Digital Commons Network^™

Sequential Esophageal Squamous Cell Carcinoma And Small Cell Carcinoma Following Prior Nissen Fundoplication, Melika Babadi, Morgan W. Stewart, Adil Bhatti, Peter Schultz, Brett Dunbar, Eric Delman

Student Publications

Primary small cell carcinoma of the esophagus (PSCCE) is a rare and aggressive malignancy with clinical features that often resemble more common esophageal cancers, leading to delayed diagnosis and uncertainty in management. We present a unique case of sequential squamous cell carcinoma followed by PSCCE in the distal esophagus after a previous Nissen fundoplication, emphasizing diagnostic and surveillance challenges. A 63-year-old man with a history of gastroesophageal reflux disease (GERD) and prior fundoplication presented with chest pain and progressive dysphagia. Initial esophagogastroduodenoscopy (EGD) revealed a distal esophageal lesion, and biopsy confirmed invasive squamous cell carcinoma arising from Barrett's mucosa, which …

Effects Of Nurse-Led Standardized Kangaroo Mother Care (Kmc) Protocol On Nicu Length Of Stay, Physiological Stability, And Bonding: Evidence-Based Recommendation For Translation Into Practice, Madison Capul, Maria Bejarano, Tionette Kirk-Banks, Kelly Mcmillin, Onyinyechukwu Ubaezuonu, Amabelle Simsuangco, Charity Msamalia Chimwala-Selico

General Submissions: Clinical Settings Materials

Background: Preterm and low birth weight infants in the neonatal intensive care unit (NICU) are at high risk for physiological instability, prolonged hospitalization, impaired bonding and breastfeeding, and increased mortality, with costs reaching up to $233,000 per stay (Broughton et al., 2022). The Kangaroo Mother Care (KMC) protocol improves thermoregulation, stability, bonding, breastfeeding, and survival; however, its implementation remains inconsistent due to the lack of standardized nurse-led protocols.

Purpose: The purpose of this study was to evaluate whether implementation of a standardized nurse-led Kangaroo Mother Care protocol, compared to current inconsistent practice, would improve NICU length of stay, physiological stability, …

Keeping Families Together: Companion Animals As A Public Health Imperative, Lori R. Kogan, Rebecca Niemiec

Journal of One Health Systems

Contemporary US public health frameworks emphasize social, economic, and environmental determinants of health, yet largely overlook the reality that most households include companion animals regarded as family members. This omission has tangible consequences during crises such as housing instability, illness, domestic violence, or disasters, when families are often forced to choose between their own safety and the safety of their animals. We argue that this represents a significant public health failure. Drawing on interdisciplinary evidence, we propose that companion animals function as a social determinant of health, that forced separation constitutes a public health harm, and that Human-Animal Support Services …

Livia Scotto V. Wells Fargo & Co

2026 Decisions

USDC for the Eastern District of Pennsylvania

Usa V. Melvin Williams

2026 Decisions

USDC for the Eastern District of Pennsylvania

The Impact Of Patient Education On Medication Adherence In Hypertensive Patients, Alexis Rodriguez

DNP and Student Works

Hypertension is a major cause of cardiovascular morbidity as well as mortality, and nonadherence to medications has consistently posed significant challenges to the effective management of blood pressure and poses avoidable risks. The purpose of this Doctor of Nursing Practice (DNP) project was to determine whether a structured medication adherence education session could enhance adherence in adult hypertension patients in a primary care clinic. As per the Health Belief Model and Johns Hopkins Nursing Evidence-Based Practice framework, a quantitative descriptive pre-test/post-test was employed. The baseline adherence was assessed by using the Morisky Medication Adherence Scale (MMAS-8), and then a 15-minute …

Cultivating Trauma Competency: Counselor Development Through Education And Experience, Kayla Bryant

Dissertations, 2020-current

This dissertation explored the development of trauma competency. Considering the prevalence of trauma and the ethical demand for counselors to work within their scope of competence, it is necessary they have skills to work with trauma. The intent of this dissertation was to contribute to the literature by providing strategies for counselor educators aiming to support counselors-in-training in their trauma development. Grounded in attachment theory, these articles acknowledge the personal lived experiences of counselors and their professional needs. The first article, a conceptual manuscript, provides strategies for counselor educators to integrate trauma competencies at the master’s level. Using both experiential …

Exploring Play: Counselor Education Strategies, Online Community Fantasy Play, And Sexuality In The Counseling Space, Nattalie Wolff-Tseng

Dissertations, 2020-current

This dissertation examines the ways that play is constructed and understood in a variety of settings. Using Relational Cultural Theory as a guiding theoretical influence, each portion examines how play influences relationships and how engagement in play and conversations about play can enhance student–teacher relationships, social connection, and the therapeutic relationship. The first section of this dissertation, the conceptual article, explores how play can support counselor education as it encourages creative engagement and discourages perfectionism, which is often noticeable in novice counselors. Play may take many forms in the classroom and offers counselor educators the opportunity to tailor activity to …

Family Quality Of Life And Infant Language Development: A Pilot Study Of Infants Without A History Of Chronic Otitis Media, Aubreigh Cartwright

Dissertations, 2020-current

Chronic otitis media (COM) is a condition associated with hearing fluctuations, recurrent medical interventions, and speech-language concerns. While the audiological impacts for children are well documented, there is less research pertaining to parents’ and caregivers’ experiences. The goal of the overall line of inquiry was to examine the impact of chronic otitis media on parent and caregiver quality of life. Parents and caregivers of ten typically developing infants from six to twelve months of age without COM were administered parent-proxy instruments to determine quality of life, as well as expressive and receptive lexicon. The parents were administered a family intake …

A Measure Of Spatial Orientation In Healthy Adults, Lauren Maloney

Dissertations, 2020-current

Spatial orientation is essential for effective navigation and movement, relying on the integration of sensory inputs from systems such as proprioception, vision, audition, and the vestibular system. The vestibular system, responsible for detecting rotational and linear movements, plays a crucial role in maintaining balance and spatial awareness. However, its specific influence on spatial orientation remains underexplored. This study investigates how vestibular input influences spatial orientation accuracy by examining participants' ability to estimate angular displacement during rotational stimuli. Twenty participants underwent testing using a rotational chair, with stimuli at varying rotational amplitudes (5-400 degrees). Along with their perceived angular displacement (i.e. …

The Effect Of Head Coverings On Directional Microphone Performance, Mariam Mohamed

Dissertations, 2020-current

Background: Directional microphones in hearing aids are a well-established strategy for enhancing speech intelligibility in background noise. While previous studies have examined the effects of hair, spectacles, and earmold venting, no systematic research has addressed whether head coverings, commonly worn for cultural, religious, or personal reasons, affect directional performance.

Objective: This study aimed to determine whether a thin cotton head covering alters the directivity index (DI) of premium receiver-in-canal hearing aids from four leading manufacturers, using laboratory-controlled conditions. 

Methods: A Knowles Electronics Manikin for Acoustic Research (KEMAR) was positioned within a sound-treated room to measure DI for both omnidirectional and …

The Impact Of Free Vs. Fixed Factor Correlations On Parameter Recovery In Multidimensional Irt Models, Stephanie Leroy

Dissertations, 2020-current

This dissertation investigated how cross-loading specification and factor-correlation treatment influence parameter recovery in multidimensional item response theory (MIRT) models. Two simulation studies extended Hosseinzadeh and Cole (2024) by examining whether freely estimating factor correlations improves recovery of item parameters, factor correlations, and latent traits. Study 1 used a compensatory multidimensional two-parameter logistic (M2PL) model with two correlated dimensions and 20 dichotomous items. Manipulated conditions included cross-loading specification (correctly specified vs. ignored), proportion of cross-loaded items, magnitude of cross-loadings, true factor correlation, and factor-correlation treatment during estimation (freely estimated vs. fixed to zero). Study 2 extended the design to a multidimensional …

How Audiologists Are Using Adapted Cognitive Behavioral Therapy For Tinnitus Management: A Preliminary Study, Katherine M. Mueller

Dissertations, 2020-current

Audiologists interact with patients reporting bothersome tinnitus frequently, however there is no standardized protocol to follow when treating/counseling these patients. Cognitive Behavioral Therapy (CBT) is highly researched and has been proven to alleviate bothersome tinnitus symptoms, yet audiologists are not clinically trained in this tinnitus management. Specific forms of CBT that were analyzed in this study include Attention Shifting, Neurophysiological Education, and Progressive Muscle Relaxations. This study surveyed current audiologists to determine how they are using adapted CBT techniques (aCBTt) for tinnitus management. This questionnaire aimed to investigate a) the effect of audiologists’ practice duration on their frequency to recommend …

Quality Care For Neurodivergent Youth, Emily V. Bogaev

Dissertations, 2020-current

Neurodivergent youth are becoming increasingly present in counseling settings, yet many counseling approaches have historically been shaped by deficit-oriented frameworks that conceptualize neurodivergence as something to be corrected. These perspectives may overlook the lived experiences and strengths of neurodivergent individuals. The purpose of this dissertation was to examine neurodivergence in counseling through three complementary manuscripts addressing conceptual foundations, youth perspectives, and counselor preparation. The first manuscript is a conceptual article that explores neurodivergent-affirming counseling and contrasts affirming frameworks with traditional deficit-based approaches. The second manuscript utilized a qualitative narrative inquiry design to explore neurodivergent youths’ perceptions of neurodivergence and the …

Professional Dispositions In Counselor Education: Building Consensus, Examining Lived Experience, And Advancing Relational Gatekeeping, Jina Yang

Dissertations, 2020-current

The purpose of this dissertation is to investigate how Council for Accreditation of Counseling and Related Educational Programs (CACREP)-accredited programs identify, implement, and assess essential professional dispositions among master’s-level counselors-in-training (CITs). The dissertation includes three components that examine conceptual, experiential, and consensus-based perspectives on professional dispositions within counselor education. The first component presents a conceptual framework for implementing gatekeeping practices that reflect the values of the counseling profession. Drawing on Relational-Cultural Theory (RCT), the article proposes gatekeeping strategies that emphasize mutuality and connection while accounting for sociocultural contextual factors and fostering psychological safety within the hierarchical dynamics inherent in evaluative …

Stigma Predicts Participation And Autonomy In Chronic Vestibulopathy: An Explanatory Mixed Methods Study, Brandy L. Hollins

Dissertations, 2020-current

Many vestibular disorders are “invisible”, not widely recognized, and challenging for patients to describe. However, its impact is visible and leads to significant challenges. Research has shown that stigma associated with other chronic health conditions can detrimentally affect patient outcomes, suggesting a greater need in this area. The World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) elucidates the role of physical, social, and cultural factors in the manifestation of health conditions within a universal framework. A critical aspect of the ICF’s contextual factors for individuals with vestibular loss is societal perception. Few studies have reported stigmatization …

Enhancing Access Through Integrated Behavioral Healthcare: Expanding Counselor Identity And Social Determinants Of Health Competency, Tiffany N. Snow

Dissertations, 2020-current

Abstract

The counseling profession has historically differentiated its identity by emphasizing a wellness-oriented approach. However, this has often led to the exclusion of counselors from integrated behavioral healthcare (IBH). With the 2024 enactment of the Mental Health Access Improvement Act, counselors now have unprecedented opportunities to serve as behavioral health providers in federal medical settings. This three-manuscript dissertation explores the intersection of counselor professional identity, social determinants of health (SDoH) competency, and interprofessional collaboration within IBH.

Manuscript 1 presents a conceptual framework for reconciling traditional counselor identity with the "medical model" of Primary Care Behavioral Health (PCBH), arguing that this …

Novel Paradigm For Assessing Vestibular Perception In Children, Nicole Kirk

Dissertations, 2020-current

While objective vestibular reflexive testing has been heavily researched, there are few studies analyzing subjective vestibular perception and to date no progress has been reported on motion perception in children. It is unknown if children perceive motion like adults creating a need for research comparing these age groups for thorough clinical profiles. This study adapted an adult psychophysics protocol for school-aged children and collected data on ten typically developing children and ten healthy adults. Participants rotated at various peak velocities and frequencies in a rotary chair and were asked to report their spatial orientation (i.e., how far around they rotated) …

Vaccination-Related Applications And Health Care Professionals' Observed Changes In Human Papillomavirus Vaccine Hesitancy: Cross-Sectional Survey, Manali Desai, Shreela Sharma, Joel Fokom-Domgue, Robert Yu, Wenyaw Chan, Onyema G Chido-Amajuoyi, Charles Darkoh, Sanjay Shete

Faculty, Staff and Student Publications

Background: Digital tools are known to promote public health interventions such as vaccine delivery. The recommendation that health care professionals (HCPs) use vaccination-related mobile apps or web-based applications has contributed to improving vaccine awareness and acceptance in the United States. The state of Texas, which has one of the lowest human papillomavirus (HPV) vaccination rates, has seen a significant increase in HPV vaccine hesitancy, particularly during the COVID-19 pandemic.

Objective: This study aimed to examine the association between changes in HPV vaccine hesitancy observed by HCPs among patients in Texas and promotion of vaccination-related applications at the health care facilities …

Exploring Spike-Dependent And Ace2-Independent Sars-Cov-2 Interactions With Salivary Epithelial Cells In The Absence Of Ace2, Caitlynn M L Barrows, Thaise C Geremias, Simon Young, Mary C Farach-Carson

Faculty, Staff and Student Publications

Salivary gland infection by SARS-CoV-2 requires viral entry via routes and mechanisms that remain unresolved. This study examined the expression of the angiotensin-converting enzyme 2 (ACE2) receptor in salivary tissues and basal cell-derived human salivary progenitor cells (hS/PCs), an unstudied potential entry point for SARS-CoV-2. Multiple detection modalities, including immunocytochemistry, Western blotting, flow cytometry and RT-PCR, demonstrated a consistent lack of ACE2 protein and transcript in both tissue specimens and primary salivary epithelial cells. Antigen retrieval at pH 9 was determined to be optimal for immunodetection protocols, yet ACE2 remained undetectable. Small intestine tissue served as a positive control, confirming …

Building A Road To Mitigate Ambulance Patient Offload Time (Apot), William J. Manguil

Doctoral Projects

Emergency departments (EDs) worldwide are experiencing increased utilization resulting in care delays for patients seeking urgent treatment. Despite critical circumstances that warrant emergency medical services (EMS) response, patients arriving to the ED via ambulance remain vulnerable to delays in care due to prolonged ambulance patient offload times (APOTs). The amount of health care providers and treatment space necessary to initiate care are both limited and often strained resources which dictate the need for innovative interventions to prevent patient harm. The following project outlines the interventions implemented at the project site to improve APOT as a means to enhance patient safety …

Jonathan Valentin V. Philadelphia County Sheriffs Department

2026 Decisions

USDC for the Eastern District of Pennsylvania

2026 May 14 - Tennessee Weekly Drought Summary, Tennessee Climate Office, East Tennessee State University

Tennessee Climate Office Weekly Drought Summaries

No abstract provided.

2026 May 21 - Tennessee Weekly Drought Summary, Tennessee Climate Office, East Tennessee State University

Tennessee Climate Office Weekly Drought Summaries

No abstract provided.

Cigarette And E-Cigarette Use In Greater Philadelphia: Proportion Of Use Compared To National Data And Local Predictors Of Smoking Status, Munjireen Sifat, Joshua Banks, Lilianna Phan, Kuang-Yi Wen, Julie A. Barta, Rebecca J. Melillo, Hee-Soon Juon

College of Population Health Faculty Papers

UNLABELLED: Objective tobacco use, cigarette, e-cigarette, cancer-related beliefs, perceived risk, lifestyle attribution, cancer disparities, health equity. We assessed cigarette smoking and e-cigarette use in the Greater Philadelphia region alongside national data. The objectives were to descriptively explore differences in tobacco use by sociodemographic characteristics. We also examined cancer belief associations with smoking and e-cigarette use in the local context.

METHODS: We descriptively compared cross-sectional survey data from 2744 adults in the Sidney Kimmel Comprehensive Cancer Center (SKCCC) catchment area (Greater Philadelphia region; May-July 2022) with 6252 Health Information National Trends Survey (HINTS 6) nationally representative respondents (United States; March-November 2022). …

Future-Oriented Science Education: A Delphi Study Of Policymakers’ Views From Four European Countries, Sibel Erduran, Jessica Chan, Olga Ioannidou

School of Law, Humanities and Social Sciences

Future-oriented skills have become increasingly important in science education. These skills include critical thinking, problem solving and managing complexity. While policymaking has a direct bearing on the what and the how of a future-oriented perspective in science education, previous research focused on a narrow group of stakeholders such as teachers and students. Little is known about what policymakers perceive as significant future-oriented skills to be included in the science curriculum. By policymakers we mean government officials, legislators, educational administrators, and other influential figures who are key decision-makers in the educational eco-system. The exploratory empirical study reported in the paper employed …

A Trinity Of Forces: A Critical Investigation Of The Intersection Of Lived Experience, Jesuit Secondary Education, And Corporate Curricula, Bernhard Bruno Walke

Dissertations

This dissertation examines how students' identities and personal experiences shape their encounters with both Jesuit Secondary Education and the Corporate Work Study Program (CWSP). Throughout this qualitative analysis, the researcher will examine how identity, secondary education, and corporate attitudes coexist, overlap, conflict, intersect, and compete with one another. By employing Gloria Ladsen-Billings’s Critical Race Theory (Ladson-Billings & Tate, 1995), Dolores Delgado Bernal and Daniel Solórzano’s contributions to Latinx Criticism (Lat Crit), (Solorzano & Bernal, 2001), Kimberlé Crenshaw’s Theory of Intersectionality (K. Crenshaw, 1989), and Tara Yosso’s Community Cultural Wealth Model (Yosso, 2005), the researcher will examine how students experience “non-linear …

Elementary Students' Science Attitudes And Teachers' Implementation Of The Ngss Science Practices: A Mixed Methods Study, Michelle Laborn

Dissertations

It has been recorded in the literature that student science interest drops as students enter and transition to middle and high school. This dissertation takes up the areas of student science interest and the teaching of the science practices in the context of elementary education. This study seeks to understand student science interest in elementary students in the years before entering middle school where a drop of interest is frequently reported. It is hypothesized that an increased use or implementation of the NGSS science practices by classroom teachers would generate higher science interest in elementary students. In a framework of …

Justice-Oriented Pedagogy: Personal And Programmatic Commitments In Teacher Education, Cheetara A. Hudson

Dissertations

This qualitative case study examined how faculty in an urban, justice-oriented undergraduate teacher education program prepare elementary teacher candidates to develop socially just and culturally responsive teaching practices. Guided by Critical Race Theory and critical multiculturalism, this study explored how instructors integrated social justice education and culturally responsive pedagogy into coursework and field experiences. Data were collected through semi-structured interviews, classroom observations, and document analysis with four faculty members teaching foundational and methods courses. Thematic analysis revealed four key findings: (a) faculty beliefs and identities, shaped by prior K–12 teaching experiences, strongly influence their pedagogical choices; (b) instructors model justice-oriented …

Pedagogical Possibilities Toward Positive Embodiment: Applying The Developmental Theory Of Embodiment To Educational Contexts, Elena Buis

Dissertations

Young adolescents, particularly girls, often experience uncomfortable and negative relationships with their bodies, contributing to negative physical, mental, and emotional outcomes. Although educators have implemented interventions to address this issue, those grounded in positive embodiment remain underexplored. Specifically, the Developmental Theory of Embodiment (DTE), a prominent framework in eating disorder and body image research, has not been integrated into educational research or practice. This dissertation explores the integration of DTE into educational theory, practice, and pedagogy across three complementary articles and examines the teaching and learning of Be Body Positive (BBP), a positive embodiment intervention, with a fifth grade Girl …