Digital Commons Network^™

Medical Tourism Patient Guidance: A Content Analysis Of Risk Reduction Guidelines Available To Global Health Seekers., Alicia Mason, Angela Ashmore

Faculty Submissions

This study examines medical tourism (MT) patient guidance messages intended to reduce procedural risks—those directly related to biomedical treatments—and process risks, which involve logistical, administrative, and interpersonal challenges of seeking healthcare abroad. The analysis focuses on print and digital publications authored by individuals independent of the MT industry, including policy researchers, travel health experts, lifestyle reporters, and consumer-focused medical travel writers. Using a two-phase digital and database search strategy, 27 publications from 2009 to 2024 were identified and analyzed using exploratory content analysis methods. Findings reveal important differences in the scope and depth of guidance aimed at reducing risks for …

Cultural Integration Of Ethiopian Immigrants And Refugees And Role Of Ethnic Nonprofits In Chicago, Aklilu Abraham Adeye

Walden Dissertations and Doctoral Studies

Despite the availability of institutional services and interventions, cultural integration outcomes among refugees and immigrants often remain uneven. Existing literature has demonstrated the important role of nonprofit organizations in supporting refugee and immigrant resettlement and early integration. However, comparatively little research has examined how refugees and immigrants themselves experience the influence of nonprofit services on long-term cultural integration. The purpose of this general qualitative study was to explore how nonprofit services and programs influence the cultural integration experiences of Ethiopian refugees and immigrants in Chicago through the lens of the new assimilation theory and the integration context perspective. Data were …

Perceiving A Competitor: Culture And Cognitive Biases Of The Strong Enemy And The Pacing Threat, Allison Abbe

Books, Monographs & Collaborative Studies

The United States and China are prone to systematic cognitive and cultural biases that distort their mutual perceptions. Addressing these biases through cultural education and professional development is essential to overcoming blind spots in understanding the United States’ primary competitor. By applying dynamic constructivist theories from cross-cultural psychology to national security, this monograph builds on existing scholarship to reveal specific cognitive asymmetries between Western and East Asian observers. Differences such as holism, dialecticism, social inference, and perspective taking reflect the cultural lenses through which security actors perceive their competitors’ actions and intentions, but US observers often overlook the cultural factors …

Economic Development Corporations In Small Communities, Mary L. Bullock

Certified Public Manager® Applied Research

This study evaluates the effectiveness of Type A and Type B Economic Development Corporations (EDCs) in supporting economic growth in small Texas communities. Using key indicators such as population trends, employment, infrastructure, housing, and legal frameworks, this paper compares how each EDC structure addresses these issues. While both Type A and Type B Economic Development Corporations contribute to economic growth, Type B EDCs are generally more effective in small Texas communities due to their broad ability to fund housing projects, create critical infrastructure, and shape quality-of-life community development projects that have a more immediate and measurable impact on unemployment, population …

Exploring The Experiences Of Nigerian Army Personnel With Toxic Leadership, Shamsideen Toyin Shafaru

Walden Dissertations and Doctoral Studies

Toxic leadership has been shown to be present in Nigeria, promoting negative consequences for organizations and adverse effects on employee performance. However, how toxic leadership behaviors impact Nigerian Army operations and the performance of personnel have not been studied. Exploring toxic leadership in the Nigerian Army is important because the way in which leaders exercise influence determines the effects it has on followers. The purpose of this general qualitative study was to examine the lived experiences of Nigerian Army personnel who had worked as subordinates of individuals who exhibited toxic leadership traits and its impact on their performance. The theoretical …

Wildfire Risk & Preparedness For Urban Rail Operators Supporting Large Stadium Events, Karl Kim, Eric Yamashita, Daniele Spirandeli, David Rother

Mineta Transportation Institute

The project team, in collaboration with partners and stakeholders, developed a four-hour training course designed to build a foundational understanding of how wildfire hazards affect rail systems infrastructure operations and how this knowledge can help equip urban rail operators with tools and best practices for proactive risk management. Led by the University of Hawaiʻi and the National Disaster Preparedness Training Center, in partnership with Haley & Aldrich, Inc., this technical report presents an overview of the four modules and scenario planning exercise that together make up the four-hour Wildfire Risk & Preparedness for Urban Rail Operators Supporting Large Stadium Events …

Enhancing Wildfire Resilience In The Rail Industry: Developing A Community Resilience Extreme Events Portal (Creep), Karl Kim, Eric Yamashita, Daniele Spirandeli, David Rother, Chris Chiesa, Greg Hampe, Michele Toner

Mineta Transportation Institute

The Community Resilience Extreme Events Portal (CREEP) provides a centralized platform for accessing wildfire danger indices, critical asset locations, and vulnerability scores for rail segments. The project team developed a data-driven, indicator-based vulnerability assessment framework that defines vulnerability as a function of exposure, sensitivity, and adaptive capacity. To build this framework, the team selected publicly available datasets, prioritizing national datasets whenever possible to ensure transparency, reproducibility, and scalability. The portal allows users to analyze and visualize vulnerability across 1-kilometer segments of Class I freight and passenger rail lines in California, supporting planning and mitigation prioritization to help reduce rail-related fatalities, …

Fighting With Data: Design Implications For Ai-Enabled Mission-Command Systems, C. Anthony Pfaff

Books, Monographs & Collaborative Studies

Fighting with Data examines how artificial intelligence (AI) is reshaping military decision making by changing both the speed of command and the structure of cognition within mission-command systems. Rather than treating AI as a tool that merely accelerates existing staff processes, this monograph recognizes AI redistributes cognitive labor across a network of people, data, tools, and operational processes. In this new environment, commanders and staffs spend less time assembling information and more time interpreting meaning, judging uncertainty, and deciding how to act.

This shift in the human role requires a new way of thinking about trust in military AI. Traditional …

Extreme Heat And Its Impact On Public Transit Ridership In Nyc, Craig Denton

Theses and Dissertations

This thesis explores the connection between extreme heat events and public transit ridership patterns in New York City, with a particular emphasis on low-income communities. It investigates the intersection of socioeconomic factors and heat-related challenges, analyzing how extreme temperature periods influence overall transit use and why certain routes or neighborhoods experience greater declines in ridership during these events.

Utilizing existing literature, NYC-specific transit and climate datasets, and the broader context of transit equity, this research aims to inform strategies that strengthen climate resilience within urban transportation systems. The study’s findings are intended to support policy development and planning initiatives that …

A Poetic Call For And A Reflection And Commentary On Clarity, Understanding, Hope, Courage, And Compassion, Carroy U. Ferguson

Psychology Faculty Publication Series

Finding a published poem I had written as a teenager, titled “The Heavens Weep.” this article uses that poem as the basis for a commentary that reflects on the state of the world today (2026),  As a commentary, the article uses the poetic and metaphoric words in the poem as a relevant "reality check" for what is still going on today.  In essence, the commentary is about a call for Clarity, Understanding, Hope, Courage, and Compassion, or what I call Archetypal Energies, Higher Vibrational Energies that operate deep within our individual and collective psyches to creatively urge us to "see" …

The Use Of Foamed Glass Aggregate (Fga) As A Lightweight Fill Above Culverts, Amr Morsy

Mineta Transportation Institute

Transportation infrastructure—including buried utilities, drainage systems, and culverts—is frequently subjected to significant external stresses arising from existing conditions and new construction, especially in urban environments where deformation and failures can lead to significant operational and safety consequences. Lightweight fills offer a viable strategy to mitigate these stresses by reducing imposed loads. This study investigates the use of lightweight fills, specifically Foamed Glass Aggregate (FGA), as a sustainable solution to support California Senate Bill 1 (SB1) efforts to repair and maintain culverts, as well as for new construction applications. A numerical investigation was conducted to evaluate the performance of culverts backfilled …

Mind The Gap: Freight And Rail System Resilience Between Planning And Practice A Synthesis Of Freight Plan Best Practices And Survey Results From U.S. Transportation Professionals, Serena Alexander, Carmella Uwineza

Mineta Transportation Institute

Freight and rail networks across the United States face mounting risks from weather-related hazards and other systemic disruptions that threaten operational continuity, economic stability, and community well-being. While state freight plans are federally mandated, local and metropolitan freight planning varies widely, leaving gaps in how resilience is addressed across scales. This study examines how resilience is being integrated into freight and rail planning through a two-part approach: (1) a content analysis of 43 recent state and metropolitan freight plans, and (2) a nationwide survey of 56 transportation professionals engaged in freight and rail planning. Findings show broad consensus on the …

Automated Battery Management Systems For Electric Vehicles, Woonki Na, Yuanyuan Xie

Mineta Transportation Institute

Electric vehicle (EV) safety, efficiency, and lifetime are strongly influenced by how well battery cells are managed, and as EV adoption accelerates, improving battery performance has become critical to vehicle reliability, cost, and public trust. This report conducts a field study on the core technologies and challenges in Battery Management Systems (BMS), focusing on the classification of BMS circuit topologies (design/structures) and systematically reviewing different topologies of active cell balancing circuits (systems that move energy from stronger battery cells to weaker ones). The study provides a detailed analysis of the working principles, advantages, and disadvantages of various active balancing circuit …

Decision-Making Criteria In Polygenic Embryo Screening: A Survey Of Reproductive Medicine Physicians, Rémy A Furrer, Aayushi Gandhi, Dorit Barlevy, Shai Carmi, Todd Lencz, Stacey Pereira, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Polygenic embryo screening (PES) examines embryos for their genetic likelihood of developing complex conditions and traits. The commercialization of PES places reproductive endocrinologists and infertility specialists (REIs) as the primary decision-makers in its use, despite professional guidelines cautioning that PES is not ready for clinical use.

Methods: This survey examines how 152 US REIs perceive and approach potential clinical decision-making scenarios regarding the use of PES.

Results: REIs were more likely to offer PES for medical conditions (up to 62% for cancer) than for traits (eg, 0% for skin color, 10% for body mass index). When evaluating 11 potential …

Cross-Border Initiatives Border Fellow Report 2025-2026, Elise Free Ma, Tori Luna Ma, Jonathan De Vicente Encarnación Ma, Yolanda Viridiana Chávez Flores Phd, Korina Odet Cortés Uribe Edd, Jessie Valcin, Cristina Solano Díaz, Etienne Mulumeoderhwa Mufungizi Phd

Kroc IPJ Research and Resources

The 2025–2026 Border Fellows Report documents six community-led projects carried out across the Tijuana–San Diego region under the Kroc Institute for Peace and Justice's Border Fellows Program. Working in academia, civil society, and the public sector, the fellows addressed distinct challenges shaped by a common context: firearms trafficking and armed violence against women and LGBTQIA+ people; youth violence and suicide risk in a public middle school; discrimination in a federal preparatory school serving more than 4,300 students; the organizational capacity and language rights of Indigenous communities in Baja California; academic accompaniment for Haitian adolescents excluded from formal schooling; and intercultural …

Survival First: How Citizens Prioritize Competing Climate-Health Risk Countermeasures Under Fiscal Constraints, Katsuya Tanaka, Kazuhide Akaishi

Center for Public Service Publications and Reports

When governments must allocate limited resources among competing climate-health countermeasures, citizen risk priorities determine political feasibility—yet whether those priorities translate into fiscal support remains poorly understood. This study develops a hybrid best–worst scaling and contingent valuation framework that integrates individual-level priority parameters into an acceptance model, enabling direct testing of whether preference intensity predicts willingness to pay. Applied to a largesample survey of residents in Yokohama, Japan—a rapidly aging metropolis facing escalating heat emergencies—the analysis reveals three findings. First, citizens exhibit a survival-first hierarchy, decisively prioritizing immediate protective measures over long-term structural interventions, with consensus varying sharply across countermeasure types. …

Exploring Discretionary Benefits’ Impact On Michigan Public Sector Employees, Sydnie N. Smith

Master of Public Administration Capstone Papers

Productivity, well-being, and retention are factors that impact organizational success and goal attainment; in the public sector in Michigan, employees are the most valuable asset. This research paper seeks to answer the following question: How does the adoption of unlimited PTO policies shape workforce morale, productivity, and retention in public sector employment? Current research into paid leave policy’s impact on employees is scant, it is further limited in the scope of public sector employees. This paper believes that research is needed to determine the relationship between paid leave benefits and employee productivity, well-being/morale, and retention as it could improve public …

The Black Student Union At Northern Michigan University: Leadership, Community, And Institutional Change Through Student Activism, Marlanaysia Rosser

Master of Public Administration Capstone Papers

This paper explores how the Black Student Union (BSU) at Northern Michigan University (NMU) has influenced and contributed to the development of support systems for Black students in alignment with broader historical movements. Through archival records and four interviews with former BSU leaders, this study examines the impact of student activism on institutional change, leadership development, and community. The findings revealed that student activism at NMU reflected many of the concerns and strategies occurring across the nation during the Civil Rights and Black Power movements. While the experiences of BSU members and institutional support shifted across generations, BSU remained a …

Mission Of Mercy: Restoring Smiles With Dignity, Anne Berquist

The Journal of the Michigan Dental Association

This feature chronicles Michigan’s 2026 Mission of Mercy clinic, where more than 1,200 volunteers provided 5,656 procedures to 771 patients. The article describes patient experiences, volunteer contributions, and the extensive planning required to transform a sports arena into a temporary dental clinic. Beyond oral healthcare delivery, the program restored confidence, relieved pain, and highlighted the dental profession’s commitment to serving underserved populations.

Theory-Informed Generative Agents For Human Behavioral Modeling In Disasters, Liming Lu

All Dissertations

This dissertation develops a theory-informed generative-agent framework for modeling human behavioral decisions in disasters. Existing flood and disaster preparedness models often emphasize physical hazards, infrastructure exposure, or statistical correlations, but they struggle to capture the heterogeneous and evolving choices households make. This limitation is especially important for climate-related hazards, where future damage depends not only on changes in rainfall, inundation, and urban development, but also on decentralized protective actions such as house elevation, flood insurance, evacuation, and early preparedness. The dissertation integrates two empirical studies: a flood-risk study in Charleston, South Carolina, and a household disaster-preparedness study across hurricane contexts. …

Essays On Opioid Prescription Limit Policy Diffusion, Evaluation, And Opioid Use Disorder Treatment Utilization, Md Ashiqur Rab

All Dissertations

The drivers of the opioid epidemic in the United States include the oversupply of prescription opioids, the availability of illicit drugs, under-resourced healthcare settings, and several socio-economic factors. Federal and state-level initiatives, including policy interventions to curb the oversupply of prescription opioids, providing access to healthcare, prevention and recovery support services, and community-level engagement, have been adopted to combat the opioid epidemic. Motivated by the need to better understand the policy and recovery efforts to address the epidemic, this dissertation examines opioid prescription limit policy diffusion, evaluation, and treatment utilization patterns. This dissertation comprises three manuscripts that offer a comprehensive …

Emergency Medical Services Mental Health: Causes Of Providers Leaving The Industry, Brian C. Selke

Graduate Theses and Dissertations (2019 - present)

Employee resilience and mental health have become critical concerns in Emergency Medical Services (EMS) as workforce shortages increasingly threaten staffing stability and patient care. National Registry of Emergency Medical Technicians (NREMT) data indicates that more than 30% of eligible EMS providers did not recertify between 2020 and 2023, raising concerns about workforce sustainability. This study examines EMS providers’ intentions to leave the profession and identifies workplace factors associated with turnover. A statewide survey of more than 1,200 licensed EMS providers in Alabama was analyzed using regression techniques to evaluate the relationship between workplace conditions and turnover intentions. Results demonstrate that …

Energy Transition In Africa: A Comparative Analysis Of Five African Countries, Boluwatife G. Ayankojo

Graduate Program in International Studies Theses & Dissertations

Global energy transition remains a critical challenge for reducing carbon emissions and protecting the environment, with solar energy adoption driving improvements in both energy efficiency and conservation. This research focuses on Africa's transition from fossil fuels to solar energy. As population growth and blackouts increase, African countries must transition from unreliable, centralized national grids to decentralized, low-carbon alternatives that ensure quality household electricity. While some countries have advanced in this transition to sustainable solar energy, others lag behind. The limited access to electricity hinders the African continent's healthcare, education, economic growth, and mortality rates. This research establishes the importance of …

Transnational Indigenous Environmental Justice: A Distant Comparative Study Of Nepali And U.S. Environmental Policies And Counter-Archives In Technical Communication, Shankar Paudel

Open Access Theses & Dissertations

This dissertation investigates how institutional communication, state bureaucracy, and Indigenous sovereignty intersect within Rhetoric and Writing Studies (RWS) and Technical and Professional Communication (TPC). Current TPC research increasingly focuses on social justice; however, the field still lacks ethical frameworks to deal with the complicated dynamics of transnational Indigenous Environmental Justice Communication (IEJC). This study addresses this gap by examining how two distinct Indigenous communities - the Tharus of Chitwan, Nepal, and the Ysleta del Sur Pueblo Tigua Indians of El Paso, Texas - communicatively navigate, contest, and resist state environmental policies.

Grounded in decolonial Distant Comparativism, Mestiza Consciousness, Rhetoric of …

Strong Job Markets Don’T Just Raise Pay, They Improve Job Quality, Brad J. Hershbein, Katherine Lim, Douglas Webber, Mike Zabek

Employment Research Newsletter

No abstract provided.

Oral History With John Barry, Dan Royles

History Faculty Scholarship

Oral history interview with John Barry, who has served as Executive Director of the Southern Tier AIDS Program (STAP) since 2008. He was born in Endicott, New York in 1966, grew up in Vestal, and attended high school at Seton Catholic Central in Binghamton before serving in Germany with the United States Army during the early 1980s. When he returned to Broome County in 1987, some of his friends had been affected by HIV/AIDS and, while earning a degree at SUNY Binghamton, Barry became involved in mutual aid efforts to help people affected by the disease. He went to work …

Should We Flee? The Mortality And Economic Impacts Of Hurricane Evacuation Orders, Lucas Kaplan

Center for Policy Research

I estimate the mortality and county-level regional economic impacts of hurricane evacuation orders using a novel instrumental variables framework. Relative to similarly affected but non-evacuated areas, evacuated counties experience fewer deaths but lower personal income, employment, and business establishments into the second year following the storm, likely stemming from delayed returns in wealthier neighborhoods. I then develop a threshold decision rule that balances the mortality benefits against these persistent economic costs and apply this framework to orders issued from 2016–2022. Incorporating these persistent economic costs alters policy evaluation: the largest orders generate net benefits that dwarf their costs, but the …

Sources Of Energy Production In Mountain West States, 2026, Kahlen Coss, Yash Kalla, Kian Parikh, Caitlin J. Saladino, William E. Brown Jr.

Environment

This fact sheet presents data on electricity generation and energy sources in March 2026 for five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah. Each state's share of total U.S. electricity production and its generation by source (coal, hydroelectricity, natural gas, nuclear, solar, and wind) are included. The Choose Energy report, "Electricity Generation by State," includes data on all 50 states and the District of Columbia.

Move Fast And Break Everything: Crypto And Party Competition In The United States, Thomas Ferguson, Jie Chen, Matthiaa Lalisse, Paul D. Jorgensen

School of Interdisciplinary Programs & Community Engagement Faculty Publications

In November, 2022, the giant cryptocurrency exchange FTX filed for bankruptcy. The financial fallout from that event, including two bank failures, made crypto politically radioactive. Yet less than three years later, crypto, like Donald Trump himself, staged a triumphant Second Coming, as the President signed into law the so-called “GENIUS Act” – short for Guiding and Establishing National Innovation for U.S. Stablecoins. Analysts have traced the industry’s phoenix-like resurrection, showing how key crypto billionaires and companies aligned with Trump early in the 2024 campaign, transforming him from a skeptic into a political champion. But the flip side of the story …

Applying Artificial Intelligence Within Decision Support Systems And Its Role In Improving Proactive Thinking And Reducing Security Threats: The Mediating Role Of Data Quality, Hany Shaaban El Anany

Journal of Police and Legal Sciences

The study aimed to identify the impact of applying artificial intelligence within decision support systems in improving the level of proactive thinking and reducing security threats in government institutions in the Arab Republic of Egypt, as well as to examine the mediating role of data quality in this relationship, at a significance level of (α ≤ 0.05). The study sample consisted of (360) participants working in the departments of information technology, decision support, and cybersecurity within government institutions and national authorities that rely on AI-enhanced decision support systems.

The study adopted the descriptive analytical method and used a questionnaire as …