Digital Commons Network^™

Parent Perspectives On Neonatal Research Without Prior Consent: A Mixed-Methods Interview Study., Stephanie A. Kraft, Abigail Brickler, Abril Beretta, Rishabh Jain, Andrea Kelsh, Kaashif A. Ahmad, Justin T. Clapp, Neal W. Dickert, Rebecca A. Dorner, Katherine F. Guttmann, Anup C. Katheria, Stephanie Kukora, Benjamin A. Mooso, Elliott Mark Weiss, Fam-Connect Collaborative

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Recruitment for clinical research in the neonatal intensive care unit (NICU) is difficult, which may lead to low enrollment rates, systematically skewed samples, and nongeneralizable results. Research without prior consent (RWPC), defined as obtaining consent only after infants have been randomized to a treatment arm, may improve enrollment but raises ethical challenges. There is a need to better understand how parents with lived experience of having an infant in the NICU consider RWPC’s impact on critical ethical values related to informed consent, including decision-making, respect, and trust. This mixed-methods study aimed to describe parental perceptions of the acceptability and …

Barrett’S Esophagus-Associated Genetic Loci In African Americans: A Case-Control Study Using The All Of Us Research Program, Ashwin Rao, Jinyoung Byun, Aaron P Thrift, Hashem B El-Serag

Faculty, Staff and Students Publications

Background and aims: Barrett's esophagus is the only known precursor lesion to esophageal adenocarcinoma (EAC). Barrett's esophagus and EAC are less common in African Americans than in non-Hispanic Whites. Studies in European populations have identified Barrett's esophagus-associated risk loci; however, none have examined loci in African Americans cohorts. We conducted a case-control targeted replication study to investigate previously identified Barrett's esophagus risk loci in an African Americans cohort in the All of Us (AoU) Research Program.

Methods: We abstracted phenomic and genomic data from 108 African Americans with Barrett's esophagus and 778 African Americans controls in the AoU database. We …

Gastrointestinal Symptoms After Sport-Related Concussion: Prevalence And Patterns In A Multi-Cohort Analysis, Emma Finnegan, Ed Daly, Katherine J. Hunzinger, Lisa Ryan

Department of Exercise Science Faculty Papers

Background/Objectives: Concussions occur across all sports globally; however, inconsistent symptom recognition continues to challenge diagnosis, management, and recovery. Although concussion effects extend beyond neurological dysfunction, gastrointestinal (GI) symptoms remain insufficiently captured within current assessment frameworks and may influence athletes’ fuelling choices and food tolerance during recovery. This study aimed to describe the prevalence and patterns of GI symptoms reported among athletes with a history of concussion and to explore whether symptom prevalence and burden differed by sex and country. Methods: A total of 401 adult athletes (225 males; mean age 32.4 ± 11.3 years) with a history of concussion were …

Improving Human-Wildlife Coexistence: An Ecological And Educational Approach To Rewilding Grizzly Bears (Ursus Arctos Horribilis) In California, Amanda C. D. Rosales

Master's Projects and Capstones

Megafauna extinction during the Holocene has been both caused and amplified by climatic changes and human influence. By the last half century, large carnivores were diminished in Europe and the United States, but policies increasingly addressed species decline and their territories expanded. This research examined large carnivore rewilding across the European Union and United States, specifically for rewilding brown bears, Ursus arctos, in historic habitat. Next, case studies for the health status of climate-impacted whitebark pine, Pinus albicaulis, a high energy food for bears, was assessed. Ultimately, research case studies, human perspective surveys, and the California Department of Education content …

Behind The Lines In The Balkans: U.S. Military, Intelligence, And Diplomatic Operations In Romania During World War Ii And The Early Cold War, Timothy W. Brophy

Masters Theses

U.S. involvement in Romania during World War II was significant. This involvement began with a U.S. Army Air Forces bombing campaign against the country’s oil refineries, which provided approximately 25% of Nazi Germany’s oil supply during the war. Initial bombing raids occurred in 1942 and 1943, but it was not until April 4, 1944, that the Fifteenth Air Force (15th AF) launched a sustained bombing campaign against Romania. By August 1944, the American bombing of Romania had successfully crippled Romanian oil production and export to Nazi Germany, paved the way for the Soviets to drive German forces out of Romania, …

Human Papillomavirus Vaccine Discourse And Sentiment On Reddit Before And After Covid-19: Mixed Methods Retrospective Cross-Sectional Study, Marcin Marciniak, Sean A Setzen, Deeya Bhattacharya, Jamie Masliah, Robin Powszok, Erich M Sturgis, Vanessa C Stubbs, Mihir K Bhayani

Faculty, Staff and Students Publications

Background: Human papillomavirus (HPV) is a sexually transmitted virus that causes various oropharyngeal and anogenital cancers. The HPV vaccine provides protection against several strains of HPV and is a key preventative tool against HPV-related cancers; however, vaccination rates remain suboptimal in the United States due to variable state mandates and misperceptions of vaccine efficacy and risks. As social media becomes an increasingly popular avenue for health discussions, platforms such as Reddit offer opportunities to understand public vaccine discourse, particularly among underrepresented groups. Furthermore, vaccine hesitancy and mistrust generally increased during the COVID-19 pandemic, potentially impacting HPV vaccination rates.

Objective: This …

The Coffee Crisis: What Starbucks Coffee Company Teaches Us About Exploitation, Chloe Baker

Masters Theses, 2020-current

The average American consumer associates the coffee shop with an earth-toned color pallet, a comfortable seating arrangement, and a delicious beverage. American popular culture mimics that imagery, in television shows like NBC’s Friends and Frasier, and movies like You’ve Got Mail. Coffee shops are one kind of third place, a term coined by sociologist Ray Oldenburg to describe tertiary spaces to work and home where people commune and form community. But a darker side of coffee shops exists relatively unnoticed. This thesis demonstrates how popular cultural portrayals of coffee and coffee shops—small businesses and Starbucks Coffee Company—have both …

Geopolitical Chessboard: How Vietnam Shapes American-Chinese Competition, Kiet H. Lê, Hiep X. Trần

The US Army War College Quarterly: Parameters

Vietnam’s geostrategic position—bordering China and commanding key South China Sea maritime routes—makes it a pivotal actor in shaping great-power competition in Southeast Asia. This article argues that the United States should support Vietnam’s neutrality and strategic autonomy as a means of countering Chinese influence. Unlike prior studies that portray regional states as passive players, this analysis highlights Vietnam’s active role in influencing regional dynamics. Through comparative analysis with the Philippines, using historical case studies, geographic assessments, and policy reviews, the article offers practical insights for military and policy practitioners on how geography shapes alliance formation and strategic competition.

From The Editor In Chief, C. Anthony Pfaff

The US Army War College Quarterly: Parameters

Welcome to the Summer 2026 issue of Parameters, which consists of two In Focus special commentaries, three forums (Indo-Pacific, Strategy, and Historical Studies) and the Strategic Competition Corner.

Parameters, Usawc Press

The US Army War College Quarterly: Parameters

No abstract provided.

Taxidermy And Technology: A History Of Climate Change Exhibitions At American Museums Of Natural History, Laura Haushalter, Amy Woodson-Boulton

Honors Thesis

My research is on the history of temporary and permanent climate change exhibitions at natural history museums in the United States. My primary research question is: How have natural history museums responded to human-caused environmental destruction through their exhibitions, and what, if anything, are natural history museums doing now to address our current environmental crisis? My research begins with a historiography of natural museums and examines how early 20th-century museums responded to a sense of environmental crisis and widespread threats of species extinction. In the early 20th century, museums shifted from Victorian-era glass cases to modern and artistic dioramas that …

Inflammatory Markers In The Emergency Department And Ptsd Symptoms In The Aurora Study: A Longitudinal Cohort Study, Kristen Nishimi, Stacey L House, Et Al.

2020-Current year OA Pubs

BACKGROUND: Systemic inflammation is hypothesized to contribute to post-traumatic stress disorder (PTSD) vulnerability. Few studies have examined inflammation shortly after trauma as a predictor of later PTSD symptoms. We examined whether inflammation from the emergency department (ED) post-trauma is associated with PTSD symptom severity over the following 6 months.

METHODS: Our sample included 742 AURORA participants, a longitudinal cohort of patients in 29 EDs across the United States after a traumatic stressor, followed up to 6 months. Plasma cytokines were assessed from a study blood draw in the ED: an inflammatory index (standardized sum of generally pro-inflammatory markers interleukin [IL]-6, …

Invasive Macrofungi In The United States: A Mushrooming Crisis, Emily Torres

Student Theses 2015-Present

Globalization has accelerated the spread of invasive species, making them one of the largest contributors to biodiversity loss worldwide. While invasive macrofungi remain largely absent from scientific discourse on invasive species, they represent a growing ecological concern throughout the United States. Invasive macrofungi disrupt forest ecosystems, alter soil communities, and displace native fungi. Beyond these ecological impacts, their presence and establishment profoundly affect human-nature relationships, most notably mushroom foraging and cultivation practices. This paper adopts a multidisciplinary approach to examine the ecological, economic, and anthropogenic impacts of invasive macrofungi in the United States. Chapter 1 provides a quantitative overview of …

The Resilient Study: A Retrospective, Descriptive, Correlational Investigation Of Correlates Of Oral Endocrine Therapy Adherence In Older Women With Breast Cancer., Sunny Y. Ruggeri, Cynthia L. Russell Lippincott, Gregory L. Alexander, Rebecca J. Bartlett Ellis, Steven R. Chesnut, Lori A. Erickson

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Breast cancer is the most prevalent and costly cancer. Oral endocrine therapy (OET) improves survival rates and quality of life while reducing recurrence, mortality, morbidity, and medical costs. However, adherence to OET is challenging because OET is prescribed for 5-10 years. Determinants of OET nonadherence (NA) among women aged 65 and older remain poorly characterized. Existing studies are limited, often focusing on small, single-site samples and focusing on patient-level rather than multi-level determinants. Despite the unique needs of older women, research on OET-NA remains scarce.

OBJECTIVE: This study identified multi-level determinants of OET-NA in older women using ecological systems …

Promises, Pitfalls, And Paths Forward For The Pediatric Research Equity Act., Alexa L. Pagano, Danielle J. Green, Jennifer Goldman, Anjali Deshmukh

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Since its enactment in 2003, the Pediatric Research Equity Act (PREA) has significantly increased the number of pediatric drug studies performed and expanded pediatric drug labeling. Despite these advancements, many drugs used in children still lack pediatric-specific US Food and Drug Administration (FDA) labeling, even when pediatric studies are required by law. Recent legislative changes strengthened the FDA's enforcement authority over PREA. As these changes are implemented, persistent gaps in pediatric drug development warrant examination. Addressing these gaps may help ensure that children are systematically included in clinical research and that medications used in children are supported by rigorous …

Exploring The Alignment Between Medical School Outcomes With Residency Competencies: A Modified Delphi Study, Sally A. Santen, Luan Lawson, Jose A. Negrete Manriquez, Marjorie Westerveld, Laurah Turner, Anita Wilson, Phd, Yoon Soo Park, Eric S. Holmboe, Michael S. Ryan, Medical School Outcomes Milestone Study Group

JeffMD Academic Affairs

PURPOSE: Facilitation of competency-based medical education adoption would benefit from alignment between medical school (undergraduate medical education [UME]) and residency (graduate medical education [GME]) assessments. This study explores the strength of an a priori alignment of medical school assessments with residency competency domains to guide programmatic assessment and research.

METHOD: In fall 2023, the authors (US faculty with UME and GME expertise) used a 2-phase Delphi consensus approach (9 participants in phase 1 and 16 in phase 2) to independently map medical school assessments to the Accreditation Council for Graduate Medical Education competency domains (0, no association; 1, some or …

Domain-Specific Concussion Knowledge And Reporting In United States Major League Rugby Players, Julie Stamm, Katherine Hunzinger, Owen Sheehy, Christine Baugh

Department of Exercise Science Faculty Papers

Previous research indicates high concussion knowledge is not associated with better concussion reporting, with research examining the relationship between reporting and global concussion knowledge. Concussion knowledge has not yet been investigated in United States Major League Rugby (MLR) players. This study evaluated domain-specific concussion knowledge, concussion history, and reporting behaviors among active MLR players. In a cross-sectional design, 207 MLR athletes (age 26.6 ± 3.4 years) completed a survey assessing concussion history, knowledge, and nondisclosure reasons. While in the MLR, 24% reported an undisclosed concussion, with nondisclosure reasons related to a lack of concussion knowledge, a desire to continue playing, …

Tips For Health Care Practitioners: A Guide For Adolescent Obesity, Regina Santana

Electronic Theses, Projects, and Dissertations

Adolescent obesity continues to be a significant public health concern that is associated with long term physical consequences. The purpose of this project was to develop an evidence based, user friendly guidebook that supports healthcare professionals in the education of adolescents with obesity and their families. A structured literature review development process was used to inform the current development of the guidebook. The guidebook includes components of obesity management such as nutrition and physical activity recommendations. The validity of the content was established through the evaluation of five healthcare professionals that include registered dietitians and licensed therapists. The guidebook was …

Perceived Neighborhood Environment And Objectively Assessed, Habitual Physical Activity Among Us Adults: An All Of Us Research Program Study, Natalia I Heredia, Michael C Robertson, Christopher D Pfledderer, Ethan T Hunt, Timothy J Walker, Deborah Salvo

Faculty, Staff and Student Publications

Introduction: The purpose of this study was to assess the associations between perceived socioenvironmental neighborhood attributes and objectively assessed habitual physical activity among US adults as well as whether associations vary by sociodemographic characteristics.

Methods: We used data from the All of Us research program, a longitudinal cohort study of a diverse sample of Americans. Perceived neighborhood social cohesion, physical and social disorder, walkability, and sociodemographic characteristics were self-reported. Habitual physical activity was ascertained using Fitbit-derived step counts over ≥24 weeks. Generalized additive mixed-effects models were used to test the associations between perceived socioenvironmental neighborhood attributes and daily step counts. …

Exploring How Acculturation In Childhood Impacts The Adult Identity Of Children Of Hispanic/Latinx Immigrants, Maritza De La Torre, Irene Zapata-Macareno

Electronic Theses, Projects, and Dissertations

The purpose of this study is to provide perspective of struggles with identity for children of Hispanic immigrants. There is limited existing literature on the impact of acculturation on children of Hispanic/Latinx immigrants in the United States. The intention is to provide insight about common experiences and underlying traumas faced by individuals who grow up in immigrant Hispanic/Latinx families. The objective is to provide adults with some insight into their identity based on their specific family dynamic since there is a gap in society about the topic. This study will use a phenomenological qualitative approach to collect data through semi-structured …

Human Trafficking Of Children Efficacy Of Counter Trafficking Programs For Youth, Alma Rodriguez

Electronic Theses, Projects, and Dissertations

Human trafficking is a global problem, and it is a significant problem within the United States. Children are a vulnerable group that become victims of human trafficking operations. Human trafficking prevention programs are available to address this issue, but there is much needed research to test the effectiveness of the countertrafficking programs for high-risk children. This study is a systematic review of studies on countertrafficking programs. This study will use a mixed methods approach to analyze quantitative and qualitative data from selected studies. This study hopes to find if current counter-trafficking programs are effective in preventing at-risk youth from becoming …

Why So Few? Sense-Making The Latino Librarian’S Place In The Hispanic-Serving Institution: A Phenomenological Approach, Valentin Macias Jr.

Electronic Theses, Projects, and Dissertations

Despite record Latinx student enrollment across California's higher education systems, Latino men remain severely underrepresented in academic librarianship, comprising less than 0.5% of librarians nationally. This persistent gap represents a critical equity issue within a profession that increasingly serves diverse student populations. This qualitative study explored the lived experiences of twelve Latino male academic library professionals at Hispanic-Serving Institutions (HSIs) through in-depth interviews to understand the factors shaping their professional identity, the barriers they encounter, and what sustains their persistence in the profession. Using transcendental phenomenology as the methodological approach and Critical Race Theory as the theoretical framework, the study …

Restorative Justice In Cache Valley: Building Community Resilience Through Restorative Practices, Rivkah Haubner

Undergraduate Honors Capstone Projects

Restorative justice as a field of study is primarily applied to criminal justice proceedings or similar topics. As such, its use as a tool in political organizing is an underdeveloped field. Due to its Indigenous history, restorative justice has intrinsically ant-colonial, anti-imperial, and anti-racist roots and is therefore already situated within the ethos of many progressive movements. Historically, radical movements within the United States and across the world experienced both internal and external pressures that undermined their goals. Restorative justice offers a framework through which to understand political action as a whole and specific tools to address internal conflict within …

Great Power Competition In Africa: U.S. Aid Responses To Chinese Aid And Investment, Ebenezer Nana Botsio

All Graduate Theses and Dissertations, Fall 2023 to Present

Over the past two decades, China’s rapid expansion of aid and investment throughout sub-Saharan Africa has raised questions about how the United States responds to growing competition in the region. While the impact of China’s aid has been the subject of considerable study, far less attention has been given to how other donors shift their strategies to adjust. This thesis asks a simple but rather consequential question: does the US change how it gives aid in Africa in response to China’s ever-growing footprint? 

With data from 54 African countries, I find that the United States does not attempt to directly …

A Smoking-Related Plasma Protein Score And Smoking-Related Cancer Risk And Mortality In The Atherosclerosis Risk In Communities Study, Meng Ru, Christopher Douville, Aghiles Guenoun, Hana Zahed, Christie M Ballantyne, Kenneth R Butler, Josef Coresh, David J Couper, Panagis Galiatsatos, Marc J Gunter, Ron C Hoogeveen, Mattias Johansson, Corinne E Joshu, P Martijn Kolijn, Christina M Lill, Jiayun Lu, Michael T Marrone, Giovanna Masala, David C Muller, Anna E Prizment, Raul Zamora-Ros, Nilanjan Chatterjee, Adrienne Tin, Elizabeth A Platz

Faculty, Staff and Students Publications

Background: Self-reported smoking may not fully capture individualized risk of smoking-related cancer, but circulating proteins may reflect biological consequences of smoking. Thus, we developed a score based on smoking-related proteins and evaluated its association with smoking-related cancer.

Methods: This prospective cohort study included 10 563 participants aged 47-70 years in the Atherosclerosis Risk in Communities study. Plasma proteins were measured using the SomaScan Platform (SomaLogic Operating Co, Inc). The score was constructed from proteins associated with current smoking, pack-years, or recent quitting identified by linear regression and elastic net regression. Cox regression was used to estimate adjusted hazard ratios and …

Sustainment Of Hydroxyurea Adherence In Patients With Sickle Cell Disease, Andrew M Heitzer, Zachary Wooten, Guangjin Luo, Marsha Treadwell, Allison A King, Victor R Gordeuk, Nirmish Shah, Christina M Abrams, Sarah Mccuskee, Siera Gollan, Jennifer Longoria, Jane S Hankins, Sickle Cell Disease Implementation Consortium

2020-Current year OA Pubs

IMPORTANCE: Despite established treatment guidelines and strong therapeutic benefit, hydroxyurea remains underused among patients with sickle cell disease.

OBJECTIVE: To assess the change in self-reported hydroxyurea use (ie, taking the medication at all) and adherence (ie, the number of days taken per week) over time and to examine factors associated with the trajectory of hydroxyurea use and adherence.

DESIGN, SETTING, AND PARTICIPANTS: Data were collected through the Sickle Cell Disease Implementation Consortium, a longitudinal, multicenter, observational cohort study that recruited patients from 8 centers across the US. Data collection occurred from 2017 to 2022, and analyses were performed from January …

How Social Media Provides Access For Human Traffickers To Victimize Children: A Literature Review With Combative Measures., Ashton Lamb

Honors Theses

This literature review focuses on how human sex traffickers utilize social media to groom children. Social media is utilized by a great number of people around the world, including many children. While social media is intended to be fun and interactive, it does provide new access for dangerous people to reach victims. There is a very real, growing issue online that is not widely known to the public. This hidden danger is known as human trafficking. Human trafficking is defined as the involvement of any force, fraud, or coercion to obtain some labor or commercial sex act (Department of Homeland …

Redefining Inclusion: The Lived Experience Of Physically Disabled Nurses In The United States, Vanessa Cameron

Creating Healthy Work Environments (CHWE)

Purpose: The purpose of this phenomenological study was to explore the lived experiences of inclusion among physically disabled nurses actively working in the United States, including how those experiences differ based on disability timing—before or after licensure. Current literature largely centers on sensory or learning disabilities within academic settings; thus, this study addresses a critical gap by focusing on inclusion within professional nursing practice.

Significance: Physically disabled nurses remain underrepresented and underexamined in nursing research and workforce discussions. Applying Critical Disability Theory (CDT)—a framework never before used in nursing—this study explores how ableism and inclusion shape workplace experiences and opportunities …

Coverage, Traits, And Geographic Distribution Of Online Surgeon Reviews: Large-Scale Cross-Sectional Analysis, Michael Geng, Carlos Riveros, Yash B. Shah, Sanjana Ranganathan, Kai Fok, Renil Sinu Titus, Vatsala Mundra, Eusebio Luna Velasquez, Dharam Kaushik, Allan S. Detsky, Angela Jerath, Benjamin N. Breyer, Yusuke Tsugawa, Christopher J. D. Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

BACKGROUND: The use of online physician rating platforms has significantly increased and has been shown to influence physician selection. There are limited data on the use of these platforms for rating surgeons.

OBJECTIVE: In this study, we sought to assess the geographic distribution of and patterns in rating scores of surgeons in the United States. Additionally, we examined rating volumes across different surgical specialties and the association between peer-nominated and patient-initiated ratings on online rating platforms in the United States.

METHODS: We conducted a cross-sectional study by identifying 201,154 surgeons in the United States via the National Plan and Provider …

Implementing Measurement-Based Care In Virtual Mental Health Services For Rural Veterans: Provider Insights From A Pre-Implementation Evaluation, Amanda Heeren, Kimberly Mccoy, Lindsey Fuhrmeister, Natalie Suiter, Jan A Lindsay, Chloe Hoang, Laura Marsh, John Fortney, Carolyn Turvey

Faculty, Staff and Students Publications

Background

Measurement-Based Care (MBC) uses repeated standardized psychological assessments to monitor treatment progress and guide clinical decision-making. Although MBC improves outcomes when results are discussed collaboratively, adoption across the Veterans Health Administration (VHA) remains below 50%, particularly in virtual and rural settings. This pre-implementation evaluation explored provider perspectives to inform development of a digital MBC workflow for rural tele-mental health settings.

Methods

Using the Alacrity Center’s Discover, Design, Build, and Test model and User Centered Design, we conducted a pre-implementation survey of mental health providers at a VHA Medical Center providing care to rural and highly rural Veterans in South …