The homeless population in Anchorage, Alaska faces many unique challenges. Over the past several winters, a number of homeless individuals have succumbed to the effects of exposure despite available cold weather services. This study investigated individual experiences within the homeless population of Anchorage, Alaska during times of inclement winter weather. Self-determination theory was used to explore motivations of behaviors of the population and to uncover the reasons why this population does not use cold weather services offered by the Municipality of Anchorage. The research questions addressed participant awareness of available cold weather services, survival strategies during inclement winter weather, and barriers to cold weather service use. This phenomenological study examined those lived experiences. Purposeful sampling was used to recruit eligible individuals (n = 14) at a local soup kitchen, and participants engaged in semistructured interviews. Data analysis procedures used McCormack's lenses and horizontalization to reveal emerging themes. Key findings included a lack of knowledge of emergency services, various survival strategies, and self-imposed barriers to services. The implications of these emerging revelations may positively influence public health providers to modify education delivery methods and interventions used to reach the homeless population in Anchorage, Alaska, with the ultimate goal of preventing wintertime mortalities.

Environmental Justice is an issue that has been relevant in the mind of the federal government for the past 18 years. Within society, the goal of Environmental Justice looks to prevent the exploitation of vulnerable populations through the siting of environmentally hazardous sites. Instead of over burdening specific vulnerable populations, fair distribution of hazards throughout the population is desired. Although there is a large body of research that study the location and impact of hazardous sites on the surrounding communities, there are few existing models which look to locate vulnerable populations through the use of quantitative data. Of the existing models none implement an intensity scaling method based upon the percent of the population that exist within certain study area dependent thresholds. The purpose of this study is to develop a multi level index that examines a study area based upon intensity scaling of census data as well as hazard siting proximity analysis. A gap in the current literature is filled by the creation of the index and introduction of intensity scaling. The final output of the index presents a method that is modular allowing for the application of each level of the index to be applied individual of the other level. The index can be used to support and facilitate decision making performed by local, state, or federal agencies, to prevent the over burdening of a community. A second use is as a predictive model, providing a base upon which a better understanding of the local impacts of future siting and/or removal of a hazardous site can be evaluated. A final use of this index is as a foundation upon which future research can be conducted, providing an environmental justice understanding of a region, allowing for targeted research to be performed.

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A particularly unhealthy and high-risk group of individuals at the intersection of the criminal justice and public health systems often cycle between arrest, jail, prison, public hospitals, emergency departments, homeless shelters, and similar institutions over time. This population, while relatively small, represents disproportionate public spending and complex, multidimensional needs. The overarching goal of the current study is to gain a deeper understanding of the patterns and dimensions of frequent cross-system involvement, or repeat cycling between the criminal justice and public health systems. Specifically, the overlap of arrest by police and contact with the ED was examined. A secondary goal was to illuminate what factors work together to encourage or differentiate between various patterns of cross-system cycling. Group-based trajectory modeling was used to determine patterns of arrest and ED contact among adults that accessed these systems in Camden, NJ between 2010 and 2014. These groups were then brought together to determine patterns of cross-system involvement with a focus on patterns representative of frequent cycling between arrest and the ED. These joint groups were then described in detail using descriptive and predictive methods. By comparing across different patterns of frequent cycling, it is clear that cross-system involved individual do not represent a homogenous group; nor is mental illness and substance abuse the only factors driving this overlap. The most frequent joint trajectory groups exhibited significantly more ED visits to address injuries including skull-related injuries, chronic physical health conditions, dental and skin issues, anxiety, depression, suicide attempts, substance abuse and co- and multimorbidity measured as chronic conditions experienced with behavioral health concerns and drug/alcohol abuse. Arrests for disorderly, drug and prostitution offenses were also significantly more prevalent among frequent cross-system cyclers when compared to groups with fewer system contacts. Many of these same factors were also more prevalent among a subsample of young adults aged 18 in 2010 with repeat contacts with both systems. These steps, together with qualitative interviews with service providers in the Camden community, illuminated important factors associated with more frequent arrest and ED contact. These are important contributions to criminological research as discussion is often restricted to behavioral health and is less often concerned with physical health, co- and multi-morbidity. This is also among the first research studies to dig deeper into specific diagnoses associated with frequent arrest and frequent cross-system cycling, among adults and young adults. Healthcare provider interviews were able to confirm that certain issues like dental and skin conditions, depression, anxiety and suicide attempts/ideation tend to increase in prevalence as system contacts accumulate. These are factors that could be targeted earlier in the lifecourse in order to reduce cross-system cycling – an important form of concentrated disadvantage and vulnerability on which to focus attention and resources. / Criminal Justice

A main challenge in medicine concerns questions of how to integrate the context and values of patient perspectives with general conceptions of illness and treatment. With medicine increasingly focused on patient-centered and individualized care, approaches to medicine must find ways to gain access to and understand the patient in such a way that recognizes her story as real while at the same time maintaining the value of medicine as an objective practice. Adding to this is the reality that under current models of medicine and decision-making in medicine, healthcare disparities persist for persons belonging to marginalized and vulnerable populations, including racial and ethnic minorities, women, and LGBTQ persons, amongst others. I argue that an approach integrative of shared decision-making built upon a phenomenological framework is a good alternative on which to try and understand questions like these and begin to address disparities in healthcare. / Urban Bioethics

In the presence and aftermath of armed conflict and war, there has always been contact between armed troops and civilians ranging from superficial to intimate; and from these contacts children have been born. These children are so-called Children Born of War (CBOW), who are typically fathered by foreign soldiers and born to local mothers. Their existence is a worldwide and timeless, yet widely ignored reality – to the disservice of these children and their communities. German and Austrian Occupation Children (GOC resp. AOC), whom I will investigate in this dissertation, are subgroups of this worldwide population of CBOW and are fathered by a soldier of the allied forces “occupying” Germany and Austria after World War II and born to a German resp. Austrian mother. 74 Several studies have described the hardships these children faced when growing up in postwar Germany and Austria, being born as a child of the enemy and out of wedlock into a defeated and tarnished former National Socialist society, in which losing the war and the regime did not equal losing the National Socialist mindset. Studies already showed that growing up as an occupation child in postwar Germany likely included experiences of discrimination and stigmatization (e.g. Aßmann et al., 2015), as well as heightened risks to be subjected to child maltreatment and to suffer from depression, somatization, PTSD, and long-term attachment issues (Glaesmer et al., 2017; Kaiser et al., 2016, 2015; Kaiser, Kuwert, & Glaesmer, 2015). There have been case-studies and reports from the field of history and social sciences about occupation children voicing problems with identity and identity formation, but systematic, empirical studies covering this topic have been lacking thus far. This dissertation intended to close this gap in literature by systematically investigating identity issues and questions of identity that occupation children face. We applied a mixed-method approach in an effort to gain different types of data and ultimately a better coverage and understanding of these topics.:INTRODUCTION ............................................................................................................................. 4 Historical Background ...................................................................................................... 4 Theoretical Background ................................................................................................... 8 RESEARCH OBJECTIVES ................................................................................................ 14 METHODOLOGY ............................................................................................................. 15 Study Design & Samples .................................................................................................. 15 Instruments ...................................................................................................................... 17 CORE PUBLICATIONS OF THIS DISSERTATION ...................................................... 21 Publication I ..................................................................................................................... 22 Publication II ................................................................................................................... 34 Publication III .................................................................................................................. 47 DISCUSSION ..................................................................................................................... 61 Summary of Findings ....................................................................................................... 61 Strengths and Limitations ................................................................................................. 62 Outlook ........................................................................................................................... 63 REFERENCES ................................................................................................................... 65 APPENDICES .................................................................................................................... 72 1. Abbreviations ............................................................................................................. 72 2. Zusammenfassung der Arbeit ..................................................................................... 73 3. Erklärung über die eigenständige Abfassung der Arbeit .............................................. 77 4. Darstellung des eigenen Beitrags ................................................................................. 78 5. Curriculum Vitae ........................................................................................................ 79 6. Publikationsverzeichnis ............................................................................................... 80 7. Danksagung ................................................................................................................ 81 8. Teilnahmebestätigung „Gute wissenschaftliche Praxis“............................................... 83 9. GOC Questionnaire ................................................................................................... 84