Digital Commons Network^™

Barriers To And Facilitators Of Sustaining A Systemic Lupus Erythematosus (Sle) Patient Decision Aid In Regular Rheumatology Outpatient Care In The Usa, Erin E Blanchard, Allyson G Hall, Ezra Gore, Parvaneh Yaghoubi Jami, Aizhan Karabukayeva, Larry R Hearld, Shelby Gontarz, Jasvinder A Singh

Faculty, Staff and Students Publications

Objective: This study investigates the barriers to and facilitators of sustaining a decision aid (DA) tool for patients with SLE in routine rheumatology outpatient care across the USA. The DA was initially developed for assisting patients with SLE in making informed medication choices by providing personalized information on their treatment process.

Methods: We conducted semi-structured interviews with clinicians, administrators, and information technology (IT) professionals from 15 geographically diverse rheumatology clinics that participated in a large-scale DA implementation trial. Interviews were transcribed and analysed using NVivo, with thematic coding to identify key factors influencing DA sustainability.

Results: The analysis identified several …

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 …

Menstrual Math: The Price Of Bleeding, Gabrielle Langston

Dissertations, Theses, and Capstone Projects

This project examines the landscape of menstrual equity in the United States through a data storytelling lens, focusing on state-level policies regarding taxation and access to menstrual products. The analysis explores which states impose sales tax on menstrual products, if state schools provide free menstrual products, and which states ensure access for incarcerated individuals using publicly available datasets from advocacy groups. Additionally, there is an investigation into potential correlations between the gender wage gap and states that tax menstrual products, shedding light on economic and policy disparities.

Through its data visualizations, this project aims to provide a clear, although not …

East Asian And “Extraordinary”: Intersecting Racial And Musical Identities In The Classical Music Solo Career, Audrey Chen

Dissertations, Theses, and Capstone Projects

A performer’s success within the classical music industry is reliant not only on musical merit but also on extramusical factors like race, gender, class, and culture, all of which influence a musician’s upbringing. For East Asian musicians, distinctions of merit can be accompanied by racialized and often paradoxical narratives about Asian identity that essentialize their performance, personality, and background. This dissertation examines how Asian and Asian-American performers of Western classical music navigate this interplay of racial and musical identity within their careers, with a specific focus on string players and pianists.

Chapter 2 introduces five major racialized narratives used to …

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 …

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 …

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 …

Comprehending The Influence Of Harassment And Stalking Laws On The Safety And Well-Being Of Victims In The Us, Khazayma Khan

Doctoral Dissertations and Projects

The purpose of this dissertation is to explore the problem of unresponsive law enforcement faced by legitimate victims of harassment and stalking in the United States and to ultimately develop recommendations to address the problem. A mixed method was used in which qualitative and quantitative data was gathered and analyzed. For this dissertation, a mixed method was applied using interviews, focus group discussions, and surveys to gather data among victims of harassment and stalking. The participants were recruited using convenience sampling in which victims of harassment and stalking were selected from relevant organizations, such as support services. A total of …

How Do The Conflicts In The Middle East And The Crisis At The Southwestern Land Border Increase The Risk Of Terrorism In The United States?, Bradly Perkins

Doctoral Dissertations and Projects

This qualitative dissertation provides an in-depth analysis of the intricate relationship between the persistent geopolitical instability in the Middle East, the complex crisis at the United States' Southwestern Border, and the associated terrorist threats facing the United States. Despite the pressing nature of these interconnected challenges, there is a notable scarcity of scholarly literature that effectively establishes links between the issues at the Southwestern Border, the conflicts occurring in the Middle East, and the risks of terrorism. This gap in research highlights the need for a comprehensive examination of these global security concerns, emphasizing how they interact and influence one …

The Joint Association Of Diet Quality And Sleep Regularity With Incident Cardiovascular Disease In The Multi-Ethnic Study Of Atherosclerosis, Kaitlin S Potts, Claire Veldkamp, Alexis C Wood, Erin D Michos, Raymond Noordam, Tianyi Huang, Susan Redline, Heming Wang

Children’s Nutrition Research Center Staff Publications

Background/objectives: Diet quality and sleep regularity both influence cardiovascular disease (CVD) risk and may influence each other, but there is scarce evidence for their joint or interacting associations in relation to CVD. We assessed these associations in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods: Participants free of CVD with valid diet and sleep measures in 2010-2013 were included and followed through 2020 for detection of incident CVD (188 events detected over 8.8 years among 1782 participants; 55% women). Sleep timing and duration regularity were assessed via the intra-individual SD of sleep onset time and duration across 5- to 7-day actigraphy. …

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, …

Causes Of Death Among Us Medical Residents, Nicholas A. Yaghmour, William E. Bynum, Frederic W. Hafferty, Karen D. Könings, Thomas Richter, Timothy P. Brigham, Thomas J. Nasca

Division of Nephrology Faculty Papers

IMPORTANCE: From 2000 to 2014, the leading causes of medical resident death in the United States were neoplastic diseases and suicide.

OBJECTIVE: To examine whether US medical resident rates of death have changed since 2014 and whether causes of resident death differ by specialty.

DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, residents and fellows who were enrolled in Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs and who died from January 2015 to December 2021 were submitted to the National Death Index to obtain causes of death. These decedents were compared with residents and fellows who died between …

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, …

The Kids Aren’T Alright: Changes In The Mental Health Of Adolescents Post-Covid-19, Tanya Belom

Education (PhD) Dissertations

Mental health is an increasing concern for today’s youth, with one in six U.S. children and adolescents aged 6-17 experiencing a mental health disorder each year, and 50% of all lifetime mental illnesses begin by age 14. The COVID-19 pandemic, which resulted in lockdowns, social isolation, school closures, and ultimately a disruption in everyday life, is believed to have adversely impacted the mental health of children and adolescents. There is limited research available on the impacts of the pandemic on adults, and even less research is available on the impact of the pandemic on youth, specifically as we navigate the …

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 …

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 …

The Association Between Economic Outcomes And Abortion: A Scoping Review, Larisa Nicole Stephenson

Capstone Experience: Master of Public Health

Background: Abortion access is not just an issue of autonomy, but an economic issue as well. Evidence of the intersectionality of abortion health care and economics has endured due to the financial cascading effects a denial of an abortion, or the inability to access an abortion, has on one’s personal, professional, and economic upward mobility. A change in recent policies impacting access to abortion warrants an updated synthesis examining the relationships between economic outcomes and abortion access for people of reproductive age in the United States (U.S.).

Aim: This scoping review summarizes evidence pertaining to the association …

Embodying Biblical Hospitality : Threshold Moments For God's Welcome In Secular Workplaces, Sandra Lynn Blumanhourst

ATS Dissertations

No abstract provided.

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 …

Associations Between The Timing Of 24 H Physical Activity And Diabetes Mellitus: Results From A Nationally Representative Sample Of The Us Population, Qian Xiao, Qiuyu Feng, Martin K Rutter, Gali Albalak, Heming Wang, Raymond Noordam

Faculty, Staff and Student Publications

Aims/hypothesis: Growing evidence suggests that timing may be an important aspect of physical activity that influences cardiometabolic health. However, the current literature is inconclusive regarding the time of day that physical activity offers the greatest metabolic advantages. We investigated associations between hourly physical activity levels and diabetes mellitus and glycaemic biomarkers in a cross-sectional and nationally representative sample of US adults.

Methods: We studied 7074 adults (mean age 48 years; 52% women) from the National Health and Nutrition Examination Survey (2011-2014). Physical activity was measured by actigraphy. A monitor-independent movement summary (MIMS) unit was used to derive the total activity …

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 …

Cdc’S Core Elements To Promote Diagnostic Excellence, Daniel J Morgan, Hardeep Singh, Arjun Srinivasan, Andrea Bradford, L Clifford Mcdonald, Preeta K Kutty

Faculty, Staff and Students Publications

Nearly a decade after the National Academy of Medicine released the "Improving Diagnosis in Health Care" report, diagnostic errors remain common, often leading to physical, psychological, emotional, and financial harm. Despite a robust body of research on potential solutions and next steps, the translation of these efforts to patient care has been limited. Improvement initiatives are still narrowly focused on selective themes such as diagnostic stewardship, preventing overdiagnosis, and enhancing clinical reasoning without comprehensively addressing vulnerable systems and processes surrounding diagnosis. To close this implementation gap, the US Centers for Disease Control and Prevention (CDC) released the Core Elements of …

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 …

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.