mental health outcomes. This research will explore two key possible mechanisms: social support and self-salience. Our aims in this study are to examine how and why mental health outcomes vary by gender? And also to what extent do social …

A Framework For Measurement Error In Self-Reported Health Conditions, Ling Li, Perry Singleton

Center for Policy Research

This study develops and estimates a model of measurement error in self-reported health conditions. The model allows self-reports of a health condition to differ from a contemporaneous medical examination, prior medical records, or both. The model is estimated using a two-sample strategy, which combines survey data linked medical examination results and survey data linked to prior medical records. The study finds substantial inconsistencies between self-reported health, the medical record, and prior medical records. The study proposes alternative estimators for the prevalence of diagnosed and undiagnosed conditions and estimates the bias that arises when using self-reported health conditions as explanatory variables.