Digital Commons Network^™

Researching Covid To Enhance Recovery (Recover) Pediatric Study Protocol: Rationale, Objectives And Design., Rachel S. Gross, Tanayott Thaweethai, Erika B. Rosenzweig, James Chan, Lori B. Chibnik, Mine S. Cicek, Amy J. Elliott, Valerie J. Flaherman, Andrea S. Foulkes, Margot Gage Witvliet, Richard Gallagher, Maria Laura Gennaro, Terry L. Jernigan, Elizabeth W. Karlson, Stuart D. Katz, Patricia A. Kinser, Lawrence C. Kleinman, Michelle F. Lamendola-Essel, Joshua D. Milner, Sindhu Mohandas, Praveen C. Mudumbi, Jane W. Newburger, Kyung E. Rhee, Amy L. Salisbury, Jessica N. Snowden, Cheryl R. Stein, Melissa S. Stockwell, Kelan G. Tantisira, Moriah E. Thomason, Dongngan T. Truong, David Warburton, John C. Wood, Shifa Ahmed, Almary Akerlundh, Akram N. Alshawabkeh, Brett R. Anderson, Judy L. Aschner, Andrew M. Atz, Robin L. Aupperle, Fiona C. Baker, Venkataraman Balaraman, Dithi Banerjee, Deanna M. Barch, Arielle Baskin-Sommers, Sultana Bhuiyan, Marie-Abele C. Bind, Amanda L. Bogie, Tamara Bradford, Natalie C. Buchbinder, Elliott Bueler, Hülya Bükülmez, B J Casey, Linda Chang, Maryanne Chrisant, Duncan B. Clark, Rebecca G. Clifton, Katharine N. Clouser, Lesley Cottrell, Kelly Cowan, Viren D'Sa, Mirella Dapretto, Soham Dasgupta, Walter Dehority, Audrey Dionne, Kirsten B. Dummer, Matthew D. Elias, Shari Esquenazi-Karonika, Danielle N. Evans, E Vincent S. Faustino, Alexander G. Fiks, Daniel Forsha, John J. Foxe, Naomi P. Friedman, Greta Fry, Sunanda Gaur, Dylan G. Gee, Kevin M. Gray, Stephanie Handler, Ashraf S. Harahsheh, Keren Hasbani, Andrew C. Heath, Camden Hebson, Mary M. Heitzeg, Christina M. Hester, Sophia Hill, Laura Hobart-Porter, Travis K F Hong, Carol R. Horowitz, Daniel S. Hsia, Matthew Huentelman, Kathy D. Hummel, Katherine Irby, Joanna Jacobus, Vanessa L. Jacoby, Pei-Ni Jone, David C. Kaelber, Tyler J. Kasmarcak, Matthew J. Kluko, Jessica S. Kosut, Angela R. Laird, Jeremy Landeo-Gutierrez, Sean M. Lang, Christine L. Larson, Peter Paul C. Lim, Krista M. Lisdahl, Brian W. Mccrindle, Russell J. Mcculloh, Kimberly Mchugh, Alan L. Mendelsohn, Torri D. Metz, Julie Miller, Elizabeth C. Mitchell, Lerraughn M. Morgan, Eva M. Müller-Oehring, Erica R. Nahin, Michael C. Neale, Manette Ness-Cochinwala, Sheila M. Nolan, Carlos R. Oliveira, Onyekachukwu Osakwe, Matthew E. Oster, R Mark Payne, Michael A. Portman, Hengameh Raissy, Isabelle G. Randall, Suchitra Rao, Harrison T. Reeder, Johana M. Rosas, Mark W. Russell, Arash A. Sabati, Yamuna Sanil, Alice I. Sato, Michael S. Schechter, Rangaraj Selvarangan, S Kristen Sexson Tejtel, Divya Shakti, Kavita Sharma, Lindsay M. Squeglia, Shubika Srivastava, Michelle D. Stevenson, Jacqueline Szmuszkovicz, Maria M. Talavera-Barber, Ronald J. Teufel, Deepika Thacker, Felicia Trachtenberg, Mmekom M. Udosen, Megan R. Warner, Sara E. Watson, Alan Werzberger, Jordan C. Weyer, Marion J. Wood, H Shonna Yin, William T. Zempsky, Emily Zimmerman, Benard P. Dreyer, Recover-Pediatric Consortium

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: The prevalence, pathophysiology, and long-term outcomes of COVID-19 (post-acute sequelae of SARS-CoV-2 [PASC] or "Long COVID") in children and young adults remain unknown. Studies must address the urgent need to define PASC, its mechanisms, and potential treatment targets in children and young adults.

OBSERVATIONS: We describe the protocol for the Pediatric Observational Cohort Study of the NIH's REsearching COVID to Enhance Recovery (RECOVER) Initiative. RECOVER-Pediatrics is an observational meta-cohort study of caregiver-child pairs (birth through 17 years) and young adults (18 through 25 years), recruited from more than 100 sites across the US. This report focuses on two of …

Measuring Standard Of Care Physical Parameters In An Academic Psychiatric Practice During The Covid Pandemic – A Trainee Driven Quality Improvement Study, Himangshu Rathinakumar, Md, James Luebbert, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Outpatient Psychiatric services need to monitor certain evidence-based quality indicators that promote patient safety and guide standards of care.
• Our Child and Adolescent Psychiatry (CAP) fellow outpatient clinic provides psychotherapy and pharmacological management to a population in a major metropolitan city, who belong to various minority predominantly African American and reduced socio-economic at-risk groups.
• The COVID pandemic has brought about a lot of changes in psychiatric practice which includes Telepsychiatry.
• This study aims to determine if greater use of telepsychiatry has resulted in changes in compliance with the evaluation of basic vital sign parameters of our patients during the …

Optimizing Resource Allocation Of A Covid-19 Prophylactic In Immunocompromised Hosts, Julianna Tolotta, Abigail Hoover, Michael Joseph, Angelinia Liddy, Anshel Kenkare, Dagan Coppock

Health Equity and Quality Improvement (HEQI) Summit

Introduction

• COVID-19 presented unique challenges for the care of immunocompromised individuals.
• Patients with suppressed immune systems lack the ability to mount a robust response to vaccines, leading to an increased likelihood of developing severe COVID-19 responses and increased mortality.
• Astra-Zeneca developed Evusheld, a monoclonal antibody (Tixagevimab/cilgavimab) as a COVID-19 prophylaxis to target the SARS-CoV-2 spike protein.¹
• In December 2023, the FDA enacted an Emergency Use Authorization (EUA) for Evusheld in immunocompromised individuals and TJUH developed a roll-out plan.²
• Thomas Jefferson University Health (TJUH) distributed the drug using a tiering system that ranked the degrees of immunocompromising conditions for …

Potential Adverse Cardiovascular Side Effects Following Mrna Covid-19 Vaccination, Abigayle Strohmeier

Senior Honors Theses

The COVID-19 vaccine, regarded as a triumph by some and a danger by others, has been studied due to the presence of adverse cardiovascular side effects experienced by some individuals following vaccination. Incidence and prevalence rates of these effects are examined by various demographic factors, primarily age and sex. The most prevalent adverse cardiovascular effects noted are myocarditis, pericarditis, cardiovascular disease, tachycardia, hypertension, palpitation, and acute myocardial infarction. Due to the novelty of the mRNA COVID-19 vaccine, many health studies have focused their data analysis on age or sex characteristics, however many excellent opportunities for future research are necessary to …

Continuing Bonds Experiences Of Bereaved Adults Within The Context Of The Pandemic, Benjamin Lyons

Honors Program Theses and Projects

COVID-19 has impacted the lives of countless people and has resulted in the death of millions. Due to this, there is a need to understand how individuals coped with the losses that came with this uniquely difficult circumstance. With this in mind, my project investigates how the COVID-related death of a loved one influences the continuing bonds relationship of bereaved adults within the context of the pandemic. Ten participants who lost a loved one to a COVID-related death during the pandemic were interviewed about their grief experiences and audio recorded. Using qualitative thematic analysis, themes in the data were constructed …

Lower Extremity Weakness In The Setting Of Covid Myositis, Christopher Dellmyer, Frank Wheeler

Rowan-Virtua Research Day

Bilateral lower extremity weakness has numerable causes including stroke, peripheral neuropathy, deconditioning, Guillain-Barre, Multiple Sclerosis, anterior cord syndrome, trauma, spinal epidural abscess and many more. It is imperative however, that we investigate and understand more rare causes of lower extremity weakness. Here we present the case of a 74-year-old female presented to the ED with a complaint of lower extremity weakness due to Covid myositis causing significant bilateral lower extremity weakness.

The Effect Of Covid-19 Pandemic On Sanitation Practices And Anxiety In The General Population, Leah Cliatt, Joanna Petrides

Rowan-Virtua Research Day

Background: Illness anxiety and fear of contracting coronavirus increased considerably during the COVID-19 pandemic. The media, being in lockdown, and cyberchondria had the largest impact on the population’s anxiety surrounding illness. While this kind of reaction to illness is expected during the pandemic, there is limited data on post-pandemic illness anxiety levels in the general population. Patients’ perception of disease impacts medicine at every level; medical professionals need to understand the concerns and fears of their patients in order to treat the post-pandemic patient. We hypothesized that sanitation practices and anxiety surrounding illness have not returned to baseline pre-COVID-19 …

The Impact Of The Covid-19 Mask Mandate On Effective Communication Between Healthcare Providers And Deaf/Hoh Patients, Antonia J. Conti, Alexa Gingerich

Rowan-Virtua Research Day

During the peak of the COVID-19 pandemic, many countries mandated the use of facial masks in public environments, especially in healthcare settings.[3] While this was beneficial in reducing the spread of the coronavirus disease, it created many challenges for the deaf/HoH community.[4] In particular, it limited effective communication between healthcare providers and deaf/HoH patients. It was found that masks limit word recognition for both deaf/HoH and non-deaf/HoH individuals. Additionally, both surgical and N95 masks hinder word recognition for deaf/HoH individuals and significantly impact communication during medical appointments.

Investigating Risk Factors Contributing To The High Incidence Of Covid-19 Among The Diné People Of The Navajo Nation, Elizabeth Lila Reynolds

Rowan-Virtua Research Day

Background: COVID-19 became international news in December 2019 and subsequently impacted global health. The research shows that the Diné people of the Navajo Nation were one of the most severely impacted populations¹. The Navajo Nation is a region spanning Arizona, New Mexico, and Utah that is composed of North American indigenous people known as the Diné. Purpose: To explore the risk factors contributing to the increased rates of COVID-19 infection and severity of infection among the Diné people. Methods: This literature review research process utilized PubMed and JAMA to find scholarly articles on this topic. Search terms …

Potential Mechanisms For New Onset Atrial Fibrillation In Covid-19 Patients, Raghav Gupta, Yara Assadi, Shaniece Nicole Lawrence, Erika Jeanie Pitsker, Michael Scott Bickford Jr., Victoria Amber Saniko

Rowan-Virtua Research Day

Introduction: This study shows the prevalence of New-Onset Atrial Fibrillation in COVID-19 patients and highlights the most prevalent explanatory pathologic theories for the correlation.

Methods: The authors carried out a literature review over PubMed using the keywords “atrial fibrillation” and “long-term COVID.” 48 articles were reviewed. Articles relating to new onset of atrial fibrillation in COVID-19 patients were included while articles posted before 2020, not related to COVID and atrial fibrillation were excluded.

Results: The prevalence of atrial fibrillation in COVID patients is often reported to be around 17%, however 44% of patients within Intensive Care units (ICU) have atrial …

Singh Thattha Beard Covering Technique And Quantitative Fit Testing Of A Tight-Fitting Filtering Facepiece (Ffp3), Harmann Singh, Allen Ecker, Todd Schachter, Thomas Boyle, Matthew Vanek

Rowan-Virtua Research Day

The study aimed to evaluate the effectiveness of the Singh Thattha beard covering technique when quantitatively fit testing tight-fitting filtering face masks (N95 respirators) on male members of the Sikh religious group. During the COVID-19 pandemic, Sikh healthcare workers faced the difficult decision of either shaving their unshorn beards to continue their profession or finding alternative solutions to maintain adequate respiratory protection. The study used a quantitative fit test method to measure the number of particles inside and outside the mask, calculating a fit factor. Participants performed exercises while wearing an N95 respirator and then repeated the exercises with a …

Chilling Complications: A Case Of Covid-Associated Cold Autoimmune Hemolytic Anemia (Aiha), Julian Coz, Kishan B. Patel

Rowan-Virtua Research Day

Cold Agglutinin disease (CAD) also known as Cold Autoimmune Hemolytic Anemia (AIHA) is a form of autoimmune hemolytic anemia wherein cold agglutinins (IgM autoantibodies against red blood cell (RBC) antigens) bind during cold temperatures causing clinical symptoms related to RBC agglutination resulting to hemolytic anemia. Clinicians should recognize that Cold Agglutinin disease can be secondary to an underlying pathology such as COVID-19. Here we describe an unusual case of Cold Agglutinin Autoimmune Hemolytic Anemia which was diagnosed in the Emergency Department with the presence of COVID-19 and with a hospital course complicated by acute deep vein thrombosis (DVT) and bilateral …

Analytical And Numerical Analysis Of The Sirs Model, Catherine Nguyen

Departmental Honors & Graduate Capstone Projects

Mathematical models in epidemiology describe how diseases affect and spread within a population. By understanding the trends of a disease, more effective public health policies can be made. In this paper, the Susceptible-Infected-Recovered-Susceptible (SIRS) Model was examined analytically and numerically to compare with the data for Coronavirus Disease 2019 (COVID-19). Since the SIRS model is a complex model, analytical techniques were used to solve simplified versions of the SIRS model in order to understand general trends that occur. Then by Euler's Method, the Runge-Kutta Method, and the Predictor-Corrector Method, computational approximations were obtained to solve and plot the SIRS model. …

Information Literacy Instruction Services At Rural Community Colleges, Fall 2019 Through Ay 2021/22, Heather Posey Vandyne

Library Faculty Publications

This exploratory study examines the instructional practices of two-year institutions located in rural areas during the onset of the Coronavirus pandemic in 2020 and the two academic years that follow. Since the virus commonly known as COVID-19 first made its way to the United States in March 2020, three classes of community college students have had an introduction to higher education unlike any other in living memory. The mixed method approach consists of a survey aimed towards rural college librarians and subsequent in-depth interviews. This study identifies attempts to retain connections with faculty and students, as well as adjustments in …

Dual-Systems And Fuzzy-Trace Theory Predictions Of Covid-19 Risk Taking In Young Adults, Sarah M. Edelson, Valerie F. Reyna, Bridget B. Hayes, David M. N. Garavito

Articles

Risk-reduction behaviors are the first line of defense in viral epidemics. Choosing to not engage in risk-reduction behaviors produced millions of preventable deaths from COVID-19. Understanding why this happens and how to predict it is important for theory development and public policy. We took four approaches to this problem: experimentally varying theory-driven predictors (social rewards, transmission risk, and mandatory/voluntary regulations) in choice scenarios, further probing choices in specific scenarios predicted to elicit risk taking, conducting hierarchical regressions with demographic and theory-driven predictors for both scenario types, and conducting corresponding regressions for self-reported protective behaviors. The sample consisted of 247 young …

The Attitudes Of Special Education Teachers Towards The Impact Of Covid-19 On Student Outcomes, Brittany Dixon

Dissertations (2016-Present)

Globally, the coronavirus (COVID-19) has significantly impacted special education teachers and educational institutions. The onset of the coronavirus pandemic in the spring of 2020 led to an almost complete closure of school buildings, triggering a significant disruption to K -12 education across the United States (Education Week, 2020). The quick transition to online and remote learning presented one of the biggest obstacles, especially for special education teachers. The routine and social connections essential for the development of special education students were disturbed by the closing of the schools. Teachers had to develop innovative ways to keep students interested and connected, …

The Lived Experiences Of K-12 Instructional Technology Leaders During Covid-19, Robin Jackson

Dissertations

This study examines the lived experiences of K-12 Instructional Technology Leaders in rural schools and school districts throughout Mississippi. It sought to explore the challenges that were encountered, the strategies they were employed, and the lessons that were learned during the COVID-19 pandemic, as traditional classroom teaching and learning was abruptly transitioned to 100% online or remote teaching and learning. Five participants were recruited. Only one participant holds the actual title of an instructional technology leader of their school district, while the other four assumed the role and responsibilities of an instructional technology leader for their schools or school districts. …

Initiating Early Review Of Paxlovid Criteria With Suspected Covid + Patients To Reduce Disqualification Of Anti-Viral Therapy, Emily Robinson

Cohort XII

Introduction: Nearly 742 million cases of COVID have been detected since the beginning of the COVID-19 pandemic and over 6 million people have lost their lives due to COVID or a COVID related illness. While Arizona’s COVID-19 emergency declaration ended on March 30, 2022, there are still nearly 100,000 new cases each week as of September 2023. Nirmatrelvir-ritonavir (Paxlovid) is an outpatient antiviral medication recommended for adults with mild-to-moderate COVID-19 who have elevated risk of severe illness.

Aim/Methods: Regardless of vaccination status, taking Paxlovid within 5 days of diagnosis reduces the hospitalization rate by 51%. The majority of COVID positive …

Exploring The Influence Of Integrating Soft Skills Training Into The Undergraduate Stem Curriculum On The Stem Identity Of Students, Candace King

Dissertations

One of the major issues that STEM graduates face is overcoming Imposter Syndrome, and there is a consensus amongst STEM graduates and job recruiters that the current higher education system is missing some elements that could better prepare students for a successful STEM career. A solution to this issue results from recent research on the importance of “soft skills.” In general, “soft skills” or non-technical skills, include communication, critical thinking, and self-motivation. These skills complement “hard skills,” or technical skills, such as skills needed for performing laboratory experiments, like pipetting and Western blotting. The lack of soft skills among recent …

An Examination Of Superintendent Turnover In Kentucky: A Decade Of Data, Kevin Hub, Gill Hunter

Journal of Excellence in College Teaching and Learning

This study makes use of a data set detailing instances of public school superintendent turnover in Kentucky between 2014 and 2023. A quantitative research design was used to analyze descriptive statistics in the sample of 205 superintendent turnovers occurring during the identified decade. The analysis reveals a disparity between females and males selected to fill superintendent vacancies. The research also demonstrates that superintendent turnover in Appalachian and non-Appalachian school districts is proportionally consistent, as is superintendent turnover among the eight geographically-assigned Kentucky Department of Education (KDE) educational cooperatives. The findings demonstrate that applicants for superintendent positions serving as assistant superintendents …

Ethnographic Survey - Mitchel J., Mitchel J., Julio Jasso

ANTH 4306/6306 Anthropology of Borders

Ethnographic survey for a resident living in Cameron County, Texas, on the topic of COVID-19.

The Impact Of The Covid-19 Pandemic On Microbiology Undergraduate Students' Academic Performance At The University Of Texas At Arlington, Mohamed S. Abdalati

2024 Spring Honors Capstone Projects - Archive

The COVID-19 pandemic has brought unprecedented challenges to higher education, impacting students' academic performance. This study investigates the effects of the pandemic on microbiology undergraduate students at the University of Texas at Arlington (UTA) A retrospective cohort study design was employed, analyzing academic records of 3,059 microbiology undergraduate students from 2020 to 2022. Results indicate a significant decline in academic performance for both cohorts of general and nursing microbiology students during spring 2020 and 2022. A literature review explored the relationship between socioeconomic status (SES) and academic performance during the pandemic. Literature shows students of lower economic status experienced more …

Christianity And Covid-19: Comparing Dallas-Fort Worth Churches' Conflicting Pandemic Responses, Steven Andrew Shaw

2024 Spring Honors Capstone Projects - Archive

The months following the onset of the COVID-19 pandemic in 2020 saw global confusion from individuals, organizations, and governments alike. Religious institutions, able to influence the attitudes of mass congregations, were not excluded. This research studies how Christian churches in the Dallas-Fort Worth Metroplex navigated the pandemic in vastly different ways, following widely opposing lockdown procedures and holding conflicting views on COVID-19 vaccines. After Texas’s initial restrictions on in person gatherings in March 2020, the 101 churches in this study relied on social media to communicate to their congregations about their responses to COVID-19. These social media pages, acting as …

The Impact Of Covid-19 On Consumer Tastes, Preferences, And Purchasing Behavior, Abbey Jin Beeck

2024 Spring Honors Capstone Projects - Archive

The COVID-19 pandemic has brought about unprecedented changes in the global consumer landscape, particularly in the realm of apparel. This project delves into the crucial importance of understanding the multifaceted effects of COVID-19 on consumer behavior within the apparel industry. The research explores the dynamic shifts in consumer tastes, preferences, and purchasing habits in response to the pandemic, shedding light on their far-reaching consequences. In addition, the pandemic has disrupted traditional retail formats, leading to store closures and reduced foot traffic. This has pushed retailers to innovate by integrating technology and providing unique in-store experiences to attract customers back to …

A Study Of Cybersecurity Landscape In The United States: Trend, Regional Variations, And Socioeconomic Factors, Trang Thi Thu Horn

All-Inclusive List of Electronic Theses and Dissertations

The Internet has become an essential part of our daily lives. Cyberspace has emerged significantly with an enormous number of users, creating a lucrative hunting field for cybercriminals. The exponential growth of internet users and online activities, along with the increased sophistication of cybercrimes, is raising significant global concerns for individuals, organizations, and governments. This research aims to explore the cybersecurity landscape in the United States, investigate regional variations, and the potential impact of the COVID-19 pandemic on the number of cybercrimes. The study utilizes a mixed research method approach, including historical analysis and a Delphi study. Historical analysis studied …

Unmasking Justice: Racial Disparity Trends In Sentencing Before And After The Covid-19 Pandemic, Noah Samuel Reynolds

All Theses

The advent of the COVID-19 pandemic profoundly impacted every facet of the United States justice system, disrupting traditional systems and introducing a new era of virtual alternatives. This unprecedented crisis provides a unique opportunity to empirically study the interplay between health risks, shutdowns, and uncertainty and the foundational value of fair and impartial justice. Using North Carolina sentencing data from 2016-2022, this study delves into the consequences of the pandemic on sentencing outcomes after the virus was declared a national emergency in March 2020. Framed within the Focal Concerns (FC) theory, I expect judges to be more lenient in their …

Personal Green Spaces During The Pandemic - Perceptions Towards Urban Home Gardens During The Covid-19 Pandemic In Bengaluru, India, Varsha Bhaskaran, Charles Nilon

Cities and the Environment (CATE)

The COVID-19 pandemic has brought about unprecedented changes in a short span of time to people’s life and living. Being in a lockdown, especially in urban areas, has led to changes in the way people perceive nature around them and within their homes. Research on this topic in the cities of the global south has been limited with even fewer studies in Indian cities. To begin to address this gap, in this exploratory study we interviewed 30 residents of Bengaluru, India to understand how they perceived the changes they experienced in their home gardens and in the nature around their …

Molecular Mechanisms Of Sensory Post-Acute Sequelae Of Covid-19 Infection: A Comprehensive Literature Review, Maha Siddiqui

Honors Scholar Theses

The COVID-19 pandemic has upended the world in the last few years, bringing with it countless varying physiological effects, some of which extend beyond the acute phase of the infection. Long-term COVID-19, also referred to as "chronic" or “long-haul” COVID, has become an increasingly prevalent health issue in recent years. Long term sensory loss, particularly anosmia and ageusia (loss of smell and taste respectively), are among the biggest concerns to patients suffering from this condition due to the considerable detriment to their quality of life. This literature review aims to provide an overview of the molecular mechanisms associated with sensory …

Cellulose Nanofiber As Mask/Personal Protective Equipment Surface Agent For Enhanced Anti-Bacterial Performance, Sophia Jackson, Jonathan Chen

Faculty Publications

The utilization of face-covering masks as an extended form of personal protective equipment has led to exponential waste measures during the COVID-19 pandemic, with estimations of up to 7200 tons of medical-type waste daily. A primary cause of this waste is surgical layered disposable masks that are constructed by melt-blown nonwovens usually made of non-biodegradable thermoplastic polymers like polypropylene. To increase widespread sustainable options to the public, commercialized or do-it-yourself-based fabric masks serve as a solution, but their resistance to harmful molecules is less than that of the medical-grade masks due to the fabric structure that leaves space for penetration. …

Betrayal As A Moderator Of Covid-19 Exposure And Ptsd Symptoms, Karly Sara Weinreb

Theses, Dissertations and Culminating Projects

In response to the COVID-19 pandemic, there has been interest in understanding how individuals have fared regarding their mental health symptoms, such as symptoms of PTSD. Prior studies have established a link between COVID-19 and PTSD without considering how COVID-19 may relate to the four PTSD symptom clusters. Further, those who feel betrayed by either an individual or institution tend to have more severe PTSD (Martin et al., 2013). It is possible that individuals felt a level of both interpersonal and institutional betrayal towards other individuals or institutions for exposing them to environments in which there was a risk of …