Association Between Decisional Conflict and Quality of Life Among Parents with a Child Undergoing Hospital-based Treatment for a Recent Cancer Diagnosis

Having a child with a chronic illness, such as cancer, can cause families significant distress. Parents of these children must make frequent decisions relating to their child’s care. Depending on factors such as health literacy and support from medical staff, parents may have varying levels of decisional conflict (DC) throughout the decision-making process. Compounding stress throughout their child’s illness can often contribute to lower levels of health-related quality of life (HRQoL) while their child is receiving hospital-based treatment. Parents with a non-English language preference (NELP) often have greater challenges navigating healthcare systems due to a lack of resources and limited health literacy. The present study investigated the association between parental DC and HRQoL among 35 Latinx and White parents caring for a child with cancer. Differences in DC and HRQoL between three language groups: monolingual English, monolingual Spanish, and bilingual English and Spanish were also examined. Results indicated that higher DC was a statistically significant predictor of lower HRQoL. Additionally, there was no significant difference between language groups on either DC or HRQoL. Results suggest the need for further support for parents making decisions for their children to limit possible impacts on their HRQoL while caring for their child. Future research should include studies in various geographic locations to gain data from more diverse hospital systems and improve the generalizability of results. Furthermore, qualitative research studies could be implemented to provide parents with opportunities to explain their experiences more in-depth, which could help inform directions for additional quantitative studies

Adopting Permissioned Blockchain Models to Enhance Consumer Protection and Comply with Consumer Protection Laws

Blockchain technology enables decentralized, peer-to-peer transactions and data management, offering transparency while raising data privacy and consumer protection concerns. As the current administration promotes blockchain adoption, including cryptocurrency, more users and businesses will likely integrate the technology. This thesis provides a framework to help businesses adopt blockchain while ensuring compliance with the California Consumer Privacy Act (CCPA). To prevent data mishandling and legal penalties, consumers and businesses must stay informed about the risks and evolving state privacy laws. A CCPA-compliant approach retains blockchain’s benefits through a permissioned model, storing only non-personal (neutral) data on-chain while keeping personal information off-chain in a cloud database subject to auditing. This model reduces transmission-stage data breaches common in permissionless blockchains and enhances security through smart contracts. However, blockchain’s immutability poses challenges for data deletion requests. While hashing can obscure consumer data, it does not comply with the CCPA since it restricts a consumer’s right to access collected information. Similarly, while encryption can safeguard sensitive business data, it does not exempt businesses from complying with consumer privacy rights. Amendments to the CCPA, effective January 1, 2025, classify encrypted data as “personal information” and require pseudonymized data to be separately protected to prevent reidentification. The European Union’s General Data Protection Regulation (GDPR) reinforces this by stating that pseudonymization alone is insufficient to protect personal data. To align with consumer protections, states should mandate that permissionless blockchains share only neutral data and define blockchain developers as data controllers. Given that 70% of blockchain hacks occur at the transmission stage, encouraging permissioned models could mitigate data leaks. This thesis calls for multistate collaboration to establish uniform regulations supporting seamless business operations. It also acknowledges the federal limitations of H.R. 6572, the Deploying American Blockchains Act of 2023, and the potential for congressional amendments under the current administration, which could preempt state laws under the Supremacy Clause

Photo Essay: Japan’s Demographic Changes and Opportunities: A Tale of Two Cities

Japan is in the midst of a population implosion. Schools struggle to fill classrooms, and vacant houses are a common sight in smaller towns. While the demographic shift makes it difficult to sustain traditional ways of life, it also brings opportunities for new possibilities. This essay highlights the challenges and opportunities of demographic change through the stories of two communities: Tsushima City in Aichi Prefecture and Ikuno Ward in Osaka City. In Tsushima, residents have embraced a more inclusive approach to their autumn festival, inviting women and non-residents to perform roles previously reserved for male residents. In Ikuno, a closed school was turned into a co-working space for community members and small businesses. The experiences of Tsushima and Ikuno illuminate opportunities for inclusiveness and creativity in the face of demographic transition

Controlling Women’s Bodies and Controlling the Population in China, Korea, and Taiwan

In 2024, Taiwan and South Korea had the lowest fertility rates in the world. Instead of solving this demographic conundrum, this paper examines the ways in which women, family and fertility have been described, measured, and discussed across time and space in East Asia and introduces the role of US Christian ideology in propagating population control. US Christian missionaries and networks forged in China and Korea in the nineteenth century built a foundation for the social sciences of the family in early twentieth century China that developed into US modernization theory-led demography in the Republic of China on Taiwan and the Republic of Korea during the Cold War. Missionary attempts to liberate women from the shackles of the East Asian family informed research, policy and political systems that continue to make her the political target of population policies today

Enhancing Access to Medication-Assisted Treatment (MAT) for Minority Inmates in the San Diego Prison System: A Quality Improvement through Culturally Competent Approach

Abstract Background The opioid crisis disproportionately affects racial and ethnic minority groups, particularly in correctional settings. In San Diego’s prison system, only 20% of incarcerated individuals with Opioid Use Disorder (OUD) receive Medication-Assisted Treatment (MAT), highlighting significant care disparities. Local Problem Limited access to MAT among minority inmates contributes to poorer health outcomes, higher overdose rates, and increased healthcare costs. Addressing these disparities is crucial for improving health equity within the prison system. Methods A review of 10 studies emphasized the importance of culturally competent care in improving treatment engagement and outcomes among minority populations. To address disparities, the intervention will include culturally sensitive training for healthcare providers, monitored through MAT utilization rates, pre- and post-intervention surveys, and qualitative feedback to assess provider confidence and practice changes. Proposed Interventions The intervention involves culturally competent training for healthcare providers to reduce treatment barriers and improve engagement with minority inmates. The aim is to increase MAT participation by 5% (from 20% to 25%) over six months while evaluating provider confidence and practice changes using pre-post surveys and feedback. Outcome Measures The primary goal is a 5% increase in MAT utilization (317 to 396 inmates) within six months. Secondary measures include qualitative feedback on training and pre-post survey results assessing providers’ confidence in delivering culturally competent care. The Project Lead will track progress through regular audits of MAT utilization rates and provider surveys. Keywords: Opioid Use Disorder (OUD), Medication-Assisted Treatment (MAT), correctional healthcare, cultural competence, health disparities, minority populations, cost savings, San Diego prison system

Trauma-Informed Care: A Therapeutic Approach in Communication

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural community clinic in Chogoria, Kenya. Objectives were achieved through pre- and post-workshop surveys and exploratory qualitative interviews conducted after an in-service workshop on Trauma-Informed Care (TIC). Healthcare workers demonstrated a 3% increase in knowledge, attitudes, and skills in postsurvey results following an in-service workshop on TIC. Analysis of focus group narrative data revealed three themes: relevance, cultural stigma and bias, and additional needs in the community. TIC’s therapeutic communication helps to mitigate biases and stigma, foster empathy, and address patient trauma, ultimately reducing health disparities. The findings of this study indicate further research regarding TIC should be conducted in LMIC to identify ways in which providers can enhance the quality of health care delivery and promote holistic healing. Keywords: adult trauma, adverse childhood events, harm reduction, trauma-informed car

Addressing Informal Caregiver Burnout in the United States: Policies, Interventions, and Recommendations

Informal caregiver burnout has been and will continue to be a significant public health concern in the United States, necessitating a comprehensive analysis of initiatives and policies to reduce its negative impacts. This paper provides an overview of existing approaches to address caregiver burnout at the individual, community, and national level, identifying critical gaps in policies and programs. By highlighting successful approaches in other developed countries, this paper presents comprehensive program and policy recommendations to strengthen informal caregiver support systems in the United States. Prioritizing these proposals can guide policymakers in creating a more supportive environment that values the crucial role of caregivers and improves their overall well-being. The paper concludes that to effectively address caregiver burnout, it is essential to implement integrated, wrap-around services tailored to the diverse needs of caregivers and ensure ongoing program evaluation. It emphasizes the need for the U.S. to re-evaluate its fiscal priorities related to public health by increasing caregiver support, especially given the growing elderly population and their increasing care needs

From Civic Duties to Democratic Mandates: The Theoretical Framework of Mill and Tocqueville on Compulsory Voting in the U.S.

This thesis examines the treatment of jury duty and voting in the United States through the philosophical framework of John Stuart Mill and Alexis de Tocqueville. While jury duty is legally mandated, voting remains optional, despite both civic responsibilities being foundational to democratic participation. This research explores the historical, theoretical, and practical implications of voting becoming compulsory in the United States, as it is in other democratic nations. The analysis includes a comparative case study of the impact of Australia’s mandatory voting to evaluate whether it could become compulsory in the U.S. Both philosophers offer insightful knowledge on the role of civic responsibilities to uphold representative democratic values, with Mill’s utilitarian emphasis on the common good and Tocqueville’s focus on self-interest and the role of exclusion evident in American laws. The findings suggest that compulsory voting, or an equitable voting system, could address inequities in representation and foster a more inclusive democracy