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Mediating Effect Of Social Determinants Of Health Between Race And Phthalate Biomarkers In Pregnancy, Tetsuya Kawakita, Misa Hayasaka, Carole Barake, Trinity Soto, Jillian Fleming, Amir Lueth, Stevens Danielle, Alfred Abuhamad, Ann Pryzybylska, Elena Sinkovskaya, Kelly K. Ferguson, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Introduction

Prenatal phthalate exposure is linked to adverse reproductive and developmental outcomes and is consistently higher among non‐Hispanic Black compared to non‐Hispanic White pregnant individuals, yet the factors responsible for these disparities are poorly characterized. We sought to quantify Black–White differences in repeated urinary concentrations of phthalate biomarkers during pregnancy and to estimate the extent to which neighborhood‐level social determinants of health (SDoH) mediate these disparities.

Methods

This secondary analysis used data from the Human Placenta Project Study, a prospective observational cohort study conducted at two academic institutions between 2016 and 2018. Eligible participants had singleton pregnancies, were recruited before …

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 …

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 …

Insurance Disparities In Hidradenitis Suppurativa: A Comprehensive Review Of Demographics, Outcomes, And Access To Care, Alim Osman, Alexandra R. Nigro, Michael C. Povelaitis, Marc Z. Handler

Department of Medicine Faculty Publications

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.

Objective: This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.

Methods: Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.

Results: Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid …

Spectral Frequency And Broadband Noise Analysis Of The Firefighter Environment: Potential Implications For Cardiac Health, James Blando, Catherine Reed, Amya Turner

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Firefighters are well known to have elevated risk of adverse health outcomes across a wide range of diseases and injuries, including cancer, hearing loss, fatal cardiac events, post-traumatic stress disorder (PTSD), sleep disorders, and many other adverse outcomes. It has been speculated that the noise environment is a significant risk factor for several of these diseases. In particular, the impact of noise on cardiac outcomes has recently been identified. An environmental survey of noise that included spectral and broadband analysis was conducted across all 14 firehouses in a southeastern city in the United States as a first step to investigate …

Enhancing Military Health System Organizational Efficiency And Quality Of Care Through A Social-Ecological Framework, Eric L. Peipelman

College of Graduate Studies: Theses & Dissertations

Timely and fair adjudication of incivility-related actions within the Department of Defense (DoD) and Military Health System (MHS) is increasingly crucial for maintaining accountability, mission readiness, and quality of care. Ongoing delays in resolving workplace complaints and inefficiencies in resource-heavy adjudications highlight the need to shift from reactive complaint handling toward proactive civility promotion and transparent decision-making. This Integrated Learning Experience (ILE) introduces the Peipelman Civility Discussion and Assessment Toolkit (PCDAT)—a comprehensive, evidence-based framework designed to improve civility, optimize resources, and enhance communication, even in the MHS. Based on the Social-Ecological Model (SEM) and adapted from the Workplace Power and …

Human Resources Representation Models And Municipal Employee Outcomes: A Quantitative Study Of Small Pennsylvania Municipalities, John W. Crouser

West Chester University Graduate Theses, Dissertations, and Final Projects

Small municipalities operate in resource-constrained environments that shape how human resource management (HRM) is organized and experienced. This study examines whether HR representation models (in-house, delegated, outsourced, and hybrid) differ in association with employee job satisfaction and manager-reported turnover trends (RQ1), and whether delegating HR responsibilities to non-HR managers is associated with outcomes differently than other models (RQ2). Grounded in Strategic Human Capital Management, the Resource-Based View, and contingency theory, the study assesses whether HR information system (HRIS) capability is associated with turnover trends or employee satisfaction (RQ3) and whether Strategic Human Capital Management (SHCM) alignment is associated with manager-reported …

Beyond Interests And Ideas: Institutions And The Persistence Of Trade Protectionism In Brazil, Samo Sérgio Gonçalves Tosatti

West Chester University Graduate Theses, Dissertations, and Final Projects

Despite decades of economic reforms and growing international integration since the 1990s, Brazil has remained one of the most protectionist large economies in the global trading system. Tariff levels remain relatively high, the country maintains a limited network of trade agreements, and non-tariff barriers play a significant role in shaping market access. Existing explanations for this persistence have focused primarily on the influence of organized interests, particularly import-competing industries, and the enduring influence of developmentalist ideas rooted in Brazil’s import-substitution industrialization (ISI) legacy.

This dissertation argues that these explanations are incomplete without accounting for a third explanatory dimension: institutions. It …

The Evolution Of Ethical Conviction, Tracy Henry

West Chester University Graduate Theses, Dissertations, and Final Projects

There is a steady decline in public opinion polling when it comes to the public’s perspective of public officials. In 2023, the combined unfavourability rating of Congress was at 72%.  There are ongoing unfavorable ratings, by issue, for the judiciary, and by individual for the executive. The researcher went in search of the reasons behind the declining opinions. Semi-structured interviews were conducted to identify those reasons and to answer the research question: To what extent do the ethical philosophies of consequentialism, deontology, and virtue inform the perceptions of the American public when they scrutinize the decision-making and conduct of public …

Negotiating Quality: A Critical Discourse Analysis Of American Higher Education Policy, John A. Foisy

Electronic Theses & Dissertations (2024 - present)

This qualitative study examined how institutional quality is constructed, communicated, and negotiated through the accreditation process in U.S. higher education. Drawing on a multiple case study design, the research analyzed accreditation-related documents from eight institutions undergoing reaffirmation, including self-study reports, peer review team reports, Commission action letters, and institutional responses. The study was guided by three research questions: (a) What institutional signals of quality are evidenced in self-studies? (b) In what ways does the accreditation process represent a negotiation between accreditors and institutions? (c) What implied views of institutional quality emerge from accreditation discourse?

The study employed a multilayered analytical …

Discord Is Still A Chord: A Mixed-Methods Analysis Of Discourse Networks, Brokerage, And The Fiscal Consequences Of Fracking Policy In The Delaware River Basin, In Hae Noh

Electronic Theses & Dissertations (2024 - present)

Beneath the policy debates of many environmental controversies lies a dynamic network of actors making claims, forming coalitions, and contesting policy discourses. Drawing on theories of discourse coalitions, discourse networks, network brokerage, and public finance, and using the Delaware River Basin hydraulic fracturing debate as a case study, this dissertation examines how discourse coalitions evolve, how discourse brokers shape coalition dynamics, and whether resulting policy decisions produce meaningful fiscal consequences. The first paper investigates how discourse coalitions shifted across three periods of the Delaware River Basin fracking debate, using a mix of methods integrating discourse network analysis, computational text analysis, …

Building Fiscal Resilience And Enhancing Social Equity In Disaster Mitigation At The Local Level, Hyoeun Kim

Electronic Theses & Dissertations (2024 - present)

As climate-related disasters are becoming more frequent and severe, local governments face growing pressure to manage disaster-related fiscal shocks. Although disaster mitigation and preparedness are widely recognized as cost-effective strategies for reducing future losses, local governments often lack the financial, political, and technical capacity to invest in them. Despite the importance of pre-disaster investment, mitigation and preparedness efforts continue to lag at the local level, and concerns remain that federal mitigation funding is not distributed equitably across communities. This has important implications for both equity and resilience because unequal access to mitigation resources can reinforce existing vulnerability to future natural …

Examining The Effectiveness Of Housing First Models On Transitional-Aged Youth Experiencing Homelessness: A Systematized Review, Cadyn Golisano

Honors Theses and Capstones

Abstract

Purpose: The purpose of this review is to examine the outcomes of Housing First (HF) programs or models for transitional-age youth (TAY) experiencing homelessness. Specifically, this review aims to synthesize existing evidence on how Housing First influences housing stability and over-all wellbeing for young adults ages 18-25. By evaluating the effectiveness of these programs within this specific population, the review seeks to identify key benefits, limitations, and gaps in the current literature to inform future practice, policy, and research. The following research question was utilized to guide this paper: How do Housing First principals and interventions impact housing stability …

Antecedents Of Emergency Services’ Street Level Bureaucrats’ (Slbs) Delivery Of Public Value: An Exploratory Study, Yvonne Brunetto, Ben Farr-Wharton, Aglae Hernandez Grande, Fleur Sharafizad, Matthew Richman

Research outputs 2022 to 2026

Street Level Organisations (SLOs) determine the Psychosocial Safety Climate (PSC) in their workplaces and we examine pathways from SLBs’ PSC and Public Service Motivation (PSM) to discretionary power, work stress, wellbeing and the subsequent delivery of public value. The structural equation modelling results from 195 Australian police, fire, ambulance, and emergency services workers indicate that PSC had a more significant role in explaining SLBs’ delivery of public value compared with PSM. The implication is that SLOs’ management must ensure psychosocially safe and supportive workplaces conducive to building SLBs’ wellbeing, because that is the pathway for delivering public value.

The Global Onboard Training Programme (Gobt) : A Comprehensive Review, World Maritime University

Reports

A stable supply of qualified seafarers is a critical component of the global maritime logistics industry, which relies heavily on maritime transportation. According to the 2021 BIMCO Manpower Report, an additional 89,510 officers will be needed by 2026. In 2021 alone, there was already a deficit of 26,240 STCW-certified officers, clearly indicating that demand continues to outpace supply. The report also noted a 45.8% increase in the number of female seafarers since 2015, although they still represent only a small share of the overall workforce. Maritime Education and Training (MET) institutions around the world continue to provide training to develop …

Magang Atau Pekerja? Menggugat Status Abu-Abu Tenaga Paruh Waktu Mahasiswa Di Fakultas Hukum Ugm, Patricia Nerissa Krisna Putri, Markus Togar Wijaya

Jurnal Hukum & Pembangunan

This study highlights the controversy surrounding the change in nomenclature for student workers at Gadjah Mada University, particularly within the Faculty of Law. The status of these workers has shifted from 'part-time' to 'student intern'. This unilateral change has created a legal grey area that could lead to students being subjected to disguised employment practices. Using socio-legal research methods, this article examines the validity of the 'internship' status based on the elements of an employment relationship (work, orders and wages) within the labour law regime, analysing it using the theory of structural injustice. The research findings suggest that reclassifying part-time …

Examining Challenges For Sociology Master’S Degree Students At California State University, David Ortuno

University of the Pacific Theses and Dissertations

The purpose of this study is to identify the lived experiences of CSU sociology graduate students pursuing a master’s degree. Seven sociology graduate students from six of the eight (75%) total sociology MA programs throughout the entire CSU system were interviewed. Their responses were designed to analyze the support systems and challenges they face while pursuing a master's degree, as well as to investigate whether their experiences correlate with or fail to correlate with the promises in the CSU mission statement, and to answer the study’s research questions and achieve the purpose of this qualitative study.

Four themes emerged from …

Redling And Soil Contamination In Los Angles County: Mapping The Influence Of Polutants And Regulatory Landscapes On Enviromental Justice Outcomes, Gillian G. Maynard

Scripps Senior Theses

This thesis examines soil contamination in Los Angeles as a pervasive yet underexamined environmental justice issue, rooted in the region’s history of industrialization, racialized land-use policy, and regulatory failure. It argues that soil operates as both a long-term repository and an active pathway of toxic exposure, embedding environmental risk directly within residential landscapes. Through an analysis of key contamination sources, including legacy lead pollution, urban oil extraction, wildfire-related toxins, and industrial sites such as the Santa Susana Field Laboratory and the Exide battery recycling facility, this study demonstrates how contaminants persist across generations, often long after their original sources have …

The Effect Of The Affordable Care Act Medicaid Expansion On The Risk Of Hospital Closure And Adolescent Hpv Immunization In Rural Counties, Juliette Des Rosiers

Scripps Senior Theses

From 2005 to 2025, over 200 rural hospitals shut their doors, often citing increased operational costs, staffing shortages, low patient volume, regulatory barriers, financial challenges exacerbated by the COVID-19 pandemic, and uncompensated care as common contributors to the closures. Rural patients are often referred by their primary care physician to a hospital for regular immunizations, since smaller clinics have less capacity to provide immunizations due to a shortage of pediatricians and limited vaccine stock. A crucial vaccine that is not required by schools and underutilized in rural areas is that against human papillomavirus (HPV), a virus that infects cutaneous and …

A Scoping Review To Conceptualize Social Privilege For Studying Patients' Health Outcomes And Health Disparities, Elizabeth A. Brown, Priyanka Patel, Esther May B. Sarino, Vladimir Markovic, Carles Muntaner

Health Behavior, Policy & Management Faculty Publications

Background

The continued reliance on single-category self-reported demographic data (e.g., race/ethnicity) reflects conceptual limitations that hinder the study and understanding of health outcomes research. There is a pressing need for more precise measures of social privilege that conceptualize privilege and oppression while enabling the examination of their effects on health outcomes in the United States (US) healthcare system.

Objective

The purpose of this scoping review was to review the literature, determine how researchers have measured aspects of privilege and oppression, and develop a conceptual framework to study patients' social privilege in the US healthcare system and public health research.

Methods …

Improving Evacuation Effectiveness On Cruise And Large Passenger Ships : An Analysis Of Human Factors, Safety Culture, And Behavioral Dynamics, Antonios Andreadakis

World Maritime University Ph.D. Dissertations

Maritime trade has long constituted a central pillar of economic development, supporting global commerce and cultural exchange. Nevertheless, the maritime environment is inherently hazardous and therefore the protection of human life has consistently constituted and will continue to remain a central priority (Casson, 1995). An instrumental turning point in maritime safety occurred after the sinking of Titanic in 1912, which prompted in 1914 an International Conference dedicated to the protection of human life at sea; which ultimately led to the adoption of the International Convention on Safety of Life at Sea (SOLAS) (Dalaklis, 2017). This Convention introduced internationally imposed safety …

The Fox Versus The Hedgehog: Firm Survival During Unprecedented Crises, Sheng Fang, Shaomin Li, Liu Wang

Management Faculty Publications

This paper examines how sales channel diversification influences firm resilience during the COVID crisis. Drawing on a series of logit regressions analyzing 11,662 firms across 31 developing countries, we find that firms embodying an open mind-set and a diverse array of sales channels, akin to foxes, are more likely to survive, as compared to their hedgehog counterparts, which focus on one particular task. Our mediation analysis suggests that this is mainly due to their faster growth in sales and exports. Moreover, we find that the impact of fox-like traits on firm survival is moderated by female leadership and corporate innovation.

Examining Inclusive Computing Education For Blind Students In India, Akshay Kolgar Nayak, Yash Prakash, Md Javedul Ferdous, Sampath Jayarathna, Hae-Na Lee, Vikas Ashok

Computer Science Faculty Publications

The growing demand for computer professionals, driven by the expanding Information Technology industry, has led to numerous inclusive computing education efforts. These efforts have even included blind or visually-impaired (BVI) students, who are being increasingly encouraged to pursue education and a career in computing, despite the visually-oriented nature of the discipline. Extant literature has predominantly focused on identifying and addressing the accessibility barriers faced by BVI students to promote more inclusive learning environments. While few studies have also investigated the accessibility of computing education from the perspectives of BVI learners and instructors, these have been primarily situated in the Global …

Towards Supporting Real-Time Estimation Of Vehicle Fuel Consumption And Co2 Emissions In Smart City Applications, Abrar Alali, Stephan Olariu

Computer Science Faculty Publications

This paper evaluates a simplified physics-based energy demand model designed to estimate vehicle fuel consumption and CO₂ emissions—a critical tool for sustainable transportation planning and smart city applications. Unlike data-driven regression models that lack generalizability for user-defined conditions or complex physics-based approaches that rely on extensive, often proprietary data, the simplified model is distinguished by its minimal parameter requirements, depending primarily on a single, overarching powertrain efficiency value. A key contribution is the comprehensive empirical evaluation of the simplified model against official Environmental Protection Agency (EPA) test data across multiple driving cycles and vehicle types, providing a rigorous validation previously …

Biosecure-Llm Framework: Protecting Llms From Cyberbiosecurity Threats And The Case For Independent Ai Safety Governance, Xavier-Lewis Palmer, Lucas Potter, Srdjan Lesaja, Sotirios Karathanasis, Mohammad Ghasemigol

Computer Science Faculty Publications

Large Language Models (LLMs) are becoming critical infrastructure in scientific, healthcare, and governmental contexts. As frontier AI laboratories increasingly partner with government agencies, a fundamental question arises: Who should control the safety and policy-enforcement layers that constrain model behavior? Current safety mechanisms (LLM guardrails) are typically designed for generic "harmlessness" and operate by detecting semantic patterns and refusing requests. However, they are inadequate governance instruments because they cannot implement auditable, domain-specific controls tied to external regulatory policy objects (e.g., control lists or rules governing personally identifying information). Even a perfectly aligned model is not able to express institution-specific policy without …

Essays On Politics And Ideology In Asset Management, Madison Borrelli

Graduate Studies Theses and Dissertations 2026

This dissertation examines how political influence and ideology shape the investment and governance decisions of institutional investors. My first essay studies the effects of political interference on public pension plan asset allocation. Plans facing investment restrictions shift away from low-cost traditional assets toward higher-fee, lower-performing alternative assets. While politicians advocating these restrictions receive increased media attention, state economies do not benefit. These findings underscore how political incentives create agency problems that adversely affect investment decisions and outcomes.

The second essay examines whether differences in political ideology between asset managers and investors give rise to conflicts of interest. Mutual fund institutions …

A Program Evaluation Research Study Of The Implementation Of Mothers With Mentors: A Dissertation On Shelter From The Rain’S Mentorship Program, Danielle Louise Smith

College of Graduate Studies: Theses & Dissertations

This program evaluation study examines the implementation of the 2025 Shelter From the Rain “Mothers with Mentors” program in Savannah, GA. Utilizing a convergent parallel mixed-methods approach, the study evaluates the program’s acceptability, feasibility, and perceived benefit through the theoretical lenses of the Theory of Planned Behavior (TPB), the Health Belief Model (HBM), and Bonding Social Network (BSN). The analysis incorporates quantitative and qualitative data for participant mentees (n=7) and mentors (n=12), with a specialized paired analysis of five mentor-mentee matches.

The findings indicate a complex landscape of convergence and divergence across the groups. Quantitative results depicted high convergence on …

Swimming In Uncertainty: Filling Data Gaps And Providing An Educational Platform For Beach Water Quality At Tybee Island, Georgia, Lukas Roberson

College of Graduate Studies: Theses & Dissertations

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Swimming in beaches water contaminated with high levels of bacteria can make you sick. Current monitoring at the public beaches on Tybee Island consists of weekly monitoring and enumeration of fecal indicator bacteria that takes 24 hours for results. If the number of bacteria exceed regulatory limits, a public health advisory is issued, and affected waters are retested until …

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 …

Identification Of A Rural Black Community-Based Mental Health Intervention Via Cbpr, Kirsten Mengell

College of Graduate Studies: Theses & Dissertations

Poor mental health in the US has increased since 2011 (Mental Health America, 2022). Rural communities face disparities in mental health shortages (Andrilla et al., 2018). African Americans face additional barriers, including a historical underutilization of mental health and high mental health stigma. This is significant given the higher rates of mental distress and discrimination among rural African Americans compared to Whites (James et al., 2017), and a recent increase in suicide among Black Americans (Stone et al., 2023). Illustrating a need for options within rural Black communities that can overcome professional shortages and cultural barriers to improve mental health …