Digital Commons Network^™

Sex-Related Measurement Bias In Autism Spectrum Disorder Symptoms In The Baby Siblings Research Consortium, Catherine A. Burrows, Sooyeon Sung, Shuting Zheng, Greg S. Young, Tony Charman, Cherly Klaiman, Ami Klin, Natasha Marrus, Sally Ozonoff, Joseph Piven, Diana L. Robins, Rebecca J. Schmidt, A. J. Schwichtenberg, Sara Jane Webb, Lonnie Zwaigenbaum, Leslie J. Carver, Katarzyna Chawarska, Suzanne Curtin, Shafali S. Jeste, Jana M. Iverson, Jane E. Roberts

Faculty Publications

Importance Disparities exist in age of diagnosis and prevalence of autism spectrum disorder (ASD) for female compared with male children. Correcting for sources of bias is critical for improving equitable ASD identification.

Objective To determine whether sex differences exist in measurement of ASD symptoms using the Autism Diagnostic Observation Schedule (ADOS) among young children at high familial likelihood (HFL) and low familial likelihood (LFL) of ASD.

Design, Setting, and Participants This cohort study collected longitudinal, prospective data from the Baby Siblings Research Consortium between January 1, 2003, and December 31, 2021. Participants included 3106 children who had an older sibling …

Sex-Related Measurement Bias In Autism Spectrum Disorder Symptoms In The Baby Siblings Research Consortium, Catherine A. Burrows, Sooyeon Sung, Shuting Zheng, Tony Charman, Cheryl Klaiman, Ami Klin, Natasha Marrus, Sally Ozonof, Joseph Piven, Diana L. Robins, Rebecca J. Schmidt, A. J. Schwichtenberg, Sara Jane Webb, Lonnie Zwaigenbaum, Leslie J. Carver, Katarzyna Chawarska, Suzanne Curtin, Shafali S. Jeste, Jana M. Iverson, Rebecca J. Landa, Daniel S. Messinger, Jane E. Roberts, Wendy L. Stone, Helen Tager-Flusberg, Amy N. Esler, Meghan Miller, Somer L. Bishop, Jed T. Elison

Faculty Publications

IMPORTANCE Disparities exist in age of diagnosis and prevalence of autism spectrum disorder (ASD) for female compared with male children. Correcting for sources of bias is critical for improving equitable ASD identification. OBJECTIVE To determine whether sex differences exist in measurement of ASD symptoms using the Autism Diagnostic Observation Schedule (ADOS) among young children at high familial likelihood (HFL) and low familial likelihood (LFL) of ASD. DESIGN, SETTING, AND PARTICIPANTS This cohort study collected longitudinal, prospective data from the Baby Siblings Research Consortium between January 1, 2003, and December 31, 2021. Participants included 3106 children who had an older sibling …

From Bed To Table: Improving Outcomes By Encouraging Patient Mobility During Meals, Quyen Ho

Master's Projects and Capstones

Abstract

Background: Hospital-acquired pneumonia (HAP) is a preventable complication associated with increased morbidity, prolonged hospital stays, and elevated healthcare costs. Early mobility, particularly positioning patients out of bed for meals, is a key strategy to mitigate this risk. Problem: On a 42-bed telemetry unit, only 24% of eligible patients were positioned out of bed for meals. This low rate of mobility presented an opportunity to reduce the risk of HAP and improve patient outcomes. Interventions: This quality improvement initiative, guided by the Donabedian Model, employed a nurse-led intervention that included daily mobility assessments, visual bedside cues, and targeted staff education. …

Comparison Of Left Breast Accelerated Partial Breast Irradiation Plans: Flattening Filter Free Vmat Vs. Standard Vmat In Deep Inspiration Breath Hold And Free Breathing Techniques, Monica Albeck

Masters Projects

This retrospective planning study compared dosimetric outcomes and treatment efficiency between flattening filter free (FFF) and standard volumetric modulated arc therapy (VMAT) plans for left breast accelerated partial breast irradiation (APBI) under deep inspiration breath hold (DIBH) and free-breathing (FB) conditions. Ten patients with early stage left breast cancer were replanned to create four plans each: FFF VMAT and standard VMAT in DIBH and FB. All plans prescribed 30 Gy in 5 fractions. Measures included planning target volume (PTV) coverage, mean heart dose, ipsilateral lung V30%, contralateral breast maximum dose, and monitor units (MUs). Statistical analysis used repeated-measures ANOVA with …

Chew On It: A Pilot Study Of A Multimodal Assessment Of Mastication Protocol, Michelle Catão

Electronic Theses and Dissertations

Despite its subconscious nature, deglutition is an elaborate and multifaceted process, contingent on the activation of specific neural pathways and muscles. The inherent complexity gives rise to a wide array of potential complications and difficulties, known as dysphagia. Screening and assessment for dysphagia aid in determining the presence and etiology of swallowing difficulties, providing information that is critical for maintaining and improving the health status of vulnerable populations from the standpoint of nutrition, hydration, and socialization (Dziewas et al., 2017). Previous studies surrounding dysphagia assessment have prioritized formulating clinical protocols to evaluate the nonvolitional stage, often failing to address the …

Illness Terminable And Interminable: A Lacanian Exploration Of Medical Assistance In Dying, Matthew Devine

Electronic Theses and Dissertations

More and more people worldwide are requesting euthanasia, physician-assisted suicide (PAS), or medical assistance in dying (MAiD). Arguments in favor of expanding access to MAiD tend to prioritize the rational, competent, autonomous subject who has the right to make decisions about their body, including their death. Some have argued that this perspective – common in biomedical and bioethical literature – tends to neglect the fact that requests for assisted dying involve a relational structure: a relationship between the subject who requests an assisted death and the Other to whom this request is addressed. After reviewing relevant psychoanalytic approaches to suicide …

Collecting The Strands: A Psychoanalytic Study Of Hair-Pulling In Women, Jacklyn Corsitto

Electronic Theses and Dissertations

This dissertation investigated compulsive hair-pulling (i.e., trichotillomania) in women from a psychoanalytic perspective. The assumption, from a psychoanalytic viewpoint, is that the symptom of hair-pulling serves meaningful, and multiple, psychical purposes that should be analyzed rather than immediately removed, as would be the case in the current gold standard of treatment—behavioral therapy with habit reversal training. This behavioral modality leaves little to no room for exploring the historical, relational, symbolic, and emotional dimensions of hair-pulling. This dissertation fleshed out these dimensions and investigated what hair-pulling was doing for the individual, what its function or purpose was, and, indeed, what ideational …

Healthy And Successful Aging Outside The Closet: How Outness And Social Support Relate To Health And Aging Concerns, Jessica Segal

Electronic Theses and Dissertations

The ability to disclose an LGBTQ+ identity is a significant part of many queer lives. A person’s outness can often be tied into their social support whether through their network or available resources. This study investigated how outness, social network, and access to resources relate to older LGBTQ+ individuals’ concerns regarding their care and their aging. A secondary data analysis was conducted using survey data from the American Association of Retired Persons (AARP). The results showed that an increase in one’s social network indicated a decrease in aging-related care concerns; an increase in access to resources indicated a decrease in …

Exploration Of The Cultural Beliefs, Values, And Practices Of African American/Black Women Or Birthing Persons Regarding Postpartum Depression: A Focused Ethnography, Stephanie Jacobs

Electronic Theses and Dissertations

Introduction: Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women, affecting approximately 10% to 20% of all women in the United States, and a disproportionately higher number of African American women. The aim of this study was to explore the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression.

Research Question: What are the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression?

Methodology: A focused ethnography was chosen for this study and consisted of semi-structured interviews. Data was transcribed and analyzed …

Assessing Greenhouse Gas Emissions From Michigan’S Drowned River Mouths Using In Situ And Remote Sensing Methods, Jillian A. Greene

Masters Theses

Freshwater estuaries are natural contributors to the carbon cycle including production and emission of methane (CH4) and carbon dioxide (CO2), potent greenhouse gases (GHGs); however, estimates of their contribution to regional and global GHG emissions is largely unconstrained. Few studies have examined the quantification and drivers of lake CH4 and CO2 production in the Great Lakes region and how it may differ in response to anthropogenic development. In this study, CH4 and CO2 emissions were measured from three drowned river mouth estuaries (DRMs) along the eastern shore of Lake Michigan in 2024. The DRMs exist along a latitudinal gradient ranging …

Improving Intraoperative Antibiotic Stewardship To Reduce Surgical Site Infections: A Quality Improvement, Allyson Nichelle Heard

Doctor of Nursing Practice (DNP) Manuscripts

Purpose: Surgical site infections (SSIs) have been associated with poor pre-surgical incision antibiotic and intraoperative redosing practices and are the leading cause of postoperative readmissions and healthcare-acquired infections. A Quality Improvement (QI) project was developed to evaluate SSIs rates and pre-surgical incision antibiotic dosing and intraoperative redosing practices of anesthesia providers at a Level 1 trauma center in the Midwest. Methods: A pre- and post-intervention knowledge, attitudes, and practices (KAP) survey addressing intraoperative antibiotic stewardship was administered to 138 anesthesia providers. Interventions included education, a reference sheet, and a clinical pathway. Data analysis for surgical procedures involving anesthesia services, …

Increasing Gonorrhea And Chlamydia Testing By Using Universal Trauma-Informed Care And Offering Self-Collected Vaginal Swabs To Patients At A Non-Profit Independent Reproductive Healthcare Center, Dana M. Bloomburg

Doctor of Nursing Practice (DNP) Manuscripts

Background & Significance: The sexually transmitted infection (STI) epidemic in the United States remains a public health concern, with over 2.4 million cases in 2023 (Centers for Disease Control and Prevention [CDC], 2024). Increased screening can help prevent complications and enable treatment for the sexual partners of these asymptomatic infections (CDC, 2024). The American College of Obstetrics and Gynecology recommends that obstetrician-gynecology offices aim to provide universal trauma-informed care (TIC) to all patients (McNicholas et al., 2021). Purpose: Universal TIC practices were used to improve acceptance of gonorrhea and chlamydia (GC/CT) testing among at-risk individuals by adding a self-collected vaginal …

Enhancing Care Coordination And Expedited Appointment Scheduling By Structured Workflow Process In Oncology Clinics: A Quality Improvement Initiative, Jasmine Lassiter

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Delays in oncology appointment scheduling can negatively impact timely cancer treatment, care coordination, and patient outcomes. Inefficiencies often stem from inconsistent workflows, communication breakdowns, and limited visibility into provider availability, contributing to scheduling inaccuracies, and treatment delays (Fletcher et al., 2023; Johnson et al., 2020). Purpose: This quality improvement project aimed to implement and evaluate a structured workflow for expedited oncology appointment scheduling in an outpatient setting to improve scheduling accuracy, care coordination, and healthcare team vitality. Intervention and Implementation Plan: Guided by the Institute for Healthcare Improvement (IHI) Model for Improvement and the Johns Hopkins Evidence-Based …

Increasing Health Literacy To Improve Cardiovascular Risk Factors In Patients With Low Socioeconomic Status In The Appalachian Region: A Quality Improvement Project, Kara M. Dougherty

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Improving health literacy is one of the main goals of Healthy People 2030. However, there are no evidence-based guidelines as health literacy is still in research status (Office of Disease Prevention and Health Promotion, n.d.). Vulnerable populations are especially at risk of having low health literacy skills. Social determinants of health, such as poverty, lack of access to care, few community resources, and low health literacy, are common issues throughout Appalachia, which includes West Virginia. These disparities negatively impact the success of primary and secondary prevention for cardiovascular disease (Mangini et al., 2018). This quality improvement project utilized the …

The Implementation Of A Pilot Program On Puberty And Menstruation Education For Adolescent Females And Youth Development Specialists For A Gender-Specific Community Organization: A Quality Improvement Project, Cassandra Tavares

Doctor of Nursing Practice (DNP) Manuscripts

Background & Significance: Adolescent girls in the United States (U.S.) often lack adequate education and support regarding puberty and menstruation, despite the importance of this knowledge for healthy development (Schmitt et al., 2022). Only 21% of school systems serving ages 8–12 provide puberty education, and many educators feel unprepared to teach it (Schmitt et al., 2022). Purpose: This quality improvement project aimed to equip youth development specialists (YDS) at a community organization with a structured curriculum and educational tools to confidently educate adolescent females (ages 8–13) on the physical, emotional, and social aspects of puberty and menstruation. Intervention: A four-day …

Northern Arizona Ecological Conservation: Assessing Quaking Aspen Health In Northern Arizona Using Earth Observations, Ikram Morso, Luke Collins, Margaret Cox, Melissa Schwan

Aspen Bibliography

Quaking aspen (Populus tremuloides) forests in Northern Arizona provide critical habitat for endangered bird species and support regional tourism and recreation. However, aspen populations are declining due to a combination of abiotic and biotic stressors. In response, land managers implemented strategies, such as ungulate exclusion fencing, prescribed burns, and stand thinning, but efforts are constrained by limited data on where and when to intervene. This project worked in collaboration with the U.S. Forest Service, the National Park Service, the Arizona Department of Forestry and Fire Management, and Northern Arizona University School of Forestry. The team utilized Earth observations …

Evaluating Dosimetric Outcomes In A Prostate Rapid Plan Model: A Comparison Of Prostate Treatment Plans With And Without Standardized Planning Structures, Erica Wartman

Masters Projects

Abstract

Knowledge-based planning (KBP) using RapidPlan (RP) has demonstrated the ability to produce high quality radiation therapy treatment plans while reducing time. This study evaluated whether the inclusion of department specific standardized planning structures, including rings and other optimization tools, improves plan quality when using a prostate and lymph node RP model, or if the model alone is sufficient to provide a quality plan without the use of these additional planning structures.

Ten previously treated Prostate+LN patients were replanned using the departmental RP model in Varian Eclipse treatment planning system.1 For each patient, two plans were created, one with standardized …

Rice (Oryza Sativa L.) Production, Productivity, And Harvested Area In Karawang Regency Under Extreme Weather From 1991-2023, Adine Syabina Buswar, Ruminta, Fiky Yulianto Wicaksono

Jurnal Kultivasi

Climate change occurred in Karawang Regency due to extreme weather events, which are included in the El Nino climate anomaly phenomenon. The existence of extreme weather events in Karawang Regency has decreased rice production, which is a climate-dependent crop. Based on this problem, a study was conducted to analyze the identification of extreme weather changes and correlation analysis of rice crops in Karawang Regency to see the magnitude of extreme weather changes and the influence of extreme weather elements on rice crops. The method used is a quantitative descriptive method by analyzing extreme weather changes, correlation analysis of extreme weather …

Effect Of Preharvest Paclobutrazol And Nitrogen Fertilizers On The Sprouting Performance Of ‘Median’ Potato Seed G0 Tuber, Jajang Sauman Hamdani, Rahmat Budiarto, Anne Nuraini, Selika Fitrian Ramadani

Jurnal Kultivasi

Various intensifications of potato cultivation, such as the provision of paclobutrazol and nitrogen (N) fertilizer, are thought to impact the quality of the seeds produced. This study aims to evaluate the effects of different N fertilizer doses and paclobutrazol concentrations applied in the preharvest period on the sprouting performance of G0 potato tuber seeds after storage. Nine treatment combinations, each repeated three times, were tested, using 50%, 100%, and 150% of the recommended N dose and paclobutrazol concentrations of 50, 100, and 150 part per million (ppm), applied at 30 and 45 days after planting, respectively. The interaction effect between …

Exploring Strategies For Mitigating Toxic Behaviors And Improving Employee Retention In Organizations, Roy Lydell Rucker

Walden Dissertations and Doctoral Studies

A lack of mitigation strategies for middle manager toxic leadership can negatively affect organizational retention outcomes. Business leaders are concerned with a lack of effective strategies to counteract these behaviors and improve retention. Grounded in the toxic leadership theory, this study aimed to explore executive leaders’ strategies for mitigating toxic leadership and enhancing retention, guided by the toxic leadership framework. A qualitative, pragmatic inquiry design employed purposive sampling of nine C-suite executives from U.S. technology small and medium-sized enterprises (SMEs). Data were collected via semistructured interviews and organizational documents. Thematic analysis, employing iterative coding and constant comparison, yielded six themes: …

Improving Fall Prevention Practices Through Nursing Staff Education In Psychiatric Hospitals, Fidelia Chukwuto

Walden Dissertations and Doctoral Studies

Summary Falls are a significant patient safety concern in psychiatric units due to unique risk factors such as impaired cognition, medication side effects, and behavioral issues. This nursing staff education project focused on fall prevention practices among RNs and mental health technicians (MHTs) in a psychiatric hospital by enhancing staff knowledge through a targeted educational intervention. The practice problem addressed inconsistent fall prevention practices stemming from a lack of specialized training, which increased the risk of patient harm, longer hospital stays, and healthcare costs. The purpose of the project was to determine whether an evidence-based educational intervention could enhance nursing …

Scalable And Adaptive Agile Framework For Semiconductor Foundry: Advanced Packaging And Heterogeneous Integration Perspective, Pravin Thorat

Harrisburg University Dissertations and Theses

This research addressed the critical requirement for a scalable and adaptive agile framework specifically designed for the unique demands of semiconductor foundries specializing in advanced packaging and heterogeneous integration (HI). The semiconductor industry was encountering growing pressure to innovate and respond quickly to rapidly evolving demands, yet traditional manufacturing processes often struggled to adapt. Existing agile frameworks, mainly developed for the software industry, lacked the necessary adaptations to address the complexities of semiconductor manufacturing, including extended lead times, high capital investment, rigorous quality requirements, and the integration of various technologies. This research gap hindered the ability of semiconductor foundries to …

Investigating Food Web Dynamics Of Great Lakes Coastal Wetlands Using A Novel Stable Isotope Approach, Alyssa M. Smith

Masters Theses

Coastal wetlands of the Great Lakes support abundant populations of fish, invertebrates, and vegetation, though the trophic linkages connecting primary production and lower consumers is not well understood in these systems. We implemented a multiple-tracer approach, pairing traditional food web isotope tracers like carbon (δ13C) and nitrogen (δ15N) with total mercury concentrations (THg). We predicted that filamentous algae would be the dominant energy resource in the diet of lower trophic-level invertebrates in the Grand River Estuary, a network of riverine coastal wetlands adjacent to lake Michigan. In addition, we predicted that adding THg as a tracer would improve the resolution …

The Application Of Macrophage-Targeted, Anti-Inflammatory Celecoxib Nanoemulgel For Nerve Regeneration In Peripheral Nerve Injury, Lu Liu

Electronic Theses and Dissertations

Peripheral nerve injury (PNI) refers to damage to the nerve located outside the brain and spinal cord. PNI is commonly caused by a physical accident (trauma) or medical operation^{1, 2}. The impact on the quality of life of PNI patients is directly correlated to neuropathic pain, resultant depression, and increased stress². Even after recovering from the PNI, patients still experience phantom pain and lose the ability to work due to the loss of tactile sensory or motor function^2-4. However, unlike damage to the central nervous system (CNS), peripheral nerves can regenerate because macrophages clean …

Landscape Of Physical Activity And Quality Of Life Research In Breast Cancer Survivors: Topic Modeling Analysis., Suryeon Ryu, Ki-Yong An, Min Song, Zan Gao

Manuscripts, Articles, Book Chapters and Other Papers

Background/Objectives: Physical activity (PA) is widely recognized as a beneficial approach to improving the health-related quality of life (HRQoL) of breast cancer survivors. This study explored key research topics and emerging trends in studies related to PA and HRQoL among breast cancer survivors. Methods: Titles and abstracts of 3847 English-language research articles (2000-2024) were retrieved from PubMed, EMBASE, Web of Science, and Scopus using keywords related to 'breast cancer', 'PA/exercise', and 'HRQoL'. A text-mining algorithm based on the Dirichlet-multinomial regression approach in Python was applied to identify the top 10 research topics and their trends over time. Results: In total, …

Amorphous Oxide Semiconductor Materials And Devices For Monolithic And Heterogeneous Integration, Eli P. Powell

Theses

The expanding consumer electronics industry has spurred significant advancements in display technology. Thin-Film Transistors (TFTs) serve as active matrix switching components in LCD and OLED panels. Amorphous metal-oxide semiconductors (AOS) support large-area deposition at low temperatures and boasts an electron mobility many times greater than that of amorphous silicon. This work presents a comprehensive study on AOS materials and devices for their introduction to display, monolithic integration, and heterogeneous integration applications. Key studies have focused on advancing the state of (Indium Gallium Zinc Oxide) IGZO TFTs by addressing challenges in device uniformity, reliability, and modeling. Device uniformity was improved by …

The Effects Of A Breastfeeding Educational Program On Nurses’ Self-Efficacy And Knowledge, Amanda Quinn

Doctor of Nursing Practice Projects

Breastfeeding, a cornerstone of maternal and infant health, faces barriers due to inadequate healthcare provider education, contributing to low exclusive breastfeeding rates. The purpose of this quality improvement project was to evaluate the impact of a four-week educational program on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. This project evaluated a four-week educational program’s effect on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. Using a quasi-experimental pre-post design, nine licensed/certified staff (medical assistants, licensed practical nurses, registered nurses, advanced practice registered nurses) …

Quality Improvement Project Evaluating The Impact Of A Structured Training Program On Cultural Competency Among Mental Health Providers In A Local Outpatient Clinic, Adedamola Adefioye

Doctor of Nursing Practice Projects

Culturally responsive care is critical in addressing mental health disparities, but many mental health providers express feeling unprepared to engage with culturally diverse patients. Low cultural competence is associated with communication failures, lack of patient trust, and the possibility of poorer treatment outcomes. This quality improvement project evaluated the impact of a structured cultural competency training program at an outpatient behavioral health clinic. A quasi-experimental, one-group pre-test/post-test design was used with the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals - Revised (IAPCC-R). Eight licensed mental health providers participated in four weekly one-hour interactive training sessions using …

Providing Leisure Opportunities To Support Mental Health & Quality Of Life For Oncology Patients In Acute Care:, Allison Adkins

Occupational Therapy Doctorate Capstone Posters

The purpose of this project was to make leisure activities accessible to patients in acute care and to explore the benefits it may have on patients' mental health and quality of life. One study found there to be a high prevalence of mental health problems among older adults with 36% having no prior mental health problems (Goldberg et al., 2012). Additionally, psychiatric disorders have been shown to affect at least 30–35% of cancer patients during all phases of the disease trajectory (Caruso & Breitbart, 2020). Research also suggests that active engagement in leisure activities helps older adults maintain functioning in …

Enhancing Adversarial Robustness In Convolutional Neural Networks By Integrating Human Viewing Strategies, Diana Velychko

Theses

Adversarial examples pose a serious threat to the reliability of deep neural networks by subtly manipulating inputs to induce incorrect outputs. Despite progress in the field, convolutional neural networks (CNNs) remain vulnerable to such perturbations. This research proposes a novel approach to improve adversarial robustness of CNNs by incorporating human viewing behavior into both training and testing processes. To establish a baseline for comparison with models trained from scratch, an eye-tracking dataset—collected during experiments involving novel objects from the Greeble dataset—was used to capture how humans learn to classify previously unseen object categories. This study compares model saliency with human …