Digital Commons Network^™

Determinants Of Routine Childhood And Adolescent Vaccine Hesitancy And Uptake Among Parents In The United States: A Scoping Review, Precious Johnson

Theses and Dissertations

Routine childhood and adolescent vaccination is an essential public health strategy for preventing disease and protecting communities. However, parental vaccine hesitancy and barriers to vaccine uptake continue to affect vaccination decisions in the United States. This scoping review examined factors associated with routine childhood and adolescent vaccine hesitancy and uptake among U.S. parents. A comprehensive literature search of PubMed and EBSCO identified peer-reviewed studies published in English between 2016 and 2026. Studies focusing on parents, guardians, or caregivers of children and adolescents in the United States were screened according to predefined eligibility criteria. Of 69 records identified, 52 remained after …

Edge Guided Channel Attention In Fsrcnn: A Novel Approach For Depth Super Resolution, Yagneshkumar Jayantilal Parmar, Paresh M. Dholakia

Mansoura Engineering Journal

Depth images from low-cost sensors often suffer from blurred edges and structural distortions when processed with standard super-resolution models. While FSRCNN is efficient for RGB images, it struggles to handle the unique geometric requirements of depth maps. To solve this, we propose the Edge Guided Channel Attention FSRCNN (EGCA FSRCNN). This method incorporates an edge-guided modulation mechanism to preserve object boundaries and a Squeeze and Excitation (SE) block to focus on critical structural features. A major benefit of this framework is the use of frozen, pretrained FSRCNN weights, which bypasses the requirement for retraining. Our evaluation on the UTKinect, Middlebury, …

Trident-Bladder: A Resolution-Aware Multimodal System For Robust, Calibrated Bladder Cancer Diagnosis Across Endoscopy, Histopathology, And Liquid Biopsy, K. Sankar, S. Venkata Lakshmi, Gummadi Reshma, V. Gokula Krishnan, M. Ganesan, V. Vijayaraja

Mansoura Engineering Journal

Bladder cancer diagnosis demands the integration of cystoscopy, histopathology, and biomarker testing, yet the majority of AI systems continue to be modality, specific and sensitive to acquisition variations. TRIDENT, Bladder is a resolution, aware multimodal framework that we have developed to address this issue. The method combines cystoscopic lesion segmentation, whole, slide image (WSI) molecular subtype prediction, and urine miRNAclinical data through reliability, weighted fusion and a utility, aware decision policy. The endoscopic branch features a quality, gated super, resolution component, resulting in mDice 87.5, sensitivity 92.1%, precision 91.4%, boundary, F1 85.3%, and ECE 0.023 at 32 FPS. mDice on …

On Saying Goodbye: Interactional Role Liminality & Post-Death Symbolic Interaction, Deborah Cobb

All Graduate Theses, Dissertations, and Other Capstone Projects

Grief is often understood as a process that culminates in detachment, with "saying goodbye" positioned as both an emotional and social necessity. Yet many bereaved individuals describe a different experience, one in which supernatural post-death contact allows them to receive messages from their deceased loved one. Drawing on 22 in-depth interviews and 47 anonymous open-ended surveys, this study explores how individuals who experience unsolicited post-death communication interpret these encounters and integrate them into everyday life. Analysis revealed three interconnected themes: resistance to saying goodbye, interpretation of encounters as specific messages from the deceased, and emotional stabilization following continued contact. These …

Understanding Phishing Susceptibility Through Expert Consensus Using Digital Marketing Parallels And A Machine Learning-Based Implementation, Mansoor Ahmad

All Graduate Theses, Dissertations, and Other Capstone Projects

Phishing remains one of the most effective attack vectors for gaining unauthorized access to organizational systems, yet defenders often lack systematic methods to assess their exposure before an attack. This study develops a framework that uses machine learning to encode the collective expertise of cybersecurity practitioners into a portable phishing susceptibility assessment tool, with the goal to help security teams proactively identify patterns, prioritize awareness training, and strengthen detection controls. The study surveyed 27 practitioners with extensive experience in social engineering, red teaming, penetration testing, and threat analysis to identify which factors most influence phishing susceptibility. Practitioners provided quantitative ratings …

Watching Over Cold Waves: The Influence Of Social And Technology Surveillance On Independent Older Adults’ Safety, S M Ashfaqur Rahman

All Graduate Theses, Dissertations, and Other Capstone Projects

Cold waves pose a recurring and serious hazard for independently living older adults, yet the monitoring arrangements that shape their protective responses remain understudied. This study examined how social surveillance, defined as check-ins and support from family, neighbors, and community contacts, and technological surveillance, defined as weather applications, smart devices, and emergency alert platforms, jointly and independently predicted cold-wave safety behavior. A cross-sectional, exploratory mixed-methods design was employed. One hundred independently living adults aged 65 and older, residing in cold-prone U.S. states, completed a survey measuring monitoring frequency, source trust, perceived autonomy, concern across six cold-wave hazard types, and a …

Stories That Wound, Stories That Heal: Navigating The Effects Of Performing Traumatic Experiences In Collegiate Forensics, Manuel Reyes

All Graduate Theses, Dissertations, and Other Capstone Projects

This thesis explores the student's motivation for performing traumatic experiences in forensics and what considerations come with the performance of choice. The literature review highlights the intricate nature of trauma, emphasizing benefits of storytelling in recovery, and the current state of forensics when it comes to performing traumatic experiences on judges and spectators. The research examines the motivation on students for performing traumatic experiences and how the students navigate the tensions before, during, and after performance. Through semistructured interviews with current and former competitors, the research delves into the justification and the impacts of performing traumatic experiences. The thesis shows …

Evaluating Soil And Plant Health In A Wide-Row Maize (Zea Mays L.) Production System Integrated With Perennial Cover Crops And Turkey (Meleagris Gallopavo), Sovika Bhattarai

All Graduate Theses, Dissertations, and Other Capstone Projects

In regions dominated by intensive maize (Zea mays L.) production systems, such as the US Midwest, sustainable agricultural practices such as cover crops and livestock integration are gaining interest for their potential to improve soil, plant, and environmental health. Traditionally, annual cover cropping systems (ACCs) have been used to maintain soil quality and crop performance without compromising ecosystem services. However, the high establishment and management costs of ACCs highlight the need for alternative approaches, such as perennial cover crops (PCCs). Grown as companion crops with maize, PCCs provide extended soil cover and can improve soil biochemical properties (e.g., total C …

Town Of Merrimack, Nh Annual Report 2025, Merrimack Town Representatives

Merrimack, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

The Future Of U.S. Higher Education: Equity Implications Of Shifting Immigration Policies, Research Institute For Social Equity Rise

Research Institute for Social Equity

This report examines the impact of U.S. immigration policies on higher education and international students from 2000 to 2025. It traces five major policy eras, from the post- 9/11 security overhaul and Obama-era expansion to the restrictive turns of 2017–2020 and 2025, and analyzes how shifting regulations have influenced enrollment patterns, economic contributions, and student well-being. Despite hosting more than 1.1 million international students in 2023–2024, the U.S. share of the global student market has fallen from 20% to 16%, underscoring how policy volatility and restrictive measures weaken national competitiveness. Drawing on federal data, scholarly research, and institutional reports, this …

From Diet To Deviance: Exploring The Link Between Eating Habits And Delinquent Behaviors In Early Adolescents, Mingxi Tong

Master of Arts in Criminal Justice Theses

This study examines associations between dietary habits and delinquent behaviors among U.S. adolescents, guided by biosocial and social bond theories. Using multilevel logistic regression analysis of 6,274 participants (ages 11-15) from the 2009/10 Health Behavior in School-aged Children survey, the research investigated relationships between four dietary patterns (breakfast consumption, fruit/vegetable intake, sweets consumption, and soft drink consumption) and five delinquent behaviors (bullying perpetration, physical fighting, alcohol use, cannabis use, and tobacco smoking). Results demonstrate partial support for the hypothesis that healthier dietary habits are associated with lower delinquency. Breakfast consumption emerged as a consistent protective factor across all behaviors (7-15% …

Evaluating The Burnout Mitigating Effects Of A Structured Mentorship Program In Newly Hired Advanced Practice Providers, Melissa Soper

DNP Projects

Importance: Burnout is a leading driver of clinician intent to leave, lower productivity, increased medical errors, and increased resource use.

Objective: The purpose of this project was to evaluate the effects of an evidence-based mentorship program on newly hired advanced practice providers’ (APPs’) level of stress, burnout, and professional fulfillment.

Results: At baseline, APPs demonstrated higher stress levels, moderate professional fulfillment, and low burnout. Outcomes showed improvement at the end of a mentorship program.

Conclusion: Longitudinal studies with larger sample sizes are needed to determine the true effect of a 6-month mentorship intervention on APP burnout, stress, and professional fulfillment.

Establishing An Advanced Practice Provider-Led Transient Ischemic Attack Clinic: A Quality Improvement Initiative, Brittany A. Young

DNP Projects

Background: Due to lack of subspecialized neurological care in many rural community settings, care in tertiary hospitals is in demand. Insufficient care pathways can lead to lack of bed and provider availability. Advanced Practice Provider Transient Ischemic Attack clinics have been shown to be safe alternatives to hospital admission, for patients who meet criteria. This study targeted practice change at a 1000 bed tertiary academic hospital.

Methods: The quasi-experimental study sample inclusion criteria included Transient Ischemic Attack patients presenting to the emergency department with an ABCD2 < 4, complete symptom resolution, and no new cardiac changes on monitoring. A pre and post survey with educational PowerPoint intervention was provided to all emergency department and Neurology providers and nurses. A Transient Ischemic Attack clinic was established with a corresponding order set to be utilized for streamlined outpatient work up.

Results: During the pilot period, 29 admissions were deferred with 69% …

Sepsis In Sight: Immersive Vr Simulation For Pediatric Training, Kelsey Wagler

DNP Projects

Abstract

Objectives: This project aimed to decrease the time required to administer antibiotics and fluid boluses to pediatric patients with sepsis by implementing a virtual reality (VR) simulation program. The initiative sought to enhance bedside nurses’ and pediatric residents’ knowledge, clinical reasoning, and confidence in sepsis assessment, early recognition, and evidence-based management. A secondary objective was to evaluate the effectiveness of VR simulation as an educational strategy for nurses in a high-acuity pediatric setting.

Design: This quality improvement project used a quasi-experimental design that incorporated a VR simulation intervention followed by a structured debriefing and targeted education session. Participants completed …

Stronger Together: Exploring The Impact Of Peer Support Meetings On Stress And Burnout In Ambulatory Nurse Managers, Sara Wellman

DNP Projects

Background

Nurse manager (NM) burnout is common and leads to decreased staff productivity, departmental effectiveness, and leadership capacity. This results in decreased staff morale, poor conflict management, and ineffective communication. Stress reduction and resilience programs have been shown to reduce burnout and enhance resilience in NMs, but more focus needs to be directed toward NMs who work in ambulatory settings.

Purpose

The aim of this project was to evaluate the effectiveness of a peer-to-peer resilience intervention in reducing stress and burnout among ambulatory nurse managers.

Methods

This project used a pre-test/post-test survey design and a convenience sample of ambulatory NMs. …

Rural Oral Health Access Coordination Program Proposal, Anna Luu

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Oral health disparities remain a major public health issue in the United States, particularly in rural Kentucky, with barriers such as limited access to preventive dental services, transportation, and insurance coverage contributing to delayed treatment and worsening oral health outcomes. In response, the proposed Rural Oral Health Access Coordination Program aims to improve care access by strengthening referral systems, integrating oral health screenings into public health settings, and enhancing care coordination for high-risk populations. The program intends to focus on the Kentucky River District Health Department Region, connecting individuals to existing services rather than providing direct clinical care. Expected outcomes …

Perry County Perinatal Access Navigator Program (Pc-Pamp) A Public Health Program Proposal To Improve Timely Prenatal Care Access In Perry County, Kentucky, Amber E. Mcguire-Chun

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Delayed initiation of prenatal care remains a significant public health concern in rural Appalachian communities, including Perry County, Kentucky, where structural barriers such as limited provider availability, transportation challenges, and fragmented referral systems contribute to inadequate access to timely care. This capstone project proposes the Perry County Prenatal Access Navigator Program (PC-PANP), a community-based patient navigation model designed to improve initiation of prenatal care in the first trimester. The program is led by the local health department and leverages partnerships with healthcare providers, the University of Kentucky College of Public Health, WIC, Extension services, and community organizations to support early …

The Seeds Of Peace And Justice, Shai Dothan

Chicago Journal of International Law

Some positive developments in international law had humble beginnings. They started from a small group of idealists who wanted to change the world for the better. Once their ideas gathered momentum, they got the support of people with power and transformed the world. State after state followed each other in a cascade toward improving international law. The purpose of this paper is to investigate the conditions that are beneficial for the initial germination of ideas with the potential to positively revolutionize international law. By using a series of case studies focused on the initiation of major transformations that improved international …

The Territorial Independence Of Intellectual Property Rights, Aaron X. Fellmeth

Chicago Journal of International Law

No abstract provided.

Balancing Nationalities In International Investment Law, Peter J. Spiro

Chicago Journal of International Law

How can you tell where someone is “from”?  Historically, an individual’s national identity was singular, starting with formal nationality. One’s national center of gravity was readily determinable. Not so today. Determining one’s primary national identification is no longer an easy thing in many cases. This is consequentially enabled by the growing acceptance of dual citizenship. One can openly identify as a formal member of more than one country in a way that was disfavored in the past.

International investment law, however, has not caught up to this reality. In an increasing number of international arbitrations, tribunals are shutting the doors …

The Nlrb’S Authority To Make Workers Whole, Wanny Mei

Fordham Law Review

In December 2022, the National Labor Relations Board (NLRB or the “Board”) announced a modified make-whole remedial framework in Thryv, Inc.For all standard make-whole relief orders, the Board would order relief for direct or foreseeable pecuniary harms that employees suffer as a result of an unfair labor practice. Proponents of this remedial design assert that this is consistent with the Board’s authority under section 10(c) of the National Labor Relations Act (NLRA). On the other hand, opponents find that this design exceeds the Board’s statutory authority and conflicts with the Seventh Amendment right to a jury trial.

This Note …

The Dead Hand And Frozen Lives: Embryonic Personhood And The Disruption Of Property Interests, Emma Miloglav

Fordham Law Review

Advances in assisted reproductive technology and the expansion of fetal personhood laws are colliding with a body of property doctrine built on assumptions about reproduction that no longer hold. In LePage v. Center for Reproductive Medicine, P.C., the Supreme Court of Alabama held that extrauterine embryos—fertilized and frozen in a laboratory—are “children” under the state’s Wrongful Death of a Minor Act. LePage represents a dramatic extension of fetal personhood.

This shift carries profound consequences for trusts and estates. If frozen embryos are treated as legal persons, they may qualify as heirs under intestacy statutes and as beneficiaries of wills, …

The Art Of Giving Good Feedback: How Principals And Other Factors Build Or Break Teacher Efficacy Through Evaluations And Feedback In The Public Elementary School Setting, Kayla Davidson

Doctor of Education (EdD)

The aim of this study was to explore how public elementary school teachers experience and interpret principal feedback in relation to their sense of self-efficacy, including how their lived experiences align with Teacher Sense of Efficacy Scale (TSES) ratings. Understanding how feedback shapes teacher confidence may help school leaders design evaluation systems that better support professional growth and retention. In this study, feedback was most influential when it was grounded in direct observation, specific, and delivered within trusting professional relationships, while formal evaluation feedback was often perceived as compliance-oriented and less impactful on teacher confidence. Findings indicated that self-efficacy was …

Supporting Functional Independence Through Task-Analytic Instruction: Implications For Skill Acquisition And Generalization In Students With Moderate To Severe Disabilities, Aisha Khan

Doctor of Education (EdD)

Students with moderate to severe disabilities often demonstrate variability in acquiring and generalizing functional skills necessary for independent participation in school and daily life. Although evidence-based practices are widely recommended, less is known about how specific instructional strategies support both skill acquisition and generalization. The purpose of this quantitative single-subject study was to examine the effects of task-analytic instruction on the acquisition, efficiency, and generalization of a functional help-seeking routine among middle school students with moderate to severe disabilities in a self-contained life skills program. Using a multiple-baseline design across three participants, the study measured (a) the percentage of independently …

An Impact Evaluation Study Of The Use Of A Structured Advisory Class To Operationalize Sel Curriculum: An Intervention To Improve School Connectedness, Lacey Rebecca Rotella

Doctor of Education (EdD)

This sequential explanatory mixed-methods study examined the impact of a structured, twiceweekly advisory class designed to operationalize social-emotional learning (SEL) curriculum as an intervention to strengthen middle school students’ sense of school connectedness. Prompted by low California Healthy Kids Survey (CHKS) results and inconsistent curriculum implementation, the study—grounded in stage-environment fit theory, ecological systems theory, social cognitive theory, and self-determination theory—investigated whether this intervention influenced students’ reported sense of connectedness and how students themselves defined and experienced belonging within the school environment. Phase I analyzed CHKS School Connectedness data from 378 eighth-grade students and engagement indicators, including chronic absenteeism, average …

Bipoc Affinity Groups: Native Educator Perspectives, Kayla Kneeland-Jaimes

Doctor of Education (EdD)

This study explored two questions related to BIPOC affinity groups for Native educators. The first research question explored “In what ways are BIPOC affinity spaces meaningful for Native educators?” The second research question this study explored “What are Native educators’ perspectives on best practices for BIPOC affinity spaces?” The problem addressed in this study explored how to support Native educators through BIPOC affinity groups by addressing the impact and value of BIPOC affinity groups from the experience and perspectives of Native educators. This study used Tribal Crit theory–developed by scholar Brayboy. Tribal Crit draws from fields and disciplines like anthropology, …

Wastewater Surveillance For Sars-Cov-2 In Rural Kentucky, 2021–2023, James W. Keck, Reuben Adatorwovor, Ann Noble, Savannah Tucker, William Strike, Soroosh Torabi, Mohammad Dehghan Banadaki, Blazan Mijatovic, Steven K. Roggenkamp, Donna Mcneil, Lindell Ormsbee, Scott M. Berry

Family and Community Medicine Faculty Publications

Wastewater testing for SARS-CoV-2 provided useful public health information during the COVID-19 pandemic yet was underutilized in rural communities. We addressed this gap by implementing wastewater surveillance and assessing its performance in 10 communities in Eastern Kentucky. We collected wastewater samples 1–2 times weekly at 10 wastewater treatment plants (WWTPs) from May 2021 until April 2023 and measured SARS-CoV-2 RNA concentrations using polymerase chain reaction testing. We calculated time-lagged correlations between wastewater concentrations and county-level reported COVID-19 cases by site. We developed a generalized linear model to estimate COVID-19 incidence from wastewater SARS-CoV-2 concentrations. The 10 participating WWTPs served 2430 …

Perceptions Of The Proposed Food And Drug Administration Graphic Cigarette Warnings Among Adults Who Smoke On A Nondaily Or Daily Basis: A Within-Subjects Experiment, Bethany Shorey Fennell, Renee E. Magnan, Jennifer I. Vidrine, Damon J. Vidrine

Family and Community Medicine Faculty Publications

Introduction: People who smoke nondaily represent nearly one third of U.S. adults who smoke and experience significant smoking-related morbidity and mortality, yet they are rarely considered when evaluating the efficacy of graphic cigarette warnings.

Method: In October 2019, U.S. adults who smoked nondaily ( n =59) and daily ( n =183) evaluated 13 Food and Drug Administration–proposed graphic warnings and 13 equivalent text-only warnings on the extent to which they elicited understanding, perceived new knowledge, worry about smoking, and discouragement to smoke and were believable. Repeated-measures ANOVA and planned comparisons tested for between-subjects (smoking status) and within-subjects (warning type) effects. …

Why Queer People Like Horror Films: An Empirical Study, Oscar Garcia

Theses & ETDs

Many queer people hold a particular affinity for horror films, despite the history of harm to queer people that those films have helped to perpetuate. Previous explorations of this relationship have focused on timelines of queer and film history, personal anecdotes, and theorization about these films and the audiences who view them, with no broad study examining how queer people themselves interact with and perceive the media. This study explores how queer people engage with horror films using a multi-method approach that involves a survey and qualitative interviews, examining queer horror fans’ opinions about subgenres, identifications, preferences, impacts of horror …

Structure-Conduct-Performance Analysis Of The Sports Industry In The United States, Luisa Hoffmann Araujo

Theses & ETDs

This study examines the U.S. professional sports industry through the Structure-Conduct-Performance (SCP) framework, which is a model commonly used to analyze how a market organization (structure) affects a firm’s behavior and its economic performance. When applying this analytical framework to the sports sector in the United States, it is possible to see with more clarity how the competition develops, the firm’s strategic decisions, and how they perform in the market. The data and research from this study were retrieved from secondary data sources, where it was possible to analyze academic literature, industry performance reports, and financial publications to deepen the …