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- Creators: Department of Psychology
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
Emerging Information Technology, Storage and Evaluation within Healthcare: A Discerning IMT Analysis
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
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.
Accessing adequate healthcare, particularly essential services like physical therapy, presents a significant challenge for individuals with Down syndrome. This demographic often encounters obstacles such as limited accessibility, scarce resources, and a lack of tailored solutions that specifically address their unique needs. The resulting disparity leads to inconsistent care and suboptimal healthcare experiences. Recognizing the importance of eliminating these barriers is crucial to create a more inclusive healthcare environment for individuals with Down syndrome. Rainbow Monster Madness serves as a multifaceted solution to the social determinants of health that significantly impact individuals with Down syndrome. The game's design directly tackles several of these determinants by offering accessible, engaging, and family-centered therapy. In terms of healthcare access and quality, the game empowers parents to actively participate in their child's therapy, ensuring the correct administration of exercises and the consistent provision of quality care. The game's design addresses neighborly and built environment determinants by providing an accessible and inclusive therapy option that can be implemented within the comfort of one's home. This approach fosters a sense of safety and familiarity for children undergoing therapy, promoting a more relaxed and conducive environment. Additionally, Rainbow Monster Madness encourages social community engagement by fostering a collaborative atmosphere between parents and children during therapy sessions. This collaborative approach creates a supportive and engaging environment, positively impacting the overall therapeutic experience. Adhering to the principles of Self-Determination Theory, the game cultivates intrinsic motivation and psychological well-being among children with Down syndrome. This approach enables active engagement in therapy and contributes to their overall health and well-being. The exercises included in Rainbow Monster Madness are carefully selected to cater to the unique needs of individuals with Down syndrome. This regimen combines muscle-strengthening, cardio, and balance exercises, tailored to this specific population. The modification of exercises and thematic design ensures that children remain enthusiastic about their therapy, ultimately promoting better adherence and more effective results. In summary, Rainbow Monster Madness represents a comprehensive solution to the multitude of challenges faced by individuals with Down syndrome in accessing healthcare. Simultaneously, it addresses the broader social determinants of health, thereby fostering a healthier and more inclusive future for this deserving population.