Medicine and Health Commons^™

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 …

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.

So Many Hospitals, So Little Information: How Hospital Value Based Purchasing Is A Game Of Chance, Andrew I. Friedson, William C. Horrace, Allison F. Marier

Center for Policy Research

As part of the Patient Protection and Affordable Care Act, participating Medicare hospitals have part of their Medicare reimbursements withheld and then redistributed based on quality performance. The Hospital Value Based Purchasing reimbursement plan relies partly on ordinal rankings of hospitals to determine how money is distributed. We analyze the quality metric distributions used for payment and show that there is not enough information to reliably differentiate hospitals from one another near the payment cutoffs; and conclude that a large part of the payment formula is driven by sampling variability rather than true quality information. Alternative reimbursement plans are developed.

Using The Theory Of Fundamental Causes To Show The Potential Effects Of Socioeconomic Status On Surgical Outcomes, Mehwish Qasim, A.B.D.

Journal of Health Disparities Research and Practice

Surgical procedures are both costly and common. There are large differences in surgical outcomes both within and between hospitals based on patient characteristics such as measures of income. In both 2000 and 2009, patients residing in low-income communities had worse morbidity and mortality rates, across a wide range of quality indicators. In this review, the author will explicate the Theory of Fundamental Causes as it relates to surgical care, review key empirical findings and address potential limitations of the theory. This review will provide a platform for researchers to discuss current research in surgical disparities using the Theory of Fundamental …

“Great Job Cleaning Your Plate Today!” Determinants Of Child-Care Providers’ Use Of Controlling Feeding Practices: An Exploratory Examination, Dipti A. Dev, Brent A. Mcbride, Katherine E. Speirs, Kimberly A. Blitch, Natalie A. Williams

Department of Child, Youth, and Family Studies: Faculty Publications

Background National early childhood obesity prevention policies recommend that child-care providers avoid controlling feeding practices (CFP) (e.g., pressure-to-eat, food as reward, and praising children for cleaning their plates) with children to prevent unhealthy child eating behaviors and childhood obesity. However, evidence suggests that providers frequently use CFP during mealtimes.

Objective Using the Academy of Nutrition and Dietetics (2011) benchmarks for nutrition in child care as a framework, researchers assessed child-care providers’ perspectives regarding their use of mealtime CFP with young children (aged 2 to 5 years).

Design Using a qualitative design, individual, face-to-face, semi-structured interviews were conducted with providers until …

The Relation Between Discrimination, Sense Of Coherence And Health Varies According To Ethnicity; A Study Among Three Distinct Population Groups Living In Israel, Orna Baron-Epel, Vincent Berardi, John Belletierre, Waleed Shalata

Psychology Faculty Articles and Research

Self-reported experiences of discrimination and sense of coherence (SOC) have been found to be associated with health. A face-to-face survey of Long Term Jewish Residents (LTJR), Arabs and former Soviet Union (fSU) immigrants in Israel was performed. Respondents reported their physical and mental health, self-reported experiences of discrimination, SOC and socioeconomic status. Multivariable logistic regressions and bootstrapping path analyses were performed. Discrimination was associated with health after adjusting for all other variables. SOC was also associated with health. SOC did not mediate the strong association between discrimination and health among Israeli LTJR, but was a significant mediator among Arabs and …

Facing Our Demons: Psychiatric Perspectives On Exorcism Rituals, Joel R. Sanford

The Hilltop Review

Belief in possession by malevolent spirits exists in many cultures and religions throughout the world, and such beliefs often serve as explanations for a variety of psychological and emotional afflictions. Traditional remedies in these cases often involve exorcism rituals, which are believed to expel spirits from a person's mind and/or body. Some of the cases commonly attributed to involuntary spirit possession are diagnosed within the psychiatric community as schizophrenia or some sort of dissociative disorder and treated with psychotherapy and/or medicine. For some in the psychiatric community, exorcisms and their use by patients are viewed as problematic due to their …

Ramadan & Pregnancy, Omar Rizvi

Celebration of Learning

Fasting during Ramadan, the ninth month of the Muslim calendar, is one of the five pillars of Islam and is fard (obligatory) for all Muslims physically and mentally capable of doing so. In the Qur’an, it is made abundantly clear that religion and its acts of worship are not meant to pose undue difficulty or hardship (Qur’an 22:78, 5:6, 2:185). My paper explores the Islamic definitions for “unnecessary difficulty” and “physically capable” specifically in regards to pregnant women. At what point does fasting incur significant, if any, damage to the fetus that it should prevent the mother from participating in …