Digital Commons Network^™

Improving Transition Services For Students With Intellectual Disability At Giles County High School, Catherine Claire Paul

Doctoral Dissertations and Projects

The purpose of this project was to improve transition services available to high school students with intellectual disabilities in Giles County, Tennessee. The problem was there is a lack of consistent transition planning in Giles County, Tennessee. The central research question was, “How can transition services for students with intellectual disabilities be improved at Giles County High School in Giles County, Tennessee?” This project was conducted through interviews with administrators and educators, surveys of parents, and a document analysis of available information in Giles County for transition services. The information was then coded and analyzed for a mixed-methods research design. …

African American Spirituality, Marital Satisfaction, And Internalized Racial Oppression, Tiara Monique Mcintosh

Doctoral Dissertations and Projects

Internalized racism was the topic of the current study. The emphasis of this study was on how African Americans deal with cultural racism and how it impacts their daily lives. One example of early internalized racism is Black teenage girls' dissatisfaction with their skin tones (Pyke, 2010). Internalized racial prejudice manifests itself in the adoption of American ideals of beauty, the devaluation of one's community, and the adoption of unhealthy habits (Campon & Carter, 2015). African Americans are a mixed group of people of many different backgrounds. The historical and contemporary links that link African countries American couples include marital …

Effective Leadership In The Us Fire Service Requires Training Programs Geared Toward Ongoing Leader Development For All Personnel, Shelley Marie Wheeler

Doctoral Dissertations and Projects

The purpose of this qualitative phenomenological study was to explore the experiences of 50 personnel from four Metro Washington D.C. area fire departments, 23 firefighters and 27 officers, at varying experience levels and ranks to determine if there was leadership training throughout a firefighter’s career that enhanced their leader development, improving teamwork needed to achieve operational objectives. Based on the analysis of the data retrieved from the participants, the proposed research problem does exist within all four departments: leadership training may not be provided at varying levels of a firefighter's career within Metro Washington D.C. area fire departments which could …

Why Arkansas Act 710 Was Upheld, And Will Be Again, Mark Goldfeder

Scholarly Works

The recent Eighth Circuit ruling in Arkansas Times, LP v. Waldrip, a lawsuit revolving around an Arkansas state anti-discrimination bill, has been widely misreported and generally misunderstood. While the decision was actually very narrow, case-specific, and ripe for review, the misleading information presented to the public has led to speculation and fear that similar anti-discrimination legislation in dozens of other states might somehow be constitutionally deficient. This essay will clarify what actually happened in the Arkansas case, and explain why legislators and advocates around the country do not have to worry about this very limited opinion affecting the legality of …

Fielding Vaccines-Challenges And Opportunities In Outbreaks, Complex Emergencies, And Mass Gatherings, Laura J. Fischer, Robert C. Rains, Sherry M. Brett-Major, Mikiko Senga, Debra Holden, David Brett-Major

Journal Articles: Epidemiology

With the recent COVID-19 pandemic, the importance of vaccine development, distribution, and uptake has come to the forefront of the public eye. Effectively fielding vaccines during an emergency-whether that emergency is a result of an infectious disease or not-requires an understanding of usual vaccine-related processes; the impact of outbreak, complex emergencies, mass gatherings, and other events on patients, communities, and health systems; and ways in which diverse resources can be applied to successfully achieve needed vaccine uptake. In this review, both the emergency setting and briefly vaccine product design are discussed in these contexts in order to provide a concise …

Uncertainty, Scarcity And Transparency: Public Health Ethics And Risk Communication In A Pandemic, Abigail Lowe, Teck Chuan Voo, Lisa M. Lee, Kelly K. Dineen Gillespie, Christy Feig, Alva O. Ferdinand, Seema Mohapatra, David Brett-Major, Matthew K. Wynia

Journal Articles: Epidemiology

Communicating public health guidance is key to mitigating risk during disasters and outbreaks, and ethical guidance on communication emphasizes being fully transparent. Yet, communication during the pandemic has sometimes been fraught, due in part to practical and conceptual challenges around being transparent. A particular challenge has arisen when there was both evolving scientific knowledge on COVID-19 and reticence to acknowledge that resource scarcity concerns were influencing public health recommendations. This essay uses the example of communicating public health guidance on masking in the United States to illustrate ethical challenges of developing and conveying public health guidance under twin conditions of …

Qualitative Analysis Of Cancer Care Experiences Among Rural Cancer Survivors And Caregivers, Kendra L. Ratnapradipa, Jordan Ranta, Krishtee Napit, Lady Beverly Luma, Tamara Robinson, Danae Dinkel, Laura Schabloske, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

PURPOSE: Rural (vs urban) patients experience poorer cancer outcomes and are less likely to be engaged in cancer prevention, such as screening. As part of a community needs assessment, we explored rural cancer survivors' and caregivers' experiences, perceptions, and attitudes toward cancer care services.

METHODS: We conducted 3 focus groups (N = 20) in Spring 2021 in rural Nebraska.

FINDINGS: Three patterns of cancer diagnosis were regular care/screening without noticeable symptoms, treatment for symptoms not initially identified as cancer related, and symptom self-identification. Most participants, regardless of how diagnosis was made, had positive experiences with timely referral for testing (imaging …

Severe Acute Respiratory Infection-Preparedness: Protocol For A Multicenter Prospective Cohort Study Of Viral Respiratory Infections, Radu Postelnicu, Avantika Srivastava, Pavan K. Bhatraju, Mark M. Wurfelc, George L. Anesi, Martin Gonzalez, Adair Andrews, Karen Lutrick, Vishakha K. Kumar, Timothy M. Uyeki, Perren J. Cobb, Leopoldo N. Segal, David Brett-Major, Janice M. Liebler, Christopher J. Kratochvil, Vikramjit Mukherjee, M. Jana Broadhurst, Richard Lee, David Wyles, Jonathan E Sevransky, Laura Evans, Douglas Landsittel

Journal Articles: Epidemiology

OBJECTIVES: Respiratory virus infections cause significant morbidity and mortality ranging from mild uncomplicated acute respiratory illness to severe complications, such as acute respiratory distress syndrome, multiple organ failure, and death during epidemics and pandemics. We present a protocol to systematically study patients with severe acute respiratory infection (SARI), including severe acute respiratory syndrome coronavirus 2, due to respiratory viral pathogens to evaluate the natural history, prognostic biomarkers, and characteristics, including hospital stress, associated with clinical outcomes and severity.

DESIGN: Prospective cohort study.

SETTING: Multicenter cohort of patients admitted to an acute care ward or ICU from at least 15 hospitals …

Western Region Health & Wellness Programming Efforts: Qualitative Results From A Three-Part Listening Session, Cris L. Meier, Lily Ward, Anders Van Sandt, Sue Schneider, Riana Gayle

All Current Publications

The purpose of this project was to understand the programming efforts and experiences of Extension professionals in the Western Region of the United States. The Health and Wellness Working Group team held a series of listening sessions with a closed cohort of Extension professionals, hoping to learn from each other while also building the foundation for future collaborations and conversations about health and wellness programing in the western region.

The objectives were to understand: (1) the state of health and wellness work in the western region, including the gaps and challenges, (2) the programs that currently exist and ways that …

The 2022 Utah College Sexual Behavior Survey: Qualitative Report, Monti Douglas, Cris Meier, Julie Gast, Melissa Ferguson

All Current Publications

Purpose: The purpose of the 2022 Utah College Sexual Behavior Survey project was to use retrospective sexual behavior and education measures to gain a better understanding of the sexual behaviors and perceptions of sex education of Utah youth by asking students aged 18-21 years old about their sexual behaviors as youth. This supplement provides additional qualitative research that aids in understanding our quantitative findings.

Measures: The qualitative survey questions represented three topical areas. These areas included questions about consent, sex education satisfaction, and student’s parental preference when discussing topics about sex and health.

Method: A one-time survey …

Abduction And Feminine Expression In Sir Orfeo, Ruth Worgan

Medieval Feminist Forum: A Journal of Gender and Sexuality

This article provides a new, queer feminist reading of Sir Orfeo, in which Dame Heurodis facilitates her abduction by the Fairy King in order to destabilize the patriarchal possession of her body. Using Luce Irigaray’s work on the exchange of women between men, I discuss Heurodis’s value as a commodity and how she extricates herself from this position. Irigaray proposes that the primeval patriarchy created an exclusive between-men discourse within society, a consequence of which is the consuming masculine gaze. I consider how the silencing of the feminine is akin to the silence of the natural world, and how …

The Long Shadow Of United States V. Rosenberg: A Biographical Perspective On The Hon. Irving Robert Kaufman, Rodger D. Citron

Scholarly Works

No abstract provided.

Current State Of The Art In Hypoplastic Left Heart Syndrome, Aditya K Birla, Sunita Brimmer, Walker D Short, Oluyinka O Olutoye, Jason A Shar, Suriya Lalwani, Philippe Sucosky, Anitha Parthiban, Sundeep G Keswani, Christopher A Caldarone, Ravi K Birla

Faculty, Staff and Students Publications

Hypoplastic left heart syndrome (HLHS) is a complex congenital heart condition in which a neonate is born with an underdeveloped left ventricle and associated structures. Without palliative interventions, HLHS is fatal. Treatment typically includes medical management at the time of birth to maintain patency of the ductus arteriosus, followed by three palliative procedures: most commonly the Norwood procedure, bidirectional cavopulmonary shunt, and Fontan procedures. With recent advances in surgical management of HLHS patients, high survival rates are now obtained at tertiary treatment centers, though adverse neurodevelopmental outcomes remain a clinical challenge. While surgical management remains the standard of care for …

The Prevalence And Spectrum Of Reported Incidental Adrenal Abnormalities In Abdominal Computed Tomography Of Cancer Patients: The Experience Of A Comprehensive Cancer Center, Aiham Qdaisat, Sara Bedrose, Obadah Ezzeldin, Ahmed W Moawad, Sai-Ching J Yeung, Khaled M Elsayes, Mouhammed Amir Habra

Faculty, Staff and Students Publications

BACKGROUND: The increasing use of computed tomography (CT) has identified many patients with incidental adrenal lesions. Further evaluation of these lesions is often dependent on the language used in the radiology report. Compared to the general population, patients with cancer have a higher risk for adrenal abnormalities, yet data on the prevalence and type of incidental adrenal lesions reported on radiologic reports in cancer patients is limited. In this study, we aimed to determine the prevalence and nature of adrenal abnormalities as an incidental finding reported on radiology reports of cancer patients evaluated for reasons other than suspected adrenal pathology. …

Rev-Erb Is Essential In Cardiac Fibroblasts Homeostasis, Xiaokang Luo, Shiyang Song, Lei Qi, Chih-Liang Tien, Hui Li, Weiyi Xu, Theodore Lemuel Mathuram, Thomas Burris, Yuanbiao Zhao, Zheng Sun, Lilei Zhang

Faculty, Staff and Students Publications

REV-ERB agonists have shown antifibrotic effects in the heart and other organs. The function of REV-ERB in the cardiac fibroblasts remains unstudied. Here, we characterize the functional difference of REV-ERB in mouse embryonic fibroblasts and cardiac fibroblasts using genetic deletion of REV-ERBα and ß in vitro. We show that REV-ERB α/β double deleted cardiac fibroblasts have reduced viability and proliferation, but increased migration and myofibroblasts activation. Thus, REV-ERB α/β has essential cell-autonomous role in cardiac fibroblasts in maintaining them in a healthy, quiescent state. We also show that existing REV-ERB agonist SR9009 strongly suppresses cardiac fibroblasts activation but in …

Evaluation Of The Clinical Effectiveness Of Modified Sacrospinous Ligament Fixation, Yuanyuan Lyu, Huafeng Ding, Ying Zhang, Suhua Shi, Jin Ding, Chengcheng Zhu, Xiaoming Guan, Guantai Ni, Yonghong Luo

Faculty, Staff and Students Publications

OBJECTIVE: To describe the surgical techniques and short-term outcomes for 50 cases of modified sacrospinous ligament fixation

METHODS: 100 patients with pelvic organ prolapse (stage III or stage IV based on POP-Q staging) from January 2018 to January 2020 were retrospectively analyzed. Among them, 50 patients received modified sacrospinous ligament fixation via the anterior vaginal wall path for pelvic organ prolapse (mSSLF group), while the other 50 patients received pelvic reconstruction using T4 mesh (T4 group). Operative time, blood loss, postoperative POP-Q score, length of the hospital stay, complications, and postoperative pain were compared between the two groups.

RESULTS: The …

Lipid Dysfunction And Adrenomedullin Expression In Omental Versus Subcutaneous Adipose Tissues In Diabetic Pregnancies, Yuanlin Dong, Ancizar Betancourt, Michael A Belfort, Chandrasekhar Yallampalli

Faculty, Staff and Students Publications

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy but the underlying mechanism remains obscure. The aims of this study are to examine if omental adipose tissue (OMAT) and subcutaneous AT (SCAT) differentially express proinflammatory and lipid metabolic adipokines, and if so, whether their regional differences have implications on lipid metabolism in GDM. Paired samples of OMAT and SCAT were excised from pregnant women in scheduled Cesarean sections with non-obese (NOBS), obese (OBS) and GDM. The results showed that the mRNA of monocyte chemoattractant protein (MCP)-1, macrophage marker CD68, and cytokines IL-6, IL-8, and TNF-α are …

Integrated Microtia And Aural Atresia Management, Mai Thy Truong, Yi-Chun Carol Liu, Jocelyn Kohn, Sivakumar Chinnadurai, David A Zopf, Melissa Tribble, Paul B Tanner, Kathleen Sie, Kay W Chang

Faculty, Staff and Students Publications

OBJECTIVES: To present recommendations for the coordinated evaluation and management of the hearing and reconstructive needs of patients with microtia and aural atresia.

METHODS: A national working group of 9 experts on microtia and atresia evaluated a working document on the evaluation and treatment of patients. Treatment options for auricular reconstruction and hearing habilitation were reviewed and integrated into a coordinated care timeline.

RESULTS: Recommendations were created for children with microtia and atresia, including diagnostic considerations, surgical and non-surgical options for hearing management and auricular reconstruction, and the treatment timeline for each option. These recommendations are based on the collective …

The Texas Collaborative Center For Hepatocellular Cancer: Reducing Liver Cancer Mortality In Texas Through Coordination, Collaboration And Advocacy, Ariel C Harrison, Fasiha Kanwal, Sumeet K Asrani, Aaron P Thrift, Chris I Amos, Maria L Jibaja-Weiss, Jane R Montealegre, Jessica P Hwang, Amit G Singal, Hashem B El-Serag

Faculty, Staff and Students Publications

Texas has the highest age-adjusted incidence rate of hepatocellular carcinoma (HCC) in the United States. To address cancer prevention and early detection through research, Cancer Prevention and Research Institute of Texas (CPRIT) has funded the Texas Collaborative Center for Hepatocellular Cancer (TeCH) to facilitate liver cancer research, education and advocacy activities. This paper describes the organizational structure, program measures, the actions completed and future plans of TeCH. This center is comprised of several cores and committees including the Administrative Core, Steering Committee, Data and Biospecimen Core, Scientific Committee, Clinical Network Committee, and the Community Outreach Committee. Each core and committee …

Why Test Results Are Still Getting "Lost" To Follow-Up: A Qualitative Study Of Implementation Gaps, Andrew J Zimolzak, Umber Shahid, Traber D Giardina, Sahar A Memon, Umair Mushtaq, Lisa Zubkoff, Daniel R Murphy, Andrea Bradford, Hardeep Singh

Faculty, Staff and Students Publications

BACKGROUND: Lack of timely follow-up of abnormal test results is common and has been implicated in missed or delayed diagnosis, resulting in potential for patient harm.

OBJECTIVE: As part of a larger project to implement change strategies to improve follow-up of diagnostic test results, this study sought to identify specifically where implementation gaps exist, as well as possible solutions identified by front-line staff.

DESIGN: We used a semi-structured interview guide to collect qualitative data from Veterans Affairs (VA) facility staff who had experience with test results management and patient safety.

SETTING: Twelve VA facilities across the USA.

PARTICIPANTS: Facility staff …

Inpatient Coding System And Opportunities For Documentation Optimization: An Interactive Session For Internal Medicine Residents, Lindsey Jordan Gay, Doris Lin, Ziba Colah, Glynda Raynaldo

Faculty, Staff and Students Publications

INTRODUCTION: The Inpatient Prospective Payment System, the framework for categorization of admissions, is based upon physician documentation leading to International Classification of Diseases, Tenth Revision code generation and Medical Severity Diagnosis-Related Group (MS-DRG) assignment. In this curriculum, we introduced internal medicine residents to this inpatient coding framework and its effects on hospital quality metrics and reimbursement. We focused on educating learners about the importance of physicians being proficient in providing thorough and specific clinical documentation to produce appropriate DRG assignment.

METHODS: Internal medicine residents participated in a 90-minute session that introduced the basic framework of inpatient coding, discussed effects of …

An Evidence-Based, Structured, Expert Approach To Selecting Essential Indicators Of Primary Care Quality, Sylvia J Hysong, Kelley Arredondo, Ashley M Hughes, Houston F Lester, Frederick L Oswald, Laura A Petersen, Lechauncy Woodard, Edward Post, Shelly Deperalta, Daniel R Murphy, Jason Mcknight, Karin Nelson, Paul Haidet

Faculty, Staff and Students Publications

BACKGROUND: The purpose of this article is to illustrate the application of an evidence-based, structured performance measurement methodology to identify, prioritize, and (when appropriate) generate new measures of health care quality, using primary care as a case example. Primary health care is central to the health care system and health of the American public; thus, ensuring high quality is essential. Due to its complexity, ensuring high-quality primary care requires measurement frameworks that can assess the quality of the infrastructure, workforce configurations, and processes available. This paper describes the use of the Productivity Measurement and Enhancement System (ProMES) to compile a …

Using Innovation-Corps (I-Corps™) Methods To Adapt A Mobile Health (Mhealth) Obesity Treatment For Community Mental Health Settings, Rita Haddad, Carolina Badke D'Andrea, Amanda Ricchio, Bradley Evanoff, Elaine H Morrato, Joseph Parks, John W Newcomer, Ginger E Nicol

2020-Current year OA Pubs

BACKGROUND: We employed Innovation Corps (I-Corps™) methods to adaptation of a mobile health (mHealth) short-message-system (SMS) -based interactive obesity treatment approach (iOTA) for adults with severe mentall illness receiving care in community settings.

METHODS: We hypothesized "jobs to be done" in three broad stakeholder groups: "decision makers" (DM = state and community clinic administrators), "clinician consumers" (CC = case managers, peer supports, nurses, prescribers) and "service consumers" (SC = patients, peers and family members). Semistructured interviews (

RESULTS: Four themes emerged across groups: education, inertia, resources and ownership. Sub-themes in education and ownership differed between DM and CC groups on …

Obstruction Of Journalism, Erin C. Carroll

Georgetown Law Faculty Publications and Other Works

Identifying oneself as press used to be a near-grant of immunity. It meant safer passage through all manner of dangerous terrain. But today, being recognizable as a journalist may be more likely to make one a target.

Physical attacks against journalists in the United States increased nearly 1,300 percent in 2020. The rate of online violence against journalists is also soaring. This violence is aimed almost entirely at women, people of color, non-Christians, and non-straight journalists. It silences voices already relegated to the edges. Rather than letting our national conversation branch, the violence attempts to shear it to a white, …

On File With: Challenges Of Inaccessible References, Austin Martin Williams

Georgetown Law Faculty Publications and Other Works

This article examines the use of “on file with” citations in student-edited law reviews and journals and their impact on future research endeavors. It then explores potential remedies to make unpublished materials held by authors more accessible and identifies factors to consider before posting these materials online. Finally, it argues that law libraries are best suited to develop solutions for making unpublished materials more accessible and to serve as long-term stewards of these valuable resources.

Leading Remote Teams, Austin Martin Williams

Georgetown Law Faculty Publications and Other Works

In the spring of 2020, many law libraries suddenly went from physical spaces with books and in-person services to digital and hybrid operations that met users’ needs through a combination of electronic offerings, book pick-up programs, and virtual reference services. Libraries were forced to implement new workflows, technology, resources, and services in a matter of days and weeks versus months and years. Through it all, library leaders were asked to do something that many had little experience with prior to the pandemic—lead a large contingent of remote workers. This article does not focus on new initiatives, resources, or services developed …

A Free Press Without Democracy, Erin C. Carroll

Georgetown Law Faculty Publications and Other Works

For several decades, the American press has been fighting for its economic survival. But while it has been consumed with this effort, the political threat to a free press has grown perhaps greater than the economic one. Democracy is eroding globally, including in the United States. Given the importance of a free press to democracy, the press needs to more urgently consider how it maintains its freedom as erosion persists.

This Article sets out a framework for American press priorities in this pivotal moment. It suggests that to resist and weather a turn to autocracy, the press must endeavor to …

Esg & Anti-Black Racism, Alicia E. Plerhoples

Georgetown Law Faculty Publications and Other Works

This essay discusses contemporary federal, financial intermediary, and company efforts to navigate racial inequality, placing those efforts in the context of ESG—environmental, social, and governance—initiatives. While ESG tools and metrics have tended to focus on a firm’s external and internal impacts on the environment, human rights, and labor standards, in recent years, firms have targeted ESG efforts at racial equity primarily through internal diversity, equity, and inclusion (DEI) initiatives and customer-facing corporate philanthropy. This essay proposes an ESG racial equity goal, discusses how federal regulations of corporate DEI programs and policies fail to meet this goal, and highlights how racial …

Monitoring Facebook, Hillary A. Sale

Georgetown Law Faculty Publications and Other Works

Few companies still in business have a track record as negative as Facebook. Facebook has paid billions of dollars in government fines and paid hundreds of millions in private settlements. Yet, the financial penalties are actually minimal relative to the harm done. Facebook seems to have been involved one way or another in privacy breaches, organized crime, election manipulation, suicide, and even genocide. Mark Zuckerberg, who still controls Facebook, appears to ignore the consequences of his choices, seemingly prioritizing profits over people. He appears to disregard the law and operate without integrity or honesty, excommunicating insiders who speak out or …

“If Rules They Can Be Called”, Amy J. Griffin

Georgetown Law Faculty Publications and Other Works

Who gets to decide what counts as law? The weight of authority in the U.S. legal system is governed almost entirely by unwritten rules—social norms that establish which sources have weight (and how much weight they have). In 2016, Bryan A. Garner and twelve judges published a treatise essentially codifying unwritten rules related to the operation of precedent. That book, The Law of Judicial Precedent, has itself become a source of authority (on legal authority), cited by judges across jurisdictions. In this essay, I question whether the judicial norms governing the operation of precedent are appropriately presented as definitive blackletter …