Evaluating U.S. Health Policy Levers Using Difference-In-Differences: Hospital Acquisitions, Global Budgets, And Income Policies, Kola Adegoke

NYMC Student Theses and Dissertations

Abstract

Background: U.S. health policy relies on multiple levers to influence system performance, financial stability, and population health. This dissertation uses a three-paper portfolio to evaluate organizational change (hospital acquisitions), payment reform (Maryland all-payer global budgets), and income-related state policies, applying difference-in-differences (DiD) designs with prespecified diagnostics to support causal interpretation.

Methods: Study 1 examined hospital change-of-ownership (CHOW) acquisitions using a national hospital-year panel from RAND HCRIS (2014–2023), linked to CHOW timing data from 2016–2023. Effects on revenue outcomes were estimated using a staggered difference-in-differences design implemented with the Callaway and Sant’Anna estimator, using doubly robust inverse probability weighting, hospital-level …

Virtual Humans In Virtual Reality: A Scoping Review On Sociability, Fidelity, And Expression, J K Sangeeth Chandran, Marisa Llorens Salvador, Cathy Ennis

Articles

Introduction:

Virtual reality (VR) systems have evolved significantly over the past decade, enabling immersive experiences with enhanced realism and interactivity. This has motivated an interest in socially oriented applications. As user proxies, Virtual Humans (VHs) play essential roles in such applications. However, despite technological advancements, achieving realistic, expressive, and socially responsive VHs continues to present design and implementation challenges. In this scoping review, we present the state-of-the-art of VR VHs, examining the impact of VHs on the user experience.

Methodology:

We reviewed 59 papers retrieved from five databases across three core themes: the implementation and impact of VH facial expressions, …

Military Sexual Trauma And Suicidality: An Analysis Of Interpersonal Risk Factors, Jacquelyn Burckley

USF Tampa Graduate Theses and Dissertations

Suicide remains a major public health concern, particularly among military personnel and veterans, who experience elevated risk compared to civilian populations. Military sexual trauma (MST), defined as sexual assault or harassment during military service, is a significant risk factor for suicidality, yet less is known about how characteristics such as recency and revictimization influence suicide severity. This study aimed to examine the relationship between MST victimization and suicide severity and to evaluate whether the Interpersonal Theory of Suicide explains suicide severity among MST victims. Using data from a large military sample, logistic regression and mediation analyses were conducted to assess …

Exploiting Chaotic Antenna Arrays For Rf Fingerprint Authentication And Physical Layer Security In Wireless Communications, Joshua K. Thomas Ranstrom

USF Tampa Graduate Theses and Dissertations

Modern wireless networks support a wide range of applications including consumer devices, healthcare monitoring, industrial automation, smart grids, and military platforms, in which transmitted information is often highly sensitive and subject to stringent confidentiality and integrity requirements. As wireless communication operates over an open broadcast medium it exposes systems to physical layer (PHY) threats such as eavesdropping, in which an adversary passively intercepts transmitted information, and spoofing, in which a forged transmission misleads the receiver about device identity. Cryptographic defenses address both threats but require computational assumptions and key management infrastructure that may not scale to dense or resource-constrained deployments. …

Geospatial Understanding Of Foundation Models: Self-Supervision, Robustness, And Resource-Constrained Learning, Gilbert Kibet Rotich

USF Tampa Graduate Theses and Dissertations

Research on large-scale geospatial understanding from satellite imagery remains relativelyunderexplored. Much of the field still relies on narrow, task-specific pipelines, and there is lim- ited work on developing true foundation models or on systematically evaluating how well these models generalize under domain shift, geographic variation, and real-world scene diversity. This dissertation advances foundation-model pretraining and evaluation for remote sensing along three complementary axes. First, we develop self-supervised multispectral pretrained models for satellite image classification by adapting BYOL, BarlowTwins, DINO, MoCo, and Simsiam to multispectral inputs, addressing the limited amount of curated satellite datasets relative to ImageNet. Pretraining on Eurosat and …

Death And Things: Toward A Theory Of Self-Holding Objects, Kirsten J. Lee

USF Tampa Graduate Theses and Dissertations

This dissertation examines how material objects function as existential supports under conditions of cultural exclusion. Drawing on Terror Management Theory (TMT), minority stress theory, and José Muñoz’s concept of disidentification, it introduces the construct of self-holding objects: possessions imbued with identity-sustaining meaning that stabilize the self. Study 1 employed a qualitative photovoice design with 16 queer adults and identified five primary existential functions of meaningful objects: affirming worth, regulating the body, mirroring the self, authorizing possibility, and enabling worldmaking. These findings suggest that objects operate as material anchors within distributed systems of meaning. Study 2 experimentally tested whether imagining the …

Implementing A Brief Dialectical Behavior Therapy-Informed Skills Group In A County Jail: A Mixed Methods Approach To Understanding Feasibility And Acceptability, Meaghan E. Brown

USF Tampa Graduate Theses and Dissertations

Correctional institutions unintentionally function as one of the largest mental health providers in the country. Short-term facilities, like jails, present an opportunity to provide mental health care to those who will quickly reenter our communities. Despite this, evidence-based practices and treatments in correctional settings have been implemented at slower rates compared to community settings and mental health institutions. Regulating emotions, refraining from impulsive maladaptive behavior, and communicating effectively are considered primary treatment needs among jail inmates. Dialectical Behavior Therapy (DBT; Linehan, 1993) can address these deficits and is commonly implemented in a skills training group format in correctional settings; however, …

It’S Not Me, It’S U(Niversity): A Longitudinal Study Of The First-Generation Graduate Student Experience Navigating Privacy And Identity During Socialization, Melissa L. Mccormick

USF Tampa Graduate Theses and Dissertations

This longitudinal study examines the experiences of first-generation graduate students (FGGS; students whose parent(s) do not hold a 4-year undergraduate degree). Specifically, it considers how FGGS manage their private information throughout the first year of their graduate program, and how the intersection of their FGGS status with other aspects of their identity may shape those experiences (e.g. the overlapping of FGGS status, race, and socioeconomic status). While there is substantial research on the first-generation student experience at an undergraduate level, FGGS have largely been left out of the conversation (exception: Levin, 2022). Guided by theories of organizational socialization (Jablin, 1985), …

Multimerin1 And Not Galectin-8 Tempers Wnt Signaling To Promote Gastric Chief Cell Differentiation, Xiaobo Lin, Gabriel Nicolazzi, Xuemei Liu, Chinye Nwokolo, Yehiel Zick, José B Sáenz, Jeffrey W Brown

2020-Current year OA Pubs

Galectins are a family of proteins that bind galactose-containing glycans. One member, galectin-8, preferentially binds galactose that contains a terminal sulfate. Aberrant expression and secretion of sulfated glycosylation epitopes, such as 3'-Sulfo-Le

Flexible Pipes Use As Offshore Activity Noise Suppression System

Defensive Publications Series

Offshore activity can create significant noise pollution in the ocean. This can occur in offshore drilling but is prominent and severe in pile driving of offshore wind foundations.

A "bubble curtain" has been shown to be an effective solution in reducing noise from offshore activities. See BBC article "How bubble curtains protect porpoises from wind farm noise" for details and benefits of such an application.

By creating a porous flexible pipe, with on-bottom stability provides a step change over current perforated hoses. Methods for creating a porous pipe are detailed in attached sketch's

Multi-Modal Signal Fusion Architecture For Employee Knowledge Gap Detection Across Heterogeneous Data Sources, Kenneth Davis

Defensive Publications Series

Field Computer-implemented systems for detecting employee knowledge deficits by fusing gap signals from multiple independent data modalities, including voice transcripts, clickstream behavior, and learning management system interaction patterns, into a unified deficit determination. Background Any single data source for gap detection has blind spots. Natural language analysis misses employees who never ask questions. Clickstream analysis misses employees who work outside enterprise software. Assessment scores miss employees who test well but perform poorly. The approach described here combines multiple modalities to produce a more complete picture of employee competency. Technical Description The system integrates gap signals from three or more independent …

Behavioral Feature Vector Drift Detection For Post-Remediation Knowledge Deficit Recurrence Monitoring, Kenneth Davis

Defensive Publications Series

Field Computer-implemented systems for detecting recurrence of previously remediated employee knowledge deficits. This publication describes an approach that uses behavioral feature vectors derived from user interaction patterns rather than semantic embeddings derived from natural language text. Background After an employee completes remediation for a knowledge deficit, organizations need to determine whether the same deficit comes back during subsequent work. One established approach compares dense semantic embeddings of text communications against stored vector fingerprints using cosine similarity. The approach described here operates on a fundamentally different input type: behavioral interaction patterns encoded as feature vectors, not semantic representations of language. Technical …

Hardware-Attested Assessment Execution In Trusted Execution Environments For Tamper-Evident Compliance Records, Kenneth Davis

Defensive Publications Series

Field Computer-implemented systems for generating tamper-evident employee assessment records using hardware-enforced trusted execution environments, providing integrity guarantees at the silicon level rather than through application-layer state management. Background Regulated industries require proof that employee assessment records have not been altered. Application-layer approaches manage validity through state machines and cryptographic hash chains verified by the application itself. The approach described here moves the trust anchor to the hardware, using the processor's built-in security features to guarantee record integrity independently of any software. Technical Description The assessment execution environment runs inside a hardware-isolated enclave. Compatible hardware platforms include Intel TDX (Trust Domain …

Knowledge Dependency Graph Traversal For Document-Change-Triggered Employee Requalification, Kenneth Davis

Defensive Publications Series

Field Computer-implemented systems for determining which employees require requalification when authoritative reference documents are updated. This publication describes an approach that uses a knowledge dependency graph rather than section-level source-attribution records with reverse-index traversal. Background When a reference document changes, organizations need to identify which employees must be retrained and on what content specifically. One approach maintains per-assessment source-attribution records binding each employee's assessment to the specific document sections tested, then performs a reverse lookup when sections change. The approach described here uses a separate knowledge graph that abstracts documents into atomic concepts with dependency relationships. Technical Description The system …

Integrated Aperiodic Geometric Stabilization For Soft-Robotic Actuation And Kinetic Damping Lattices., Daniel Schramm

Defensive Publications Series

This disclosure establishes the foundational math for high-precision, low-energy soft robotics and protective apparel. By utilizing the Golden Ratio (\phi) as a rotational and structural constant, we eliminate the "Pinch Factor" (mechanical resonance) and enable near-total energy recovery (92%+) in dynamic systems.

Core Technical Pillars:

1. Aperiodic Joint Articulation: Robotic joints and suit hinges are tuned to a non-integer frequency (f_1 = \omega, f_2 = \omega \cdot \phi). This prevents constructive wave interference, ensuring fluid motion without "dead zones" or "locking."

2. Kinetic Waste Harvesting: Using the Tractor Gradient Identity F = \nabla (\mathbf{m} \cdot \mathbf{B}), the system converts deceleration …

Binary Credential Validity Model With Document-Change-Triggered Invalidation And Cryptographic Hash Verification, Kenneth Davis

Defensive Publications Series

Field

Computer-implemented systems for maintaining employee competency credential validity. This publication describes a two-state model (valid/invalid) with document-level change detection and cryptographic hash verification. It does not use proposition-level granularity, multi-state lifecycle management, or validity bitmaps.

Background

In regulated industries, organizations must keep competency records showing that employees have been trained on the current version of authoritative reference materials: standard operating procedures, regulatory guidelines, product specifications, and similar documents. When a reference document gets updated, employee credentials linked to it may need invalidation followed by retraining. Commercial systems like Veeva Vault Training Impact Assessment and MasterControl Training Management handle this …

Categorical Label Matching For Post-Remediation Knowledge Deficit Recurrence Monitoring, Kenneth Davis

Defensive Publications Series

Field

Computer-implemented systems for monitoring whether identified knowledge deficits recur after remediation. This publication describes an approach that uses categorical label comparison rather than dense vector embedding similarity computation.

Background

Once an employee completes remediation for a knowledge deficit, organizations want to know if the same deficit comes back. One way to do this is with embedding-based approaches that compute cosine similarity between dense vector representations of subsequent communications and stored gap fingerprints. The approach described here takes a different path: it compares classification labels rather than embedding vectors. The computational cost is much lower, though discrimination capability is reduced. …

Blockchain Consensus Protocol For Federated Knowledge Gap Record Validation And Cross-Organizational Competency Attestation, Kenneth Davis

Defensive Publications Series

Field

Distributed ledger systems for validating, federating, and attesting organizational knowledge gap records across multiple organizations. This publication describes an approach that uses blockchain consensus rather than centralized cryptographic hash chain verification.

Background

Organizations that maintain knowledge gap records and competency evidence need ways to ensure record integrity, prevent unauthorized modification, and support cross-organizational competency attestation. Think of a nurse transferring between hospitals or a financial advisor moving between firms. Centralized hash chain approaches keep all integrity verification data in a single organizational data store. The approach described here distributes the verification function across multiple nodes using a blockchain network. …

Structured Assessment Score Gap Detection Without Natural Language Processing, Kenneth Davis

Defensive Publications Series

Field

Computer-implemented systems for detecting individual knowledge deficits in organizational workforces. This publication describes an approach based on structured assessment score analysis that does not require natural language processing of unstructured communications.

Background

Organizations routinely assess employee knowledge through structured instruments: multiple-choice quizzes, Likert-scale self-assessments, scored simulations, timed task completions. These instruments produce numerical score vectors. The scores can be analyzed computationally to surface knowledge deficits without ever touching a natural language processing pipeline.

Technical Description

The system receives structured assessment results. Each result contains numerical scores across predefined dimensions (for example, product accuracy scored 1 to 5, procedural compliance …

Integrated Active Dimming Assembly In Compression-Molded Optical Lens

Defensive Publications Series

The present disclosure generally relates to optical lenses, and more particularly, to integrated active dimming assembly in compression-molded optical lens.

Transformational Leadership In Higher Education, Dr. Jewel Hale, Jr., Kristi Apostel

Tapestry: Journal of Research in Education

A crisis can highlight the critical need for resilient leadership within higher educational settings. Educational leaders encounter extraordinary difficulties, ranging from different learning options to prioritizing the well-being of both staff and students, necessitating flexible and innovative methods. By exploring how school leaders apply transformational techniques in actual educational environments, this article addresses the impact of the four I’s of transformational leadership, idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration, on building educator resiliency, sustaining school effectiveness, and promoting student achievement in higher education.

Silent Detonations: Redirecting Focus, Preserving Identity, And Leading Under The Weight Of Microaggressions, Ray Lavan

Tapestry: Journal of Research in Education

African American educational leaders consistently navigate racial microaggressions that challenge their focus, identity, and well-being. This study explores how these leaders deploy attention to manage the emotional weight of microaggressions in K-12 public school settings. Using Gross’s emotion regulation theory and Sue’s taxonomy of racial microaggressions, this qualitative phenomenological study examines how attentional deployment serves as both a shield and constraint. Data from the African American leaders reveal that silence, background processing, selective focus, and redirection to professional goals are common strategies to sustain composure. These strategies protect leaders in the moment but create emotional strain, identity conflict, and cumulative …

Fierce Leadership-Perspectives Of Black Women Educational Leaders: A Transcendental Phenomenological Study, Janice Taylor, Dianne Reed

Tapestry: Journal of Research in Education

The authors of this transcendental phenomenological study aimed to describe the lived experiences of Black women based on their perceptions, values, and beliefs about the complexities of leadership and the kind of leadership required to succeed in their respective roles, as educational leaders. This study was framed by the adaptive leadership theory. Adaptive leadership recognizes the need for leaders to stay flexible and resilient in fast-paced environments (Nelson & Squires, 2017). The three Black women leaders in this study were fierce adaptive leaders. The information acquired from this study is significant and highlights how Black women educational leaders developed the …

Being-Their-Ship: A Presence-Based Model Of Human-Centered Leadership, Ricky J. Martinez

Tapestry: Journal of Research in Education

Being-Their-Ship describes a presence-based approach to leadership grounded in lived experience rather than positional status. Developed over years of service in rural education, the framework highlights leadership as a relational practice grounded in steadiness, quiet support, and a willingness to take responsibility for others. Drawing from autoethnography and narrative inquiry, the framework articulates four interconnected dimensions: Caring-Ship, Loving-Ship, Load-Ship, and Being-There-Ship, that define leadership not through authority but through consistent action and cultural trust. Each dimension reflects how leadership emerges when individuals become a stabilizing presence, absorb burdens that others would otherwise carry, and remain committed to a community through …

Research Literacy And Research Production Skills As Core Competencies In Leaders, Kk O'Byrne

Tapestry: Journal of Research in Education

No abstract provided.

Teaching Experience And Burnout During Remote Learning, Tony Durr, Nicole Graves, Patrick D. Hales

Mid-Western Educational Researcher

During the spring of 2020 many K-12 teacher were forced to transition their classes to remote learning environments. This study examines the extent to which teaching experience related to symptoms of burnout reported by teachers when switching instruction to remote learning during the COVID-19 pandemic. Results indicated that years of teaching experience was a significant predictor of the emotional exhaustion component of burnout, with mid-career (β = 0.966, p ≤ .001) and veteran teachers (β = 1.085, p ≤ .01) reporting significantly higher levels of emotional exhaustion compared to novice teachers. These results indicate that novice teachers experienced less burnout …

Tolkien's Joyful Sorrow, The "Gift Of Tears" Of Medieval Mysticism, And John Donne's Sermon "Jesus Wept", Giovanni Carmine Costabile

Journal of Tolkien Research

At the field of Cormallen, the emotion of joy felt by the victorious Hobbits is so great that Sam wonders whether everything sad will come untrue. At the same time, their joy is so great that it is described as "poignant as grief". Dimitra Fimi in 2017 pointed out Tolkien's probable indebtedness to Christian Orthodox tradition of "charmolype", or joyful sorrow. Another relevant parallel of the intermingling of joy and sorrow is the eleventh century Norman monk and abbot John of Fécamp's notion of the "Gift of Tears" (Gratia lacrymarum) from God, which brings true happiness. …

Making Water Visible: Neutral, Verification-First Infrastructure For Basin-Scale Water Accountability, Eric Mcculley

Spring Runoff Conference

Every Tool Tells You What the Lake Level WAS.

None Tell You What It WILL BE.

• Current monitoring is retrospective — USGS gauges and DWR reports show only historical data
• Decision lag: By the time you see the problem, it’s too late to adjust
• 2024–2025 season: GSL dropped to record lows before upstream conservation kicked in
• Agricultural users, municipalities, and GSL all compete for limited supply with imperfect information

Meteorological Monitoring With Real-Time Data Processing Using Uas, Htoo Poe Sar, Cal Coopmans, Sierra Young

Spring Runoff Conference

Background and Motivation 

• Agricultural water management requires information about crop water use and water consumption 
• Remote sensing methods are used to model and estimate environmental processes – but they require weather data 

Utah Prototype For Visualizing Vulnerabilities Downstream Of Dams, Courtney Flint, Michael Englert, Nicolas Holden

Spring Runoff Conference

The climate question 

• Overtopping = 1/3^rd of all dam failures (ASDSO) 
• Drought concerns and supply uncertainty motivate keeping reservoirs full 
• Overtopping likelier if extreme storm when reservoir full 
• Over much of the country the probability of the annual daily maximum rainfall > 100-year event and the preceding 30-day rainfall >10-year event are going up (Hwang & Lall 2024)