Phenomenology and the Medical Humanities

https://dsc.duq.edu/phen-intro-videos/1013/thumbnail.jp

Making and Breaking Bonds: Studying Intrinsic Chemistry in the Gas-Phase

The nature of chemical interactions can be difficult to ascertain in the condensed phase; chemistry can be observed, but with the plethora of variables such as solvation, mixes of counter-ions, and complex equilibria, the true intrinsic chemical properties of a given chemical species may be obfuscated. By conducting research in the gas-phase, many of these variables can be reduced, if not eliminated entirely, which can allow for the careful observation of the true physical phenomena driving chemical reactivity. The research presented herein focuses on the use of ion-trapping (specifically in a linear ion trap) as a method for unveiling the intrinsic chemistry of gaseous ions. The ion trap as a platform for this research provides a mechanism for inducing exergonic reactions by providing energy to the trapped species, and also a method of observing spontaneous (endergonic) reactions by allowing ions to interact with neutral molecules. A series of experiments are presented which highlight the methods available for the interrogation of gas-phase ions, showing how one may determine the composition, reactivity, and structure of both known and unknown species. These methods include isotopic substitution experiments, collection of high mass-accuracy measurements of the ions’ m/z, observation of reactions with adventitious neutral molecules, introduction of specific neutral molecules to observe reactivity, and the use of theoretical calculations such as density functional theory and natural bonding orbital theory. Data is presented on a range of metal-centered species is shown, specifically focusing on copper-, uranium-, calcium-, strontium-, and barium-centered complexes. The development of a technique specific to the instrumentation discussed in this work for the measurement of kinetic data is also presented. Ideas for future work which can be based around the conclusions and methods of this work are also presented

Lateral Others in the Trauma Narrative: The Place of the Sibling in Accounts of Abuse and Neglect

The present study aimed to investigate the place of the sibling in narratives of developmental trauma as well as the sibling relationship’s impact on the formation of sense of self. Another area of interest was the impact of congruence versus incongruence in the narrative between siblings. In other words, this study sought to illuminate the impact when the sibling is understood to have reached different conclusions about shared experiences of abuse and neglect. This study is grounded in the literature on siblings from psychoanalytic, attachment, and family systems perspectives. A series of narrative interviews were conducted with participants who identified as survivors of childhood abuse and neglect and had a sibling in the home during these experiences. The data was then analyzed using a method of narrative analysis adapted from Lieblich, Tuval-Mashiach, and Zilber (1998). The analysis was organized to address the relevant themes that emerged around the sibling as a figure in their story, as well as sense of self, sense of narrative congruence or incongruence with the sibling, and narrative form. The sibling emerged as an ambivalent figure in the context of trauma, capable of facilitating growth and possibility or compounding the effects of the trauma through repetition of harmful dynamics. These elements were categorized into broader themes of foreclosure and themes of transformation. Another theme that emerged was that of meaning making. Cultural influence, particularly religion, gender, and race, were explored as crucial factors that shaped the meaning making process as well as sense of self

For The Good of Association: The Call-and-Response Communication Ethics of the Early NAACP

This dissertation is an exploration of the formation of the National Association for the Advancement of Colored People (NAACP), from the standpoint of communication studies. In particular, this dissertation is based on the research of several crucial, communicative artifacts, including: “The Call” penned by William English Walling; the addresses, speeches, and the panel discussion of the Negro National Conference; and the editorial of the first issue The Crisis magazine. The contention is that the communication of the NAACP was catalyzed by a communication ethic, nominated as call-and-response communication ethics. Therefore, this dissertation elucidates the four practices of call-and-response communication ethics: Provocation, convocation, evocation, and “polyvocation” and it announces the implications of call-and-reponse communication ethics for this current historical moment

The Aquatic Microbial Environment Shapes the Gut Microbiota, Brain, and Behavior of Larval Amphibians

Microbial communities comprising bacteria, viruses, fungi, and protists live within and on the surfaces of animal hosts. These microbial communities exist in symbiosis with the host, and heavily influence host physiology, development, health, and fitness. Gut-dwelling microbes (i.e., gut microbiota) contribute to host neurodevelopment through a bidirectional Microbiota-Gut-Brain (MGB) axis. Evidence of the MGB axis has been primarily derived from studies that use germ-free (GF) models, which commonly display altered neurophysiology and behavior compared to conventionally raised counterparts. Almost all studies of the MGB axis have used mammalian models in a biomedical framework, leaving a knowledge gap regarding the role of the gut microbiota in neurodevelopment and behavior in non-mammalian animals and in more ecological contexts. The goal of my dissertation was to evaluate how the aquatic microbial environment influences the biodiversity of the amphibian gut microbiota, and how these shifts in the microbiota influence amphibian neurodevelopment and behavior. Findings of associations between the gut microbiota and amphibian neurodevelopment and behavior are consistent with the presence of a MGB axis and can offer insight as to whether particular aspects of the gut microbiota (i.e., diversity and taxa abundance) were significantly associated with tadpole development and physiology. First, I tested whether manipulation of the gut microbiota affected the brain development of Green Frog (Lithobates clamitans) tadpoles. Tadpoles were raised in natural (unmanipulated) pond water or autoclaved pond water at three different water temperatures: 14, 22 and 28°C. Autoclaving reduced the number of aquatic microbes available to colonize the tadpole and thereby resulted in a gut microbiota with reduced microbial biodiversity and altered community composition compared to tadpoles raised in natural pond water. Both temperature and the aquatic microbial community during development affected tadpole brain shape, and the biodiversity of the tadpole gut microbiota was negatively associated with the size of the optic tectum. These results provide some of the first evidence of the MGB axis in amphibians. Next, I examined an additional species and incorporated behavioral assays to evaluate potential functional consequences of gut microbial manipulation. To do this, I raised Northern Leopard Frog (Lithobates pipiens) tadpoles in natural or autoclaved pond water. Compared to tadpoles raised in natural pond water, tadpoles raised in autoclaved pond water: (1) had altered gut microbial community composition and decreased biodiversity, (2) had decreased locomotory responses to visual stimuli, (3) had relatively heavier brains and altered brain shape, and (4) were larger and developed faster. Additionally, the composition and diversity of the gut microbiota was a significant predictor of tadpole brain size, brain shape, and locomotory behavior. Finally, I tested whether exposure to both a depleted aquatic microbial community and an ecological stressor had interactive effects on physiological and neurodevelopmental endpoints in tadpoles. In mammals, the composition of the gut microbiota, and subsequently the development of the MGB axis, is shaped by stressors. Due to frequent exposure of wildlife to relevant ecological stressors such as predation, examining the role of stressors on the formation of the gut microbiota and subsequent physiological and neurodevelopmental endpoints is of interest. I exposed tadpoles to predation-derived chemical cues, exogenous corticosterone (CORT), or a vehicle control. I simultaneously exposed tadpoles to either natural or autoclaved pond water. I found no clear effects of predator cues, but tadpoles exposed to CORT had altered composition of their gut microbiota, altered brain shape, and altered tail shape compared to control. Additionally, I replicated previous results by finding that tadpoles raised in autoclaved pond water were larger, had altered brain development, and a dramatically altered gut microbiota that predicted several neurodevelopmental endpoints. Encouragingly, tadpoles raised in autoclaved pond water also displayed reduced ability to evade predators, which likely impacts fitness and survival. I found surprisingly few interactive effects of the aquatic microbial community and stressors. Overall, my dissertation work provides novel evidence of the MGB axis in larval amphibians. My work highlights the importance of the promotion and maintenance of freshwater ecosystem health, as aquatic microbial communities present in these waters are shown to have dramatic and consistent impacts on amphibian body size, neurodevelopment, and fitness-related behaviors

The Role of Consumerism in Pharmacy Education

The notion of consumerism and that students are customers of pharmacy colleges was explored by proponents and opponents of the idea. First, a working definition of a “customer” in pharmacy education is pondered with respect to the roles and responsibilities of students and schools/colleges of pharmacy. Second, the pros and cons of “student-centered” education are considered in the light of students and their families being consumers of the educational experience. Third, the duality of student-centered education is discussed including student engagement/disengagement in their learning, professional/unprofessional behaviors, and shared/individual responsibilities. Lastly, learning and teaching environment dynamics are discerned when higher education becomes more student-centric and how that may affect the overall outcome of the student and the goals of pharmacy educational programs

Healthcare for Undocumented People in America

Millions of undocumented people live in America and roughly a million have entered every year since 2021. This is a hot-button issue in mainstream politics for a variety of reasons. However, there is an issue that tends to get overlooked which is their health care. In most states, undocumented people do not qualify for healthcare coverage of any kind. This leaves them reliant on EMTALA and emergency departments (ED). Through an examination of the various state and federal policies that pertain to undocumented people’s healthcare coverage, we can see that these people are in desperate need of assistance. It becomes clear that having millions of people reliant on EDs as their primary care leads to major issues with resource allocation, budgeting, and physician fatigue for hospitals around the country. New York and California both have programs that extend Medicaid eligibility to undocumented people. This model is quick and effective. However, it can be quite controversial since there are still nearly a dozen states that have yet to sign on to the Medicaid expansion for low-income Americans put in place by the ACA. Another possible model is one represented in Massachusetts that helps fund more free clinics and city or charitable hospitals around the state. This is a model that may be less controversial since it helps everyone, Americans and undocumented people alike. Also, a case study of a patient named Mrs. Gomez who was an undocumented person with kidney failure receiving care regularly through an ED can show the tension that can arise between the beneficence-focused physician and the justice-focused director of the ED. All of this suggests that America must find effective ways to provide affordable and accessible health care for all people in America, Americans and undocumented people alike. This is a matter of justice

Catholic Ethics in the World of Clinical Research: A Study of Social Responsibility

After the many global tragedies of the early 20th century, an emerging sense of social and moral urgency catalyzed the nations of the world to attempt to develop and promulgate ethical standards for clinical research. Seminal documents such as The Nuremberg Code, The Declaration of Helsinki, and The Belmont Report attempted to bridge the chasm that allowed such tragedies. The Belmont Report, specifically, pointed towards universal ethical principles that later evolved into what is widely known now as the four core bioethical tenets: beneficence, the duty to promote the welfare and good of others; nonmaleficence, the obligation to avoid causing harm; justice, the requirement of equal and fair treatment; and autonomy, the right of individuals to make independent, informed choices. More nuanced guidance would later be refined from the four principles for clinical research in the 21st century, such as those outlined in The Oxford Textbook of Clinical Research Ethics. However, despite the ubiquitous nature of these principles, they have disconnected instructions on the inherent social responsibilities of clinical research. To fill this void, Catholic Social Teachings founded on the three-fold cornerstone of human dignity, solidarity, and subsidiarity offer a basis for a new principle of social responsibility. Human dignity, the first of the three cornerstones, is the belief that all human life possesses intrinsic, inviolable value. Solidarity is the overarching interdependence among all humans on one another, and finally, subsidiarity is the coordination of society to support the lives of local communities. Therefore, this research assesses the essential components of clinical research while also exploring the foundational documents that led to the principles approach; by doing so, it highlights the deficiency in these principles\u27 ability to address social stewardship. To address this apparent gap, it proposes a new principle of social responsibility built upon Catholic Social Teachings. Incorporating the new principle of social responsibility will enrich our current ethical framework for clinical research, and it is imperative to truly fulfill the goals set by humanity after World War II

Social Communication and Parent Verbal Responsiveness Across Interaction Contexts in Toddlers on the Autism Spectrum

PURPOSE: Interactions with caregivers during the ordinary activities that occur as families go about their everyday lives are critical to supporting children\u27s acquisition of social communication and language skills. The purpose of this study was to examine child communication and parent verbal responsiveness across interaction contexts in 211 children (Mage= 20 months) on the autism spectrum (n = 121), with developmental delay (n = 46), or with typical development (n = 44). METHOD: Families participated in up to eight activities during an hour-long, video-recorded home observation. We tested differences in the strength of associations between diagnostic group and interaction context using linear mixed-effects models, with child rate per minute of communication and proportions of parent follow-in comments and directives as outcome variables. Child communicative functions expressed across contexts were also examined. RESULTS: Children across groups communicated at significantly higher rates per minute during book sharing and play with people compared to other interaction contexts. Most child communication was for the function of joint attention during book sharing, for social interaction during play with people, and for behavior regulation during necessary activities such as family chores and meals. On average, parents of children responded using proportionally more follow-in comments during book sharing and play compared to necessary activities, during which parents used more follow-in directives. CONCLUSION: Results provide a glimpse into the dyadic communication that may occur within everyday activities at home, which supports the need for future intervention research and may aid clinicians seeking to identify activities that serve as important contexts for intervention

Digital Inclusivity Matters: Media Selection Among Arab English Teachers

This qualitative, phenomenological study investigates the impact of culture on media choices in English as a Foreign Language (EFL) classrooms within an Arab region in Israel. In addition to traditional grammar-focused instruction, EFL instructors in Israel integrate technology and media to expose students to authentic English pronunciation and cultural communication. However, this technological integration not only facilitates global material transfer but also triggers shifts in different life dynamics. The EFL curriculum, shaped by Western and Jewish ideologies and overseen by the Ministry of Education, faces a critical gap: the lack of representation of Palestinian Arabs. This absence results in conflicts related to teaching methods and identity formation within the Arab sector. Guided by the frameworks of technological and cultural determinism, this research poses a pivotal question: How do Arab EFL teachers in Israel teach authentic English using media and navigate the potential cultural differences that may arise from this exposure? Through semi-structured interviews, data from seven Arab EFL teachers reveal that culture significantly influences their pedagogical choices regarding media integration. Despite recognizing the potential of technology, teachers employ strategies such as avoiding certain media or editing content to preserve their own culture and religion, which may inadvertently impact implicit language acquisition. Furthermore, the absence of Arab representation in media and textbooks perpetuates Western cultural superiority, affecting Arab students’ perceptions of their own culture. Consequently, this study advocates for a comprehensive curriculum design and an inclusive digital educational environment that emphasizes diverse cultural perspectives. Keywords: EFL Pedagogy, Cultural Determinism, Technology Determinism, TA