Digital Commons Network^™

Building The Infection Prevention Workforce: Development, Implementation And Evaluation Of Texas Epidemic Public Health Institute Infection Prevention And Control 300 Series, Kayla E Ruch, Janelle Rios

Faculty, Staff and Student Publications

Background: The Texas Epidemic Public Health Institute (TEPHI) was established to strengthen infectious disease preparedness across Texas. The Infection Prevention and Control (IPC) 300 Series represents the third year of a multi-tiered educational initiative designed to provide free, accessible, evidence-based IPC training and continuing education credits for the healthcare workforce.

Methods: Registration and attendance data were collected through Zoom™ and Microsoft Teams™. Knowledge assessments, post-module surveys, and mid- and end-of-series evaluations were administered through QuestionPro™. Module content was informed by guidance from APIC, CDC, CMS, and OSHA. Descriptive statistics and the Kirkpatrick Model of Training Evaluation were used to assess …

Correction: Feasibility Of Conducting A Pilot Randomized Trial Of A Mindfulness-Based Intervention Among Sheltered Young Adults Experiencing Homelessness, Diane Santa Maria, Paula Cuccaro, Erica Sibinga, Kimberly Bender, Ethel Jacko, Widumini Liyanage, Jennifer Jones, Stanley Cron

Faculty, Staff and Student Publications

This corrects the article "Feasibility of conducting a pilot randomized trial of a mindfulness-based intervention among sheltered young adults experiencing homelessness" in volume 16, 1649664.

Enhancing Data Compatibility In An Evolving Landscape: Medical Cannabis And Polysubstance Use Protocols In The Phenx Toolkit, Anne Buu, Johannes Thrul, Amanda Bunting, Tamara Haegerich, Wayne Huggins, Christian Hopfer, Denise Vidot, Cataia Ives, Ryan Mcneil, Sarah Zemore, Corrie Vilsaint, Elizabeth Fallon, Christine Hill, Carol Hamilton, John Kelly

Faculty, Staff and Student Publications

Introduction: With increasing legalization of medical cannabis and prevalence of polysubstance use in the United States comes the need for standard psychometrically validated measures to study these substances' health effects in the population. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit (www.phenxtoolkit.org) is a freely accessible catalog of recommended measurement protocols to promote data compatibility across studies, but this extensive catalog did not include measures in these important areas.

Methods: In 2024, a PhenX Working Group of experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in studies on medical cannabis and polysubstance …

Hiv Testing In African American Churches: Results From The Taking It To The Pews Cluster-Randomized Trial., Jannette Berkley-Patton, Carole Bowe Thompson, Alexandria G. Bauer, Marcie Berman, Kelsey Christensen, Andrea Bradley-Ewing, Kathy Goggin, Delwyn Catley, Eric Williams, Cassandra Wainright, Kathryn P. Derose, Alex Geyer, Frank Thompson, Lesha Dennis, Stephen Smith, Jenifer E. Allsworth

Manuscripts, Articles, Book Chapters and Other Papers

To examine effects of a multilevel, religiously-tailored HIV testing intervention, Taking It to the Pews (TIPS), on receipt of HIV testing with African American church-affiliated populations, 14 African American churches (N = 1,491) were randomized to TIPS or a multilevel, non-tailored HIV education attention-control arm in a cluster-randomized trial (Kansas City urban area, 2013 to 2019). Receipt of an HIV test was examined using objective data and participant self-reports (last 12 months), including self-reported exposure to intervention components. Overall, 471 HIV tests were completed; TIPS intervention churches conducted significantly more tests than controls (339 versus 132, p = 0.003). Also, …

Picturing The Past: The Role Of Photo Cue Visual Perspective On Positive Autobiographical Memory Recall In Dysphoria, Sarah Snow, Zachary Adolph Niese, Julie L Ji

School of Psychology

Positive autobiographical memory plays a key role in emotional well-being and is distorted by cognitive processing biases in dysphoria. This experiment investigated how the visual perspectives (first-person vs. third-person) of personal photographs influence recall of positive memories depending on dysphoria. Eighty-five participants (42 low dysphoria, 43 high dysphoria) submitted photos of positive events from both perspectives. Later, participants recalled these events while viewing either a first- or third-person photo before rating and describing their memory. While first-person photos promoted more recall from an own-eyes vantage point regardless of dysphoria level, dysphoria was still associated with greater observer-like recall, reduced mental …

Functional, Pharmacogenomic, And Immune Landscapes Of Long Non-Coding Rnas In Cancer, Runhao Wang, Mei Luo, Yuan Liu, Jingwen Yang, Yamei Chen, Chengxuan Chen, Lifei Ma, Stephanie Ding, James Wengler, Yong Zang, Bora Lim, Wenbo Li, Liuqing Yang, Chunru Lin, Lixia Diao, Leng Han

Faculty, Staff and Student Publications

Long non-coding RNAs (lncRNAs) are emerging as key regulators in cancer, with significant potential as diagnostic, prognostic, and therapeutic targets. Here, this work systematically analyzes lncRNA associations with targeted therapies and immunotherapies across 33 cancer types using The Cancer Genome Atlas (TCGA) and real-world datasets. This work identifies 53,173 lncRNA-pathway associations, millions of lncRNA-drug response associations (via CancerRxTissue and VAEN), and extensive correlations with immune checkpoints and infiltration. This work further identifies 69 lncRNAs associated with immunotherapy response and 2,611 differentially expressed lncRNAs between low and high objective response rate (ORR) groups. Additionally, two lncRNAs are correlated with immune-related adverse …

Examining Motivators And Barriers To Meditation Practice Among Individuals With Spinal Cord Injury: Insights From A Survey Study, Radha Korupolu, Chelsea G Ratcliff, Ariana Andampour, Susan Robinson-Whelen, Shrasti Lohiya, Audrey S Cohen, Christine Bakos-Block, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Context: Meditation and mindfulness practices offer promising non-pharmacological alternatives for individuals with spinal cord injury (SCI) to improve their health and well-being, but integrating such practices into daily routines can be challenging.

Objectives: This survey study aims to identify motivators and barriers to engagement with meditation and mindfulness interventions among individuals with SCI.

Methods: A cross-sectional survey was conducted among adults with SCI (N = 94) from a single large acute rehabilitation center in the United States.

Results: Results from the survey showed a strong interest in meditation among individuals with SCI, with nearly half reporting current engagement in meditation …

Preliminary Examination Of Orexin Receptor Antagonism With Suvorexant In Individuals With Methamphetamine Use Disorder: A Case Series Study, Heather Webber, Jessica Badawi, Douglas Calvillo, Jin Yoon, Michael Weaver, Scott Lane, Joy Schmitz

Faculty, Staff and Student Publications

No abstract provided.

Preclinical Ischemic Stroke Multicenter Trials (Prism) Collective Statement: Opportunities, Challenges, And Recommendations For A New Era, Cenk Ayata, Philip M Bath, Anna M Planas, Stuart M Allan, Johannes Boltze, Ryan P Cabeen, Claire L Gibson, Marilyn J Cipolla, Marcio A Diniz, Stefano Fumagalli, Fahmeed Hyder, Raymond C Koehler, Arthur Liesz, Sarah K Mccann, Tim Magnus, Louise D Mccullough, Emily S Sena, Simone Beretta, Jaroslaw Aronowski, Francesca Bosetti, Clinton B Wright, Patrick D Lyden, Lauren H Sansing

Faculty, Staff and Student Publications

Preclinical stroke research faces a critical translational gap, with animal studies failing to reliably predict clinical efficacy. To address this, the field is moving toward rigorous, multicenter preclinical randomized controlled trials (mpRCTs) that mimic phase 3 clinical trials in several key components. This collective statement, derived from experts involved in mpRCTs, outlines considerations for designing and executing such trials. mpRCTs offer advantages such as increased sample sizes, robust statistical design, incorporation of heterogeneity, and standardized protocols, but they face challenges in finding the right balance between standardization and heterogeneity, appropriate stroke model selection, and outcome measures, as well as the …

Educational Interventions To Prepare Undergraduate Students For Out-Of-Hours Practice As A Newly Qualified Doctor In The United Kingdom: A Scoping Review, Alex Gordon, Molly Parkinson, Rosanna Watts, Kamal El-Badawi, Erin Dawson, Rohan Chiktara, Lorna Burns, Nicola Brennan

Peninsula Dental School

Background: In the United Kingdom (UK), newly qualified doctors are routinely responsible for out-of-hours (OOH) care, often managing acutely unwell patients with limited supervision. Despite national recommendations encouraging OOH experience during medical school training, there is no formal curriculum for OOH practice. Objectives: This scoping review aimed to identify the range of educational interventions designed to prepare UK medical students for OOH clinical responsibilities and assess their reported effects on perceived and actual preparedness. Methods: Following Joanna Briggs Institute methodology, a systematic search of seven databases and grey literature sources was conducted. Eligible studies involved UK-based medical students and reported …

Seeing Anxiety: Ecological Video Ethnography And Simulation To Understand Anxiety And Decision-Making In Dental Care, Mona Nasser, Hannah Drayson, Sally Hanks, Nicholas Peres, Michael Punt

Peninsula Dental School

BACKGROUND: Dental anxiety is a widespread barrier to care, often contributing to appointment avoidance, treatment disruption, and emotional strain for both patients and clinicians. While extensively studied as a psychological trait, less attention has been paid to how anxiety manifests situationally and relationally, through non-verbal, affective, and spatial cues within clinical encounters. Moreover, in certain contexts, such affective signals can intersect with decision-making processes, shaping how patients interpret, engage with, or withdraw from clinical choices.

OBJECTIVE: To explore how anxiety manifests within the micro-choreography of dental encounters, develop a taxonomy of 'anxious tells', and assess the utility of ecological video …

First-Generation Medical School Applicants: A Quantitative Study Designed To Identify Areas Of Educational Support, Bethsabe Romero, Amanda K. Burbage

EVMS School of Health Professions Faculty Publications

First-generation (First Gen) students are unique medical school applicants. Due to their lived experience, they approach patient care by prioritizing trust, comfort and understanding. They have proven ability to overcome obstacles and were found to be more resilient than their continuing generation (Cont Gen) peers. Despite these notable attributes, they face unique challenges in gaining medical school acceptance. There are very few quantitative studies examining this student subpopulation, and our study identifies characteristics of first-generation medical school applicants while highlighting areas of needed support. This cross-sectional study used deidentified Application and Matriculating Student Questionnaire survey data that was obtained from …

Exploring The Acceptability Of Integrating Dietitians Into Primary Care Dental Services For Children, Lauren Hallewell, Raul Bescos, Zoe Brookes, Tracey Parkin, Robert Witton, Patricia Casas-Agustench

School of Health Professions

BACKGROUND: Dental caries is a common childhood non-communicable disease strongly associated with high sugar intake. Beyond oral health, a poor diet can affect children's growth, development, and overall well-being. While dietary advice is central to preventive dental care, some primary care dental clinics have introduced body mass index (BMI) assessments and further dietary advice to address wider nutritional concerns in children. However, these efforts are often constrained by limited nutrition training, time constraints and concerns about sensitivity. Integrating dietitians into primary dental care may help overcome these barriers by enhancing dietary guidance, supporting broader nutritional needs and facilitating structured BMI …

Perceived Hiv Risk, Barriers, And Preferences For Hiv Testing In Structurally Vulnerable Communities In St. Louis: A Best-Worst Scaling Survey, Emmanuel K Tetteh, Noelle Le Tourneau, Gregory Gross, Mckenzie Swan, Tyrell Manning, Justin Cole, Katie Wolf, Lawrence Hudson-Lewis, Julia D López, Todd Combs, Virginia R Mckay

2020-Current year OA Pubs

BackgroundPersistent gaps in efforts to end the HIV epidemic in the United States highlight the need for community-specific, evidence-based HIV testing strategies. This study investigated barriers and preferences around HIV testing among underserved populations, including Black, queer, and young adults in the St. Louis, Missouri area.MethodsWe conducted a Best-Worst Scaling (BWS) survey with adults (16+ years) recruited at community events, collecting responses electronically and providing a $25 incentive. The survey assessed the relative importance of 13 potential barriers to HIV testing such as stigma, structural barriers, and perceived HIV risk, chosen based on literature review and community input. Mean preference …

Biomechanical Integrity Of The Female Pelvic Floor: A Comparison Of Military And Civilian Women, Vladimir Egorov, Peter Takacs, Vincent Lucente, Heather Van Raalte, Joy A. Greer, Noune Sarvazyan

Department of Obstetrics & Gynecology Faculty Publications

Introduction

The health of the pelvic floor depends on the integrity of its muscles, connective tissue, ligaments, and their innervation. The female pelvic floor may be more vulnerable to repetitive heavy loads in a military environment than the male pelvic floor because of anatomical and physiological differences. The study aim was to identify and explore possible differences in the female pelvic floor conditions between active military and civilian women with similar demographics.To identify and explore possible differences in the conditions of the female pelvic floor between active military women and civilian women with similar demographics.

Materials and Methods

Military active …

Hungarian Validation Of The Pelvic Floor Distress Inventory - 20 (Pfdi-20) Questionnaire And The Pelvic Floor Impact Questionnaire - 7 (Pfiq - 7), Barbara Kozma, Bence Kozma, Peter Takacs, Dávid Rátonyi, Nelli Farkas, Attila G. Sipos, Balint Farkas

Department of Obstetrics & Gynecology Faculty Publications

Introduction and Hypotheses

Pelvic floor disorders (PFDs) affect women's quality of life through physical, psychological, and social domains. The Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) are validated tools for assessing symptom severity and quality of life impact. The current study aim to investigate the reliability and validity of the Hungarian versions of these questionnaires in women with PFD symptoms.

Methods

This validation study was carried out at the University of Debrecen among women with clinically confirmed pelvic floor disorders. The PFDI-20 and PFIQ-7 questionnaires were translated into Hungarian using independent native English speaker in …

The Impact Of The 7th October War On Preterm Birth Rates And Neonatal Outcomes: A Retrospective Comparative Study From Northern Israel, Raghda Zidan Sweid, Adi Sharabi Nov, Hana Helfgot, Steven L. Warsof, Inbar Ben-Shachar

Department of Obstetrics & Gynecology Faculty Publications

PURPOSE: Maternal psychological stress is associated with adverse obstetric and neonatal outcomes, including preterm birth and low birthweight. Warfare represents a significant source of acute and chronic stress, yet its impact on pregnancy outcomes remains unclear. This study aimed to evaluate the association between a 6-month period of continuous wartime exposure following October 7, 2023, during the "Iron Swords" conflict and preterm birth, neonatal outcomes, and obstetric management.

METHODS: This retrospective cohort study included all deliveries at ZIV Medical Center during the 6-month conflict period, compared with a pre-war cohort from 2021 until October 6, 2023. The primary outcome was …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

Paneugenesis: A Regenerative Systems Hypothesis For Advancing Health Promotion, Craig M. Becker, Leslie Hoglund, Beth Chaney, Joseph G. L. Lee, Michael Stellefson, Alex Davis

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Despite major advances in health promotion science, dominant approaches remain largely prevention-and risk-reduction-oriented. The prevailing orientation creates a substantial opportunity to advance generative, system-design strategies that intentionally produce well-being rather than merely prevent disease. This article proposes paneugenesis as a regenerative systems framework and a testable theoretical model for the intentional creation of net-positive outcomes, thereby extending health promotion beyond its traditional pathogenic emphasis. Paneugenesis integrates systems science, salutogenesis, behavioral science, complexity theory, and quality management principles into a unified four-function process: operationalizing idealized outcomes, identifying key precursors, optimizing processes, and continually plotting progress through feedback mechanisms. The central hypothesis …

The Cognitive-Affective Social Processing And Emotion Regulation (Casper) Model, M Catalina Camacho, Elina Deshpande, Michael T Perino

2020-Current year OA Pubs

Humans are intensely social creatures. It is therefore not surprising that many psychiatric disorder criteria include social dysfunctions; however, overlapping presentations and diverse, complex etiologies make treating social dysfunctions difficult. Here, we introduce the Cognitive Affective Social Processing and Emotion Regulation (CASPER) model. CASPER integrates research from social psychology, cognitive neuroscience, and developmental science to describe how real-world social processing unfolds and is associated with differing psychiatric social cognitive neurophenotypes. Briefly, social processing can be broken down into the following cognitive steps: identifying relevant social cues, attending to related cues, interpreting cues, and adjusting behavior appropriately. Each of these steps …

Application Of The Lancet Commission Criteria For The Diagnosis Of Obesity To A Clinical Trials Population: The Leap Trial, Faith Anne N Heeren, Kathleen R Ruddiman, Courtney Simmons, Brian N White, Byron C Jaeger, Nicholas M Pajewski, Stephanie A Hooker, Deborah B Horn, Katy Martin-Fernandez, Kimberly A Gudzune, Caroline Blackwell Young, Jamy Ard, Kristina Henderson Lewis

Faculty, Staff and Student Publications

Objective: This study aimed to apply The Lancet Diabetes & Endocrinology criteria for diagnosing obesity among clinical trial participants and understand participants' characteristics by obesity status.

Methods: The criteria were operationalized and applied to baseline data from the Long-term Effectiveness of the Anti-obesity medication Phentermine (LEAP) trial (NCT05176626). Excess adiposity, organ and tissue dysfunction, and limitations to daily activities were assessed. We examined differences between participants with "no obesity," "pre-clinical obesity," and "clinical obesity."

Results: Among the 860 participants, 0.8% had no obesity (mean BMI 29.0 kg/m2 [SD 0.6]), 18.7% had pre-clinical obesity (mean BMI 35.2 kg/m2 [SD …

Advancing Models Of Ptsd-Aud Comorbidity: Protocol For A Multimethod Framework Using Genetics And Ecological Momentary Assessment, Elizabeth A. Stinson, Samhita Lellapalli, Sage E. Hawn, Natalie Merrill, Lance M. Rappaport, Christina M. Sheerin, Vasiliki Michopoulos, Silviu-Alin Bacanu, Roseann E. Peterson, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and …

Sex And Gender Differences Between Experiences Of Discrimination And Physical Health: A Systematic Review, Saam Honarvar, Maryam Ajose, Bronwyn Sutherland, Alejandra Fernandez, Shakia T Hardy, Miguel Ángel Cano, Samaah Sullivan

Library Staff Publications

Background: Despite a plethora of previous research on experiences of discrimination and physical health outcomes, there has been less attention to sex/gender differences, although some research suggests a greater stress-related biological and behavioral impact on women.

Methods: Five databases were reviewed up to May 2023 using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We included studies that examined self-reported experiences of discrimination and physical health outcomes among adults (aged 18+) in the United States if results were either stratified by sex/gender or tested a sex/gender-by-discrimination interaction term.

Results: A total of 3,397 articles were extracted, and 50 …

Psycinfo Platforms: A Tale Of Two Interfaces (Ovid Vs Ebsco), Sandra Yvette Desjardins, Jamie Quinn

Library Staff Publications

PsycInfo is a foundational database for evidence-based behavioral health literature, which makes it an essential tool for health sciences librarians. This column provides a comprehensive comparison of PsycInfo on Ovid and EBSCO platforms. It offers a foundational overview for new librarians, guiding them through essential functionalities and navigation. The article also helps librarians evaluate potential database acquisitions by highlighting the distinct features and search capabilities of each interface. This comparison aims to equip health sciences librarians with the knowledge to optimize search strategies and inform strategic purchasing decisions.

Prenatal Exposure To Nicotine And Postpartum Depression: A Systematic Review And Meta-Analysis, Reem Sharaf-Alddin, May Salama, Denise Mckinney, George Saade, Qi Zhang

Health Behavior, Policy & Management Faculty Publications

Purpose: Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD.

Methods: We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000&Sep.19th ,2024, with the outcome PPD. Studies …

Involving Parents In Prevention: A Case Example Of Research And Intervention Development To Improve Financial Well-Being Support, Nick Axford, Gisella Hanley, Rebecca Summers, Kristin Liabo, Amy Bond, Eleanor Bryant, Georgia Smith, Rachel Silcock, Vashti Berry

Peninsula Medical School

The adverse effects on parent and child outcomes of poverty and stressors associated with low income are well established. With notable exceptions, however, the potential role of frontline services in improving family financial well-being is underexplored. This article outlines how patient and public involvement (PPI) was initiated early on in research on financial well-being support (FWbS). It illustrates how research can build on and integrate what parents say about services and how to research them. The involvement work was undertaken in one city in part to inform the adaptation of an income maximisation service to be delivered in local children’s …

Measuring Outcomes In Evaluations Of Interventions To Prevent Youth Crime And Violence: Challenges And Potential Solutions, Sajid Humayun, Finlay Green, Helen Downham, Nick Axford

Peninsula Medical School

There is a clear imperative to prevent youth crime and violence owing to the significant social and economic costs for individuals involved and wider society. A considerable evidence base for ‘what works’ in this space exists but gaps remain. To address these, it is necessary to evaluate intervention effectiveness. The aim of this article is to explore challenges and potential solutions regarding outcome measurement in such evaluations. To do this we draw on the literature and our experience as evaluators. We argue that outcome selection should be informed by a robust theory of change, and that normally this will mean …

An Insidious Interstice: Understanding Cognition And Language Behaviour Through The Eyes Of Juvenile Justice Professionals, Anne M. Perrotti, Allison T. Chappell, Tancy Vandecar-Burdin

Human Movement Studies & Special Education Faculty Publications

Introduction

Despite evidence suggesting language and cognition deficits are prevalent for justice involved youth, little research explores how juvenile justice personnel experience language and cognition behaviours in the youth they serve.

Aims

This qualitative study explored how juvenile justice personnel understand language and cognition skills and deficits in justice involved youth.

Methods

Twenty-two U.S. juvenile justice professionals participated in individual, semi-structured interviews. Questions focused on individual understanding of receptive language, expressive language, social communication, and cognition (i.e., problem-solving, predicting consequences and impulsiveness) in juveniles served. Using a phenomenological lens, transcripts were coded identifying themes and sub-themes of participant responses.

Results …

Can I Get A Witness? The Ethical Dimensions Of Family Presence In Patient Suffering, Jennifer Blumenthal-Barby, Trevor M Bibler, Holland Kaplan, Adam Omelianchuk, Joanna Smolenski

Center for Medical Ethics and Health Policy Staff Publications

For patients who are suffering, the bedside presence of a family member can provide comfort, and many people hold that there is moral value in being present with a conscious, suffering patient. Yet what is the moral significance of the absence of family members when a patient is minimally conscious or unconscious and not aware of their absence? Clinicians are often troubled when family members and surrogate decision-makers who are able to spend a significant amount of time at an unconscious, seriously ill patient's bedside do not do so. Clinicians feel frustrated that they must bear the burden of witnessing …

Anything But Endo: Diagnostic Buck-Passing In Endometriosis Diagnosis, Rita Dexter, Megan Kitts, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

People living with endometriosis, a disease in which tissue similar to the lining of the uterus grows elsewhere in the body, often experience prolonged diagnostic journeys because of symptom variability, normalisation of period pain and other symptoms, and lack of awareness of the condition. In this article, we analyse the endometriosis diagnostic journey through the lens of epistemic injustice. Drawing on in-depth interviews with 52 people living with endometriosis in the United States, we introduce the concept of diagnostic buck-passing to characterise the phenomenon wherein individuals who seek treatment for their symptoms end up stuck in a cycle of seeing …