Digital Commons Network^™

The Growth And Need For Veterans Treatment Courts, Chad Lennon

Touro Law Review

No abstract provided.

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 …

Mobile Health Technologies May Be Acceptable Tools For Providing Social Support To Tuberculosis Patients In Rural Uganda: A Parallel Mixed-Method Study, Angella Musiimenta, Wilson Tumuhimbise, Esther Atukunda, Aaron T. Mugaba, Conrad Muzoora, Mari Armstrong-Hough, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background. Social support has been shown to mitigate social barriers to medication adherence and improve tuberculosis (TB) treatment success rates. The use of mobile technology to activate social support systems among TB patients, however, has not been well explored. Moreover, studies that tie supportive SMS (Short Message Service) texts to electronic monitoring of TB medication adherence are lacking.

Objective. To explore TB patients’ current access to social support and perceptions of utilizing real-time adherence monitoring interventions to support medication adherence. Methods. We purposively selected TB patients who owned phones, had been taking TB medications for ≥1 month, were receiving their …

Hiv Care Continuum Characteristics Among People With Opioid Use Disorder And Hiv In Vietnam: Baseline Results From The Bravo Study, Caroline King, Le Minh Giang, Gavin Bart, Lynn Elizabeth Kunkel, P. Todd Korthuis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Little is known about patient characteristics that contribute to initiating antiretroviral therapy (ART) and achieving viral suppression among HIV people with opioid use disorder in Vietnam. The primary objective of this analysis was to evaluate associations between participant characteristics and the critical steps in the HIV care continuum of ART initiation and HIV viral suppression among people with opioid use disorder and HIV in Vietnam.

Methods

We assessed baseline participant characteristics, ART status, and HIV viral suppression (HIV RNA PCR < 200 copies/mL) enrolled in a clinical trial of HIV clinic-based buprenorphine versus referral for methadone among people with opioid use disorder in Vietnam. We developed logistic regression models to identify characteristics associated with ART status and HIV viral suppression.

Results

Among 283 study participants, 191 (67.5%) were prescribed ART at baseline, and 168 of those on ART (90%) …

Tracking Multimorbidity Changes In Diverse Racial/Ethnic Populations Over Time: Issues And Considerations, Ana R. Quiñones, Heather G. Allore, Anda Botoseneanu, Jason T. Newsom, Corey L. Nagel, David A. Dorr

OHSU-PSU School of Public Health Faculty Publications and Presentations

Multimorbidity is widely recognized as having adverse effects on health and wellbeing and may threaten the ability of older adults to live independently. Much of what is known about multimorbidity rests on research that has largely focused on one point in time, or from a static perspective. Given that there remains a lack of agreement in the field on how to standardize multimorbidity definitions and measurement, it is not surprising that analyzing and predicting multimorbidity development, progression over time, and its impact are still largely unaddressed. As a result, there are important gaps and challenges to measuring and studying multimorbidity …

Association Of A Multisite Interprofessional Education Initiative With Quality Of Primary Care, Samuel T. Edwards, Elizabeth Hooker, Rebecca Brienza, Bridget O’Brien, Hyunjee Kim, Stuart Gilman, Nancy Harada, Lillian Gelberg, Sarah Shull, Meike Niederhausen, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance Studies have shown that interprofessional education (IPE) improves learner proficiencies, but few have measured the association of IPE with patient outcomes, such as clinical quality.

Objective To estimate the association of a multisite IPE initiative with quality of care.

Design, Setting, and Participants This study used difference-in-differences analysis of US Department of Veterans Affairs (VA) electronic health record data from July 1, 2008, to June 30, 2015. Patients cared for by resident clinicians in 5 VA academic primary care clinics that participated in the Centers of Excellence in Primary Care Education (CoEPCE), an initiative designed to promote IPE among …

Narrative Therapy To Reduce Self-Stigma: Empowering Children, Adolescents, And Their Families, Jillian Baldwin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The effects of self-stigma on children and adolescents with mental health diagnoses is a documented psychological issue in academic literature; however, no studies or articles to date present strategies for reducing its negative effects. Additionally, very few studies have connected the experience of parental stigma, or courtesy/affiliate stigma, and its effects on child and family well-being. Self-stigma has been conceptualized as existing on the opposite end of the spectrum from empowerment, suggesting that empowerment may serve as a promising approach to tackling self-stigmatization. This paper presents a novel therapeutic intervention for reducing self-stigma in children, adolescents, and their families through …

Exploring Sex And Contact Sport Differences In Baseline Impact Post-Concussion Symptom Scale Scores Among Collegiate Athletes Without A History Of Concussion, Madison Mackenzie

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Introduction: The use of baseline or preseason cognitive testing, including symptom endorsement, to quantify post-injury changes, is a practice supported by most major sports associations. In the absence of baseline data, normative data are used for this purpose and research suggests that those data often fail to accurately represent some groups of athletes, particularly non-concussed female athletes in all sports. In clinical practice, inaccurate normative scores can mask or exaggerate post-injury changes which can result in mismanaged athlete care and inaccurate return-to-play decisions. This study examines differences in baseline symptom scores between male and female athletes in different types of …

The Role Of Awareness In Traumatic Brain Injuries: Interviews With Experts, Dominique Chao

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Approximately 2.8 million US citizens sustain a traumatic brain injury (TBI) annually, with more than 275,000 requiring inpatient rehabilitation (Taylor, Bell & Breiding, 2013). As rehabilitation techniques are refined and adapted to increase the speed of recovery and functional independence following TBIs, there is an ongoing need for better prognostic assessment tools. Research has shown that a lack of self-awareness following TBI is associated with poorer outcomes (e.g. employability, community reintegration) following discharge from inpatient hospitalizations (Cheng & Man, 2006; Robertson & Schmitter, 2016) and can result in decreased motivation (Simmonds & Fleming, 2003), compromised safety, poor community re-integration, and …

Access Law Schools & Diversifying The Profession, Deseriee A. Kennedy

Scholarly Works

Lawyers do not reflect the racial diversity in the United States. The legal profession continues to struggle with ways to achieve and maintain racial diversity. Law schools play a critical role in the path to practice, and therefore an examination of the barriers to the profession they created is warranted. This essay critiques the over-reliance on standardized testing in law school admissions and advocates for an open admissions process that prioritizes racial and academic diversity. It suggests that the benefits of minimizing the role of standardized tests far outweigh any perceived costs in legal education. This essay concludes that the …

Associations Of Neighborhood Socioeconomic Conditions With Self-Rated Health, Mental Distress, And Health Behaviors: A Nationwide Cross-Sectional Study In Japan, Tomoya Hanibuchi, Tomoki Nakaya

Geography Faculty Publications and Presentations

Although associations between neighborhood socioeconomic conditions and health have been well established, their geographical scope is mostly limited to Western societies, while multilevel studies in the non-Western context (e.g., Japan) are limited to specific cities/regions within countries. This consequently limits the external validity of the findings. To fill the gap, this study examined the associations between neighborhood socioeconomic conditions and health-related indicators by using nationwide cross-sectional data in Japan. Individual data was collected from a nationwide online survey conducted in 2015 (n = 4593). Self-rated health, mental distress (Kessler Psychological Distress Scale: K6), smoking, and physical activity were analyzed in …

The Relationship Between Workload, Performance And Fatigue In A Short-Haul Airline, Lucia Arsintescu, Ravi Chachad, Kevin B. Gregory, Jeffrey B. Mulligan, Erin E. Flynn-Evans

Faculty Research, Scholarly, and Creative Activity

The aim of this study was to determine the relationship between pilot workload, performance, subjective fatigue, sleep duration, number of sectors and flight duration during short-haul operations. Ninety pilots completed a NASA Task Load Index, Psychomotor Vigilance Task and a Samn-Perelli fatigue scale on top-of-descent of each flight and wore an activity monitor throughout the study. Weak, but significant, correlations were revealed between workload and all factors. Subjective fatigue, number of sectors and lapses were significant predictors of workload. Pilots reported higher workload when fatigue increased, the number of sectors were higher, and objective performance was worse.

Pregnancy Intentions And Outcomes Among Transgender, Nonbinary, And Gender-Expansive People Assigned Female Or Intersex At Birth In The United States: Results From A National, Quantitative Survey, Heidi Moseson, Laura Fix, Jen Hastings, Ari Stoeffler, Mitchell R. Lunn, Annesa Flentje, Micah E. Lubensky, Matthew R. Capriotti, Sachiko Ragosta, Hannah Forsberg, Juno Obedin-Maliver

Faculty Research, Scholarly, and Creative Activity

Background: Transgender, nonbinary, and gender-expansive (TGE) people experience pregnancy. Quantitative data about pregnancy intentions and outcomes of TGE people are needed to identify patterns in pregnancy intentions and outcomes and to inform clinicians how best to provide gender-affirming and competent pregnancy care. Aims: We sought to collect data on pregnancy intentions and outcomes among TGE people assigned female or intersex at birth in the United States. Methods: Collaboratively with a study-specific community advisory team, we designed a customizable, online survey to measure sexual and reproductive health experiences among TGE people. Eligible participants included survey respondents who identified as a man …

Is It Permissible To Teach Buddhist Mindfulness Meditation In A Critical Thinking Course?, Anand Jayprakash Vaidya

Faculty Research, Scholarly, and Creative Activity

This essay argues for the permissibility of teaching Buddhist mindfulness meditation in a critical thinking course. One might object that Buddhist mindfulness meditation is part of a religion, and religions are thought to be dogmatic and uncritical, and thus inappropriate for a critical thinking course. However, I argue that there is a pathway from the importance of self-regulation for good critical thinking to the permissibility of including mindfulness meditation in a critical thinking course. I offer three arguments for the permissibility of inclusion: the self-regulation argument, the expansion by way of cognitive science argument, and the persistence through emotional volatility …

Unstructured Data For Cybersecurity And Internal Control, Jesus Canelón, Esperanza Huerta, Normal Leal, Terry Ryan

Faculty Research, Scholarly, and Creative Activity

This paper proposes a research framework for studying the connections-realized and potential-between unstructured data (UD) and cybersecurity and internal controls. In the framework, cybersecurity and internal control goals determine the tasks to be conducted. The task influences the types of UD to be accessed and the types of analysis to be done, which in turn influences the outcomes that can be achieved. Patterns in UD are relevant for cybersecurity and internal control, but UD poses unique challenges for its analysis and management. This paper discusses some of these challenges including veracity, structuralizing, bias, and explainability.

Crossing Boundaries: Steps Toward Measuring Undergraduates' Interdisciplinary Science Understanding, Brie Tripp, Sophia A. Voronoff, Erin Shortlidge

Biology Faculty Publications and Presentations

A desired outcome of education reform efforts is for undergraduates to effectively integrate knowledge across disciplines in order to evaluate and address real-world issues. Yet there are few assessments designed to measure if and how students think interdisciplinarily. Here, a sample of science faculty were surveyed to understand how they currently assess students’ interdisciplinary science understanding. Results indicate that individual writing-intensive activities are the most frequently used assessment type (69%). To understand how writing assignments can accurately assess students’ ability to think interdisciplinarily, we used a preexisting rubric, designed to measure social science students’ interdisciplinary understanding, to assess writing assignments …

The Internet As A Speech Machine And Other Myths Confounding Section 230 Reform, Danielle K. Citron, Mary Anne Franks

Faculty Scholarship

A robust public debate is currently underway about the responsibility of online platforms. We have long called for this discussion, but only recently has it been seriously taken up by legislators and the public. The debate begins with a basic question: should platforms should be responsible for user-generated content? If so, under what circumstances? What exactly would such responsibility look like? Under consideration is Section 230 of the Communications Decency Act—a provision originally designed to encourage tech companies to clean up “offensive” online content. The public discourse around Section 230, however, is riddled with misconceptions. As an initial matter, many …

The Automated Administrative State: A Crisis Of Legitimacy, Danielle K. Citron, Ryan Calo

Faculty Scholarship

The legitimacy of the administrative state is premised on our faith in agency expertise. Despite their extra-constitutional structure, administrative agencies have been on firm footing for a long time in reverence to their critical role in governing a complex, evolving society. They are delegated enormous power because they respond expertly and nimbly to evolving conditions.

In recent decades, state and federal agencies have embraced a novel mode of operation: automation. Agencies rely more and more on software and algorithms in carrying out their delegated responsibilities. The automated administrative state, however, is demonstrably riddled with concerns. Legal challenges regarding the denial …

Disparities In Health Behavior Risks Among Employed And Disparities In Health Behavior Risks Among Employed And Unemployed Black And White Older Adults, M. Courtney Hughes, Tamara A. Baker, Hansol Kim

Faculty Articles, Papers, and Other Scholarship

Objective: Examine health behavior risk rates and disparities in health behavior risks related to race and employment among older adults.

Methods: A cross-sectional analysis of a representative sample of noninstitutionalized adults aged 65 and older (150,669 in 2015 and 168,011 in 2016) from the Behavioral Risk Factor Surveillance System. Self-reported health behavior risks were measured as well as multiple logistic regression analyses assessing the independent effects of demographic variables on health behavior risks.

Results: Employed older adults have greater health behavior risks than unemployed older adults. Black employed older adults have greater health behavior risks than Black unemployed older adults …

Teaching During The Pandemic? An Opportunity To Enhance Curriculum, M. Courtney Hughes, Beverly W. Henry, Michael R. Kushnick

Faculty Articles, Papers, and Other Scholarship

The rapid transition of courses to an emergency remote teaching and learning format at the onset of the COVID-19 pandemic in early 2020 created challenges across the university landscape for faculty and students and, inevitably, affects the future of higher education. We drew upon education theory, evidence-based teaching practices, and insights from a rapid-response survey of academics in the fields of public health, health promotion, and health communication about their perspectives on the impact of COVID-19. This article aims to help educators explore potential strategies to incorporate the lessons and reality of the pandemic into their curriculum. Shifting expectations and …

Responding To Students Experiencing Emotional Distress: An Action Research Study Of Professional Learning Experiences For Faculty And Staff, Christopher Taylor Lakes

Theses and Dissertations--Educational Leadership Studies

Students entering college are increasingly presenting with complex mental health conditions that negatively affect their college experiences. This mixed methods action research study was designed to assess the current level of faculty and staff member’s abilities with respect to, comfort with, and role in identifying and responding to students who exhibit signs of emotional distress (e.g., anxiety, depression, suicidal ideation). Specifically, this study was designed to evaluate faculty and staff understanding of skills, techniques, and resources that can support them in this work, identify an appropriate professional learning experience (i.e., intervention) to increase the level of comfort in this area, …

Knee Joint Loading Following Anterior Cruciate Ligament Reconstruction: Link To Patient Reported Outcomes And A Novel Method To Monitor With Wearable Sensors, Alex Spencer

Theses and Dissertations--Kinesiology and Health Promotion

Recovery from anterior cruciate ligament reconstruction (ACLR) commonly results in undesirable physical and patient-reported outcomes (PROs). Identification of modifiable factors such as knee contact force (KCF) early in rehabilitation that can improve these outcomes is important due to the rapid decrease in function, quality of life, and joint health in this population. Additionally, if noninvasive measurement of KCFs outside of a traditional laboratory were possible, clinicians could optimize patient treatment with personalized care. Therefore, there are two primary aims to this thesis: 1) quantify the link between KCF and PROs which measure pain, ability to perform activities of daily living, …

Is Athlete Activism A Predictor Of Resilience?, Travis Robert Scheadler

Theses and Dissertations--Kinesiology and Health Promotion

Several athletes have taken personal responsibility to engage in activism, often with hopes of bringing social and political change. While scholars have identified several barriers preventing athletes from engaging in activism (e.g., public criticism, status and job loss, withdrawal of funding, anticipated distress; Cunningham & Regan, 2012), other scholars have identified personal benefits from engaging in activism (e.g., improved confidence, self-concept, belief in change, agency, life meaning; Klar & Kasser, 2009; Rabkin et al., 2019). Distress from the barriers, however, may be prerequisites to enhancing resilience, a theoretical construct that may help explain the benefits of activism. Thus, by applying …

A Systematic Review Of Mindfulness Interventions’ Impact On Athlete Emotional Distress & Wellbeing, Trevor Nathan Tierney

Theses and Dissertations--Kinesiology and Health Promotion

Mindfulness-based interventions’ (MBIs) effectiveness for improving wellbeing and reducing emotional distress is well-documented in both clinical and non-clinical sections of the general population (McAlarnen & Longshore, 2017). Although mindfulness has been shown to be effective with these populations, less is known about the specific effects for athletes. The effects of MBI’s for athletes may be different given that the intention for MBIs in the sport context is typically to improve performance, where in most other contexts it is not (Gardner & Moore, 2012). Furthermore, athletes are a distinct population who possess unique factors on which their wellbeing and mental health …

Health Priorities, Current Lifestyle Behaviors, And Barriers To A Healthy Lifestyle Among Emergency Department Nurses, Shannon C. White

Theses and Dissertations--Kinesiology and Health Promotion

Background: Emergency nurses are tasked with managing the hectic, unpredictable, and constantly changing environment of an ED. In addition, emergency nurses have been shown to have high levels of stress, irregular meal schedules, rotating shift work, long hours, and a lack of physical activity. Furthermore, research has suggested that nurses are at an increased risk for non-communicable diseases, such as diabetes, hypertension, and coronary heart disease (Phiri, et al., 2014), in addition to a high prevalence of obesity (Kyle, et al., 2016).

Methodology: In this study, 23 emergency nurses completed a 43-item survey regarding current behaviors and constructs of …

Negotiating My Chineseness In College: The Complexities And Uniqueness Of Being Chinese American, Yan Wang

Theses and Dissertations--Educational Policy Studies and Evaluation

Chinese Americans are historically perceived as “perpetual foreigners” in the American political, cultural and racial discourses. People of Chinese descent have long been conceived as sharing a same ancestor as those in China. Situated in the global context of China’s rise in the world, culturally, politically and economically, this research looks at how Chinese American college students negotiate their ethnic identity in the Midwest of the United States. The current Coronavirus outbreak brought new waves of anti-Chinese/Asian sentiment into American political and cultural life. This rhetoric makes the discussion of Chinese American college students’ ethnicity construction crucial.

Using qualitative research …

Exploring Positive Identity And Relationship Satisfaction In Bisexual Women In Relationships With Men, Kamryn Michel

Theses and Dissertations--Kinesiology and Health Promotion

Bi-negative discrimination, negative attitudes, and beliefs regarding bisexual individuals are at least partially responsible for mental and physical distress in the bisexual community (Friedman et al., 2014). Romantic relationships can act as a buffer against negative health outcomes as well as increase overall well-being (Dush & Amato, 2005). However, research has shown that binegitive attitudes can impact a person’s willingness to begin relationships with bisexual individuals (Fienstein et al., 2014). This study aimed to explore the impact of positive identity on relationship satisfaction of bisexual women in relationships with men. In particular, we investigated five possible facets of positive identity: …

Advanced Multilevel Models For Comparing Group Characteristics: The Case Of Sex Differences In Reading Achievement, Rongxiu Wu

Theses and Dissertations--Education Sciences

To help improve and advance research methodology when comparing the group characteristics, two advanced multilevel models were developed and introduced, which would allow a deeper and more refined look at the issue of sex differences in reading achievement.

The first model is a restricted multilevel model for the examination of institutional effects on multiple groups of individuals. The goal of this multivariate multilevel model with individuals nested within institutions was to estimate the institutional effects on multiple groups of individuals. With the employment of 2009 OECD Programme for International Student Assessment (PISA) data, an application was illustrated to examine whether …

Assessing The Performance Of Two Procedures For Detecting Differential Item Functioning Within The Multilevel Partial Credit Model, Carol Hanley

Theses and Dissertations--Education Sciences

This is a simulation study that evaluates the performances of two models for the detection of uniform differential item functioning (DIF). Simulated data are generated by a multilevel partial credit model (MLPCM). The purpose of this study was to compare the accuracy of two DIF detection procedures, hierarchical ordinal logistic regression (HOLR) for multilevel data and multilevel generalized Mantel-Haenszel (MGMH: French & Finch, 2013; French, Finch, & Imekus, 2019). Conditions manipulated were the number of participants per cluster (20, 40), number of clusters (50, 100, 200), DIF magnitude (0, .4, .8), and magnitude of intraclass correlation coefficient (.05, .25, .45). …

The Sound Of Leadership: The Self-Leadership Strategies Of Local Activist Musicians, John Hill

Theses and Dissertations--Education Sciences

Within this dissertation I focused on the examination of local activist musicians’ self-leadership strategies and the method in which they lead social change movements. Additionally, I sought to increase the understanding of charismatic leadership, self-leadership strategies of local activist musicians, and the method in which local activist musicians lead social movements. To my knowledge, no published studies have explored local activist musicians’ self-leadership strategies. Therefore, this study is significant because I (a) explored a term which lacks a unifying definition, charismatic leadership, (b) provided theoretical foundations for activist musicians and social change, and (c) explored the self-leadership strategies of …