Medicine and Health Sciences Commons^™

Maternal Healthcare In The United States: An Exploration Of The Organizational And Political Determinants Of Maternal Healthcare Quality And Outcomes, Tamaya S. Browder

College of Graduate Studies: Theses & Dissertations

Despite having an advanced U.S. healthcare system, childbirth remains risky in the US, especially for socially vulnerable populations. Medicaid covers a large portion of births and is equipped to implement large-scale interventions to improve maternity care and patient outcomes. Two studies were conducted to (a) examine the relationship between organizational factors in U.S. hospitals and adverse clinical outcomes among Medicaid-insured maternity patients, and (b) analyze state-level Medicaid bundled payment models for maternity care. Guided by the Donabedian Quality of Care Model, Study One used logistic regression on data from the 2018-2020 National Inpatient Sample to explore how hospital organizational factors …

Putting The L In Elsi: Legal Methods For Bioethics Research, Anya E R Prince, Benjamin Berkman, Donald Ford, Dov Fox, Christi Guerrini, Amy Koopmann, Natalie Ram, Jessica L Roberts, Kayte Spector-Bagdady, Sonia Suter

Center for Medical Ethics and Health Policy Staff Publications

Lawyers and law professors are increasingly involved in interdisciplinary scientific teams and grant research to answer ethical, legal and policy questions related to biomedical topics. Yet, the methods that lawyers use to conduct legal research and analysis are not always familiar to scientists and social scientists conducting peer review of a proposed project with legal aims or a publication reporting a legal study. To better facilitate interdisciplinary ethical, legal, and social implications collaboration, there is a need to better explain how legal research methodologies can provide robust tools to address a range of nuanced biomedical questions. This paper explores …

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 …

Educational Attainment And Symptom Improvement In Treatment-Resistant Depression: A Longitudinal Cohort Analysis Across Treatment Modalities, Marjorie Harrison, Giselli Scaini Msc, Phd, Aspen Viamontes

Summer Research Program Abstracts

No abstract provided.

Organ Chips And Translational Research: Identifying And Examining New Ethical Issues, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

Organ chips, also known as organ-on-a-chip devices, tissue chips, or microphysiological systems, have emerged over the last decade as a promising translational technology amidst growing concern about the translational crisis between laboratory research and patient bedside. Pointing to high rates of failure between nonhuman animal models and safety and efficacy in humans, organ chips and similar new approach methods have attracted substantial public and private investment. As human-cell-based alternatives to animal models, organ chips promise more predictive, efficient, and ethical platforms for pharmaceutical and toxicity testing. Engineered cultivation systems that enable cells to assemble into tissue-like structures (e.g. kidney, brain, …

Toward Ethical Provenance Tracking: The Ga4gh Model Data Access Agreement (Daa), Alexander Bernier, Bartha Maria Knoppers, Jonathan Lawson, Robyn Mcdougall, Maili Raven-Adams, Vasiliki Rahimzadeh

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Standardizing contractual clauses that govern data access enables research institutions to responsibly steward genomic and related health data while enabling its efficient downstream reuse.

Methods: We describe a document analysis study using both qualitative and comparative law analytical approaches to identify the most common categories of clauses from 29 different data access agreements used by human biomedical research consortia globally. We furthermore characterized the legal positions and standard practices for each common element of the agreement and synthesized across them to develop model clauses. A total of 3 discussion sessions were organized virtually to refine the clauses among members …

Differences Between Government, Consortium, And Private Database Stewards Impacting The Genomic Data Market: A Survey Of U.S. Academic Genetic Researchers., Amanda K Greene, J Denard Thomas, Kaitlyn Jaffe, Luyun Chen, Kerry A Ryan, Brian J Zikmund-Fisher, J Scott Roberts, Amy L Mcguire, Katherine Hendy, Kayte Spector-Bagdady

Center for Medical Ethics and Health Policy Staff Publications

Background: Despite major shifts in U.S. federal government data sharing requirements, their impact, and relation to researcher choice of database, are underexplored. This study surveyed genetic researchers regarding trends, priorities, perceptions of quality, impact on research outcomes, and genomic data sharing and use across government, consortium, and private databases.

Methods: As part of an exploratory sequential mixed methods project, we surveyed 294 U.S.-based genomic academic researchers.

Results: Genetic researchers generally have a choice between databases, which allows them to prioritize data quality. This might explain recent trends toward the use of government and consortium databases away from private ones. Respondents …

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 …

Imagining Genomics And Population Health In 2050: Anticipating Future Research, Policy, And Governance Needs, Bartha Maria Knoppers, Yann Joly, Ma Apos N H Zawati, Habiba Alsafar, Jeffrey C Barrett, Laura Blackburn, Brian Hon-Yin Chung, Martina C Cornel, Edward S Dove, David Glazer, Calvin Wai-Loon Ho, Muin J Khoury, Anna C F Lewis, Anneke Lucassen, Peter F R Mills, Colin Mitchell, Nicola Mulder, Ainsley J Newson, Anthony Ng, Paul D P Pharoah, Vasiliki Rahimzadeh, Megan C Roberts, Saskia C Sanderson, Jeffrey M Skopek, Ron Zimmern, Eric M Meslin

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Clinicians’ Views On A Patient Decision Aid For Deep Brain Stimulation In Parkinson’S Disease, Hillary S King, Jennifer Blumenthal-Barby, Benjamin H Levi, Sol De Jesus, Harini Sarva, Laura Y Cabrera

Center for Medical Ethics and Health Policy Staff Publications

Introduction: For people with Parkinson's disease (PD), deciding whether to pursue deep brain stimulation (DBS) has become increasingly complex. Evidence suggests current approaches to collaborative decision-making may fall short of accepted standards. Thus, a decision support intervention, such as a patient decision aid (PtDA) may be warranted. PtDAs have been shown to improve patients' knowledge, expectations, and participation in decision-making for other, similar healthcare decisions. We therefore sought to assess neurologists' awareness of, and experience using, PtDAs, and to solicit their opinions on the ideal features of a PtDA for PD patients considering DBS.

Methods: Sixteen United States-based neurology clinicians …

Access To Digital Health Technologies: Personalized Framework And Global Perspectives, Sanjiv M Narayan, Mina K Chung, Demilade Adedinsewo, Luisa C C Brant, Leslie L Davis, David Duncker, Jennifer L Hall, Janet K Han, Carolyn S P Lam, Eldrin Lewis, Joseph Loscalzo, Manlio F Márquez, Vasiliki Rahimzadeh, Fatima Rodriguez, Prashanthan Sanders, Emma Svennberg, Kenneth Stein, Mintu Turakhia, Clyde Yancy, Antonis A Armoundas

Center for Medical Ethics and Health Policy Staff Publications

The emergence and rapid adoption of digital health technologies (DHT) present unprecedented opportunities to democratize and reduce disparities in health care by monitoring health and disease at the point of care in all patients. However, limited access to DHT is becoming a major obstacle to realizing these goals. Access to DHT is influenced not only by well-recognized social determinants of health, but also by digital determinants of health, such as digital literacy and the need for broad access to digital infrastructure, as well as commercial and economic factors. Addressing these challenges and designing unbiased systems of care are essential to …

A Qualitative Analysis Of Counseling And Nurse Practitioner Trainee Experiences Engaging With An Integrated Behavioral Health (Ibh) Training, Alexander M. Fields, Margaret Emerson, Stephanie Burge, Jill R. Reed, Therese L. Mathews Ph.D., Aprn, Bcba-D, Abby L. Bjornsen

Teaching and Supervision in Counseling

Integrated behavioral health (IBH) is recognized as the standard for holistic healthcare, addressing the intersection of mental and physical health. As IBH gains prominence, graduate healthcare programs must equip students with strategies to meet its demands. However, limited research exists on training methods that address diverse professional identities and the unique needs of graduate students. Our novel IBH training incorporates interprofessional education (IPE) through modules and simulations grounded in Bandura’s (2001) social cognitive theory. We explored the experiences of 12 counseling, family nurse practitioner, and psychiatric/mental health nurse practitioner students through focus groups. Through interpretative phenomenological analysis (IPA), we analyzed …

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Role-Playing For Rehabilitation: Enhancing Empathy Among Juveniles In Correctional Facilities, Nina Permatasari, Muhammad Arsyad, Muhammad Andri Setiawan, Hendro Yulius Suryo Putro, Muhammad Fajar Riva’I, Wiwik Widyanti

Buletin Konseling Inovatif

This study examines the effectiveness of role-playing-based counseling services in enhancing empathy among children at Juvenile Rehabilitation Center Class I Martapura. Employing a quantitative approach, the research utilized a one-group pre-test post-test experimental design to measure changes in empathy levels before and after the intervention. A total of 32 children participated in the study. Data were collected using two instruments: the Empathy Scale and the Role-Playing Engagement Questionnaire. The intervention consisted of structured role-playing sessions designed to improve both cognitive and affective components of empathy. Data analysis using paired sample t-tests revealed a statistically significant increase in empathy scores, with …

Bibliometric Analysis: Publish Or Perish And Vosviewer For Research Trends On Online Violence (2023–2025), Indriyana Rachmawati, Widya Juwita Sari, Sesya Dias Mumpuni

Buletin Konseling Inovatif

Cases of online violence have become increasingly widespread since the end of the COVID-19 pandemic, during which individuals began to grow dependent on the digital world. The digital realm has become a fundamental aspect of human life, bringing with it new forms of online violence. Online violence such as threats, hate speech, harassment, and bullying has emerged as a new weapon to control, isolate, and even torment affected victims. However, only a small body of literature has explored the changing nature of online violence following COVID-19. This study aims to review the literature on patterns of online violence post-pandemic, focusing …

Harmonizing Hope: An Idea Of Music Therapy Interventions For Schizophrenia, Dominikus David Biondi Situmorang

Buletin Konseling Inovatif

Schizophrenia is typified by a wide range of symptoms, such as delusions, hallucinations, cognitive decline, and social disengagement. Even with improvements in pharmaceutical and psychosocial therapy, many people with schizophrenia still require supplementary treatment methods due to their chronic symptoms and functional limitations. Utilizing music's therapeutic capacity to address a variety of symptoms and enhance general well-being, music therapy has emerged as a possible supplementary intervention for schizophrenia. In this study, the author used a literature review with a Critically Appraised Topic (CAT); this research is a summary of the best available evidence regarding the focused aims. This CAT looks …

Integrating Islamic-Based Behavioral Activation With Buya Hamka's Tazkiyatun Nafs To Reduce Social Media-Induced Anxiety Among University Students, Dosi Juliawati, Hengki Yandri, Farid Imam Kholidin, Rasmita Rasmita, Daflaini Daflaini, Yatti Fidya

Buletin Konseling Inovatif

The pervasive use of social media has led to a growing concern regarding social media-induced anxiety among university students. This study aims to integrate Islamic-based Behavioral Activation with the concept of Tazkiyatun Nafs, defined as the purification of the soul or self-purification, as proposed by Buya Hamka, to reduce this anxiety among university students. The method employed is a Single-Subject Experimental Design involving three participants from IAIN Kerinci, all of whom exhibited the highest scores of social media anxiety. Data were collected using the Social Media Anxiety Scale (SMAS) and analyzed through visual data analysis. The results indicate that all …

Peaceful School Counselors For School Violence In The Digital Era, Ahmad Yusuf Sobri, Nur Mega Aris Saputra, Dzulkifli Abdullah

Buletin Konseling Inovatif

The problem of violence that occurs in the world of education is a manifestation of the incomplete realization of schools as safe places. One strategy to make this happen is through the implementation of peace education in schools that involves all school members. School counselors are one of the key roles needed for the implementation of peace education in schools. This study aims to find out the role of school counselors in implementing peace education in schools. The study is a systematic literature review using the PRISMA stages. Fifteen academic articles were selected based on the main keywords: peace education …

The Role Of Self-Management Techniques For Reducing Gadget Addiction: Empowering Students Toward Healthier Digital Habit, Dian Ari Widyastuti, Lucky Resta Widias Putri

Buletin Konseling Inovatif

This study aims to examine the effectiveness of individual counseling using self-management techniques in reducing gadget addiction among students. The research employed an experimental approach with a single-subject design (SSD). One participant, a student from Yogyakarta, Indonesia was selected through purposive sampling. Data were collected using observation guidelines and a gadget addiction scale. Data analysis in single-subject research emphasizes individual data, and therefore, this study utilized visual analysis through graphical representations. The results of the visual analysis indicated a reduction in gadget addiction, as demonstrated by the A-B-A design graph. Based on these findings, it can be concluded that individual …

Peace Counseling In The Scientific Spotlight: A Bibliometric Analysis Of Global Research Trends, Wahyu Nanda Eka Saputra

Buletin Konseling Inovatif

This study aims to map global trends in peace counseling research using a bibliometric approach. Data were taken only from the Scopus database, focusing on publications containing keywords related to peace counseling, such as peace counseling, peace psychotherapy, and peacebuilding therapy. The analysis was conducted on 769 selected documents published between 1937 and 2025. The results showed a significant increase in publications since 2020, reflecting the growing need for counseling approaches that support peace and psychological well-being. Authors from various countries made different contributions, with the United States dominating the number of publications and citations, while developing countries such as …

Validation Of Micro Digital Content Model Of Project-Based Learning For Guidance And Counseling Courses In Non-Formal Education, Ella Faridati Zen, Yuliati Hotifah, Riskiyana Prihatiningsih, Nur Mega Aris Saputra

Buletin Konseling Inovatif

The research aims to produce a product in the form of a learning device for guidance and counseling courses in non-formal education in the form of micro digital based on project-based learning, which is theoretically accepted through expert testing. The development method uses the ADDIE design, with the procedures of Analysis, Design, Development, Implementation and Evaluation. The trial subjects or product assessors consist of material experts and media experts in the field of guidance and counseling. Data were collected with expert assessment instruments and analyzed using the average technique. The expert assessment of the product by material experts produced an …

Family Dementia Caregivers’ Disaster Preparedness In Chinese American Communities In New York City, Weiyu Mao, Bei Wu, Yaolin Pei, Zhen Cong

Health Sciences and Kinesiology Faculty Articles

Disaster preparedness is a significant public health concern. Disasters manifest in different forms and often lead to disruption of daily life. This is especially challenging for family dementia caregivers and their care recipients in the community. There remains much unknown regarding dementia caregiver disaster preparedness, especially in ethnic and racial communities. Guided by Protection Motivation Theory, with the backdrop of Hurricane Ida, this study explored the association between caregiving-related characteristics, cognitive appraisals, and disaster preparedness among caregivers in Chinese American communities. Data came from a pilot study on Chinese American family dementia caregivers in New York City between November 2021 …

Translating Evidence Into Action: Understanding How Community- Based Practitioners Make Intervention Implementation Decisions In Practice, Kristin C. Bennett

Dissertations and Theses (Open Access)

This study examined how community-based practitioners implement public health interventions in practice settings to identify gaps between existing implementation frameworks and real-world practice. Six farmers' markets in Southeast Texas served as cases to understand implementation decision-making by community-based practitioners addressing food access challenges. A qualitative case study approach was employed, using semi-structured interviews with program adopters and key stakeholders to examine how practitioners addressed food access problems, selected interventions, and navigated implementation decisions. This methodology captured the contextual nature of implementation decision-making in community settings. The findings revealed that program adopters recognized health problems through lived experience rather than formal …

Assessment Perception: Delivery Matters, Nicole Marie Arcuri-Sanders, Chelsey Simmons

Educational Sciences and Organizations

Perception shapes how individuals experience the world and guides their actions toward personal goals. In counseling, clients’ accurate understanding of assessment results is essential for informed decision-making and effective treatment engagement. Mental health clinicians have an ethical responsibility to communicate findings in ways that safeguard client welfare and empower both clients and stakeholders to collaborate in care. This conceptual manuscript introduces the BRIEF (Brief, Relevant, Interpretive, Empathetic, and Factual) Feedback Integration Framework, a structured model for delivering assessment feedback ethically and accessibly. Integrating cognitive, developmental, and cultural considerations. BRIEF provides counselors, supervisors, and educators with a practical strategy for improving …

Occupational Resilience (Part 1): Origins And Significance To Health And Well-Being, Bernard A. Muriithi, Jyothi Gupta

Occupational Therapy Faculty Scholarship

Occupational resilience (OR) is a novel concept emerging in occupational therapy and occupational science, with significant implications for the field. However, its definition is still evolving and needs clarity and consensus. In this article, we offer a definition inspired by the real-life experiences of refugee immigrants who have been resettled in the United States of America (USA). We define OR as the ability to persist in an occupation, where the duration and intensity of engagement are the essential contributors. Therefore, we propose that three elements, occupation, intensity, and duration, constitute the nature of OR and shape how occupation impacts health, …

Occupational Resilience (Part 2): Toward A Cross-Culturally Relevant Measure Of A Novel Construct, Bernard A. Muriithi, Milan Bimali

Occupational Therapy Faculty Scholarship

Occupational resilience (OR) refers to an individual’s ability to persist in performing an occupation, with the duration and intensity of engagement determining resilience for each occupation. It is a key determinant of both the manner and the extent to which occupations influence health; therefore, it is a promising construct with several potential applications. There are currently no validated OR measures; which problematizes its application. Three considerations were made in designing the Occupational Resilience Measure (ORM 1.0) and evaluating its potential as a cross-culturally relevant measure of OR: 1) the findings of a published study of lived experiences of refugees from …

A Study Of Perceptions, Readiness, Benefits, And Barriers Related To Exoskeleton Adoption In New Jersey’S Warehousing Sector, Terry Asante

Theses

The warehousing industry in New Jersey remains a vital component of the region's logistics network, employing more than 200,000 workers who routinely engage in lifting, bending, overhead reaching, and other physically demanding activities. These exposures contribute to musculoskeletal disorder (MSD) rates that exceed national averages, particularly affecting the low back and shoulders. Nationally, MSDs account for an estimated $420 billion in combined direct and indirect costs each year, underscoring the need for interventions that can effectively reduce biomechanical strain. Industrial exoskeletons have emerged as a potential solution, with prior research demonstrating reductions in muscle activation, perceived exertion, and fatigue during …

Accelerated Molecular Aging In Neighborhood Poverty: A Racial/Ethnic Comparison, Jennifer Robinette, Jennifer Smith

Psychology Faculty Articles and Research

In the US, racial/ethnic health disparities are undeniable and partially stem from residing in low SES neighborhoods. Associations between neighborhood SES and health may have some underlying molecular mechanisms reflected in the epigenome. Yet, neighborhood characteristics are not always experienced the same way for all residents, and questions remain regarding whether those most exposed to low SES neighborhoods build greater resilience to, or embody greater harmful and cumulative outcomes from, such neighborhoods. The present study tested the hypothesis that greater neighborhood poverty would relate to accelerated epigenetic aging on the Horvath, Hannum, PhenoAge, and GrimAge clocks, and that these associations …

Food Apartheid And The Retail Food Environment In The Bronx, Aissatou Barry

CUNY Mexican Studies Institute

This project examines the structural mechanisms that contribute to unequal food access, both historical and ongoing, in the South Bronx, and applies the food apartheid framework created by Bronx food activist Karen Washington. This paper applies the framework to two food retail initiatives in NYC: the New York State Regional Hub and the New York City FRESH food program to assess whether their policies address the structural mechanisms that contribute to food inequality. I ask: How does the unequal distribution of healthy food access in the Bronx reflect broader patterns of racial and economic exclusion? To what extent do current …

Clinical Pathway Sebagai Solusi Keberlanjutan Jkn Di Indonesia: Systematic Review, Septiana Septiana, Siti Soekiswati, Burhannudin Ichsan

Jurnal Ekonomi Kesehatan Indonesia

The National Health Insurance (JKN) program is threatened with a deficit and potential default in 2026 due to inefficiency and the risk of fraud in healthcare facilities. In the context of JKN, which uses a package system (INA-CBG), Clinical Pathway (CP) is a strategic instrument within the JKN system that has dual benefits for both Payers (BPJS Kesehatan) and Providers (Hospitals). For BPJS Kesehatan, CP primarily functions to ensure service quality and prevent undertreatment fraud, the practice of reducing services to benefit hospitals. This prevention ultimately achieves cost efficiency in the JKN program by avoiding payment of complication claims and …