Digital Commons Network^™

Monotherapy Versus Combination Levothyroxine And Liothyronine In The Treatment Of Hypothyroidism, Anne F. Thomas

The PA Department Journal of Medical Science

Introduction: Primary hypothyroidism is a common condition where the thyroid gland cannot produce free thyroxine (T4), leading to low serum levels of it. For this reason, it is often treated directly with monotherapy synthetic T4 or as a combined synthetic T4/T3. The purpose of this clinical review is to analyze the effectiveness of T4 monotherapy versus T4/T3 combination therapy in normalizing TSH values and improving symptoms in adults with hypothyroidism.

Methods: A specific search strategy in PubMed was used to conduct the research, incorporating key terms such as “hypothyroidism,” “levothyroxine,” “liothyronine,” and “TSH.” Four quality articles were left for final …

Modern Approaches To Mental Health: App-Based Cbt Versus Traditional Psychotherapy, Samira Shende

The PA Department Journal of Medical Science

Background: Digital mental health tools are becoming widely used as flexible alternatives to in-person therapy. A key question is how effective they are compared to traditional therapy for people with depression and anxiety.

Objective: To compare how effective digital interventions, like app-based CBT or telehealth, are compared to in-person psychotherapy in reducing symptoms of depression and anxiety in adults.

Methods: A structured PubMed search was conducted using specific search terms, limited to English-language randomized controlled trials, systematic reviews, and meta-analyses published between 2020 and 2025. After screening 116 articles, four high-quality studies were selected for review.

Results: Of the four …

Psilocybin Treatment For Refractory Depression: A Clinical Review, Hailey A. Jensen

The PA Department Journal of Medical Science

Introduction:

Depression is a widespread mental illness that affects a large portion of the world population and many of those who suffer from depression are resistant to treatment currently available. The purpose of this review is to compare the efficacy of psilocybin to the current available methods for the treatment of refractory depression.

Methods:

PubMed was searched with the key search terms: resistant depression, psilocybin therapy, and adults. Operators and filters narrowed down the search to 43 results. Four articles were then chosen based on quality and specificity with this review.

Results:

The articles included in this review compare the …

“I Don’T Always See A Future For Me Here”: Oppressive Political Pressures On Lgbtq+ College Students’ Well-Being, Jodi Linley, Olivia M. Copeland, Kathleen J. Buell, Cindy Ann Kilgo, Megan Pendleton, Alex C. Lange, N F. Tennessen

Journal of Queer and Trans Studies in Education

In recent decades, colleges have broadly supported LGBTQ+ students. Now, institutions have shuttered LGBTQ+ initiatives in response to political pressures, with little consideration for the effects on students. This study answers the question, what current policy factors do LGBTQ+ college students describe as affecting their well-being, and in what ways? We analyzed 426 responses from a multi-institution study of LGBTQ+ students. By and large, students feel anxious and fearful as they navigate the current climate. Our analysis illustrated numerous factors, from the President and his administration to states and general emboldened violence, and the real and potential consequences of those …

Civil Death By A Thousand Cuts, Eisha Jain

Faculty Publications

Commentators have leveled trenchant critiques of collateral consequences of criminal conviction, analogizing them to a form of “civil death.” This Essay develops the related concept of “civil death by a thousand cuts” in two senses. First, penalties such as voting bans or deportation after a conviction are often just the tip of the iceberg. Second, a system of far-flung, intertwined civil and criminal penalties portends the death of a civil society capable of recognizing and mediating excessive penalties. Recognizing how these penalties operate—and how difficult they can be to address—is a critical step toward creating a more proportionate criminal legal …

Teacher Perceptions Of Best Teaching Practices For Improved Student Outcomes In An Alternative School Setting, Chasity Clark

Doctor of Education Dissertations

This dissertation explores the experiences and professional perspectives of educators working in urban alternative school settings and examines how they foster positive outcomes for marginalized youth. Although alternative education is frequently characterized as a punitive “last resort,” this study highlights its potential as a setting for transformative resilience, student empowerment, and innovative teaching practices. Guided by social constructivism, transformative learning theory, and critical pedagogy, the study employed a qualitative design involving two rounds of semi-structured interviews and a focus group with 11 educators. Analysis of the data resulted in six integrated themes: psychological safety as a prerequisite for agency, self-efficacy …

Beyond The Paycheck: An Exploration Of The Role Of Management And Leadership Support In Employee Retention, Stacia Leach Lomax

Doctor of Education Dissertations

Employee retention remains a significant organizational challenge, particularly in the post-COVID-19 workplace where employees increasingly seek meaningful support, recognition, and workplace well-being in addition to compensation. Guided by Herzberg et al.’s (1959) Two-Factor Theory, the purpose of this qualitative study was to explore how employees perceive management support and how those perceptions influence decisions to remain with or resign from an organization. The study was conducted using a qualitative descriptive design involving 12 semi-structured interviews with individuals who had voluntarily resigned from organizations across multiple employment sectors. A follow-up focus group was conducted to confirm and validate emerging findings. Data …

A Multiple Case Study Exploring The Lived Experiences Of Special Education Teachers Of Students With Intellectual Disabilities, Patrece A. Scott

Doctor of Education Dissertations

Special educators, particularly the teachers of students with intellectual disabilities, remained an understudied group in research. The purpose of this phenomenological qualitative study was to examine how special educators navigated their lived experiences collaborating with three key stakeholder groups: parents, general education teachers, and administrators, particularly working with students with intellectual disabilities. Specifically, this study examined how special educators experienced collaboration with those stakeholder groups through the framework of McClelland's (1961) Theory of Needs. The study involved two semi-structured interviews with each of the 12 participants, all of whom were special educators at the middle or high school level. These …

Employee Engagement And Retention Strategies For Merchandisers Within The First 90 Days Of Employment At Refresh Drinks - Mixed Methods, Valerie M. Williams

Doctor of Education Dissertations

This convergent mixed methods study examined employee engagement and retention strategies for frontline merchandisers during the first 90 days of employment at Refresh Drinks (pseudonym) in North Carolina and South Carolina. Guided by Herzberg’s (1959, as cited in Miner, 2005) Two-Factor Theory, the study investigated how onboarding, management engagement, professional development, career advancement, and recognition influenced early employee experiences and retention. Quantitative data were collected from 75 participants using Likert scale survey items, while qualitative data were gathered through open-ended responses to provide deeper insight into employee perceptions. Findings revealed that onboarding and management engagement were perceived as strong organizational …

Anything But Endo: Diagnostic Buck-Passing In Endometriosis Diagnosis, Rita Dexter, Megan Kitts, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

People living with endometriosis, a disease in which tissue similar to the lining of the uterus grows elsewhere in the body, often experience prolonged diagnostic journeys because of symptom variability, normalisation of period pain and other symptoms, and lack of awareness of the condition. In this article, we analyse the endometriosis diagnostic journey through the lens of epistemic injustice. Drawing on in-depth interviews with 52 people living with endometriosis in the United States, we introduce the concept of diagnostic buck-passing to characterise the phenomenon wherein individuals who seek treatment for their symptoms end up stuck in a cycle of seeing …

Can I Get A Witness? The Ethical Dimensions Of Family Presence In Patient Suffering, Jennifer Blumenthal-Barby, Trevor M Bibler, Holland Kaplan, Adam Omelianchuk, Joanna Smolenski

Center for Medical Ethics and Health Policy Staff Publications

For patients who are suffering, the bedside presence of a family member can provide comfort, and many people hold that there is moral value in being present with a conscious, suffering patient. Yet what is the moral significance of the absence of family members when a patient is minimally conscious or unconscious and not aware of their absence? Clinicians are often troubled when family members and surrogate decision-makers who are able to spend a significant amount of time at an unconscious, seriously ill patient's bedside do not do so. Clinicians feel frustrated that they must bear the burden of witnessing …

Imagining Genomics And Population Health In 2050: Anticipating Future Research, Policy, And Governance Needs, Bartha Maria Knoppers, Yann Joly, Ma Apos N H Zawati, Habiba Alsafar, Jeffrey C Barrett, Laura Blackburn, Brian Hon-Yin Chung, Martina C Cornel, Edward S Dove, David Glazer, Calvin Wai-Loon Ho, Muin J Khoury, Anna C F Lewis, Anneke Lucassen, Peter F R Mills, Colin Mitchell, Nicola Mulder, Ainsley J Newson, Anthony Ng, Paul D P Pharoah, Vasiliki Rahimzadeh, Megan C Roberts, Saskia C Sanderson, Jeffrey M Skopek, Ron Zimmern, Eric M Meslin

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Master's Recital: Anna Godtland, Anna Godtland

Dissertations and Theses @ UNI

The two purposes of this recital are to partially fulfill the requirements for the Master of Music degree in Jazz Pedagogy and to display proficiency on the drum set, piano, and string bass. Anna Godtland presented her graduate recital on April 27, 2026, at 7:30 PM in Bengtson Auditorium. The recital program included two pieces each on piano, drum set, string bass, and four pieces on trombone. These selections showcased an array of styles and required a variety of skills necessary to fulfill the requirements of the Jazz Pedagogy degree. The recital featured personnel from two UNI jazz combos (Cincopatos …

Can’T Sue A Movement: Greenpeace’S $667 Million Crisis Narrative, Trevor Hart

Dissertations and Theses @ UNI

In March of 2025, the environmental group Greenpeace was found liable for nearly $667 million to Energy Transfer, the oil company behind the Dakota Access Pipeline (DAPL). The lawsuit was widely regarded as a SLAPP, or Strategic Lawsuit Against Public Participation, because it weaponized civic torts to infringe upon Greenpeace’s First Amendment rights. The $667 million verdict is an unprecedented figure in SLAPP litigation–it’s enough to bankrupt Greenpeace in the United States and “chill” democratic participation. This thesis used a hybrid blame-renewal crisis narrative framework to analyze Greenpeace’s public response to lawsuits against a backdrop of cultural and political economic …

Prescribing Religion: The Ten Commandments On Classroom Walls, Samuel L. Bray, Nathan S. Chapman, Brent A. Strawn

Public Law and Legal Theory Working Papers

Several states have recently enacted laws requiring the display of the Ten Commandments in public schools. This Article considers the application of the Establishment Clause to these statutes. First, it examines the history of England and its North American colonies to show that a central feature of an established religion was the government’s prescription of particular religious beliefs and practices. Second, it demonstrates that choosing one version of the Ten Commandments to display in public school classrooms necessarily specifies particular religious beliefs. This is in contrast to expressions of generic providentialism that the founders understood the Establishment Clause to permit. …

Psychometric Properties Of A Novel Affective Bias Task And Its Application In Clinical And Nonclinical Populations, Prathik Kalva, Kourtney Kanja, Brian A Metzger, Xiaoxu Fan, Brian Cui, Bailey Pascuzzi, John Magnotti, Madaline Mocchi, Raissa Mathura, Kelly R Bijanki

Faculty, Staff and Students Publications

To mitigate limitations in self-reported mood assessments, we introduce a novel affective bias task (ABT). The task quantifies instantaneous emotional state by leveraging the phenomenon of affective bias, in which people interpret external emotional stimuli in a manner consistent with their current emotional state. This study establishes task stability in measuring and tracking depressive symptoms in clinical and non-clinical populations. Initial assessment in a large non-clinical sample established normative ratings. Depressive symptoms were tracked relative to task performance in a non-clinical sample, as well as in a clinical cohort undergoing surgical evaluation for severe epilepsy. In both cohorts, a stronger …

The Weight Of Stigma, Rebekah A. King, Michael S. Sinha

All Faculty Scholarship

Many health care providers, both implicitly and explicitly, perpetuate stigma in their treatment of patients classified as obese. While medical professionals understand that a one-size-fits-all approach to treatment is ineffective, patients classified as obese are frequently offered limited treatment options that fail to account for their unique needs. Access to a range of effective treatment options has historically been limited, but new GLP-1 receptor agonist medicines like Wegovy (semaglutide) and Zepbound (tirzepatide), have shown incredible promise in addressing the obesity crisis. Unfortunately, these transformative drugs are costly, in high demand, and not widely covered by insurance, rendering them inaccessible for …

The Asexual Assumption, Faith K. Whatley-Blaine, Michael S. Sinha

All Faculty Scholarship

Inclusion-focused dating shows such as ‘Love on the Spectrum’ feature individuals with developmental or neurological disabilities on a quest for love. Despite the focus on disability representation, these shows perpetuate stigma against the disabled community by fostering an infantilizing portrayal of individuals with disabilities. This portrayal undermines the premise of encouraging meaningful romantic relationships and reinforces the stigmatizing association of asexuality with disability. This framing aligns with the broader societal narrative that individuals with disabilities are incapable of or lack interest in participating in romantic relationships or physical intimacy.

The stigma that associates asexuality with disability extends beyond mere entertainment, …

Winding Roads: A Qualitative Phenomenological Study Of Female Educational Leadership, Nicole Casper

Graduate Student Theses, Dissertations, & Professional Papers

The experiences of female superintendents were examined in this study to provide insight into the commonalities in their leadership journeys within public school organizations. A phenomenological, qualitative approach, aligned with Moustakas’s (1994) framework, was used to explore participants’ shared experiences. Comprehensive interviews were conducted with 17 female superintendents serving during the 2022–2023, 2023–2024, and/or 2024–2025 academic years in the states of Idaho, Montana, Oregon, and Washington. Through phenomenological reduction, three overarching commonalities emerged: (a) barriers, (b) challenges, and (c) supporting factors. The findings illuminate how organizational, societal, and gendered influences interact to shape female leadership advancement toward assistant superintendent or …

Effectiveness Of Behavioral Cough Suppression Therapy In A Closed Enrollment Group Telehealth Delivery Model And Comparison To A Rolling Enrollment, Kinsey Louise Roberts

Graduate Student Theses, Dissertations, & Professional Papers

Background:

Refractory chronic cough (RCC) is a subtype of chronic cough (CC) that persists

despite guideline-based treatment and can negatively affect quality of life. Behavioral cough

suppression therapy (BCST), typically delivered by speech-language pathologists (SLPs), is an

effective treatment for RCC. However, access to BCST remains limited due to geographic

barriers and a shortage of trained providers. Group-based telehealth may help expand access to

treatment. This study evaluated the effectiveness of BCST delivered via telehealth using

a closed enrollment group model and compared outcomes to a rolling enrollment group model.

Methods:

In this prospective sequential cohort study 32 participants attended …

Beyond Words: The Horse-Human Encounter In Equine-Assisted Psychotherapy For Residential Substance Use Treatment, Leah Finch Lungren

Graduate Student Theses, Dissertations, & Professional Papers

Equine-assisted psychotherapy (EAP) has emerged as a promising experiential therapeutic intervention, yet the lived experience of adults participating in EAP within residential substance use disorder (SUD) treatment settings remains underexplored. This hermeneutic phenomenological study examined the lived experience of 12 adults who participated in EAP groups during residential SUD treatment across three treatment facilities in the United States. The primary research question was: What is the lived experience of participating in EAP for adults in residential SUD treatment? Data was collected through semi-structured interviews and analyzed through iterative hermeneutic interpretation guided by van Manen’s (1990) existential framework.

Six themes emerged …

Instructor Created Video: Differences In Perception Of Administrative Support In Respiratory Care, Brian Daniel Cayko

Graduate Student Theses, Dissertations, & Professional Papers

Background: The recent proliferation of online education has highlighted the need to reduce transactional distance and increase the community of inquiry presence between the instructor and students and between students. This quantitative non-experimental study examined the differences in perception of administrative support for instructor-created video (ICV) between faculty and administrators within Commission on Accreditation of Respiratory Care (CoARC) higher education programs of Respiratory Care. Methodology: The Difference in Perception of Administrative Support (DPAS) survey was utilized to collect data from 93 valid participants through a snowball sampling method. Analysis was performed using an independent samples t test and Cohen's d …

An Exploratory Analysis Of The Role Of Sex In Load Carriage, Rachel E. Perez, Dustin R. Slivka, Brent C. Ruby

Graduate Student Theses, Dissertations, & Professional Papers

Axially loaded weight may impose a metabolic demand equivalent to that of fat mass (FM) during load carriage. Males (M) typically have a lower body fat percentage than females (F), resulting in metabolic demand differences during load carriage that may be mitigated by accounting for FM in pack loads. PURPOSE: To determine whether normalizing pack load to FM equalizes metabolic cost across sexes during load carriage. METHODS: Twenty-eight participants (14M, 23 ± 5 y, 1.81 ± 0.07 m, 78.7 ± 10.0 kg, 12.7 ± 5.4% body fat, VO₂peak 4.18 ± 0.54 L·min^-1; 14F, 22 ± 4 …

Heart Of Stone: Geomorphization Through Stone-Oriented Affects, Grace F. Foster

Graduate Student Theses, Dissertations, & Professional Papers

This thesis draws from the work of geologist Marcia Bjornerud to bring a scientific (specifically geologic) understanding of humanity’s relationship to our home planet to bear in a literary context. I employ Bjornerud’s term “geomorphization” to expand from inter-species kinship to inter-substance kinship and to establish stone as an active, lively subject without relying on anthropomorphization. Geomorphization as I define it refers to recognizing similarity between ourselves and stone/Earth on the basis of our stoniness rather than stone’s human-ness. Geomorphizing ourselves entails what Bjornerud calls “timefulness,” a geologic perspective on temporality that sees the past as continually acting in the …

Adults With Dyslexia: Experiences Accessing And Using Reading Strategies And Assistive Technology, Brenda Rosalie King

Graduate Student Theses, Dissertations, & Professional Papers

Dyslexia is a specific learning disorder of neurobiological origin characterized by persistent difficulties with accurate and/or fluent reading, word recognition, spelling, and decoding. Although dyslexia is widely recognized as a lifelong learning difference, the majority of research has historically focused on children and adolescents, with less attention given to adult experiences. The purpose of this study was to explore how adults with dyslexia access and use reading strategies and assistive technologies to support reading comprehension and independence across contexts. The study also examined barriers and supports influencing access to these tools, as well as the emotional experiences associated with their …

Advancing Understanding Of Lived Experience Of Unhoused People To Reduce Social Stigma And Promote Community Health: A Theoretically-Guided Photovoice Study, B-Rad Stephen Applegate

Graduate Student Theses, Dissertations, & Professional Papers

Homelessness is a persistent public health challenge shaped by structural inequities, stigma, and exclusion from social and health systems. Community-Based Participatory Research (CBPR) has increasingly been used to center the knowledge of people who are unhoused, yet limited attention has been given to the theoretical frameworks guiding this work across disciplines. The purpose of this dissertation was to examine theories and methods used in CBPR with unhoused populations and to explore the extension of Margaret Newman’s Theory of Health as Expanding Consciousness from a nursing-focused theory to a public health framework for understanding lived experience.

Using a scoping review methodology …

Ghostly Grieving In Theatre’S Now Also The Dramaturgy Of Perception And The Body In Contemporary American Ghost Plays, Jacob Mann Christiansen

Graduate Student Theses, Dissertations, & Professional Papers

“Ghostly Grieving in Theatre’s Now Also” explores how contemporary American plays and playwrights stage the dead as a way of understanding theatre’s unique language for dealing with the shared, complex human experience of grief. Focusing on theatrical ghosts and other “impossible” presences, I articulate how these figures function as dramaturgical devices. I also argue that theatre’s ghosts “set the stage” (as it were) for communicable meaning-making by inviting audiences into the tasks of creation and mourning.

My work draws on performance theory (especially phenomenological accounts of theatrical storytelling), on dramaturgical analysis, and on grief studies. In this dissertation project, I …

Developing Identity After Goodbye: Social Identity Theory And How Adolescent Survivors Navigate Suicide Loss, Elizabeth Susan Lawton

Graduate Student Theses, Dissertations, & Professional Papers

Adolescents who lose a loved one to suicide, known as suicide-loss survivors, face a disruption to identity development, a life stage defined by identity formation (Adler et al., 2018) and group belonging (Pittman & Richmond, 2008). Suicide bereavement is complicated not only by grief but also by stigma, which can fracture social ties and undermine self-concept. Social identity theory (SIT) provides a framework for examining how young adults, now ages 18 to 30, reconstruct their social identities after experiencing suicide loss in adolescence. Research in other stigmatized contexts shows that adopting positive in-group identities can buffer against stigma and protect …

Á’Po’Taki Iiyika’Kimaa Work/Try Hard For Such A Time As This, Misamsai’Piaakíí Longtime Charging Woman Kimberly Lynn Paul

Graduate Student Theses, Dissertations, & Professional Papers

This body of work adds to a recent shift in the academic landscape, valuing interdisciplinary research and Indigenous worldview. Predominant is the reversal of extractive research norms within Indigenous populations and the biosystems they steward, instead claiming Piikani (Blackfeet) led community-needs-based research valuing Indigenous data sovereignty, research methodologies, ethics, equity, and Indigenous empowerment. This research proffers requisite historical information providing the ‘why’ context, followed by three of the author’s studies: in toxic dumping, food sovereignty, and Piikani well-being. Under an environmental justice framework, the first study presents a cursory investigation of decades-long illicit toxic waste disposal reports linked to observed …

Hidden Wounds: Exploring Moral Injury In Childhood Exposure To Domestic Violence, Megan Elizabeth Denny

Graduate Student Theses, Dissertations, & Professional Papers

The profound impacts of Childhood Exposure to Domestic Violence (CEDV) have been documented extensively, revealing long-term psychological effects such as the potential development of post-traumatic stress disorder (PTSD) and increased likelihood of future victimization or perpetration of violence. Yet, the concept of moral injury (MI) traditionally explored in military and healthcare contexts, remains significantly underexplored in populations exposed to CEDV. This study examines the relevance of MI among individuals who experienced domestic violence (DV) during their youth. The research focused on two primary aims: (1) to describe the level and variability of moral injury-related distress among adults with histories of …