Digital Commons Network^™

Letter Of Concern From The Association Of Academic Chairs Of Emergency Medicine Regarding Acgme Proposed Changes, Richard J. Hamilton, Lance B. Becker, Richard E. Wolfe, D. Adam Algren, Arnold Thomas, Michael Baumann, Ross P. Berkeley, Terrell S. Caffery, Chad Cannon, Theodore J. Corbin, Michael E. Chansky, Harinder S. Dhindsa, Charles L. Emerman, David A. Farcy, Chris Fox, Michael A. Gibbs, Christopher S. Goode, Steven "Andy" Godwin, Dietrich Jehle, David Johnson, Samuel M. Keim, Babak Khazaeni, Barry J. Knapp, Clint Hawthorne, John D. Hoyle Jr., Michael Christopher Kurz, Evan Leibner, Robert Mcnamara, Robert F. Mccormack, Edward A. Michelson, Chadwick Miller, Ashley Norse, Andrew Nugent, Brian J. O'Neil, David T. Overton, Edward A. Panacek, William F. Paolo, Denis R. Pauzé, Amanda L. Perez, Ralph J. Riviello, Scott W. Rodi, Peter S. Pang, Juan A. Gonzalez Sanchez, David P. Sklar, Ben C. Smith, Jeffrey R. Stowell, Marc D. Squillante, J. Jeremy Thomas, Terry Vanden Hoek, Gregory A. Volturo, E. Lea Walters, Thomas E. Wyatt, Donald M. Yealy

Department of Emergency Medicine Faculty Publications

This letter, signed by over 50 academic chairs of emergency medicine, urges the ACGME to reconsider a proposed mandate requiring all emergency medicine residency programs to adopt a four-year training model. The authors argue that current three-year programs are supported by data demonstrating equivalent educational and clinical outcomes compared to four-year formats. They criticize the flawed survey methodology underpinning the proposal, note the loss of milestone-based training flexibility, and highlight the lack of added scholarly or clinical value in the fourth year. The letter also outlines negative consequences for fellowship participation, workforce development, trainee debt, and diversity. The signatories advocate …

Choice Of Law In The American Courts In 2024: Thirty-Eighth Annual Survey, John F. Coyle, William S. Dodge, Aaron D. Simowitz

GW Law Faculty Publications & Other Works

This is the Thirty-Eighth Annual Survey of American Choice-of-Law Cases. It was written at the request of the Association of American Law Schools Section on Conflict of Laws. It is intended as a service to fellow teachers and to students of conflicts law, both inside and outside of the United States. Its purpose remains to inform, rather than to advocate. This Survey covers cases decided by American state and federal appellate courts during 2024.

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 …

Factors Affecting The Quality Of Life Of Residents In The United States: Lessons From Virginia, Daniel K. Pryce

Sociology & Criminal Justice Faculty Publications

Evaluating community members' views about their quality of life is important for improving quality of well-being in society, as most societies are interested in the collective well-being of the people. Moreover, quality-of-life research helps public officials to understand how well they are meeting the needs of the electorate. Using the theoretical framework of Maslow's Developmental Perspective, which argues that the higher the need satisfaction of the majority in a given society the greater the quality of life of that society, I explore the effects of multiple variables on quality of life in the Hampton Roads region of Southeast Virginia (this …

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 …

U.S. And Russian Responses To The Syrian Civil War: A Comparative Analysis, Grace Dewitt

Williams Honors College, Honors Research Projects

The Syrian Civil War was among the most devastating conflicts in the 21st century and was defined by the involvement of various international actors, including the United States (U.S.) and Russia. The Syrian conflict was sparked by the Arab Spring movement. The Asad regime, which controlled the Syrian government at the time of the Arab Spring, reacted violently to the civilian protests and calls for reform. This led to the formation of organized rebel groups, creating a complex and violent civil war. The U.S. and Russia, as well as other international actors such as Turkey and Iran, became involved in …

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 …

Internal Or External: An Exploration Of The United States Police Chief Hiring Process, Kayleigh Walker

Williams Honors College, Honors Research Projects

This paper explores the hiring processes of police chiefs across the United States, focusing on internal versus external hiring practices. The goal of this research was to identify common trends, legislative barriers, and the impact of leadership on the hiring process through historical context, legal analysis, and case studies. The findings suggest that internal hires dominate chief appointments, though external hires are often sought during crises. The paper concludes with recommendations for future research and highlights the need to more fully understand this phenomenon. Understanding the processes and limitations surrounding the appointment of new leadership is critical to reform and …

Twice Sold, Twice Ransomed : Autobiography Of Mr. And Mrs. L. P. Ray, Mrs. Emma J. Ray

Heritage Material

No abstract provided.

The Animated Frontier: Fluctuations Of Power Across Time And Space In Flows Of U.S. And Japanese Animated Media, Kendall Belopavlovich

Dissertations, Master's Theses and Master's Reports

This project critiques the historical and contemporary relationships between the U.S., Japan, and marginalized groups through the lens of animation. The U.S. and Japan share a complex history, from the opening of Japan during the Edo period to events like Pearl Harbor and the atomic bombings, which shaped their present-day alliance. Furthermore, the U.S. and Japan are the central nodes in flows of animation, where both nation states have dominated the global market at various points in animation’s history. Today, Japan's soft power in media is significant, and the flow of power between these nations has influenced media forms and …

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 …

Association Between Parathyroid Hormone Concentration And Incident Atrial Fibrillation In Older Persons With Kidney Failure Initiating Dialysis, Pascale Khairallah, Sai Liu, Maria E Montez-Rath, Kevin F Erickson, Tara I Chang, Wolfgang C Winkelmayer

Faculty, Staff and Students Publications

Introduction: Atrial fibrillation (AF) is common in persons with kidney failure on hemodialysis. In the general population, higher intact parathyroid hormone (iPTH) levels were found to be associated with presence of AF. Whether iPTH associates with AF in patients on hemodialysis is unknown.

Methods: Using merged USRDS-DaVita data (2006-2011), we selected persons aged 67+ years who initiated hemodialysis and survived 120 days. Eligible persons had continuous Medicare A + B coverage from 2 years prior to kidney failure and no diagnosis of AF. Sociodemographic, comorbidity, and clinical information were abstracted from Medicare forms, billing claims, and electronic health records. iPTH …

Impact Of An Electronic Medical Record Quality Improvement Intervention On Helicobacter Pylori Treatment And Eradication Rates In A U.S. Hospital System, Shivani Kastuar, Samanthika Devalaraju, Juan Gomez Cifuentes, Hashem B El-Serag, Mimi C Tan

Faculty, Staff and Students Publications

Background: In this pre- and post-intervention quality improvement (QI) study, the impact of an electronic medical record (EMR) order set for Helicobacter pylori treatment was assessed. We evaluated changes in optimal treatment regimen usage, eradication testing, and successful eradication rates based on the intervention.

Materials and methods: Data were collected from patients within the Harris Health System (Houston, TX) with H. pylori infection. The pre-intervention cohort included patients with a positive H. pylori test from January to February 2022. An EMR order set for H. pylori treatment implemented in May 2022 included optimal treatment recommendations using local antibiotic resistance patterns …

Epidemiology And Longitudinal Course Of Chylomicronemia: Insights From Nhanes And A Large Health Care System, Seyedmohammad Saadatagah, Mohammadreza Naderian, Miriam Larouche, Daniel Gaudet, Iftikhar J Kullo, Christie M Ballantyne

Faculty, Staff and Students Publications

Background: Chylomicronemia is characterized by fasting triglyceride (TG) ≥1000 mg/dL; its longitudinal course is not well studied.

Methods: Using National Health and Nutrition Examination Survey (NHANES) data (1999-2018; n = 21,998), we determined chylomicronemia prevalence and temporal trend. Using Mayo Clinic data (4,524,506 TG measurements for 1,294,044 individuals), we studied the longitudinal course and ascertained persistent chylomicronemia (PC), defined as TG ≥1000 mg/dL in more than half the measurements for individuals with ≥3 measurements. We used logistic regression to assess factors associated with PC.

Results: In NHANES, the prevalence of chylomicronemia was 0.20% overall, with higher prevalence in men (0.32%) …

Sodium-Glucose Cotransporter-2 Inhibitor And Glucagon-Like Peptide-1 Receptor Agonist Discontinuation In Patients With Ckd, L Parker Gregg, Peter A Richardson, Vijay Nambi, Laura A Petersen, Michael E Matheny, Salim S Virani, Sankar D Navaneethan

Faculty, Staff and Students Publications

Key Points:

1. Treatment discontinuation is common among patients with CKD prescribed sodium-glucose cotransporter-2 (SGLT2) inhibitors (discontinued in 37%) or glucagon-like peptide-1 receptor agonists (GLP-1 RA; discontinued in 47%).

2. Discontinuation of SGLT2 inhibitors and GLP-1 RA was associated with recent hospitalizations, Black race, Hispanic ethnicity, and vascular disease.

3. Discontinuation of both agents was associated with death and cardiovascular events.

Background: Little is known about the association of discontinuation of sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RA) with outcomes in patients with CKD.

Methods: We identified adults with CKD stages 3–4 from 2005 to 2022 in the Veterans …

Research For All: Building A Diverse Researcher Community For The All Of Us Research Program, Rubin Baskir, Minnkyong Lee, Sydney J Mcmaster, Jessica Lee, Faith Blackburne-Proctor, Romuladus Azuine, Nakia Mack, Sheri D Schully, Martin Mendoza, Janeth Sanchez, Yong Crosby, Erica Zumba, Michael Hahn, Naomi Aspaas, Ahmed Elmi, Shanté Alerté, Elizabeth Stewart, Danielle Wilfong, Meag Doherty, Margaret M Farrell, Grace B Hébert, Sula Hood, Cheryl M Thomas, Debra D Murray, Brendan Lee, Louisa A Stark, Megan A Lewis, Jen D Uhrig, Laura R Bartlett, Edgar Gil Rico, Adolph Falcón, Elizabeth Cohn, Mitchell R Lunn, Juno Obedin-Maliver, Linda Cottler, Milton Eder, Fornessa T Randal, Jason Karnes, Kitani Lemieux, Nelson Lemieux, Nelson Lemieux, Lilanta Bradley, Ronnie Tepp, Meredith Wilson, Monica Rodriguez, Chris Lunt, Karriem Watson

Faculty, Staff and Students Publications

OBJECTIVES: The NIH All of Us Research Program (All of Us) is engaging a diverse community of more than 10 000 registered researchers using a robust engagement ecosystem model. We describe strategies used to build an ecosystem that attracts and supports a diverse and inclusive researcher community to use the All of Us dataset and provide metrics on All of Us researcher usage growth.

MATERIALS AND METHODS: Researcher audiences and diversity categories were defined to guide a strategy. A researcher engagement strategy was codeveloped with program partners to support a researcher engagement ecosystem. An adapted ecological model guided the ecosystem …

Application Of A Digital Quality Measure For Cancer Diagnosis In Epic Cosmos, Andrew J Zimolzak, Sundas P Khan, Hardeep Singh, Jessica A Davila

Faculty, Staff and Students Publications

Objectives: Missed and delayed cancer diagnoses are common, harmful, and often preventable. We previously validated a digital quality measure (dQM) of emergency presentation (EP) of lung cancer in 2 US health systems. This study aimed to apply the dQM to a new national electronic health record (EHR) database and examine demographic associations.

Materials and methods: We applied the dQM (emergency encounter followed by new lung cancer diagnosis within 30 days) to Epic Cosmos, a deidentified database covering 184 million US patients. We examined dQM associations with sociodemographic factors.

Results: The overall EP rate was 19.6%. EP rate was higher in …

Cervical Cancer Prevention Behaviors In Young Black Women, Angela J Johnson, Monica J Johnson, Juinell B Williams, Emma Muscari, Laura Palmo, Michelle Ruiz, Brianna Bush, Lisa C Campbell

Faculty, Staff and Students Publications

Background: In the United States, Black women have the second highest incidence of cervical cancer (CC) due to high incidence of human papillomavirus (HPV), slow HPV clearance rates, and low receipt of preventive pap smears and vaccines.

Objective: A Black Feminist Thought framework was used to examine how the media portrayal of Black women, racial identity, and familial factors impact CC prevention behaviors among young Black women.

Design: Black women enrolled at a large southeastern university consented and participated in an online mixed-methods survey examining facilitators and barriers to CC prevention behaviors. Quantitative items were analyzed via descriptive statistics, and …

Comparing Guillain-Barré Syndrome Outcomes Between Rural And Urban Hospitals In The United States: A Retrospective Cohort Study, Anudeep Surendranath, Rahul Damani, Anushareddy Muddasani, Anupam Kumar Gupta

Faculty, Staff and Students Publications

Background and purpose: Rural-urban disparities in neurological care have been well documented, but limited data exist regarding Guillain-Barré Syndrome (GBS). This study examines differences in patient demographics, hospital characteristics, and outcomes among GBS admissions to rural versus urban hospitals in the United States.

Methods: Using the 2021 National Inpatient Sample, we conducted a retrospective cohort study of adult hospitalizations with a principal diagnosis of GBS. Hospitals were classified as rural or urban based on U.S. census designations. Multivariate logistic and linear regression models were used to assess associations between hospital location and outcomes, adjusting for demographic, clinical, and hospital-level factors. …

Long-Term Mortality Following Sars-Cov-2 Infection In Rural Versus Urban Dwellers With Autoimmune Or Inflammatory Rheumatic Disease: A Retrospective Cohort Analysis From The National Covid Cohort Collaborative, A Jerrod Anzalone, Lesley E Jackson, Namrata Singh, Maria I Danila, Elizabeth Reisher, Rena C Patel, Jasvinder A Singh

Faculty, Staff and Students Publications

Objective: Autoimmune or inflammatory rheumatic diseases (AIRDs) increase the risk for poor COVID-19 outcomes. Although rurality is associated with higher post-COVID-19 mortality in the general population, whether rurality elevates this risk among people with AIRD is unknown. We assessed associations between rurality and post-COVID-19 all-cause mortality, up to two years post infection, among people with AIRD using a large nationally sampled US cohort.

Methods: This retrospective study used the National COVID Cohort Collaborative, a medical records repository containing COVID-19 patient data. We included adults with two or more AIRD diagnostic codes and a COVID-19 diagnosis documented between April 2020 and …

The War On Knowledge And How Everyone Is A Part Of The Problem: Through The Lens Of Science Communication And The Trump Administration, Aidan D. Valcich

CEG 450 Cultural, Environmental, and Global Studies Capstone

Science communication as an emerging field of study has become increasingly important in the age of the internet and rapid information dissemination. The work of science communication focuses on the complexities of communicating sciences between experts and non-experts such as politicians and laymen. The importance is not only communicating the science but also why everyone, not just the experts, should care. In what has been called the War on Knowledge, there has been an increase in attacks against science and academia. A major example of this is in the United States during both of the presidential terms of Donald Trump. …

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 …

Soviet-American Relations During The Cold War: What Policies And Circumstances Conspired To Unravel The Soviet Empire?, John W. Krey

Dissertations and Theses

The two victorious superpowers of World War II – America and the Soviet Union – conceived and implemented unilateral foreign policies amid an atmosphere of intense hostility and suspicion of each other’s international intentions. Regardless of Moscow’s acquiescence in joining the United Nations and resolving a host of disputes (for example, the Security Council veto) regarding the establishment and operation of the same organization, it threatened to disequilibrate power relations between the US and the Soviet Union in the immediate aftermath of the second world war, which convinced Washington to develop the containment policy, a defensive realist posture for repelling …

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.

Relationship Partners’ Experiences Of Managing Conflict With Individualist And Collectivist Cultural Perspectives: A Reflexive Thematic Analysis, Rebecca Alithia Payan

Department of Conflict Resolution Studies Theses and Dissertations

In the United States, the increasing number of multicultural marriages leads to the individualistic traditional American nuclear family colliding with ideals from a collective culture. This conflict over individualistic and collective nature can lead to martial conflict, including divorce. In this context, this study seeks to answer an important question: How do relationship partners experience managing conflict, considering individualist and collectivist perspectives in the United States? The methodology utilized the Medium-Q of Reflexive Thematic Analysis of data gathered from qualitative open-ended interview questions and a brief survey. Findings reveal engaging themes, leading us to understand that individualism and collectivism influence …

Interventions Designed To Increase Scholarly Activity And Achieve Promotion Among Primarily Junior Clinical Faculty In The United States: A Scoping Review, Heather A. Billings, Ashlee Mills Duffy, Gary L. Beck Dallaghan, Emily Glenn, Eric S. Peeples, Matthew R. Sandbulte, Jason F. Shiffermiller, Carrie Valenta, Bethany Lowndes, Jana L. Wardian

Journal Articles: Hospital Medicine

BACKGROUND: For many U.S. academic physicians, direct patient care is the primary focus of daily work and the most important professional responsibility. Concurrently, some degree of scholarly activity is often required for career advancement. Junior clinical faculty often face challenges that limit their success in this area such as heavy clinical workloads or other time constraints, a lack of personal expertise or experience, mentorship, and institutional infrastructure. Support systems and faculty development interventions may mitigate these challenges and contribute to increased academic productivity and promotion. The objective of this study was to perform a scoping review of literature on strategies …

Dental Care Trajectories Among Formerly Incarcerated Older Adults In The United States, Alexander Testa, Luis Mijares, Mateus Renno Santos, Vahed Maroufy, Dylan B Jackson, Rafael Samper-Ternent, Rahma Mungia, Ana C Neumann

Faculty, Staff and Student Publications

A growing body of research has documented an association between prior incarceration and lower dental care use, yet the longitudinal impact of prior incarceration on dental care patterns over time among older adults remains unexplored. This study aims to investigate whether prior incarceration is associated with differing trajectories of dental care use among older adults in the United States. Data were drawn from the 2012-2020 waves of the Health and Retirement Study (HRS), a nationally representative longitudinal survey of older adults in the United States (n =  5,893). Group-based trajectory modeling was used to estimate dental care use patterns over …

Risk Of Post-Acute Symptoms Among Adults: A Comparison Study Of Severe Covid-19, Pneumonia, And Influenza, Caroline M Schaefer, Trudy Millard Krause, George L Delclos, Raymond S Greenberg

Faculty, Staff and Student Publications

Background: A retrospective cohort study was undertaken to assess the relationship between initial disease severity of COVID-19 and the risk of post-acute symptoms. The COVID-19 cohort was compared against influenza and pneumonia cohorts to assess whether risk of post-acute symptoms differed.

Methods: Administrative health claims data were obtained for commercially insured and Medicare Advantage covered adults (≥ 18 years) with symptomatic laboratory-confirmed COVID-19 diagnosed in 2020 (n=121,205), and similar cohorts of influenza (n=20,844) and pneumonia (n=29,052) patients diagnosed prior to the pandemic. Post-acute symptoms were assessed at four weeks, three and six months following initial diagnosis.

Results: Among the patients …