Undergraduate Honors Program - Department of Medicine, Health, and Society

Permanent URI for this community

https://ir.vanderbilt.edu/handle/1803/8376

Browse

Browsing Undergraduate Honors Program - Department of Medicine, Health, and Society by Issue Date

Filter results by year or month
Now showing 1 - 20 of 60
  • Thumbnail Image
    Item
    Military Sexual Assault and Posttraumatic Stress Disorder
    (Elizabeth G. Gilbert, 2014-04) Gilbert, Elizabeth G.
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Mind-body Practice in Undergraduates: User involvement in undergraduate mental healthcare setting
    (2016-04-22) Krishna, Vibhuti
    Mental health issues, particularly anxiety and depression, have risen nationally in frequency and severity among college students. The Vanderbilt University Psychological & Counseling Center (PCC) has also experienced this phenomenon. As a result, wait times for therapist appointments are often several weeks. In response to these trends, the PCC dedicated a room within its building to Mind-Body Practices (MBPs) called the Mind-Body Lab (MBL). The room, despite a significant national rise in MBPs, a surge in research indicating the therapeutic and preventative effectiveness of MBPs, and its availability to all undergraduates, is under-booked and infrequently used. This study investigated potential explanations for this occurrence through surveys of the student body and MBL users as well as Vanderbilt student interest in MBPs. Female respondents engaged in more MBPs than male respondents. Additionally, stigma and demographic background may play a role in underuse of the MBL. Overwhelmingly, Vanderbilt students desire university support for MBPs.
  • No Thumbnail Available
    Item
    The Effect of Ownership on Length of Stay and Total Charges for Hospital Inpatient Substance Abuse Treatment
    (2016-04-29) Hill, Anna
    The purpose of this study is to determine if hospital ownership has an effect on economic factors and quality outcomes related to inpatient substance abuse treatment. The study examines these factors through analyzing the effect of ownership on length of stay and total revenue charges for inpatient substance abuse treatment provided at hospitals in Florida. Hospital inpatient data were collected from the Florida Agency for Health Care Administration. Two multiple regression models were used to compare the effect of ownership, along with other patient factors, on length of stay and total revenue charges. Overall, three key conclusions were made. First, for-profit hospitals charged substance abuse patients more for inpatient care than non-profit hospitals. Second, patients treated in for-profit general hospitals stayed fewer days and received higher charges than patients treated in non-profit general hospitals. Lastly, Medicare patients stayed more days and received higher charges than patients with other types of payers in both facilities, but this trend was stronger in for-profit hospitals. This study concludes that, while hospital ownership results in economic differences in care, the measure of quality of care is inconclusive. It is important that further information is collected to understand the difference in the quality of care provided at non-profit and for-profit hospitals.
  • Thumbnail Image
    Item
    The Effect of Ownership on Length of Stay and Total Charges for Hospital Inpatient Substance Abuse Treatment
    (2016-04-29) Hill, Anna
    The purpose of this study is to determine if hospital ownership has an effect on economic factors and quality outcomes related to inpatient substance abuse treatment. The study examines these factors through analyzing the effect of ownership on length of stay and total revenue charges for inpatient substance abuse treatment provided at hospitals in Florida. Hospital inpatient data were collected from the Florida Agency for Health Care Administration. Two multiple regression models were used to compare the effect of ownership, along with other patient factors, on length of stay and total revenue charges. Overall, three key conclusions were made. First, for-profit hospitals charged substance abuse patients more for inpatient care than non-profit hospitals. Second, patients treated in for-profit general hospitals stayed fewer days and received higher charges than patients treated in non-profit general hospitals. Lastly, Medicare patients stayed more days and received higher charges than patients with other types of payers in both facilities, but this trend was stronger in for-profit hospitals. This study concludes that, while hospital ownership results in economic differences in care, the measure of quality of care is inconclusive. It is important that further information is collected to understand the difference in the quality of care provided at non-profit and for-profit hospitals.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    The Federal Government’s Controversial Impact on American Public Health: A Review of the FDA’s Attempted Actions to Regulate the Rogue Tobacco Industry
    (2020) Quinto, Drew
    At the beginning of the 20th century, technological innovations in the ability to mass-produce rolled cigarettes resulted in the creation of a multi-billion-dollar industry in the United States. As the popularity of combustible tobacco products grew exponentially, scientific research on their potential harmful effects began being made public. By the 1960s, the research was brought into the public eye by the federal government’s Surgeon General Advisory Committee. Although there were countless conclusive studies and organizational warnings, the tobacco companies that led the industry acted practically uncontrolled for the better part of a century. With minimal regulation by Congress, the Food and Drug Administration (FDA) attempted to intervene in 1996 with the intention of regulating the industry and ultimately improving the welfare of the American population. The Supreme Court, however, denied the FDA the ability to implement advertising regulations that would have strongly limited the influence the tobacco industry had over the population. The reasons for denial are not that the proposed regulations were unconstitutional, but that the regulations came from the wrong branch of the federal government. As a result of this controversial Supreme Court ruling in 2000, the tobacco industry was able to continue its successful and manipulative tactics until Congressional legislation granted the FDA authority to regulate the industry in 2009. Once granted authority, the FDA implemented guidelines that have directly contributed to the lowest cigarette consumption rates since the 1920s. Although the federal government is now better handling the tobacco epidemic, conflicting precedents between branches were taken advantage of by big tobacco and were the direct cause for the prolongment of this national threat to public health.
  • No Thumbnail Available
    Item
    Animal-Assisted Interventions for Children with Advanced Cancer: The Impact of Canines on Stress
    (2020) Brisman, Rebecca
    Children and the families of children with advanced cancer are at an increased risk of experiencing stress and anxiety, and this can be especially heightened during hospital visits. While there is extensive literature on the positive effects that animal-assisted interventions (AAI) have on the stress levels and quality of life of humans, there is little data indicating the effects that AAIs have specifically on children with advanced cancer and their families. Using a randomized control design, this study examines the effects that AAI sessions have on children with advanced cancer through a number of qualitative and quantitative methods. This research paper specifically explores the impact that AAIs had on the participants by analyzing end of study interviews. The results reveal that participants experienced a significant reduction in stress and anxiety levels, an increased willingness to go to the hospital, and an improvement in communication between the child and caregiver. Furthermore, the results showed that the effects of the AAIs were not impacted by whether or not the participant had a pet at home.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    How Art Therapy Interacts with Medicinal Care and Can Improve Patient Outcome
    (2021) Bauer, Lauren
    The impact of art therapy, specifically painting and studying painted works on patient coping, recovery, and healing is not highly researched and professionals commonly regard art therapy as only beneficial to an emotional extent on health. Problematically, there is not much data and clinical research collected or performed regarding the role of art therapy in a hospital setting, and research that exists often uses a small population, less than 50 persons, to determine conclusions. The aim of this research paper is to survey the available data and research regarding the integration of painting or studying paintings in a hospital or clinical environment on patient health outcomes. This paper determines if a more holistic approach to healing using art therapy over solely analgesics or other Western medicine methods of health intervention can impact patients of many different diseases in a positive way. Diseases studied alongside art therapy and discussed in this paper include but are not limited to, Alzheimer's, strokes, end-stage kidney failure, depression, Schizophrenia, Diabetes, PTSD, Cancer, and other Chronic illnesses. I used secondary research as the methodology for this paper, conducting a survey of the existing research. Many of the studies and research trials that were reviewed in this paper used interviews, questionnaires, regression analysis, and paired t-tests, as well as other quantitative measures. From my findings, I argue that the act of painting and studying paintings in a clinical setting does extend beyond creative expression and can positively impact holistic healing through neurobiology and biosocial mechanisms. Many quantitative metrics were used to determine the success of an art therapy intervention in this paper such as blood pressure, direct effects on a patient's functional recovery, length of stay in a hospital, and cortisol levels. Overall, art therapy can prove beneficial to the medical community and patient interaction with painting and paintings should become more widespread in medical interventions.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    AN EVALUATION OF THE INSTITUTIONAL, CLASSROOM, AND INTERPERSONAL EXPERIENCES OF BLACK HETEROSEXUAL AND LGBTQ+ STUDENTS AT VANDERBILT UNIVERSITY
    (2021) Mulraine, Zoe
    The issues that disproportionately affect Black students at Vanderbilt University are broad, and they are many. Social media discussions, Campus Climate Surveys, and student-organized petitions have all called on University administration to do more to protect vulnerable student populations. This study was prompted by the harsh criticism that Vanderbilt University faced from students and alumni during the summer of 2020, which specifically highlighted the University’s shortcomings in regards to support for racial and sexual minorities. The research focuses on the institutional, classroom, and interpersonal experiences of Black Vanderbilt students, with a distinct interest in Black students who also identify as LGBTQ+. Using the intersectionality framework to analyze the anecdotal experiences of two Black, bisexual, female Vanderbilt students along with the responses from 21 Black survey respondents, seven of which identified as LGBTQ+, I present recommendations for university procedural and policy changes. More research is needed to understand how to best implement these procedures and to continue to document the experiences of Black college students and increase data related to Black LGBTQ+ college students.
  • No Thumbnail Available
    Item
    WOMEN IN THE TRENCHES: THE IMPACT OF THE COVID-19 PANDEMIC ON DOMESTIC VIOLENCE SERVICES IN NASHVILLE, TN
    (2021) Stanton, Noah
    Since the COVID-19 pandemic officially began in March 2020, risks and rates of domestic violence (DV) have unilaterally risen across the globe in correspondence with lockdown procedures. Aside from administering a singular block grant under the Coronavirus Aid, Relief, and Economic Security (CARES) Act to the Administration for Children and Families (ACF), the U.S. federal government took little initiative to support DV victims and service providers, most of whom are women, during this time. This qualitative study explores how both this political response and the pandemic in general has impacted the operations of DV organizations, using the city of Nashville, Tennessee as a case study to represent the experiences of the country at large. Interviews conducted with eight DV workers––four from shelters, two from local government, one from a university, and one from a legal association––reveal increased demand for DV services since March 2020 yet decreased organizational capacity to provide. Disparities in victim resource access during the pandemic fall across geographic, racial, and socioeconomic divides, with technological adaptations implemented to accommodate stay-at-home orders lessening geographic barriers to care yet raising obstacles for low-income clients. Disconnect, unpreparedness, low morale, and financial concerns plague all eight organizations, reflecting broader societal patterns of U.S. policymakers disregarding women’s issues vis-à-vis underfunding and under-prioritization of DV services. Analyzed within a feminist political economy framework, participants’ negative opinions on government response indicate structural insufficiency in how the U.S. views, treats, and prevents Violence Against Women (VAW).
  • No Thumbnail Available
    Item
    ANALYZING SOCIAL MEDIA NARRATIVES OF MATERNAL MORTALITY
    (2021) Joshua, Kaitlin
    The purpose of this study was to investigate agenda-setting activity relevant to maternal mortality by using social media data. The study ultimately sought to determine what subset(s) of social media users dominate conversations of maternal mortality online, and did so by interrogating (1) who discusses maternal mortality online and (2) what narratives of maternal mortality are present among their conversations. To address my research objectives, I utilized the marketing software Brandwatch to amass a database of relevant tweets authored within the past two years, using key phrases and hashtags to isolate data relevant to the American maternal mortality crisis. In my analysis, I engaged several Brandwatch functions, including demographic comparison tools, world cloud analyses, and topic wheels, as well as my own line-by-line content analysis of some of the most popular tweets. Between December 2019 and January 2021, I found approximately 34,000 relevant tweets, among which “women,” “rate,” “health,” and “healthcare” were the most-used words. Ultimately, my findings indicate that a particular narrative’s popularity was significantly associated with the professional affiliations of frequent and/or influential posters. They also indicate that maternal mortality is often framed as being one of several “measuring stick” issues meant to denote a certain set of political, or even moral, beliefs and/or affiliations. This research has implications not only for politicians who may wish to communicate about health issues with their constituents using social media platforms, but also for any organizations, activists, advocates, or unaffiliated individuals who wish to influence health-related discussions online.
  • No Thumbnail Available
    Item
    Punishment and the Body: The COVID-19 Pandemic in Incarcerated Populations
    (2021) Fahhoum, Madelyn
    This study traces the history of punishment and prison healthcare in the United States from public execution and torture in the town square to formal incarceration as we know it now. Through exploration of the most recent scholarship and inmate narratives, this thesis argues that although nominally the mode of punishment has shifted from harming the body to reforming the soul, prison today still affects a physical hold on the incarcerated body. In the ongoing COVID-19 pandemic, this physical hold on the incarcerated body manifests itself as an increased risk of contracting communicable disease when comparing prison health metrics with those of the general population. With the specific goal of exploring the how the design and administration of prison healthcare delivery detriments the health of inmates, this study aims to illuminate preventable patterns of excess morbidity and mortality from communicable diseases in prison.
  • No Thumbnail Available
    Item
    Controversy Over the Diagnosis and Treatment of Hypothyroidism
    (2021-04) Schwartz, Lana
    This study surveys clinicians’ hypothyroidism diagnosis and treatment practices and their opinions on current diagnostic standards. By distributing a redcap survey, the study ascertained whether practicing clinicians disagree with each other, where they stand on the debate over appropriate standards, and which standards they apply in practice. The survey garnered participants’ opinions on seven primary aspects of hypothyroidism: organizations’ differing recommendations, arguments for changing the standards, which thyroid hormones are worth testing, which ranges of thyroid hormones are appropriate, the psychosocial effects of the condition, their experience with clinical disagreements in practice, and their confidence in current standards. After asking for their opinions on these topics, participants were presented with nine fictional patient cases. Each patient case presented a fictional patient’s age, BMI, thyroid hormone levels, and symptoms. Participants were asked to indicate whether they were “very likely,” “likely,” “moderately,” “unlikely,” or “very unlikely” to diagnose the hypothetical patients. The survey was distributed to 750 healthcare providers, including endocrinologists, GPs, PAs, and NPs that practice in the United States. 48 practitioners responded. The results of the survey indicated that clinicians consistently and drastically disagree over diagnostic and treatment standards for hypothyroidism. Clinicians recommended testing for different hormones, indicated different healthy ranges of hormones, sided with opposing organizations, valued the psychosocial effects of the disease differently, and indicated varying levels of confidence in modern standards. Notably, practitioners’ likelihood of diagnosing and treating the fictional patients varied drastically. Qualitative responses provided the study with reasons for their answers. The qualitative results illustrated the polarizing nature of the disagreements; some practitioners deem clinicians of opposing opinions as committing “malpractice.” In conclusion, current standards are not unambiguous enough to create near-unanimous agreement among clinicians regarding the diagnostic threshold.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    CHARACTERISTICS OF VOCAL INTERACTIONS BETWEEN PARENTS AND CHILDREN WITH AUTISM SPECTRUM DISORDER IN RELATION TO HIERARCHICAL TEMPORAL CLUSTERING
    (2021-04) Zhang, Yumeng
    The current study explores the vocal interactions of parents and children with and without Autism Spectrum Disorder (ASD) through a novel measure of hierarchical acoustic clustering in order to better understand the specific characteristics of parent and child speech that differ within ASD communication. Interactions between the parent and child were video-recorded and coded for the frequency and timing of parent and child vocalizations. To measure hierarchical temporal clustering, audio recordings of the dyadic interactions were analyzed across twelve timescales ranging approximately from the phoneme-level scale to the phrase-level scale and quantified using Allan Factor (AF) variances. There were three main findings of the study. First, significant relationships were found between frequency of interpersonal turns and ASD toddler language and developmental assessment scores. Second, ASD dyads exhibited significantly greater hierarchical temporal clustering compared to TD dyads. Third, the vocal characteristics which most correlated with hierarchical clustering in ASD dyads were frequency of total vocalizations and turn-taking, particularly when considering total interpersonal turns and total turns. These findings call attention to the importance of turn-taking in communication, and the reduced quality of turn-taking in interactions of parents and children with ASD.
  • No Thumbnail Available
    Item
    Cervical Cancer Screenings in Sexual and Gender Minority Individuals: Evidence from the Behavioral Risk Factor Surveillance System, 2018-2019
    (2021-04) Mosca, Lindsay
    Background: The rate of new cervical cancer cases and cervical cancer deaths in the United States has declined in the last fifty years due to the widespread use of cervical cancer screenings known as Papanicolaou (Pap) tests. Sexual minority women, or women who identify as lesbian, bisexual, queer or otherwise have sex with women, may be less likely to receive Pap test screenings than heterosexual women. Other studies that have been conducted on sexual minority women do not consider the intersection of sexual orientation and gender identity. This study examined sexual orientation disparities in Pap test screenings among cisgender women as well as individuals assigned female at birth with a cervix who identify as transgender (female-to-male, FTM), or gender nonconforming. Methods: This study used data on adults aged 18-64 years who self-responded that their sex assigned at birth was female (n = 147,840) from the 2018 and 2019 Behavioral Risk Factor Surveillance Survey. We used descriptive statistics and logistic regression models to examine the associations between sexual orientation and Pap test use in the previous three years. All analyses were conducted in Stata. Results: Individuals who reported that their sex at birth was female and identified as gay or lesbian were less likely to have had a Pap test in the last three years compared to heterosexual individuals (OR, 0.75; 95% CI, 0.55-0.99). Individuals who responded “something else” when asked about their sexual orientation were less likely to have had a Pap test in the last three years compared to heterosexual individuals (OR, 0.67; 95% CI, 0.48-0.83). Transgender (FTM) individuals were less likely to have received a Pap test in the last three years compared to cisgender women (OR, 0.55; 95% CI, 0.31-0.98). Gender non-conforming individuals were also less likely than non-transgender individuals to have received a Pap test in the last three years, but these results were not significant (OR, 0.90; 95% CI, 0.45-1.82 for gender non-conforming). Conclusions/Implications: All individuals with a cervix are at risk of cervical cancer, regardless of their sexual orientation or gender identity. Sexual orientation and gender identity disparities in sexual and reproductive health services demonstrate a need to reconsider the way in which these services are provided. Our study found that some SGM individuals were less likely to be compliant in Pap test screenings than non-SGM individuals. Further research should be done to conclude the impact of sexual orientation and gender identity on Pap test screening compliance.
  • No Thumbnail Available
    Item
    MANIFESTATIONS OF THE CONTEMPORARY “CLINCAL GAZE” IN HISPANIC TYPE 2 DIABETES MELLITUS TREATMENT
    (2021-04) Carlson, Caroline
    Type 2 diabetes mellitus (type 2 diabetes) varies significantly in prevalence and morbidity among minority groups in the U.S. (“Prevalence of Diagnosed Diabetes” 2020). In particular, individuals considered to be of Hispanic origin are highlighted by institutions such as the CDC as being at increased risk for developing type 2 diabetes (“Diabetes Risk Factors” n.d.). Health care providers play an important role in treating and preventing chronic illnesses like diabetes; however, a growing body of evidence in medical anthropology suggests that the “culture of biomedicine” contributes to the development of health disparities and the maintenance of racial bias and stigma in institutional settings (Kleinman and Benson 2006, Wailoo 2001). Utilizing qualitative evidence from semi-structured interviews with nurses, physicians, endocrinologists, and diabetes researchers, the following study characterizes the contemporary “clinical gaze” toward Hispanic type 2 diabetes patients and how this manifests in providers’ considerations of genetic predispositions, blame, and culture. Interviews with providers suggest a technoscientific quality of U.S. medicine that shapes providers to place significant value on scientific knowledge and language, while concomitantly differentiating themselves from their diverse and socially complex patients.