Medicine and Health Sciences Commons^™

Expanding Narrative Medicine Through The Collaborative Construction And Compelling Performance Of Stories, Woods Nash, Mgbechi Erondu, Andrew Childress

Center for Medical Ethics and Health Policy Staff Publications

This essay proposes an expansion of the concept of narrative competence, beyond close reading, to include two more skills: the collaborative construction and compelling performance of stories. To show how this enhanced form of narrative competence can be attained, the essay describes Off Script, a cocurricular medical storytelling program with three phases: 1) creative writing workshop, 2) dress rehearsal, and 3) public performance of stories. In these phases, Off Script combines literary studies, creative writing, reflective practice, collegial feedback, and drama. With increased narrative competence, Off Script participants are likely better equipped to engage in more impactful health advocacy and …

Correction To: Black Bioethics In The Age Of Black Lives Matter, Keisha Ray, Faith E Fletcher, Daphne O Martschenko, Jennifer E James

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Pulse Oximetry And Arterial Saturation Difference In Pediatric Covid-19 Patients: Retrospective Analysis By Race, Fabio Savorgnan, Adel Hassan, Nirica Borges, Sebastian Acosta

Faculty, Staff and Students Publications

OBJECTIVES: Pulse oximetry (Sp o2 ) may overestimate arterial oxygen saturation (Sa o2 ) in blood laboratory testing. This study aimed to assess Sp o2 -Sa o2 difference in relation to race (i.e., patient self-reporting as Black or White), occult hypoxemia, and length of stay (LOS) in pediatric patients with COVID-19.

DESIGN: Single-center retrospective study in pediatric COVID-19 patients. We used multivariable linear regressions to examine the association between race and oximetry measurements and between occult hypoxemia and LOS. Oximetry bias was defined using Sp o2 and Sa o2 data according to approved comparisons. Occult hypoxemia was defined as Sp …

Promoting Ocd Wellness And Resilience (Power) Study: Rationale, Design, And Methods, Jessica D Leuchter, Minjee Kook, Daniel A Geller, Alyssa G Hertz, Jessica Garcia, Erika S Trent, Tracey Dibbs, Ogechi Onyeka, Wayne K Goodman, Andrew G Guzick, Andrew D Wiese, Amanda D Palo, Brent J Small, H Blair Simpson, Lauren K Havel, Sohail A Nibras, Kirti Saxena, Eric A Storch

Faculty, Staff and Students Publications

Obsessive-compulsive disorder (OCD) affects 1-2% of children and is associated with functional impairment and diminished quality of life. Several treatments are efficacious: cognitive behavioral therapy (CBT) with exposure and response prevention, serotonin reuptake inhibitor (SRI) monotherapy, and combined treatment (SRI + CBT). Expert clinician-informed practice parameters suggest that youth with mild to moderate OCD should be treated initially with CBT yet SRIs are frequently employed as the first-line intervention or in combination with psychotherapy in applied practice. Empirical data to guide SRI discontinuation in pediatric OCD are very limited. This study, Promoting OCD Wellness and Resiliency (POWER), aims to address …

Patient Engagement In A Multimodal Digital Phenotyping Study Of Opioid Use Disorder, Cynthia I. Campbell, Ching-Hua Chen, Sara R. Adams, Asma Asyyed, Ninad R. Athale, Monique B. Does, Saeed Hassanpour, Emily Hichborn, Melanie Jackson-Morris, Nicholas C. Jacobson, Heather K. Jones, David Kotz, Chantal A. Lambert-Harris, Zhiguo Li, Bethany Mcleman, Varun Mishra, Catherine Stanger, Geetha Subramaniam, Weiyi Wu, Christopher Zegers, Lisa A. Marsch

Dartmouth Scholarship

Background: Multiple digital data sources can capture moment-to-moment information to advance a robust understanding of opioid use disorder (OUD) behavior, ultimately creating a digital phenotype for each patient. This information can lead to individualized interventions to improve treatment for OUD.

Objective: The aim is to examine patient engagement with multiple digital phenotyping methods among patients receiving buprenorphine medication for OUD.

Methods: The study enrolled 65 patients receiving buprenorphine for OUD between June 2020 and January 2021 from 4 addiction medicine programs in an integrated health care delivery system in Northern California. Ecological momentary assessment (EMA), sensor data, and social media …

Divergent Clinical Presentations And Outcomes Among Children And Adolescents With Kaposi Sarcoma In Malawi And Tanzania, Liane R Campbell, Allison Silverstein, Erin Peckham-Gregory, William Kamiyango, Jimmy Villiera, Casey L Mcatee, Jason M Bacha, Carrie L Kovarik, Parth S Mehta, Toni Chanroo, Asulwisye Kapesa, Beatrice Malingoti, Rizine Mzikamanda, Nmazuo W Ozuah, Carl E Allen, Michael E Scheurer, Nader K El-Mallawany

Center for Medical Ethics and Health Policy Staff Publications

Objectives: The Kaposi sarcoma (KS) T0 versus T1 staging classification does not address the unique clinical features of paediatric KS in human gammaherpesvirus 8 (HHV-8) endemic regions of Africa. This study seeks to define patterns of childhood KS using a paediatric-specific approach.

Methods: The Lilongwe paediatric KS staging classification categorizes disease based on clinical phenotype: stage 1 = mild/moderate KS limited to cutaneous/oral involvement, stage 2 = primarily lymphadenopathic disease, stage 3 = woody edema KS, stage 4 = visceral and/or severe/disseminated mucocutaneous disease. Characteristics and outcomes were evaluated from paediatric referral centres in Lilongwe, Malawi, and Mbeya, Tanzania.

Results: …

Black Bioethics In The Age Of Black Lives Matter, Keisha Ray, Faith E Fletcher, Daphne O Martschenko, Jennifer E James

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Strategies For Recruiting Underrepresented In Medicine And Sexual And Gender Minority Students To Emergency Medicine, Lauren T Wilson, Benjamin Weigel, Edgardo Ordonez, Navdeep Sekhon, Adedoyin Adesina, Anisha Turner, Aleksandr M Tichter, Sarah Bezek, Ynhi T Thomas

Faculty, Staff and Students Publications

BACKGROUND: Despite having well-described benefits, diversifying the physician workforce has been an ongoing challenge. Within emergency medicine (EM), multiple professional organizations have identified expanding diversity and inclusion as top priorities. The following is a description of an interactive session held at the SAEM annual meeting addressing recruitment strategies for underrepresented in medicine (URiM) and sexual and gender minority (SGM) students into EM.

METHODS: During the session, the authors provided an overview of the current state of diversity in EM. In the small-group portion of the session, a facilitator helped characterize the challenges programs face in recruiting URiM and SGM students. …

“Too Many Meanings”: Reading “Piro Designs”, Paolo Fortis, Margherita Margiotti

Tipití: Journal of the Society for the Anthropology of Lowland South America

This paper explores the notion of painting as meaningful action (Gow 1999) and highlights the productivity of the idea as emerging from, and dovetailing, different strands of thought on the nature of symbols and actions. Bringing together Lévi-Strauss’ intuition on the dynamism and generativity of graphic systems, phenomenological studies on meaning making, and ethnographic analyses of Amazonian theories of corporeality and sociality, Gow has shown how Yine (Piro) designs provide a developmental model that combines ontogenesis and social change. This paper argues for the productivity of this approach in Amerindian studies, in anthropology, and in a dialogue with psychoanalytic theory …

The Effect Of Information On Blame Attributed To Four Entities In A Police Shooting, Pauline Meyer

Student Theses and Dissertations

Police shootings continue to negatively impact the public perception of police. When it comes to attributing blame in a police shooting, both internal and external factors affect how much blame a person places on the entities involved. One hundred and twenty Arkansas State undergraduate students enrolled in a psychology or criminology course were randomly assigned to one of the three type of information groups: the episodic, thematic-pattern of violence (TPV), or the thematic-police reform (TPR) group, and then read about the Stephon Clark shooting in 2018. Participants attributed blame scores to the four entities involved: Stephon Clark, the police chief, …

Strengthening The Marketing Of Pediatric Cardiac Surgery Services To Support The Transformation Of Health Services In Indonesia, Felicia Gunardi, Puput Oktamianti

Journal of Indonesian Health Policy and Administration

This study aims to determine the marketing strategy 7P carried out by cardiac surgery services in Indonesia and to identify actionable policy recommendations. This study is observational descriptive research. Data were collected from Cardiothoracic and Vascular surgeons and hospital websites with cardiac surgery services. Through the marketing analysis approach of 7P, this study identifies problems and policy recommendations that can be alternative solutions. The price of the service is high, but most of the patients used BPJS, and it is found that the hospital rate is higher than BPJS claims. The actionable recommendation to respond to it is that the …

Hospital Ambulance Standardization In Jakarta: Narrative Review, Roy Michael Suranta, Ascobat Gani

Journal of Indonesian Health Policy and Administration

Ambulance is one of the hospital infrastructures that must meet service standards, security, and occupational safety and health in hospital operations. Therefore, it is the obligation of every hospital to ensure the standard of ambulance service. In the DKI Jakarta area, every ambulance, including hospital ambulances, must meet the standards in accordance with regulations and have an ambulance operating license. Based on data until the end of 2021, there were 82 (34.9%) hospital ambulances in Jakarta that carried out the recommendation process for an ambulance operation license from a total of 235 hospital ambulances, meaning that most hospital ambulances in …

Implementation Analysis Of The Pariaman City Regional Regulation No. 9 Of 2015 Concerning The Drinking Water Depot Business Permit, Melia Roza

Journal of Indonesian Health Policy and Administration

To regulate the existence of Drinking Water Depots (DAM) in the city of Pariaman, the Pariaman City government issued Regional Regulation (Perda) Kota Pariaman No. 9 of 2015 concerning Business Permits for Drinking Water Depots. However, many depot owners do not implement these regulations. The purpose of this study was to analyze the implementation of Pariaman City Regional Regulation No. 9 of 2015 concerning Drinking Water Depot Business Permits. This research is a type of qualitative research. Data collection was carried out through in-depth interviews with informants involved in the implementation of Pariaman City Regional Regulation No. 9 of 2015 …

Obesity Risk And Comorbidities Among Colombians In New York City And In Colombia, Carlos A. Devia

Dissertations and Theses

Introduction: The prevalence of obesity and overweight in adults and children continues to increase worldwide, accounting for the mortality and morbidity from several diseases. Obesity disproportionally impacts Latinos in the United States (U.S.), and despite their diversity in origins, ancestry, and culture, it is still unclear the burden of obesity by specific Latino groups. For example, little information is available about how obesity impacts Colombians in the U.S. (the largest South American population). New evidence also indicates that Latino immigrants may no longer be arriving with healthy weight status to the U.S. because Latin American countries are undergoing epidemiologic and …

Investigating And Mitigating The Harmful Impact Of Precarious Employment On The Health And Well-Being Of New York City Food Workers, Emilia F. Vignola

Dissertations and Theses

Much of the United States (US) food chain – from production to processing, wholesale, retail, and services – is characterized by precarious employment, defined as work with little employment security, inadequate income, and limited rights and protections. Studies show that precarious employment is associated with adverse mental and physical health and well-being outcomes. Separate research indicates numerous health issues in certain segments of the food workforce; little scholarly work has explored the contribution of precarious employment as an upstream driver of these health issues. Gaps remain in our understanding of 1) the health needs and status of workers across the …

Whole-Genome Sequencing Analysis Of Human Metabolome In Multi-Ethnic Populations, Elena V Feofanova, Michael R Brown, Taryn Alkis, Astrid M Manuel, Xihao Li, Usman A Tahir, Zilin Li, Kevin M Mendez, Rachel S Kelly, Qibin Qi, Han Chen, Martin G Larson, Rozenn N Lemaitre, Alanna C Morrison, Charles Grieser, Kari E Wong, Robert E Gerszten, Zhongming Zhao, Jessica Lasky-Su, Bing Yu

Faculty, Staff and Student Publications

Circulating metabolite levels may reflect the state of the human organism in health and disease, however, the genetic architecture of metabolites is not fully understood. We have performed a whole-genome sequencing association analysis of both common and rare variants in up to 11,840 multi-ethnic participants from five studies with up to 1666 circulating metabolites. We have discovered 1985 novel variant-metabolite associations, and validated 761 locus-metabolite associations reported previously. Seventy-nine novel variant-metabolite associations have been replicated, including three genetic loci located on the X chromosome that have demonstrated its involvement in metabolic regulation. Gene-based analysis have provided further support for seven …

Perceptions Of Health Workers Regarding The Covid-19 Vaccine Report Application In Ogan Ilir Regency, South Sumatra, Haerawati Idris, Amrina Rosyada, Anggun Budiastuti, Nurmalia Ermi

Journal of Indonesian Health Policy and Administration

The Lapor Vaksin COVID-19 Application was developed to support a vaccination coverage surveillance database sourced from community self-report. This application provides data on vaccination coverage and allows users to view updates to educational content about vaccines and visualization of COVID-19 vaccine data in real-time. This study aims to analyze the perception among health worker about Lapor Vaksin COVID-19 application in the community. This study uses descriptive research with a case study design. This study was conducted in September 2021 through a virtual zoom meeting, in Ogan Ilir Regency, South Sumatra. The research sample was 42 health workers consisting of vaccine …

Health Care Spending For Cardiovascular Disease Under National Health Insurance Scheme In Indonesia Before And During Covid-19: Descriptive Analysis And Policyrecommendations, Atik Nurwahyuni, Prastuti Soewondo, Mardiati Nadjib, Yuli Farianti, Mazda Novi Mukhlisa, Helmi Wahyuningsih, Emmy Ridhawaty Mangunsong, Athiyah Athiyah, Yunita Yunita, Sekar Arum Handarbeni Sayekti, Kurnia Sari, Amila Megraini

Journal of Indonesian Health Policy and Administration

The Cardiovascular disease (CVD) prevalence continues to increase. This study aims to identify the CVD spending and utilization in the Indonesia National Health Insurance (JKN) scheme 2017-2021 using the JKN claims classified by Disease Accounts analyzed descriptively. The CVD spending increased by $125,4 million in 2019 compared to 2017 and mostly for the hospital (91% in 2019) with the highest spending occurring in the age above 60 years. Moreover, the hospital inpatient spending was dominated during these five years. The highest portion of spending by severity level was at mild level, followed by moderate and severe levels. Health facilities’ capacities …

Table Of Contents Vol 6 (1) May 2023

The International Journal of Ecopsychology (IJE)

No abstract provided.

Phenomenographic Interpretation Of The Spanish Universalist School: Part I/Iii

The International Journal of Ecopsychology (IJE)

Since the beginning of the XX Century, it exists as anti-Spanish propaganda, a stable narrative promoted since the XVI Century: The black legend (Leyenda Negra). This is one of the main reasons why, frequently, the Spanish pensamiento has been reconstructed in a half-hazard and incomplete manner. Paradoxically, this is the result of a past with high relevancy, developing as it did as imperial Catholic culture, integrating and civilizing different peoples as humanly and morally equals. More deservedly, a modern sense of a “self,” rightfully examined, is the idea of a “self” created by the School of Salamanca (see …

Editorial Introduction Vol 6 (1) 2023

The International Journal of Ecopsychology (IJE)

No abstract provided.

New Coyote (Qomu'tsau) Stories: Death

The International Journal of Ecopsychology (IJE)

No abstract provided.

Death Cafés As A Strategy To Foster Compassionate Communities: Contributions For Death And Grief Literacy

The International Journal of Ecopsychology (IJE)

The death-positive movement, the most recent manifestation of the death awareness movement, contends that modern society is suffering from a “death taboo” and that people should talk more openly about death. This movement is striving to shift the dialogue about (and place of) death and dying into community spaces. Death literacy is defined as a set of skills and knowledge enabling people to learn about, understand, and act on end-of-life and death-care options. People and groups with a high level of death literacy have a context-specific comprehension of the death system and can more easily adapt to it, becoming better …

Interview: Implementing A “Sense Of Place” Pedagogy In The Valley Of Alagón, Spain

The International Journal of Ecopsychology (IJE)

No abstract provided.

Exordium: Lost Words, Lost Worlds

The International Journal of Ecopsychology (IJE)

Brunold-Conesa, C. (2022). Lost Words, Lost Nature: A Dictionary's Controversial Choices. Montessori Life: The Official Blog and Magazine of the American Montessori Society, Wednesday, September 07, 2022. https://amshq.org/Blog/2022-09-07-Lost-Words-Lost-Nature

Book Review: Jared Farmer's (2022) Elderflora: A Modern History Of Ancient Trees. Ny: Basic Books.

The International Journal of Ecopsychology (IJE)

No abstract provided.

Poem: Adrienne Rich's (1955) "Ideal Landscape"

The International Journal of Ecopsychology (IJE)

No abstract provided.

Dirt, Ground And Groundedness: Material Semiotics And Social Anchors Of The Real And Truth In The Modernist Imaginary

The International Journal of Ecopsychology (IJE)

What makes the ground (earth, dirt, soil) the axial point of reference for modern subjectivity? In this paper, I explore the semiotics of the ground and the complex ways modern subjectivity sets a performative frame around association/disassociation with dirt. From the hygiene hypothesis and the problematic of modern existence and the lack of understanding of the good of dirt for the immune system to the ontology of being real in grounded theory, how we posit our connection to the ground can inform us of the way that we seek to anchor our place in the world. In this anchoring to …

Psychenatur: Selfing And Naturing

The International Journal of Ecopsychology (IJE)

Insofar as our sense of and appreciation of “nature aesthetics” is both culturally biased and subjectively determined (given our agentic proclivities and/or actual degrees of freedom), and while taking the more inclusive perspective that, objectively so, ‘nature’ are all the processes seen and unseen that existed, now exist, and will exist, from the infinitesimally small to those of cosmic proportions, and, that whatever we mean by a singular “self” stands, in reality, for a multiplicity of self-other and self-otherness references (i.e., intersectionality during the entire life of a given individual—see Fig. 3), then all characterizations easily or convolutely described …

Artist's Corner: Isabel Cidoncha

The International Journal of Ecopsychology (IJE)

No abstract provided.