Matching Items (104)
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- All Subjects: COVID-19
- All Subjects: healthcare
- Creators: School of Life Sciences
- Status: Published
Description
Despite a continuously growing body of evidence that they are one of the major causes of pregnancy loss, preterm birth, pregnancy complications, and developmental abnormalities leading to high rates of morbidity and mortality, viruses are often overlooked and underestimated as teratogens. The Zika virus epidemic beginning in Brazil in 2015 brought teratogenic viruses into the spotlight for the public health community and popular media, and its infamy may bring about positive motivation and funding for novel treatments and vaccination strategies against it and a variety of other viruses that can lead to severe congenital disease. Lymphocytic choriomeningitis virus (LCMV) is famous in the biomedical community for its historic and continued utility in mouse models of the human immune system, but it is rarely a source of clinical concern in terms of its teratogenic risk to humans, despite its ability to cause consistently severe ocular and neurological abnormalities in cases of congenital infection. Possibilities for a safe and effective LCMV vaccine remain difficult, as the robust immune response typical to LCMV can be either efficiently protective or lethally pathological based on relatively small changes in the host type, viral strain, viral dose, method of infection/immunization, or molecular characteristics of synthetic vaccination. Introducing the immunologically unique state of pregnancy and fetal development to the mix adds complexity to the process. This thesis consists of a literature review of teratogenic viruses as a whole, of LCMV and its complications during pregnancy, of LCMV immunopathology, and of current understanding of vaccination against LCMV and against other teratogenic viruses, as well as a hypothetical experimental design intended to initially bridge the gaps between LCMV vaccinology and LCMV teratogenicity by bringing a vaccine study of LCMV into the context of viral challenge during pregnancy.
ContributorsHarris, Maryl (Author) / Blattman, Joseph (Thesis director) / Scotch, Matthew (Committee member) / Luna, Evelyn (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Over the past seven years, the Student Health Outreach for Wellness (SHOW) Community Initiative has served vulnerable populations in Maricopa County through a volunteer workforce of providers, graduate health professional students, and undergraduates from all three of Arizona’s public universities. With an interprofessional volunteer base, SHOW has managed to transition its health education and screenings from a clinic-based setting to community-based settings. These new clinical outreach programs within SHOW present unique challenges to maintaining the integrity of interprofessional, team-based care, and new evaluative tools are needed to provide feedback for improvement. Now, as a pioneer site for the National Center for Interprofessional Practice and Education, SHOW must continue to conduct internal research to evaluate their innovative model of care. For this project, the four core competency domains for interprofessional collaborative practice were used to outline proposals for the implementation of several new evaluative measures: the Assessment for Collaborative Environments (ACE-15), the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), patient satisfaction surveys, and critical incident reporting. These tools and protocols are necessary to solidify SHOW as a national model for interprofessional education and practice.
ContributorsSmith, Julianna Marie (Author) / Harrell, Susan (Thesis director) / Saewert, Karen (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
The purpose of this study is to analyze what barriers of care exist within the Senor de los Milagros community in Trujillo, Peru and how these barriers to care can identify shortcomings in the public healthcare system. This study is a collaboration of field research and outside literature. The research conducted was done via structured interviews with 15 participants, all promotoras (mothers of the community) and their husbands in the Senor de los Milagros community of Trujillo, Peru. Summaries and quotes from these interviews were uploaded and quantified to identify common barriers to care derived from socioeconomic and cultural determinants . Although this was on the main focus of the study, observations and conversations with healthcare staff and patients showed that the two most specific barriers found when data was analyzed were the wait times of public sector facilities and quality of care within these facilities. These barriers to care did not stop the promotoras from seeking care at MINSA facilities, but it does pose the questions as to how it affects healthcare-seeking behaviors and if this affects long-term healthcare outcomes.
ContributorsDragon, Jordan Elizabeth (Author) / Maupin, Jonathan (Thesis director) / Marsteller, Sara (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
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 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.
ContributorsKumar, Navneet Surjit (Co-author) / Kumar, Navneet (Co-author) / Wutich, Amber (Thesis director) / Brewis, Alexandra (Committee member) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
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 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.
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.
ContributorsDebray, Hannah Zara (Co-author) / Debray, Hannah (Co-author) / Blattman, Joseph (Thesis director) / Jurutka, Peter (Committee member) / Manhas, Kavita (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Human trafficking is a widespread global health issue impacting communities both locally and globally. Despite its prevalence in our world, there is a lack of education amongst healthcare providers. Research suggests that more than 80 percent of human trafficking victims encountered one or more healthcare professionals while being trafficked. Of these providers encountered, 60 percent were emergency department personnel (Lederer & Wetzel, 2014). Although emergency department personnel have a high rate in interaction with victims, less than 5 percent have received formal training regarding human trafficking (Lederer & Wetzel, 2014). It is my goal to better educate current and future healthcare professionals on human trafficking. Through education, more victims can be recognized and be offered the resources they deserve. In order to do this, I want to understand current perceptions, knowledge, and beliefs that healthcare personnel have, and how education affects these perceptions. To gain this information, I will distribute the same survey to healthcare professionals before and after receiving a formal training on human trafficking. Through this survey, I hope to better understand how education affects people’s perceptions, knowledge, and beliefs on human trafficking.
ContributorsWilson, Lauren Noelle (Author) / Calvin, Samantha (Thesis director) / Gaughan, Monica (Committee member) / School of Human Evolution & Social Change (Contributor, Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Brought on by extended survival due to Highly Active Anti-Retroviral Therapy and increased incidence among older adults, the demographic profile of the HIV epidemic has begun to shift towards the aging population. As people living with HIV (PLWH) begin to age and develop multiple comorbidities, their needs are no longer limited to HIV treatment and disease management; they may require aging services similar to those with a negative HIV status. Increased attention has been placed on HIV and aging to assess the unique needs of older PLWH, however, limited research exists on the preparedness of aging services to provide adequate care to this population. This study aims to assess HIV and aging within Maricopa County, where individuals aged 50 years and older account for nearly half the reported HIV/AIDS cases in the county, and 30% of cases in Arizona. Two focus groups – one with older PLWH and another with aging service professionals – were conducted to gather information about existing aging services and the perspectives of older PLWH regarding their growing needs. Older PLWH were found to experience challenges similar to those that have been well-documented in previous studies: most notably, PTSD and other mental health conditions; fear of the future and isolation; HIV status disclosure and stigma; and economics and financial security. An anonymous survey was developed in conjunction with Aunt Rita’s Foundation to evaluate Maricopa County aging services; it was discovered that providers lack experience with HIV and admit deficiencies in their preparation to address the age-related concerns of older PLWH. The results show that the majority of providers were supportive of offering care to older PLWH and expressed interest in improving their preparedness. Future research is necessary to obtain perspectives from additional aging services in Maricopa County and word towards the development of an aging services directory to connect older PLWH to care.
ContributorsLayon, Sarah (Author) / Jacobs, Bertram (Thesis director) / Coon, David (Committee member) / Spencer, Glen (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Art (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
This thesis discusses the complex situation involved in a person’s choice or means to vaccinate
themselves as well as their children. Included is a brief history on vaccines, a section describing
their mechanism of action, as well as information on how the vaccines work within our bodies.
The focus will then turn to the patient’s choice on whether or not to vaccinate themselves or their
child, including factors such as socioeconomic status, education level and their location. Within
this paper are the views of anti-vaccinators, as well as the views of pro-vaccinators and
suggestions on how to reeducate the public. I conclude that the AFIX model is of particular value
in public education: This involves Assessment of immunization coverage, Feedback in
informing providers of their performance, Incentives to help keep them motivated, and eXchange
of information which can be combined with incentives. While the AFIX model has focused on
doctors and nurses in the past, I conclude this model would be most effectively employed with
pharmacists, who see patients more routinely and often have higher levels of trust among the
general public.
themselves as well as their children. Included is a brief history on vaccines, a section describing
their mechanism of action, as well as information on how the vaccines work within our bodies.
The focus will then turn to the patient’s choice on whether or not to vaccinate themselves or their
child, including factors such as socioeconomic status, education level and their location. Within
this paper are the views of anti-vaccinators, as well as the views of pro-vaccinators and
suggestions on how to reeducate the public. I conclude that the AFIX model is of particular value
in public education: This involves Assessment of immunization coverage, Feedback in
informing providers of their performance, Incentives to help keep them motivated, and eXchange
of information which can be combined with incentives. While the AFIX model has focused on
doctors and nurses in the past, I conclude this model would be most effectively employed with
pharmacists, who see patients more routinely and often have higher levels of trust among the
general public.
ContributorsBernal-Fung, Yasmin (Author) / Martin, Thomas (Thesis director) / Morgan, Lawrence (Committee member) / School of Life Sciences (Contributor) / College of Integrative Sciences and Arts (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
REACT is a student-led venture which strives to address the healthcare disparities from geographic, linguistic and cultural isolation of the refugee community in Arizona/Phoenix. We will achieve this by Understanding the needs of the community, Engaging the community directly, Educating through the use of culturally appropriate materials, and providing access to supplemental Patient Care.
This venture is unique in that it is an interdisciplinary fusion between students, health professionals, and non-profit organizations empowering underserved refugees. A refugee is an individual forced to leave their country because of persecution, war, or violence. Once they arrive in the United States, they are forced to restart their lives, often with little to no financial assets, minimal English literacy, and a lack of transferable skills from their previous occupations in their home countries. In addition to these socioeconomic disparities, it is common for refugees to face health disparities. Consequently, refugees are one of the most vulnerable populations in our society.
Our organization provides value to the refugee community through our three key services. These are made up of supplemental resources, educational workshops, and clinical services. Our supplemental materials include resources that our clients will use after they have left our care to further improve their health and quality of life. These items include personal hygiene kits, informational pamphlets, and nutritional foods.
The educational workshops we provide specifically address identified knowledge gaps that impede the autonomy of our clients’ health and wellbeing. Several of the topics that we cover (but are not limited to) are diabetes, postpartum depression, nutrition, dental hygiene, AHCCCS, and nutrition. The clinical services that the clinic will provide will be supplementary primary care services that will encompass basic physical exams, A1C blood pressure checks, and vaccinations. These services all are aimed at alleviating the barriers to health that refugees face and ultimately improve their quality of life.
Our venture seeks to maintain positive and sustained relationships with our client segments through continuous community engagement. In conjunction with providing educational workshops and clinical care in the future, REACT continually engages the community by planning formal and informal programming with the refugees based on the needs and wishes of individual communities.
REACT generates these services through the work of medical students from Mayo Clinic Alix School of Medicine and undergraduates from Arizona State University. Our team brings together the experience from hundreds of hours of work in the community, collaborations with refugee community leaders, and the insight of professionals in the healthcare/social-work industry.
Further, our members have had extensive experience working with refugees, training in culturally sensitive practices, and delivering care to those that need it most. With the cost of healthcare exponentially rising, there is little hope for refugees to find adequate culturally competent healthcare. This leads to an increase in chronic diseases, preventable health issues, and increased hospitalization costs. Supporting REACT is not only an investment in the health of the refugees but the health of our entire healthcare system.
This venture is unique in that it is an interdisciplinary fusion between students, health professionals, and non-profit organizations empowering underserved refugees. A refugee is an individual forced to leave their country because of persecution, war, or violence. Once they arrive in the United States, they are forced to restart their lives, often with little to no financial assets, minimal English literacy, and a lack of transferable skills from their previous occupations in their home countries. In addition to these socioeconomic disparities, it is common for refugees to face health disparities. Consequently, refugees are one of the most vulnerable populations in our society.
Our organization provides value to the refugee community through our three key services. These are made up of supplemental resources, educational workshops, and clinical services. Our supplemental materials include resources that our clients will use after they have left our care to further improve their health and quality of life. These items include personal hygiene kits, informational pamphlets, and nutritional foods.
The educational workshops we provide specifically address identified knowledge gaps that impede the autonomy of our clients’ health and wellbeing. Several of the topics that we cover (but are not limited to) are diabetes, postpartum depression, nutrition, dental hygiene, AHCCCS, and nutrition. The clinical services that the clinic will provide will be supplementary primary care services that will encompass basic physical exams, A1C blood pressure checks, and vaccinations. These services all are aimed at alleviating the barriers to health that refugees face and ultimately improve their quality of life.
Our venture seeks to maintain positive and sustained relationships with our client segments through continuous community engagement. In conjunction with providing educational workshops and clinical care in the future, REACT continually engages the community by planning formal and informal programming with the refugees based on the needs and wishes of individual communities.
REACT generates these services through the work of medical students from Mayo Clinic Alix School of Medicine and undergraduates from Arizona State University. Our team brings together the experience from hundreds of hours of work in the community, collaborations with refugee community leaders, and the insight of professionals in the healthcare/social-work industry.
Further, our members have had extensive experience working with refugees, training in culturally sensitive practices, and delivering care to those that need it most. With the cost of healthcare exponentially rising, there is little hope for refugees to find adequate culturally competent healthcare. This leads to an increase in chronic diseases, preventable health issues, and increased hospitalization costs. Supporting REACT is not only an investment in the health of the refugees but the health of our entire healthcare system.
ContributorsMarostica, Chance William (Author) / Ferry, Lara (Thesis director) / Smith, Diana (Committee member) / Economics Program in CLAS (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
The rate of vaccinations has been consistently decreasing in the past years in children of ages 0-18. Multiple factors and barriers contribute to these low rates. This comparative case study investigated the accessibility of information regarding childhood vaccinations to parents in areas with differing poverty levels in the greater Phoenix region, specifically in the West Valley, Downtown Phoenix, and the East Valley. Pediatric clinics, public elementary schools, and public libraries were visited in each area to assess how much information was available where. The analysis produced unexpected results: the West Valley, which had the highest poverty level, contained the most amount of accessible information for parents in many languages, while the East Valley, with a low poverty level, had almost no information accessible to parents of these children. Implications for future research, policy, and practice are discussed. Based on these unexpected results, one recommendation is to develop a pamphlet that could be distributed to these public places to raise awareness of the importance of vaccinations in children to parents.
ContributorsShah, Veedhi (Author) / Bates, Denise (Thesis director) / Castillo, Elizabeth (Committee member) / College of Health Solutions (Contributor) / School of Life Sciences (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05