Digital Commons Network^™

Protecting Participants In Genomic Research: Understanding The "Web Of Protections" Afforded By Federal And State Law, Leslie E. Wolf, Catherine M. Hammack, Erin Fuse Brown, Kathleen M. Brelsford, Laura M. Beskow

Law Faculty Scholarship

Advances in genomic research increasingly rely on large-scale datasets combining biospecimens, electronic health records, and behavioral data. This article examines the complex legal framework governing privacy and confidentiality protections for participants in genomic research in the United States. Through a combination of qualitative interviews with national thought leaders and systematic legal analysis of federal and state statutes, the authors assess how existing legal protections operate in practice. The study evaluates several hypothetical research scenarios—including the return of individual results, data breaches, and legal demands for data access—to illustrate how laws such as the Common Rule, HIPAA, the Genetic Information Nondiscrimination …

Expert Perspectives On Oversight For Unregulated Mhealth Research: Empirical Data And Commentary, Laura M. Beskow, Catherine Hammack-Aviran, Kathleen M. Brelsford, P Pearl O'Rourke

Law Faculty Scholarship

This study explores expert perspectives on oversight mechanisms for unregulated mobile health (mHealth) research conducted outside traditional regulatory frameworks. Through qualitative interviews with stakeholders including patient advocates, researchers, regulators, and technology developers, the authors examine concerns surrounding ethical protections in research utilizing data from mobile applications and devices. Participants highlighted risks associated with inadequate study design, lack of informed consent, and insufficient safeguards for participant privacy and autonomy. Experts proposed a range of potential oversight mechanisms, including voluntary ethical review processes, industry standards, and expanded institutional policies. The findings underscore the growing ethical challenges posed by nontraditional research environments and …

"It’S Just A Bad Period" And Other Ways Of Dismissing Women's Pain: An Ethnographic Look Into The Experience Of Endometriosis, Selina Hays

Honors Undergraduate Theses

This thesis uses online ethnographic methods to analyze the impact of patriarchal values on the illness experiences of women with endometriosis. Current literature suggests that negative impact on patients with endometriosis with regard to cultural discourse surrounding menstruation and chronic illness. Utilizing a combination of critical discourse analysis and constructivist grounded theory, the results of this research demonstrate that patients engage in a form of performance that is reactive to normalization and dismissal of pain by doctors and wider social support due in part to cultural stigmas of menstruation and chronic pain, as well as the inherent power imbalance in …

Understanding The Responder Experience: Trauma, Peer Support And Resilience, Diane L. Downie

Graduate Research Theses & Dissertations

The purpose of this study was to understand the public health responder experience, especially related to managing deployment-related trauma in public health responders who were deployed to the Ebola Outbreak Response in West Africa (2014–2016). This study used a semi structured interview design grounded in the literature of peer support, trauma, and resilience with analysis and coding of the interview data led by emerging themes. In this study, public health responders perceived aspects of their shared organization and peer relationships as helpful when encountering difficult situations during deployment. The unique bond shared among responders may reduce responder stress and promote …

Modulation Of Parasympathetic Reactivation Post-Exercise Via Slow Breathing, Brent Burg

CSB and SJU Distinguished Thesis

During exercise sympathetic nervous activity increases and parasympathetic nervous activity decreases to fuel energy demands. Heart rate variability (HRV) indicates activity of the autonomic nervous system and the balance of its two branches. Slow breathing (SB) (6 breaths/minute) increases parasympathetic activity both spontaneously during practice and at rest after long-term practice. Thus, SB may increase parasympathetic activity after exercise. PURPOSE: This study aimed to determine whether post-exercise SB increases parasympathetic activity as measured by HRV. METHODS: Ten recreationally active college aged males (21 +/-1 years old) completed the study. A VO2max test was used to determine 70% of VO2max for …

Development Of Natural Language Processing Algorithm For Dental Charting, Yi-Fan Zhang

All ETDs from UAB

Purpose: The purpose was to develop a natural language processing algorithm, which will input data from oral examination transcripts to a structured database. Methods: Four case vignettes were produced for primary, mixed, and permanent dentition patients with varying degree of soft tissue pathology, caries, existing restorations and occlusion relationships. After calibration, dental students were instructed to perform simulated oral examinations based on the case vignettes, using natural language as they would to an assistant who was charting the case. The investigator transcribed the audio recordings of the simulated oral exams. Twenty simulated oral examinations were collected to develop a natural …

The Needs At 48 Hours Of Immediate Family Members Of Patients Admitted To The Intensive Care Unit At The Aga Khan University Hospital, Nairobi, Maalim Fahad

Master of Medicine in Anaesthesiology

Background: Family members of patients admitted to Intensive Care Unit (ICU) have been shown to have important needs. Inability of the critical personnel to interrelate appropriately with relatives of critically unwell patients, or to recognize or meet their needs, may lead to increased anxiety, misconception and distrust from relatives. Aim: To determine the needs of immediate family members of adult patients admitted to ICU at 48 hours at the Aga Khan University Hospital, Nairobi. Methods: This was a cross-sectional descriptive study. The Critical Care Family Needs Inventory questionnaire was employed to identify the needs of the immediate relatives of adult …

Preparing Future Health Care Workers: An Assessment Of Undergraduate Student Integrative Pre-Health Education, Haley Bevza Brennan, Pamela Erickson

Undergraduate Papers

This paper analyzes the current state of, and demand for, integrative pre-health education in the undergraduate setting, specifically at the University of Connecticut. Students’ knowledge of, exposure to, and attitudes towards complementary and alternative medicine (CAM) are assessed through a web-based survey and semi-structured interviews. This paper compares this research with surveys conducted in undergraduate, medical school, and medical professional settings to gauge current efforts to provide a more holistic approach to educating health care workers in subjects such as mind-body therapies, lifestyle contributors to health such as diet and exercise, culturally competent care, and therapeutic techniques outside of the …

Healthcare Organizational Design Strategies To Improve Performance, Katherine Madonna Chubbs

Walden Dissertations and Doctoral Studies

Business leaders are exploring ways to improve organizational performance through organizational design, including reviewing the structures of their organization. Grounded in McKinsey’s 7S framework, the purpose of this qualitative single case study was to explore organizational design strategies healthcare leaders used to improve organization performance. Participants were 6 leaders within a healthcare organization in Alberta, Canada, who successfully developed and implemented organizational design strategies to improve organizational performance. The data collection techniques included a review of internal and external documents, a reflective journal, and semistructured interviews. I used methodological triangulation and thematic analysis to complete the data analysis. The data …

Mothers’ And Community Stakeholders’ Perspectives About The Vitamin A Supplementation Program In Nigeria, Olufolakemi Mercy Anjorin

Walden Dissertations and Doctoral Studies

Vitamin A deficiency (VAD) affects about one third of children under the age of five in Nigeria. There is low uptake of biannual Vitamin A supplementation (VAS) used since year 2010 as the national response to addressing VAD among children 6 to 59 months. Yet, there is limited research on barriers or facilitators to uptake of VAS. The purpose of this study was to examine the perspectives of stakeholders about the VAS program in Nigeria. The theoretical underpinning was the social marketing framework. The central question related to the views of stakeholders toward the VAS program, and their perception about …

Systematic Review Of Falls Among Older Individuals In The Long- Term Care Settings, Nonyelum Patience Odenigbo

Walden Dissertations and Doctoral Studies

Falls are common in the older population and can result in disability, increased dependence, or mortality. Falls have received increased attention in the literature as the most common cause of injuries among older individuals. The incidence of falls in the older population has a positive correlation with adverse health issues necessitating major lifestyle adjustments. The problem is magnified for older patients in long-term care settings where they are 3 times more susceptible to falls. The purpose of this project study was to conduct a systematic review of the literature to understand the impact and incidence of fall rates among older …

Readiness Of Stakeholders To Adopt Community Paramedicine Programs In Tennessee, Roger Lloyd Ritchie

Walden Dissertations and Doctoral Studies

Abstract

Community paramedicine is an emerging model of care that promulgates EMS in a more community-based and integrated role within the broader health care system. A hallmark characteristic of community paramedicine is that programs are designed to meet the specific needs of a given community, rendering programs unique but perplexing. A need for research aimed at exploring possible barriers that may impede the adoption and implementation of community paramedicine programs has been identified by the National EMS Advisory Board, the North Central EMS Institute, and the Joint Committee on Rural Emergency Care. The purpose of this study was to explore …

Analysis Of The Impact Of Family Structure And Type 2 Diabetes Among Adolescents, Danny Lee Self

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2D) has increased among the adolescent population in the United States within the past 30 years. While the increase in T2D is linked to obesity and a lack of physical activity, it lacks contextual analysis within the structure of the non-traditional family unit. The purpose of this quantitative study was to examine family structure and prevalence of T2D among adolescents. Krieger’s ecosocial theory guided the study. The research questions were designed to investigate whether family structure directly impacts T2D prevalence or indirectly through socioeconomic status. The research design was quantitative with cross-sectional analysis of secondary data. The …

Statistical Shape Analysis Of Hand And Wrist In Paediatric Population On Radiographs, Ural Koç, İlker Ercan, Senem Özdemi̇r, Semi̇h Bolu, Ayşegül Yabaci, Onur Taydaş

Turkish Journal of Medical Sciences

Background/aim: The goal of this study was to compare differences in hand and wrist shapes and to evaluate these according to growth and allometry in children on radiographs related to bone age.Materials and methods: The study included 263 males and 189 females. A total of 452 left hand and wrist radiographs were retrospectively collected. Standard anatomical landmarks marked on radiographs.Results: There were seen to be significant differences in comparisons of hand and wrist shapes according to sex (P = 0.009). The most suitable model in the growth models was seen as the Gompertz growth model for both females and males …

Changing The Subject Of Sati, Deepa Das Acevedo

Faculty Articles

Charan Shah's 1999 death was widely considered to be the first sati, or widow immolation, to have occurred in India in over twenty years. Media coverage of the event focused on procedural minutiae-her sari, her demeanor-and ultimately, several progressive commentators came to the counterintuitive conclusion that the ritually anomalous nature of Charan's death confirmed its voluntary, secular, and noncriminal nature. This article argues that the "unlabeling" of Charan's death, like those of other women between 1999 and 2006, reflects a tension between the nonindividuated, impervious model of personhood exemplified by sati and the particularized citizen-subject of liberal-democratic politics in India.

Essentializing Labor Before, During, And After The Coronavirus Pandemic, Deepa Das Acevedo

Faculty Articles

In the era of COVID-19, the term essential labor has become part of our daily lexicon. Between March and May 2020, essential labor was not just the only kind of paid labor occurring across most of the United States; it was also, many argued, the only thing preventing utter economic and humanitarian collapse. As a result of this sudden significance, legal scholars, workers’ advocates, and politicians have scrambled to articulate exactly what makes essential labor “essential.” Some commentators have also argued that the rise of essential labor as a conceptual category disrupts—or should disrupt—longstanding patterns in the way the nation …

An Analysis Of The Association Between Adverse Childhood Experiences And Food Insecurity Within The United States, Margaret Brooks

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Adverse childhood experiences and food insecurity are significant public health issues within the United States. Previous studies have established the overall relationship between ACEs and food insecurity. This research investigates the statistical relationship between individual ACE indicators and food insecurity as well as the relationship between having two or more ACEs and food insecurity.

Connecting Communities To Primary Care: A Qualitative Study On The Roles, Motivations And Lived Experiences Of Community Health Workers In The Philippines, Eunice Mallari, Gideon Lasco, Don Jervis Sayman, Arianna Maever L. Amit, Dina Balabanova, Martin Mckee, Jhaki Mendoza, Lia M. Palileo-Villanueva, Alicia Renedo, Maureen L. Seguin, Benjamin Palafox

Development Studies Faculty Publications

Background

Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines.

Methods

This cross-sectional qualitative study draws on 23 semi-structured interviews held …

Low Carbohydrate Ketogenic Diet Versus Aerobic Physical Activity In The Management And Treatment Of Type 2 Diabetes: A Review Paper, Nicole Weis

Capstone Showcase

Introduction: In recent decades, the number of people affected by type 2 diabetes mellitus has been a topic of interest. The wide reaching impact on both, individual and societal, healthcare costs and quality measures, begs for attention and interventions. Lifestyle modifications, such as: weight management or loss, increasing physical activity, and making healthier dietary choices, are the first line intervention. However, there are not studies that directly compare the role of a single dietary approach to a form of physical activity. Rather, different diets go head to head as well as aerobic versus resistance training. Therefore, in an attempt to …

The Path To Pregnancy: Fertility Services And Assisted Reproductive Technologies, Olivia H. Gilbert

Scripps Senior Theses

The emergence of reproductive assistance like fertility treatments and assisted reproductive technologies (ART) in recent decades have provided new paths to pregnancy for many individuals. However, certain demographics in the US like low-income women and women of color are often excluded from utilizing these services on the basis of race, geography, and socioeconomic status. This in turn leads to significant disparities in access to and usage rates of such services. This research points out the perceived shortcomings in the current academic discussion surrounding fertility service disparities with the ultimate goal of expanding access to fertility assistance services for those who …

If At Least The Patient Could Not Be Forgotten About: Communication In The Emergency Department As A Predictor Of Patient Satisfaction, Seiichi Villalona, W. Alex Webb, Carol Boxtha, Cirenio Cervantes, Jason Wilson

College of Medicine & TGH Faculty Publications

Press Ganey survey data are used by institutions to understand patient experiences in the emergency department (ED). The present mixed-methods retrospective cohort study examined the effects of hallway placement, pain management reporting, communication approaches, time spent in the ED, and other demographic variables on predicting satisfaction ratings of doctors, nurses, and overall ED care. A total of 4940 patient responses between January 1, 2012, and December 31, 2017, were analyzed from 2 EDs associated with an academic institution and tertiary care center. Consensus coding was used to qualitatively capture patient responses that relate to communication issues pertaining to care/empathy and …

The Extent To Which A Professional Development Program Can Support Caring Nursing Practice In Western Australian Hospitals, Tonia Naylor

Theses

Continuous professional development (CPD) has been purported to be able to enhance and support caring nursing practice; however, the relationship has never been studied in Western Australia. CPD is used in Australia as an overarching term. It includes three types of study leave; accredited courses, training with defence force reserves, and professional development (PD). The aim of this study was to determine the extent to which a professional development program can support caring nursing practice in Western Australian (WA) hospitals.

A PD program consisting of a one-day Master Class (MC) on caring nursing practice with additional and optional on-line reflective …

Trajectories Of Hiv-Related Internalized Stigma And Disclosure Concerns Among Art Initiators And Non-Initiators In South Africa, Brian T. Chan, Brendan G. Maughan-Brown, Laura M. Bogart, Valerie A. Earnshaw, Gugulethu Tshabalala, Ingrid Courtney, Janan J. Dietrich, Catherine Orrell, Glenda Gray, David R. Bangsberg, Alexander C. Tsai, Ingrid T. Katz

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV-related stigma among people living with HIV (PLHIV) is associated with worse health outcomes. We used longitudinal data from a multisite cohort in South Africa to assess changes over time in stigma after HIV diagnosis and determine whether antiretroviral therapy (ART) initiation is associated with stigma reduction. We administered the Internalized AIDS-Related Stigma Scale (IARSS, a six-item dichotomous scale questionnaire) at baseline, 3 months, and 6 months to newly diagnosed ART-eligible participants between 2014 and 2015. A confirmatory factor analysis indicated that the IARSS contained a four-item internalized stigma factor (α = .80) and a two-item disclosure concerns factor (α …

A Sexual Health Promotion App For Transgender Women (Trans Women Connected): Development And Usability Study, Christina J. Sun, Kirsten M. Anderson, Tamara Kuhn, Liat Tzvia Mayer, Charles H. Klein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: HIV severely impacts the transgender communities in the United States, and transgender women have the highest HIV incidence rates among any identified risk group. Guided by formative research with transgender women and by an expert advisory panel of transgender women, we designed a prototype mobile app to promote HIV prevention among transgender women.

Objective: This study aimed to develop and test the usability and acceptability of the prototype Trans Women Connected mobile app.

Methods: We engaged in a 3-phase prototype development process. After conducting formative research about the health needs of this population, we outlined a theory-based app framework …

Assessing Methods For Estimating Biological Sex From Subadult Skeletal Elements, Dorota Zabnicka

Cal Poly Humboldt theses and projects

While methods for estimating the sex of adult skeletons are relatively accurate, these methods are often inconclusive when applied to subadults (non-adults), especially when many secondary sexual characteristics have not fully developed. Furthermore, existing methods for subadults are often tested on samples with relatively homogenous ancestries, calling into question their reliability in more diverse populations. This thesis reviewed techniques for estimating sex in subadult skeletal remains, and the most promising methods were retested on individuals of known sex between ages 3 and 17 years (n=39, 14 males, 25 females) from the Hamann-Todd Osteological Collection. Data collection included measurements of the …

Hispanic Nursing Students’ Perspectives On Student-Clinical Instructor Relationships And Learning, Inela Brito

Walden Dissertations and Doctoral Studies

Non-Hispanic students are more likely to be successful in their nursing school studies than Hispanic students. Facilitators and barriers to classroom success for Hispanic students has been studied; however, few studies have addressed the academic clinical experience and the clinical instructor’s role in Hispanic students’ success. The purpose of this descriptive phenomenological study was to explore the perspectives of undergraduate senior Hispanic nursing students regarding how student-instructor interactions in the clinical setting influenced students’ ability to learn and succeed in completing their studies. The research questions were guided by an adapted institutional support model and were used to explore how …

Use Of Managerial Epidemiology By Healthcare Leaders In Ambulatory Settings, Chantelle Schenning

Walden Dissertations and Doctoral Studies

Despite many health reforms, the United States continues to struggle with limited healthcare access, exponential healthcare costs, and poor quality of care. Overcoming these challenges requires healthcare leaders’ effective navigation of industry transformation towards population health and a shift in patient volume to ambulatory healthcare settings. Research has demonstrated that the use of managerial epidemiology, an application of epidemiology tools and principles to management decision-making within healthcare organizations, can better serve the health of the population and could improve the triple aim of inadequate access, high costs, and poor quality. However, the adoption of this practice is weak and its …

Shifting The Gaze Of The Physician From The Body To The Body In A Place: A Qualitative Analysis Of A Community-Based Photovoice Approach To Teaching Place-Health Concepts To Medical Students, Lauri Andress, Matthew P. Purtill

Faculty & Staff Scholarship

Medical practitioners, trained to isolate health within and upon the body of the individual, are now challenged to negotiate research and population health theories that link health status to geographic location as evidence suggests a connection between place and health. This paper builds an integrated place-health model and structural competency analytical framework with nine domains and four levels of proficiency that is utilized to assess a community-based photovoice project’s ability to shift the practice of medicine by medical students from the surface of the body to the body within a place. Analysis of the medical student’s photovoice data demonstrated that …

The Subject-Centered Integrative Learning Model: A New Model For Teaching Occupational Therapy’S Distinct Value, Barb Hooper, Matthew Molineux, Wendy Wood

Journal of Occupational Therapy Education

The concept of occupation-centered education has been used to describe what programs do when they infuse occupation throughout an occupational therapy curriculum. In describing occupation-centered education, educators often describe the strategies they use to help students learn occupation, including courses about occupation, direct experience with occupation, cases and questions that connect biomedical sciences and health conditions to occupation, assignments that require students to infuse occupation into therapy, curriculum threads related to occupation, and many others. While each of these strategies is important, no conceptual model exists that defines occupation-centered education, elaborates its concepts and principles, and guides the development of …

An International Fieldwork Placement: A Mixed Methods Study, Dianna Lunsford, Kristin A. Valdes

Journal of Occupational Therapy Education

The purpose of this study was to evaluate the impact of an international fieldwork placement on occupational therapy doctoral (OTD) students’ cultural competence, community engagement, and ethical leadership. This study used a mixed methods approach. The Public Affairs Scale (PAS) was used to gather pre and post placement data on cultural competence, community engagement, and ethical leadership. Qualitative data was themed from a reflection paper along with researcher field notes from a fieldwork placement to Ibarra, Ecuador. Eleven OTD students participated in the study. The study demonstrated a convergence of the data in the area of cultural competence and responsiveness. …