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Most studies on refugee populations tend to focus on mental health issues and communicable diseases. Yet, reproductive health remains a major aspect of refugee women's health needs. African refugee women in the United States continue to experience some difficulties in accessing reproductive health services despite having health insurance coverage. The

Most studies on refugee populations tend to focus on mental health issues and communicable diseases. Yet, reproductive health remains a major aspect of refugee women's health needs. African refugee women in the United States continue to experience some difficulties in accessing reproductive health services despite having health insurance coverage. The purpose of this study was to understand the reproductive health journey of African refugee women resettled in Phoenix, Arizona. This study also explored how African refugee women's pre-migration and post-migration experiences affect their relationships with health care providers. The study was qualitative consisting of field observations at the Refugee Women's Health Clinic (RWHC) in Phoenix, verbally administered demographic questionnaires, and semi-structured one-on-one interviews with twenty African refugee women (between the ages of 18 and 55) and ten health care providers. The findings were divided into three major categories: pre-migration and post migration experiences, reproductive health experiences, and perspectives of health care providers. The themes that emerged from these categories include social isolation, living between two cultures, racial and religious discrimination, language/interpretation issues and lack of continuity of care. Postcolonial feminism, intersectionality, and human rights provided the theoretical frameworks that helped me to analyze the data that emerged from the interviews, questionnaire and fieldnotes. The findings revealed some contrasts from the refugee women's accounts and the accounts of health care providers. While refugee women spoke from their own specific social location leading to more nuanced perspectives, health care providers were more uniform in their responses leading to a rethink of the concept of cultural competency. As I argue in the dissertation and contrary to conventional wisdom, culture per se does not necessarily translate to resistance to the American health care system for many African refugee women. Rather, their utilization (or lack thereof) of health services are better conceived within a broader and complex context that recognizes intersectional factors such as gender, racialization, language, displacement, and class which have a huge impact on the reproductive health seeking patterns of refugee women.
ContributorsJatau, Mary (Author) / Koblitz, Ann Hibner (Thesis advisor) / James, Stanlie (Committee member) / Robillard, Alyssa (Committee member) / Johnson, Crista (Committee member) / Arizona State University (Publisher)
Created2011
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HIV/AIDS is the sixth leading cause of death worldwide and the leading cause of death among women of reproductive age living in low-income countries. Clinicians in industrialized nations monitor the efficacy of antiretroviral drugs and HIV disease progression with the HIV-1 viral load assay, which measures the copy number of

HIV/AIDS is the sixth leading cause of death worldwide and the leading cause of death among women of reproductive age living in low-income countries. Clinicians in industrialized nations monitor the efficacy of antiretroviral drugs and HIV disease progression with the HIV-1 viral load assay, which measures the copy number of HIV-1 RNA in blood. However, viral load assays are not widely available in sub-Saharan Africa and cost between 50-$139 USD per test on average where available. To address this problem, a mixed-methods approach was undertaken to design a novel and inexpensive viral load diagnostic for HIV-1 and to evaluate barriers to its adoption in a developing country. The assay was produced based on loop-mediated isothermal amplification (LAMP). Blood samples from twenty-one individuals were spiked with varying concentrations of HIV-1 RNA to evaluate the sensitivity and specificity of LAMP. Under isothermal conditions, LAMP was performed with an initial reverse-transcription step (RT-LAMP) and primers designed for HIV-1 subtype C. Each reaction generated up to a few billion copies of target DNA within an hour. Presence of target was detected through naked-eye observation of a fluorescent indicator and verified by DNA gel electrophoresis and real-time fluorescence. The assay successfully detected the presence of HIV in samples with a broad range of HIV RNA concentration, from over 120,000 copies/reaction to 120 copies/reaction. In order to better understand barriers to adoption of LAMP in developing countries, a feasibility study was undertaken in Tanzania, a low-income country facing significant problems in healthcare. Medical professionals in Northern Tanzania were surveyed for feedback regarding perspectives of current HIV assays, patient treatment strategies, availability of treatment, treatment priorities, HIV transmission, and barriers to adoption of the HIV-1 LAMP assay. The majority of medical providers surveyed indicated that the proposed LAMP assay is too expensive for their patient populations. Significant gender differences were observed in response to some survey questions. Female medical providers were more likely to cite stigma as a source problem of the HIV epidemic than male medical providers while males were more likely to cite lack of education as a source problem than female medical providers.
ContributorsSalamone, Damien Thomas (Author) / Jacobs, Bertram L (Thesis advisor) / Marsiglia, Flavio (Committee member) / Stout, Valerie (Committee member) / Johnson, Crista (Committee member) / Arizona State University (Publisher)
Created2011
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Background: Endometriosis is a condition characterized by the growth of the endometrium, or the tissue that lines the uterus, outside of the uterus, and it is diagnosed through the presence of endometriotic lesions in the pelvic region. The disease is most often associated with abnormal and painful vaginal bleeding. Currently,

Background: Endometriosis is a condition characterized by the growth of the endometrium, or the tissue that lines the uterus, outside of the uterus, and it is diagnosed through the presence of endometriotic lesions in the pelvic region. The disease is most often associated with abnormal and painful vaginal bleeding. Currently, minimal literature exists concerning the management of endometriosis in low and middle-income countries (LMICs), which may influence the lack of a cultural competent understanding of menstruation in LMICs and, therefore, a lack of evidence-based policies concerning menstruation.

Methods: Social and cultural barriers influencing endometriosis reporting and management in LMICs were examined through a systematic literature review. Online databases yielded a list of relevant studies. Then, use of MAXQDA, a qualitative data analysis software program, helped to extract and code specific text segments from each study that pertain to the research topic. In-context analysis of coded segments revealed the most common trends, which were organized into broader themes.

Results: Findings demonstrated that social and cultural ideas regarding vaginal bleeding influenced the lack of disease reporting and management of endometriosis in LMICs. Socioeconomic challenges include a lack of hygiene and sanitation measures and education regarding menstruation and vaginal bleeding. Also, many diseases associated with the abnormal vaginal bleeding are often disregarded and not prioritized in clinical settings. It also became clear that cultural taboos regarding menstruation and vaginal bleeding often create feelings of anxiety and fear in women and girls throughout communities in LMICs. However, further research is needed to examine the ways in which women in those communities treat symptoms of irregular vaginal bleeding related to endometriosis.

Conclusions: Socioeconomic, gender, and sex-related factors may influence the ways in which endometriosis is reported and treated and may affect the way the related diseases are understood. Evidence-based policies using a culturally competent understanding of abnormal vaginal bleeding in LMICs may help positively affect the reproductive health of women and girls in such areas.
ContributorsSantora, Emily (Author) / Maienschein, Jane (Thesis director) / Abboud, Carolina (Committee member) / Hagaman, Ashley (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Social Transformation (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
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Breast cancer affects about 12% of women in the US. Arguably, it is one of the most advertised cancers. Mammography became a popular tool of breast cancer screening in the 1970s, and patient-geared guidelines came from the American Cancer Society (ACS) and the US Preventative Task Force (USPSTF). This research

Breast cancer affects about 12% of women in the US. Arguably, it is one of the most advertised cancers. Mammography became a popular tool of breast cancer screening in the 1970s, and patient-geared guidelines came from the American Cancer Society (ACS) and the US Preventative Task Force (USPSTF). This research focuses on ACS guidelines, as they were the earliest as well as the most changed guidelines. Mammography guidelines changed over time due to multiple factors. This research has tracked possible causes of those changes. Research began with an extensive literature search of clinical trials, the New York Times and the Washington Post archives, systematic reviews, ACS and USPSTF archives.

Created2021-02-16
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Science fiction works can reflect the relationship between science and society by telling stories that are set in the future of ethical implications or social consequences of scientific advancements. This thesis investigates how the concept of reproduction is depicted in popular science fiction works.

Created2021-02-10
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By questioning methods of sex selection since their early development, and often discovering that they are unreliable, scientists have increased the creative and technological capacity of the field of reproductive health. The presentation of these methods to the public, via published books on timing methods and company websites for sperm

By questioning methods of sex selection since their early development, and often discovering that they are unreliable, scientists have increased the creative and technological capacity of the field of reproductive health. The presentation of these methods to the public, via published books on timing methods and company websites for sperm sorting, increased interest in, and influence of, sex selection within the global society. The purpose of explaining the history, interest, development, and impact of various sex selection methods in the mid-twentieth century based on the information that is available on them today is to show couples which methods have failed and provide them with the knowledge necessary to make an informed decision on how they choose to go about utilizing methods of sex selection.

Created2021-02-26
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By demonstrating the struggle for sound standard of care for non-medical reproductive health care providers during the nineteenth and early twentieth century, this project emphasizes what the standards of reproductive health care for abortion and contraception might be like if the organizations that made them so readily available, like Planned

By demonstrating the struggle for sound standard of care for non-medical reproductive health care providers during the nineteenth and early twentieth century, this project emphasizes what the standards of reproductive health care for abortion and contraception might be like if the organizations that made them so readily available, like Planned Parenthood, were defunded or criminalized in our modern setting.

Created2021-02-23
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On 29 June 1988, in Bowen v. Kendrick, the US Supreme Court ruled in a five-to-four decision that the 1981 Adolescent Family Life Act, or AFLA, was constitutional. Under AFLA, the US government could distribute federal funding for abstinence-only sexual education programs, oftentimes given to groups with religious affiliations. As

On 29 June 1988, in Bowen v. Kendrick, the US Supreme Court ruled in a five-to-four decision that the 1981 Adolescent Family Life Act, or AFLA, was constitutional. Under AFLA, the US government could distribute federal funding for abstinence-only sexual education programs, oftentimes given to groups with religious affiliations. As a federal taxpayer, Chan Kendrick challenged the constitutionality of AFLA, claiming it violated the separation of church and state. The Supreme Court found that although AFLA funded programs that aligned with certain religious ideologies, it was constitutional because it did not encourage government involvement in religion, and it held a valid secular purpose in seeking to prevent adolescent pregnancy and premarital sexual relations. By upholding AFLA, Bowen v. Kendrick enabled the US government to continue funding abstinence-only education, which researchers have found to be ineffective.

Created2021-02-26
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In 1997, physicians and researchers Ambre Olsen, Virginia Smith, John Bergstrom, Joyce Colling, and Amanda Clark published, “Epidemiology of Surgically Managed Pelvic Organ Prolapse and Urinary Incontinence,” in the journal Obstetrics and Gynecology. In their article, the authors retrospectively analyzed data from patients who underwent surgery for pelvic organ prolapse

In 1997, physicians and researchers Ambre Olsen, Virginia Smith, John Bergstrom, Joyce Colling, and Amanda Clark published, “Epidemiology of Surgically Managed Pelvic Organ Prolapse and Urinary Incontinence,” in the journal Obstetrics and Gynecology. In their article, the authors retrospectively analyzed data from patients who underwent surgery for pelvic organ prolapse or urinary incontinence two years prior in 1995. Often due to a weakening of or damage to their pelvic muscles, women with pelvic organ prolapse can experience a descent of pelvic organs into the lower pelvis and vagina. People with urinary incontinence can experience bladder control issues and urinary leaks. According to the authors, an estimated fifty percent of women who have previously given birth have had a prolapse. In their article, Olsen and colleagues analyze factors such as race, age, and weight in women who had surgery to treat pelvic organ prolapse and ultimately advocate for a standard assessment for the severity of those conditions.

Created2021-02-23
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In 1996, a team of researchers associated with the International Continence Society published “The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction” in American Journal of Obstetrics and Gynecology. Pelvic organ prolapse is characterized by the descent of the pelvic organs into the lower portion of

In 1996, a team of researchers associated with the International Continence Society published “The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction” in American Journal of Obstetrics and Gynecology. Pelvic organ prolapse is characterized by the descent of the pelvic organs into the lower portion of the pelvis and is often caused by a weakening of the muscles and ligaments that normally hold the organs in place. The authors concluded that physicians and researchers needed to develop a system of standardized terms to use to describe the anatomical position of pelvic organ prolapse in women. They propose using terms that emphasize the location of the prolapse rather than just the involved organ. They also suggest that the system utilizes a series of examinations and imaging to uniformly describe and quantify pelvic organ prolapse. The article by Bump and colleagues was one of the first to call for a standardized system using specific terms to communicate findings about pelvic organ prolapse systematically across clinical and academic research settings.

Created2021-03-10