Matching Items (116)
Filtering by
- All Subjects: healthcare
- Creators: Barrett, The Honors College
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
- Resource Type: Text
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
As of March 2020, there were over 112,400 patients actively waiting on the United States national organ transplant waitlist with only about 3,300 donors1. Although transplantation is an effective treatment for end-stage organ failure, the access to a procedure will vary depending on national regulations, cost of health care, extensive screening processes, and the availability of organs2. Organ shortage is a worldwide problem, and the growing insufficiency has resulted patients becoming too for ill or dying while waiting3. Due to the varying wait times and costs of procedures, some patients have begun to outsource their own transplantation through international transactions, also known as transplant tourism2. The 2004 World Health Assembly resolution recognized these trades as a significant health policy issue, while also acknowledging the inability of national health care systems to meet the needs of patients4. To address this issue, a proposal will be made such that all live kidney and liver donors will be compensated $22,500 and $12,150 respectively through a cost-neutral scheme based on annual healthcare expenditures per organ that would be eliminated by a transplant. With this proposal, it is suggested that the organ transplant waitlist would not only be significantly reduced, but potentially eliminated, and the crisis of organ shortage would be defeated.
ContributorsMartin, Starla (Author) / Kingsbury, Jeffrey (Thesis director) / Edmonds, Hallie (Committee member) / School of Molecular Sciences (Contributor) / School of Human Evolution & Social Change (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
This thesis explores the connection between how the stigmatization of mental illness may be perpetuated by health care workers and the effect this has on individuals using mental health care services, focusing on how it negatively impacts the outcome of treatment. Much research and studies have been done on the topic of stigma, but few have surveyed how mental health care service users are directly impacted by stigma, specifically from members of the health care community. The Tempe Mental Health Court, a local alternative program for individuals who have diagnosed serious mental health issues and have committed misdemeanor offenses, is an exemplar of a treatment program that may be impacted by this stigma. Literature research collected for this paper analyzed how stigmatization is perpetuated through actions and words, and how this negatively impacts the stigmatized. Additionally, research was also gathered on how mental health care workers may play a part in the stigmatization of mental illness. A survey based off of The Stigma Scale developed by Michael King and his associates was administered at the Mental Health Court to be taken by participants of the program (2007). The survey aimed to figure out whether stigma was present at the court, if so, how it was being presented, and what role health care professionals and other members of the court had in perpetuating it. The survey was administered online and totaled 30 questions. Afterwards, survey data was compared and analyzed to the information gathered through literature research. Solutions for intervening in the stigma were derived from the survey as well as outside research. Based on these survey results as well as the outside research conducted, proposals for further research were suggested at the end of this paper.
ContributorsBoon, Jessica (Author) / Broberg, Gregory (Thesis director) / Kane, Kevin (Committee member) / School of Criminology and Criminal Justice (Contributor) / School of Social Transformation (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
In 2017 alone, over 250,00 patients died due to medical errors and is the 3rd leading cause of death in America. These errors attributed to incorrect diagnosis and treatment of illnesses can be preventable. The solution to this major issue is the creation of an app called HealthKeep. Primary market research done during the first semester of the study included the creation of a school-wide survey across all ASU campuses that consisted of key questions for people of all ages in regards to their healthcare. These questions include how often patients of specific age ranges visit the doctor, their overall experience during appointments, and their attitudes towards the creation of a mobile health application that would be able to tabulate all your medical information neatly and securely. The overwhelming response stated that patient’s from all ranges would be open to the idea of having such an application. Further development included the creation of a business plan and application storyboard used when interviewing potential customers about the application. All of these tools aided in the first entry for Venture Devils in the first semester leading to the disappointing failure of winning funding. However, the feedback on the website created, executive summary, expanded pitch deck, and market research aided in the successful key revisions of the venture during this second semester and has resulted in placement in the final round of Pitch Playoffs where funding can be awarded.
ContributorsSiraj, Salim (Co-author) / Undrill, Grayson (Co-author) / Ott, Madison (Co-author) / Smith, Keaton (Co-author) / Byrne, Jared (Thesis director) / Sebold, Brent (Committee member) / School of Molecular 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
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.
ContributorsGilmore, Emily Anne (Author) / Chiou, Erin (Thesis director) / Wu, Teresa (Committee member) / Industrial, Systems & Operations Engineering Prgm (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
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 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.
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.
ContributorsSt Martin, Zachary (Author) / White, Adrienne (Thesis director) / Reddy, Swapna (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05