Digital Commons Network^™

One Cutoff Is Not Enough: Assessing Different Area Deprivation Index Cutoffs For Insurance Types On Surgical Desirability Of Outcome Ranking (Door), Susanne Schmidt, Michael A Jacobs, Daniel E Hall, Karyn B Stitzenberg, Lillian S Kao, Bradley B Brimhall, Chen-Pin Wang, Laura S Manuel, Hoah-Der Su, Jonathan C Silverstein, Paula K Shireman

Faculty, Staff and Student Publications

Background: Social Determinants of Health impact health outcomes. Area Deprivation Index (ADI) is used to risk-adjust for neighborhood affluence/deprivation but guidance on choosing deprivation cutoffs is lacking. We hypothesize that different ADI cutoffs are required for different insurance types.

Methods: National Surgical Quality Improvement Program data 2013-2019 merged with electronic health records from three academic healthcare systems. Desirability of Outcome Ranking (DOOR) assessed the association of ADI cutoffs for different insurance types, adjusted for operative stress, frailty, and case status (elective, urgent, emergent). Secondary analyses assessed the association of ADI with case status.

Results: Patients with Private insurance living in …

The Equal Rights Amendment: The 28th Amendment To The U.S. Constitution, Twiss Butler, Patrick Butler

Dignity: A Journal of Analysis of Exploitation and Violence

This article reviews how Supreme Court interpretations of the 14^th Amendment have allowed laws to discriminate against women. It aims to show that the Equal Rights Amendment, ratified as the 28^th Amendment in 2020, offers a constitutional basis for eliminating all forms of legal sex discrimination against women. These forms include discrimination based on pregnancy and abortion, commodifying women’s bodies, and allowing men to intrude into women’s protected spaces. The review starts with the denial of protection for women by America’s Declaration of Independence in 1776, denounces the Supreme Court’s precedent-setting 1974 Geduldig decision, which ruled—quite illogically—that discrimination …

The Burden Of Burnout: Understanding Its Prevalence And Organizational Drivers In Medical Physics, Deborah Schofield, C Lynn Chevalier, Laurence Court, William Harmsen, Akiva Turner

Faculty, Staff and Student Publications

Background: Burnout is a work-related syndrome characterized by increased levels of emotional exhaustion (EE) and depersonalization (DP) along with decreased levels of personal achievement. In the healthcare setting, higher burnout levels have been associated with negative impacts on personnel, an increased risk of errors, and a decrease in the quality of delivered care.

Purpose: The purpose of this study was to assess the prevalence of burnout among medical physicists working in the United States. Additionally, the impact of personal and organizational features on burnout risk was examined.

Methods: The anonymous survey was distributed to 1962 full members of the American …

Impact Of Screening For Human Papillomavirus-Positive Oropharyngeal Cancers: A Microsimulation-Based Modeling Study, Rebecca Landy, Gregory W Haber, Barry I Graubard, Carole Fakhry, Nicole G Campos, Emily A Burger, Li C Cheung, Hormuzd A Katki, Maura L Gillison, Anil K Chaturvedi

Faculty, Staff and Student Publications

Background: We estimated the impact of screening on morbidity and mortality of human papillomavirus (HPV)16-positive oropharyngeal cancer among US men aged 45-79 years.

Methods: We developed an individual-level, state-transition natural history microsimulation model to estimate the impact of screening using oral HPV16 detection, HPV16-E6 antibody detection, and transcervical ultrasound of neck/oropharynx. We compared clinical detection to counterfactual screen detection for cancer stage, single- vs multiple-modality treatment, and survival. Screening scenarios encompassed 4 progression speeds across cancer stages (very slow, slow, fast, and very fast) and 4 screening frequencies.

Results: Among US men aged 45-79 years in 2021 (n = 54 …

Colorectal Cancer And The Risk Of Mortality Among Individuals With Suicidal Ideation, Srikanta Banerjee, Jagdish Khubchandani, Stanley Nkemjika

Department of Psychiatry and Human Behavior Faculty Papers

Suicide is a major public health problem that has grown at alarming rates in the last two decades. Colorectal cancer (CRC) is one of the most common causes of cancer deaths in the United States in both males and females. However, the influence of suicidal ideation (SI) on the association between CRC and risk of mortality has not been well examined.

METHODS: For this study, the 2005-2018 National Health and Nutrition Examination Survey (NHANES), a nationally representative survey of United States adults aged 20 years or older, was utilized. CRC survivorship was determined from self-reported data on CRC, and mortality …

Glitter, Gold, And Glory: The Social, Economic, And Political Legacy Of The Dollar Princesses In Gilded Age Anglo-America, Makayla Elise Talley

Masters Theses

In the late nineteenth century, America and Europe were experiencing drastically different financial situations. While the British aristocracy struggled to maintain their estates and lavish lifestyle due to the repeal of the Corn Laws and agricultural decline, America’s newly self-made men celebrated the expansion of the American frontier, dominating industries and amassing huge fortunes. As a result, the dollar princesses emerged—wealthy American heiresses who married European nobility, stereotypically “trading” money for an aristocratic title and prestige. Many of these transatlantic marriages, however, were actually a result of love or parental/societal force. Through an analysis of the reasons behind the dollar …

A Deconstruction Of The American Dream Through An Analysis Of 'The Great Gatsby', Juliet Hila Katherine Sage

Masters Theses

This thesis addresses the physiological, social, relational, and spiritual issues associated with materialism through Fitzgerald’s The Great Gatsby. It examines wealth and prosperity, “The American Dream” through Jay Gatsby, and argues that Gatsby and Daisy’s relationship was shaped by Fitzgerald’s personal life experiences. Fitzgerald concludes that financial success and societal achievement cannot replace human connections. Through the character Jay Gatsby, Fitzgerald illustrates that obtaining “The American Dream” does not guarantee success in all areas of one’s life. This paper dives deeper into the psychological, social, and spiritual ramifications of materialistic gain. As a result, the premise of this thesis concludes …

Development And Pilot Testing Of An Addiction Clinic-Based Pre-Exposure Prophylaxis Uptake And Adherence Intervention For Women With Substance Use Disorders: Protocol For A Pilot Randomized Trial, Angela M Heads, Diane Santa Maria, Mandy J Hill, Robert Suchting, Kimberly N Evans, Zaneta Gaul, Luba Yammine, Constanza De Dios, Joy M Schmitz

Faculty, Staff and Student Publications

Background: Black and Hispanic women in the United States continue to bear disproportionate incidence of HIV related to sexual transmission and injection drug use. Specifically, women with substance use disorders (SUDs) are more likely to engage in vaginal or anal condomless sex associated with HIV transmission. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool but is not widely used by racial or ethnic minority women. Effective interventions for engaging women with SUDs in HIV prevention interventions that are culturally appropriate and, therefore, more appealing to racial or ethnic minority women with SUDs are critically needed.

Objective: This 3-phased …

Dietary Intake Of Protein By Food Source And Incident Hypertension Among Diverse Us Adults: The Mesa Study, Ji Yun Tark, Ruosha Li, Bing Yu, Alexis C Wood, Nikhil S Padhye, Marcia C De Oliveira Otto

Faculty, Staff and Student Publications

Background: Dietary guidelines recommend adequate protein intake from diverse sources for optimal blood pressure; however, its role in hypertension risk remains unclear. We examined prospective associations of protein intake and diversity, overall and by source, with hypertension risk in the MESA (Multi-Ethnic Study of Atherosclerosis) study.

Methods and results: Among 2294 participants aged 45 to 84 years without hypertension at baseline, total, animal, and plant protein intake was assessed using a 120-item food frequency questionnaire. Protein diversity was evaluated using count and the dissimilarity index. Over a 9-year median follow-up, 1356 hypertension cases were identified through blood pressure measurements and …

Justifying Intervention By Shaping Perception: A Framing Analysis Of United States Propaganda During The 1953 Iranian Coup D’État, Dorreen Darya-Bari

Undergraduate Honors Theses

This thesis examines how major United States newspapers framed the 1953 Iranian Coup, which overthrew democratically elected Prime Minister Mohammad Mossadegh. During the Cold War, the U.S. frequently violated international law, infringing on the sovereignty of foreign nations by orchestrating coups under the guise of combating communist threats to protect strategic interests. The 1953 CIA-backed coup in Iran followed this pattern. This research examines how U.S. media shaped public perception to justify intervention, focusing on the question: What does the framing of the 1953 Iranian Coup d’État in U.S. print media reveal about U.S. interests and their influence on media …

Prevalence Of Cardiovascular-Kidney-Metabolic Stages In Us Adolescents And Relationship To Social Determinants Of Health, Carissa M. Baker-Smith, Abigail M. Gauen, Lucia C. Petito, Sadiya S. Khan, Norrina B. Allen

Department of Pediatrics Faculty Papers

BACKGROUND: Risk factors for atherosclerotic cardiovascular disease begin in youth. Knowledge of the prevalence of cardio-kidney-metabolic (CKM) syndrome in adolescents and its risk factors is critical to understanding the cause of atherosclerotic cardiovascular disease risk burden.

METHODS: We conducted a cross-sectional analysis of the 2017 to 2020 US National Health and Nutrition Examination Survey data and determined the prevalence of each CKM stage in adolescents aged 12 to 18 years. We then assessed the relationship between the family income-to-poverty ratio, health insurance, routine health care access, food security, health behaviors, and CKM stage. We quantified associations between social factors, behaviors, …

Meeting Mandates In A New Labour Federalism: Opportunities And Challenges, Jake Barnes, Hana Shepherd, Janice Fine

Comparative Labor Law & Policy Journal

Worker advocates seeking to affect labour policy change in the United States have shifted their attention and energy to states and localities in a move that has been called the “new labour federalism.” new labour federalism has broadened the scope of public worker protections, while also making the enforcement of those protections even more necessary. In this article, we draw on interviews with agencies and advocates, analysis of agency enforcement data, violation estimates, and publicly available information to understand better how federalism has created both opportunities and challenges for workers, employers, and agencies tasked with enforcing employment standards. We contextualise …

Atoms For Agency: How Argentina’S Pursuit Of Nuclear Power Plants Represents International Legitimacy And Autonomy, 1951-1978., Jacob R. Gressin

Binghamton University Undergraduate Journal

Since 1949 Argentina has developed nuclear power plants (NPPs), overcoming political instability and financial barriers, to eventually succeed in the activation of Latin America’s first nuclear power plant, Atucha-1, in 1974. However, given the ample means of electrical production though fossil fuels and hydroelectric power, NPPs in Argentina present a paradoxical means of electrical production. This paper analyzes the history of Argentina’s nuclear power program, from 1951-1978, in order to offer a more holistic understanding of why NPPs were developed. I argue that nuclear power in Argentina was motivated not by a desire for electrical generation or to manufacture …

Defining The Enemy Within: Examining The Case For A Federal Mechanism To Designate Domestic Terrorist Organizations In The United States, Evelyn Schneider

College Honors Program

Domestic terrorist incidents are on the rise within the United States. Activities of domestic terrorism increased by 357% between 2013 and 2021. While the United States has experienced a dramatic growth in domestic terrorism from violent organizations, other countries have faced this similar problem with a different approach as they have created mechanisms to officially designate domestic terrorist organizations. In this thesis, I will answer the question: Could and should the United States create a federal proscription mechanism for domestic terrorist organizations? Chapter 2 explores whether the Proud Boys, a domestic organization within the United States, could be considered a …

Healthcare Leadership In Western Societies: Religion, Politics, And Rhetoric, Nelly D. Figueroa-Herrera

Pepperdine Journal of Communication Research

No abstract provided.

An Analytical Evaluation Of Economic Geography Within Maine And Its Resource Industries: 1600 To Present, Maureen Mantooth

Graduate Theses and Dissertations

Resource peripheries represent a fringe area within economic geography, originating from the core-periphery theory developed by Friedmann and Miller. This concept has evolved to address global and regional contexts, referring to marginalized regions that rely heavily on the extraction and export of natural resources. By studying these regions, we gain a deeper understanding of critical components in global economic systems. This dissertation focuses on Maine as a case study of a resource periphery, using the framework proposed by Hayter et al. (2003) within the broader regional contexts of New England and the United States. Key factors explored include resource exploitation, …

Robust Privacy Amidst Innovation With Large Language Models Through A Critical Assessment Of The Risks, Yao-Shun Chuang, Atiquer Rahman Sarkar, Yu-Chun Hsu, Noman Mohammed, Xiaoqian Jiang

Faculty, Staff and Student Publications

Objective: This study evaluates the integration of electronic health records (EHRs) and natural language processing (NLP) with large language models (LLMs) to enhance healthcare data management and patient care, focusing on using advanced language models to create secure, Health Insurance Portability and Accountability Act-compliant synthetic patient notes for global biomedical research.

Materials and methods: The study used de-identified and re-identified versions of the MIMIC III dataset with GPT-3.5, GPT-4, and Mistral 7B to generate synthetic clinical notes. Text generation employed templates and keyword extraction for contextually relevant notes, with One-shot generation for comparison. Privacy was assessed by analyzing protected health …

A Scoping Review Of Sexual And Reproductive Health Interventions With Youth In U.S. Juvenile Facilities., April Mcneill-Johnson, Jason Glenn, Nekia Ivory Daniel, Mira Menon, Basil H. Aboul-Enein, Patricia J. Kelly, Megha Ramaswamy

Manuscripts, Articles, Book Chapters and Other Papers

Youth placed in U.S. juvenile detention facilities face multilevel barriers that contribute to disparate sexual and reproductive health (SRH) outcomes when compared to their peers in the general adolescent population. Minimal information is available about evidence-based interventions that have been effective in changing these outcomes. The aim of this scoping review was to focus on the current state of SRH and identify recommendations for SRH care. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews guidelines, we searched electronic databases for publications published through March 2024. The search terms were designed to find intervention studies focusing …

Multiregional Implementation Initiative's Impact On Guideline-Based Performance Measures For Patients Hospitalized With Heart Failure: Implement-Hf, Andrew J. Sauer, Nancy Sweitzer, Et Al.

2020-Current year OA Pubs

BACKGROUND: Despite randomized data for survival benefit (with class 1 recommendations) for treating heart failure (HF) with reduced ejection fraction using quadruple medical therapy (QMT)-defined as evidence-based β-blockers, sodium-glucose cotransporter 2 inhibitor, preferably angiotensin receptor/neprilysin inhibitor, and mineralocorticoid receptor antagonist-it is underutilized. IMPLEMENT-HF is a multiregional HF quality improvement initiative to improve care and outcomes for patients with HF by enhancing the use of QMT in routine practice.

METHODS: This analysis of HF with reduced ejection fraction treatment in patients from hospitals participating in the American Heart Association's Get With The Guidelines-HF who volunteered to participate in IMPLEMENT-HF in 7 …

Reviving Baybayin: The Pre-Hispanic Writing System Of The Philippines, And Raising Awareness In The United States, Richana K. Stone

Honors Thesis

Baybayin is an Indigenous system of writing in the Philippines that has been preserved, but has seen rapid decline in usage throughout the centuries. This paper explores the history of Baybayin and the methods of reviving the written script that have been suggested and used to reimplement Baybayin into the daily lives of Filipinos. Furthermore, this paper will look at how Lakota and Peruvian recording systems, the winter count and the khipu, respectively, have been preserved and used in modern times. Viewing the history of these groups and how they preserved these writing systems sparks a potential for the adoption …

How To Use Social Media And Artificial Intelligence To Promote Mental Health Among Chinese And Chinese American College Students In The U.S., Ni Zhang, Jingru Guan, Terry Zou, Tianqin Shi, Kaikai Liu

Faculty Research, Scholarly, and Creative Activity

This study explored the potential of using social media and artificial intelligence (AI) to tackle language and cultural barriers in order to promote mental health among Chinese and Chinese American college students. Ten bilingual (Chinese Mandarin and English) focus group sessions were conducted over Zoom with 26 Chinese and Chinese American students at a university on the west coast of the United States between October 2023 and February 2024. Thematic analysis of the focus group meeting transcripts was conducted via deductive coding and then inductive selection of quotes on Google Document and Nvivo. Social media provides a platform for providing …

Aiming High: A Narrative Inquiry Of Christian Music Educators’ Higher Purpose, William E. Rhoden Iii

Doctoral Dissertations and Projects

Educators in the United States may question music education’s higher purpose, considering high-stakes testing and an emphasis on non-musical subjects. This qualitative narrative study examines three American protestant Christian music educators’ perceptions of music education’s higher purpose and compares them to Martin Luther’s (1483-1546) writings. The researcher conducted interviews with three participants to record the story of how they developed their higher purpose for music education. The data was tabulated and coded for thematic analysis. This study supports a Christian defense of continued music education in America’s schools, distinguishes modern Christian perspectives, and offers a fresh understanding of the historical …

Testing For Bleeding Disorders In Child Abuse: Aap Recommendation Adherence And Testing Results, Lyndsey Hultman, Angela Doswell, Henry T Puls, Shannon L Carpenter, Angela Bachim, Caitlin R Mcnamara, Farah W Brink, Lori D Frasier, Nancy S Harper, Natalie Laub, Kristine A Campbell, Daniel M Lindberg, Joanne N Wood, James Anderst

Faculty, Staff and Students Publications

Objectives: Using a multicenter child abuse pediatrics research network (CAPNET), the study objectives were to characterize the adherence to American Academy of Pediatrics (AAP) recommendations for bleeding disorder testing and the frequency of bleeding disorder identification.

Methods: We performed a descriptive study of bleeding disorder evaluations among children younger than 10 years of age who presented with bruising and/or intracranial hemorrhage (ICH) concerning for abuse from February 2021-May 2022 utilizing CAPNET. Cases were classified as bruising without ICH or ICH with or without bruising. Based on AAP guidance, testing was not recommended in cases with concomitant suspicious injuries, inflicted injury …

Comparative Risk Of Mortality In New Users Of Prescription Opioids For Noncancer Pain: Results From The International Pharmacosurveillance Study, Meghna Jani, Nadyne Girard, David W Bates, David L Buckeridge, William G Dixon, Robyn Tamblyn

Faculty, Staff and Students Publications

Although opioids continue to be used internationally for noncancer pain, evidence to date on the comparative safety of different opioids is sparse and conflicting. The aim of this study was to examine the comparative risk of all-cause mortality in patients newly initiated on opioids for noncancer pain, across 3 jurisdictions in the United Kingdom (UK), United States, and Canada. A multicentre retrospective, population-based cohort study was conducted. Data sources included UK national primary care electronic health records (Clinical Practice Research Datalink), The Partners HealthCare Research Patient Data in Boston (US), and The Montreal Population Health Record data (Canada). New users …

Discharge Practice Variability In Pediatric Chronic Home Invasive Ventilation, Guillermo Beltran-Ale, Ryne Simpson, Terri Magruder, Ajay S Kasi, Amit Agarwal, Jake A Kaslow

Faculty, Staff and Students Publications

Introduction: The Pediatric Mechanical Ventilation Society is a collaboration of pediatric pulmonologists with a focus on pediatric chronic home invasive ventilation (PCHIV). Since the initial discharge on PCHIV is not always directed by pediatric pulmonologists, we sought to understand how this variability between centers impact adherence to American Thoracic Society (ATS) guidelines for PCHIV.

Methods: A survey was distributed to pediatric pulmonologists across multiple platforms inquiring about discharging practices for PCHIV and adherence to six of the nine ATS recommendations for PCHIV. Two subgroups were created based on common practices - discharge by pediatric pulmonologists from a non-ICU unit (pulmonary …

Forced Sterilizations And Reproductive Control: A Legacy Of Eugenics And White Supremacy In The United States, Bshara Alsheikh

Electronic Theses, Projects, and Dissertations

Women of color have suffered racial reproductive abuse by the hands of government-funded white supremacist institutions. From federal government agencies to the highest court of the land, they have all played a crucial role in the reproductive oppression of women of color and have failed to protect their bodily autonomy. This thesis examines legal cases like Buck v. Bell, Madrigal v. Quilligan, and Relf v. Weinberger to showcase how the bodies and reproductive capacities of women of color have been targeted and controlled under the guise of public health, to advance supposed economic stability, and through a racially charged eugenics …

Survival In Patients With Rheumatoid Arthritis And Recently Diagnosed Early-Stage Colorectal, Lung, Or Prostate Cancer Receiving Tumour Necrosis Factor Inhibitors: A Retrospective Cohort Study, Juan I Ruiz, Xiudong Lei, Sharon H Giordano, Hui Zhao, Suja S Rajan, Heather Lin, Maria E Suarez-Almazor

Faculty, Staff and Student Publications

Background: Tumor necrosis factor (TNF) inhibitors could impair tumoural immunity in patients with rheumatoid arthritis and cancer. We aimed to investigate the association between survival and TNF inhibitor treatment during the first 3 years after a diagnosis of colorectal, lung, or prostate cancer in patients with rheumatoid arthritis.

Methods: In this cohort study, we conducted a secondary data analysis of the Surveillance, Epidemiology, and End Results Medicare-linked dataset. We included patients aged 66 years and older with rheumatoid arthritis diagnosed with colorectal, lung, or prostate cancer between Jan 1, 2008, and Dec 31, 2019, using ICD-O-3 site and histology codes. …

Evolution And Strengths Of School Lunch Programs In The United States And Japan, Sarah Ritterling

Honors Program: Senior Projects (Public)

School lunches around the world perform a vital role in children’s nutritional needs and overall health. These nutritional programs provide a chance for children to learn how to create a balanced meal and about the production and serving of food. However, many countries, including the United States and Japan, have taken different approaches to meet these goals, influenced by the needs of children and communities over time. The United States provides support, funding, and nutritional standards through the National School Lunch Program. Japan promotes the Basic Act of Shokuiku (food and nutrition education) within society and outlines goals for schools …

Temporal Trends Of Subsequent Central Nervous System Malignancies Among Survivors Of Childhood Cancer, Robert T Galvin, Yan Chen, Yan Yuan, Tabitha Cooney, Rebecca Howell, Susan Smith, Michael A Arnold, Miriam Conces, Wendy Leisenring, Gregory T Armstrong, Joseph P Neglia, Lucie M Turcotte

Faculty, Staff and Student Publications

Background: It is not known whether temporal changes in childhood cancer therapy have reduced risk of subsequent malignant neoplasms of the central nervous system (CNS), a frequently fatal late effect of cancer therapy.

Methods: Five-year survivors of primary childhood cancers diagnosed between 1970 and 1999 in the Childhood Cancer Survivor Study with CNS subsequent malignant neoplasms were identified. Cumulative incidence rates and standardized incidence ratios were compared among survivors diagnosed between 1970-1979 (n = 6223), 1980-1989 (n = 9680), and 1990-1999 (n = 8999). Multivariable models assessed risk factors for CNS subsequent malignant neoplasms.

Results: A total of 157 CNS …

Church Planting : Challenges, Opportunities, And Nurturing Healthy Churches, Michael Magar

ATS Dissertations

No abstract provided.