Digital Commons Network^™

Associations Between Deficit Accumulation Frailty And Baseline Markers Of Lifestyle In The Us Pointer Trial, Mark A Espeland, Yitbarek N Demesie, Kayloni Olson, Samuel N Lockhart, Sarah E Tomaszewski Farias, Maryjo L Cleveland, Christy C Tangney, Lucia Crivelli, Heather M Snyder, Michele K York, Laura D Baker, Rachel A Whitmer, Rena R Wing, Katelyn R Garcia, Kathryn E Callahan

Faculty, Staff and Students Publications

BACKGROUND: Multidomain lifestyle interventions may have the potential to slow biological aging as captured by deficit accumulation frailty indices. We describe the distribution and composition of the 49-component frailty index developed by the U.S. POINTER clinical trial team of investigators and assess its cross-sectional associations with sociodemographic factors and markers chosen to be representative of behaviors targeted by the trial's multidomain interventions.

METHODS: We draw baseline data from the 2 111 volunteers enrolled in U.S. POINTER who were ages 60-79 years and at increased risk for cognitive decline. Frailty components were grouped into 9 domains. Associations that frailty index scores …

Cancer-Related Health Behaviors During The Covid 19 Pandemic In Geographically Diverse Samples Across The Us, Breanna B Greteman, Bettina F Drake, Kia L Davis, Et Al.

2020-Current year OA Pubs

BACKGROUND: The COVID-19 pandemic involved business closures (e.g., gyms), social distancing policies, and prolonged stressful situations that may have impacted engagement in health behaviors. Our study assessed changes in cancer-related health behaviors during the pandemic, specifically physical activity, fruit/vegetable intake, smoking/tobacco use, and alcohol consumption.

METHODS: Eight cancer centers administered mailed/web-based/telephone surveys between June 2020 and March 2021. Surveys assessed demographics, perceptions on social distancing, and self-reported changes of behaviors (less/same/more) associated with cancer prevention or risk, e.g., physical activity, fruit/vegetable intake, tobacco/smoking use, and alcohol consumption. Descriptive analyses and logistic regression models assessed association of variables with behavior change. …

Us Military Veterans’ Perceived Concordance With Their Providers Regarding Persistent Physical Symptoms Prospectively Predicts Satisfaction With Care And Adherence To Care Plans, L Alison Phillips, Laura M Lesnewich, Katharine Bloeser, Yong Lin, Rachel L Boska, Justeen K Hyde, Peter J Bayley, Helena K Chandler, Matthew J Reinhard, Susan L Santos, Rachel Stewart, Drew A Helmer, Lisa M Mcandrew

Center for Medical Ethics and Health Policy Staff Publications

Background: Medically unexplained, persistent physical symptoms and syndromes are commonly seen in primary care. These are debilitating for patients and difficult to treat, causing frustration for patients and providers.

Purpose: This study investigates how well US military veterans with multiple persistent physical symptoms (PPS), called Gulf War illness (GWI), agree with their healthcare providers about their illness. This agreement, called perceived concordance, is hypothesized to influence veterans' satisfaction with care, adherence to care plans, and disability levels.

Methods: Participants were 230 veterans with GWI deployed to the 1990-1991 Gulf War who were recruited from Veteran Affairs primary care and War …

Covid-19 Pandemic And Racial And Ethnic Disparities In Long-Term Nursing Home Stay Or Death Following Hospital Discharge, Laurent G Glance, Karen E Joynt Maddox, Patricia W Stone, Jingjing Shang, E Yoko Furuya, Ashley M Chastain, Ji Won Lee, Bridget Morse-Karzen, Andrew W Dick

2020-Current year OA Pubs

IMPORTANCE: Long-term nursing home stay or death (long-term NH stay or death), defined as new long-term residence in a nursing home or death following hospital discharge, is an important patient-centered outcome.

OBJECTIVE: To examine whether the COVID-19 pandemic was associated with changes in long-term NH stay or death among older adults with sepsis, and whether these changes were greater in individuals from racial and ethnic minoritized groups.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used patient-level data from the Medicare Provider Analysis and Review File, the Master Beneficiary Summary File, and the Minimum Data Set. Community-dwelling individuals aged at least …

Factors Impacting Undergraduate Student Use Of Mental Health Care In The U.S. And France, Samantha Lamontagne

CISLA Senior Integrative Projects

No abstract provided.

“God’S Image Carved In Ebony” : African-American Women In The Holiness Movement, Robert A. Danielson

Academic Books

No abstract provided.

Lower Electronic Health Record Adoption And Interoperability In Rural Versus Urban Physician Participants: A Cross-Sectional Analysis From The Cms Quality Payment Program, Alfred J. Anzalone, Carol R. Geary, Ran Dai, Shinobu Watanabe-Galloway, James C. Mcclay, James Campbell

Journal Articles: Epidemiology

BACKGROUND: The Health Information Technology for Economic and Clinical Health Act of 2009 introduced the Meaningful Use program to incentivize the adoption of electronic health records (EHRs) in the U.S. This study investigates the disparities in EHR adoption and interoperability between rural and urban physicians in the context of federal programs like the Medicare Access and CHIP Reauthorization Act of 2015 and the 21st Century Cures Act.

METHODS: A cross-sectional analysis was conducted using the 2021 Quality Payment Program Experience Report Public Use File to compare EHR adoption and Promoting Interoperability scores (PISs) between urban and rural physician participants. Data …

Abundance And Other Food Fixations, Margot J. Pollans

Elisabeth Haub School of Law Faculty Publications

Although most people in the United States no longer devote the majority of their time to food production, processing, and distribution, food remains a daily fixation. This Article explores three driving food fixations--abundance, thinness, and health--and situates each against an inverse fear--scarcity, fatness, and illness, respectively. Mapping these threats onto U.S. food policy, this Article examines, among other policy arenas, food waste policy, nutrition and health claim labeling law, and food additive regulations. Across food policy, these fixations feed what this Article calls the “politics of abundance.” This politics helps to insulate the food industry from deeper systemic reform aimed …

Cronyism In Creating Chronic Disease—A Path To Food Justice, Martha Leonard

St. Thomas Law Review

Central to this discussion is a quote often attributed to the ancient Greek physician Hippocrates: “Let food be thy medicine, and medicine be thy food.” Today, physicians recognize the crucial role of diet in maintaining good health and preventing chronic disease, but U.S. laws fail to reflect this understanding. The health field has seen significant progress in scientific research on pathology; however, nutritional research presents a challenging and contradictory landscape. Corporate influence in scientific research leads to a lack of consensus on the most optimal diet for promoting general health, presenting a challenge for policymaking. The dark reality is that …

The Role Of Mentoring In Combating Racism And Sexism In Higher Education As A Blueprint For Other Historical Institutions In The United States, Michelle R. Gherardi

West Chester University Doctoral Projects

Racism and sexism create a bottleneck to advancement for women in higher education.

This qualitative study and dissertation investigate the role of mentoring in combating racism and sexism in higher education in the United States as a blueprint for other historical institutions. Twenty-six women of color in four categories (presidents/provosts/chancellors, deans of law and medical schools, vice presidents of diversity, equity, and inclusion/student affairs, and graduate students) of higher education were interviewed to explore their experiences with racism, sexism, and mentor relationships. Findings demonstrate all but one participant (96%) disclosed racial victimization in higher education, all participants (100%) disclosed sexist …

Addressing The Challenges Of A Catholic Parish Elementary School With Systemic Design Problem Solving, Alfred E. Bradley

Full-Text Theses & Dissertations

For more than a decade the repeated use of conventional analytic thinking and linear strategic planning approaches produced little effective progress or solutions for the many ongoing and emerging problems of St. Laurentius Catholic School, a parish elementary school within the Archdiocese of Philadelphia. Indeed, many in the community believed that their distressing pathway characterized by continued differing perceptions among stakeholders, resource limitations and lack of autonomy were leading the school to closure. When a new clerical leader who was also a Doctor of Management in Strategic Leadership student was assigned, however, he suggested a novel approach. By reframing the …

A Comparative Analysis Of Third-Party Litigation Funding In The United States And The United Kingdom, Gary Myers

Saint Louis University Law Journal

Third-Party Litigation Funding (“TPLF”), which is also known as litigation finance, involves a financial arrangement in which a third party provides funding to support the plaintiff’s pursuit of a civil lawsuit. The third party, in return, receives a portion of the proceeds if the litigation is successful. Like a contingent-fee agreement, this type of funding model enables a party to bring a lawsuit even if that party does not have the resources to pay the up-front costs of the litigation. The important difference is that the litigation funder is not counsel to a party in the case, and that TPLF …

Informal Caregivers Connecting On The Web: Content Analysis Of Posts On Discussion Forums, Michelle L. Foster, Chinenye Egwuonwu, Erin Vernon, Mohammad Alarifi, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

Background: About 53 million adults in the United States offer informal care to family and friends with disease or disability. Such care has an estimated economic value of US $600 million. Most informal caregivers are not paid nor trained in caregiving, with many experiencing higher-than-average levels of stress and depression and lower levels of physical health. Some informal caregivers participate in web-based forums related to their caregiving role.

Objective: This study aimed to explore how informal caregivers use easy-to-access caregiving web-based forums, including the types of information they share and seek from others. It also aimed to gain insights into …

An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.

METHODS: The Medical Expenditure Panel Survey data (2010-2021) …

A Self-Fulfilling Prophecy: Realism In U.S. Foreign Policy, Olivia M. Licata

CMC Senior Theses

This paper examines the influence of realist theory on U.S. foreign policy from 1776 to 2025. Through a temporal analysis of policy across three international power systems – multipolarity, bipolarity, and unipolarity – this paper determines that U.S. foreign policymakers follow realist prescriptions for state behavior given their perception of the United States’ status within the international balance of power system. As a result, the U.S. foreign policy has become rooted in realist assumptions and constrained to realism-prescribed behavior, which will ultimately lead to hegemonic decline. This paper calls for the reexamination of realist influences on foreign policy decision-making.

Social Anxiety, Negative Affect, And Hearing Difficulties In Adults, Katrina Kate S. Mcclannahan, Sarah Mcconkey, Julia M Levitan, Thomas L Rodebaugh, Jonathan E Peelle

2020-Current year OA Pubs

Subjective ratings of communication function reflect both auditory sensitivity and the situational, social, and emotional consequences of communication difficulties. Listeners interact with people and their environment differently, have various ways of handling stressful situations, and have diverse communication needs. Therefore, understanding the relationship between auditory and mental health factors is crucial for the holistic diagnosis and treatment of communication difficulty, particularly as mental health and communication function may have bidirectional effects. The goal of this study was to evaluate the degree to which social anxiety and negative affect (encompassing generalized anxiety, depression, and anger) contributed to subjective communication function (hearing …

Cluster Randomized Multilevel Intervention For Promoting Physical Activity In Rural Communities, Alan M Beck, Natalicio Serrano, Dixie Duncan, Amy A Eyler, Amanda Gilbert, Fatemeh Naghiloo, Rodrigo Reis, Rachel G Tabak, Ross C Brownson

2020-Current year OA Pubs

INTRODUCTION: Rural areas of the United States have lower levels of physical activity (PA) as compared to their urban and suburban counterparts, leading to higher levels of chronic diseases. The objective of the study was to increase PA in rural communities via a multilevel intervention.

METHODS: We implemented a cluster randomized controlled trial of a community-based multilevel PA intervention between 2019 and 2022 in 14 rural communities. The intervention consisted of (1) text messaging (i.e., individual level), (2) encouragement of walking groups (i.e., interpersonal level), and (3) community-based marketing (i.e., community level).

RESULTS: Participants meeting the 2018 PA guidelines for …

Perceptions Of Anti-Racism Efforts And Mental Health Among Students In Higher Education In The United States, Hans Oh, Nicole R Karcher, Megan Besecker, Jordan E Devylder, Karen D Lincoln

2020-Current year OA Pubs

BACKGROUND: Anti-racism efforts are imperative for campus communities, yet little is known about whether perceiving their presence on campuses relates to a range of mental health outcomes among students.

METHODS: We analyzed data from the Healthy Minds Study 2020-2021 (

RESULTS: Individuals who disagreed that their schools combatted racism in their campus communities had significantly greater odds of mental health problems (depression, anxiety, psychotic experiences, suicidal ideation, suicide plan, suicide attempt, perceived need for help, and loneliness), and lower odds of flourishing when compared with those who strongly agreed with the statement. For most outcomes, we observed an apparent dose-response …

The Cross-Sectional Association Between State-Level Public Health Funding Per Capita And Physical Health Among Adults In The United States, Stephen Hunter, Sze Y. Liu, Daniel M. Cook, Kia L. Davis, Brendan T. Smith, Roman Pabayo

2020-Current year OA Pubs

OBJECTIVES: This study examined the association between state-level public health funding per capita and the odds of poor physical health.

STUDY DESIGN: Cross-sectional.

METHODS: Data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) were used. Participants' self-reported physical health was reported using the CDC Healthy Days Core Module. State-level public health funding per capita was obtained from the State Health Access Data Assistance Center website. Multilevel logistic regression was used to adjust for self-reported individual-level characteristics and state-level characteristics from the 2018 American Community Survey. We also tested whether household income or education attainment moderated any observed associations.

RESULTS: …

Exploring Psychological Impacts, Coping, And Conflict Resolution Of Transnationalism On Parent-Child Relationships, Sally Sanchez

PCOM Psychology Dissertations

The number of immigrants migrating to the United States has increased over the past 30 years. Many of these immigrants leave behind their spouses and children, creating transnational families. Researchers have focused on the experiences of transnational families, but there is a need for continued research to further explore the psychological impact of separation and reunification. The purpose of this study was to identify the possible psychological impact of the separation and reunification process experienced by transnational families, and the coping strategies used during the process. This study used a qualitative design to explore the experiences of transnational families who …

Guide To The Aaron Horne Collection, Columbia College Chicago

CBMR Collection Guides / Finding Aids

The Aaron Horne collection contains scores collected from Black composers, some of which are inscribed by the composer, spanning from 1960 to 1987.

Cascadian Independence: A Rising Movement For An Independent Northwest Amid Growing Regionalism In The United States And Canada, Elias V. Savitt

Capstone Showcase

Because of the Civil War, secession is a sore topic to many Americans. However, the idea of secession has not been confined to this notorious example. My essay focuses on the idea that Oregon, Washington, and British Columbia could be the basis for a unified autonomous or even independent entity called Cascadia. First, I discuss the history of secession as such, and the arguments that have been made pro and con as to its legality and under what situations. I then situate this within the histories of the United States and Canada and the phenomena of regionalism and independent movements. …

Selling Egg-Cellence: An Exploration Of Commercial Oocyte Donation And Genetic Determinism In 21st Century America, Abigail C. Oswald

Scripps Senior Theses

This thesis examines the impact of genetic determinism on commercial egg donation in the United States. Through critical analysis of social media advertisements, online forums, and interviews, it argues that reductionist, genetically deterministic thinking drives the commodification of oocytes. Fertility agencies exploit assumptions about heritable traits (health, ethnicity, intelligence) to market "desirable" donors, influencing intended parents' choices and compensation hierarchies. Then the research explores how these same ideas shape perceptions of familial closeness in donor-conceived individuals and their parents, revealing mixed feelings surrounding genetic ties. This study highlights the complex interplay of biology, technology, and social constructs in defining family …

From Curiosity To Controversy: American Perception Of Japanese Immigrants, 1853-1924, Chloe Elizabeth Curbelo

Theses and Dissertations

In the mid-nineteenth century, as the United States reached the Pacific through westward expansion, Asia emerged as a new stage for commerce and power. Japan, long isolated under the Tokugawa shogunate, became an object of American fascination when forced into relations. While early depictions cast Japan as an exotic yet uncivilized nation in need of Western guidance, Japan’s rapid modernization and the growing number of Japanese immigrants on the West Coast transformed curiosity into anxiety. My paper traces this evolution of perception from 1850 to 1924, arguing that shifting views of Japan and its people reflected America’s ethnocentric notions of …

Use Of Clinical Competency Examinations For Dental Hygiene Licensure, Jocelyn D. Weinhagen, Tara L. Newcomb, Brenda T. Bradshaw

Dental Hygiene Faculty Publications

Dental hygiene licensure with a clinical competency examination (CCE) using a live patient has been required by state licensing boards since 1929. Clinical competency examinations were initially used when dental training was poorly developed, non-standardized, and largely based on the apprenticeship model. Currently, Canada and the state of California have removed the requirement of passing a CCE for dental hygiene licensure, provided certain requirements have been met. Dentistry is the last health care profession to mandate that graduates pass a CCE. The vast majority of dental licensing boards continue to require that third party testing agencies validate the clinical skills …

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

The Potential For Albedo-Induced Climate Mitigation Using No-Till Management In Midwestern U.S. Croplands, Xian Wang, Mallory Barnes, Landon Yoder, Christopher A. Williams, Jennifer Tank, Todd Royer, Shellye Suttles, Kim Novick

Geography

No-till management is often recognized for its environmental and economic benefits, but its potential to reduce climate warming is still uncertain. Beyond ongoing debate over its effects on soil carbon storage, no-till also leaves plant residue on the surface, which can reflect more sunlight. This increase in surface reflectivity, called albedo, may help mitigate climate change by reducing the energy absorbed by the land. Here, we assessed this climate benefit of no-till across the U.S. Corn Belt using conservation survey records, county-level tillage data, and satellite observations. We found that no-till increased land surface brightness during the dormant season, reducing …

Academic Proposals For Combating Authoritarian Populism In The United States: A Review Of The Social Science Literature, Emily A. Padgett

Honors Undergraduate Theses

Throughout American history, the idea of “democracy” has been taught at a base level throughout the school system. While we have been taught what a democracy is, it is rare to understand what a democracy isn’t. There have been threats identified by academics to our democracy throughout different eras in history. Now, in our current political climate, all main threats to democracy have been enacted at once.

This thesis serves as a literature review of a handful of academics and their idea of what the main threats to democracy are. There will be references to different perspectives and schools of …

Partisan Divides In Environmental Spending Attitudes: A Two-Level Hierarchical Analysis, 1973-2022, Jordan Lipner

Honors Undergraduate Theses

Public attitudes toward environmental spending have become increasingly divided along party lines, with sharp shifts over the past five decades. This thesis updates and expands on Johnson and Schwadel’s 2019 study by applying a two-level hierarchical linear model to General Social Survey data updated to include data from 2015-2022, capturing how political affiliation, education, race, and economic context interact with broader political and economic contexts to shape environmental attitudes over time.
The results show that political affiliation remains the strongest and most reactive predictor of environmental spending attitudes. Republican respondents are significantly more likely to oppose environmental spending, especially under …

Cannabis Use Among Cancer Survivors And The Impact On Cancer-Related Pain, Tiffanie A. Vargas

Theses and Dissertations

With a growing population of older adult cancer survivors—many of whom experience cancer-related pain—interest in medical cannabis as a pain management strategy has increased. This secondary analysis used data from the 2022 U.S. Behavioral Risk Factor Surveillance System (BRFSS) to examine cannabis use behaviors among cancer survivors and assess associations with cancer-related pain. The study had three aims: (1) to describe 30-day cannabis use (prevalence, intensity, and administration routes) by chronic health condition and cancer diagnosis, focusing on non-melanoma skin cancer, melanoma, and other cancers; (2) to compare demographics, health characteristics, and tobacco use by cannabis use status among cancer …