Community Medicine

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Now showing 1 - 6 of 6
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    Guardianship: Ethical Dilemmas and Resources Available in Tarrant County
    (2020) Wilder, Alyssa; Dorton, Cody; Nguyen, Thanh; Caballero, Austin
    Purpose: Guardianship is a legal relationship established by the probate court in which one person is given legal authority over another when they are unable to make safe and sound decisions regarding their person, or property. Here we discuss the local resources for those faced with this ethically challenging dilemma, types of guardianship, and solutions to make guardianship a simpler and less ethically strenuous process on those facing this tough decision. Methods: Data collection from official resources in the Tarrant County area that are available to those struggling with the challenges of gaining or maintaining guardianship. Results: There are a number of resources in the area to help patients struggling with Guardianship and the challenges it presents. However, the resources have many criteria and barriers that may prevent those in need from accessing their expertise. Conclusions: We hope that this information can equip those with a future in healthcare with knowledge of guardianship and its practices in the DFW area.
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    Asthma Care in an Academic Pediatric Primary Care Clinic: An Examination of Asthma Triggers
    (2020) Bui, Priya; Garcia, Joanna; Habiba, Nusrath; Guerra, Alejandro
    Purpose: The prevalence of asthma among pediatric populations is increasing: 8.4% of children (approximately 6.2 million) in the United States have asthma. It is the leading cause of chronic disease in children. It is hoped the implementation of asthma action plans will better help children (and their parents) manage their condition. A primary way in which asthma action plans are believed to assist their patients in understanding their condition is the identification of triggers for each patient's asthma. In pursuit of this goal, a local study of the asthmatic pediatric patient population at the UNTHSC Health Pavilion was carried out; specifically, research into the most prevalent asthma triggers within this population, as well as trigger exposures and disease severity. Methods: In order to craft a questionnaire designed to capture relevant information, PubMed was utilized to research pre-existing asthma action plans and questionnaires in order to create our own questionnaire for use at the Health Pavilion. This questionnaire was then used to attempt to contact 300 pediatric asthma patients currently being seen at the clinic and gather information on their asthma triggers and disease state, with data recorded in RedCap. Results: Data from 107 of these patients was recorded, which demonstrated a predominance of allergy-induced asthma, with exercise- and dust-induced asthma close behind. Conclusions: An emphasis on identifying prevalent asthma triggers can help pediatric patients and their parents better understand their disease. These triggers can also be focused on and worked into action plans in future patient care.
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    Mobilizing medical students to address Refugee's barriers to Healthcare
    (2020) Le, Minh; Nguyen, Alexandra; Murphy, Joshua; Singhal, Juhi; Philip, Timothy
    Texas, a top state for refugee resettlement in the nation, still faces a number of barriers in providing healthcare access to refugees including cost of care, health education, resource navigation, language, and cultural barriers. In 2017, the Refugee Health Initiative (RHI), a student-run clinic at University of North Texas Health Science Center (UNTHSC), was founded to bridge the gap between established healthcare systems and the refugee population in Tarrant county, Texas. Overview of Clinic: The RHI Refugee clinic is currently held at two apartment complexes in Fort Worth that house a large number of refugees. While consulting with overseeing physicians, students run the clinics by gathering histories, conducting physical exams, offering ultrasounds, and educating patients. Services include screenings, disease management, and education. Interpretation is provided by volunteers and remote interpreters through a mobile app. Furthermore, RHI partners with local organizations that provide advertisement, translation, and other resources that are beneficial in providing care. Successes and Challenges: One of the main challenges, among many, is finding translators who can come to the clinics in person. Some successes include being able to conduct regular health screenings for the refugees at these locations and helping connect them to healthcare systems already established. Conclusion: To help bridge the gap between healthcare systems and the refugee population, RHI provides free services directly in their neighborhood, connections with local programs, and lifestyle education. The goal is to expand services, provide vaccinations, and incorporate clinic roles for other health professional students to foster cross-cultural care.
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    Resources for Effective Management of Substance Abuse Disorders In The Tarrant County.
    (2020) Zooper, Sabri; Cassimere, Crystal; Jaoude, Dustin; Walsh, Emerald
    Substance use disorder (SUD) is defined as "the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs." In this particular study, the substances referenced are marijuana, illicit drugs, and certain controlled prescription medications. The purpose of this study is to identify the resources available in Tarrant County for those who suffer from substance abuse as well as the barriers they have in accessing these resources. For many individuals' suffering from SUD in Tarrant County, there are numerous obstacles faced including socioeconomic challenges, environmental impacts, psychosocial influence and comorbidities associated with other mental disorders. Through literature and website review, six resources were identified, all with onsite services of different varieties. It was conclusively found that there are significant gaps in the preventative measures taken against SUD in the Tarrant County area. Additionally, due to the community impact of SUD, there are several challenges in addressing the barriers of accessing effective treatment, including cost and difficulty of chronic disease management. In turn, this leads to increased premiums for health care plans and higher burdens on hospitals and clinics in Tarrant County. Collectively, these negative prospects lend to a very high incentive to create an efficient system in which SUDs may be properly managed and prevented. While Tarrant County has some available services that are outlined in this study, there are specific areas which necessitate improvement in order to achieve an ideal patient outcome and prime community health from a local perspective and a more broad, national scope.
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    Effects of Political Ideology on Rates of Infant Mortality
    (2020) Choi, Won Seok; Sam, Erin; Ka, Aminata
    Background and Objectives: Infant mortality is a large indicator of a nation's health and maternal health outcomes. Prior studies investigated race, education, income, smoking, and the percentage of women legislators as essential factors contributing to infant mortality. We conjecture that state-level political ideology contributes to infant mortality through maternal healthcare policies and funding. Methods: We used the Centers for Disease Control and the US Census Bureau to examine the marginal effect of political ideology on infant mortality. We employed the African American population, Hispanic population, income, smoking rate, maternal education, and percentage of women legislators to control various relative risks following previous studies. The sample covers 11 years of state-level data: 2006 and 2016. We used state-level presidential election results as a proxy for political ideology. We obtained 27 days and 365 days of mortality to investigate the relationship between political ideology and infant mortality. We used various regression analyses, such as OLS, WLS, and 2SLS. Results: All regression analysis results indicate that state-level political ideology has a negative marginal effect on infant mortality, and are all statistically significant. Between the two mortality measures, the effect is stronger with a mortality of 365 days. All control variables are consistent with previous studies. Conclusion: These empirical results suggest that democratic preference contributes to lower infant mortality. We believe a democratic state is more likely to be supportive of maternal-child health. Thus, the marginal effect of political ideology is stronger with the 365 days of infant mortality.
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    Does substance use differ by veteran status in young adult males ages 18-44?
    (2020) Potter, Aaron; Springfield, Kathryn; Korth, Brigette; Bowser, Paige
    Introduction: There are conflicting findings regarding differences in prevalence of substance use (tobacco/alcohol) between veteran and nonveteran males. The purpose of this study was to assess whether substance use differs by veteran status in young adult males in the general population. Methods: This was a cross sectional analysis that used the 2017 data from BRFSS for veteran and nonveteran males ages 18-44 from California, Florida, North Carolina, Texas, and Washington. Ordered logistic analysis by state was conducted to assess the relationship between veteran status and substance use after controlling for demographic, socioeconomic, and health-related factors. Results: For males ages 18-44, more than one-third of participants reported no alcohol use and around one-fourth reported excessive alcohol use. The majority of participants reported never using tobacco and around one-fifth reported current tobacco use. The results of adjusted analysis indicated that substance use wasn't significantly related to veteran status across states. However, tobacco use was significantly related to general health, mental health, and health conditions and alcohol use was significantly related to mental health status across states. Conclusion: Overall, substance use did not differ by veteran status. Therefore, practitioners should continue screening for substance use in young adult males ages 18-44, regardless of veteran status. Education about the potential harm and health risks of substance use should be provided. Additionally, if signs of either alcohol misuse or smoking are present, providers should provide resources for both and referrals for alcohol misuse treatment programs and/or smoking cessation.