Digital Commons Network^™

A Qualitative Assessment Of Changes In Occupational Exposures Among Healthcare Facility Workers, David Gimeno Ruiz De Porras, Jenil Patel, Sadie Conway, Lisa Pompeii, Laura E Mitchell, Arch Carson, Lawrence W Whitehead, Inkyu Han, Jan-Paul Zock, Paul K Henneberger, Riddhi Patel, Joy De Los Reyes, George L Delclos

Faculty, Staff and Student Publications

Adult-onset asthma, notably prevalent among healthcare professionals, especially nurses, is often attributed to occupational factors such as exposure to cleaning agents. Studies consistently underscore the substantial role of such exposure in work-related asthma among hospital staff. We aimed to (a) identify and characterize current practices in cleaning and aerosolized medication administration; (b) assess changes in practices since a similar 2003 study of Texas healthcare workers; and (c) identify factors contributing to diverse exposures within healthcare job categories. We conducted focus groups with 38 participants in 6 healthcare settings, analyzing current practices, changes since 2003, and factors contributing to exposure diversity. …

Status Of Abortion Curriculum In Genetic Counseling: Survey Of Graduate Programs And Recent Graduates In The United States, Gina Sanchez, S Shahrukh Hashmi, Erica Bednar, Sarah Horvath, Bhavik Kumar, Katelynn Sagaser, Claire N Singletary, Aarti Ramdaney

Faculty, Staff and Student Publications

Genetic counselors (GCs) are trained to help individuals navigate the medical and psychological implications of genetic test results, familial conditions, and ultrasound anomalies. Therefore, familiarity with reproductive options, including abortion, is vital. However, previous studies have found gaps in GCs' knowledge regarding abortion care and there are currently no recommendations regarding abortion curriculum. This study aimed to assess the state of abortion curriculum in genetic counseling graduate programs in the United States and to examine and compare the satisfaction levels of program representatives and recent graduates. Program representatives and recent graduates were invited to complete an anonymous survey evaluating the …

Association Between Early Immunosuppression Center Variability And One-Year Outcomes After Pediatric Liver Transplant., Vikram K. Raghu, Scott D. Rothenberger, James E. Squires, Elizabeth Eisenberg, Anna L. Peters, Jennifer Halma, Swati Antala, Irini D. Batsis, Ke-You Zhang, Amy G. Feldman, Daniel H. Leung, Steven J. Lobritto, John Bucuvalas, Simon P. Horslen, George V. Mazariegos, Emily R. Perito

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite the existence of institutional protocols, liver transplant centers often have variability in early immunosuppression practices. We aimed to measure within-center variability in early immunosuppression after pediatric liver transplant (LT) and examine its association with one-year outcomes.

METHODS: We analyzed pediatric LTs from 2013 to 2018 in the United Network for Organ Sharing registry, with data aggregated by center. We categorized induction regimen as corticosteroids only vs. T-cell depleting antibody vs. non-T-cell depleting antibody. Primary exposures were coefficient of immunosuppression variability (CIV) in (1) induction and (2) mycophenolate mofetil (MMF) use. Primary outcomes were one-year graft survival, patient survival, …

Regulation Of Artificial Intelligence In Healthcare: Clinical Laboratory Improvement Amendments (Clia) As A Model, Brian R Jackson, Mark P Sendak, Anthony Solomonides, Suresh Balu, Dean F Sittig

Faculty, Staff and Student Publications

Objectives: To assess the potential to adapt an existing technology regulatory model, namely the Clinical Laboratory Improvement Amendments (CLIA), for clinical artificial intelligence (AI).

Materials and methods: We identify overlap in the quality management requirements for laboratory testing and clinical AI.

Results: We propose modifications to the CLIA model that could make it suitable for oversight of clinical AI.

Discussion: In national discussions of clinical AI, there has been surprisingly little consideration of this longstanding model for local technology oversight. While CLIA was specifically designed for laboratory testing, most of its principles are applicable to other technologies in patient care. …

Implementation Of Electronic Triggers To Identify Diagnostic Errors In Emergency Departments, Viralkumar Vaghani, Ashish Gupta, Usman Mir, Li Wei, Daniel R Murphy, Umair Mushtaq, Dean F Sittig, Andrew J Zimolzak, Hardeep Singh

Faculty, Staff and Students Publications

Importance: Missed diagnosis can lead to preventable patient harm.

Objective: To develop and implement a portfolio of electronic triggers (e-triggers) and examine their performance for identifying missed opportunities in diagnosis (MODs) in emergency departments (EDs).

Design, setting, and participants: In this retrospective medical record review study of ED visits at 1321 Veterans Affairs health care sites, rules-based e-triggers were developed and implemented using a national electronic health record repository. These e-triggers targeted 6 high-risk presentations for MODs in treat-and-release ED visits. A high-risk stroke e-trigger was applied to treat-and-release ED visits from January 1, 2016, to December 31, 2020. A …

Hospital Commitments To Address Diagnostic Errors: An Assessment Of 95 Us Hospitals, Alexandra Campione Russo, Jean-Luc Tilly, Leah Kaufman, Melissa Danforth, Mark L Graber, J Matthew Austin, Hardeep Singh

Faculty, Staff and Students Publications

Background: Diagnostic errors are a leading cause of patient harm. In 2022, the Leapfrog Group published a report containing 29 evidence-based practices that hospitals can adopt to reduce diagnostic errors.

Objectives: To understand the extent to which US hospitals have already implemented these practices, we conducted a national pilot survey of Leapfrog-participating hospitals.

Methods: To reduce respondent burden, we divided the 29 practices across two surveys: one focused on organizational culture and structure (Domain 1), and the second focused on the diagnostic process itself (Domain 2).

Results: A total of 95 hospitals from 23 states responded to one or both …

American Cochlear Implant Alliance Position Statement On Newborn Congenital Cytomegalovirus Screening, Megan Honor Pesch, Kevin David Brown, Amy L Birath, Gail J Demmler-Harrison, Cailtin Sapp, Anne Morgan Selleck, Alex D Sweeney

Faculty, Staff and Students Publications

It is estimated that 1 in every 200 US newborns has congenital cytomegalovirus (cCMV). Delayed identification of cCMV in newborns precludes timely intervention to mitigate sequelae of the infection such as hearing loss and other neurological complications. Newborn testing for cCMV enables appropriate diagnosis and intervention by multidisciplinary teams to properly manage the immediate sequelae of cCMV, avoid unnecessary additional testing that can result from delayed diagnosis, and monitor for future complications. It is the position of the American Cochlear Implant Alliance, the National CMV Foundation, and the American Academy of Otolaryngology-Head and Neck Surgery that universal newborn cCMV screening …

Antiseizure Medication Prescribing In People With Dravet Syndrome: An Analysis Of Real-Time Administrative Data, Kevin Y Xu, Binx Yezhe Lin, M Scott Perry, Fábio A Nascimento

2020-Current year OA Pubs

Since 2018, three new antiseizure medications (ASMs) received FDA approval for Dravet syndrome (DS) in the U.S: cannabidiol, stiripentol, and fenfluramine. Yet, the uptake of these ASMs in routine clinical practice is unknown. We use new ICD-10 codes for DS (implemented in 2020) to estimate ASM receipt in patients with DS. We analyzed the TriNetX Network, a real-time electronic health record-based dataset linked to prescription data encompassing all 50 states of the U.S. After identifying patients with health care encounters for DS in 2021 and 2022 (via ICD-10 codes), we examined ASM prescribing in the year following a DS claim: …

Priority Competencies For Designated Education Officers In The Veterans Health Administration, Duane R. Bidwell, Anita Samuel, Ronald M. Cervero, Steven J. Durning, Sherri L. Stephan, Erin L. Patel, Marjorie A. Bowman, Holly S. Meyer

Population and Public Health Sciences Faculty Publications

Designated Education Officers (DEOs) at Veteran Health Administration (VHA) hospitals are senior educational leaders tasked with oversight of all clinical training at a particular facility. They prioritize dozens of tasks and responsibilities each day, from educational policy and strategy to staff management, financial planning, onboarding of trainees, and facility planning and management. Clarifying priority competencies for the role can help executives recruit, appoint, and evaluate capable personnel and promote effective, efficient performance. Using a federally developed method of competency analysis, researchers consulted a panel of subject-matter experts to identify priority competencies for DEOs, using data from a 2013 study that …

Us Military Veterans’ Perceived Concordance With Their Providers Regarding Persistent Physical Symptoms Prospectively Predicts Satisfaction With Care And Adherence To Care Plans, L Alison Phillips, Laura M Lesnewich, Katharine Bloeser, Yong Lin, Rachel L Boska, Justeen K Hyde, Peter J Bayley, Helena K Chandler, Matthew J Reinhard, Susan L Santos, Rachel Stewart, Drew A Helmer, Lisa M Mcandrew

Center for Medical Ethics and Health Policy Staff Publications

Background: Medically unexplained, persistent physical symptoms and syndromes are commonly seen in primary care. These are debilitating for patients and difficult to treat, causing frustration for patients and providers.

Purpose: This study investigates how well US military veterans with multiple persistent physical symptoms (PPS), called Gulf War illness (GWI), agree with their healthcare providers about their illness. This agreement, called perceived concordance, is hypothesized to influence veterans' satisfaction with care, adherence to care plans, and disability levels.

Methods: Participants were 230 veterans with GWI deployed to the 1990-1991 Gulf War who were recruited from Veteran Affairs primary care and War …

Covid-19 Vaccine Hesitancy Among Black Women In The Us, Brittany C Slatton, Farrah G Cambrice, Serwaa S Omowale

Faculty, Staff and Student Publications

IMPORTANCE: COVID-19 vaccine hesitancy among Black women is a critical public health concern, potentially exacerbating existing health disparities and impacting community-wide vaccination efforts.

OBJECTIVE: To explore the factors associated with COVID-19 vaccine hesitancy among Black women in the US and identify the specific concerns and experiences shaping hesitant attitudes toward vaccination.

DESIGN, SETTING, AND PARTICIPANTS: Qualitative study using in-depth, semistructured interviews conducted virtually between June and November 2021. Thematic analysis was used to identify key themes from the interview data. Participants were recruited through social media platforms and word-of-mouth referrals from various regions of the US. Interviews were conducted remotely …

Factors Impacting Undergraduate Student Use Of Mental Health Care In The U.S. And France, Samantha Lamontagne

CISLA Senior Integrative Projects

No abstract provided.

Representing Climate Wreckers, Camila Bustos

Elisabeth Haub School of Law Faculty Publications

In recent years, lawyers have become increasingly aware of the implications of the climate crisis for legal practice. Amidst this context, United Nations Secretary General Ant6nio Guterres has urged recent graduates to decline work on behalf of "climate wreckers." This Article examines how professional responsibility rules and principles in the United States should be interpreted on a warming planet, particularly in the context of attorneys representing so-called "climate wreckers" in civil matters. I use the term "climate wrecker" to refer to fossil fuel corporations and trade associations that have engaged in public disinformation campaigns to stall climate action and sow …

Abundance And Other Food Fixations, Margot J. Pollans

Elisabeth Haub School of Law Faculty Publications

Although most people in the United States no longer devote the majority of their time to food production, processing, and distribution, food remains a daily fixation. This Article explores three driving food fixations--abundance, thinness, and health--and situates each against an inverse fear--scarcity, fatness, and illness, respectively. Mapping these threats onto U.S. food policy, this Article examines, among other policy arenas, food waste policy, nutrition and health claim labeling law, and food additive regulations. Across food policy, these fixations feed what this Article calls the “politics of abundance.” This politics helps to insulate the food industry from deeper systemic reform aimed …

Relationship Partners’ Experiences Of Managing Conflict With Individualist And Collectivist Cultural Perspectives: A Reflexive Thematic Analysis, Rebecca Alithia Payan

Department of Conflict Resolution Studies Theses and Dissertations

In the United States, the increasing number of multicultural marriages leads to the individualistic traditional American nuclear family colliding with ideals from a collective culture. This conflict over individualistic and collective nature can lead to martial conflict, including divorce. In this context, this study seeks to answer an important question: How do relationship partners experience managing conflict, considering individualist and collectivist perspectives in the United States? The methodology utilized the Medium-Q of Reflexive Thematic Analysis of data gathered from qualitative open-ended interview questions and a brief survey. Findings reveal engaging themes, leading us to understand that individualism and collectivism influence …

Cronyism In Creating Chronic Disease—A Path To Food Justice, Martha Leonard

St. Thomas Law Review

Central to this discussion is a quote often attributed to the ancient Greek physician Hippocrates: “Let food be thy medicine, and medicine be thy food.” Today, physicians recognize the crucial role of diet in maintaining good health and preventing chronic disease, but U.S. laws fail to reflect this understanding. The health field has seen significant progress in scientific research on pathology; however, nutritional research presents a challenging and contradictory landscape. Corporate influence in scientific research leads to a lack of consensus on the most optimal diet for promoting general health, presenting a challenge for policymaking. The dark reality is that …

The New World's Pandemic: Sexual Exploitation In The Digital Age, Rocio Iglesias Gonzalez

St. Thomas Law Review

Mary is a fifteen-year-old who is excited about starting her sophomore year of high school. Unbeknownst to Mary, George, a classmate whose romantic advances Mary had rejected, created a sexually explicit image generated by artificial intelligence, most commonly known as a deepfake, of Mary and started sending it to other classmates. Once Mary discovered the deepfaked pictures, she and her parents sought legal advice on available remedies. Unfortunately, Mary lives in Nevada, a state that has no legislation addressing the issue of nonconsensual sexually explicit deepfakes. Similarly, at the federal level, Mary has no course of action against her offender. …

No Remedy For Colonization, Sigrid Vendrell-Polanco

Faculty Articles

The United States purports to maintain a democratic relationship with its inhabited territories, yet the Supreme Court continues to uphold twentieth century laws that affirm rather than abrogate colonial policies. The gap between how the United States idealizes democracy and its real world application, especially in its five colonized territories (Puerto Rico, American Samoa, Guam, the Northern Mariana Islands, the United States Virgin Islands, and American Samoa), is not just growing—it is becoming a chasm. These colonies are currently referred to as United States territories. In 2023, the U.S. territory of Puerto Rico experienced a controversial sovereignty challenge surrounding the …

Islamic Themes In Us Hip-Hop Culture, Anders Ackfeldt

Music & Performance in Muslim Contexts

Explores how Islam is produced in American hip-hop culture by both Muslims and non-Muslims

Islam has been a part of hip-hop culture since it sprang from New York’s street culture in the 1970s. Today hip-hop has evolved into a global artform with a diversity of Muslim Islamic discourses expressed. Using tools from the field of social semiotics, this book examines how Islamic themes feature in US hip-hop culture, maintaining a particular awareness that both Muslims as well as non-Muslims participate in their production.

Anders Ackfeldt analyses a collection of lyrics, sounds and images to show how Islamic themes are featured …

Food Waste Crisis In The United States Of America: The Known, The Overlooked And The Undisclosed, Sagarika Srivastava, David J. Tonjes

Technology & Society Faculty Publications

With a loss of 1,250 calories per day per person or 140 kg/p/yr, the United States (U.S.) has a large problem with food waste. The later a product is wasted in the supply chain, the greater its environmental cost. Many food waste mitigation efforts focus on the retail and consumer stages, but there is also considerable food waste in the production phase, which includes growing, harvesting, transportation, storage and processing. The study is conducted in two steps: a bibliometric analysis of 218 articles on food waste in the U.S., followed by an investigation of options to meet food waste recovery …

A Comparative Analysis Of Third-Party Litigation Funding In The United States And The United Kingdom, Gary Myers

Saint Louis University Law Journal

Third-Party Litigation Funding (“TPLF”), which is also known as litigation finance, involves a financial arrangement in which a third party provides funding to support the plaintiff’s pursuit of a civil lawsuit. The third party, in return, receives a portion of the proceeds if the litigation is successful. Like a contingent-fee agreement, this type of funding model enables a party to bring a lawsuit even if that party does not have the resources to pay the up-front costs of the litigation. The important difference is that the litigation funder is not counsel to a party in the case, and that TPLF …

Columbus State University Honors College: Senior Theses, Fall 2024/Spring 2025, Mary Claire Bucanan, Amanda Byars, Marcos Falck, Celeste Grantham, Jarrett Huckaby, Kangjin Joo, Lauren Katzfey, Samual Kimball, Apoorva Kollaram, Ma'lon Lane, Yesmin Mezeyek, Collin Miller, Elizabeth Williams, Matthew Woods

Senior Theses from the Honors College

This is a collection of senior theses written by honors students at Columbus State University during the Fall 2024 and Spring 2025 semesters.

Titles:

- "Listening, Looking, and Learning: An Exploration of Musical Influence on the Narratives and Characters of Call the Midwife" , by Mary Bucanan

- "Stop Suffering for Your Art" , by Amanda Byars

- "Cross-Cultural Narratives: A Comparative Analysis of "Yo Soy Betty La Fea" and "Ugly Betty" " , by Marcos Falck

-"Innovative Teaching Strategies and Lesson Plans to Support Students and ADHD" , by Celeste Grantham

-"Inquiry Based Eighth Grade Math and Science Lessons" …

A Self-Fulfilling Prophecy: Realism In U.S. Foreign Policy, Olivia M. Licata

CMC Senior Theses

This paper examines the influence of realist theory on U.S. foreign policy from 1776 to 2025. Through a temporal analysis of policy across three international power systems – multipolarity, bipolarity, and unipolarity – this paper determines that U.S. foreign policymakers follow realist prescriptions for state behavior given their perception of the United States’ status within the international balance of power system. As a result, the U.S. foreign policy has become rooted in realist assumptions and constrained to realism-prescribed behavior, which will ultimately lead to hegemonic decline. This paper calls for the reexamination of realist influences on foreign policy decision-making.

Exploring Psychological Impacts, Coping, And Conflict Resolution Of Transnationalism On Parent-Child Relationships, Sally Sanchez

PCOM Psychology Dissertations

The number of immigrants migrating to the United States has increased over the past 30 years. Many of these immigrants leave behind their spouses and children, creating transnational families. Researchers have focused on the experiences of transnational families, but there is a need for continued research to further explore the psychological impact of separation and reunification. The purpose of this study was to identify the possible psychological impact of the separation and reunification process experienced by transnational families, and the coping strategies used during the process. This study used a qualitative design to explore the experiences of transnational families who …

The Animated Frontier: Fluctuations Of Power Across Time And Space In Flows Of U.S. And Japanese Animated Media, Kendall Belopavlovich

Dissertations, Master's Theses and Master's Reports

This project critiques the historical and contemporary relationships between the U.S., Japan, and marginalized groups through the lens of animation. The U.S. and Japan share a complex history, from the opening of Japan during the Edo period to events like Pearl Harbor and the atomic bombings, which shaped their present-day alliance. Furthermore, the U.S. and Japan are the central nodes in flows of animation, where both nation states have dominated the global market at various points in animation’s history. Today, Japan's soft power in media is significant, and the flow of power between these nations has influenced media forms and …

The Legality Of Nuclear-Weapons Sharing Arrangements Under International Law: United States-Nato And Russia-Belarus, Anthony J. Colangelo

Faculty Journal Articles and Book Chapters

This Essay argues that certain nuclear sharing agreements between nuclear and non-nuclear powers are legal under the Nuclear Non-Proliferation Treaty. This topic is highly important as Russia has announced its stationing of nuclear weapons in Belarus and Belarus has signaled its intent to use them.

Unflexed Muscle: Sec Enforcement And Officer Sox 302 Certifications, Marc I. Steinberg, A.B. Steinberg

Faculty Journal Articles and Book Chapters

This article represents the first work to analyze the Securities and Exchange Commission’s neglect in its enforcement of the chief executive officer (CEO) and chief financial officer (CFO) Sarbanes-Oxley certification requirement. The article addresses the appropriate construction of the statute’s reach, the enforcement proceedings instituted by the SEC under this provision, and the Commission’s failure to fulfill its legislative directive to enforce this statute and Rule 13a-14 promulgated thereunder. In its implementation of the CEO and CFO certification requirement, the SEC has brought relatively few enforcement actions during over a two-decade period. Its enforcement with respect to CEOs and CFOs …

Empowering U.S. Allies In The Indo-Pacific: An "America First" Approach To Great Power Competition, Nathaniel Benjamin

Graduate Theses/Dissertations

The Indo-Pacific is the primary area for Great Power Competition between the United States and China. China’s rapid but cautious rise has allowed it to achieve a position that threatens to upset the norms and rules of the U.S.-led system in the region. The second Trump Administration has pursued an “America First” policy since taking office in January 2025, but pushing U.S. allies to take on more responsibility for their own defense will not be enough. U.S. allies are major regional players and should be trusted to uphold the principles of the current international system; therefore the U.S. must limit …

Cascadian Independence: A Rising Movement For An Independent Northwest Amid Growing Regionalism In The United States And Canada, Elias V. Savitt

Capstone Showcase

Because of the Civil War, secession is a sore topic to many Americans. However, the idea of secession has not been confined to this notorious example. My essay focuses on the idea that Oregon, Washington, and British Columbia could be the basis for a unified autonomous or even independent entity called Cascadia. First, I discuss the history of secession as such, and the arguments that have been made pro and con as to its legality and under what situations. I then situate this within the histories of the United States and Canada and the phenomena of regionalism and independent movements. …

Selling Egg-Cellence: An Exploration Of Commercial Oocyte Donation And Genetic Determinism In 21st Century America, Abigail C. Oswald

Scripps Senior Theses

This thesis examines the impact of genetic determinism on commercial egg donation in the United States. Through critical analysis of social media advertisements, online forums, and interviews, it argues that reductionist, genetically deterministic thinking drives the commodification of oocytes. Fertility agencies exploit assumptions about heritable traits (health, ethnicity, intelligence) to market "desirable" donors, influencing intended parents' choices and compensation hierarchies. Then the research explores how these same ideas shape perceptions of familial closeness in donor-conceived individuals and their parents, revealing mixed feelings surrounding genetic ties. This study highlights the complex interplay of biology, technology, and social constructs in defining family …