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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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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

Description

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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AI in Radiology: How the Adoption of an Accountability Framework can Impact Technology Integration in the Expert-Decision-Making Job Space

Description

Rapid advancements in Artificial Intelligence (AI), Machine Learning, and Deep Learning technologies are widening the playing field for automated decision assistants in healthcare. The field of radiology offers a unique platform for this technology due to its repetitive work structure,

Rapid advancements in Artificial Intelligence (AI), Machine Learning, and Deep Learning technologies are widening the playing field for automated decision assistants in healthcare. The field of radiology offers a unique platform for this technology due to its repetitive work structure, ability to leverage large data sets, and high position for clinical and social impact. Several technologies in cancer screening, such as Computer Aided Detection (CAD), have broken the barrier of research into reality through successful outcomes with patient data (Morton, Whaley, Brandt, & Amrami, 2006; Patel et al, 2018). Technologies, such as the IBM Medical Sieve, are growing excitement with the potential for increased impact through the addition of medical record information ("Medical Sieve Radiology Grand Challenge", 2018). As the capabilities of automation increase and become a part of expert-decision-making jobs, however, the careful consideration of its integration into human systems is often overlooked. This paper aims to identify how healthcare professionals and system engineers implementing and interacting with automated decision-making aids in Radiology should take bureaucratic, legal, professional, and political accountability concerns into consideration. This Accountability Framework is modeled after Romzek and Dubnick’s (1987) public administration framework and expanded on through an analysis of literature on accountability definitions and examples in military, healthcare, and research sectors. A cohesive understanding of this framework and the human concerns it raises helps drive the questions that, if fully addressed, create the potential for a successful integration and adoption of AI in radiology and ultimately the care environment.

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2019-05

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Bridging the Rural-Urban Divide: Addressing Barriers to Health Services in the Rural USA and Mexico

Description

Due to unique barriers to access and quality of healthcare, rural Americans have, among many other poorer health outcomes, a worsening life expectancy than their urban counterparts: 76.8 years compared to 78.8 years. In addition to overall mortality, the burden

Due to unique barriers to access and quality of healthcare, rural Americans have, among many other poorer health outcomes, a worsening life expectancy than their urban counterparts: 76.8 years compared to 78.8 years. In addition to overall mortality, the burden of disease is greater in rural areas, as well as rates of physical injury. There are many intersecting influencing factors including, but not limited to, barriers to access needed healthcare, issues regarding the quality of healthcare provided, the ability to pay for healthcare and other socioeconomic considerations are both causes and consequences of poor health and healthcare access.
The health disparities between rural and urban communities in the United States are not uniquely American. This rural-urban divide in health outcomes is present across the world and, closer to home, across North America. In addition to reviewing the current literature surrounding barriers to health and healthcare access in the United States, we will also use southern neighbor Mexico’s history and their pursuit of rural equity (universally and in health/healthcare access) to contrast initiatives that the U.S. has attempted, with the intent of exploring new theories of rural healthcare provision. By combining the history of social medicine in Mexico with literature on barriers to healthcare access, I hope to highlight areas of innovation and improvement in the American health care delivery system.
The purpose of this paper is to review the current literature regarding health disparities among rural Americans, possible causes of such disparities and current strategies to improve health, healthcare access and healthcare quality in rural America in order to recommend the most effective, practical solutions to improve rural mortality, morbidity and quality of life.

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2019-05

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Transitions of Privatized Healthcare in the United States

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This thesis project discusses the transitions of the physician profession and their struggle to maintain autonomy throughout American History until approximately the 1980's. Included in the historical account of the physician profession, is the development of the American Hospital System

This thesis project discusses the transitions of the physician profession and their struggle to maintain autonomy throughout American History until approximately the 1980's. Included in the historical account of the physician profession, is the development of the American Hospital System and its origins working under the physician profession. As history progresses from 1760 on, what comes to light is a cyclical struggle for physicians to remain independent from the corporations, while using them to gain social and economic prestige. This work focuses on how the establishment of private practice in the United States has lead to the current system in place today, illustrating a long fight for control of the medical field that still rages on today. As physicians gained power and autonomy in the medical field during the 20th century, constant attempts of government intervention can be seen within the convoluted history of this professional field. The rise of corporate healthcare, that works in tandem with private physicians, was a critical period in forgotten American History that subsequently allowed physicians to increase their stranglehold on the medical service industry. The goal of this research was to establish a better understanding of American Medicine's history to better tackle the new problems we face today. As America transitions to a period of public health outcry, it is important to establish a somewhat linear rendition of a mostly untold history that directly impacts the lives of every citizen in this country. This work attempts to mend the broken pieces of that history to give light to how healthcare evolved into what it is today.

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2018-12

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Barriers Refugee Women Face When Accessing Healthcare: A Review of Current Available Solutions

Description

Currently, refugee women’s access to healthcare is a major topic of research. Refugee women face many barriers when attempting to access healthcare, and this paper aims to complete a systematic review of the results of studies published from 2009 to

Currently, refugee women’s access to healthcare is a major topic of research. Refugee women face many barriers when attempting to access healthcare, and this paper aims to complete a systematic review of the results of studies published from 2009 to 2019 that investigate what specific best solutions have been put in place globally to combat struggles refugee women face while trying to obtain healthcare, identify common underlying themes, and see how these solutions can be applied to countries caring for refugees. Twelve total articles were reviewed and four main themes emerged: women’s care, mental health, health professional perspective, and community. From these four main themes, three crucial ideas emerged: culturally competent care, team-based care, and trust between patient and provider. The results showed that to improve access to healthcare for refugee women: health professionals must receive cultural sensitivity training to provide culturally competent care, team-based care must be implemented to improve patient adherence and satisfaction, and trust between the patient and provider is key to allowing refugee women feel safe enough to seek out healthcare. Culturally competent team-based care based on physician-patient trust needs to be more thoroughly adapted globally to provide care that is sensitive and empowering for refugee women, and all patients. However, these strategies will need to be further studied to determine their impact on refugee women’s health literacy & healthcare experience.

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2019-05

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Personal Memories and Social Associations: How Positive Emotions Influence the Activation of Implicit Prejudices

Description

The purpose of this study was to examine the effects of two positive discrete emotions, awe and nurturant love, on implicit prejudices. After completing an emotion induction task, participants completed Implicit Association Test blocks where they paired photos of Arab

The purpose of this study was to examine the effects of two positive discrete emotions, awe and nurturant love, on implicit prejudices. After completing an emotion induction task, participants completed Implicit Association Test blocks where they paired photos of Arab and White individuals with "good" and "bad" evaluations. We hypothesized that nurturant love would increase the strength of negative evaluations of Arab individuals and positive evaluations of White individuals, whereas awe would decrease the strength of these negative evaluations when compared to a neutral condition. However, we found that both awe and nurturant love increased negative implicit prejudices toward Arab individuals when compared to the neutral condition.

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2018-05