Digital Commons Network^™

The Impact Of Body Mass Index And Physical Disability On Home-Based Anal Self-Sampling, Jenna Nitkowski, Maria E Fernandez, Tim Ridolfi, Elizabeth Chiao, Anna R Giuliano, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Alan G Nyitray

Faculty, Staff and Student Publications

PURPOSE: Self-sampling is increasingly being used in screening programs, yet no studies to date have examined the impact of bodily characteristics on self-sampling experiences. Our objective was to assess whether body mass index (BMI) and physical disability were associated with anal self-sampling difficulty.

METHODS: We recruited sexual minority men (SMM) and trans persons in Milwaukee, Wisconsin to participate in an anal cancer screening study. Between January 2020 and August 2022, 240 participants were randomized to a home (n = 120) or clinic (n = 120) screening arm. Home participants received a mailed at-home anal self-sampling kit and were asked to …

The Perpetual Evidence-Practice Gap: Addressing Ongoing Barriers To Chronic Pain Management In Primary Care In Three Steps, Laura Ellen Ashcraft, Megan E Hamm, Serwaa S Omowale, Valerie Hruschak, Elizabeth Miller, Shaun M Eack, Jessica S Merlin

Faculty, Staff and Student Publications

Background: Most management of chronic pain, a serious illness affecting the physical and psychological wellbeing of millions, occurs in primary care settings. Primary care practitioners (PCPs) attempt to provide evidence-based practices to treat chronic pain. However, there continues to be a gap between the care people receive and the evidence. The objectives for this study were to (1) explore determinants of evidence-based chronic pain management and (2) develop a novel approach to using implementation science to address the evidence-practice gap.

Method: A convenience sample of twenty-one Pennsylvania PCPs participated in one-time semi-structured telephone interviews. Interviews were transcribed verbatim and both …

Self-Perception Of Mental Health, Covid-19 And Associated Sociodemographic-Contextual Factors In Latin America, Pablo Roa, Guillermo Rosas, Gloria Isabel Niño-Cruz, Sergio Mauricio Moreno-López, Juliana Mejía-Grueso, Haney Aguirre-Loaiza, Javiera Alarcón-Aguilar, Rodrigo Reis, Adriano Akira Ferreira Hino, Fernando López, Deborah Salvo, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in …

Prozone Masks Elevated Sars-Cov-2 Antibody Level Measurements, Micaela N Sandoval, Samuel P Mcclellan, Stephen J Pont, Jessica A Ross, Michael D Swartz, Mark A Silberman, Eric Boerwinkle

Faculty, Staff and Student Publications

We report a prozone effect in measurement of SARS-CoV-2 spike protein antibody levels from an antibody surveillance program. Briefly, the prozone effect occurs in immunoassays when excessively high antibody concentration disrupts the immune complex formation, resulting in a spuriously low reported result. Following participant inquiries, we observed anomalously low measurement of SARS-CoV-2 spike protein antibody levels using the Roche Elecsys® Anti-SARS-CoV-2 S immunoassay from participants in the Texas Coronavirus Antibody Research survey (Texas CARES), an ongoing prospective, longitudinal antibody surveillance program. In July, 2022, samples were collected from ten participants with anomalously low results for serial dilution studies, and a …

Colonial Drivers And Cultural Protectors Of Brain Health Among Indigenous Peoples Internationally, Rita Henderson, Joyla A Furlano, Shayla Scott Claringbold, Ashley Cornect-Benoit, Anh Ly, Jennifer Walker, Lisa Zaretsky, Pamela Roach

Faculty, Staff and Student Publications

Despite relatively higher rates of dementia among Indigenous populations internationally, research into drivers of disparities in brain health and cognitive function has tended to focus on modifiable risk factors over cultural understandings and contextual determinants. By seeking to characterize social and cultural factors that shape brain health and cognition in Indigenous populations, this mini scoping review expands prevailing schools of thought to include Indigenous knowledge systems. This reveals important gaps in culturally aligned care. It also reclaims horizons for research important to Indigenous Peoples that have garnered diminished attention in biomedical approaches. Twenty-three sources were included for data extraction. This …

Higher Baseline Serum Bilirubin Levels Are Associated With Increased Risk Of Early Neurological Deterioration In Women With Acute Ischemic Stroke, Meng Sun, Yingfeng Weng, Jiwei Cheng, Guoyi Li, Qian Xiao

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Early neurological deterioration (END) occurs in up to one-third of patients with acute ischemic stroke (AIS) and associated with poor outcome. The role of serum bilirubin in END remains controversial. This study aims to investigate the association of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) with END.

METHODS: This study was a cross-sectional retrospective study with 344 AIS patients enrolled. We retrospectively reviewed consecutive AIS patients with END through a medical record retrieval system and enrolled patients as control randomly from the AIS patients without END at the same period. The bilirubin levels were …

Patterns Of Failure For Recurrent Head And Neck Squamous Cell Carcinoma Treated With Salvage Surgery And Postoperative Imrt Reirradiation, Abdallah S R Mohamed, Geoffrey V Martin, Sweet Ping Ng, Vinita Takiar, Beth M Beadle, Mark Zafereo, Adam S Garden, Steven J Frank, C David Fuller, G Brandon Gunn, William H Morrison, David I Rosenthal, Jay Reddy, Amy Moreno, Anna Lee, Jack Phan

Faculty, Staff and Student Publications

PURPOSE/OBJECTIVES: The purpose of this study was to evaluate patterns of locoregional recurrence (LRR) after surgical salvage and adjuvant reirradiation with IMRT for recurrent head and neck squamous cell cancer (HNSCC).

MATERIALS/METHODS: Patterns of LRR for 61 patients treated consecutively between 2003 and 2014 who received post-operative IMRT reirradiation to ≥ 60 Gy for recurrent HNSCC were determined by 2 methods: 1) physician classification via visual comparison of post-radiotherapy imaging to reirradiation plans; and 2) using deformable image registration (DIR). Those without evaluable CT planning image data were excluded. All recurrences were verified by biopsy or radiological progression. Failures were …

Photovoice As A Reflective Pedagogy For Undergraduate Community Psychology Students, Shereé Bielecki

Theses and Dissertations

This descriptive qualitative study was designed to understand the experiences of former Community Psychology (CP) undergraduate students who participated in a degree program at a California university. The purpose of this qualitative study is to explore how former Community Psychology undergraduate students describe their experiences using reflective Photovoice activities to learn about and become involved in social justice. The theoretical frameworks that informed this study were in social justice theory, pedagogical practices related to teaching social justice using Photovoice, and the practice of self-reflection in college classrooms. Two primary research questions guide the inquiry: 1) How do former Community Psychology …

Leadership In Social Service Non-Profit Organizations: An Interpreative Phenomenlogical Analysis Of Executive Leadership High Attrition Levels And Proposals For Change, Stephanie Fredericka Wanza

Theses and Dissertations

The purpose of this study is to address how leaders who are employed at non-profit organizations can utilize change management frameworks, leadership style, strategic planning and organizational best practices to reduce attrition levels at their organizations. The focus of this study is three-fold: a) to understand why high attrition takes place at non-profits; identify what change model/s, types of leadership styles and best practices can be effective in reducing leader attrition, b) explore the development of a leadership framework by understanding how to manage change at nonprofits through the Carnall (1986), Shields (1999) and Cummings and Worley (2009) change management …

How Political Elite Leverage Twitter To Polarize America, Woodson Morris Hobbs V

Theses and Dissertations

While social media has changed how humans use the internet, Twitter has drastically reformed how individuals worldwide receive their news. As news outlets fail to keep up with the rapid dissemination of information online, Twitter has become a sounding board for the political elite who leverage the platform's immediacy and virality. This study, using Quantitative Ethnography's Epistemic Network Analysis, seeks to determine if the political elite, specifically members of Congress, are leveraging Twitter to spread polarizing information to strengthen their base. In this study, extensive coding of select members of the 118th Congress was completed and compared to Voteview.com's DW-Nominate …

A Systematic Review Of Risk And Protective Factors For Mental Health Among Latinx College Students, Melissa Gavilanes

Theses and Dissertations

A quantitative studies systematic review with narrative synthesis was conducted to explore the risk and protective factors among Latinx college students’ mental health. This systematic review also aimed to identify the relevant demographic variability to the mental health of Latinx college students, and the relationship between mental health and academic performance within this population. Data was collected from four electronic databases and included peer-reviewed articles published between 2000 and 2022, conducted within the United States, participants over the age of 17, and samples comprised of or including Latinx college students. Studies utilizing quantitative designs, and quantitative portions of mixed method …

Psychological Safety During The Covid-19 Pandemic Restrictions-A U.S. Healthcare Context, Mary Jean Brown

Theses and Dissertations

The pandemic forced many employees to transition to remote work, leading to concerns about the economic impact and inequities between remote and on-site workers. The shift to remote work has raised psychological safety issues, work-life balance, and employee engagement. The virtual workspace created during the pandemic has highlighted communication challenges, interpersonal dynamics, and maintaining boundaries between work and personal life. Through a quantitative approach, this study explored changes in perceived psychological safety, its relation to the psychosocial impact of COVID-19, and demographic factors, offering the opportunity to gain insights into this unprecedented experience during a global pandemic. Findings showed that …

The Success Strategies Of The Iranian-American Women Who Initially Received Their Primary And/Or Secondary Education In The Post-Revolution Iranian Education System In Attaining Higher Education Degrees In The United States, Niloufar Mirhashemi

Theses and Dissertations

The driving theme for this research was cultural discontinuity as experienced in the American academic institutions. Cultural discontinuity is understood as a way in which the cultural practices and values of students’ home culture affect the academic achievements of the students usually, resulting in low academic accomplishments. This phenomenon can be triggered by the existing disparities and gaps in the educational and cultural structures of a society. This research investigated the encounters, challenges, and perspectives of women born in Iran who initially received their primary and/or secondary education in the post-revolution Iranian education system and later obtained college degrees in …

Beyond The Classroom: Unraveling The Impact Of Student Engagement On Graduation Rates In New York City, Kimberly Mccall

Theses and Dissertations

This study critically examined the impact of student engagement on high school graduation rates amidst the educational disruptions ushered in by the COVID-19 pandemic, with a concentrated focus on the United States. It evaluated the essential engagement factors--rigorous instruction, collaborative teaching, supportive environments, and trust--and their role in addressing disparities in graduation outcomes (New York City Panorama, 2022; Wang & Degol, 2014). Anchored in the theoretical frameworks of Bronfenbrenner’s ecological systems theory (Bronfenbrenner, 1979), social-emotional learning theory (Durlak et al., 2011; Williamson et al., 2015), and Vygotsky’s sociocultural theory (Vygotsky, 1987), this research utilized a comprehensive quantitative analysis of data …

Strategic Framework For Achieving Successful Sustainable Tourism In Egypt, Maher Abdelwahab

Theses and Dissertations

This phenomenological study explored the lived experiences of tourism leaders who operate a tour operator company in Egypt. It sought to examine how the lack of collaborative leadership adversely affects tourism. The study further investigated the challenges the tourism industry faces, and the strategies tour companies’ leaders use to achieve successful sustainable tourism. The study revealed the connection between the challenges, strategies, competitiveness, factors of success, and recommendations to create a strategic framework for successful sustainable tourism. The strategic framework promoted collective tourism leadership and sustainable tourism as significant economic drive in Egypt to reduce poverty, develop society, and bring …

The Latina Career Journey: Experiences Of Latinas In Accounting, Alba Ruth Prato

Theses and Dissertations

Latina voices remain largely silent in the scholarship on leadership, and their representation in leadership roles lags behind other minority and majority groups. This research explored the Latina career journey through in-depth narrative interviews with 19 Latinas who told the stories of how they carry out their role, act on opportunities, navigate between cultures, and overcome challenges. Through comprehensive qualitative analysis using a grounded theory approach, a theoretical framework emerged that brings to light the larger social and cultural forces that impact the management arena and function as levers that, when activated, hinder and facilitate the emergence of Latina leaders. …

Navigating Embodied Self-Awareness States To Produce Work-Enhancing Adaptive Stress Responses, Kristina Banfield

Theses and Dissertations

Work-related stress is increasingly problematic for middle managers and executives, leading to escalating problems of burnout, turnover, diminished performance, and compromised well-being. However, given the same stressor, differential outcomes are observable across individuals, ranging from paralysis to agitation, and even enhanced performance. Individuals’ responses to stress are strongly influenced by their mental models, physiology, and nervous systems—all of which can be deliberately modulated to promote more adaptive stress responses. The purpose of this study was to examine managers’ experiences of their modulated self-awareness states to optimize their stress response for work performance. A purposive sample of 10 senior managers and …

Addressing Inappropriate Polypharmacy: Investigating Perceived Facilitators And Barriers To U.S. Pharmacists' Ability To Recommend Deprescribing, Susanne Steiner

Theses and Dissertations

While the concurrent use of multiple prescriptions (polypharmacy) is common for those with chronic conditions, professional ownership is lacking when it comes to tapering or discontinuing potentially inappropriate medications. Our growing elderly population is especially vulnerable to negative risks associated with polypharmacy. Pharmacists are highly educated and skilled healthcare professionals working as critical touchpoints with patients; yet they are not empowered to deprescribe potentially inappropriate medications directly. This qualitative research study examined the perceived barriers and facilitators pharmacists encounter when pursuing deprescribing recommendations and initiatives with prescribers, healthcare staff, patients, and caregivers. Findings from this study revealed three key implications …

Exploring Teachers' Mastery And Use Of Minecraft In The Classroom A Survey Of The Minecraft Teachers, Hae Ryung Rinpoche Kim

Theses and Dissertations

This study explored the dynamic interplay of social constructivism, game-based learning, and communities of practice in the context of teachers using Minecraft as an educational tool. This study used a teacher survey to collect insights from teachers who use Minecraft and are members of the Minecraft Teachers’ Lounge. The research investigated how teachers learn to use Minecraft, the resources that support their learning journey, and the factors influencing their confidence in utilizing game-based learning tools. The findings highlighted the significance of collaborative learning environments, experiential learning approaches, and ongoing professional development opportunities for teachers using technology-enhanced tools like Minecraft. The …

Veterans, Providers, Moral Injury, And The Integration Of Spirituality In Clinical Care, Claire Muldrew

Theses and Dissertations

Moral Injury (MI) is known to be prevalent among military populations, however, the integration of spirituality into the treatment of veterans with trauma/posttraumatic stress disorder (PTSD) is an understudied topic. This systematic review sought to explore how mental health clinicians and chaplains view the integration of spirituality in the course of clinical care with traumatized veterans who experience MI. Utilizing qualitative methodology, the existing knowledge base was studied to shed light on this topic and to also identify the similarities and differences between these types of providers. The meta-aggregation approach was applied to analysis of the available data and a …

The Examination Of Workplace Well-Being In The Context Of Conversations On Artificial Intelligence, Haille Trimboli

Theses and Dissertations

This study explored the relationship between technological advancements in the workplace, particularly artificial intelligence (AI), and employee well-being. As the use of AI in organizational practices increases, this study sought to examine how fostering social connections, primarily through AI-focused conversations, could enhance employee well-being amid these technological shifts. This research employed a mixed-methods framework with an embedded convergent core design to collect qualitative and quantitative data from employees at a global organization that made recent, significant investments in AI. This methodology integrated pre- and post-intervention surveys to assess changes in employee well-being and an analysis of team discussions about AI …

An Examination Of The Facilitators And Barriers For Implementing Environmental Sustainability Plans Into Corporate Strategy, Nathan Maton

Theses and Dissertations

This study examined how organizations integrate environmental sustainability and corporate strategy, describing that intersection as strategic sustainability. The goal of the study was to use qualitative interviews of public American corporations to understand the facilitators and barriers to strategic sustainability. The study identified three facilitators (i.e., emerging regulations, customer demand, and leadership) and two barriers (i.e., data quality and education). These results suggest corporations leverage upcoming regulations, leaders who advocate for sustainability, and customer demand to embed sustainability while improving their education and data quality. Additionally, the research suggests more quantitative research and validation of the results.

Fostering A Culture Of Belonging Within Women Working In A Hybrid Environment, Jam Narte Harley

Theses and Dissertations

This research discusses the opportunity presented by the post-pandemic return to work to support Diversity, Equity, Inclusion, and Belonging initiatives by creating a new belonging framework for women working in a hybrid environment. The transition to remote and hybrid work arrangements amid the pandemic highlighted the importance of leaders tackling ongoing challenges in leadership and management, such as digital transformation and remote management, which led to rapid change, anxiety, and uncertainty. The lack of daily contact has significantly impacted workplace relationships and highlighted the importance of belongingness for employees' well-being and retention. Hybrid work arrangements are likely to become a …

The Power Of Organizational Purpose In Customer Engagement, Claudio Ludovisi

Theses and Dissertations

In a hyperconnected world, direct customer engagement is becoming a significant competitive advantage. Technologies like database marketing, social media, personalization, and artificial intelligence are widely available to create and support direct relationships with customers at scale; yet, as evidenced by the unabated rise in marketing and paid media costs, firms continue to use third parties to engage their audiences. At the same time, organizational purpose has been shown to drive firm value, but majority of research has focused on internal dynamics of purpose rather than its effect on external stakeholders and customers in particular. Very little has been empirically studied …

Cybersecurity—The Human Element, James Mcgibney

Theses and Dissertations

This phenomenological study’s objective was to review the existing initiatives for cybersecurity awareness and training that are in place for the K-12 education system throughout the United States. Every facet of life is now plagued by the potential, perceived, and real threat of cyber warfare, which includes, but is not limited to, K-12 schools throughout the United States. Massive cascading effects result from cybersecurity breaches, and some are so severe that the targeted organization is forced to shut down. The digital anatomy of these massive hacks' origins is sometimes overlooked in their context. Even if they have the best intrusion …

Best Practices Of Information Technology Project Managers Leading Agile Projects, Anshu Singh Lal

Theses and Dissertations

Within software development, various methodologies are leveraged to structure the software development process. Among these methodologies, the waterfall and agile models are most popular. Historically, in software development, the waterfall methodology has been applied to IT projects and project management has aligned with this plan-driven approach. Recently, due to its flexible nature, software development trends have resulted in an increased adoption of the agile methodology within organizations. The Agile methodology is an incremental, iterative software development methodology. This approach transforms the larger project into smaller segments that are iteratively developed and delivered for utilization. This methodology is dependent on deliverables …

Student Engagement In Model School Math: A Phenomenological Study Of Student Perspectives At A Model Continuation High School, James Robert Coles Iii

Theses and Dissertations

The purpose of this phenomenological study was to explore the perspectives on engagement of students who had passed Model School Math (Integrated Math 1 or Algebra 1) and graduated within the years 2015 to 2019 from a Model Continuation High School in California. This study sought to discover the strategies, policies, and procedures which best supported at-risk students and adequately prepared them for college and career after attending a continuation high school. The theoretical framework used for this study was flow theory. This phenomenological qualitative study was conducted in one school district with students who attended a single site. Each …

Lifting The Voices Of Cisgender Female Survivors Of Sexual Violence: A Systematic Review Of Their Experiences With Formal Support Providers/Systems, Madeleine Walker

Theses and Dissertations

This qualitative systematic review aimed to recognize what adult cisgender female survivors of sexual violence said about their experiences with formal support providers upon disclosure and their recommendations to enhance the disclosure process. Using a deductive content analysis of nice qualitative studies, the researcher identified and explored supportive and unsupportive formal support providers’ behaviors. Results indicated that supportive experiences typically involved aspects of both emotional support and tangible aid. Unsupportive experiences mainly focused on how providers responded to and negatively treated cisgender female survivors during the entirety of the investigation process. Also, cultural factors, such as race, gender, ethnicity, and …

Understanding How The Organizational Systems That Select, Promote, And Retain First-Time, Managers Can Be Improved For The Growing Millennial Supervisory Population, Stephanie Castillo

Theses and Dissertations

The success rate for first-time managers is staggeringly low (approximately 40%) during their first 24 months in the role. While various journals and studies have addressed this topic, few have addressed it with a focus on millennial, first-time managers. Given that many millennials are stepping into the role of front-line supervisor, understanding their experience is an important step in understanding how organizational systems can be improved to increase new managers’ success rates. Therefore, the purpose of this study is to understand how to improve the organizational systems that select, promote, and retain first-time managers for the growing millennial supervisory population. …

Making The Middle Matter: Considering Project-Based, Experiential, And Work-Based Instructional Strategies With Middle School Teachers, Trishauna Pulos

Theses and Dissertations

Middle school is about the growth, potential, and change of adolescents. Students at the middle school age level, generally ages 10 to 14, struggle with the dynamics of making the transitions from recess and active learning in elementary school to multiple teachers, bigger workloads and campuses, and larger student populations (Alexander et al., 1969; Howell et al., 2016). For this study, the instructional practices, and strategies of project-based, experiential, and work-based learning are researched including challenges, measurements of growth and success, and recommendations for future educators using these instructional delivery methods (Dincer, 2021; Flannery & Smith, 2021; Kalkan & Dagli, …