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MENTAL HEALTH DISPARITIES IN U.S. MILITARY ADOLESCENTS AND TELEHEALTH DISPARITIES IN MEDICAID: A MULTI-METHOD STUDY USING QUALITATIVE AND QUANTITATIVE RESEARCH METHODS
No full textThis work is embargoed by the author and will not be publicly available until May 2026.This manuscript style dissertation presents three studies highlighting significant challenges in mental health treatment and differences within, and between, civilian and military households. The included studies focus on mental health (MH) factors and the role disparities play in both civilian and military settings. Starting within Medicaid where one would traditionally expect to see health disparities, the first study examines MH and substance use as two areas of substantial inequity and the impact of recent telehealth expansion as a result of the COVID19 pandemic on a civilian focused population. Continuing into a cross examination of differences between military and civilian adolescents, study two looks at select MH conditions utilizing a national survey. The third study expands on the second, examining the role of stigma and the military environment on several MH conditions in a military-only population. The first and third study also examine modalities and access to care, while the second examines differences in receipt of care.The purpose of the first study was to understand how expanded access to telehealth has affected equitable care and uncover policy gaps. Semi-structured interviews were conducted to explore variations in telehealth access and implementation through three levels of care: patients, providers, and insurers. When asked about advantages,100% of participants expressed positives towards telehealth implementation, with 67% of patients expressing a preference for telehealth versus in-person care. Equity of accessibility, adaptability, and increased service availability to patients emerged as a key theme. The second study examined the prevalence and factors associated with suicidal behavior in adolescents in both military and civilian populations. This study utilized a robust analysis of differences between these two populations using a nationally representative sample which is the first of its kind. Compared to civilian adolescents, having a military parent was associated with 22% higher odds of being treated for active suicidal ideation (SI), suicidal planning (SP), or suicidal attempts (SA), 20% higher odds of self-reported active SI/SP/SA (not tied to help seeking), and 13% higher odds of self-reported passive suicidal thoughts. Military affiliated adolescents (MAAs) had significantly higher prevalences of most MH variables, with almost twice as many MAAs requiring inpatient services for emotional problems, higher overall MH service utilization, and higher levels of major depressive episodes than civilians. Finally, the third study examined the factors uniquely impacting mental health in MAAs, how military cultural norms may impact MH help seeking behaviors, and explored barriers and facilitators to care. Semi-structured interviews were conducted from both adolescents and their parents, combined with a pre-interview survey to thoroughly examine the MH burden in MAAs. History of MH included anxiety and fear (100%), depression (100%), self-harm and/or suicidal behaviors (73%), and aggression (67%), with participants attributing the majority of these issues to the military environment. The majority of participants reported stronger MH stigma in the military environment, with fear that MH care would impact the active-duty member's career, fervent minimization of MH concerns, and added gender role pressures reported. Our findings suggest that a more focused approach towards addressing MH concerns in both civilian and military families is warranted, and we suggest several implications for policy makers to address the critical unmet MH needs of these minority populations.2026-05-1
Expressed Intellectual Humility: A Framework for the Person-Centered Library Manager
Get PDFThis chapter takes a theoretical approach to examine how intellectual humility is critical to person-centered management practices, particularly in a profession, like librarianship, which contains a variety of subfields and specializations. The chapter combines philosophy, psychology, and organizational development literature and applys it to person-centered management in academic libraries
Measuring and Modeling the Relationships between Student Sustainability Literacy, Culture, and Behaviors in Higher Education
No full textThis work is embargoed by the author and will not be publicly available until May 2026.Sustainability assessments have garnered increasing attention and importance in higher education in recent years. Through a series of three studies, this dissertation examines the relationship between college students’ sustainability literacy, culture, and behavior. It also explores the motivations and challenges for institutions to engage in these assessments, and what can be done within higher education to better assess the factors that influence student sustainability behavior. A theoretically-informed model reveals that time spent on campus and informal program participation influences nature-social connectedness and norms, which in turn affect sustainability behavior. However, the breadth of measurement variability for sustainability literacy and culture between a 4-year “very high research activity” (R1) university, a 2-year community college, and a historically black college and university (HBCU) suggests the need for more generalizable and robust scales.2026-05-1
Utilizing the DIME Model to Examine the United States Free and Open Indo-Pacific Strategy from 2021-2025
Get PDFThe Indo-Pacific region is a vast region with a general understanding of countries from the eastern shores of Africa to the western United States. Of course, there are variations in what constitutes a part of the Indo-Pacific, with debating sources. This variant depends on several factors, such as the geographical interests of various states. A more accurate framing for the context of the research paper will utilize what the United States Indo-Pacific Command (USINDOPACOM) defines as consistent with the Indo-Pacific. According to INDOPACOM, the Indo-Pacific is classified as a vast region of approximately 38 countries, each with diverse histories and unique cultures. It is home to seven of the largest militaries in terms of manpower, and the region comprises more than 50% of the world's population. A significant number of the largest economies are within the area.
Undoubtedly, the Indo-Pacific region holds immense contemporary significance. It has been a site of significant trade, cultural, and military interests, leading to the formulation of strategic goals by countries with stakes or significant interests in the region. The United States, driven by its history since independence, has consistently been one of these countries, with the Indo-Pacific's interests shaping the foreign policies of various American administrations.
In February of 2022, the Biden administration published five core objectives to provide general directional guidelines on how the U.S. will support its interests and goals in the Indo-Pacific. These objectives are (1) The advancement of a Free and Open Indo-Pacific (FOIP), (2) To build strong connections between countries both within and beyond the region, (3) To drive and promote regional prosperity, (4) To ensure adequate support to bolster Indo-Pacific security, and (5) To support regional resilience to various transnational threats that otherwise, would bring instability to the region
Topology-Based Protein Classification Using Deep Learning
Get PDFUtilizing Artificial Intelligence (AI) in computational biology techniques could offer significant advantages in alleviating the growing workloads faced by structural biologists, especially with the emergence of big data. In this study, we employed Delaunay tessellation as a promising method to obtain the overall structural topology of proteins. Subsequently, we developed multi-class deep neural network models to classify protein superfamilies based on their topology. Our models achieved a test accuracy of approximately 0.92 in classifying proteins into 18 well-populated superfamilies. We believe that the results of this study hold substantial value since, to the best of our knowledge, no previous studies have reported the utilization of protein topological data for protein classification, particularly through deep learning
Examining the Emergence of Per- and Polyfluoroalkyl Substances as a Federal Policy Topic
Get PDFPer- and polyfluoroalkyl substances (PFAS), colloquially referred to as “forever chemicals”, include approximately 15,000 chemicals. These chemicals have applications in commercial, household, and industrial settings, and have been detected nearly everywhere on earth. While data about PFAS’ environmental persistence and human health risks came to the attention of the U.S. Environmental Protection Agency around the turn of the century, protective policies regarding PFAS use and acceptable exposure levels has been slow to evolve. Using John J. Kingdon’s multiple streams framework as a theoretical lens, this study reviewed Congressional bills and surveyed policy community stakeholders to analyze the factors important in PFAS’ emergence as a policy agenda topic. We found that support from policy entrepreneurs as information brokers was crucial in advancing policy, whether inside or outside of government. Additionally, attorneys, scientists, and community organizers were identified as key individuals in defining PFAS as a problem and raising awareness on a larger scale. These findings contribute to better understanding how environmental topics such as emerging contaminants, where there is a period of information gathering necessary to inform policy development, may successfully rise as agenda topics
Three Essays on Education and Peace
No full textThis work is embargoed by the author and will not be publicly available until May 2034.This dissertation explores topics in education, peace, and political economy. The first chapter examines the response by various types of schools to the COVID-19 pandemic shut down when almost all schools closed in March 2020. All schools, public, private, and charter had to adjust to the new conditions of educating during the pandemic. All types of schools had to deal with decisions regarding public health and how to educate students. The three types of schools responded differently throughout the pandemic. It is argued the main reason for the differences in response are due to the differences in institutional settings and laws regarding decision making. Private schools are in more of a market setting with school leaders being more directly accountable to tuition paying families. Public schools are in a more entangled market setting including multiple decisions makers and interest groups between the families and the school. Charter schools are a mix of the two settings. I use a variety of data including when schools began teaching content, if it was new content, when schools returned to in-person learning, attendance, and test scores to measure and compare the differences in response by the various types of schools. The second chapter, co-authored with Christopher Coyne, examines the different strategies employed for developing a liberal order. The concept of a liberal order dominates discussions of international affairs. The dominant approach to achieving a liberal order is grounded in a warmonger vision based on state military force as a primary means to social cooperation, peace, order, and human flourishing. This stands in contrast to the peacemonger vision, which emphasizes the primacy of nonviolence in interactions between people, especially in conflict situations. We offer reasons for skepticism regarding the warmonger vision and then discuss features and misconceptions of the peacemonger mentality. In doing so, we discuss how the peacemonger vision better fits with the liberal ends advocated by many who share the warmonger mentality. The third chapter is an analysis of how undergraduate economic textbooks address peace. Kenneth Boulding wrote economics has a role to play in establishing peace in society through the image individuals have for the role of their nation state and through policy. Textbooks are replete with examples of individuals cooperating peacefully in a market setting. There are many examples of individuals in potentially contentious situations finding solutions to problems without resorting to violence. However, economic textbooks often take the underlying condition of peace for granted as well as the process for finding peaceful solutions. Concepts of trade, competition, and overcoming externalities are presented with solutions where the issue of violence never enters the conversation. Individuals are able to solve problems without violence or threats of violence. By neglecting the underlying condition of peace and the process for establishing peace, students are presented with an incomplete view of how key economic principles work. It also stunts the growth of individuals knowledge of future possibilities of finding peaceful solutions to problems. This paper presents evidence of a lack of discussion in microeconomic, macroeconomic, international and development textbooks around the ideas of peace and the role of economics in peace.2034-05-1
Project 5a: Trend of Kidney Transplant Recipients and Donor Cause of Death Before vs During the Covid-19 Pandemic
Get PDFThis project included two student researchers who wish to remain anonymous.Objective: The objective of this study was to assess the outcomes of transplants using kidneys from donors with various causes of death before and during the pandemic. The specific interest was to identify any changes in the outcomes of transplants using kidneys from donors died from drug overdose during the pandemic given the reported change in the profile of drug overdose death victims during the pandemic
Separating Forced and Internal Variability in North Atlantic Sea Surface Temperature
Get PDFQuantifying the relative contributions of external forcing and internal variability to North Atlantic Sea Surface Temperature (NASST) has important implications for attributing and predicting climate changes around the North Atlantic basin. Many previous methods have approached this problem by estimating the externally forced signal directly, making assumptions about forced variability for which there is no consensus. In this work, the separation of variability is approached in a fundamentally different way that does not specify the forced response's temporal evolution. We propose a dynamical adjustment method in which the internal, spatially uniform component of NASST is predicted based on patterns of NASST that are orthogonal to the spatially uniform pattern. This dynamical adjustment method is trained and validated in preindustrial simulations, where only internal variability is present. In preindustrial simulations, the dynamical adjustment demonstrates skill in reconstructing the NASST basin mean variability. Applying the preindustrial-trained dynamical adjustment to historical simulations demonstrates skill in a majority of climate models, although the skill is reduced relative to preindustrial simulations because external variability partly contaminates the predictors. The skill of dynamical adjustment is compared to several other methods which directly estimate the externally forced signal. We find that dynamical adjustment performs similarly to these comparative methods, despite the fundamentally different prediction method. However, methods based on different principles yield considerably different estimates of external and internal variability. In efforts to contend with the presence of external variability in predictor time series in historically forced simulations, several modifications to the dynamical adjustment methodology are investigated. Most directly, low-frequency filters are applied to the predictor time series to estimate and remove any external variability. We find that the filters applied in this study do not skillfully identify the external variability, and the application of dynamical adjustment using these filtered predictors does not demonstrate a consistent improvement. Modifying the dynamical adjustment by training in historical simulations or including the NASST basin mean as a predictor is also explored. While training using historical simulations does not produce a more skillful dynamical adjustment on its own, we find some variations of dynamical adjustment that include the NASST basin mean as a predictor can produce skill equal to or greater than the original, preindustrial-trained dynamical adjustment. Several variations of dynamical adjustment are applied to observational data from ERSSTv5. These estimates of internal variability are fairly consistent amongst variations, but are distinguished in both amplitude and phase with some residual estimates produced by the comparative methods that directly estimate external variability. The range of estimated external and internal variability in ERSSTv5 reinforce the sensitivity to assumptions that underly different methods
Three Essays on Economic Clusters and their Determinants, Structures, and Transformations
Get PDFWhat determinants lead to the creation of economic clusters, what are the different types of economic cluster structures, and what factors lead developmental state approaches to clusters to change over time? Each of these questions addresses a different puzzle related to economic clusters. Economic clusters are widely defined as a geographic space with a concentration of institutions, firms, and organizations that work in or support a specific industry or set of related industries. Clusters are home to important networks between governments, firms, and research and education institutions as well as key resources which enable innovation. Empirically, the first essay of this dissertation explores the conditions under which clusters emerge (in Africa), the second determines the different types of institutional structures of clusters (in the European Union), and the third investigates the factors which lead to changes in developmental state approaches to clusters (in South Korea)