Digital Commons Network^™

Hiv And Sti Testing Service Utilization Among Youth Experiencing Homelessness: A Multi-Method Inquiry, Alexander A. Ochs

Electronic Theses and Dissertations

Youth experiencing homelessness (YEH) face disproportionately high risk for HIV and sexually transmitted infections (STIs), yet rates of testing remain low. This dissertation examines the individual and social network level factors that influence HIV/STI testing behaviors among YEH. Guided by insights from multiple theoretical frameworks, this three-paper dissertation integrates quantitative and qualitative approaches to better understand how personal relationships and social context shape HIV/STI testing decisions in this population.

Paper 1 presents a secondary data analysis of the Homeless Youth Risk and Resilience Survey (HYRRS), which includes 1,426 YEH across seven U.S. cities. Logistic regression models identified geographic variation in …

Comparing Ordinary Least Squares And Quantile Regression: A Causal-Comparative Approach To Modeling Conditional Relationships, Samuel Nnorom

Electronic Theses and Dissertations

Ordinary Least Squares (OLS) regression has traditionally been the preferred quantitative method for estimating linear relationships. However, it assumes that the effect of a predictor variable remains constant across the entire outcome distribution, which can miss important insights when data are heterogeneous. Quantile Regression (QR), on the other hand, offers a more detailed analysis by focusing on the full response variable distribution, thereby revealing different relationship patterns at various quantiles within the outcome. This study compares how OLS and QR perform in modeling conditional relationships within a causal-comparative framework based on ex post facto research. Using the mortality data from …

Better Serving Those Who Serve: Supporting Psychological Wellness Of Lgb Military Personnel In The Post “Don’T Ask Don’T Tell” Era, Anne Neuweiler

Electronic Theses and Dissertations

Few studies have been able to explore lesbian, gay, and bisexual military personnel’s experiences in military mental healthcare settings. This study examined the experience of LGB servicemembers in military counseling environments, as well as how to support these servicemembers in military mental health and military communities. Six participants volunteered for the study and six semi-structured interviews were completed with LGB servicemembers who had contact with mental health. Three research questions guided the present study and a transcendental phenomenological frame was used to analyze the data and themes emerged. Research question one yielded three themes: 1) “I'm Definitely not Gay”: The …

The Covid-19 Pandemic As An Environmental Jolt And Its Impact On Firms And Essential Workers, Kimberly Kay Hyett Nehls

Electronic Theses and Dissertations

Environmental jolts are sudden, large-scale disruptions that challenge organizational and societal stability and demand new ways of understanding adaptation across individuals and firms. This two-paper dissertation explores the human and organizational dimensions of such jolts through the empirical context of the COVID-19 pandemic. Paper 1 examines how global tourism firms navigated the crisis, introducing the constructs of global stakeholder interconnectedness and stakeholder prioritization fluidity to refine stakeholder theory. The findings show how international exposure shaped communication strategies under duress. Paper 2 turns to the lived experiences of low-wage essential workers, extending sensemaking theory through the concept of constrained sensemaking, highlighting …

The Safety Of Abiraterone Acetate In Patients With Metastatic Castration-Resistant Prostate Cancer: An Individual-Participant Data Meta-Analysis Based On 14 Randomized Clinical Trials, Amy L Shaver, Nikita Nikita, Swapnil Sharma, Scott W. Keith, Kevin K. Zarrabi, Wm. Kevin Kelly, Grace Lu-Yao

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Background/objectives: Multiple systemic treatments are available for metastatic castration-resistant prostate cancer (mCRPC), with unclear safety profiles. This study seeks to describe the safety determined in randomized clinical trials of a systemic treatment for mCRPC and whether safety differs by age. Methods: We utilized individual patient data from industry-funded phase 2/3 trials in mCRPC on abiraterone acetate (AA). Vivli, a clinical trial repository site, was used. One investigator independently performed screening. Relative effects of treatment were assessed with frequencies and odds of serious adverse events (SAEs). The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was used. Subgroup analysis measured …

The Multicultural Orientation Framework In Couple Therapy, Jasmine R. Davis

Electronic Theses and Dissertations

Couples’ cultural values and beliefs are important to their relational connection. Cultural values and beliefs can be sources of strength in relationships, but they can also lead to impasses. As such, clinicians and researchers could benefit from a cultural framework to inform conceptualization and treatment when working with couples. The Multicultural Orientation (MCO) framework has three pillars: cultural humility, cultural comfort, and cultural opportunities. The MCO framework is empirically supported for use in individual and group psychotherapy but has not been applied to couple therapy. This dissertation includes two parts. First, we outline a conceptual framework for the application of …

A Developmental Evaluation Of A Dental Hygiene Program And A Community Health Partnership, Laura Jacob

Higher Education: Doctoral Research Projects

Today, dental hygiene education commonly occurs in community college settings which are removed from dental schools thus dental hygiene students graduate with relatively little to no exposure to dentistry or directly with a clinically practicing dentist. With dental hygiene workforce shortages at an extremely high level, locally and nationally, it is imperative to matriculate students who are poised to be successful in the changing landscape of healthcare.

The purpose of this program evaluation was to investigate via the developmental program evaluation model, the perceived benefits of a potential collaboration between the Colorado Mountain College (CMC) dental hygiene program and a …

A Systematic Review Of Technology-Infused Physical Activity Interventions In K-12 School Settings: Effectiveness, Roles, And Implementation Strategies, Taemin Ha, Jongho Moon, Hyeonho Yu, Xiaoping Fan, Lisa Paulson

Department of Kinesiology Scholarship and Creative Works

Background

Rapid technological advancements have rendered many prior reviews of technology-integrated physical activity (PA) interventions in K–12 schools obsolete. A comprehensive analysis examining both the effects of these interventions and the specific roles that technology plays has been notably lacking. This review aimed to systematically examine the effects of technology-infused PA interventions and identify the specific types, roles, and contextual applications of technology within K–12 schools.

Methods

This systematic review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A thorough search across seven electronic databases (CINAHL, ERIC/EBSCOhost, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus, and Web of Science) …

Temporary Intravascular Shunting Using A Carotid Shunt For Traumatic Femoral Artery And Vein Injury In A Hemodynamically Unstable Patient, Nicola Habash, Fari Fall, Jin Park, Babak Abai, Michael Nooromid

Department of Surgery Faculty Papers

Vascular trauma involving the peripheral arteries of the extremities can lead to limb loss and, in severe cases, death. The use of intravascular shunts can help to temporarily perfuse the limb, while allowing for resuscitation of a critically injured patient. Here we present a case of a concomitant complex injury of the common femoral artery and common femoral vein, and the complementary vascular strategies used to achieve limb salvage.

Code Before Clause: Building Canada’S Digital Defences Before Negotiating Trade, Barry Appleton

Articles & Chapters

Canada is about to give away the keys to its digital future — before it even decides what future it wants.

This paper argues that any exploratory discussions between Canada and the European Union on a digital trade agreement must be paused until Canada legislates a domestic digital sovereignty framework and builds the governance capacity to implement it.

A Phenomenological Study Of Caregivers For Sexual Minority Hospice Patients, Catherine H. Bianchi

Electronic Theses and Dissertations

Lesbian, gay, and bisexual (LGB) individuals face disproportionate barriers in healthcare across the lifespan that persist and often intensify at the end of life. Despite hospice’s mission to provide comfort, dignity, and patient-centered support, it remains unclear whether these services equitably meet the needs of sexual minority patients. Seeking hospice care presents a unique conundrum for many LGB individuals: it necessitates inviting representatives of a historically exclusionary healthcare system into the privacy of their homes - spaces that often serve as sanctuaries of identity, safety, and autonomy. The already vulnerable experience of seeking care in one’s final days can be …

Chronic Pain: An Exploration Of The Experience Of Chronic Pain, Andrea Alzalde

Electronic Theses and Dissertations

Chronic pain is a pervasive public health issue within Western society today and amongst humans worldwide. Although chronic pain is something that many people have or will experience sometime in their life, it is a complex experience that does not have a simple universal solution or immediate cure. The causes of pain can be a multitude of things and the treatments that work for some may not work for others. The current research seeks to explore the experience of chronic pain to help fill gaps in the wider research of pain. This study pursues answers to two research questions including; …

Phase 1 Clinical Trial Of ¡Iniciando! La Adultez: A Culturally Tailored Intervention For Transitioning Latino Young Adults With Autism, Antonio F Pagán, Ana Esparza, Ana Ramirez, Miriam Ortiz, Linda Hernandez, Mary Beth Morgan, Geohanna Noel, Alejandro L Pagán, Jada Salas, Katherine Maurano, Grace Sattem, Leela Sydow, Noor Ahmed, Katherine A Loveland, Cecilia Montiel-Nava, Ron Acierno

Faculty, Staff and Student Publications

This Phase 1 clinical trial evaluated ¡Iniciando! la Adultez, a culturally adapted intervention for Latino autistic young adults (n = 56) and their parents (n = 63). Young adults showed significant post-treatment improvements on measures of social responsiveness (SRS-2), adaptive behavior (ABAS-3), executive functioning (BRIEF-A), quality of life (WHOQOL-BREF), transition readiness (TRS-A), coping self-efficacy (CSES), and emotion regulation (DERS-SF). Parents reported significant improvements in their perceptions of their child’s social responsiveness, adaptive behavior, and executive functioning, as well as increased transition readiness ratings. Notably, parents evinced a significant decrease in acculturative stress (RASI) and depressive symptoms (PHQ-9), however, …

Supervisee Barriers To Disclosure And The Supervisory Working Alliance, Rachel G. Hughitt

Electronic Theses and Dissertations

This study investigated barriers influencing supervisees’ willingness to disclose clinical errors in mental health training contexts, with a focus on the supervisory working alliance (SWA) as a potential moderating factor. Participants read two vignettes – one describing a clinical error and the other a client concern – and were asked to indicate which case they would discuss with their supervisor. They also completed the Brief Supervisory Working Alliance Inventory–Trainee Form (BSWAI-T) and the Supervisee Disclosure in Supervision Scale (SDSS), which assessed the quality of the supervisory alliance and perceived barriers to disclosure, including fear of negative evaluation, lack of confidence, …

Linda Mercer Roberts

African American Funeral Programs

Funeral program for Linda Roberts. Service was held on August 23, 2025 in Nevils, Georgia

Surgeon Ergonomics While Performing Total Knee Arthroplasty, Cameron Dahman

Electronic Theses and Dissertations

One of the most prevalent hazards to orthopedic surgeons are musculoskeletal disorders with 97% of arthroplasty surgeons reporting procedural-related musculoskeletal pain and 66% of orthopedic surgeons reporting procedural-related musculoskeletal injury [1], [2], [3]. With the annual number of total knee arthroplasties (TKA) on the rise, orthopedic surgeons are taking on larger annual caseloads and retiring later in life [4], [5]. The goal of this study was to quantify postural demand for 11 discrete surgical steps of TKA to identify ergonomically unfavorable positions surgeons experience while operating. Four orthopedic surgeons performed TKA while their motions were recorded using marker-based motion capture. …

Developing Deep Learning Methods For Cognitive Impairment Detection Based On Non-Invasive Data, Muath Alsuhaibani

Electronic Theses and Dissertations

Cognitive impairment detection is on the rise to help reduce the burden of healthcare costs on institutions and individuals. Mild Cognitive Impairment (MCI) is an early stage of cognitive decline progressing to Alzheimer’s disease (AD) or AD-related Dementia (ADRD). Detecting the early stages of AD/ADRD is crucial for early interventions among older adults to mitigate cognitive decline over time. However, the current diagnostic methods are often costly and/or invasive, such as MRI and PET scans. Thus, the search for non-invasive and cost-effective screening tools for the early detection of cognitive impairment using speech, language, visual, and motor data is growing. …

Centrosomal And Non-Centrosomal Microtubule Networks Coordinate To Drive Nuclear Dynamics In Developing Epithelium, Rashmi Budhathoki

Electronic Theses and Dissertations

The morphogenesis of developing tissues relies on extensive cellular rearrangements in shape, position, and identity. A key process in reshaping tissues is cell intercalation-driven elongation, where epithelial cells align and intercalate along a common axis. Typically, analyses focus on how peripheral cortical forces influence cell shape changes. Less attention is given to how inhomogeneities in internal structures, particularly the nucleus, impact cell shaping. Here, we examine how pulsed contractile and extension dynamics interact with the nucleus in elongating Drosophila embryos. Our data show that tightly packed nuclei in apical layers hinder tissue remodeling/oscillatory behaviors. We identify two mechanisms for resolving …

Beyond The Benefit: A Multi-Modal Narrative Study Of Black Women's Experiences With Employer-Sponsored Tuition Assistance, Britany Patricia Hamilton

Electronic Theses and Dissertations

This dissertation explores the lived experiences of Black women engaging with employer-sponsored tuition assistance programs, focusing on how social, structural, and identity-based factors shape their educational and professional trajectories. While these benefits are often framed as neutral tools for career advancement, this study examines them through the intersecting lenses of race, gender, and labor, revealing deeper dynamics of access, value, and belonging. Guided by a qualitative narrative inquiry approach, this study employed a multi-modal data collection design involving video diaries, semi-structured interviews, and a focus group. Three participants, all Black women between the ages of 30 and 40, shared their …

Transgender Individuals’ Experiences Of Ruptures And Repairs In Group Psychotherapy, Gabrielle W. Kaufman

Electronic Theses and Dissertations

As the political climate across the United States worsens for transgender and gender diverse (TGD) individuals (Harmon, 2025), it has become increasingly important to attend to the mental health needs of this population (James et al., 2016). Group therapy is a widely used treatment modality that is often more accessible than individual therapy (Burlingame & Strauss, 2021) and provides unique interpersonal opportunities (Burlingame et al., 2016). While it is expected that TGD individuals face unique challenges in group therapy due to their gender identities (Chen et al., 2020), very little is actually known about the experiences of TGD individuals participating …

Food Insecurity, Diet And Health Outcomes In Pediatric Inflammatory Bowel Disease: A Pilot Study, Nicole Zeky, Alysse Baudier, Colleen Leblanc, Elizabeth Mcdonough, Sarah A. Dumas, Dedrick Moulton

School of Medicine Faculty Publications

Background/Objectives: Food insecurity (FI) is a well-defined factor in pediatric health outcomes and has been associated with lower diet quality. While poor diet quality has been linked to the rising prevalence of inflammatory bowel disease (IBD), little is known about the impact of FI on pediatric IBD. This pilot study explores the feasibility and potential impact of FI on dietary intake and clinical outcomes in children with newly diagnosed IBD. Methods: This pilot study included newly diagnosed IBD patients aged 5 to 18. FI screening was completed using the USDA 6-item and AAP 2-item screeners at diagnosis and 6 months. …

The Experiences Of School Psychologists Serving Students With Traumatic Brain Injuries: A Phenomenology, E. Grace Ritchie

Electronic Theses and Dissertations

Traumatic Brain Injury (TBI) is a complex experience associated with a diverse constellation of symptoms and challenges. TBI scholars have extensively explored the varying needs of youth in the aftermath of a head injury. Likewise, recent literature details recommendations for school psychological services in support of these students. Such recommendations largely reflect insights drawn from broader TBI and disability research, integrated with the established scope of school psychologists’ practice (e.g., the National Association of School Psychologists Practice Model). Nevertheless, school psychologists’ perceptions of these students’ challenges have been inadequately examined. Such perspectives are likely valuable, given school psychologists’ unique training …

Trainee Countertransference And Competency In Bereavement Therapy: Strengths And Limitations Of The Wounded Healers, Meghan Paynter

Electronic Theses and Dissertations

Countertransference is a common experience in therapy, happening among clinicians of all stages of their career and the outcomes of this experience hinge largely on how countertransference is managed. Challenging topics, such as grief, only make countertransference harder to manage effectively and the management of this experience improves with practice and time—something trainees have not yet ascertained. Given the pervasiveness of grief as a human experience, also indiscriminate in nature, the experiences of trainees experiencing countertransference are important to understand, including what is experienced, how they experience it, and how it impacts their process and self-perception of confidence and competence …

A Guidance Practice Model: Reframing Prevention, Identification, And Treatment Of Trauma-Impacted Students With Intellectual Disabilities, Mark H. Thomas

Electronic Theses and Dissertations

The experience and exposure of trauma among youth, especially continuous traumatic experiences, poses considerable risks of long-term effects. Moreover, untreated trauma and subsequently negative mental health outcomes, like anxiety and depressive disorders, can negatively impact the psychosocial and academic functioning of students. One population that is generally overlooked regarding mental health in schools are students with intellectual disabilities (ID). This is problematic as this population is at an increased risk of traumatic experiences, such as maltreatment and social exclusion.

Moreover, the comorbidity of trauma and internalizing disorders among students with ID can exacerbate already existing challenges and deficits with social …

Using The R = Mc2 Heuristic To Assess Whole-Of-School Physical Activity Implementation In Elementary Schools: A Cross-Sectional Study, Derek W Craig, Kevin Lanza, Christopher D Pfledderer, Andjelka Pavlovic, Kempson Onadeko, Natalia I Heredia, Jizyah Injil, Laura F Defina, Timothy J Walker

Faculty, Staff and Student Publications

Background: Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC2 heuristic, which defines readiness for implementation as a combination of an organization's motivation and capacity to implement, can enhance our understanding of implementation in the school setting. This study examines associations between constructs from the R = MC2 heuristic and schools' implementation of a WOS approach.

Methods: We conducted a secondary analysis of cross-sectional data from U.S. elementary schools participating in …

Behavioral Neuroscience Of Drug Addiction And Mental Disorder, Mona Muzammil, Muzammil Arshad, Washain Muzammil

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Chemistry)

This book explores the molecular, cellular, and neurocircuitry systems in the brain that are responsible for drug addiction. Common neurobiological elements are emphasized that provide novel insights into how the brain mediates the acute rewarding effects of drugs of abuse and how it changes during the transition from initial drug use to compulsive drug use and addiction. The book provides a detailed overview of the pathophysiology of the disease. The information provided will be useful for neuroscientists in the field of addiction, drug abuse treatment providers, and undergraduate and postgraduate students who are interested in learning the diverse effects of …

Blood And Neuronal Extracellular Vesicle Mitochondrial Disruptions In Schizophrenia, A Ankeeta, Ashutosh Tripathi, Bindu Pillai, Yizhou Ma, Joshua J Chiappelli, Jessica N Jernberg, Keiko Kunitoki, Xiaoming Du, Si Gao, Bhim M Adhikari, Consuelo Walss-Bass, Giselli Scaini, Peter Kochunov, Anilkumar Pillai, L Elliot Hong

Faculty, Staff and Student Publications

The high energy demand of the human brain obligates robust mitochondrial energy metabolism, while mitochondrial dysfunctions have been linked to neuropsychiatric disorders, including schizophrenia spectrum disorders (SSD). However, in vivo assessments that can directly inform brain mitochondrial functioning and its etiopathophysiological path to SSD remain difficult to obtain. We hypothesized that system and brain mitochondrial dysfunctions in SSD may be indexed by elevated cell-free mitochondrial DNA (cf-mtDNA) levels in the blood and in neuronal extracellular vesicles (nEVs). We also explored if these mtDNA marker elevations were associated with brain metabolites as measured by magnetic resonance spectroscopy (MRS). We examined blood …

A Clinical Pathway For Differential Diagnosis Of Adhd Vs Trauma: Early Childhood Recognition And Intervention, Maria Neiers

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Distinguishing Attention-Deficit/Hyperactivity Disorder (ADHD) from Complex Posttraumatic Stress Disorder (C-PTSD) presents significant diagnostic challenges due to overlapping symptom presentations, shared neurobiological impacts, and frequent comorbidities. This paper explores the nuanced clinical differentiation between ADHD and C-PTSD, and other trauma disorders, in pediatric populations, emphasizing the importance of trauma-informed assessment, early identification, and integrative clinical reasoning. The discussion highlights how structured diagnostic reasoning can reduce uncertainty, enhance diagnostic clarity, and support effective treatment planning. As a central contribution, this paper introduces an original clinical reasoning flowchart and a case conceptualization to illustrate its practical application in real-world diagnostic dilemmas. The need …

“My Body Was Never Mine”: An Arts-Based Phenomenological Analysis Of Queer And Trans Adolescent Involuntary Psychiatric Hospitalization Experiences, Megan Doyle

Electronic Theses and Dissertations

Involuntary psychiatric hospitalization has life-saving and crisis-stabilizing intentions for queer and trans adolescents experiencing mental health crises; however, there are significant concerns about the adverse effects of this practice. This study employed two interwoven qualitative methods, interpretative phenomenological analysis and arts-based research, to gain a deeper understanding of queer and trans individuals’ adolescent experiences of involuntary psychiatric hospitalization. The theory of abolition was applied to examine the carcerality and identity-based oppression embedded within this procedure. Participant narratives and artwork revealed how involuntary psychiatric hospitalization is non-affirming for queer and trans young people in crisis, and the impacts of experiencing coercion, …

Why Jerk Bosses Stress Us: Burnout As An Evolved Appeasement Strategy, Hector A. Garcia, Jarad Reiss, Ray Garza

All Faculty Scholarship (Archived)

Burnout is a pandemic and costly public health problem. Studies link leadership and peer behavior to burnout, but explanations are constrained to proximate mechanisms. Evolutionary models describe depression as an ancient appeasement response to avert dangerous physical conflict with higher-ranking group members and coalitions. In turn, psychometric research consistently finds high construct overlap between burnout and depression. This shared phenomenology suggests that burnout in response to workplace social stressors reflects appeasement. The purpose of the current study is to test the relationship between rank and competition related variables and burnout.