Matching Items (9)

Filtering by

Clear all filters

134343-Thumbnail Image.png

Evaluating Structural Barriers to Quality Care in the SHOW Free Clinic

Description

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
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.

Contributors

Agent

Created

Date Created
2017-05

134581-Thumbnail Image.png

Does an extended washout period of six weeks following the end of chronic stress continue the benefits on spatial learning and memory?

Description

Chronic stress often leads to cognitive deficits, especially within the spatial memory domain mediated by the hippocampus. When chronic stress ends and a no-stress period ensues (i.e., washout, WO), spatial ability improves, which can be better than non-stressed controls (CON).

Chronic stress often leads to cognitive deficits, especially within the spatial memory domain mediated by the hippocampus. When chronic stress ends and a no-stress period ensues (i.e., washout, WO), spatial ability improves, which can be better than non-stressed controls (CON). The WO period is often the same duration as the chronic stress paradigm. Given the potential benefit of a post-stress WO period on cognition, it is important to investigate whether this potential benefit of a post-stress WO period has long-lasting effects. In this project, chronic restraint (6hr/d/21d) in Sprague-Dawley rats was used, as it is the minimum duration necessary to observe spatial memory deficits. Two durations of post-stress WO were used following the end of chronic restraint, 3 weeks (STR-WO3) and 6 weeks (STR-WO6). Immediately after chronic stress (STR-IMM) or the WO periods, rats were tested on various cognitive tests. We corroborated past studies that chronic stress impaired spatial memory (STR-IMM vs CON). Interestingly, STR-WO3 and STR-WO6 failed to demonstrate improved spatial memory on a radial arm water maze task, performing similarly as STR-IMM. Performance outcomes were unlikely from differences in anxiety or motivation because rats from all conditions performed similarly on an open field task and on a simple object recognition paradigm, respectively. However, performance on object placement was unusual in that very few rats explored, suggesting some degree of anxiety or fear in all groups. One possible interpretation of the unusual results of the 3 week washout group may be attributed to the different spatial memory tasks used across studies or external factors from the study. Further exploration of these other factors led to the conclusion that they did not play a role and the STR-WO3 RAWM data were anomalous to other studies. This suggests that a washout period following chronic stress may not be fully understood.

Contributors

Agent

Created

Date Created
2017-05

135363-Thumbnail Image.png

How We Live and Die: A Qualitative Analysis of the Relationship between Healthcare Experiences and Perspectives on Physician-Assisted Suicide

Description

Physician-assisted suicide occurs when a physician facilitates a patient's death by prescribing a lethal medication that they understand will be used for the purpose of ending the patient's life. It is a highly contentious subject and, with the recent addition

Physician-assisted suicide occurs when a physician facilitates a patient's death by prescribing a lethal medication that they understand will be used for the purpose of ending the patient's life. It is a highly contentious subject and, with the recent addition of California to the list of states that allow physician-assisted suicide, is an increasingly relevant subject. Physician-assisted suicide is rarely framed as a healthcare experience, despite being a choice in the process of end-of-life care. The research seeks to bring together the debates about physician-assisted suicide with conversations about health care experiences. The experiences and perspectives of young people are particularly valuable to evaluate now, as their voices will soon be the leaders in the debate over physician-assisted suicide. Within this research, there is an underlying theme of independence of individuals that is present through both the literature review and the body of data collected and analyzed. The study found that there was no significant relationship between the quality of a person's healthcare and their perspectives about physician-assisted suicide.

Contributors

Agent

Created

Date Created
2016-05

135161-Thumbnail Image.png

Sex Trafficking Victim Identification in the Medical Setting

Description

The National Center for Missing & Exploited Children (2014) estimated that one in six runaways were likely to be victims of sex trafficking. Nearly 88% of trafficking survivors reported having some kind of contact with the health care system while

The National Center for Missing & Exploited Children (2014) estimated that one in six runaways were likely to be victims of sex trafficking. Nearly 88% of trafficking survivors reported having some kind of contact with the health care system while they were trafficked (Lederer & Wetzel, 2014). In this study, the Office of Sex Trafficking Intervention Research at Arizona State University is attempting to determine the knowledge medical students and healthcare professionals have on identification of a sex trafficking victim and methods of reporting these situations within their organizations. To explore the knowledge providers and students have on sex trafficking victim identification as well as reporting protocols, our office sent out an online, anonymous survey to current medical students and healthcare professionals in the United States. The survey results will assist in the development of a training curriculum addressing the identification of sex trafficking victims within a medical setting and how to report within organizations. The anticipated outcome of this study was that medical students and healthcare professionals have not had training or continuing education on identifying a potential sex trafficking victim.

Contributors

Agent

Created

Date Created
2016-05

135447-Thumbnail Image.png

Health Disparities Among LGB Women From Experiences With Their Healthcare Providers

Description

This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball

This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball sampling. Interviews were conducted inquiring about their health history and their experiences within the healthcare system in the context of their sexual orientation. The data collected from these interviews was used to create an analysis of the healthcare experiences of those who identify as queer. Although the original intention of the project was to chronicle the experiences of LGB women specifically, there were four non-binary gender respondents who contributed interviews. In an effort to not privilege any orientation over another, the respondents were collectively referred to as queer, given the inclusive and an encompassing nature of the term. The general conclusion of this study is that respondents most often experienced heterosexism rather than outright homophobia when accessing healthcare. If heterosexism was present within the healthcare setting, it made respondents feel uncomfortable with their providers and less likely to inform them of their sexuality even if it was medically relevant to their health outcomes. Gender, race, and,socioeconomic differences also had an effect on the patient-provider relationship. Non-binary respondents acknowledged the need for inclusion of more gender options outside of male or female on the reporting forms often seen in medical offices. By doing so, medical professionals are acknowledging their awareness and knowledge of people outside of the binary gender system, thus improving the experience of these patients. While race and socioeconomic status were less relevant to the context of this study, it was found that these factors have an affect on the patient-provider relationship. There are many suggestions for providers to improve the experiences of queer patients within the healthcare setting. This includes nonverbal indications of acknowledgement and acceptance, such as signs in the office that indicate it to be a queer friendly space. This will help in eliminating the fear and miscommunication that can often happen when a queer patient sees a practitioner for the first time. In addition, better education on medically relevant topics to queer patients, is necessary in order to eliminate disparities in health outcomes. This is particularly evident in trans health, where specialized education is necessary in order to decrease poor health outcomes in trans patients. Future directions of this study necessitate a closer look on how race and socioeconomic status have an effect on a queer patient's relationship with their provider.

Contributors

Created

Date Created
2016-05

136711-Thumbnail Image.png

Formation of a Guide to Implementing a Student-Run Clinic for Underserved Populations

Description

This manual provides a "how-to" framework for the development of a student-run clinic. The manual should be used as a resource, referring to the table of contents and summaries of topics for specific areas of interest. The manual details the

This manual provides a "how-to" framework for the development of a student-run clinic. The manual should be used as a resource, referring to the table of contents and summaries of topics for specific areas of interest. The manual details the phases for the development of a student-run clinic focusing on underserved populations. The Student Health Outreach for Wellness (S.H.O.W.) Community Initiative in Phoenix, Arizona serves as the example. S.H.O.W. represents just one type of clinic structuring. As such, it is important to realize when developing a clinic that there are numerous clinic approaches based on community needs, volunteer support, and funding.

Contributors

Created

Date Created
2014-12

136579-Thumbnail Image.png

Knowledge and Attitudes of American College Students About the Affordable Care Act

Description

The Affordable Care Act, or Obamacare, was signed into law with the goals of providing quality and affordable health care to every American, but there is concern that not enough young adults are gaining health insurance. Some believe it is

The Affordable Care Act, or Obamacare, was signed into law with the goals of providing quality and affordable health care to every American, but there is concern that not enough young adults are gaining health insurance. Some believe it is because of the "young invincible" mentality of being healthy enough to not need health insurance, and others claim that the cost of health care is the main reason behind low enrollment rates in young adults. However, young adults may not be obtaining insurance because of a lack of understanding and awareness concerning the ACA. Do young adults understand how the ACA functions, and does this understanding (or lack thereof) determine their opinions towards it? In order to research this question, students at Arizona State University were given the opportunity to complete a survey and interview detailing their knowledge of Obamacare and how they felt about the health care law. Results indicated that though many respondents supported the law, respondents did not feel like they had enough information to understand the health care law, affecting their knowledge of it. These findings imply that in order for the ACA to be considered successful among young adults, awareness and education of the law must increase in order for young people to feel like they have an adequate understanding of it.

Contributors

Created

Date Created
2015-05

135595-Thumbnail Image.png

Midwifery around the World: A Study in the Role of Midwives in Local Communities and Healthcare Systems

Description

2015 marks the deadline for the UN Millennium Development Goal 5 to reduce global maternal mortality rate (MMR) by 75% since 1990. As of 2015, MMR has only been reduced by 45%. Many international organizations claim that more medically trained

2015 marks the deadline for the UN Millennium Development Goal 5 to reduce global maternal mortality rate (MMR) by 75% since 1990. As of 2015, MMR has only been reduced by 45%. Many international organizations claim that more medically trained midwives can meet global maternal health care needs. This study investigates two major questions. What is the role of midwives in diverse international maternal healthcare contexts? How do midwives in these different contexts define their roles and the barriers to providing the best care for women? From May to August 2015, I conducted over 70 interviews with midwives in Netherlands, Sweden, Rwanda, Bangladesh, Australia and Guatemala, interviewing between 6 and 13 midwives from each country. The majority of midwives defined their roles as supporting women's individual capacities and power through normal birth, and knowing when to refer when high-risk complications arise. Although thematic barriers vary by country, midwives in all countries believed that maternal healthcare can be improved by increased collaboration between midwives and other health care professionals, better access to culturally appropriate services, and greater public awareness of the role of midwives.

Contributors

Created

Date Created
2016-05

135181-Thumbnail Image.png

Designing for Fulfillment: The Importance of Creative Spaces in Long-Term Healthcare Settings

Description

The introductory section of my thesis will draw heavily from sources written by experts in the field of creative thinking. First, I will introduce the ideas proposed by Mihaly Csikszentmihalyi in his groundbreaking publications, Flow and Finding Flow. Here, I

The introductory section of my thesis will draw heavily from sources written by experts in the field of creative thinking. First, I will introduce the ideas proposed by Mihaly Csikszentmihalyi in his groundbreaking publications, Flow and Finding Flow. Here, I will discuss the "what" and "why" elements of my thesis, more specifically explaining why creativity is so important and how it could serve to improve the lives of those feeling emotionally or intellectually stifled by their stays in long-term healthcare facilities. Next I will use the steps outlined in Keith Sawyer's Zig Zag to explain the different elements that are involved in achieving creativity, "flow," and fulfillment. This will begin to touch on the issue of "how" from a theoretical perspective. For the latter half of my thesis, I draw from case studies, research papers, and design solutions from architects, designers, and manufacturers alike to begin imagining what designing a creatively conducive long-term care facility would entail, along with providing some examples of how these spaces might look, feel, and function. This portion is not meant to be a comprehensive design solution, but is simply meant to provide a framework and foundation for healthcare designers interested in incorporating creative spaces into their designs. The conclusion of this thesis is that creatively conducive spaces would be a beneficial contribution to the health care environment, particularly in settings that provide long-term care for individuals with limited capacity to leave the facility. These creative spaces will be guided by three key themes: (1) taking influence from children's health care facilities, which are more focused on the formative experiences of the user, (2) utilizing technology to provide opportunity for creative inspiration, expression, and collaboration, and (3) providing patients with the means to be creatively productive, including giving patients the power to control aspects of their environment.

Contributors

Agent

Created

Date Created
2016-05