Digital Commons Network^™

Understanding Adolescent Perinatal Wellbeing In Rural Parts Of Kenya: A Qualitative Study, Evaline Chepchirchir Langat, Marleen Temmerman, Margrette Hanselmann, Kethakie Lamahewa, Violet Naanyu, Mellan Lilumbi, Tatiana Taylor Salisbury

Centre of Excellence in Women and Child Health

Introduction: Despite global efforts to reduce adolescent birth rates, the problem persists in low- and middleincome countries. Sub-Saharan Africa has the highest rates (97.9 births per 1000 women). In Kenya, more than 15 % of adolescent girls become pregnant. Forty-three percent of these develop depression. This study investigated adolescent pregnancy in rural Kenya to understand the challenges and context-specific factors that can help adolescents maintain good mental health during pregnancy and the motherhood.

Methods: An exploratory qualitative study was conducted in Kilifi County between October and November 2021. A total of 73 participants consented to participate in the …

Community Perspectives On Maternal Dietary Diversity In Rural Kenya, Mozambique And The Gambia: A Precise Network Qualitative Study, Mai-Lei Woo Kinshella, Shilla Dama, Onesmus Wanje, Rosa Pires, Helena Boene, Papa Jagne, Hawanatu Jah, Angela Koech, Grace Mwashigadi, Violet Naanyu

Centre of Excellence in Women and Child Health

Pregnant and lactating women in sub-Saharan Africa are vulnerable to micronutrient inadequacies, with risk of adverse pregnancy outcomes. Adequate intakes of diverse foods are associated with better micronutrient status and recommended by the World Health Organization as part of healthy eating counselling during antenatal care. However, our understanding of community knowledge of dietary diversity within the context of maternal diets is limited. We used a descriptive qualitative approach to explore community perceptions of dietary diversity during pregnancy and lactation, as well as influencing factors in sub-Saharan Africa. A total of 47 in-depth interviews were conducted between May and October 2022 …

Standardization And Quality Control Of The Introduction Of A Noninvasive Cardiac Output Monitor For Pregnancy Measurements In A Low- And Middle-Income Country, Helen Perry

Centre of Excellence in Women and Child Health

Introduction :There is increasing awareness of the role of the maternal cardiovascular system in complicated pregnancies. Despite the high disease burden, noninvasive cardiac output monitors have not been used extensively in low- and middle-income countries. The aim of this study was to evaluate the quality control of the use of the ultrasonic cardiac output monitor (USCOM) 1A® in a LMIC.

Material and Methods This was a quality assessment study of the introduction of the USCOM 1A® to measure maternal hemodynamic indices. Inter-observer agreement was assessed across all four study sites by intraclass correlation coefficient. Quality control was assessed using pre-defined …

The Lawyer: Spring 2025, Seattle University School Of Law

Lawyer

No abstract provided.

Aversion-Induced Dopamine Reductions Predict Drug-Taking And Escape Behaviors, Elaine M. Grafelman, Bridgitte E. Côté, Lisa Vlach, Ella Geise, G. Nino Padula, Daniel S. Wheeler, Matthew C. Hearing, John R. Mantsch, Robert A. Wheeler

Biomedical Sciences Faculty Research and Publications

Dopamine release in the nucleus accumbens core (NAcC) has long been associated with the promotion of motivated behavior. However, inhibited dopamine signaling can increase behavior in certain settings, such as during drug self-administration. While aversive environmental stimuli can reduce dopamine, it is unclear whether such stimuli reliably engage this mechanism in different contexts. Here we compared the physiological and behavioral responses to the same aversive stimulus in different designs to determine if there is uniformity in the manner that aversive stimuli are encoded and promote behavior. NAcC dopamine was measured using fiber photometry in male and female rats during cocaine …

Property And Prejudice, Fatma E. Marouf, Vanessa Casado Pérez

Faculty Scholarship

“Alien land laws”—laws restricting noncitizens from owning real property—are back. A dozen states have enacted such laws during the past year, and over thirty states have considered such bills. These new bills are rooted in xenophobia, much like their predecessors, but they also have unique characteristics. They single out governments, citizens, and corporations of specific countries perceived to pose a threat; they impose ownership restrictions based on arbitrary distances to U.S. military bases and critical infrastructure; they inflict particularly harsh penalties; and they try to ferret out foreign control in complex corporate structures. The purported justifications are national defense, food …

Preferences And Willingness For Starting Daily, On-Demand, And Long-Acting Injectable Hiv Pre-Exposure Prophylaxis Among Transfeminine Persons In The Us, 2022-2023, Duygu Islek, Travis Sanchez, Stefan Baral, Carolyn Brown, Joanna A. Caldwell, Jennifer L. Glick, Danielle Friedman Nestadt, Jeb Jones, Iaah L. Lucas, Supriya Sarkar, Annemiek De Ruiter, Patrick S. Sullivan, Mariah Valentine-Graves, Savannah Winter, Vani Vannappagari

School of Public Health Faculty Publications

Background There remains limited information concerning US transfeminine persons preferences across varying PrEP options. We examined PrEP option willingness, preferences, and associated factors among a US nationwide sample of transfeminine persons. Methods Sexually active transfeminine persons age 15 + were recruited online between June 2022-October 2023 through social media advertisements. Transfeminine persons not diagnosed with HIV were asked about willingness to initiate, and ranked preference, of three PrEP options- daily oral (DO), on-demand, and long-acting injectable (LA-PrEP). Log-binomial models were used to examine PrEP modality willingness and associated sociodemographic and behavioral characteristics. Results Among 2657 transfeminine persons not currently using …

Dotphotozine, Issue 14, 2025, Students Of The Csusb Art Department, Francis Almendarez

Dotphotozine

No abstract provided.

Unraveling Early Onset Disparities And Determinants: An Analysis Of Colorectal Cancer Outcomes And Trends In Texas, Tyler Torres, Elias Arellano Villanueva, Yossef Alsabawi, Demba Fofana, Manish Tripathi

School of Medicine Publications

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the U.S., with disparities in incidence, survival, and age at diagnosis across racial, ethnic, and socioeconomic groups. The rising incidence of early-onset CRC (< 50 years) has amplified concerns regarding access to care, screening disparities, and outcomes, particularly among minorities. This study examines the impact of race, ethnicity, socioeconomic status (SES), and sex on CRC survival and age at diagnosis in Texas from 1995 to 2016.

Methods: This retrospective cohort study utilized Texas Cancer Registry (TCR) data, including 235,076 CRC cases diagnosed between 1995 and 2016. Kaplan-Meier analysis and log-rank tests assessed 10-year survival by race and ethnicity and time period (1995-2005 vs. 2006-2016). Kruskal-Wallis tests with Bonferroni correction were used to compare survival years between racial/ethnic groups within each period. Age at diagnosis was analyzed by race and …

Efficacy Of Glucagon-Like Peptide-1 Receptor Agonists For Prevention Of Stroke Among Patients With And Without Diabetes: A Meta-Analysis With The Select And Flow Trails, Asmita Gera, Fakhar Latif, Vamsikalayan Borra, Sidra Naz, Vivek Mittal, Fathima Shehnaz Ayoobkhan, Tushar Kumar, Zarghoona Wajid, Novonil Deb, Tanisha Prasad

School of Medicine Publications

Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown a reduction in major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). However, its efficacy on cerebrovascular events is yet to be well established among diabetic and non diabetic patients.

Objective

We sought to evaluate the efficacy of GLP-1 RAs on stroke risk among its different types in patients with and without Diabetes.

Methods

We performed a systematic literature search on PubMed, EMBASE, and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) from inspection until 15th July 2024, without any language restrictions. Odds ratios (OR) and 95 % …

Baseline Associations Of Office And Ambulatory Blood Pressure Monitoring With Cognitive Function And Dementia Prevalence, Jesus Melgarejo, Dhrumil Patil, Sokratis Charisis, Kristina P. Vatcheva, Silvia Mejia-Arango, Luis J. Mena, Claudia Satizabal, Eron G. Manusov, Sudha Seshadri, Gladys E. Maestre

School of Medicine Publications

Background: High blood pressure has been associated with dementia prevalence and incident. However, it is unclear the relationship of office and ambulatory BP monitoring with cognitive function and dementia and in particular, it remains unknown whether ambulatory BP variability relates to dementia.

Objective: To investigate the associations of office and 24-h blood pressure (BP) with cognitive function and dementia prevalence.MethodsCross-sectional population-based study of 1435 participants aged ≥40 years with office BP/24-h BP, and cognitive assessments (Mini-Mental State Examination [MMSE] and Selective Reminding Test [SRT]). Dementia was diagnosed with a clinical dementia rating ≥1.0. Statistics included logistic and linear regression models. …

Advancing Pandemic Response: Integrated Strategies For Testing, Prediction, And Bias Mitigation, Tianshu Gu

Theses and Dissertations (ETD)

The COVID-19 pandemic, along with prior outbreaks such as SARS and Ebola, has revealed critical gaps in global pandemic preparedness, emphasizing the need for integrated approaches to infectious disease management. This dissertation addresses three key areas of pandemic response: developing scalable screening strategies, constructing reliable predictive models, and mitigating demographic biases in artificial intelligence (AI) models used for healthcare decision-making.

The first study introduces a global screening strategy designed to optimize resource use and increase testing capacity, particularly in low- and middle-income countries (LMICs) where resources are limited. This study leverages pooled testing methods, where multiple samples are combined into …

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …

Partial And Full Arc With Dynamicarc Technique In Pencil Beam Scanning Proton Therapy For Bilateral Head And Neck Cancer: A Feasibility And Dosimetric Study, Suresh Rana, Noufal Manthala Padannayil, Shyam Pokharel, Michael Kasper, Hina Saeed

All Publications

Purpose: A novel proton beam delivery method known as DynamicARC spot scanning has been introduced. The current study aims to determine whether the partial proton arc technique, in conjunction with DynamicARC pencil beam scanning (PBS), can meet clinical acceptance criteria for bilateral head and neck cancer (HNC) and provide an alternative to full proton arc and traditional intensity-modulated proton therapy (IMPT).

Method: The study retrospectively included anonymized CT datasets from ten patients with bilateral HNC, all of whom had previously received photon treatment. The clinical target volumes (CTV) were categorized into three levels: CTV_7000, CTV_5950, and CTV_5600. IMPT plans included …

Physical Therapy Outcome Measures Used In Persons With Long Covid: A Systematic Review Of Interventional Studies Up To 1-Year Postglobal Health Emergency, Andrea Lopes Sauers, Liana Johnson, Marissa Mortensen, Laura Bianca Dorásio Da Silva, Luciana Angélica Da Silva De Jesus, Jaime González, Cristino Oliveira

Physical Therapy Faculty Publications

Purpose:

To identify the most frequently used outcome measures in interventional studies for Long Covid in outpatient, home-based, and telerehabilitation physical therapy settings.

Methods:

Registered in PROSPERO (registration number: CRD42021286714) and conducted according to PRISMA guidelines, this review included interventional studies performed in outpatient, telerehabilitation, or home-based physical therapy settings, assessing adults with persistent Long Covid symptoms in at least 3 months post-COVID-19 infection and published in English, Spanish, or Portuguese. A comprehensive search strategy was executed across PubMed, Embase, Scopus, PEDro, SciELO, Web of Science, and CINAHL. Data were managed via Covidence, with studies independently screened and extracted by …

Behind The Curtain: The Influence Of Tourism And Production Costs On Broadway Success, João Branco Chaves

Student Publications

Broadway’s success is closely tied to the fluctuating dynamics of tourism and the rising costs of production. This paper explores how the growth in NYC tourism impacts Broadway’s profitability and the challenges producers face as production costs (lumber and cotton) continue to soar. Through an analysis of various sources, this study highlights the key role tourism plays in sustaining Broadway’s revenue and the vulnerabilities created by its unpredictability. It also examines the increasing financial burden of mounting Broadway productions, exploring how producers are adapting to stay financially viable. The paper identifies key strategies for managing these challenges, including innovative cost …

El Penacho De Moctezuma Or Kopilli Ketzalli?: A Study Of Colonialism & Featherwork, Natalie Heiland

Student Publications

This paper focuses on an object with many titles: Moctezuma’s Headdress, El Penacho or Kopilli Ketzalli. These names, in English, Spanish and Nahuatl, perfectly highlight the way colonialism has affected the discourse around it. The piece was initially taken during the Spanish conquest of Mexico in the early 16th century and shipped to Vienna, where it has remained ever since. Through analysis of historical sources and modern discussions, I will address how this object has been treated poorly throughout history, from the initial seizure, to its time in storage where it was improperly researched and labeled, the many conservations it …

Spatial And Temporal Trends Of Reburns In Western Us Forests, Jackson M. Boyle

Student Publications

In the Western United States, understanding the role of reburns, or repeat wildfires, has become a topic of increased interest as the damages caused by wildfires have risen. While some forests are adapted to frequent burns, others have fire regimes characterized by few or infrequent burns. While all fires alter ecosystems, reburns have been found to specifically lower seeding probability and accelerate or start the shift from forests to shrublands. Despite these ecological impacts, the temporal and spatial trends of reburns remain understudied. Using Google Earth Engine, I analyzed the Composite Burn Index (CBI) dataset to see if reburns are …

Mapping Trends In Gender-Inclusive Legal Language Between Circuit Courts In The United States, Juliette M. Rhinow

Student Publications

This study examines the use of gender-inclusive legal language in federal circuit court opinions in the United States between 2020 and 2024, with a focus on how judicial political ideology influences linguistic behaviors. Drawing on postmodern feminist theory and utilizing content analysis, the research compares six federal circuit courts by coding 46 court opinions for inclusive and exclusive linguistic practices related to transgender and non-binary individuals. Inclusive practices included the use of self-identified names and pronouns, affirming decisions, and acknowledgment of transgender identities, while exclusive practices involved misgendering, outdated terminology, and restrictive rulings. Results show that progressive circuits demonstrated significantly …

Smart Strategies: The Impact Of Social Media And Ai In Modern Marketing, Waverly O. Smith

Student Publications

In recent times, social media and artificial intelligence (AI) have become increasingly popular in the world of marketing. With these technologies, companies can more efficiently and effectively find consumers and create tailored product advertisements. AI has helped companies segment consumers, identify trends, and predict consumer needs. Social media has created a platform in which companies can connect with consumers and gain direct feedback. Additionally, it has created a space in which anyone can become an influencer or market a product. With the evolution of technology and digital marketing, it has also become increasingly important for companies to use high quality …

Cash Or Credit: A Collection Of Short Essays About Economic Philosophy And The Trajectory Of Political Economy, Jackson C. Dusart

Student Publications

From John Locke to Herbert Marcuse, discussions about economics and societies have dominated the philosophical battleground. While Adam Smith waged a war against mercantilism, men like Karl Marx and John Stuart Mill, two ideological enemies, were both writing to address the same problems they saw in society. Each one of these men has contributed to a different part of the discussion. In understanding their differences, and their common ground, these essays examine a hypothetical four-hundred-dollar jacket, stolen from the author at Gettysburg College. Each one of these philosophers, each writing at different times and in different circumstances, will attempt to …

The Effectiveness Of Sms Marketing Campaigns Versus Email Marketing Campaigns, Akriti Nepal, Edward A. Porter, Eliza M. Hoover, Kyla G. Cordell

Student Publications

In the present study, we examine the effectiveness of using SMS marketing campaigns versus email marketing campaigns when marketing towards consumers. We used the e-commerce direct messaging multichannel from 2021 to 2023 to test our hypotheses. A random sample was taken of a messages-demo data set with 7,564 rows that contains 10 million messages to test our hypotheses. The effectiveness of purchasing rates in email and SMS marketing campaigns was tested using an independent samples t-test. The results demonstrate that email marketing messaging had a more positive customer perception compared to SMS marketing messaging, as measured by whether customers opened …

“To Ponder And Dream”: Gettysburg’S Conflict Heritage And Cultural Constructions Of History In Its Museums, Camryn Counsil

Student Publications

After providing brief historical context and a review of relevant literature, this paper analyzes four overarching concerns that inform the work of Gettysburg’s museums and historical organizations: ensuring commercial success, including underrepresented stories without alienating visitors, balancing scholarly and emotional approaches, and acknowledging the larger political implications of their choices. Using an anthropological approach, this work shows how these larger economic, social, and political concerns influence the construction of history and memory in a conflict heritage site like Gettysburg, Pennsylvania.

Incarcerated Adolescence: Historical Archaeology And Finding Teenagers In The Japanese American Concentration Camp, Jack Kendall

Student Publications

Through looking at the teenagers of the Granada Relocation Center, commonly called Amache, this research posits a unique framework to understanding and searching for teenagers in the past. This uses a combination of historical sources and oral histories in order to outline what materials to search for. This research also uses an emotional approach, titled an "archaeology of the heart" to understand and work alongside descendants to properly understand the nuance of the forced relocation of 110,000 Japanese Americans through World War II. By combining these different elements, this research shows the ways that teenagers were constructing and reconstructing a …

The Relationship Between Precision Strikes And Terrorist Activity, Connor A. Joyce

Student Publications

Precision warfare is intended to reduce the human costs for allied combatants in conflict. However, as this new form of fighting becomes increasingly central to modern military campaigns, its impact on terrorist activity warrants close examination. This paper explores the psychological effects of trauma on terrorist behavior, engages with scholarly debates on the outcomes of precision tactics, and presents statistical analysis to argue that the United States’ use of precision warfare, from 2000 through 2019, contributed to increased amounts of terrorist activity. Empirical findings in Somalia, Yemen, and Afghanistan support this claim. Precision tactics have been known to save American …

Skeletons In The Courtyard: Why The Maya Came Back For Their Dead, Kayla R. Tursack

Student Publications

This paper explores Maya secondary burials with a particular focus of the exhumed burial of SubOp Ax at Courtyard B-1, Chan Chich, Belize. Drawing on an array of archaeological sources, it examines a series of case studies throughout the Maya region and beyond of secondary burials, symbolic mortuary practices, and instances of ancestor veneration. The partial exhumation of SubOp Ax, with the crypt only containing a leg bone, is interpreted as a deliberate act of ancestral remembrance during the Terminal Classic collapse. This is done through a comparative analysis of case studies from Caracol, Naachtun, K’axob, Tikal, and Mitla. Understanding …

Tracking Phenological Shifts Of Black Guillemots Cepphus Grylle In The Gulf Of Maine, Jocelyn L. Little

Student Publications

Rapid warming in the Gulf of Maine has coincided with changes in phenology across trophic levels. Phenological change has yet to be studied in black guillemots (Cepphus grylle), a widely distributed benthic forager that is showing population decline in the region. Because black guillemots nest in burrows, their phenology can be challenging to study. I developed methods to track black guillemot phenology on Petit Manan Island, a seabird breeding colony in the Gulf of Maine. Specifically, I asked Q1) Can daily tower count data be used to predict black guillemot breeding phenology? Q2) How is black guillemot breeding phenology shifting …

Common Terns (Sterna Hirundo) As Bioindicators For Atlantic Herring (Clupea Harengus) Distribution In The Gulf Of Maine, Logan R. Becker

Student Publications

Effective fisheries management is increasingly challenged by climate-driven shifts in species distribution and by a lack of data on early life stages of key forage fish species. In the Gulf of Maine, Atlantic herring (Clupea harengus), a once economically dominant fishery species and a key prey species for many dependent predators, has declined due to poor early-stage recruitment and warming waters. Despite this decline, current trawl surveys do not inform early-stage Atlantic herring distribution due to mesh size limitations, leaving critical gaps in our knowledge. To address this knowledge gap, I used common terns (Sterna hirundo) …

Reporting On The Dark Continent: The Albert Chance Collection As An American Representation Of Africa, Devon Szczepkowicz

Student Publications

For Americans in the throes of World War II, the international world was a complex and uncertain place. The news media, which offered reports from the war fronts, helped to ground Americans in this world. Another source which supplemented these reports, and which has been overlooked in the historiography, was the letters of soldiers stationed abroad. In writing on their surroundings, soldiers acted as journalists, supplying their audiences with intimate insights into foreign locations. Albert Chance (1903-1990), stationed in North Africa and in Italy, was one such soldier. His letters from North Africa provide a glimpse into the ways in …

Eliciting Patient Past Experiences Of Healthcare Discrimination As A Potential Pathway To Reduce Health Disparities: A Qualitative Study Of Primary Care Staff, Dharma E. Cortés, Ana M. Progovac, Frederick Lu, Esther Lee, Nathaniel M. Tran, Margo A. Moyer, Varshini Odayar, Caryn R.R. Rodgers, Leslie Adams, Valeria Chambers, Jonathan Delman, Deborah Delman, Selma De Castro, María José Sánchez Román, Natasha A. Kaushal, Timothy B. Creedon, Rajan A. Sonik, Catherine Rodriguez Quinerly, Ora Nakash, Et Al

School for Social Work: Faculty Publications

Objective

To understand whether and how primary care providers and staff elicit patients' past experiences of healthcare discrimination when providing care.

Data Sources/Study Setting

Twenty qualitative semi-structured interviews were conducted with healthcare staff in primary care roles to inform future interventions to integrate data about past experiences of healthcare discrimination into clinical care.

Study Design

Qualitative study.

Data Collection/Extraction Methods

Data were collected via semi-structured qualitative interviews between December 2018 and January 2019, with health care staff in primary care roles at a hospital-based clinic within an urban safety-net health system that serves a patient population with significant racial, ethnic, …