Digital Commons Network^™

The Impact Of Ambient Air Quality On Asthma Outcomes In California, Abigail Obour

Graduate Student Theses, Dissertations, & Professional Papers

This study investigates the relationship between ambient air quality and asthma-related health outcomes in California, focusing on emergency department visits and hospitalizations from 2005 to 2022. Despite California’s strict air quality standards, individuals still face significant pollution challenges contributing to poor respiratory health, particularly among vulnerable populations. Therefore, this study looks at how fine particulate matter (PM2.5) affects asthma outcomes using panel data from 37 counties. A fixed effects regression model is employed to control for unobserved heterogeneities that are constant over time but vary across individual counties, ensuring robust estimates of the impact of pollution on health outcomes. This …

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

Reinventing The Concepts Of Group And Isomorphism In Abstract Algebra, Chrisitan José Lopez-Mercado

Graduate Student Theses, Dissertations, & Professional Papers

This study explores the reinvention of the concepts of group and isomorphism in abstract algebra through design-based research. It investigates how students can reinvent these concepts and how mathematical artifacts transform their mathematical reasoning during the reinvention process. The study identifies a reinvention ecology comprising three interrelated components: students' mathematical activity, social interaction, and the continual emergence of mathematical artifacts. Using the guided reinvention principle of realistic mathematics education, students engaged with contextual situations, such as a 12-hour analog clock and the symmetries of an equilateral triangle, to progressively develop structural observations, formalize group axioms, and assemble them into the …

Investigating The Impact Of Aerial Firefighting On Rate Of Wildfire Spread, Lindsay Ann Wiard

Graduate Student Theses, Dissertations, & Professional Papers

Aerial retardant drops are widely used in wildfire suppression, yet their effectiveness in slowing fire spread remains difficult to quantify at scale. This study evaluates the impact of aerial suppression on wildfire rate of spread (ROS) using a modeling framework that incorporates both observed (real) and counterfactual (synthetic) drop locations from a sample of 62 wildfires in Oregon. Synthetic drops were generated to simulate a no-suppression baseline, allowing us to compare changes in ROS in the presence and absence of suppression. We trained two random forest classifiers: one using both real and synthetic drops (the full model), and another using …

Methods To Improve Efficiency, Sensitivity, And Selectivity Of Sequence Similarity Search, Daniel Olson

Graduate Student Theses, Dissertations, & Professional Papers

The rapid growth of biological sequence data presents significant challenges for bioinformatic analysis. A cornerstone of this analysis, sequence similarity search, is hampered by three main obstacles: sensitivity in detecting distant evolutionary relationships, selectivity in distinguishing true homology from spurious similarity caused by features like tandem repeats, and scalability to handle massive databases. This dissertation introduces two novel computational tools, ULTRA and NEAR, that address these challenges to improve the efficiency, sensitivity, and selectivity of sequence similarity search. Part I of this dissertation addresses the problem of selectivity by focusing on tandem repeats, a common source of false-positive results in …

Challenged: A Practice-Based Analysis Of Simulating The Realities Of Teaching Through Play, Shanel Lara Locke

Graduate Student Theses, Dissertations, & Professional Papers

ChallengED is a classroom simulation game designed to explore the emotional and procedural realities of teaching through interactive play. Rather than attempting to manufacture empathy, the project focuses on conveying the unpredictability, humor, and fatigue that shape daily classroom life. Drawing from my own teaching experience, the game uses experiential realism and embodied interaction to communicate how educators navigate constant interruptions, shifting demands, and limited control. The development process also became a therapeutic practice, offering a way to reinterpret professional challenges through creative experimentation. Situated within practice-based research, ChallengED demonstrates how game design can function as both artistic inquiry and …

Refining Population-Level Measures Of Early Childhood Vaccination Coverage Using National Immunization Survey-Child Data, Alexandria Nicole Albers

Graduate Student Theses, Dissertations, & Professional Papers

Background: From 2011-2021, the U.S. Advisory Committee on Immunization Practices (ACIP) recommended 10 vaccine series by age 24 months, with guidelines for minimum vaccination age, maximum age for rotavirus vaccination, minimum dose intervals, and a catch-up schedule for delayed series initiation. National vaccination surveillance evaluates series completion based on whether children received the recommended number of doses, including a combined 7-vaccine metric (completed seven series collectively). However, this approach overlooks: 1) vaccinations given too early, too late, or too close together, 2) catch-up schedule vaccinations, and 3) completion of all 10 recommended vaccines.

Purpose: To refine national childhood vaccination coverage …

Formication With Destruction Of The Nasal Septum: A Rare Case Report, Michele White, Dwayne Evans, Gary Frey, Cleverick Cd Johnson, Ben F Warner

Faculty, Staff and Student Publications

Delusions of parasitosis are known by several names, one of which is formication. It is an uncommon psychiatric disorder listed in the DSM V under the classification of delusional disorders. Patients experience an established, incorrect belief that they have an infection of living organisms such as parasites. There are two types of delusions of parasitosis, primary and secondary. In the primary form, the symptom is the delusion of a parasitic infection without secondary cause. The secondary form includes this symptom as well as additional psychiatric disorder, drug abuse, or medical illness. Patients often seek consultation with dental providers for dental …

Association Between Trust In The Incumbent President And Covid-19 Preventive Behaviors During The Pandemic In Four Latin American Countries, Juliana Mejía-Grueso, Gloria Isabel Niño-Cruz, Javiera Alarcón-Aguilar, Pablo Roa-Urrutia, Sergio Mauricio Moreno-López, Adriano Akira Ferreira Hino, Alexandre Augusto De Paula Da Silva, Fernando López, Deborah Salvo, Rodrigo Siqueira Reis, Guillermo Rosas, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = …

Secondhand Tobacco Smoke Exposure And Sleep Disturbance In School-Aged Children In Appalachian Ohio, Ketrell Mcwhorter, Christine Kim, Timothy J. Hilbert, Danielle E. Mcbride, Anthony A. Mangino, Patrick J. Parsons, Kurunthachalam Kannan, Erin N. Haynes

Epidemiology and Environmental Health Faculty Publications

Introduction: Secondhand tobacco smoke (SHS) exposure remains a major public health concern for children and has been implicated in sleep disturbances through biological and behavioral mechanisms. Different methods of measuring SHS exposure have yielded inconsistent results. This study examined the relationship between SHS exposure and sleep among rural Appalachian 7–9-year-olds, utilizing three SHS measurements: natural log-transformed (ln) serum cotinine concentrations, dichotomized serum cotinine levels (≥0.05 vs. <0.05 ng/ml), and parent/caregiver report of ≥1 smoker in the home. We hypothesized SHS-exposed children would have a significantly higher prevalence of sleep disturbance—e.g., short sleep, frequent snoring, night awakenings—compared to unexposed, regardless of measurement method. Methods: We used data from the Marietta Community Actively Researching Exposure Study, a cohort of 404 children in Marietta and Cambridge, Ohio. Sleep disturbances were parent/caregiver-reported. Linear models were used for continuous outcomes to estimate beta coefficients; log-binomial models with generalized estimating equations (exchangeable correlation) were applied for dichotomized outcomes to estimate prevalence ratios (PR), each with 95% confidence intervals (CI). Results: Twenty-six percent of children had a parent/caregiver report of ≥1 sleep disturbance. There was a 35% increased prevalence of short sleep [PR = 1.35 (95%CI:1.02–1.80), p =.04] with each unit increase of ln serum cotinine levels, adjusting for age, sex, parent education, BMI percentile, and history of breathing difficulties in the past two years. Increasing ln serum cotinine levels were associated with a significant 5.5-min decrease in average sleep duration in age-adjusted models. Conclusions: Higher SHS exposure was associated with poorer sleep outcomes, with serum cotinine emerging as the only measure linked to short sleep, underscoring the importance of smoke-free environments, particularly in rural communities, and objective exposure assessment.

‘Impact Of Titration Of Atropine On Clinical Outcomes In Organophosphorus Poisoning Patients: An Observational Study’, Ashwini Ashwini, Janet Alva, Vivek Gopinathan

Manipal Journal of Nursing and Health Sciences

Background: Organophosphorus (OP) poisoning is a significant public health problem globally, leading to symptoms such as cholinergic crisis, intermediate syndrome, and altered consciousness. Proper administration of atropine, based on acetylcholinesterase enzyme levels, is critical to prevent deterioration. This study aims to describe how atropine titration parameters affect clinical outcomes in patients with organophosphorus poisoning

Materials and Methods: An observational cohort study included 46 OP poisoning patients aged over 18 years, admitted to the Intensive Care Unit (ICU). Data were collected within 24 hours of ICU admission using structured checklists covering demographic profiles, atropine titration, and clinical outcomes. Descriptive statistics were …

Posterior Circulation Stroke- A Case Report, Janet Alva, Shwetha Prabhu, Raghavendra Rao S

Manipal Journal of Nursing and Health Sciences

Background: Stroke is most commonly seen in individuals over 65 years of age. When it occurs in adults between 18 and 65 years, it is classified as a young stroke. Unusual presentations such as dizziness, visual disturbances, or sensory changes often contribute to delayed recognition. Early identification is crucial for preventing complications and enhancing neurological outcomes. Case presentation: A 34-year-old female presented to the emergency department with a sudden onset of dizziness, right-sided tingling and weakness, and blurred vision. The neurological examination revealed subtle signs of posterior circulation impairment. MRI brain stroke protocol demonstrated an acute posterior circulation infarct involving …

Academic Stress, Performance, And Satisfaction Among Undergraduate Nursing Students Under The Semester System, Kalyani Sinha, Sangeetha Priyadarshini, Baby S Nayak, Meghna Pandit

Manipal Journal of Nursing and Health Sciences

Introduction: Stress is a key indicator of psychological well being. Various factors contribute to the psychological disturbances among undergraduate students. These issues can affect academic satisfaction and increase stress. Examination-related stress negatively impacts students’ academic performance. Each course determines its assessment methods, content, learning strategies and instructional approaches. Objectives: This study assessed academic stress, performance, and satisfaction among undergraduate nursing students in the semester system at selected nursing colleges in Udupi District, Karnataka and find it’s relationship. Method: A descriptive study was conducted among 210 undergraduate students selected from the second and fourth semesters using a purposive sampling …

Modeling Healthcare Managerial And It Sophistication, Gary Hackbarth, Teuta Cata

Journal of International Technology and Information Management

Sophisticated healthcare managers understand that managing information and selecting technology are two related but separate skill sets. Information Technology Governance (ITG) allows healthcare organizations to deal with complex issues, compete effectively, and support patient needs by integrating managerial and IT sophistication to improve business performance. An organizational model that merges IT and managerial sophistication by improving ITG to forecast business outcomes must grasp the intricacies of technology to acquire, manage, and utilize information technology in alignment with business strategies. The proposed model differentiates between internal and external IT management strategic thinking, emphasizing the critical need to govern IT effectively by …

California, Elizabeth Ford

Thin Blue Advantage: Police Exceptionalism and the Two-Tier System of Public Sector Collective Bargaining

In general, California may be the most hospitable state to public sector collective bargaining. The basic rules are far more favorable to placing matters within the scope of mandatory subjects than any other state. There are, however, serious differences in how police and non-police bargaining is treated.

• Choice of Forum for Police. Under California’s public sector collective bargaining law, most unions and employers must resolve their conflicts about the scope of bargaining through California’s Public Employment Relations Board (PERB). For police only, however, the parties can also bring the disputes to court.
• Los Angeles Labor Relations. The scope …

Massachusetts, Elizabeth Ford

Thin Blue Advantage: Police Exceptionalism and the Two-Tier System of Public Sector Collective Bargaining

In Massachusetts there are several areas of difference in the treatment of police and non-police collective bargaining. They include the following:

• Interest Arbitration. In Massachusetts police and fire bargaining units are entitled to interest arbitration to resolve bargaining disputes. Other employees have access to a less powerful non-binding fact finding process. All public employees are prohibited from striking.
• Transparency of Rules and Agency Processes. The rules that govern police impasse procedures are hidden in a law that was passed in 1987 and never codified, creating a “if you know, you know” process for police.
• Use of Impact Bargaining …

Florida, Elizabeth Ford

Thin Blue Advantage: Police Exceptionalism and the Two-Tier System of Public Sector Collective Bargaining

In general, Florida Public Employment Relations Commission (PERC) decisions and statute demonstrate a dramatic divergence between police and non-police mandatory subjects of bargaining, particularly in the area of discipline. In addition,

• Duty to Bargain Discipline More Expansive for Police. The duty to bargain disciplinary rules in the non-police setting is much more expansive in the police setting.
• Duty to Bargain Work Reassignment More Expansive For Police. The reassignment rules are dramatically different in the police and non-police context.
• Duty to Bargain Change of Duties Broader for Police. There are few cases about changes of duties, but those that exist are …

Pennsylvania, Elizabeth Ford

Thin Blue Advantage: Police Exceptionalism and the Two-Tier System of Public Sector Collective Bargaining

In Pennsylvania there are several areas of difference in the treatment of police and non-police collective bargaining. They include the following:

• Police Units are Governed by a Separate Statute. In Pennsylvania an earlier enacted statute governs police collective bargaining, and the Pennsylvania Supreme Court’s decision requires that statute to be read in pari materia with the Pennsylvania Public Employee Collective Bargaining Act, allowing police units to benefit from both laws.
• Police Have Interest Arbitration. Police units in Pennsylvania have access to interest arbitration to resolve impasses, most other units do not.
• Board Discretion and Lack of Transparency. …

Delaware, Elizabeth Ford

Thin Blue Advantage: Police Exceptionalism and the Two-Tier System of Public Sector Collective Bargaining

Delaware law governing police and non-police bargaining is separated into two largely identical statutory schemes. Both statutes provide for interest arbitration and adopt “baseball arbitration” to expedite the arbitration process. Keeping with the goal of expedient dispute resolution, the state’s ULP process seems designed to facilitate settlement.

As a result of this ULP structure, there are few cases from Delaware’s PERB compared to other states. This may have to do with the fact that the myriad preliminary stages of ULP proceedings serve as “off-ramps” to encourage settlement and that the agency’s Executive Director (E.D.) has more power than non-Delaware analogs. …

Accuracy And Repeatability Of Autorefraction In Young Adults: A Comparison Of Cycloplegic And Non-Cycloplegic Methods, Megan Doyle, Veronica O'Dwyer O'Dwyer, Michael Moore, Síofra Harrington

Articles

Clinical Relevance: Cycloplegic refraction remains crucial in young adults, where accommodative activity can obscure accurate refractive status. Autorefractor repeatabil­ity is essential for precise optical correction and refractive error categorisation in clinical and research settings.

Background: Cycloplegic autorefraction is recommended for individuals up to 20 years to prevent hyperopia underestimation and myopia overestimation. This study evaluated differences between non-cycloplegic and cycloplegic spherical equivalent refraction following cyclopentolate hydrochloride (cycloplegic agent) administration in young adults. This study also explored whether this difference varied by refractive status (hyperopia (≥1.00D), emmetropia ( >−0.50, < 1.00D), myopia (≤-0.50D)) or pre- instillation of proxymetacaine hydrochloride and whether cycloplegia improved autorefractor repeatability.

Methods: Participants were 182 young adults (17–30 years) (mean (standard deviation): 21.66 …

Spanking And Children's Approaches To Learning: Estimates From A Longitudinal Matched-Sample Design, Jeehye Kang, Christina M. Rodriguez

Sociology & Criminal Justice Faculty Publications

One form of corporal punishment commonly used in the United States is spanking. Spanking is a well-known risk factor for adverse child development, although its influence on children's approaches to learning (ATL) has been largely overlooked. Existing research is particularly limited in inadequately considering multiple confounds and selection biases in children's exposure to spanking. This study examined the links between spanking and children's ATL, using a matched-group design to strengthen causal estimates among children aged 5 to 7.5 (N = similar to 12,800) from the Early Childhood Longitudinal Study, Kindergarten Class of 2010-2011. Entropy-balanced matching mitigated selection and confounding biases, …

Confining Rights: The Neuroscientific Challenge To Long-Term Solitary Confinement Under The Eighth Amendment

Minnesota Journal of Law, Science & Technology

No abstract provided.

One Step Forward, Two Steps Back: The United States’ New Direction On Digital Trade

Minnesota Journal of Law, Science & Technology

No abstract provided.

Effect Of Trauma Type And Trauma Burden On Self-Efficacy For Physical Exercise In Military Veterans, Kaley E. Davis, Meghan M. Bennett, Cecilia J. Hillard, Jeffrey Whittle, Zeno Franco, Rachel E. Bollaert, Jacklynn M. Fitzgerald

Exercise Science Faculty Research and Publications

Introduction

United States (U.S.) military veterans experience significant physical health problems. Lifestyle modifications, such as increasing daily physical activity, are often considered the first course of action in treatment for the general public. However, veterans report low levels of physical activity, often due to perceived barriers to engaging in exercise. Trauma exposure type and cumulative trauma burden may be differentially associated with exercise attitudes and behaviors.

Methods

We surveyed U.S. military veterans on perceived self-efficacy to overcome barriers to engaging in exercise and physical activity levels. Additionally, we explored the relationship between the type of traumatic event exposure and cumulative …

A Survey On Non-Invasive Computing: Neurological-Hematological Framework For Early Infection And Stroke Detection With Future Directions, Masud Rabbani, Nafi Us Sabbir Sabith, Sheikh Iqbal Ahamed

Computer Science Faculty Research and Publications

This paper introduces a novel, non-invasive tool for building a holistic neurological-hematological diagnostic framework that can be used for early detection of infection and stroke. We proposed and developed a multimodal sensing approach, where an ear canal–based acoustic system can be used to identify brain activities and a smartphone-based facial video analysis platform to estimate white blood cell (WBC) and hemoglobin (Hb) levels. Our ear-based EEG methodology achieved a remarkable 96% classification accuracy from the low-frequency level (>30hz), with regression models with mean R2 scores above 0.96 across all EEG bands. For hematological diagnostics, the system predicted WBC counts …

Fine-Tuned Large Language Models (Llms): Improved Prompt Injection Attacks Detection, Md Abdur Rahman, Hossain Shahriar, Guillermo Francia, Fan Wu, Alfredo Cuzzocrea, Sheikh Iqbal Ahamed

Computer Science Faculty Research and Publications

Large language models (LLMs) are becoming a popular tool as they have significantly advanced in their capability to tackle a wide range of language-based tasks. However, LLMs applications are highly vulnerable to prompt injection attacks, which poses a critical problem. These attacks target LLMs applications through using carefully designed input prompts to divert the model from adhering to original instruction, thereby it could execute unintended actions. These manipulations pose serious security threats which potentially results in data leaks, biased outputs, or harmful responses. This project explores the security vulnerabilities in relation to prompt injection attacks. To detect whether a prompt …

Reliability Of An Extended Version Of The 3m™ Eargage Tool To Assess Earcanal Size And Assist Earplug Selection, Bastien Poissenot-Arrigoni, Laurence Martin, Alessia Negrini, Djamal Berbiche, Olivier Doutres, Franck Sgard

Études primaires

Objective: Evaluate the ability of an extended version of the 3 MTM Eargage to estimate the earcanal size and assess the likelihood that a particular earplug can fit an individual’s earcanal, ultimately serving as a tool for selecting earplugs in the field. Design: Earcanal morphology, assessed through earcanal earmolds scans, is compared to earcanal size assessed with the extended eargage (EE) via box plots and Pearson linear correlations coefficients. Relations between attenuation measured on participants (for 6 different earplugs) and their earcanal size assessed with the EE are established via comparison tests. Study sample: 121 participants exposed to occupational noise …

Measuring Toluene Diisocyanate Concentrations In Accordance With Acgih® Inhalable Fraction And Vapor (Ifv) Notation, Charles Larocque, Pierre-Luc Cloutier, Sébastien Gagné, Loïc Wingert, Sylvain Canesi, Jacques Lesage, Simon Aubin

Études primaires

Toluene diisocyanate (TDI) is an irritant (skin, eye and respiratory) and a sensitizer. This compound is used to manufacture polyurethane materials such as flexible foams. The use of isocyanates may lead to exposure by inhalation and/or skin contact and isocyanates are recognized as a cause of occupational asthma. The American Conference of Governmental Industrial Hygienists (ACGIH^®) recommends a threshold limit value (TLV) for TDI of 1 part per billion (ppb) (7 µg m-^³) with inhalable fraction and vapor (IFV) notation. This notation means that the inhalable fraction of particles and the vapor phase of TDI may …

Survey Study On College Student’S Acceptance And Attitude Towards Generative Ai To Their Learning, Jinhua Wang

Selected Full Text Dissertations, 2011-

This study investigated college students’ attitudes and acceptance of generative AI tools like ChatGPT. These tools are advanced programs capable of understanding questions and responding in a conversational manner. The main objective is to determine whether college students find generative AI tools helpful for their learning and schoolwork. A comprehensive survey was conducted with 57 college students at an online survey platform SurveyMonkey.com. The survey solicited college students’ perceived usefulness of generative AI tools in academic settings regarding their school activities (such as writing papers, explaining complex topics, coding, solving math problems, and researching information). The model of Diffusion of …

Goodtimer For Good Behavior: A Nonconcurrent Multiple Baseline Examination Of A Behavioral Device Intervention To Reduce Child Misbehaviors, Morgan Weinstein

Selected Full Text Dissertations, 2011-

Behavioral Parent Training (BPT) effectively decreases disruptive behavior in children (Daley et al., 2014). Nonetheless, many parents perceive BPT to be challenging and demanding, leading to reports of high treatment dropout rates (Chacko et al., 2016.) To address this, the present study evaluated the effectiveness of Goodtimer, a behavioral health device utilizing contingency management, an element of BPT, to mitigate child disruptive behaviors. The Goodtimer is designed to make administering a contingency management system easier for parents. Employing a nonconcurrent multiple baseline design, the study assessed six families with children aged 3-9 years. Most parents who used the Goodtimer reported …