In this formative research project, we seek to better understand the general barriers to refugee access to higher education. Using mixed methods research--which included surveys, interviews, and course data--we evaluate the benefits and challenges experienced by refugee students in Israel who are enrolled in Arizona State University's Education for Humanity programs. In the end, this case study resulted in 24 recommend programmatic changes designed to eliminate the barriers that prevent refugee students from accessing and succeeding in higher education.

The purpose of this research is to exploit the neglect of specific populations and diseases in Latin America through an epidemiological literature review. As a small part of a larger publication, the foci of this research was the infectious disease, helminthiasis. Using manually indexed abstracts from the National Library of Medicine database in PubMed, 4,594 papers were synthesized and then processed for further review. Of those papers, 29 provided information about helminths in indigenous populations. These papers were reviewed and used in prevalence data extraction and variable analysis. The main conclusion was to reveal the fact that from an entire health database less than 30 papers provided information about the persistence of helminths in indigenous communities of Latin America. Not only that but the few papers that could be analyzed had consistently high prevalence ratios.

Motor learning is the process of improving task execution according to some measure of performance. This can be divided into skill learning, a model-free process, and adaptation, a model-based process. Prior studies have indicated that adaptation results from two complementary learning systems with parallel organization. This report attempted to answer the question of whether a similar interaction leads to savings, a model-free process that is described as faster relearning when experiencing something familiar. This was tested in a two-week reaching task conducted on a robotic arm capable of perturbing movements. The task was designed so that the two sessions differed in their history of errors. By measuring the change in the learning rate, the savings was determined at various points. The results showed that the history of errors successfully modulated savings. Thus, this supports the notion that the two complementary systems interact to develop savings. Additionally, this report was part of a larger study that will explore the organizational structure of the complementary systems as well as the neural basis of this motor learning.

In this formative research project, we seek to better understand the general barriers to refugee access to higher education. Using mixed methods research--which included surveys, interviews, and course data--we evaluate the benefits and challenges experienced by refugee students in Israel who are enrolled in Arizona State University's Education for Humanity programs. In the end, this case study resulted in 24 recommend programmatic changes designed to eliminate the barriers that prevent refugee students from accessing and succeeding in higher education.

This project is an investigation of the gene by environment (GxE) interactions’ effect on substance use outcomes among refugee communities. Substance use disorders (SUDs) are a major public health concern, affecting individuals and communities worldwide. The etiology of SUDs is complex, involving a combination of genetic, environmental, and social factors. In recent years, there has been growing interest in the role of gene by environment interactions in the development of SUDs, particularly in vulnerable populations such as refugees. Refugee populations are exposed to a range of environmental stressors that may interact with genetic factors to increase their risk of SUDs. However, a number of studies describe a “refugee paradox,” where despite having been exposed to risk factors that can lead to SUDs, they are less likely to develop SUDs. Understanding these gene by environment interactions in refugee communities is crucial for not only understanding this phenomenon, but developing effective prevention and treatment strategies for this population. This thesis aims to investigate the gene by environment interactions underlying substance use in refugee communities and to analyze different methods for gene by environment analyses, ultimately determining which method is best suited for this population.

Refugee women face many challenges to obtaining maternal, reproductive, and sexual health post-resettlement including the language barrier, navigating the healthcare system, finding childcare to attend appointments, and cultural mismatches between their beliefs and practices around the prenatal, childbirth, and postpartum periods and that of the healthcare system in which they resettle into. This cultural barrier poses a challenge to healthcare providers as well as it necessitates that they respect their patients’ cultural beliefs while still providing them with the highest standard of care. Cultural competency training has been used to assist providers in understanding and responding to cultural differences, but gaps still exist when it comes to navigating specific scenarios. The objective of this research was to conduct a literature review of studies pertaining to refugee maternal, reproductive, and sexual healthcare post-resettlement to investigate the following questions: how tensions between biomedically accepted best practices and cultural norms present themselves in these healthcare fields, how healthcare providers take into consideration their patients’ cultural beliefs and norms when providing maternal, reproductive, and sexual healthcare to refugee women, and what can be done to continue to improve the provision of culturally appropriate care to refugee women. Findings from twenty different studies that focused primarily on eight cultural groups identified that Cesarean sections, inductions, and certain family planning methods are significant points of contention regarding cultural norms for refugee women and that they prefer certain foods, birthing positions, and other cultural practices during the delivery. Healthcare providers consider their refugee patients’ cultural beliefs by creating relationships with them built on trust, utilizing community liaisons, and through attempts to accommodate cultural practices when possible. Some potential improvements offered to improve cultural competency were improved cultural competency training that focused on how healthcare providers ask questions and interact with their patients, increased partnership with refugee communities, and an emphasis on patient education surrounding interventions and procedures related to maternal and reproductive health that could cause hesitations. The results of this literature review accentuated the importance of relationships within the field of refugee women’s healthcare, between both refugee patients and their providers and refugee communities and the healthcare systems. Providing refugee women access to more culturally competent healthcare can increase their trust in the healthcare systems of the countries they resettle in and healthcare utilization that can contribute to improved health outcomes for refugee women and their children.

The combined use of methamphetamine and opioids has been reported to be on the rise throughout the United States (U.S.). However, our knowledge of this phenomenon is largely based upon reported overdoses and overdose-related deaths, law enforcement seizures, and drug treatment records; data that are often slow, restricted, and only track a portion of the population participating in drug consumption activities. As an alternative, wastewater-based epidemiology (WBE) has the capability to track licit and illicit drug trends within an entire community, at a low cost and in near real-time, while providing anonymity to those contributing to the sewer shed. In this study, wastewater was collected from two Midwestern U.S. cities (2017-2019) and analyzed for the prevalence of methamphetamine and the opioids oxycodone, codeine, fentanyl, tramadol, hydrocodone, and hydromorphone. Monthly 24-hour time-weighted composite samples (n = 48) from each city were analyzed using isotope dilution liquid chromatography tandem mass spectrometry. Results showed that methamphetamine and total opioid consumption (milligram morphine equivalents) in City 1 were strongly correlated only in 2017 (Spearman rank order correlation coefficient, ρ = 0.78), the relationship driven by fentanyl, hydrocodone, and hydromorphone. For City 2, methamphetamine and total opioid consumption were strongly positively correlated during the entire study (ρ = 0.54), with the correlations driven by hydrocodone and hydromorphone. In both cities, hydrocodone and hydromorphone mass loads were highly correlated, suggesting a parent and metabolite relationship. WBE provides important insights into licit and illicit drug consumption patterns in near real-time as they evolve; important information for community stakeholders in municipalities across the U.S.