Digital Commons Network^™

Anything But Endo: Diagnostic Buck-Passing In Endometriosis Diagnosis, Rita Dexter, Megan Kitts, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

People living with endometriosis, a disease in which tissue similar to the lining of the uterus grows elsewhere in the body, often experience prolonged diagnostic journeys because of symptom variability, normalisation of period pain and other symptoms, and lack of awareness of the condition. In this article, we analyse the endometriosis diagnostic journey through the lens of epistemic injustice. Drawing on in-depth interviews with 52 people living with endometriosis in the United States, we introduce the concept of diagnostic buck-passing to characterise the phenomenon wherein individuals who seek treatment for their symptoms end up stuck in a cycle of seeing …

The United States' Nuclear Deterrent Outlook: Strategies, Challenges, And Future Prospects, Jonathon L. Beening

Graduate Theses/Dissertations

This study contends that the United States cannot sustain a credible nuclear deterrent through the mid-21st century without modernizing its aging nuclear arsenal and revising its nuclear doctrine to address emerging technological, geopolitical, and strategic threats posed by both near-peer adversaries and non-state actors. Through an examination of deterrence theory, historical developments, current force posture, modernization initiatives, doctrinal debates, counterarguments, and prospective geopolitical scenarios, this research assesses the adequacy of existing policies in maintaining strategic stability. The analysis concludes that credible deterrence in the coming decades will require integrated modernization, doctrinal clarity, and strategic adaptability to face any future threat …

An Insidious Interstice: Understanding Cognition And Language Behaviour Through The Eyes Of Juvenile Justice Professionals, Anne M. Perrotti, Allison T. Chappell, Tancy Vandecar-Burdin

Human Movement Studies & Special Education Faculty Publications

Introduction

Despite evidence suggesting language and cognition deficits are prevalent for justice involved youth, little research explores how juvenile justice personnel experience language and cognition behaviours in the youth they serve.

Aims

This qualitative study explored how juvenile justice personnel understand language and cognition skills and deficits in justice involved youth.

Methods

Twenty-two U.S. juvenile justice professionals participated in individual, semi-structured interviews. Questions focused on individual understanding of receptive language, expressive language, social communication, and cognition (i.e., problem-solving, predicting consequences and impulsiveness) in juveniles served. Using a phenomenological lens, transcripts were coded identifying themes and sub-themes of participant responses.

Results …

From Aid To Looting: Justice And Sovereignty Issues In The Ukraine–U.S. Mineral Deal, Petra Gümplova

Emancipations: A Journal of Critical Social Analysis

This essay identifies three central moral and political issues with the the Ukraine–U.S. Mineral Deal. First, by linking financial and military assistance to access to Ukraine’s natural resources, the deal entrenches a form of resource conditionality that is highly problematic from the moral standpoint of international justice and other ethical principles. Second, the absence of a commitment to a just peace—including the restoration of territorial integrity, reparations, and security guarantees—renders the conditions for secure, long-term investment in Ukraine’s extractive economy a distant prospect, while raising the risk that a substantial portion of Ukraine’s resource wealth unlawfully seized by Russia will …

The Impact Of Pasifikas In Medicine On Pacific Islander Medical Student Experiences, Devon Hori Harvey, Micah Ngatuvai, Siale Vaitohi, Paige E. Faasuamalie, Maegan Tupinio, Lisa H. Smith

Student Papers, Posters & Projects

BACKGROUND: Pacific Islanders experience significant health disparities. One contributing aspect to these disparities is the lack of racial concordance as Pacific Islanders are underrepresented in the U.S. physician work force. Several factors contribute to this underrepresentation including lack of support systems for Pacific Islander premed and medical students. Pasifikas in Medicine (PiM) is a recently established national student organization founded to provide support for Pacific Islander premed students, medical students, residents, fellows and attending physicians. This study seeks to understand the impact of PiM on medical student experiences.

METHODS: An anonymous survey was distributed to the PiM listserv and to …

Star Wars And Gender In 1980s America, Melissa Ulmer

Rushton Journal of Undergraduate Humanities Research

This research paper examines the role of gender in the franchise Star Wars. With the first installment of the trilogy released in 1977, many expected this film would turn out like many before. However, the world that George Lucas created was an instant hit and continues to be today. This paper focuses on how the franchise was set apart from other science fiction films based on a defiance of typical gender roles that were prevalent in the late twentieth century, specifically focusing on the two leading roles, Luke Skywalker and Leia Organa, and employing analysis of the films, cast …

A Comparative Analysis Of Domestic Violence Legislation In India And The United States: Understanding Protection Of Women Against Violence Act 2005 And Violence Against Women Act 1994, Deon Rodrigues

2025 Fall Honors Capstones Projects - Archive

Domestic violence continues to affect millions of individuals worldwide, yet legal systems respond to it in very different ways. This research compares how India’s Protection of Women from Domestic Violence Act (2005) and the United States’ Violence Against Women Act (1994; 2021) protect victims and hold offenders accountable. Using a comparative legal analysis, the study examines both laws’ language, enforcement mechanisms, and effectiveness through court cases, government reports, and statistical data. By identifying the strengths of the United States model such as mandatory arrest provisions and victim support systems, the study aims to propose practical reforms for India’s legal framework. …

Leaving The Fold: Young Adult Disaffiliation From Protestantism In Political And Cultural Context, Kimberly S. Johnson

Doctoral Dissertations and Projects

This study investigated the lived experiences of young adults who have disaffiliated from a Protestant church, focusing on political, national, and religious dynamics, including reflections on Christian Nationalism. The study also examines how these meaning-making processes informed participants’ retrospective accounts of disaffiliation. Building on the quantitative research that has dominated prior studies, this study employed interpretative phenomenological analysis to investigate how encounters with Christian Nationalism have shaped perceptions of organized religion. The study’s ten participants ranged in age from 21 to 29 years old and identified as having been part of the Protestant Church prior to disaffiliating from organized religion. …

Representation In Science And Trust In Scientists In The Usa, James Druckman, Katherine Ognyanova, Alauna Safarpour, Jonathan Schulman, Kristin Lunz Trujillo, Ata Aydin Uslu, Jon Green, Matthew Baum, Alexi Quintana Mathe, Hong Qu, Roy Perlis, David Lazer

Political Science Faculty Publications

Scientists provide important information to the public. Whether that information influences decision-making depends on trust. In the USA, gaps in trust in scientists have been stable for 50 years: women, Black people, rural residents, religious people, less educated people and people with lower economic status express less trust than their counterparts (who are more represented among scientists). Here the authors probe the factors that influence trust. They find that members of the less trusting groups exhibit greater trust in scientists who share their characteristics (for example, women trust women scientists more than men scientists). They view such scientists as having …

The Civic Oath At Saint-Lazare, 1790, John E. Rybolt C.M.

Vincentian Studies

This study presents the French text, English translation, historical context, and a brief analysis of the speech given at Saint-Lazare on the civic oath-taking in support of the 1790 revolutionary government in France, which every adult citizen had to do publicly. At Saint-Lazare, a group of Vincentians and their neighbors assembled in the motherhouse’s chapel for the oath. This very rare and virtually unknown document is in Richardson Library’s special collections at DePaul University in Chicago. Oath-taking was a way of replacing royal legal authority before assemblies of citizens had been formed. By the time of this oath on 7 …

Three Additional Texts From Felix De Andreis, John E. Rybolt C.M.

Vincentian Studies

Three texts add to our knowledge of the work of Felix De Andreis (1778–1820), the founding superior of the Congregation of the Mission in the United States. These have recently come to light. Two are originals, and the third is a copy. They are given in the original languages and in English, with introduction and commentary. The first is an “Indian grammar” with the Lord’s Prayer and catechism by Felix De Andreis, written circa 1817. According to David J. Costa, a scholar in Native American linguistics, it “provide[s] us with the only source of data that is clearly transitional between …

Louis William Valentine Dubourg: His First Years As Bishop Of Louisiana, John E. Rybolt C.M.

Vincentian Studies

Louis William Valentine Dubourg, a priest of the Society of Saint Sulpice, invited the Vincentians to establish a seminary for his diocese of Louisiana. Part of his fundraising efforts to support these and other works was this booklet, The Notice sur l’état actuel de la Mission de la Louisiane (Notice Concerning the Current State of the Mission of Louisiana). Printed in 1820, it circulated widely in Europe and was corrected, updated, and reprinted twice in 1822. Transcriptions given here illuminate differences between the editions. The booklet’s author is anonymous but is probably Charles de la Croix, the bishop’s secretary. The …

Knowing One's Place At The Table: Taste As A Means Of Othering In The American Colonies, 1700-1775, Nicholas Harp

Master's Theses or Doctor of Nursing Practice

This thesis began as an inquiry into a simple question. How did people in the American colonies talk about the food that they ate? This question led to a fascinating look into the social dynamics of the people living in eighteenth century America. Their own personal writings demonstrate how they understood their place in society through the food that they ate. Moreover, they often wrote about the way that other people ate in ways that alienated or discriminated against different ethnic groups. A look into the secondary historiography revealed that other historians had noticed this trend. However, very few addressed …

Trump’S Lasting Impact On The U.S. Presidency, Imer Kj Cespedes-Alvarado

Political Science Student Research

The first presidency of Donald J. Trump had a lasting impact on the American Presidency, expanding executive power through robust assertions of constitutional power, unconventional communications, and an unprecedented disregard for political norms. The two terms further blurred the line between governance and personal branding, cultivating this new model of leadership that depends on constant public exposure and polarization among the American people. This research examines how Trump's executive power and political tactics during both of his presidencies redefined expectations of presidential behavior and accountability by consolidating executive authority, reorganizing federal institutions, and placing even greater emphasis on loyalty and …

Risk Of Late-Onset Depression In Long-Term Survivors Of Breast, Prostate, And Colorectal Cancer, Melissa Taylor, Sarah Westvold, Jessica Long, Terry Hyslop, Andrea Silber, Rebecca Forman, Faiza Yasin, Tendai Kwaramba, Shi-Yi Wang, Michael Leapman, Michael Cecchini, Ira Leeds, Lisa Spees, Stephanie Wheeler, Cary Gross, Kevin Oeffinger, Michaela Dinan

Kimmel Cancer Center Faculty Papers

IMPORTANCE: The prevalence of depression is higher in cancer survivors than in the general population. As the long-term cancer survivor population increases, it is increasingly important to understand risk factors for late-onset depression.

OBJECTIVE: To identify risk factors associated with late-onset depression in long-term (5-year) survivors of breast, prostate, or colorectal cancer.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used 2022 linkage of Surveillance, Epidemiology, and End Results (SEER) and Medicare data to identify 5-year survivors of breast, prostate, or colorectal cancer 66 years or older who were enrolled in fee-for-service Medicare and had no previous depression diagnosis. Long-term …

High Risk Of Persistence And Risk Of Dysplasia After Diagnosis Of Ultrashort Barrett's Esophagus, Wasseem Skef, Jasmine Haydel, Ashwin Rao, Ronan Allencherril, Rollin George, Gyanprakash A Ketwaroo, Aaron P Thrift, Hashem B El-Serag, Theresa Nguyen Wenker

Faculty, Staff and Students Publications

Introduction: The management of ultrashort (< 1 cm) Barrett's esophagus (BE) remains unclear. We aimed to determine the prevalence of ultrashort BE (USBE) at index diagnosis, identify factors associated with persistent BE after USBE diagnosis, and identify risk of dysplasia after initial USBE in a population of US veterans.

Methods: This was a retrospective cohort study at the Veterans Affairs hospital in Houston, TX, of consecutive patients with new BE diagnosis from November 1990 to June 2022 with follow-up through April 2023. Using a pathology database, we identified patients with a new USBE diagnosis and any subsequent follow-up esophagogastroduodenoscopy (EGD). We examined the association of sociodemographic and clinical risk factors of persistent USBE cohort compared with longer-length segment BE and those with a negative follow-up EGD after index USBE with χ 2 tests and logistic regression models. Last, we calculated the prevalence and …

Exploring The Future Of Occupational Safety Research: A Strategic Foresight Approach, Jessica M K Streit, Sarah A Felknor, Nicole T Edwards, John J Howard

Faculty, Staff and Student Publications

A team from the U.S. National Institute for Occupational Safety and Health conducted a strategic foresight project to explore the future of occupational safety research (OSR). Data collected via systematic horizon scanning and key informant interviews were synthesized into six drivers of OSR change: (1) technological advancement, (2) partnerships and public trust, (3) prioritizing research investments, (4) safety and health integration, (5) data and science quality, and (6) worker protections. These drivers served as the basis for envisioning four potential OSR futures. Analysis of the resulting scenarios identified opportunities to enhance and advance OSR methods and approaches, innovation, systems thinking, …

Nationalism And Anglo-American Neo-Colonialism In Southeast Asia, 1945-1965, Wen-Qing (Wei Wenqing) Ngoei

Research Collection College of Integrative Studies

It is tempting to treat the United States’ ill-fated military intervention in Vietnam in the 1960s as the desperate final gasp of a moribund Western imperial system. Certainly, scholars have described Washington’s military debacle in Vietnam as the end of America’s “short-lived empire” in Southeast Asia, emblematic of the broader, decisive triumph of Southeast Asian nationalism over western colonialism. This reading of Southeast Asian countries attaining formal independence after 1945, with tacit assumptions that colonialism and nationalism exist in binary opposition, tends to ossify when the region’s history is viewed through the lens of U.S. defeat in Vietnam.

In contrast, …

The Implications Of Pulsifer V. United States For The Interpretation Of Criminal Statutes, Aparajita (Pj) Das

San Diego Law Review

All signs in Pulsifer point to considerable discretion for courts, all while operating within the confines of statutory text. For one, the opinion indicates that courts can override the text of a statute if the context so demands. The Court’s rejection of lenity also confirms this trend in two ways. It highlights the Court’s inconsistent approach when it comes to requiring the legislature to speak clearly. It also confirms that the threshold of ambiguity required to trigger lenity continues to be a high one, thus allowing judges to selectively apply the canon, even when a split in the Court demonstrates …

Bowers, Lawrence And Obergefell: A Case-By-Case Analysis, Hailey Moran

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

What does Bowers v. Hardwick, Lawrence v. Texas, and Obergefell v. Hodges all have in common? Each of these Supreme Court cases chronicles the passage of time and advancement in LGBTQ+ rights in America. Not only, however, do they chronicle the rights that have been achieved for LGBTQ+ individuals, but they also chronicle the evolution of the Justices on the bench. These cases here help us understand the influences that encourage the Justice’s decision-making, whether it be the state of the law or the Court’s environment. By analyzing each case, we can understand not only how these cases were decided, …

Estimated Waste Generation From 1 Million Basic Metabolic Panels: A Multisite U.S. Study, Seema Khattri Bhandari, Kwaku Twum, Erving T Laryea, Yaqing Du, Raeshun T Glover, Rachel G Brackbill, William Butler, Khushbu Patel, Christopher W Farnsworth, Christina C Pierre, Steven W Cotten, Joesph R Wiencek

2020-Current year OA Pubs

OBJECTIVES: Clinical laboratory operations consume large amounts of electricity and water and generate considerable quantities of solid waste. In this study, we quantified and compared the estimated solid waste produced from performing one million basic metabolic panels (BMPs) across five major high-throughput chemistry analyzer systems commonly used in the United States. Additionally, we estimated the carbon emissions associated with the electricity and water usage of each analyzer to better understand their environmental impact.

METHODS: Five academic medical centers each using a different clinical chemistry analyzer system, collected their respective annual vendor purchase data (January 2022-December 2022). Consumables including reagent cartridges, …

Trends And Disparities In Acute Coronary Syndrome-Related Mortality In The United States: Implications For Healthcare, Muhammad Khuzzaim Khan, Ibrahim Ahmed Khan, Abdul Moiz Javed, Arslan Wazir, Hira Saleem, Muhammad Zohaib, Faisal Rasheed, Priyanka Mohan Lal, Syeda Laiba Sherazi, Amiaz Karim, Nikhil Duseja, Hussam Al Hennawi

Abington Jefferson Health Papers

Acute coronary syndrome (ACS) is a major cause of morbidity and mortality in the United States (US). However, the trends and disparities in ACS mortality are not well understood. This study aimed to analyze the ACS mortality in the US from 1999 to 2020 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. The age-adjusted mortality rates (AAMR) due to ACS were calculated for each year from 1999 to 2020, stratified by sex, race, urbanization, and state. The trends and disparities in AAMR were examined using descriptive statistics and graphical methods. The AAMR due …

Trajectories Of Recovery After Intravenous Propofol Versus Inhaled Volatile Anaesthesia (Thrive) Randomised Controlled Trial In The Usa: A Protocol, Bethany R Tellor Pennington, Laura Swisher, Mara L Bollini, Michael S Avidan, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Millions of patients receive general anaesthesia every year with either propofol total intravenous anaesthesia (TIVA) or inhaled volatile anaesthesia (INVA). It is currently unknown which of these techniques is superior in relation to patient experience, safety and clinical outcomes. The primary aims of this trial are to determine (1) whether patients undergoing (a) major inpatient surgery, (b) minor inpatient surgery or (c) outpatient surgery have a superior quality of recovery after INVA or TIVA and (2) whether TIVA confers no more than a small (0.2%) increased risk of definite intraoperative awareness than INVA.

METHODS AND ANALYSIS: This protocol was …

Unplanned Hospitalization Among Advanced Prostate Cancer Patients By Diabetes Status: A Population-Based Study, Amy L. Shaver, Krupa Gandhi, Scott W. Keith, Nikita Nikita, Christopher C. Yang, Felix J. Kim, Hushan Yang, William K. Kelly, Stephen J. Freedland, Grace Lu-Yao

Kimmel Cancer Center Faculty Papers

BACKGROUND: Older adults with advanced prostate cancer and type 2 diabetes mellitus are underrepresented in trials of androgen receptor pathway inhibitors. This study examined changes in unplanned hospitalization rates in patients receiving androgen receptor pathway inhibitors by type 2 diabetes mellitus status and assessed if unplanned hospitalization varies according to androgen receptor pathway inhibitors.

METHODS: This population-based study of advanced prostate cancer patients aged older than 66 years used Surveillance, Epidemiology, and End Results-Medicare data. Prepost androgen receptor pathway inhibitor initiation changes and androgen receptor pathway inhibitor differences in unplanned hospitalization rates were estimated by adjusted incidence rate ratio with …

Leveraging Existing Cohort Studies Of Mexican Women To Better Understand Hispanic Health And Cancer Risk, Dalia Stern, Liliana Gomez-Flores-Ramos, Britton Trabert, V Wendy Setiawan, Loïc Le Marchand, Henry Gomez, Paul A Scheet, Humberto Parada, Amber Pirzada, Martin Lajous, Leslie V Farland

Faculty, Staff and Student Publications

Background: Hispanics have been historically underrepresented in epidemiologic cancer research. Existing cohort studies focused on recruiting Hispanic participants have been relatively small, making studying cancer outcomes challenging. Therefore, we aimed to compare the distribution of cancer risk factors among Hispanic women of Mexican heritage (HWMH) participating in existing cohorts to explore the possibility of future data pooling efforts.

Methods: We used baseline data of HWMH from three US-based studies, the Mexican American Cohort (MAC; n = 19,797; 2001-2017), the Multiethnic Cohort (MEC; n = 18,007; 1993-1996), and the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; n = 4,022; 2008-2011), and …

A. Syllabus His 207 Comparative Twentieth Century South African And United States Civil Rights And Voting Rights Histories, Frankie Nicole Weaver

Frankie Nicole Weaver, Comparative Twentieth Century South African and United States Civil Rights and Voting Rights Histories

Originally shared as an in-person comparative upper-level undergraduate history course, this course was adapted for online, virtual use. It works well in either format; however, if you share it virtually, I strongly encourage at least one weekly synchronous class meeting and utilizing breakout rooms to promote discussion. Also, provide discussion questions and randomly enter breakout rooms to facilitate discussion --ensuring that engaging discussions occur. I recommend offering both in-person and virtual office hours, regardless.

Compensation, Horizontal Diffusion, And Bottom-Up Pathways: State Climate Policies In The United States And Australia, Ian Bailey, Roger Karapin

Publications and Research

Recent years have seen growing interest in subnational governments as arenas of climate governance, but limited systematic research exists on the extent, conditions, or pathways through which subnational climate policies can influence, or compensate for deficits in, national policies. This article addresses this gap by examining options for states to influence climate policy in the United States and Australia, two countries where federal governments have made limited progress in developing national climate policies. As an analytical framework, it conceives a typology of state government approaches to climate policy that distinguishes among compensating, horizontal diffusion, and bottom-up pathways. It then uses …

Hepcidin, Incident Heart Failure, And Cardiac Dysfunction In Older Adults: The Aric Study, Iman A F Aboelsaad, Brian L Claggett, Victoria Lamberson, Pranav Dorbala, Kunihiro Matsushita, Pamela Lutsey, Bing Yu, Brandon W Lennep, Youssef M K Farag, Amil M Shah, Leo F Buckley

Faculty, Staff and Student Publications

Aims: Hepcidin regulates plasma and tissue iron levels. We studied the association of hepcidin levels with the risk of incident heart failure (HF) and cardiac dysfunction in older adults.

Methods and results: We included adults from the ongoing, longitudinal Atherosclerosis Risk in Communities (ARIC) study, who were free from prevalent anaemia and HF at Visit 5 (2011-13) and had available hepcidin and covariate data. Associations of plasma hepcidin levels with overall adjudicated incident HF, HF with reduced ejection fraction (HFrEF), and HF with preserved ejection fraction (HFpEF) were assessed using multivariable Cox proportional hazards regression models. Cross-sectional associations of hepcidin …

“Rights Not Rescue”: How Stigma Influences Harmful Legislation Toward Sex Workers In The Deep South, Abigail Mckenzie Conover

Graduate Thesis and Dissertation post-2024

In the United States, while prostitution or sex work is not explicitly illegal at a federal level, certain characteristics have been criminalized, mainly in indirect ways. This is significant when considering the different ways that sex work is regarded (both positively and negatively) at an institutional level. The current study examines the potential correlation between structural/institutional stigma regarding sex work/sex workers and legislation meant to directly or indirectly harm sex workers. The overall goal of this research was to answer the following question: How does structural/institutional stigma against sex workers present itself in legislation? To accomplish this, I conducted a …

Variability In Long Covid Definitions And Validation Of Published Prevalence Rates, Lauren E. Wisk, Michelle L'Hommedieu, Kate Diaz Roldan, Imtiaz Ebna Mannan, Erica S. Spatz, Robert A. Weinstein, Arjun K. Venkatesh, Michael Gottlieb, Ryan Huebinger, Kristin L. Rising, Juan Carlos C. Montoy, Kari A. Stephens, Robert M. Rodriguez, Mandy J. Hill, Kelli N. O'Laughlin, Nicole L. Gentile, Ahamed H. Idris, Shu-Xia Li, Michelle Santangelo, Efrat R. Kean, Samuel A. Mcdonald, Kristyn Gatling, Joann G Elmore

Jefferson Center for Connected Care Faculty Papers

IMPORTANCE: Long COVID definitions vary widely, and no consensus exists on how to accurately measure its prevalence, complicating both clinical care and research.

OBJECTIVE: To assess long COVID prevalence using various definitions from published literature.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multicenter cohort study used data from the longitudinal Innovative Support for Patients With SARS-CoV-2 Infections Registry (INSPIRE). Participants aged 18 years or older with symptoms suggestive of COVID-19 illness at the time of their index SARS-CoV-2 test enrolled at 8 sites across the US from December 11, 2020, through August 29, 2022, with follow-up surveys collected through February 28, …