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Description
Opioid use disorder (OUD) has been a growing problem in the United States since the start of the 20th century, but a new wave of the “Opioid Epidemic” began in the mid-1990s when the use of opioid analgesics became the premier method for treating acute pain. In response to the increasing rates of OUD, in 2002 the Federal Drug Administration (FDA) approved a treatment course known as medication-assisted treatment (MAT), which is a combination therapy that uses buprenorphine, a partial opioid analgesic, and behavioral therapy to treat OUD. However, the use of buprenorphine to treat OUD is relatively controversial and as a result, is not widespread in primary care settings. New Mexico is an area that has seen some of the highest rates of OUD, with patient populations that suffer from the disorder prevalent in both rural and urban areas. This paper seeks to identify the barriers that urban and rural medical providers face when it comes to successfully establishing medication-assisted treatment options for opioid use disorder patients. To answer this question, 20 medical practitioners across the state of New Mexico shared their opinions on the subject in semi-structured interviews. A qualitative analysis of the information gathered from these interviews concluded that there are 3 main barriers (patient-related, provider-related, and medical system-related) that contribute to the inconsistent spread of MAT services in New Mexico. These barriers are relatively consistent across both rural and urban communities, however, in specific instances, they manifest differently. The preliminary findings from this study highlight multiple methods for reducing barriers to the implementation of MAT including starting provider education about OUD and MAT earlier (i.e. in residency) and improving the infrastructure and support systems available to vulnerable patient groups (including those in rural areas and homeless individuals).
ContributorsPentecost, Abigail (Author) / Hruschka, Daniel (Thesis director) / Drake, Alexandria (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor)
Created2022-05
Description
HIV/AIDS remains a pressing global health challenge, not only because of its medical complexities but also due to associated stigma and the lack of knowledge of the illness in communities around the world. This thesis analyzed cross-cultural differences and long-term changes in women’s knowledge and stigma around HIV/AIDS in low- and middle-income countries. Using Demographic and Health Survey (DHS) data from 24 countries for knowledge and stigma from 2000-2018, we examined changes in HIV/AIDS knowledge score and stigma score. The findings shed light on the perception of HIV/AIDS knowledge improving while stigma persisted indicative of remaining concerns about the illness amongst women.
ContributorsMurala, Divya Sruthi (Author) / Hruschka, Daniel (Thesis director) / Loebenberg, Abby (Committee member) / Barrett, The Honors College (Contributor) / School of Molecular Sciences (Contributor) / School of Life Sciences (Contributor) / Department of Information Systems (Contributor)
Created2023-12
Description
Latest estimates show that roughly 188 individuals in the United States die everyday due to an opioid-related overdose. This dissertation explores three avenues for
mitigating opioid use disorder (OUD) and the opioid epidemic in the United States (1.)
How can researchers and public health professionals identify areas most in need of
treatment for OUD in an easy-to-use and publicly accessible interface?; (2.) What do
practitioners see as opportunities for reducing barriers to treatment?; and (3.) Why do
differences in opioid mortality exist between demographic groups? To address question
one, I developed an interactive web-based to assist in identifying those counties with the
greatest unmet need of medically assisted treatment (MAT). To answer question two, I
conducted a study of stakeholders (medical providers, peer support specialists, public
health practitioners, etc.) in four New Mexico counties with high unmet need of MAT. to
identify cultural and structural barriers to MAT provision in underserved areas as well as
opportunities for improving access. To answer the third question. I conducted a
systematic review of peer-reviewed literature and government reports to identify how
previous research accounts for race/ethnic and sex disparities in opioid-related
mortality. While many opioid mortality studies show demographic differences, little is
known about why they exist. According to the findings of this systematic review, research
needs to go beyond identifying demographic differences in opioid-related mortality to
understand the reasons for those differences to reduce these inequities.
ContributorsDrake, Alexandria (Author) / Hruschka, Daniel (Thesis advisor) / Jehn, Megan (Committee member) / Scott, Mary Alice (Committee member) / Arizona State University (Publisher)
Created2023
Description
Previous work suggests that lower-income individuals are more likely to engage in mutual aid as a means to manage risk, giving rise to a psychology that is other-oriented, including an empathetic disposition and a proclivity to help people in need. While no study has directly investigated whether helping in times of need increases dispositional empathic concern over time, this assumption is deep-seated among social psychologists. Employing a two-year longitudinal survey of US adults (N = 915), I show that people who experience more needs report helping others when in need a greater number of times, in turn leading to a small but positive increase in their empathetic disposition. This study also identifies the types of needs that elicit empathic concern (i.e., those that arise from unpredictable sources of risk), and shows why cultivating an empathetic disposition is likely to pay off in the long run: those who provide help are more likely to receive help during future times of need. Moreover, this study identifies the types of targets for whom providing help might cultivate an empathetic disposition: those with whom people are likely to share lower interdependence. While previous theoretical frameworks posit that empathic concern selectively directs investment towards interdependent others, providing help to non-interdependent targets might allow people to build positive interdependence with prospective risk pooling partners. Cultivating an empathetic disposition and building interdependence with prospective risk pooling partners can allow people to manage needs that arise from unpredictable sources of risk.
ContributorsGuevara Beltran, Diego (Author) / Aktipis, Athena (Thesis advisor) / Hruschka, Daniel (Committee member) / Kenrick, Douglas (Committee member) / Shiota, Michelle (Committee member) / Arizona State University (Publisher)
Created2023
Description
Significant health inequalities exist between different castes and ethnic communities in India, and identifying the roots of these inequalities is of interest to public health research and policy. Research on caste-based health inequalities in India has historically focused on general, government-defined categories, such as “Scheduled Castes,” “Scheduled Tribes,” and “Other Backward Classes.” This method obscures the diversity of experiences, indicators of well-being, and health outcomes between castes, tribes, and other communities in the “scheduled” category. This study analyzes data on 699,686 women from 4,260 castes, tribes and communities in the 2015-2016 Demographic and Health Survey of India to: (1) examine the diversity within and overlap between general, government-defined community categories in both wealth, infant mortality, and education, and (2) analyze how infant mortality is related to community category membership and socioeconomic status (measured using highest level of education and household wealth). While there are significant differences between general, government-defined community categories (e.g., scheduled caste, backward class) in both wealth and infant mortality, the vast majority of variation between communities occurs within these categories. Moreover, when other socioeconomic factors like wealth and education are taken into account, the difference between general, government-defined categories reduces or disappears. These findings suggest that focusing on measures of education and wealth at the household level, rather than general caste categories, may more accurately target those individuals and households most at risk for poor health outcomes. Further research is needed to explain the mechanisms by which discrimination affects health in these populations, and to identify sources of resilience, which may inform more effective policies.
ContributorsClauss, Colleen (Author) / Hruschka, Daniel (Thesis director) / Davis, Mary (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution & Social Change (Contributor) / Department of Psychology (Contributor)
Created2022-05
Description
Background In the United States (US), first-year university students typically live on campus and purchase a meal plan. In general, meal plans allow the student a set number of meals per week or semester, or unlimited meals. Understanding how students’ use their meal plan, and barriers and facilitators to meal plan use, may help decrease nutrition-related issues.
Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates.
Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together.
Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition.
Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates.
Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together.
Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition.
Contributorsvan Woerden, Irene (Author) / Bruening, Meg (Thesis advisor) / Hruschka, Daniel (Committee member) / Schaefer, David (Committee member) / Vega-Lopez, Sonia (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2019
Description
Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
ContributorsHall, Sarah (Author) / Jehn, Megan (Thesis advisor) / Mongeau, Paul (Committee member) / Hruschka, Daniel (Committee member) / Margolis, Eric (Committee member) / Arizona State University (Publisher)
Created2015
Description
In this thesis, I present the study of nucleon structure from distinct perspectives. I start by elaborating the motivations behind the endeavors and then introducing the key concept, namely the generalized parton distribution functions (GPDs), which serves as the frame- work describing hadronic particles in terms of their fundamental constituents. The second chapter is then devoted to a detailed phenomenological study of the Virtual Compton Scattering (VCS) process, where a more comprehensive parametrization is suggested. In the third chapter, the renormalization kernels that enters the QCD evolution equations at twist- 4 accuracy are computed in terms of Feynman diagrams in momentum space, which can be viewed as an extension of the work by Bukhvostov, Frolov, Lipatov, and Kuraev (BKLK). The results can be used for determining the QCD background interaction for future precision measurements.
ContributorsJi, Yao, Ph. D (Author) / Belitsky, Andrei (Thesis advisor) / Lebed, Richard (Committee member) / Schmidt, Kevin E (Committee member) / Vachaspati, Tanmay (Committee member) / Arizona State University (Publisher)
Created2016
Description
The work presented in this dissertation examines three different nonequilibrium particle physics processes that could play a role in answering the question “how was the particle content of today’s universe produced after the big bang?” Cosmic strings produced from spontaneous breaking of a hidden sector $U(1)_{\rm X}$ symmetry could couple to Standard Model fields through Higgs Portal or Kinetic Mixing operators and radiate particles that contribute to the diffuse gamma ray background. In this work we calculate the properties of these strings, including finding effective couplings between the strings and Standard Model fields. Explosive particle production after inflation, known as preheating, would have produced a stochastic background of gravitational waves (GW). This work shows how the presence of realistic additional fields and interactions can affect this prediction dramatically. Specifically, it considers the inflaton to be coupled to a light scalar field, and shows that even a very small quartic self-interaction term will reduce the amplitude of the gravitational wave spectrum. For self-coupling $\lambda_{\chi} \gtrsim g^2$, where $g^2$ is the inflaton-scalar coupling, the peak energy density goes as $\Omega_{\rm GW}^{(\lambda_{\chi})} / \Omega_{\rm GW}^{(\lambda_{\chi}=0)} \sim (g^2/\lambda_{\chi})^{2}$. Finally, leptonic charge-parity (CP) violation could be an important clue to understanding the origin of our universe's matter-antimatter asymmetry, and long-baseline neutrino oscillation experiments in the coming decade may uncover this. The CP violating effects of a possible fourth ``sterile" neutrino can interfere with the usual three neutrinos; this work shows how combinations of various measurements can help break those degeneracies.
ContributorsHyde, Jeffrey Morgan (Author) / Vachaspati, Tanmay (Thesis advisor) / Easson, Damien (Committee member) / Belitsky, Andrei (Committee member) / Comfort, Joseph (Committee member) / Arizona State University (Publisher)
Created2016
Description
With the discovery of the Higgs Boson in 2012, particle physics has decidedly moved beyond the Standard Model into a new epoch. Though the Standard Model particle content is now completely accounted for, there remain many theoretical issues about the structure of the theory in need of resolution. Among these is the hierarchy problem: since the renormalized Higgs mass receives quadratic corrections from a higher cutoff scale, what keeps the Higgs boson light? Many possible solutions to this problem have been advanced, such as supersymmetry, Randall-Sundrum models, or sub-millimeter corrections to gravity. One such solution has been advanced by the Lee-Wick Standard Model. In this theory, higher-derivative operators are added to the Lagrangian for each Standard Model field, which result in propagators that possess two physical poles and fall off more rapidly in the ultraviolet regime. It can be shown by an auxiliary field transformation that the higher-derivative theory is identical to positing a second, manifestly renormalizable theory in which new fields with opposite-sign kinetic and mass terms are found. These so-called Lee-Wick fields have opposite-sign propagators, and famously cancel off the quadratic divergences that plague the renormalized Higgs mass. The states in the Hilbert space corresponding to Lee-Wick particles have negative norm, and implications for causality and unitarity are examined.
This dissertation explores a variant of the theory called the N = 3 Lee-Wick
Standard Model. The Lagrangian of this theory features a yet-higher derivative operator, which produces a propagator with three physical poles and possesses even better high-energy behavior than the minimal Lee-Wick theory. An analogous auxiliary field transformation takes this higher-derivative theory into a renormalizable theory with states of alternating positive, negative, and positive norm. The phenomenology of this theory is examined in detail, with particular emphasis on the collider signatures of Lee-Wick particles, electroweak precision constraints on the masses that the new particles can take on, and scenarios in early-universe cosmology in which Lee-Wick particles can play a significant role.
This dissertation explores a variant of the theory called the N = 3 Lee-Wick
Standard Model. The Lagrangian of this theory features a yet-higher derivative operator, which produces a propagator with three physical poles and possesses even better high-energy behavior than the minimal Lee-Wick theory. An analogous auxiliary field transformation takes this higher-derivative theory into a renormalizable theory with states of alternating positive, negative, and positive norm. The phenomenology of this theory is examined in detail, with particular emphasis on the collider signatures of Lee-Wick particles, electroweak precision constraints on the masses that the new particles can take on, and scenarios in early-universe cosmology in which Lee-Wick particles can play a significant role.
ContributorsTerBeek, Russell Henry (Author) / Lebed, Richard F (Thesis advisor) / Alarcon, Ricardo (Committee member) / Belitsky, Andrei (Committee member) / Chamberlin, Ralph (Committee member) / Parikh, Maulik (Committee member) / Arizona State University (Publisher)
Created2015