Medicine and Health Commons^™

Addicts Speak: An Exploratory Ethnographic Study Of Opioid Addiction, James A. Hamm

Honors Theses

This thesis explores the experiences of people in recovery from opioid addiction in order to better understand the many process of recovery. Employing both participant observation and focused life history interview, and utilizing a grounded theory approach to data analysis, this research emphasizes data-driven conclusions. The research provides numerous insights into the process of recovery from opioid addiction, as well as factors that help to facilitate and sustain the process, the role that services play, and how services can be developed to better meet the needs of those in recovery.

The Summit Ambulatory‑Icu Primary Care Model For Medically And Socially Complex Patients In An Urban Federally Qualified Health Center: Study Design And Rationale, Brian Chan, Samuel T. Edwards, Meg Devoe, Richard Gil, Matthew Mitchell, Honora Englander, Christina Nicolaidis, Multiple Additional Authors

School of Social Work Faculty Publications and Presentations

Background: Medically complex urban patients experiencing homelessness comprise a disproportionate number of high-cost, high-need patients. There are few studies of interventions to improve care for these populations; their social complexity makes them difficult to study and requires clinical and research collaboration. We present a protocol for a trial of the streamlined unified meaningfully managed interdisciplinary team (SUMMIT) team, an ambulatory ICU (A-ICU) intervention to improve utilization and patient experience that uses control populations to address limitations of prior research.

Methods/design: Participants are patients at a Federally Qualified Health Center in Portland, Oregon that serves patients experiencing homelessness or …

The Relationship Between Black And Gay Community Involvement And Hiv-Related Risk Behaviors Among Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

Black gay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their White male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV-related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of young Black men who have sex with men (YBMSM) on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16 to 29. Cross-sectional measures for this study include Black and …

Dynamics Of Household Role Performance And The Culture Of Child Health Production In Igbo-Ora, Southwestern Nigeria, Kabiru K. Salami, Ayodele S. Jegede, Frederick O. Oshiname

Journal of Social, Behavioral, and Health Sciences

Studies about production of health for children have mainly concentrated on the behavior of one or two key household members compared to the dynamics in households involving three or more members. Health production refers to the process of directing available knowledge, skills, and resources towards ensuring, maintaining, and sustaining the health of the members. This cross-sectional design study explored how the dynamics of household structure and members’ roles influence the process of health production in a rural Nigerian community. An interviewer-moderated questionnaire was administered through a panel survey approach in 576 households. Twelve in-depth interviews and eight group discussion sessions …

Postmodern Social Control: Dividuals And Surveillance, Ernest M. Oleksy

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

As a society's foundational philosophy changes, so, too, will its forms of social control. By using the works of thinkers like Deleuze and Foucault as pivot points, the dynamic nature of social interactions and the agents to mediate those actions shall be investigated. This article includes findings from archival analysis written in a journalistic prose for simplicity of consumption.

Hiv In The Heartland: Experiences Of Living With Hiv In Urban And Rural Areas Of The Midwest, Sarah B. Donley, C. Patrice Lockett

The Qualitative Report

Scholarly research on HIV/AIDS and stigma has largely demonstrated a different experience for people living with HIV and AIDS (PLWHA) who inhabit urban and rural areas. Largely missing from this scholarship are experiences in low prevalence areas. Low prevalence areas typically have fewer resources, social networks, and HIV infection and prevalence is less common. In this paper, we examine the challenges PLWHAs in rural and urban areas of the Midwest face and how these individuals manage, respond, and combat HIV/AIDS related stigmas in their communities. This paper utilizes interview data to understand the lived experiences of 18 persons living with …

The U.S. Heath Care Experience, Cristian Montes

Ursidae: The Undergraduate Research Journal at the University of Northern Colorado

This research project intends to look in depth into the U.S. health care system specifically the Affordable Care Act (ACA). The overview of the ACA will be evaluated to see if it has reached all its objectives it was pursuing prior to being signed into law in 2010. The questions we seek to answer is if the ACA is working or not. Additionally the project will also overview health care systems in other countries and understand how other private insurance functions along with how countries with universal health care and how its people are able to benefit from these specific …

Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh

Electronic Theses and Dissertations

Over the last hundred years, the Appalachian region has been dominated by the coal industry. It has also been and currently is one of the unhealthiest regions in the United States. Recent scholarship has examined the relationship between coal mining and health and mortality rates in the Appalachian region. The first study incorporates air quality and pollution data to examine if coal mining counties have higher levels of pollution and if this pollution contributes to mortality disadvantage. In the second study, I construct a population-based coal-exposure measure to better evaluate the relationship between coal mining and health I find that …

Strategies For Delivering Sexual Health Education To Adolescents With Autism Spectrum Disorders: An Integrative Review Of The Literature, Megan Harris

Grace Peterson Nursing Research Colloquium

Autism spectrum disorder (ASD) is a neurobiological condition leading to cognitive and social deficits within individuals on the spectrum. Adolescence is a time of intense physical and psychosocial changes that prove difficult for youth with ASDs. As families work through this transition they try to navigate teaching sexual health to their adolescent with an ASD. Teaching should be done to promote health, healthy relationships, and to prevent victimization. Yet, parents report that they lack the knowledge and support to complete this task. The purpose of this literature review was to synthesize research on strategies for teaching sexual health education to …

Patient Experience Of Taking Adjuvant Endocrine Therapy For Breast Cancer: A Tough Pill To Swallow, Kuang-Yi Wen, Rita Smith, Aruna Padmanabhan, Lori Goldstein

Patient Experience Journal

Adjuvant endocrine therapy (AET) has substantially improved the mortality rate among breast cancer survivors. Despite the proven efficacy, the non-adherence rate to therapy is still high. This study is aimed to examine women’s challenges related to AET adherence and management. Semi-structured interviews were conducted with six Caucasian and six African American breast cancer survivors who were prescribed for AET. The transcripts of audio-taped interviews were qualitatively analyzed. Key themes were: 1) positive beliefs in AET, 2) uncertainty about long-term adherence, 3) experiences with side effects, 4) forgetting and remembering, 5) other concerns and information needs, 6) potential intervention format, and …

Pathways To Delinquency And Substance Use Among African American Youth: Does Future Orientation Mediate The Effects Of Peer Norms And Parental Monitoring?, Dexter R. Voisin

Faculty Scholarship

The following study assessed whether future orientation mediated the effects of peer norms and parental monitoring on delinquency and substance use among 549 African American adolescents. Structural equation modeling computed direct and indirect (meditational) relationships between parental monitoring and peer norms through future orientation. Parental monitoring significantly correlated with lower delinquency through future orientation (B = −.05, standard deviation =.01, p <.01). Future orientation mediated more than quarter (27.70%) of the total effect of parental monitoring on delinquency. Overall findings underscore the importance of strengthening resilience factors for African American youth, especially those who live in low-income communities.

Doing And Undoing Gender In The Hospital Workplace, Nayyara Tabassum, Antonio Chiesi

Journal of Interdisciplinary Feminist Thought

In the hospital, both male and female doctors ‘do gender’, but because men and masculinity are associated with greater authority (and by association, competence), masculinised traits are favoured over feminine traits in the hospital workplace. In order to be accepted as competent doctors, female doctors expend a great deal of ‘emotional labour’ and ‘do gender’ by acting out prized masculine traits through appearance and behaviour strategies and thereby gaining legitimacy as respected, competent doctors in their interactions with other co-workers (doctors, nurses) and patients. Our study looks at the varied experiences of both older/senior and younger/junior medical doctors. Through in-depth …

Project Ngage: Results Of A Randomized Controlled Trial Of A Dyadic Network Support Intervention To Retain Young Black Men Who Have Sex With Men In Hiv Care, Dexter R. Voisin

Faculty Scholarship

HIV-positive young black MSM (YBMSM) experience poor outcomes along the HIV care continuum, yet few interventions have been developed expressly for YBMSM retention in care. Project nGage was a randomized controlled trial conducted across five Chicago clinics with 98 HIV-positive YBMSM aged 16–29 between 2012 and 2015. The intervention used a social network elicitation approach with index YBMSM (n = 45) to identify and recruit a support confidant (SC) to the study. Each index-SC dyad met with a social worker to improve HIV-care knowledge, activate dyadic social support, and develop a retention in care plan. Each index and SC also …

“First, Do No Harm”: Old And New Paradigms In Prehospital Resuscitation In The Aquatic Domain, John H. Pearn, Richard Charles Franklin

International Journal of Aquatic Research and Education

The balance between benefit and risk is central to the work of all those involved in aquatic services. The Hippocratic exhortation of Primum non nocere, “First, do no harm,” has a history of over 2000 years. Superficially, all would support this dictum, but harm can result from inaction. The balance between no or little intervention on the one hand and proactive intervention with iatrogenic risk on the other is complex and enduring. Risk implies that one does not have all the information available to know the exact likelihood of an outcome, a common situation involving rescue, first aid, and …

Discrimination And Anger Control As Pathways Linking Socioeconomic Disadvantage To Allostatic Load In Midlife, Samuele Zilioli, Ledina Imami, Anthony D. Ong, Mark A. Lumley, Tara Gruenewald

Psychology Faculty Articles and Research

Objective

Recent evidence suggests that experiences of discrimination contribute to socioeconomic status health disparities. The current study examined if the experience and regulation of anger—an expected emotional response to discrimination—serves as an explanatory factor for the previously documented links between socioeconomic disadvantage (SED), discrimination, and allostatic load.

Methods

Data were drawn from the second wave of the Midlife Development in the U.S. study and included 909 adults who participated in the biomarkers subproject.

Results

Results revealed that perceived discrimination was associated with higher levels of allostatic load. Furthermore, we found evidence that perceived discrimination and anger control sequentially explained the …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty and Staff Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Pololeo Y Protección: Las Barreras De Acceso A Métodos Anticonceptivos Para Adolescentes Vulnerables En La Comuna De Macul, Santiago De Chile / Pololeo Y Protección: Barriers To Access Contraceptive Methods For Vulnerable Adolescents In The District Of Macul, Santiago De Chile, Louisa Boswell

Independent Study Project (ISP) Collection

El embarazo adolescente sigue siendo un problema de salud pública al nivel nacional en Chile. Aunque por ley, todos tienen el derecho a una educación sexual y a elegir un método de control de fecundidad, todavía existen casos de embarazos no planificados, particularmente entre adolescentes. Este estudio investigó las barreras que limitan el acceso a métodos anticonceptivos para adolescentes, enfocando primariamente en el sistema público en la Región Metropolitana. Específicamente, la investigación consideró las adolescentes de la comuna de Macul, utilizando muestras de un colegio local y dos centros de salud familiar para hacer conclusiones. La investigadora entrevistó a matronas …

Physicians' Moral Dispositions, Role Perceptions, And Patient Interactions: Exploratory Findings From Physicians In The Midwestern United States, Aaron B. Franzen

Faculty Publications

We know that patients and their well-being is important to physicians, but what this means in terms of their practice is not always as clear. One potentially fruitful approach to understanding this variation is to look to physicians' value dispositions and moral foundations. Prior work within the general population has highlighted the place and importance of religion/spirituality, but very little is known about physicians and how moral foundations matter for medicine more broadly. The purpose of this research note is to explore these issues with a sample of physicians in Michigan. We find that individual characteristics are related to physicians' …

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …