Digital Commons Network^™

Symbolic Justice: The Continued Limits Of International Criminal Justice Without A Permanent Prison System, Meg Penrose

Faculty Scholarship

Many people misremember Nuremberg, Tokyo, and the subsequent World War II tribunals. These seminal international tribunals gave the world convictions but largely failed to fully enforce the sentences imposed. Most people do not recall the mass clemency following the World War II tribunals. This Article seeks to fill a scholarly void by explaining why international criminal justice has never matured beyond Nuremberg and Tokyo. The modern ad hoc tribunals, as well as the permanent International Criminal Court (“ICC”), have failed to deliver lasting justice. Much like Nuremberg and Tokyo, the modern tribunals fixate on arrests and convictions and then seemingly …

Predictive Factors Of Academic Success During Transition To Undergraduate Studies In Stem Programs In Kansas, Elizabeth L. Butler

Electronic Theses and Dissertations

In tThis dissertation the researcher exploreds the correlations between high school GPA, ACT Math, ACT cComposite scores, and first -semester GPA for first-time freshmen at a mid-sized university in the Midwest. This quantitative correlational study uses multiple regression analysis to discover correlations that may exist between these interval variables. Data for this study was collected through a request to the study site’s oOffice of pPlanning and aAnalysiss at the university and was all archival data at a record level for the students. Data had been collected through the admissions process and was stored in Banner and SLATE, both data management …

The Impact Of Career Development Education In Rural Communities: A Program Evaluation, Hayden S. Austin

Electronic Theses and Dissertations

This study examined the impact of a regional career development education program using a post-test-only, exploratory descriptive design with middle and high school students from rural and urban school districts in West Central Texas. Students who participated in the Career and Education Outreach (CEO) program received four classroom sessions focused on labor market information, high-demand industries, employability skills, and career pathways. The purpose of this research was to explore whether students’ perceptions of the value of career development education differed based on geographic region, economic level, educational level, ethnic composition of the district, and the students’ own demographic characteristics. A …

Exploring Commuter Trio Students' Student Support Services At A Public University, Travis J. Batiste Edd

Electronic Theses and Dissertations

The study explored the experiences and service needs of TRiO Student Support Services (SSS) commuter students at a public regional university in northern Louisiana. The literature review showed that while TRiO SSS programs have a demonstrated history of promoting academic success and retention for first-generation students, low-income students, and students with disabilities, little institutional research has been conducted to better understand how student residential status impacts learning outcomes and utilization of campus resources. Drawing on Astin’s theory of involvement, this study described the lived experiences of TRiO SSS commuter participants and the impact of commuting on their engagement, programmatic use, …

World On Fire: The Hunger Games And The Rhetoric Of Revolution, Rachel Olivares

Electronic Theses and Dissertations

In the decade between 2010 and 2020, more people participated in mass protests than at any other point in human history. From the Arab Spring to Occupy Wall Street and Hong Kong’s “umbrella movement,” street demonstrations exploded on a global scale. This period of global unrest coincided with another explosion: the dystopian young adult series The Hunger Games surged in popularity, quickly becoming a cultural phenomenon. Following the release of the book series and its subsequent film adaptations, The Hunger Games became a global symbol of grassroots resistance as social and political movements adopted the language and symbols of its …

Sex, Riots, And Holy Water: How Modern Society Desecrates And Reconsecrates The Sacred, Jodeyah J. Mills

Electronic Theses and Dissertations

This thesis explores how modern societies desecrate and reconsecrate the sacred through rhetoric, ritual, and visual performance. Using three case studies, Nazi Germany’s transformation of Quedlinburg Abbey, the January 6th attack on the U.S. Capitol, and Sabrina Carpenter’s controversial church music video, “Feather,” this project analyzes how sacred meaning is violated and restored in religious, civic, and popular contexts. Drawing on Kenneth Burke’s dramatistic cycle and postsecular theory, it argues that desecration and reconsecration are dialogic acts that expose competing moral vocabularies within culture. Each event demonstrates that even in a secular age, people respond to ruptures of ultimate meaning …

Consequences Of Secondary Traumatic Stress On Individuals Without Formal Psychological Training Working With Trauma-Exposed Children, Juan F. Valdez

Electronic Theses and Dissertations

Literature has suggested that secondary traumatic stress could cause various adverse effects for individuals working with trauma-exposed populations. However, direct care workers performing in shelters designed to serve unaccompanied immigrant children are faced with the task of caring for these minors who may have been exposed to trauma in their home countries, while traveling to the United States, or after arriving in the country. This qualitative case study was conducted to understand and describe the experiences of 15 current employees and five ex-employees who have worked with unaccompanied children for at least a year. These individuals participated in in-depth personal …

Exploring The Role Of Christian Religiosity In The Acceptance Or Rejection Of Ai Chatbot Use Among Faculty At Church Of Christ Universities, Amos Gutierrez

Electronic Theses and Dissertations

Higher education institutions are navigating the benefits and challenges of generative AI chatbot use and preparing faculty and students to engage with these tools ethically and responsibly. The problem is that there are many challenges and barriers to using these technologies in higher education, and Christian higher education institutions must also address context-specific considerations regarding mission and vision rooted in biblical faith and practice. The purpose of this quantitative, nonexperimental, cross-sectional study using confirmatory factor analysis and multiple regression through structural equation modeling was to examine faculty perceptions of AI chatbots and how Christian religiosity moderates acceptance. An online survey …

The 4-Day School Week: Impacts On Rural Texas School Districts, Geoffery Bowdoin

Electronic Theses and Dissertations

This study examined how school administrators, teachers, and parents in rural Texas districts view the effects of the 4-day school week. Across Texas, a growing number of districts have adopted shorter calendars to address teacher shortages, boost morale, and manage tight budgets. The goal of this research was to gain a clearer understanding of how this schedule shift influences student performance, district finances, and teacher recruitment and retention. The study followed a qualitative descriptive approach. Data were collected through two means. Semistructured interviews were conducted with 12 school administrators, while 29 teachers and 42 parents completed surveys. Research participants came …

Characterization Of Water Intake And Water Conversion Ratio For Male And Female Broilers From Four Commercial Broiler Lines Reared To Eight Weeks Of Age, J.Z. Hiltz, C.W. Maynard, T.W. Tabler, M.A. Maquesda, K.M. Shafer, K.B. Nelson, M.T. Kidd, N.B. Anthony, S.K. Orlowski-Workman

Poultry Science Faculty Publications and Presentations

Increased interest and investigation into the sustainability of broiler production has led to a need for reliable and repeatable means to measure water intake and its conversion rate into salable meat. Therefore, a study was conducted to characterize the water intake and water conversion ratio (WCR) of male and female broilers from four modern broiler strains. Two of these lines represented fast growing broiler strains (FGB A and FGB B) targeting a small bird market and two represented high yielding broiler strains (HYB A and HYB B). Three replicates of 25 sexed broilers from each line were placed into 24 …

Safety In Stability: A Cdc-Guided Evaluation Of Hospital Fall Prevention Practices, Matthew C. Dougherty

Electronic Theses and Dissertations 2020 - Present

Hospital falls remain a persistent and preventable cause of patient harm, emphasizing the need for continuous evaluation of fall prevention practices. This project assessed the effectiveness of AdventHealth Orlando’s fall prevention policy using the Centers for Disease Control and Prevention (CDC) Program Evaluation Framework. A mixed-methods design incorporated quantitative analysis of 12 months of fall data and qualitative feedback from frontline staff surveys and discussions. Results demonstrated a decrease in total falls from 549 in the previous year to 528 in the current year, indicating early progress despite the incomplete reporting period. Unit-level analysis showed a mean improvement of 16.9% …

Breaking The Silence With Routine Genitourinary Syndrome Of Menopause Screening: A Quality Improvement Project, Ashley R. Noel

Electronic Theses and Dissertations 2020 - Present

Affecting upwards of 87% of women in post menopause, genitourinary syndrome of menopause is greatly under-diagnosed, and consequently, under-treated. Genitourinary syndrome of menopause refers to health conditions impacted by hypoestrogenic state experienced in menopause. Common symptoms of GSM include vaginal dryness, irritation, clitoral or labial atrophy, dyspareunia, decreased libido, anorgasmia, dysuria, recurrent UTI, urinary incontinence (Kaufman et al., 2025). Despite the burdensome consequences of GSM, women are unlikely to vocalize their symptoms and seek treatment. Additionally, societal beliefs of shame surrounding sexual health impede patients and clinicians from addressing GSM specifically (Mili et al., 2021). As a result, the North …

Enhancing Td Screening With The Aims Scale: A Quality Improvement Project, Dionne Smith

Electronic Theses and Dissertations 2020 - Present

Tardive dyskinesia (TD) is a persistent, often irreversible movement disorder associated with long-term use of dopamine receptor–blocking agents. Early identification is critical to prevent progression and minimize functional impairment; however, routine TD screening remains inconsistent in many clinical settings despite the availability of the Abnormal Involuntary Movement Scale (AIMS), the evidence-based gold-standard tool. This quality improvement project aimed to enhance TD screening in an outpatient psychiatric setting through an educational intervention designed to improve provider knowledge of risk factors, diagnostic criteria, and screening guidelines. Data were collected retrospectively and prospectively from patient encounters, with 33 pre-intervention and 35 post-interventions. AIMS …

Persons With Alzheimer’S Disease And Related Dementias And Caregiver Burnout: A Quality Improvement Project, Reede A. Walke

Electronic Theses and Dissertations 2020 - Present

Alzheimer's Disease and Related Dementias (ADRD) represented an escalating public health challenge, profoundly affecting individuals, families, and healthcare systems. As the number of individuals diagnosed with ADRD rises, the prevalence of caregiver burden and burnout among those providing care also increases. The purpose of this quality improvement project was to evaluate the existing assessment processes for caregiver burnout and determine the effectiveness of the Zarit Burden Interview (ZBI), a measurement which identifies caregivers’ levels of stress, at a memory disorder center in south Florida. Sixteen caregivers reported overall mild-to-moderate caregiver burden, with a mean ZBI score of 22.19 (SD = …

Improving Intimate Partner Violence Screening In Telehealth Mental Health Settings, Marina Oliynyk

Electronic Theses and Dissertations 2020 - Present

Intimate partner violence (IPV) is a pervasive yet frequently underrecognized public health concern, particularly within telehealth psychiatric care, where nonverbal cues may be absent. This quality improvement (QI) project aimed to improve the identification and response to IPV by implementing a standardized, evidence-based screening protocol in a private telepsychiatry practice. Guided by the Plan-Do-Study-Act (PDSA) framework, the validated E-HITS screening tool was introduced, along with structured trauma-informed care training, to six psychiatric-mental health nurse practitioners (PMHNPs). Six PMHNPs completed pre/post-confidence surveys (5-point Likert) and tracked screening activity across 100 telehealth encounters (98 of 100 visit were eligible). Over a three-month …

Implementing Primary Care Fall Prevention With The Steadi Algorithm Toolkit, Roslyn Pechet

Electronic Theses and Dissertations 2020 - Present

Falls among older adults remain a leading cause of morbidity and mortality, especially in underserved populations. The Centers for Disease Control and Prevention (CDC) developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit to help providers systematically identify and address fall risks. The purpose of this Doctor of Nursing Practice (DNP) project was to implement and evaluate integration of the CDC STEADI toolkit within primary care at Palm Beach Program of All-Inclusive Care for the Elderly (PACE) Greenacres. The aim was to train the interprofessional leadership team to use the STEADI program to enhance knowledge, confidence, screening, and implementation …

Plasma Metabolomic And Proteomic Signatures Of Blood Pressure Management After Bariatric Surgery Among Adolescents, Shudi Pan, Zhenjiang Li, Juan Pablo Lewinger, Jesse A Goodrich, Hongxu Wang, Sarah Rock, Carmen Chen, Todd M Jenkins, Stephanie Sisley, Stephen R Daniels, Douglas I Walker, Max T Aung, Erika Garcia, Rob Mcconnell, Sandrah P Eckel, Michele A La Merrill, Tanya L Alderete, Zhuanghua Chen, Frank D Gilliland, Thomas H Inge, David V Conti, Justin R Ryder, Lida Chatzi

Faculty, Staff and Students Publications

Background: Emerging omics approaches, including metabolomics and proteomics, can be integrated into obesity treatment for better blood pressure management. We tested whether preoperative metabolomic and proteomic profiles predict long-term elevated blood pressure (EBP) changes better than known risk factors in adolescents undergoing bariatric surgery.

Methods: We included 108 participants from the Teen-LABS (Teen-Longitudinal Assessment of Bariatric Surgery). Plasma untargeted metabolomics (via liquid chromatography with high-resolution mass spectrometry) and Olink proteomics were assessed pre surgery. An elastic net model with stability selection was used to identify features predictive of EBP reductions 5 years post surgery. Models including identified metabolites, proteins, and …

Letter From The Editors: The Value Of Research, Quality Improvement And Evidence-Based Practice Projects, And Innovations In Clinical Practice, Nohemi Sadule Rios, Stephen Breazeale

Nursing & Health Sciences Research Journal

No abstract provided.

Evaluating The Role Of Covid-19 On Delay In Cancer Care And Health Disparities Of Women With Breast Cancer: A Retrospective, Multi-Site Study, Nohemi Sadule Rios, Morgan Nestingen, Mukesh Roy, Lucy Morales, Andrew Salner, Margaret Barton-Burke, Natalie Bermudez, Annmarie Mazzella, Muni Rubens, Muhammad A. Rizvi, Morgan Horton, Suresh G. Nair Md, Tania Silva Santos, Patricia Shearburn, Melissa Kratz, Morgan Hume, Kerry Kluska, Nayla Cepero, Wanli Xu, Wu Weizi, Batool Almasri

Nursing & Health Sciences Research Journal

Introduction: COVID-19 had a profound impact on cancer screening, diagnosis, and treatment worldwide. The purpose of this study was to examine the role that the COVID-19 pandemic had on delays in breast cancer screening, diagnosis, treatment, and other related variables, including cancer staging and oncology measures of performance (ECOG Performance Status), in the inpatient and ambulatory oncology settings.

Methods: This was a multi-site, interdisciplinary retrospective review study including 1,514 participants. Four cancer centers collaborated, submitting de-identified data in accordance with their policies and procedures.

Results: Our study's results showed significantly higher delays in screening mammogram appointments (p < .001) during the COVID-19 pandemic (N=142) than before the COVID-19 pandemic (N=56), with a 52% higher likelihood of canceling screening mammogram appointments during COVID-19. Our findings also revealed a statistically significant difference (p < .001) in the time from diagnosis to the first recommended treatment for scheduled initially appointments, with an increase of 18 days, suggesting delays in cancer treatment during the COVID-19 pandemic.

Discussion: Our findings …

Promoting Self-Reflection And Implicit Bias Awareness In Nursing: A Mixed-Method Study Advancing Practice And Fostering Healthcare Equality, Diane S. Kramer, Victoria Y. Mccue, Anshul Saxena, Jeanette B. Deniz, Nicole Burks, Patricia Russell

Nursing & Health Sciences Research Journal

Background: Implicit biases influence how nurses perceive and interact with patients and shape clinical practice. Awareness is crucial because implicit biases are difficult to detect. Our study evaluated how educational sessions impacted awareness and understanding of implicit bias. In our study, we sought to mitigate effects of these biases on patient care to promote equitable healthcare outcomes.

Methods: The research involved registered nurses from all levels employed at nine hospitals. Data were collected anonymously through voluntary participation to ensure confidentiality. A mixed-methods approach with a quasi-experimental prepost design was utilized to measure the effectiveness of the educational session. Descriptive statistics …

A Β-Lactamase Inhibitory Protein Mutant Displays High Potency And A Broad Inhibition Profile Due To An Altered Binding Mode With Β-Lactamases, Paola Rivera, Shuo Lu, Dignite Ngango, Banumathi Sankaran, Bidadi Venkataram Prasad, Timothy Palzkill

Faculty, Staff and Students Publications

β-lactamase enzymes inactivate β-lactam antibiotics, leading to drug resistance. The β-lactamase inhibitory protein (BLIP) is a naturally occurring inhibitor of β-lactamases, with inhibition constants (Ki) ranging from picomolar to micromolar values. For example, BLIP inhibits CTX-M-14 β-lactamase with a Ki of 330 nM, whereas the Ki for CTX-M-15 is 3 nM, despite CTX-M-14 and CTX-M-15 sharing 83% sequence identity. We used a genetic screen to identify a BLIP mutant, E73W, that potently inhibited CTX-M-14. Subsequent purification and testing of BLIP E73W revealed that it is a potent, broad-spectrum inhibitor of class A β-lactamases. We determined …

Patient-Centered Communication Case: Threatened Miscarriage, Anita Rohra, Daniela Ortiz, Shagun Berry, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Charles Lei, Alaa Aldalati, Stephanie Stapleton, David Fernandez

Faculty, Staff and Students Publications

Audience: This communication case is intended for EM residents of all levels.

Introduction: Patient-centered communication is a necessary skill in the practice of emergency medicine. This style of communication is crucial for promoting high-quality healthcare by prioritizing patient needs, perspectives, and values. This patient-centered communication case centers on miscarriage, a diagnosis where patient-centered communication is requisite. Approximately one in six or 17.1% of patients with a final diagnosis of miscarriage, also known as early pregnancy loss, present initially to the emergency department.1 Advising a patient of the diagnosis of miscarriage requires excellent communication skills including facile rapport building, empathy, nonverbal …

Screening For Diabetes After Solid Organ Transplantation: A 10-Year Retrospective Study, Ridwan B Ibrahim, Sneha Kumar, Sahil Malik, Joseph A Spinner, Daniel H Leung, Sridevi Devaraj

Faculty, Staff and Students Publications

Post-transplantation diabetes mellitus (PTDM) is a common and important complication after solid organ transplantation, affecting long-term outcomes. Graft rejection, decreased patient survival, infections and increased cardiovascular risk are associated with PTDM and may arise from both transplant-related and traditional risk factors. Early screening for PTDM is crucial for early detection and management. Despite clinical guidelines recommending regular screening for PTDM, screening rates remain suboptimal. This retrospective study analyzes PTDM screening rates between January 2014-January 2024 among pediatric kidney, liver, heart and lung transplant recipients at a large quaternary academic pediatric transplant center. PTDM screening rates vary by organ type, with …

Corrigendum To “Clinical Characteristics And Longitudinal Associations With Obsessive-Compulsive Disorder In Youth Exposed To Trauma” [J Mood Anxiety Disord 10c (2025) 100117], Caitlin M Pinciotti, Paul J Rathouz, Andrew G Guzick, Jeffrey D Shahidullah, Emily J Bivins, David B Riddle, Ogechi Cynthia Onyeka, Eric A Storch, Wayne K Goodman, Kelli Franco, Justin F Rousseau, D Jeffrey Newport, Karen Dineen Wagner, Charles B Nemeroff

Faculty, Staff and Students Publications

This corrects the article "Clinical characteristics and longitudinal associations with obsessive-compulsive disorder in youth exposed to trauma" in volume 10, 100117.

Implications Of Cooccurring Adhd For The Cognitive Behavioural Treatment Of Anxiety In Autistic Children, Elise Ng-Cordell, Eric A Storch, Philip C Kendall, Jeffrey J Wood, Amori Yee Mikami, Connor M Kerns

Faculty, Staff and Students Publications

Background: Childhood mental health conditions commonly cooccur, with potential treatment implications. Autistic children frequently experience anxiety and attention deficit/hyperactivity disorder (ADHD). We investigated the implications of this cooccurrence for Cognitive Behavioural Therapy (CBT), a front-line treatment for anxiety in autistic children. We tested whether (1) ADHD predicts anxiety treatment response, (2) ADHD improves in response to anxiety treatment and (3) ADHD improvement is related to reductions in anxiety.

Method: Autistic children with elevated anxiety (N = 167) enrolled in a multisite, randomised controlled trial comparing standard CBT, autism-adapted CBT and treatment as usual. ADHD symptoms and severity were assessed via …

How Well Can Commonly Used Anxiety Scales Detect Treatment Outcomes In The Context Of Autism?, Huilin Chen, Jeffrey J Wood, Connor M Kerns, Eric A Storch, Philip C Kendall, Gaia Scerif, Cathy Creswell

Faculty, Staff and Students Publications

Anxiety is one of the most prevalent mental health challenges in autistic children, yet there is limited evidence on effective tools to measure treatment outcomes. Previous research with non-autistic children has found that the Child Anxiety Impact Scale, Parent Version achieved good diagnostic accuracy when measuring treatment outcomes and performed better than a commonly used symptom measure. However, this has not been evaluated for autistic children. The present study examined the psychometric properties of the Child Anxiety Impact Scale, Parent Version in autistic children and compared its utility against other anxiety symptom measures, to detect treatment outcomes as assessed by …

Difficult Conversation Case: Death Notification, Charles Lei, Tiffany Moadel, Suzanne Bentley, Amrita Vempati, David Fernandez, Daniela Ortiz, Anita Rohra, Stephanie Stapleton, Hillary Moss

Faculty, Staff and Students Publications

Audience: This case is meant for senior emergency medicine (EM) resident physicians as a preparatory tool for the American Board of Emergency Medicine Certifying Exam. However, it is applicable for EM residents at all levels of training.

Introduction: Difficult conversations are an integral part of the practice of emergency medicine. Competent EM physicians routinely engage in challenging conversations with patients and their families (eg, delivering bad news, disclosing medical errors, providing death notifications).1 Despite their importance, communication skills are often not formally taught in residency training.2 Instead, learners frequently rely on role modeling to develop the skills necessary to navigate …

A Review Of The Efficacy Of Complementary And Alternative Medicines In Managing Dermatologic Infectious Diseases, Promise Ufomadu, Bartley Joseph Gill, Ikue Shimizu, Ida Orengo, Theodore Rosen

Faculty, Staff and Students Publications

Dermatologic infections, particularly fungal and viral, are globally prevalent and often lead patients to seek complementary and alternative medicines (CAMs). This review critically evaluates 17 studies investigating CAM efficacy in treating dermatologic infectious diseases, focusing on those evaluated in randomized controlled trials (RCTs). Tea tree oil shows modest benefit for fungal infections such as tinea pedis and onychomycosis, though studies are limited by poor blinding and dropout rates. For herpes simplex virus (HSV), propolis and Melissa officinalis demonstrate potential antiviral effects, but findings are limited by subjective outcomes and industry sponsorship. Green tea extract (polyphenon E) shows efficacy in treating …

Rationale And Design Of The Rembrandt Trial: A Phase 3 Study To Evaluate The Effect Of Obicetrapib/Ezetimibe On Coronary Plaque Characteristics, Cian P Mccarthy, Christie M Ballantyne, Ron Blankstein, Matthew J Budoff, Marc Ditmarsch, C Michael Gibson, John J P Kastelein, Ann Marie Navar, Stephen J Nicholls, Kausik K Ray, Cheerag Shirodaria, Michelle C Williams, James L Januzzi

Faculty, Staff and Students Publications

Background: Obicetrapib is a potent, selective cholesteryl ester transfer protein (CETP) inhibitor that significantly lowers low-density lipoprotein cholesterol (LDL-C). Additive reductions in LDL-C occur when obicetrapib is combined with ezetimibe. The impact of obicetrapib and ezetimibe fixed-dose combination (FDC) on coronary plaque burden is unknown. Favorable changes in noncalcified coronary atherosclerotic plaque volume (NCPV) may indicate a potential beneficial effect on atherosclerotic cardiovascular disease (ASCVD) events.

Methods: REMBRANDT is a placebo-controlled, double-blind, randomized trial designed to assess the efficacy of obicetrapib and ezetimibe FDC on coronary plaque burden. Individuals aged 45 years or older with ASCVD (imaging evidence of vascular …

Where, How, And How Much? A Multicenter Cohort Study Of The Relationship Across Lupus Decision-Aid Modality, Place Of Administration, Interruption And Viewing Completeness, And Patient-Reported Outcomes, Jasvinder A Singh, Mark Beasley, Larry R Hearld

Faculty, Staff and Students Publications

Objective: We assessed whether shared decision-making (SDM) and patient acceptability, feasibility, and overall satisfaction with a computerized patient decision aid (PtDA) for patients with systemic lupus erythematosus (SLE) differs by PtDA setting, modality, and the viewing experience.

Methods: Patients with SLE were invited to view a self-administered computerized SLE PtDA during regular clinic visits at 15 rheumatology clinics in an implementation trial. Patients completed a survey that included SDM measures including the decision conflict scale (DCS), Preparation for Decision Making (PDM) scale, and CollaboRATE scale, and we measured perceived patient acceptability, feasibility, and satisfaction. Patients viewed the SLE PtDA in …