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Breast Health Seeking Behaviors In Countries With Varying Health Coverage

Description

There is an enormous unmet need for services, education, and outreach to improve women’s breast health. Healthcare systems and insurance systems vary widely around the world, and this may play an important role in understanding variability in women’s breast health

There is an enormous unmet need for services, education, and outreach to improve women’s breast health. Healthcare systems and insurance systems vary widely around the world, and this may play an important role in understanding variability in women’s breast health knowledge and behavior globally. The goal of this study is to determine how varying healthcare systems in three countries (Japan, Paraguay, US) affect a woman’s likelihood of seeing a physician in regard to their breasts. For example, Japan is a clear example of a region that provides universal health insurance to its citizens. The government takes responsibility in giving accessible and equitable healthcare to its entire population (Zhang & Oyama, 2016). On the other hand, a country such as Paraguay is composed of both public and private sectors. In order for citizens to gain insurance, one would have to either be formally employed or choose to pay out-of-pocket for hospital visits (“Paraguay”, 2017). A country such as the United States does not have universal health insurance. However, it does have a mix of public and private sectors, meaning there is little to no coverage for its citizens. To accommodate for this, the United States came up with the Affordable Care Act, which extends coverage to the uninsured. Although the United States might be a country that spends more on healthcare than any other nation, there are residents that still lack healthcare (De Lew, Greenberg & Kinchen, 1992). This study, then, compares women’s breast health knowledge and behavior in Japan, Paraguay, and the US. Other variables, which are also considered in this study, that might affect this include wealth level, education, having general awareness of breast cancer, having regular health checks, and having some breast education. Using statistical analysis of breast check rates of women in Japan, Paraguay, and the United States, this research found that women sampled in Asunción, Paraguay check their breasts more often than either women sampled from Scottsdale, U.S. or Osaka, Japan. It was also found that women sampled from Paraguay were more confident in detecting changes in their breast compared to women sampled from the Japan or the US. Finally, it was noted that women sampled from Japan were least likely to partake in seeing a doctor in concern of changes in their breasts compared to women sampled from the other two research locations. These findings have relevance for the implementation of advocacy and public education about breast health.

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2020-05

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Effect of Rexinoids on Inducing Effector T Cell Chemotaxis

Description

The retinoid-X receptor (RXR) can form heterodimers with both the retinoic-acid
receptor (RAR) and vitamin D receptor (VDR). The RXR/RAR dimer is activated by ligand all
trans retinoic acid (ATRA), which culminates in gut-specific effector T cell migration. Similarly,

The retinoid-X receptor (RXR) can form heterodimers with both the retinoic-acid
receptor (RAR) and vitamin D receptor (VDR). The RXR/RAR dimer is activated by ligand all
trans retinoic acid (ATRA), which culminates in gut-specific effector T cell migration. Similarly,
the VDR/RXR dimer binds 1,25(OH)2D3 to cause skin-specific effector T cell migration.
Targeted migration is a potent addition to current vaccines, as it would induce activated T cell
trafficking to appropriate areas of the immune system and ensure optimal stimulation (40).
ATRA, while in use clinically, is limited by toxicity and chemical instability. Rexinoids
are stable, synthetically developed ligands specific for the RXR. We have previously shown that
select rexinoids can enhance upregulation of gut tropic CCR9 receptors on effector T cells.
However, it is important to establish whether these cells can actually migrate, to show the
potential of rexinoids as vaccine adjuvants that can cause gut specific T cell migration.
Additionally, since the RXR is a major contributor to VDR-mediated transcription and
epidermotropism (15), it is worth investigating whether these compounds can also function as
adjuvants that promote migration by increasing expression of skin tropic CCR10 receptors on T
cells.
Prior experiments have demonstrated that select rexinoids can induce gut tropic migration
of CD8+ T cells in an in vitro assay and are comparable in effectiveness to ATRA (7). The effect
of rexinoids on CD4+ T cells is unknown however, so the aim of this project was to determine if
rexinoids can cause gut tropic migration in CD4+ T cells to a similar extent. A secondary aim
was to investigate whether varying concentrations in 1,25-Dihydroxyvitamin D3 can be linked to
increasing CCR10 upregulation on Jurkat CD4+ T cells, with the future aim to combine 1,25
Dihydroxyvitamin D3 with rexinoids.
These hypotheses were tested using murine splenocytes for the migration experiment, and
human Jurkat CD4+ T cells for the vitamin D experiment. Migration was assessed using a
Transwell chemotaxis assay. Our findings support the potential of rexinoids as compounds
capable of causing gut-tropic migration in murine CD4+ T cells in vitro, like ATRA. We did not
observe conclusive evidence that vitamin D3 causes upregulated CCR10 expression, but this
experiment must be repeated with a human primary T cell line.

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2020-05

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Analysis of Screening Tools for Identifying Sex Trafficking Victims in the Medical Setting

Description

The purpose of this study was to create a screening tool specifically for the identification of sex trafficking victims in the medical setting through the analysis of existing human trafficking screening tool studies geared towards use in the medical setting.

The purpose of this study was to create a screening tool specifically for the identification of sex trafficking victims in the medical setting through the analysis of existing human trafficking screening tool studies geared towards use in the medical setting. Screening questions from these studies were compiled and modified into a survey that was distributed to healthcare professionals through the nationwide HEAL (Health Professional Education, Advocacy, Linkage) Trafficking listserv. Each screening tool study demonstrated benefits and disadvantages that were helpful in the sampling and selection of screening tool questions. The small sample size and a lack of data on the attitudes of medical professionals on sex trafficked victims were noted as limitations to this study. Further implications for this study would include validating the screening tool questions in a medical setting to determine the sensitivity of the survey in identifying patients as possible sex trafficking victims.

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2018-05

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Assisted Cycle Therapy (ACT) Did Not Improve Depression in Older Adults with Down Syndrome

Description

The purpose of this study was to examine the influence of Assisted Cycling Therapy (ACT) on depression in older adults with Down Syndrome (DS). We predicted that older adults with Down Syndrome would see an improvement in their depressive symptoms

The purpose of this study was to examine the influence of Assisted Cycling Therapy (ACT) on depression in older adults with Down Syndrome (DS). We predicted that older adults with Down Syndrome would see an improvement in their depressive symptoms after ACT and Voluntary Cycling (VC). However, we predicted there would be a greater improvement in depressive symptoms after ACT in comparison to VC. Depression was measured using a modified version of the Children's Depression Inventory 2 (CDI 2) due to the low mental age of our participant population. Twenty-one older adults with DS were randomly assigned to one of three interventions, which took place over an eight-week period of time. Eleven older adults with DS completed the ACT intervention, which is stationary cycling on a recumbent bicycle with the assistance of a motor to maintain a cadence at least 35% greater than the rate of voluntary cycling. Nine participants completed the voluntary cycling intervention, where they cycled at a cadence of their choosing. One participant composed our no cycling control group. No intervention group reached results that achieved a conventional level of significance. However, there was a trend for depression to increase after 8 weeks throughout all three intervention groups. We did see a slightly slower regression of depression in the ACT group than the VC and control. Our results were discussed with respect to social and cognitive factors relevant to older adults with DS and the subjective nature of the CDI2. This study brings attention to the lack of accurate measures and standardized research methods created for populations with intellectual disabilities in regards to research.

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Date Created
2018-05

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Best Practices for Undergraduate Mental Health Support for Study Abroad

Description

This paper describes a mixed methods investigation of undergraduate mental health support practices at Arizona State University (ASU), as well as an outside look at peer and other leading institutions. Methods employed in this study include: ASU undergraduate student survey

This paper describes a mixed methods investigation of undergraduate mental health support practices at Arizona State University (ASU), as well as an outside look at peer and other leading institutions. Methods employed in this study include: ASU undergraduate student survey to assess perception of resources provided by ASU and the likelihood to disclose physical and mental health conditions, key informant interviews to understand ASU mental health support from the perspective of those who implement support measures, participant observation of study abroad events that provide resources to prospective and pre-departure students, and a document review of the study abroad website from peer and other institutions. The target population of this study is undergraduate students who participate or plan to participate in study abroad programs across the United States. The sample population for the undergraduate student survey is undergraduate students at ASU, as well as sixteen institutions for the document review. Significant findings from the research include student concerns about financial and academic barriers to study abroad, as well as a greater likelihood to disclose physical health conditions rather than mental health conditions due to fear of stigma or of being a burden to program coordinators. Additionally, it was found that there is a separation between available resources and student awareness and use of these resources. ASU can work to remedy this disconnect by explicitly presenting easily accessible resource information on the website and in pre-departure materials, as well as addressing mental health awareness abroad in an inclusive manner towards all students in addition to those with pre-existing mental health conditions. Overall, more work should be done to fulfill the vision of comprehensive mental health support at ASU.

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2018-05

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The Future of Mental Health Treatment in the Criminal Justice System: A Restorative Approach

Description

It is a tragic reality that many individuals in the criminal justice system suffer from a mental illness. As a result, both mental health programs and mental health courts have been developed in response to the increasing number of individuals

It is a tragic reality that many individuals in the criminal justice system suffer from a mental illness. As a result, both mental health programs and mental health courts have been developed in response to the increasing number of individuals in the criminal justice system that are suffering from a mental illness. The first objective of this review is to discuss the background on mental illness as it relates to the criminal justice population, and to understand the common causes of incarceration amongst the mentally ill, including the deinstitutionalization movement of the 1960s, the unavailability of intermediate and long-term hospitalization in state hospitals, more formal and rigid criteria for civil commitment, a lack of adequate support systems and access to mental health treatment in the community, and the high recidivism rates by these types of offenders. Considering these causes, another objective of this review is to compare and contrast the United States' first mental health courts, including those in Broward County, Florida, King County, Washington, San Bernardino, California, and Anchorage, Alaska, by ultimately focusing on the origins of each court, the stages of intervention, methods of entry, competency evaluations, treatment approaches, and disposition of charges. From there, this review considers the differences between the courts and proceeds with a synthesis of the common and recurring themes between them, and then ends with recommendations specific to the mental health court system on practices that can be implemented or altered in order to encourage a more effective form of justice for the mentally ill, and a discussion of the policy solutions that have already been proposed to address the problem.

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2018-05

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Parental Stress in Raising a Child with ADHD

Description

This paper investigates how stress in parents is affected by their child's Attention-Deficit/Hyperactivity Disorder (ADHD). The purpose of this paper is to identify common stressors for parents of children with ADHD, as well as to determine what parents need from

This paper investigates how stress in parents is affected by their child's Attention-Deficit/Hyperactivity Disorder (ADHD). The purpose of this paper is to identify common stressors for parents of children with ADHD, as well as to determine what parents need from healthcare providers to mediate this stress. A survey was developed to identify sources of stress, consequences of parental stress, parental coping methods, resources provided by their healthcare provider that have been helpful, along with what they feel that they need from their healthcare providers in order to better support themselves and their family. Participants were composed of members of Facebook support groups for parents of children with ADHD. Major findings of this study include: parents experience the most stress when dealing with their child's oppositional and aggressive behaviors; parents frequently experience disruption in their marital relationship; and parents perceive that they receive little health care resources that are helpful for themselves, their child, and their family overall.

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2018-05

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An investigation into the language barrier between health professionals and the Deaf community, and how it affects healthcare and doctor-patient relations

Description

This study looked into the cultural competency of physicians when interacting with patients who identify themselves as part of the Deaf and Hard of Hearing community. Through the course of this paper, it was found that the language barrier between

This study looked into the cultural competency of physicians when interacting with patients who identify themselves as part of the Deaf and Hard of Hearing community. Through the course of this paper, it was found that the language barrier between these two communities played a large role in healthcare disparities for the D/HoH community. The language and culture barrier contributed to the misconceptions that are commonly found in the hearing world about the Deaf community, including assumptions about Deaf patients' opinion on their hearing loss, the efficacy of yelling, and the notion that all Deaf people can lip read with 100% accuracy. In addition, the perspectives of both the healthcare professionals and D/HoH patients was analyzed. Finally, the efficacy of current hospitals solutions for the language barrier was evaluated, particularly the use of video interpreting in hospital settings. More lasting solutions were proposed as an extension of this study, with an emphasis on education in all field of healthcare.

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2018-05

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Development of a Risk Assessment Tool for University of California- Riverside's Healthcare Enterprise

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The purpose of this project is to develop a risk assessment tool for the University of California, Riverside (UCR). UCR is health enterprise that manages operations under an environment of innate and uncontrollable risks. Therefore, a risk assessment tool is

The purpose of this project is to develop a risk assessment tool for the University of California, Riverside (UCR). UCR is health enterprise that manages operations under an environment of innate and uncontrollable risks. Therefore, a risk assessment tool is highly advisable under California State Laws and federal laws. In the case of overlapping laws, federal law will always prevail unless State law explicitly states otherwise. California Health Information Privacy Manual states that California must follow numerous state guidelines and a federal set of guidelines called HIPAA (Health Insurance Portability and Accountability Act of 1996). HIPAA is put in place to protect and serve as an organizational tool to develop a stronger and more secure infrastructure of security measures within healthcare enterprises. Under HIPAA is a Security and Privacy Rule that was implemented by The U.S. Department of Health and Human Services (HHS) and will serve as the basis for the risk assessment tool I developed. The Security and Privacy Rule's main goal is to set a national standard of how electronic protected health information (ePHI) will be appropriately used and disclosed by organizations subject to this rule, also known covered entities. Covered entities include health plans, health care providers and health care clearinghouses unless specifically stated otherwise. Permitted uses and disclosures of PHI or ePHI are outlined in detail and covered entities are expected to follow all aspects of it that pertain to their role within a healthcare system. Under HHS, the Office of Civil Rights (OCR) strictly enforces the Security and Privacy Rules and can issue civil money penalties and/or other major consequences making this a sizable and critical issue in healthcare environments. Each risk and impact must be assessed to determine an overall risk score. This score will then determine what risks need to be immediately addressed and which risks are most critical to UCR. To do this, potential impacts were determined for each section. The impact score can be decided by using a chart that will be discussed in the development section. The likeliness of the risk can be determined by a UCR professional via the provided chart and an overall risk score can be assigned. From here, an action plan can be set and carried out to eliminate possible hazards and imminent risks. Once a Risk Assessment tool is developed, potential risks can be indentified and dealt with appropriately in regard to level of impact and the likelihood of the risk occurring. By reducing risk, a healthcare enterprise can gain greater financial stability, decrease loss and protect vital information that is critical to the success organization.

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2018-05

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Remote Presence in Nature through Virtual Reality: A Pilot Study on the Mental Well-Being of Older Adults

Description

By 2030, the number of people above the age of 65 is projected to outnumber those under the age of 18 for the first time in United States history. With a growing older population, it is predicted that the amount

By 2030, the number of people above the age of 65 is projected to outnumber those under the age of 18 for the first time in United States history. With a growing older population, it is predicted that the amount of people moving into nursing homes and care facilities will also increase. However, a pressing problem is the high prevalence of depression and anxiety among elderly people residing in institutionalized living arrangements. With drugs and antidepressants less effective at treating patients with both dementia and depression, there is a need for more non-pharmacological interventions geared toward improving older adults’ mental well-being. In response, the potential therapeutic effect of exploring virtual nature through EcoRift—which provides dynamic and realistic 360-degree audio and visual environments—on older adults’ mental well-being was examined in this study. Ten individuals (3 men and 7 women) aged 50 and above were recruited and each participant experienced the virtual nature sojourns for 15 minutes once a week, for a total of three weeks. Pre- and post- virtual reality (VR) survey questionnaires were implemented to gauge the participants’ emotional response, including overall well-being and level of relaxation. Physiological measures such as heart rate and blood pressure were also taken before and after the VR experience. Findings show that immersion in nature through virtual reality improves older adults’ mental well-being by eliciting a transient sense of relaxation, peacefulness, and happiness. Further studies need to be performed in order to validate EcoRift’s effect on physiology; however, preliminary data suggests that immersive virtual nature also acts to decrease blood pressure. Overall, EcoRift shows to be a promising tool for bridging access to remote natural environments and may be a mentally beneficial activity for patients isolated in hospitals, hospices, and nursing homes.

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2019-05