Digital Commons Network^™

Persistent Peristomal Pain Due To An Exposed Cutaneous Nerve, Iain Noel Encarnacion, Kaylin Beiter, Natasha Hakkal, Emily Hejazi, Paul Hernandez, Melissa Laughter, Shannon Nugent, Samir Thaker, Xiaowei Xu, Misha Rosenbach

Department of Medicine Faculty Publications

[Introduction]

Case description

A 25-year-old woman with a history of ulcerative colitis treated with multiple abdominal surgeries complicated by peristomal pyoderma gangrenosum (PPG) presented with severe peristomal pain and ulceration. Treatment course was complicated; disease control was achieved via combination infliximab 10 mg/kg every 4 weeks, corticosteroids (topical triamcinolone 0.1% ointment, intralesional 10 mg/ml injections, and oral prednisone 30 mg daily with a gradual taper), and cyclosporine 125 mg tapering by 25 mg every 3 weeks, ultimately tapered to infliximab monotherapy.

Insurance Disparities In Hidradenitis Suppurativa: A Comprehensive Review Of Demographics, Outcomes, And Access To Care, Alim Osman, Alexandra R. Nigro, Michael C. Povelaitis, Marc Z. Handler

Department of Medicine Faculty Publications

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.

Objective: This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.

Methods: Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.

Results: Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid …

Regional Pain Is Associated With Functional Performance In People With Parkinson's Disease, Ryan P. Duncan, Monica R. Hendricksen, Luke Ekdahl, Kevin Smaller, Benjamin Friedman, Miriam R. Rafferty

Department of Medicine Faculty Publications

Background and Purpose:

Little is known about how pain influences physical function in people with mild Parkinson disease (PwPD). The purpose of this study was to investigate the association between physical function and pain presence, location, and intensity in PwPD who were evaluated in an early physical therapy program.

Methods:

Retrospective cross-sectional analysis of electronic medical records from patients with PD evaluated at a single center (2016-2023). Pain presence, location, and intensity (0-10 scale) were recorded at the initial physical therapy evaluation. Functional outcomes included 5-time sit-to-stand, 10-meter walk test, 6-minute walk test, timed up and go, mini-BESTest, and Functional …

Substitution Of Cannabis For Prescribed Medications In The Management Of Anxiety And Depression Among Midlife Women: A Cross-Sectional Study, Jocelyn Mueller, Jamia Sapp, Jennifer Attonito, Aditya Chakraborty, Karina Villalba

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Aims

Given the rising prevalence of cannabis use as an alternative strategy for managing mental health symptoms, there is a crucial need to understand the determinants of substitution behavior, particularly among midlife women who may experience distinct psychosocial and clinical profiles. This study examined the predictors of cannabis substitution among midlife women by comparing profiles of women who substituted cannabis for antidepressant medications versus those who substituted for anxiolytic medications.

Methods

A cross-sectional survey of 172 women who reported substituting cannabis for either anxiety or depression medications was conducted. Measures included the PHQ-8, OASIS, AUDIT, and ACEs. Logistic …

The Impact Of True Crime Podcasts On Cold Case Investigations And Victims' Advocacy, Kyle Gamache, Karlie Rice, Ashley Allen, Willem Pontbriand

Arts & Sciences Faculty Publications

True crime has long captivated public interest, evolving from sensationalized accounts in the Middle Ages to the widespread popularity of modern podcasts. This qualitative study explores the ethical complexities of true crime media by examining how it intersects with criminal investigations, public perception, and victim advocacy. Through in-depth interviews with law enforcement officers, victim advocates, and true crime content creators, the study investigates differing attitudes toward the role of podcasts in active and cold cases. Using Colaizzi’s (1978) phenomenological method, data were analyzed to uncover shared and divergent themes across professional roles. Law enforcement participants voiced concerns over web- sleuthing …

Location, Location, Reaction: How Mandatory Ip Disclosure Silences Critics And Sparks Backlash, Sirui Li, Ping Xu, Yue Guo

Political Science Faculty Publications

Previous research has identified two competing outcomes of regulatory disclosure for negative online sentiment: chilling effects, which suppress negative online sentiment, and reactance effects, which intensify it. In this study, we apply these theories to examine the impact of mandatory IP location disclosure on citizens' negative online sentiment expressed on Sina Weibo, a leading Chinese social media platform. We argue that the mandatory IP location disclosure can have opposite effects on negative online sentiment depending on the type of social media context. To test this, we use a quasi-natural experiment and analyze more than 160,000 comments posted before and after …

The Gendered Path Of Least Resistance: First Entry And Exit Behaviors Of Public And Nonprofit Employees, Tiana Marrese, Ying Liu, Femida Handy

Political Science Faculty Publications

Public and nonprofit organizations exhibit high rates of female employment often attributed to sector structures and social roles. To better understand how individual behaviors dynamically contribute to these distinctive ratios, we deconstruct public and nonprofit employment into gendered patterns of attraction and attachment. Using duration analysis and following a cohort from the National Longitudinal Survey of Youth 1997, this research finds that women demonstrate a higher attraction to their first public and nonprofit job compared to men, evidenced through a faster rate of entry into this employment. There are no significant gender differences when considering the duration of an individual's …

Restorative Restitution, Lula A. Hagos

American University Law Review

How to best meet the needs of crime victims while also furthering the imperative of decarceration has long vexed advocates and scholars alike. This dilemma comes into sharp focus when one examines two developments in criminal procedure that, until now, have been analyzed separately: victim restitution and restorative justice.

Criminal restitution, the monetary payments ordered from defendants to victims, often fails both groups. Because most defendants are indigent, restitution obligations lengthen defendants’ involvement with the criminal legal system without delivering meaningful compensation to victims, making restitution more symbolic than restorative. At the same time, interest in restorative justice has surged …

The Leasehold World, Jeffrey Manns

American University Law Review

The ideal of American fee simple property rests on a popular misconception. Many Americans often think of fee simple property in terms of absolute ownership. In reality, however, fee simple title has many similar features of a “public” leasehold in practice, which has significant implications for understanding the relationship of private property “owners” to the state. The American state, at all levels, effectively serves as a landlord over private property “owners,” mirroring the traditional role of the king in feudal England.

The American Revolution is often framed as a sea change in property rights and individual liberty. But efforts to …

Beyond Marriage: Challenging Marital Prerequisites In State Adoption Laws Through A Constitutional And Child-Centered Lens, Alisha Glass

American University Law Review

Many state adoption laws restrict joint adoptions to married couples, thus excluding unmarried partners who share loving and committed relationships with the children they seek to adopt. These marital prerequisites reflect society’s outdated preference for the nuclear family while conflicting with adoption law’s commitment to the best interests of the child. Nonmarital families experience unequal legal protections based on marital status and geographic location. Building on the Kentucky Supreme Court’s decision in G.G. v. Cabinet for Health & Family Services, this Comment examines the limits of resolving these disparities through statutory interpretation and identifies the constitutional questions that remain …

Application Of The Lancet Commission Criteria For The Diagnosis Of Obesity To A Clinical Trials Population: The Leap Trial, Faith Anne N Heeren, Kathleen R Ruddiman, Courtney Simmons, Brian N White, Byron C Jaeger, Nicholas M Pajewski, Stephanie A Hooker, Deborah B Horn, Katy Martin-Fernandez, Kimberly A Gudzune, Caroline Blackwell Young, Jamy Ard, Kristina Henderson Lewis

Faculty, Staff and Student Publications

Objective: This study aimed to apply The Lancet Diabetes & Endocrinology criteria for diagnosing obesity among clinical trial participants and understand participants' characteristics by obesity status.

Methods: The criteria were operationalized and applied to baseline data from the Long-term Effectiveness of the Anti-obesity medication Phentermine (LEAP) trial (NCT05176626). Excess adiposity, organ and tissue dysfunction, and limitations to daily activities were assessed. We examined differences between participants with "no obesity," "pre-clinical obesity," and "clinical obesity."

Results: Among the 860 participants, 0.8% had no obesity (mean BMI 29.0 kg/m2 [SD 0.6]), 18.7% had pre-clinical obesity (mean BMI 35.2 kg/m2 [SD …

Healthcare Provider Perspectives On A Clinical Decision Tool To Support Individualized Exercise Prescriptions And Discussions For Breast Cancer Survivors, Jinani Jayasekera, Oliver W. A. Wilson, Kaitlyn M. Wojcik, Eleanor M. Kerr, Rachelle Brick, David Berrigan, Jennifer Yeong-Shin Sheng, Takeo Fujii, Kathleen Thomas, Henri K. Parson, Padma Sheila Rajagopal, Richard L. Street Jr.

Department of Medicine Faculty Publications

Purpose: We evaluated healthcare providers' current knowledge, practices, and perspectives on a novel clinical decision tool (beta-version) to facilitate individualized exercise prescriptions and discussions in clinical settings.

Methods: We recruited healthcare providers who had treated or provided care to breast cancer survivors aged >= 35-years in the past 12 months. The participants were presented with a tool to provide individualized exercise recommendations considering women's individual, clinical, and contextual characteristics. Validated and reliable pre-existing instruments were used to survey providers' current knowledge, practices regarding exercise discussions, and perspectives on the beta-version (paper-draft) of the novel tool.

Results: The sample consisted of …

By Design, Roger Allan Ford

American University Law Review

In recent years, scholars and policymakers have increasingly embraced regulation “by design” to address new problems, especially those caused by new technologies. These approaches go by various names, like privacy by design, security by design, even the rule of law by design. Despite the popularity of these approaches, though, describing what goes into regulation “by design” is surprisingly challenging. Different speakers use the term in strikingly different ways, with little consensus about why design is important, how design and new technologies interact, or how design can be harnessed to deliver policy results.

Design exists along multiple dimensions: process versus result, …

Tyranny Of A Feather: Asymmetry In Civil Burdens Of Proof, Thomas O. Main

American University Law Review

Civil litigation suffers from a paradox that is at once self-evident, unfair, and overlooked: the trial process promises equality between plaintiffs and defendants under the preponderance-of-the-evidence standard, even as the pretrial process is skewed dramatically in defendants’ favor. At trial a plaintiff needs only “50% plus a feather” to tip the scales and prevail, reflecting a commitment to equal treatment of the parties. Pretrial, however, the playing field tilts steeply: plaintiffs alone must navigate a procedural gauntlet of motions that impose pleading and production burdens for which defendants face no equivalent. This entrenched asymmetry in pretrial practice has become so …

The Painted Ones’ Fine Line: Batok As A Protectable Form Of Traditional Knowledge Under Trade Secret Jurisprudence, Kathleen M. Dinoso

American University Law Review

For centuries, the ancestral tattooing practice of batok has served not as mere ornamentation but as a visual archive of Indigenous Filipinos’ history and identity. In 2021, a digital creator invited the public to learn batok online for merely fifteen dollars. Soon after, many discovered that the renown instructor, Apo Whang-Od, may not have agreed to take part. The resulting discourse exposed a broader issue: Indigenous customs and creations become increasingly vulnerable to misappropriation and improper commodification as they enter global markets and multimedia platforms. Though this event occurred abroad, it highlights how U.S. law is poorly designed to protect …

A Quantitative Analysis Of Barriers To College Students’ Seasonal Vaccination Intentions And Behaviors, Kelly S. Clemens, John Matkovic

Faculty Publications – Health Sciences

Objective
Vaccination is crucial to college student health, but quantitative analyses of barriers in this population are limited. The present study expands the work of Su and Chen to determine the relative influence of structural, psychological, and social vaccination barriers.

Participants
Participants were 650 students from a large, midwestern university during the 2024 vaccination season.

Methods
Participants were recruited from a college campus and randomized to respond to items assessing their barriers to, intentions to receive, and uptake of the COVID-19 or influenza vaccination.

Results
Structural, psychological, and social barriers were differentially important to vaccinations and to intentions vs. uptake …

Shades Of Stress: Colorism As Minority Stress For Women Of Color, Caitlin M. Mercier, Brea M. Banks, Lourdes D. Concepción Cabán, Michelle Duong

Faculty Publications – Psychology

Women of color often endure indignities shaped by colorism and skin tone discrimination, pressuring them to adhere to racialized beauty ideals (i.e., lighter skin). In response, some women of color may internalize these standards (i.e., through internalized coping and racial self-hatred) which can foster psychological distress. Yet, these associations remain underexplored. Using minority stress theory, in our cross-sectional study we collected online survey data to examine whether internalization and racial self-hatred explained the indirect link between colorist microaggressions and psychological distress among 121 women of color at a Midwestern US historically white institution. Using path analysis, we found support for …

Artificial Intelligence Adoption Among Future Journalism And Mass Communications Professionals: A Tam-Based Approach To Students’ Generative Ai Adoption Intent, Chinwendu P. Akalonu

Journal of Communication Pedagogy

As artificial intelligence (AI) reshapes industries, journalism and mass communications professions are slowly adapting to these technologies. This study employs the Technology Acceptance Model (TAM) and AI-TAM frameworks to examine predictors of AI adoption intent among college students preparing for careers in the field. Survey results reveal that perceived usefulness, trust in AI output quality, organizational requirement, ethical awareness, and certain sociodemographic factors such as race predict AI adoption intent. Additionally, the study highlights differences in adoption intent among students in different subfields of mass communication, including journalism, advertising, and public relations. It underscores the importance of expanding traditional TAM-based …

Impact Of Tactical Breathing On Marksmanship And Cognitive Function After Anaerobic Fatigue In Law Enforcement Personnel, Jackson D. Gilleland

College of Graduate Studies: Theses & Dissertations

Background: Tactical breathing is commonly used in law enforcement training to regulate stress, yet limited evidence exists regarding its acute effectiveness following physical fatigue. Purpose: To examine whether a brief tactical breathing intervention improves shooting performance and heart rate variability (HRV) following anaerobic fatigue in law enforcement officers. Methods: Thirty-eight officers completed baseline HR/HRV and a shoot/no-shoot scenario, followed by a maximal 500-m row and post-fatigue shooting. Participants were assigned to either a control group or a tactical breathing group, which received brief instruction and coaching before post-testing. Results: No significant between-group differences were observed for A-zone accuracy, shot time, …

Comparison Of 2000-Meter Row Prediction To Measured Vo2peak During Gxt, Andrew S. Ashley

College of Graduate Studies: Theses & Dissertations

BACKGROUND: Aerobic capacity is essential for the performance of military personnel and first responders. Traditionally, graded exercise tests (GXTs) with metabolic gas analysis have been the criterion-referenced method for assessing aerobic fitness. However, treadmill running and cycle ergometers may not fully reflect the whole-body demands required in tactical environments. Rowing-based assessments and the currently commercially available VO2max prediction formula are widely used across tactical organizations as practical field measures, and most tactical operators are considered inexperienced rowers, which has been minimally examined. PURPOSE: The purpose of this study is to compare measured VO2peak from a rowing GXT with estimated VO2max …

Untalented: What Is The Role Of “Talent” In Art Class?, Sean Bianchi

College of Graduate Studies: Theses & Dissertations

The concept of talent in art education is widely accepted yet rarely challenged or questioned. This essay critically examines the construction of artistic talent perceptions, the sociohistorical roots of the term itself, and the implications of what talent does for art education. This speculative essay problematizes talent as a persuasive force over art students and art teachers alike, criticizes the accessibility of art to the naïve and art enthusiast alike, as well as the consequences of talent constructs over the future of artistic instruction within public education. Utilizing an aesthetic framework, I explore what the role of talent in art …

Holding Space For Teachers: A Phenomenological Exploration Of Social-Emotional Competence And School Climate In Title I Schools, Zsa Zsa B. Davis

College of Graduate Studies: Theses & Dissertations

Teacher retention remains a critical concern in education, particularly within Title I schools, where educators face elevated stress levels, emotional exhaustion, and burnout due to the complex needs of students and limited institutional resources. Addressing teachers’ social-emotional competence (SEC) can mitigate the adverse effects of stress by enhancing emotional regulation, well-being, and relational trust which in turn promote job satisfaction and professional fulfillment. Likewise, a positive school climate plays a crucial role in sustaining teachers’ long-term commitment to the profession. This qualitative study employed a descriptive phenomenological design to explore the lived experiences of Title I elementary teachers as they …

Enhancing Military Health System Organizational Efficiency And Quality Of Care Through A Social-Ecological Framework, Eric L. Peipelman

College of Graduate Studies: Theses & Dissertations

Timely and fair adjudication of incivility-related actions within the Department of Defense (DoD) and Military Health System (MHS) is increasingly crucial for maintaining accountability, mission readiness, and quality of care. Ongoing delays in resolving workplace complaints and inefficiencies in resource-heavy adjudications highlight the need to shift from reactive complaint handling toward proactive civility promotion and transparent decision-making. This Integrated Learning Experience (ILE) introduces the Peipelman Civility Discussion and Assessment Toolkit (PCDAT)—a comprehensive, evidence-based framework designed to improve civility, optimize resources, and enhance communication, even in the MHS. Based on the Social-Ecological Model (SEM) and adapted from the Workplace Power and …

Community Care During Austerity: Mutual Aid And Online Connection Among Disabled Americans, Maeve J. King

College of Graduate Studies: Theses & Dissertations

Amidst a mental health epidemic and rising inequality, online communities offer a medium for peer support networks for disabled Americans. Community care, especially in the form of mutual aid, has increased in popularity since the beginning of the COVID-19 pandemic. Considering troubling increases in eugenics-based messaging and disproportionate economic inequality, disabled Americans in particular have leaned into community care. Previous research establishes social media as a hub for resource mobilization and safe space for members of marginalized communities to connect. This research aims to explore the impacts of social, political, and economic unrest on the development of community care and …

Exploring Psychological Safety And Workforce Experiences Among Employees In Recovery Community Organizations In The Southern United States: A Qualitative Study, Claire-Lorentz Ugo-Ike

College of Graduate Studies: Theses & Dissertations

This qualitative study explored how employees in Recovery Community Organizations (RCOs) in the Southern United States experience psychological safety and how these experiences shape employee well-being and their intentions to stay or leave their organizations. Guided by Edmondson’s Psychological Safety Theory and the Job Demands-Resources (JD-R) model, the study examined how leadership practices, workplace culture, and the emotional demands of recovery support work shape employees’ perception of safety, support, and sustainability in the workforce. Semi-structured interviews were conducted with 19 RCO employees working in various peer support roles. Thematic analysis identified five major themes: (1) leadership behaviors shape psychological safety …

Emotion Regulation: The Effectiveness Of Reappraisal And Potential Benefit Of Music, Ezra J. Greidinger

College of Graduate Studies: Theses & Dissertations

Literature has supported potential benefits to cognitive reappraisal as a method of emotion regulation, as well as intentional music usage as an enhancer of these effects. It has been suggested that instruction be provided to individuals to use these methods, especially in highly stressed populations (Sakka et al., 2018). However, there has not been an experimental study to follow up on these claims. When instruction is provided, is cognitive reappraisal more effective than naturally developed habits in regulating anxiety, and would music enhance these effects? College students (N = 170) were randomly assigned to three treatment conditions: control, cognitive reappraisal, …

Trends Among Suspected Opioid Overdose Emergency Medical Service (Ems) Incidents In Georgia From 2019-2023, Ashton Harris

College of Graduate Studies: Theses & Dissertations

Opioid overdoses remain a problem in the United States, underscoring the need for additional surveillance tools to monitor trends in opioid overdoses. Emergency Medical Services (EMS) data is a timely surveillance method that captures more potential overdoses than hospitals by representing the pre-hospital setting. Research questions in the study assess EMS responses to suspect opioid overdose incidents from 2019-2023 in Georgia to encompass the following characteristics: timeframe (pre, during, post-pandemic), urban versus rural counties, race/ethnicity, categorical type of first responder, mean dosage of naloxone in milligrams administered, and death. 84,359 records meeting the inclusion criteria were initially retrieved from the …

Another Day's Journey: Birthing Brilliance Through Culturally Relevant/Responsive/Sustaining Pedagogies, Letitice Johnson

College of Graduate Studies: Theses & Dissertations

This dissertation examines the implementation of culturally relevant/responsive/sustaining mathematics using hip-hop pedagogy with special education students. The theoretical frameworks for this include with Culturally Relevant Pedagogy (Ladson-Billings, 1995), Culturally Responsive Teaching (Gay, 2018), and Culturally Sustaining Pedagogy (Paris & Alim, 2014). Utilizing an autobiographical case study methodology, I examined the use of culturally relevant math tasks and hip-hop pedagogy with 3^rd grade students with disabilities. From this study, the following findings emerged: (1). Learning environments characterized by hope, empathy, and critical agency can be cultivated through the use of community resources and structured classroom norms that promote support, collaboration, …

Fur-Ever In Memory: College Student Grief And Coping After Pet Loss, Rohit Paruchuri

College of Graduate Studies: Theses & Dissertations

Pet loss is a significant yet often overlooked form of bereavement, particularly among college students who are navigating emerging adulthood. Pets play an important role serving as a source of emotional support and are often viewed as family members; however, grief following pet loss is a type of disenfranchised grief, meaning it is not accepted by the society as something significant and often overlooked when compared to grief following human loss (Spain et al., 2019). Research suggests that grief following pet loss can mirror responses to human loss including sadness, guilt, loneliness, and disruption of daily routines (Eckerd et al., …

Effects Of A Context-Based Intervention On Sidelining Teacher Bias Toward Students With Attention-Deficit/Hyperactivity Disorder, Marisa Kortright

College of Graduate Studies: Theses & Dissertations

Students with Attention-Deficit/Hyperactivity Disorder (ADHD) often display behaviors such as inattention, impulsivity, and hyperactivity that may be perceived as disruptive in classroom settings. These behaviors can influence teachers’ responses and disciplinary decisions, which may be shaped by stereotypes or biases associated with ADHD diagnoses. This study examined whether a context-based intervention could reduce bias in teachers’ disciplinary decisions. Participants were 112 current or former elementary school teachers living in the United States who were recruited through the online recruitment platform Cloud Research. Using an experimental design, participants were randomly assigned to a neutral or empathetic intervention condition and evaluated student …