Digital Commons Network^™

Solidarity And Strife After The Atlanta Spa Shootings: A Mixed Methods Study Characterizing Twitter Discussions By Qualitative Analysis And Machine Learning, Shaniece Criss, Thu T. Nguyen, Eli K. Michaels, Gilbert C. Gee, Mathew V. Kiang, Quynh C. Nguyen, Samantha Norton, Eli Titherington, Leah Nguyen, Isha Yardi, Melanie Kim, Nhung Thai, Ariel Shepherd, Chris J. Kennedy

Open Access Fund Publications

Background: On March 16, 2021, a white man shot and killed eight victims, six of whom were Asian women at Atlanta-area spa and massage parlors. The aims of the study were to: (1) qualitatively summarize themes of tweets related to race, ethnicity, and racism immediately following the Atlanta spa shootings, and (2) examine temporal trends in expressions hate speech and solidarity before and after the Atlanta spa shootings using a new methodology for hate speech analysis.

Methods: A random 1% sample of publicly available tweets was collected from January to April 2021. The analytic sample included 708,933 tweets using race-related …

Socioecological Factors Linked With Pharmaceutical Incentive-Driven Prescribing In Pakistan, Muhammad Naveed Noor, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Wafa Aftab, Sadia Shakoor, Rumina Hasan, Mishal Khan

Department of Pathology and Laboratory Medicine

Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can compromise the health and well-being of patients. We draw on a conceptual framework outlined in the ecological system theory to identify multiple factors linked with pharmaceutical incentivisation to GPs in Pakistan. We conducted qualitative interviews with 28 policy actors to seek their views on the health system dynamics, how they sustain pharmaceutical incentivisation and their effect on the quality of care. Our analysis revealed four interlinked factors operating at different …

Pulse Oximetry: Why Oxygen Saturation Is Still Not A Part Of Standard Pediatric Guidelines In Low-And-Middle-Income Countries (Lmics), Maheen Sheikh, Huzaifa Ahmad, Romesa Ibrahim, Muhammad Imran Nisar, Fyezah Jehan

Department of Paediatrics and Child Health

Background: With the high frequency of acute respiratory infections in children worldwide, particularly so in low-resource countries, the development of effective diagnostic support is crucial. While pulse oximetry has been found to be an acceptable method of hypoxemia detection, improving clinical decision making and efficient referral, many healthcare set ups in low- and middle-income countries have not been able to implement pulse oximetry into their practice.
Main body: A review of past pulse oximetry implementation attempts in low- and middle-income countries proposes the barriers and potential solutions for complete integration in the healthcare systems. The addition of pulse oximetry into …

Covid-Dynamic: A Large-Scale Longitudinal Study Of Socioemotional And Behavioral Change Across The Pandemic, Tessa Rusch, Yanting Han, Dehua Liang, Amber R. Hopkins, Carolyn V. Lawrence, Uri Maoz, Lynn K. Paul, Damian A. Stanley, The Covid-Dynamic Team

Pharmacy Faculty Articles and Research

The COVID-19 pandemic has caused enormous societal upheaval globally. In the US, beyond the devastating toll on life and health, it triggered an economic shock unseen since the great depression and laid bare preexisting societal inequities. The full impacts of these personal, social, economic, and public-health challenges will not be known for years. To minimize societal costs and ensure future preparedness, it is critical to record the psychological and social experiences of individuals during such periods of high societal volatility. Here, we introduce, describe, and assess the COVID-Dynamic dataset, a within-participant longitudinal study conducted from April 2020 through January 2021, …

From In-Person To Virtual: A Case Study Of An Animal-Assisted Visiting Program In A Pediatric Setting, Whitney Romine

People and Animals: The International Journal of Research and Practice

This article focuses on the practical aspects of converting a successful in-person AAA program to a virtual program in a health care setting including human, canine, and physical resources; animal welfare considerations; training, infection control, and safety guidelines; and visit delivery procedures. In 1992, an interdisciplinary team at Akron Children’s Hospital founded the Doggie Brigade, an animal-assisted activities (AAA) program where volunteer therapy dogs and their handlers visit pediatric patients. The program has become a cornerstone of the hospital’s culture over its now 30-year tenure. In March 2020, the announcement of the COVID-19 pandemic forced health care organizations to suspend …

Social Support And The Effects Of The Covid-19 Pandemic Among A Cohort Of People Living With Hiv (Plwh) In Western Kenya, Adel Mburia-Mwalili, Karla D. Wagner, Edith Kamaru Kwobah, Lukoye Atwoli, Maurice Aluda, Brianna Simmons, Jayne Lewis-Kulzer, Suzanne Goodrich, Kara Wools-Kaloustian, Jennifer L. Syvertsen

Internal Medicine, East Africa

As coronavirus disease (COVID-19) was declared a pandemic in 2020, countries around the world implemented various prevention strategies, such as banning of public and social gatherings, restriction in movement, etc. These efforts may have had a deleterious effect on already vulnerable populations, including people living with HIV (PLWH). PLWH were concerned about contracting COVID-19, the impact of COVID-19 on their social networks that provide social support, and the continued availability of antiretroviral medications during the pandemic. In addition, their mental health may have been exacerbated by the pandemic. The purpose of this study was to explore pandemic-related concerns among a …

Sit Less, Move More: A National Study Of Physical-Activity Behavior And Cancer, Stella O. Nwogugu

Dissertations, Theses, and Capstone Projects

Background: Physical activity is associated with lower risks of cancer, the second leading cause of death among Americans. Yet, sedentary behavior is the prevailing lifestyle for about 80% of American adults. Additionally, cancer survivors remain significantly inactive, even though physical activity has been shown to decrease risk of cancer and cancer recurrence, improve tolerance of cancer therapy, and reduce mortality. This research explores the relative impact of personal agency, social support, and key demographic variables on physical-activity behavior for a national sample of adults as well as how these relationships differ for cancer survivors and their counterparts.

Methods: Using the …

A Review Of Research On The Potential Value And Realistic Dilemma For Homework In Physical Education, Yue Xu, Chenyu Jia, Zhihua Yin

International Journal of Physical Activity and Health

Homework in physical education (PE) has become a central strategy of educational reform movements (Novak & Lynott, 2015). A Chinese policy called “the Double Reduction” provides an opportunity for the implementation of PE homework. There are abundant studies about homework in subjects like English, Math, Science, etc., but relatively few studies have been devoted specifically to PE homework. The primary purpose of this study was to analyze the value and dilemma of PE homework, with the goal of identifying the major contributions to the research knowledge base. We followed three parts to conduct the review: a) literature was searched using …

Race, Gender, Physical Activity, And Cancer: A Quantitative Investigation, Shawna A. Townsend

Dissertations, Theses, and Capstone Projects

Black women are more likely to die from cancer than any other population in the United States. Physical activity is known to be associated with preventing and reducing cancer burden. However, Black women are less physically active than their White counterparts and have a higher prevalence of diseases related to lack of physical activity than any other female group. To better understand these issues, this study employed the self-and-family management framework and intersectionality as theoretical frameworks through a secondary analysis of the Health Information National Trends Survey (HINTS) dataset and hierarchical regression modeling to examine the relative impact of (a.) …

Would You Like Fries With That? Investigating Fast-Food Outlet Availability Near Schools In Perth, Western Australia, Gina S. A. Trapp, Paula Hooper, Wesley Billingham, Lukar Thornton, Ainslie Sartori, Kelly Kennington, Amanda Devine, Stephanie Godrich, Ros Sambell, Justine Howard, Alexia Bivoltsis

Research outputs 2022 to 2026

Issue addressed: Locating fast-food outlets near schools is a potential public health risk to schoolchildren, given the easy access and repeated exposure to energy-dense, nutrient-poor foods they provide. Fast-food outlet availability near schools has not been previously investigated in Perth, Western Australia. This study aimed to quantify fast-food outlet availability near Perth schools and determine whether differences in area-level disadvantage and school type exist. Methods: Fast-food outlet locations were sourced from Perth Local Governments in 2018/2019. All Perth Primary (n = 454), Secondary (n = 107) and K-12 (n = 94) schools were assigned an area-level disadvantage decile ranking based …

Are College Students Interested In Family Health History Education? A Large Needs Assessment Survey Study, Ming Li, Oi Man Kwok, Ping Ma, Tung-Sung Tseng, Lei Shih Chen

School of Public Health Faculty Publications

Family health history (FHH) is an essential foundation for personalized disease prevention. As the incidence of early-onset chronic diseases is increasing among college students, it is important to provide them with the education required to learn about their FHH. This study aimed to assess college students’ interest in receiving FHH education, preferred topics, and desired learning methods. We invited college students to complete an online survey from a large research-intensive university. A total of 2276 college students completed the survey. Nearly half of the participants self-identified as non-Hispanic white (45.5%). Slightly more than half of the sample (53.9%) were not …

Cognitive Assessment Of Health-Care Workers Exposed To Ionizing Radiation And The Assessment Of Radiation Safety Awareness In Different Radiation Oncology Hospitals In Egypt, Basma M. Saleh

Theses and Dissertations

The increase in cancer cases and subsequent increase in chemotherapy and radiotherapy sparked worries over hospital workers' health and safety. There is a global trend towards routine assessment of awareness, safety measures, and radiation protection culture among healthcare workers. There is also a trend towards monitoring the various associations between radiation exposure and different health outcomes. In low- and middle-income countries, the use of advanced techniques and biomarker tests to track the health status of the workers is hard to achieve. This is due to the scarce resources and economic instabilities and that is why using a survey as a …

Differential Transcriptional Alterations In Detoxification Genes In Parkinson’S Disease In Egypt, Nourhan Shebl

Theses and Dissertations

PD is the most common motor neurodegenerative disease worldwide. The underlying cause of PD is still unknow, owingthis to the complexity of the disease. Often, genetics and environmental factors are collaborating in the initiation of the disease. Despite the diversity of its genetical and environmental profiles, the Egyptian population is one of the mostunderrepresented population in terms of PD research. In this study, we investigated PD through various perspectives tohighlight the complexity of the disease in Egypt, taking into consideration the diversity of the Egyptian population. We recruited PD patients and reference controls from 4 governorates: Cairo, Giza, Alexandria, and …

Autonomic Function Recovery And Physical Activity Levels In Post-Covid-19 Young Adults After Immunization: An Observational Follow-Up Case-Control Study, Ana Paula Coelho Figueira Freire, Shaan Amin, Fabio Santos Lira, Ana Elisa Von Ah Morano, Telmo Pereira, Manuel-João Coelho-E-Silva, Armando Caseiro, Diego Giulliano Destro Christofaro, Vanessa Ribeiro Dos Santos, Osmar Marchioto Júnior, Ricardo Aurino Pinho, Bruna Spolador De Alencar Silva

All Faculty Scholarship for the College of Education and Professional Studies

Coronavirus disease 2019 (COVID-19) has detrimental multi-system consequences. Symptoms may appear during the acute phase of infection, but the literature on long-term recovery of young adults after mild to moderate infection is lacking. Heart rate variability (HRV) allows for the observation of autonomic nervous system (ANS) modulation post-SARS-CoV-2 infection. Since physical activity (PA) can help improve ANS modulation, investigating factors that can influence HRV outcomes after COVID-19 is essential to advancements in care and intervention strategies. Clinicians may use this research to aid in the development of non-medication interventions. At baseline, 18 control (CT) and 20 post-COVID-19 (PCOV) participants were …

A Novel Defined Tlr3 Agonist As An Effective Vaccine Adjuvant, Kwang Hyun Ko, Seung Bin Cha, Seung-Hwan Lee, Hyun Shik Bae, Chul Soo Ham, Min-Gyu Lee, Dong-Ho Kim, Seung Hyun Han

Faculty, Staff and Student Publications

Synthetic double-stranded RNA analogs recognized by Toll-like receptor 3 (TLR3) are an attractive adjuvant candidate for vaccines, especially against intracellular pathogens or tumors, because of their ability to enhance T cell and antibody responses. Although poly(I:C) is a representative dsRNA with potent adjuvanticity, its clinical application has been limited due to heterogeneous molecular size, inconsistent activity, poor stability, and toxicity. To overcome these limitations, we developed a novel dsRNA-based TLR3 agonist named NexaVant (NVT) by using PCR-coupled bidirectional in vitro transcription. Agarose gel electrophoresis and reverse phase-HPLC analysis demonstrated that NVT is a single 275-kDa homogeneous molecule. NVT appears to …

Protocol For Validation Of The Global Scales For Early Development (Gsed) For Children Under 3 Years Of Age In Seven Countries, Vanessa Cavallera, Gillian Lancaster, Melissa Gladstone, Maureen M. Black, Gareth Mccray, Ambreen Nizar, Salahuddin Ahmed, Muhammad Imran Nisar, Farzana Begum, Fyezah Jehan

Department of Paediatrics and Child Health

Introduction: Children's early development is affected by caregiving experiences, with lifelong health and well-being implications. Governments and civil societies need population-based measures to monitor children's early development and ensure that children receive the care needed to thrive. To this end, the WHO developed the Global Scales for Early Development (GSED) to measure children's early development up to 3 years of age. The GSED includes three measures for population and programmatic level measurement: (1) short form (SF) (caregiver report), (2) long form (LF) (direct administration) and (3) psychosocial form (PF) (caregiver report). The primary aim of this protocol is to validate …

Digital Health Interventions To Improve Adolescent Hpv Vaccination: A Systematic Review, Jihye Choi, Irene Tamí-Maury, Paula Cuccaro, Sooyoun Kim, Christine Markham

Faculty, Staff and Student Publications

Digital technologies are being increasingly utilized in healthcare to provide pertinent and timely information for primary prevention, such as vaccination. This study aimed to conduct a systematic review to describe and assess current digital health interventions to promote HPV vaccination among adolescents and parents of adolescents, and to recommend directions for future interventions of this kind. Using appropriate medical subject headings and keywords, we searched multiple databases to identify relevant studies published in English between 1 January 2017 and 31 July 2022. We screened and selected eligible studies for inclusion in the final analysis. We reviewed a total of 24 …

Investigating Stigma During The Early Stages Of A Pandemic Through The Lens Of Covid-19, Zach Thornton, Bethany Hodge, Sheridan Langford

The University of Louisville Journal of Respiratory Infections

Background: Individuals face stigma associated with numerous health conditions. Stigma can arise rapidly during the early spread of a new disease, adding to the burden felt by those affected. COVID-19 can be used as an example to study stigma during the early phases of a pandemic. This narrative review is a descriptive analysis that tracks the ways in which COVID-19 stigma was discussed in the scholarly literature during the first year of the pandemic to understand how stigma was viewed in the context of a rapidly spreading pandemic.

Methods: PubMed was used as a non-exhaustive sample of the literature. Searches …

Could Hypertension In Radiographers Associated With Low Ionizing Radiation Exposure? An Evidence-Based Case Report, Rita I. Wijaya, Levina C Khoe, Muchtaruddin Mansyur

Occupational and Environmental Medicine Journal of Indonesia

Low-dose ionizing radiation exposure (

Socio-Demographic Determinants Of Non-Utilisation Of Antenatal Care Services By Women In The Northern Region Of Nigeria, Abubakar Yakubu Abbani, Yothin Sawangdee, Olusola Akintoye Omisakin, Maretalinia Maretalinia

Journal of Health Research

Background: A large proportion of women in the northern region of Nigeria do not utilise antenatal care (ANC) services. As a result, the region has the worst maternal and child health indicators. This study aims to identify the socio-demographic determinants of the non-utilisation of ANC services by pregnant women to provide evidence for policymakers to base decisions towards addressing the problem.

Methods: Data from the 2018 Nigeria Demographic and Health Survey was used with a sample of 14,421 women with a pregnancy history. Descriptive, bivariate, and hierarchical regression analyses were applied to the data using STATA software version 15.

Results: …

Living Healthier: A Grounded Theory Of Older Adults With Prehypertension, Junjira Seesawang, Pulawit Thongtang

Journal of Health Research

Background: To prevent hypertension and long-term risk of cardiovascular events, older adults with prehypertension have to adhere to preventive behaviors. Little is known about the experience of adherence to preventive behavior among older adults with prehypertension.

Method: A constructivist grounded theory approach was used to develop a model explaining the process of adherence to preventive behavior among older adults with prehypertension living in Thailand. Participants were recruited using purposive and theoretical samplings from two primary health care units in Western Thailand. Semi-structured interviews were conducted with 26 participants. All interview data collection was recorded, transcribed, and analyzed simultaneously. Initial and …

Antibody-Dependent Enhancement Activity Of A Plant-Made Vaccine Against West Nile Virus, Amber M. Paul, Haiyan Sun, Dhiraj Acharya, Huafang Lai, Junyun He, Fengwei Bai, Qiang Chen

Publications

West Nile virus (WNV) causes annual outbreaks globally and is the leading cause of mosquito-borne disease in Unite States. In the absence of licensed therapeutics, there is an urgent need to develop effective and safe human vaccines against WNV. One of the major safety concerns for WNV vaccine development is the risk of increasing infection by related flaviviruses in vaccinated subjects via antibody-dependent enhancement of infection (ADE). Herein, we report the development of a plant-based vaccine candidate that provides protective immunity against a lethal WNV challenge mice, while minimizes the risk of ADE for infection by Zika (ZIKV) and dengue …

Understanding Quality Of Life In Patients With Acute Leukemia, A Global Survey, Zack Pemberton-Whiteley, Samantha Nier, Jan Geissler, Sophie Wintrich, Bregje Verhoeven, Rita O. Christensen, Sam Salek, Esther Natalie Oliva, Tatyana Ionova, Jennie Bradley

Journal of Patient-Centered Research and Reviews

Purpose: The Acute Leukemia Advocates Network (ALAN) sought to determine which factors are most associated with poor quality of life (QoL) in patients with acute leukemia and to determine key issues and unmet needs through administration of an online survey distributed worldwide via partner patient organizations.

Methods: ALAN developed a questionnaire informed by literature review and based extensively on the hematological malignancy-specific patient-reported outcomes (HM-PRO) measure to assess the impact of acute leukemia on QoL and its relationships with patients’ demographics, disease state, disease impact, and support from health care professionals. Univariate and multivariable statistical analysis was used to investigate …

Neighborhood Condition Prevalence Rates Correlate With Covid-19 Mortality In Milwaukee County, Wisconsin, George L. Morris Iii

Journal of Patient-Centered Research and Reviews

Purpose: We sought to determine if census tract-level (ie, neighborhood) COVID-19 death rates in Milwaukee County correlated with the census tract-level condition prevalence rates (CPRs) for individual COVID-19 mortality risk.

Methods: This study used Milwaukee County-reported COVID-19 death rates per 100,000 lives for the 296 census tracts within the county to perform a linear regression with individual COVID-19 mortality risk CPR, mean age, racial composition of census tract (by percentage of non-White residents), and poverty (by percentage within census tract), followed by multiple regression with all 7 CPRs as well as the 7 CPRs combined with the additional demographic variables. …

Identification Of Cancer Related Risk And Protective Factors For American Indian Youth: A Mixed Studies Review, Melanie Nadeau, Kathryn Wise, Vianca Farfan Cuela, Devon Olson, Karan Saravana

Indigenous Health Faculty Publications

Introduction: Many causes of cancer related morbidity and mortality can be traced back to childhood behaviors. The culmination of cancer related risk and protective factors impacting the health and wellbeing of American Indian youth is unknown. The aim of this Mixed Studies Review was to identify cancer related risk and protective factors among American Indian youth. Results will be shared with Tribal communities to inform surveillance efforts.

Methods: A Mixed Studies Review process was deemed most appropriate for the search process and data collection. 7 databases were included in the search along with 3 databases that were hand searched. Google …

Racial Differences In Perceived Risk And Sunscreen Usage, Rebecca Fliorent, Alicia Podwojniak, Lianne Adolphe, Katharine Milani

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background Although White individuals have higher incidence of melanoma, clinical outcomes are worse among patients with skin of color. This disparity arises from delayed diagnoses and treatment that are largely due to clinical and sociodemographic factors. Investigating this discrepancy is crucial to decrease melanoma-related mortality rates in minority communities. A survey was used to investigate the presence of racial disparities in perceived sun exposure risks and behaviors. Methods A survey consisting of 16 questions was deployed via social media to assess skin health knowledge. Over 350 responses were recorded, and the extracted data were analyzed using statistical software. Results Of …

Predictors Of Success In Establishing Orthotopic Patient-Derived Xenograft Models Of Triple Negative Breast Cancer, Gloria V Echeverria, Shirong Cai, Yizheng Tu, Jiansu Shao, Emily Powell, Abena B Redwood, Yan Jiang, Aaron Mccoy, Amanda L Rinkenbaugh, Rosanna Lau, Alexander J Trevarton, Chunxiao Fu, Rebekah Gould, Elizabeth E Ravenberg, Lei Huo, Rosalind Candelaria, Lumarie Santiago, Beatriz E Adrada, Deanna L Lane, Gaiane M Rauch, Wei T Yang, Jason B White, Jeffrey T Chang, Stacy L Moulder, W Fraser Symmans, Susan G Hilsenbeck, Helen Piwnica-Worms

Faculty, Staff and Student Publications

Patient-derived xenograft (PDX) models of breast cancer are an effective discovery platform and tool for preclinical pharmacologic testing and biomarker identification. We established orthotopic PDX models of triple negative breast cancer (TNBC) from the primary breast tumors of patients prior to and following neoadjuvant chemotherapy (NACT) while they were enrolled in the ARTEMIS trial (NCT02276443). Serial biopsies were obtained from patients prior to treatment (pre-NACT), from poorly responsive disease after four cycles of Adriamycin and cyclophosphamide (AC, mid-NACT), and in cases of AC-resistance, after a 3-month course of different experimental therapies and/or additional chemotherapy (post-NACT). Our study cohort includes a …

Moderation Effect Of Community Health On The Relationship Between Racial/Ethnic Residential Segregation And Hiv Viral Suppression In South Carolina: A County-Level Longitudinal Study From 2013 To 2018, Fanghui Shi, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Xiaowen Sun, Zhenlong Li, Chengbo Zeng, Huan Ning, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: Viral suppression is the ultimate goal of the HIV treatment cascade and a primary endpoint of antiretroviral therapy. Empirical evidence found racial/ethnic disparities in viral suppression among people living with HIV (PWH), but the evidence of the relationship between racial/ethnic residential segregation and place-based viral suppression is scarce. Further exploring potential structural moderators in this relationship has substantial implications for healthcare policymaking and resource allocation. The current study aimed to investigate the spatial-temporal disparities in the HIV viral suppression rate across 46 counties in South Carolina from 2013 to 2018. We also examined the impact of racial/ethnic residential segregation …

Immune Environment And Antigen Specificity Of The T Cell Receptor Repertoire Of Malignant Ascites In Ovarian Cancer, Kyoko Yoshida-Court, Tatiana V Karpinets, Aparna Mitra, Travis N Solley, Stephanie Dorta-Estremera, Travis T Sims, Andrea Y Delgado Medrano, Molly B El Alam, Mustapha Ahmed-Kaddar, Erica J Lynn, K Jagannadha Sastry, Jianhua Zhang, Andrew Futreal, Alpa Nick, Karen Lu, Lauren E Colbert, Ann H Klopp

Faculty, Staff and Student Publications

We evaluated the association of disease outcome with T cell immune-related characteristics and T cell receptor (TCR) repertoire in malignant ascites from patients with high-grade epithelial ovarian cancer. Ascitic fluid samples were collected from 47 high-grade epithelial ovarian cancer patients and analyzed using flow cytometry and TCR sequencing to characterize the complementarity determining region 3 TCR β-chain. TCR functions were analyzed using the McPAS-TCR and VDJ databases. TCR clustering was implemented using Grouping of Lymphocyte Interactions by Paratope Hotspots software. Patients with poor prognosis had ascites characterized by an increased ratio of CD8+ T cells to regulatory T cells, which …

Navigating The Adoption Of Interprofessional Education As A Performance Standard In Dietetics Education, Paige Whitney, Mary Ann Kluge

Journal of Dietetic Education

Abstract: The purpose of this collective case study was to explore the diffusion of interprofessional education (IPE) in response to specific Future Education Model (FEM) Graduate Program accreditation standards and performance indicators. Data were collected via semi-structured interviews with a purposive sample of 12 FEM program directors from geographically diverse US states. Website and document review were triangulated with the interview data, and Roger’s Diffusion of Innovation (DOI) was used as a theoretical framework to add dimension to the study. Three themes emerged from analysis: 1) Accreditation standards are not the driving force of IPE; 2) Program Directors can serve …