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Undefined By Design: The Fragmented Public Understanding Of Diversity, Equity, And Inclusion (Dei) By Americans, Caroline Umphlet Jan 2027

Undefined By Design: The Fragmented Public Understanding Of Diversity, Equity, And Inclusion (Dei) By Americans, Caroline Umphlet

Theses and Dissertations

Diversity, equity, and inclusion (DEI) policies have become a contentious issue in contemporary United States public discourse, yet a critical question remains as to whether the public shares a common foundational understanding of these terms. While DEI as a concept has developed and evolved significantly since the 1960s, public understanding remains ardently fragmented.

This thesis aims to answer the research questions: how does the 60+ age group in the US define and understand diversity, equity, and inclusion and DEI policies? The 60+ age group was specifically chosen because their definitions give insight into the publics’ understanding of policy topics when …


Eviscerating The State: An Update, Jean L. Cohen Sep 2026

Eviscerating The State: An Update, Jean L. Cohen

Emancipations: A Journal of Critical Social Analysis

A year after the publication of her article “Eviscerating the State: The New Oligarchic and Authoritarian Project to Undermine American Constitutional Democracy (Emancipations, Vol.4: Iss.2, July 2025) Jean Cohen looks again at the threats to American constitutional democracy posed by new oligarchic and authoritarian actors in the economy, the state, and society.


Urban Counterpoint (1992–2003): The Piano Music Of Ed Bland, Joseph Vaz Sep 2026

Urban Counterpoint (1992–2003): The Piano Music Of Ed Bland, Joseph Vaz

Dissertations, Theses, and Capstone Projects

This dissertation analyzes the piano music of Ed Bland, a politically and philosophically vocal composer active in the second half of the twentieth century, whose music draws on both the European and American twentieth-century avant-garde, and on African American vernacular music genres from ragtime to hip-hop. A review of the historical and personal context for these pieces, and a detailed examination of the compositional processes used in this music, work together to demonstrate how Bland thought about the relationship between different musical genres and languages.

Through this combination of theory of musical genre, historical and biographical study, and detailed analysis …


Book Reviews, Usawc Press Aug 2026

Book Reviews, Usawc Press

The US Army War College Quarterly: Parameters

No abstract provided.


African American Gold Star Mothers: Race, Black Motherhood, Loyalism And European Superiority In The First World War, Giovanni Nickolette Gibbs Aug 2026

African American Gold Star Mothers: Race, Black Motherhood, Loyalism And European Superiority In The First World War, Giovanni Nickolette Gibbs

Masters Theses, 2020-current

This thesis examines the US government’s pilgrimages for Gold Star Mothers of the First World War. It focuses on the Jim-Crowing of black Gold Star Mothers. Through the analysis of archival records, letters, telegrams, newspaper articles, poems, and secondary literature, the thesis explores how two domineering forces, the National Association for the Advancement of Colored People and the federal government of the United States of America, captured dissension when seeking to send black Gold Star Mothers on segregated pilgrimages to Europe. The War Department’s announcement that the widows’ pilgrimages to Europe in the 1930s would be segregated caused a great …


Premarket Clinical Evidence Strength And Recalls Of High-Risk Therapeutic Medical Devices, Maryam Mooghali, Faaizah Arshad, Vinay K Rathi, Kushal T Kadakia, Alexander O Everhart, Joseph S Ross, Sanket S Dhruva Aug 2026

Premarket Clinical Evidence Strength And Recalls Of High-Risk Therapeutic Medical Devices, Maryam Mooghali, Faaizah Arshad, Vinay K Rathi, Kushal T Kadakia, Alexander O Everhart, Joseph S Ross, Sanket S Dhruva

2020-Current year OA Pubs

IMPORTANCE: High-risk medical devices approved through the US Food and Drug Administration (FDA) premarket approval (PMA) pathway may be supported by limited premarket clinical evidence, leaving uncertainties about safety. Whether device, premarket clinical evidence, or regulatory characteristics are associated with subsequent device recalls is unknown.

OBJECTIVE: To examine the association between device, premarket clinical evidence, and regulatory characteristics and serious recalls among high-risk therapeutic devices.

DESIGN AND SETTING: This cross-sectional study reviewed 193 high-risk therapeutic medical devices approved through the FDA's PMA pathway between January 1, 2014, and December 31, 2023. Data were analyzed between August 2025 and December 2025. …


Patterns Of Presidential Executive Orders And Democratic Quality: Evidence From The United States, 2017-2025, Karyn Sofie Sanford Aug 2026

Patterns Of Presidential Executive Orders And Democratic Quality: Evidence From The United States, 2017-2025, Karyn Sofie Sanford

All Graduate Theses and Dissertations, Fall 2023 to Present

Democratic backsliding has become an increasingly prominent topic in political science, yet relatively little attention has been devoted to how observable expressions of executive authority correspond with changes in democratic quality. Using the United States as a case study, this study examines the relationship between presidential executive orders and democratic quality from 2017 to 2025. More specifically, it investigates whether characteristics of executive orders correspond with changes in democratic quality, measured using the Liberal Democracy Index and the Judicial Constraints Index from the Varieties of Democracy (V-Dem) Project.

Presidential executive order issued between 2017 and 2025 were collected from the …


Womanhood On The Veranda: Maternalism And The Expansion Of American Women's Public Life, Abigail J. Swanson Jul 2026

Womanhood On The Veranda: Maternalism And The Expansion Of American Women's Public Life, Abigail J. Swanson

History ETDs

Motherhood and child welfare became central organizing principles for reform during the United States Progressive Era.  From these guiding principles, the government formed the United States Children’s Bureau. It was the country's first governmental agency that focused solely on the welfare of children. Mothers writing to the federal government for motherhood advice was a phenomenon that was completely new to twentieth century mothers. Women took pride in their roles as mothers, particularly when it came to child health matters. To the generation of mothers who came before these early twentieth century letter writers, asking the government for advice on child …


Digital Empowerment For South Asian Immigrants: An Intervention For Metabolic Syndrome (Desi-Mets), Amir U. Islam, Sharon Wexler, Lin Drury, Jeffery A. Stahl Jul 2026

Digital Empowerment For South Asian Immigrants: An Intervention For Metabolic Syndrome (Desi-Mets), Amir U. Islam, Sharon Wexler, Lin Drury, Jeffery A. Stahl

International Nursing Research Congress (INRC)

Background: South Asian immigrants (SAIs) in the US have a disproportionately high prevalence of metabolic syndrome (MetS), leading to increased risks of cardiovascular disease and diabetes. Increased waist circumference and early-onset heart disease further potentiate health disparities, underscoring the need for culturally tailored interventions. Digital health interventions (DHIs) have been recognized for their potential to effectively support lifestyle modifications in minority populations, including SAIs, by providing accessible and culturally tailored health management solutions.

Purpose: The purpose of the study is to evaluate the effectiveness of a culturally tailored digital health intervention (CT-mHealth) in reducing MetS among SAIs in Hudson Valley, …


Board Exam Preparation Resource Trends In Academic Health Sciences Libraries Serving Colleges Of Osteopathic Medicine Programs., Joanne Muellenbach, Kyle Robinson, Hsin-Liang (Oliver) Chen, Harold S Bright, Lori Fitterling Jul 2026

Board Exam Preparation Resource Trends In Academic Health Sciences Libraries Serving Colleges Of Osteopathic Medicine Programs., Joanne Muellenbach, Kyle Robinson, Hsin-Liang (Oliver) Chen, Harold S Bright, Lori Fitterling

PCOM Scholarly Works

BACKGROUND: The study seeks to identify the board exam preparation (prep) resources made available to medical students by academic health sciences libraries and other departments within U.S. colleges of osteopathic medicine (COM) programs, and the extent to which these resources are utilized by medical students and educators.

METHODS: The study was conducted in two phases. In phase one, forty-two COM library directors were invited to complete a survey regarding their usage, funding, and access models for available board prep resources. In phase two, semi-structured interviews were conducted via Zoom to explore the library's role in providing access to these resources. …


Online Rights Defense Among Chinese Americans Against Racial Aggression In The U.S. During The Covid-19, Fangzhu Lu, Wenshan Jia Jun 2026

Online Rights Defense Among Chinese Americans Against Racial Aggression In The U.S. During The Covid-19, Fangzhu Lu, Wenshan Jia

Communication Faculty Articles and Research

Purpose

This study investigates how Chinese American communities responded to heightened racial discrimination during the COVID-19 pandemic by utilizing social media platforms to safeguard their civil rights, articulate collective concerns, and mobilize resistance against racial aggression.

Methodology

Through qualitative case study analysis, the research examines the social media activities of six advocacy organizations, including three X accounts (WashTheHate, Chinese for Affirmative Action, Asian Americans Advancing Justice) and three Instagram accounts (Stop AAPI Hate, Stop Asian Hate, Advancing Justice: AAJC). The analysis focuses on the content strategies and communication mechanisms employed to counteract racial hostility.

Findings

The selected organizations used social …


Cure Sickle Cell Initiative Recommendations On Common Data Elements For Sickle Cell Disease Gene Therapy Trials, Sophie Lanzkron, Victoria H. Coleman-Cowger, Alexis A. Thompson, C. Patrick Carroll, Traci Clemons, Michael Debaun, Julie Kanter, Punam Malik, Deepa Manwani, Francis John Pierciey, Mark C. Walters, Sherita Alai Jun 2026

Cure Sickle Cell Initiative Recommendations On Common Data Elements For Sickle Cell Disease Gene Therapy Trials, Sophie Lanzkron, Victoria H. Coleman-Cowger, Alexis A. Thompson, C. Patrick Carroll, Traci Clemons, Michael Debaun, Julie Kanter, Punam Malik, Deepa Manwani, Francis John Pierciey, Mark C. Walters, Sherita Alai

Cardeza Foundation for Hematologic Research

The Cure Sickle Cell Initiative (CureSCi), created by the National Heart, Lung, and Blood Institute, has developed data standards to increase interoperability and meta-analysis of studies specifically investigating gene therapy for sickle cell disease (SCD). The aims of the CureSCi Common Data Elements (CDE) initiative are to facilitate the development of safe, effective, and accessible gene therapies. Five working groups (WGs) comprising people living with SCD, stakeholders, clinicians, and researchers reviewed current definitions used for SCD clinical studies, including those from the American Society of Hematology, US Food and Drug Administration, PhenX catalog of consensus measures for phenotypes and exposures, …


How International Copyright Approaches To Generative Ai May Influence The Development Of U.S. Copyright Laws For Ai, Tessa Chew Jun 2026

How International Copyright Approaches To Generative Ai May Influence The Development Of U.S. Copyright Laws For Ai, Tessa Chew

San Diego International Law Journal

Since late 2022, Generative Artificial Intelligence (GenAI) has emerged as a vital technological tool in many industries by producing human-like content based on its trained datasets. This advancement has sparked an international debate over the ethical and legal implications of using copyrighted works for Artificial Intelligence (AI) training. Countries have taken differing legislative approaches to this issue. Japan aims to promote innovation with minimal restrictions; the United Kingdom aims to protect copyright holders by implementing strict AI copyright protections; and the European Union focuses on the transparency of the AI’s copyright use. The United States is currently at a regulatory …


Science-Related Rhetoric And Action By United States Presidents From 1977-2017, Amanda E. Shea Jun 2026

Science-Related Rhetoric And Action By United States Presidents From 1977-2017, Amanda E. Shea

Interdisciplinary Studies

Presidential rhetoric and executive action have played an important role in shaping how scientific issues are presented to the American public. This project examined how United States presidents from Jimmy Carter through Barack Obama (1977–2017) employed science-related rhetoric and policy regarding climate science and reproductive health. Findings suggest that reproductive health remained a partisan issue throughout the study period, while climate science shifted from a largely bipartisan concern to a more partisan one over time. The results also indicate that presidential rhetoric and executive action were not always aligned, with several administrations using science-related rhetoric more extensively than corresponding policy.


Trust In Cancer Information Sources And Awareness Of Human Papillomavirus As A Cause Of Cervical Cancer Among Us Adults, Olajumoke Ope Oladoyin, Paula Cuccaro, Lara S Savas, Robert Yu, Joel Fokom Domgue, Sheryl Mccurdy, Sanjay Shete Jun 2026

Trust In Cancer Information Sources And Awareness Of Human Papillomavirus As A Cause Of Cervical Cancer Among Us Adults, Olajumoke Ope Oladoyin, Paula Cuccaro, Lara S Savas, Robert Yu, Joel Fokom Domgue, Sheryl Mccurdy, Sanjay Shete

Faculty, Staff and Student Publications

Importance: Religiosity, trust in physicians, and trust in government health agencies influence individual decision-making and behavior toward public health programs. However, trust in information about cancer from these sources and their association with public awareness of human papillomavirus (HPV) as a cause of cervical cancer remain understudied.

Objective: To assess the association of trust in cancer information sources with awareness that HPV causes cervical cancer among US adults.

Design, setting, and participants: This cross-sectional study used the nationally representative 2022 Health Information National Trends Survey (HINTS) data on noninstitutionalized US adults aged 18 years or older collected between March 7 …


Gastrointestinal Symptoms After Sport-Related Concussion: Prevalence And Patterns In A Multi-Cohort Analysis, Emma Finnegan, Ed Daly, Katherine J. Hunzinger, Lisa Ryan May 2026

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 …


Extra Omnes: Analyzing The United States’ And Ireland’S Methods Of Quelling The Criminal Clergy Sexual Abuse Scourge, Dana Aprigliano May 2026

Extra Omnes: Analyzing The United States’ And Ireland’S Methods Of Quelling The Criminal Clergy Sexual Abuse Scourge, Dana Aprigliano

Journal of Catholic Legal Studies

(Excerpt)

In late 2008, an Irish businessman was successful in legally preventing sexual assault claims from being brought against him. In explaining why one “victim” should be discredited, the court cited a threat she made against the businessman to make allegations of a sexual nature against him if he did not pay her a sum of money. In particular, she told him that if he did not pay her, she would “have him . . . ’plastered all over the front of the Evening Herald like those p[e]dophile priests.’ ” Although the businessman was not a priest or, as it …


Crime, Economic Forces And Trucks Crossings In The Us–Mexico Border Region, René Cabral, André Varella Mollick, Eduardo Saucedo May 2026

Crime, Economic Forces And Trucks Crossings In The Us–Mexico Border Region, René Cabral, André Varella Mollick, Eduardo Saucedo

School of Economics and Finance Faculty Publications

We investigate northbound loaded truck crossings from Mexico to the United States between 2015 and 2023. A weaker peso, exports and US industrial production positively affect loaded containers. Truck robberies at the municipal level show no statistically significant relationship with truck loadings, whereas truck robberies at the national and state levels present a negative, persistent association. Results suggest that Mexico–US trade would benefit from lower average Mexican crime rates. In addition to comparing Texas with other border states, this study documents the role of crime specific to the transportation sector as a negative relevant driver of truck crossings to the …


Improving Human-Wildlife Coexistence: An Ecological And Educational Approach To Rewilding Grizzly Bears (Ursus Arctos Horribilis) In California, Amanda C. D. Rosales May 2026

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 …


The Educational Gender Gap Explored Through The Lens Of Hegemonic Masculinity, Marcell V. Csikos May 2026

The Educational Gender Gap Explored Through The Lens Of Hegemonic Masculinity, Marcell V. Csikos

University Honors Theses

Women's college attendance skyrocketed with the passing of Title IX, and by the eighties, college campuses featured men and women at an even fifty-fifty split. Today, women make up over fifty-seven percent of college students. It is not a new phenomenon, studies and surveys have shown that women are doing better at school for decades, but they rarely tie men's underperformance to the concept of masculinity. The study of hegemonic masculinity is an overarching theory that looks at the values, rules, and dynamics that men have to follow in order to keep their social status. This literature review uses said …


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 May 2026

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 May 2026

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 …


Parameters, Usawc Press May 2026

Parameters, Usawc Press

The US Army War College Quarterly: Parameters

No abstract provided.


Inherited Strategies: Why The U.S. And France Pursued Different Counterterrorism Approaches In The Horn Of Africa And The Sahel, Matthew B. Blackwood May 2026

Inherited Strategies: Why The U.S. And France Pursued Different Counterterrorism Approaches In The Horn Of Africa And The Sahel, Matthew B. Blackwood

Honors Theses

This thesis examines the counterterrorism strategies employed by the United States and France in Sub-Saharan Africa. In Somalia, the United States utilized a remote warfare centric strategy, precision drone strikes and limited special operations raids, in an attempt to degrade the Somali groups al-Shabaab and ISIS-Somalia. In the broader Sahel, France utilized large ground operations in Operation Serval and Operation Barkhane fighting various groups such as AQIM and JNIM. The thesis aims to explore why the United States and France, both Western countries, who fought similar non-state actors decided to employ drastically different strategies. Through process tracing and comparative analysis, …


Taxidermy And Technology: A History Of Climate Change Exhibitions At American Museums Of Natural History, Laura Haushalter, Amy Woodson-Boulton May 2026

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 …


How Ai Governance Differs Between Regime Type, Jackson T. Guillou May 2026

How Ai Governance Differs Between Regime Type, Jackson T. Guillou

Honors Theses

This thesis will examine how artificial intelligence (AI) regulation and development differ across political regime types, arguing that governance outcomes are fundamentally shaped by institutional political structures. This thesis will draw on comparative frameworks analyzing democratic and authoritarian systems. This thesis will also include case studies of the European Union, the United States of America, China, and Russia. The study finds that democratic regimes tend to emphasize transparency, accountability, and rights-based regulation of AI. This often results in slow regulation of AI, but it is more ethically legitimate and constrained. In contrast, authoritarian regimes prioritize centralized control, strategic coordination, and …


Fear Of The Other: Explaining Immigration Anxiety In The United States, Ramon Arguelles May 2026

Fear Of The Other: Explaining Immigration Anxiety In The United States, Ramon Arguelles

Student Scholar Symposium Abstracts and Posters

Illegal immigration has become one of the most politically divisive issues in the United States, with many Americans fearing its social, political, and economic effects. This paper examines possible causes of the fear of illegal immigration, specifically focusing on media consumption, employment status, and education level. Using Wave 11 of the Chapman Survey of American Fears, a nationally representative survey of U.S. adults, this paper analyzes whether these variables can serve as indicators of fear of illegal immigration. Drawing on media framing theory, labor-market competition theory, and theories of education and cognitive sophistication, three hypotheses were tested using Pearson correlation …


Age And Congressional Leader Success: Are They Getting Too Old, Edward N. Drinkwine, Scot Schraufnagel May 2026

Age And Congressional Leader Success: Are They Getting Too Old, Edward N. Drinkwine, Scot Schraufnagel

Honors Capstones

Congressional leaders play a central role in shaping legislative agendas, maintaining party cohesion, and negotiating policy outcomes. Despite the important roles they play, our nation's congressional leaders continue to grow older, and research has rarely examined how age influences their effectiveness in these roles. This study asks whether older congressional leaders are less effective at advancing legislation than their younger counterparts. Using data on leaders serving in the U.S. House and Senate from the 93rd through the 118th Congress, the analysis compares leaders’ ages with their Legislative Effectiveness Score Ratios, controlling for legal experience, state legislative experience, elite education, ideology, …


The Anti-‘Refugee Crisis’: A Comparative Analysis Of Anti-Immigrant Extremist Violence In The United States And The Nordic Countries, Ethan Mitchell May 2026

The Anti-‘Refugee Crisis’: A Comparative Analysis Of Anti-Immigrant Extremist Violence In The United States And The Nordic Countries, Ethan Mitchell

Graduate Theses and Dissertations

Using data from the U.S. Extremist Crime Database (ECDB), the Bias Homicide Database (BHDB), and the Right-Wing Terrorism and Violence (RTV) database, this study explores how attributes of anti-immigrant extremist violence compare across the United States and the Nordic countries. Compared to the long, complicated history of U.S. immigration and anti-immigrant violence, the homogeneity of the Nordic nations has only relatively recently been interrupted by mass immigration events like the mid-2010s’ “refugee crisis.” Rapid demographic change in these nations has inspired increased levels of extremism targeting immigrants and refugees. Quantitative analyses of cases ranging from 1990-2022 illuminate how broader social, …


Promises, Pitfalls, And Paths Forward For The Pediatric Research Equity Act., Alexa L. Pagano, Danielle J. Green, Jennifer Goldman, Anjali Deshmukh May 2026

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 …