2021 Theses and Dissertations

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    An investigation of the impact of the COVID-19 pandemic on the use of computer-aided instruction in middle school choral programs
    (12/20/2021) Hernandez, Eleazar; Baker, Vicki
    The purpose of this study was to determine how the COVID-19 pandemic impacted the use of computer-aided instruction (CAI) in Texas middle school choral classrooms. Participants (n=23), Texas middle school choral directors, were asked to complete a researcher-designed survey about their demographics and their use of CAI in the classroom both pre-March 2020 and post-March 2020. Results indicated that CAI use increased after March 2020, with Flipgrid, Chrome Music Lab, Sight Reading Factory, iTunes, Garageband, and Mustheory.net being the most frequently used CAI in their respective categories. Participants considered tracking student progress as the greatest challenge to using CAI. Almost 70% of participants had less than one year’s experience using CAI and 50% had been required to teach in-person, synchronously, and asynchronously simultaneously. Future studies could determine if the increased use of CAI in music classrooms extends to other areas of music and if music teachers will continue to incorporate CAI in the post-pandemic period.
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    Silent stories and puzzled paradigms: A reflexive autoethnography of identity, motherhood, and dominant discourse
    (12/1/2021) Peterson, Treisha; Dutton, Catherine
    Identity development continues across the lifespan, revisited as transitions spark new beliefs and life experiences demand new ways of being; a re-examination of old patterns, beliefs, relationships, and visions of what one might become (Bogaerts et al., 2019; Meca et al., 2020; Piotrowski, 2020). The purpose of this research is to explore the concept of self and identity for a mother when the maternal role includes the discrepant identity exploration of adolescent offspring. Maternal identity is an amalgamation of roles, responsibilities, and attitudes that can be disrupted when sudden changes or challenges exceed an individual’s perceived coping and reasoning skills (Piotrowski, 2020; Praharso et al., 2017; Stanley & Stanley, 2017). These disruptions often become moments of crisis; turning points where group membership is questioned and previously held beliefs and patterns of behavior are re-considered in exchange for new ways of thinking, being, believing, and becoming (Bogaerts et al., 2019; Fossas, 2019; Praharso et al., 2017). Data for this autoethnographic research are gathered from artifacts dated between 2015-2021; drawn from personal journal entries, yoga class notes, voice recorded notes, and hand drawn doodles. Revisiting one’s identity, middle stage mothers are at increased risk of internalizing responsibility, resulting in a cycle of shame and self-blame that Through reflection or rumination, an individual will craft a storied narrative of self and other that provides the backdrop for the event related outcomes that pave the path to stagnation or transformative meaning making that impacts mental health, relational satisfaction, well-being, and one’s sense of self (Bogaerts et al., 2019; Hardy et al., 2017; Meca et al., 2020; van Halen et al, 2020). Results from this study illustrate that, both, the significant and mundane moments may result in seismic and subtle paradigm shifts that can wreak havoc on middle-stage maternal identity and domain specific distress (Li et al., 2019; Luthar & Ciciolla, 2015; Luthar, 2016; Meca et al., 2020). Offering an analysis of the lived experience of self and identity, this research concludes with implications for help professionals and future research.
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    Caring in nursing education: The role of the educator
    (11/18/2021) Gillson, Suzanne M; Freysteinson, Wyona
    The purpose of this study was to discover the perception and demonstrating of caring by nurse educators towards nursing students in the classroom setting. A phenomenological hermeneutic design was used to elicit and express this experience. The questions guiding the study were: 1.) What is the perception of caring by the nurse educator in the nurse educator to nursing student relationship? 2.) How is caring demonstrated in the nurse educator to nursing student relationship? Thirteen experienced nurse educators teaching both undergraduate and graduate-level students discussed their perceptions of caring for students in the classroom. A classroom was defined as a face-to-face modality in a synchronous format during a set time of instruction. The philosophical underpinning was based on the work of Paul Ricoeur and included both structural analysis and phenomenological interpretation. The structural analysis unearthed three salient elements within the nurse educator’s world: the students’ nature, the context of the classroom, and the degree of support from the university. The phenomenological interpretation revealed the following themes: embodied caring, why we care, developing a rhythm of caring, influences on caring, and caring communication. Implications for nurse educators is the discovery that caring is based in a shared humanity. Caring for students is a decisive action that also models desired behaviors. Nurse educators can create safe and optimal learning environments that are relational, professional, and able to uphold the standards of the nursing profession.
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    In-school and out-of-school adolescent identities in high school English Language Arts classrooms
    (11/18/2021) Thaggard, Kimberly; Anderson, Nancy
    ABSTRACT KIMBERLY VILLARREAL THAGGARD IN-SCHOOL AND OUT-OF-SCHOOL ADOLESCENT IDENTITIES IN HIGH SCHOOL ENGLISH LANGUAGE ARTS CLASSROOMS DECEMBER 2021 Adolescents’ in-school- identities, out-of-school identities, and literacy practices are intertwined and connected. This research project aimed to explore the development of adolescent identities and out-of-school literacy practices in students’ English Language Arts classes. As a high school teacher and administrator, the researcher adopted a constructivist approach and conducted a cross-case analysis of six ninth-grade students from classroom observations, interviews, and an identity-centered word sort activity created for the study. The researcher’s analyses revealed the students’ out-of-school identities, preferred literacy practices, and personal affinities were underrepresented in their English Language Arts class. The key findings in the study support a multi-faceted definition of literacy for adolescents and that identity-centered approaches in classrooms may be conducive to increasing their interest in English Language Arts skills and content. These findings support the argument that adolescents’ in-school- identities and out-of-school identities need to be incorporated into classroom literacy practices.
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    Synthesis of doxorubicin-protein conjugates via cobalt coordination chemistry: Conjugates of transferrin and immunoglobulin G
    (11/8/2021) Carvajal de Luna, Juan Jose
    Protein-drug conjugates are a rapidly expanding family of therapeutics that hold significant potential to ameliorate off-target toxic effects commonly observed in patients undergoing chemotherapy. chemotherapy. In this context, the protein acts as a nanoscale delivery vector that alters the biodistribution of the drug upon administration by restricting its unhindered distribution in vivo. This thesis explores the use of cobalt coordination chemistry in the synthesis of doxorubicin-protein conjugates. Previous work has shown that cobalt can be used to crosslink amine-containing molecules in a reversible reaction that only utilizes the lone pair of electrons on nitrogen to form a dative bond with cobalt. Doxorubicin was chosen for initial studies because it contains a primary amine that could be crosslinked with lysine residues on a protein to form a protein-drug conjugate. Conjugates of dox with albumin, transferrin, and immunoglobulin G were investigated to demonstrate the broad applicability of the method for bioconjugation reactions. Drug loading was investigated by HPLC, and the conjugates further characterized by dynamic light scattering, calorimetry, and cytotoxicity. Details of the effects of reaction conditions on synthesis of stable conjugates will be discussed.
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    Interaction of disgust sensitivity and type of nature exposure on mood and anxiety
    (11/15/2021) Alonso, Alyssa; Porras Pyland, Claudia
    E.O. Wilson (1984) asserted human beings have an innate tendency to be drawn into an emotional relationship with nature based on our evolutionary history. This relationship with nature has been shown to impact several aspects of psychological well-being, and also be impacted by situational and personality factors. The current study investigates the relationship between someone’s connection to nature, their sensitivity to disgust, and the way they are exposed to nature, either using technology or physical exposure. This study used a video of a natural area as a technological means of exposing people to nature. Disgust sensitivity, connection to nature and mood were measured using different previously validated scales. Results showed that exposure to nature, regardless of type of exposure, decreased anxiety and negative affect. Technology nature exposure decreased positive affect while physical nature exposure increased positive affect. Disgust and connectedness to nature were not significant predictors of anxiety or mood regardless of exposure type. This research provides future directions for investigating how nature impacts mood.
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    Examining the intersections of age, race, and mental health through linguistic analysis
    (11/3/2021) Rook-Phenis, Amber R.; Scott, Shannon; Williams, Marlene
    The purpose of the current study was to examine patterns in the language used to describe individuals at different stages of the lifespan, and to determine through a framework of intersectionality, whether language use directed toward others differs in relation to perceived identity and social location. Researchers also sought to examine the ways in which study participants’ own intersecting identities influence their use of language. A pilot study was conducted to obtain descriptive words associated with general and specific concepts of being elderly, mental illness, and race/ethnicity. Custom dictionaries were created and used for linguistic analysis of archival data from a previous study examining differences in language use to describe images of women at different life stages (Rook-Phenis & Scott, 2019). A theme analysis of the previous archival data was also undertaken. Results demonstrated differences in themes and stereotypical language between descriptions of the younger versus older woman based on age and other perceived intersectional identities. The analysis also found that participants’ own unique intersecting identities influenced their use of stereotypical language.
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    Examining sexual assault disclosure and non-disclosure using an attachment lens
    (11/3/2021) Poe, Darian J; Mollen, Debra
    Research regarding non-disclosure among sexual assault victims remains limited with primary focus on non-disclosure to formal networks. The purpose of this study was to examine interpersonal factors related to disclosure and non-disclosure following sexual assault and potential outcomes associated with sexual assault disclosure to informal networks. Participants were recruited from social media sites and academic listservs. A total of 240 cisgender women completed an author-generated demographic questionnaire and six instruments online. Women with an insecure attachment orientation experienced higher rates of posttraumatic symptomology and overall wellness than women with a secure attachment orientation. Further, women who disclosed at higher rates experienced higher posttraumatic outcomes and higher wellness outcomes than non-disclosers. Analyses additionally revealed that positive social reactions and unsupportive social reactions to sexual assault disclosure are related to psychological wellness outcomes. Implications for theory, practice, policy, and research are provided.
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    The perceived impact of African American fathers’ involved presence on their adult children
    (11/1/2021) Dardar, Kristopher K; Hwang, Shann Hwa
    The African American family can be viewed as a dynamic enterprise of tenacity, resilience, and flexibility. Throughout the African Americans’ history in America, the African American family has lived within contexts that have, in many instances, been divisively constructed for their demise. Duly noted, African American families have been and continues to be more likely to live in poverty, live in at-risk communities, undereducated, experience early, pre-martial pregnancies, die of disease and other unhealthy aliments such as high blood pressure and obesity, operate in social and systematic racism, and experience familial breakdown than any other racial group in America (Miller, 2018). With these adversities daily besetting the African American family, including in many instances the absence, displacement, and disengagement of the “father role,” I am seeking to explore the lived experiences of African American adult children who self-report the involved presence of their father during childhood through a phenomenological approach. Four major domains will be explored for African American fathers’ effect: (1) gender role development, (2) romantic attachment, (3) self-concept, and (4) future parenting styles. These father-adult child dyads will be explored through three theoretical lenses: (1) family systems theory, (2) resilience, and (3) Afrocentricity. The overarching purpose of this research project is to explore, through a phenomenological approach, the effects of the involved presence of African American fathers on their adult children. With this information, I wish to add to the body of knowledge the lived experiences of such families and add positive outcomes and elements to the literature concerning African American families, fathers and men in particular. The principal purpose is to share such results with everyday fathers in the community who may be statically and/or realistically absent, disengaged, invisible, or displaced. Such illuminating evidence would become vital for all to comprehend the important role constructive, fatherly engagement plays in the development and positive outcome of their children.
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    Exploring perceptions of violence and factors that impact help-seeking
    (11/15/2021) Olguin-Aguirre, Rosario; Pyland, Claudia
    Intimate Partner Violence (IPV) is a serious problem that has impacted the lives of many individuals in a variety of ways. While we have a general definition of abuse, the behaviors that constitute abuse vary from person to person and it can be presumed that gender and gender stereotypes may influence perceptions of what abuse. For this reason, the current study examined the way that men and women perceive abuse. Additionally, help-seeking behaviors for survivors of IPV have been found to be impacted by various factors, and can be a difficult step for victims to make. Therefore, the present study also analyzed how various factors such as shame and guilt, gender, and gender stereotypes impact help-seeking behaviors in victims of IPV. While gender was not a significant predictor of how individuals perceive abuse or of their help-seeking behaviors, gender stereotypes were found to be a significant predictor of perceptions of abuse and help-seeking behaviors. Further, gender stereotypes, and shame and guilt predicted help-seeking behaviors for individuals in same-sex and different sex relationships. Results from this study will be valuable for mental health professionals to consider when working with IPV survivors. Implications of the findings for mental health professions will be explored and suggestions for practice will be discussed.
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    The relationship between the self-efficacy of school counselors and the use of family systems approaches in the school setting
    (11/1/2021) Morrow, Ebony; Vittrup, Brigitte
    The purpose of this study was to examine if school counselors’ level of self-efficacy could be predicted from the use of family systems approaches in the school setting, and to determine if self-efficacy could be predicted from perceived importance and preparedness of using a family systems approach. In addition, this study explored personal and professional factors of school counselors that could be used to predict school counselors’ self-efficacy. A total of 120 practicing school counselors completed a 53-item online questionnaire for a response rate of 60%. The results of this study can be beneficial in determining how to better train and prepare school counselors to be effective advocates. Results of this study can also be used to inform training, workshops, or professional development opportunities directly related to the use of family systems approaches in school counseling. Results of the current study indicate participants generally felt somewhat competent to deliver school counseling through use of a family systems approach. Findings resulted in recommendation for training considerations in family systems approaches for school counselor educators.
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    The effects social structures have on COVID-19 outcomes among three states in the United States
    (12/3/2021) Adame, Jessica Louisa; Lo, Celia C.
    This study aimed at examining the effects social structures have on COVID-19 outcomes. Since the emergence of the COVID-19 virus in late 2019, there has been an ongoing increase of confirmed cases and deaths worldwide. Past literature on structural factors and health have concluded that select communities target health disparities. However, because this virus is so recent, and continues to unravel itself. This dissertation empirically analyzes the effects social structures have on COVID-19 outcomes by examining counties within three states in the U.S. to understand better health disparities related to COVID-19, particularly from a macro-level perspective. The three states in this discussion are California, Texas, and New York. Specifically, this dissertation presents three hypotheses. Generalized Least Square Regression techniques were utilized to assess the hypotheses. Results indicate that overall, county population size, county racial composition, percentage of married households, occupation, total percentage of citizenship, and disadvantage are all significant predictors of rates of COVID-19 confirmed cases. The overall unemployment rate, county population size, racial composition, occupation, and the total percentage of citizenship were significant predictors of COVID-19 death rates. When examining each state individually, I found unique results on whether and how social structural factors affect each outcome. Findings from this study can contribute to the awareness and literature on health disparities and ultimately lead to policy implications that could alleviate these disparities.
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    Comparative insulin and glycemic response to dietary protein intake in healthy males
    (9/8/2021) Long, Tatyana; Everts, Helen; Broughton, Shane K
    The aim of this study was to compare plasma AA concentrations, insulin and glycemic response to an intake of whey protein concentrate (WPC) or chicken protein isolate (CPI). 28 healthy males were assigned to a treatment drink of WPC, Glucose, or CPI. WPC and glucose intake caused an insulinogenic effect followed by a significant drop below baseline at 180-minutes leading to blood glucose changes with similar characteristics as rebound hypoglycemia. CPI resulted in a significant rise in insulin (p< .05) much lower than that seen in the other treatment groups. Plasma glucose levels remained within a normal range for chicken ingestion and did not show a significant decrease below baseline. Whey led to a higher early AA response whereas chicken had a longer-term sustained response. In conclusion, CPI may induce a more favorable insulin response in combination with a steady moderate range of postprandial blood glucose compared to WPC.
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    Mothers in academia and their unique needs: Navigating multiple roles while maintaining personal wellbeing
    (9/14/2021) Skinner, Amy; Johnson, Wendi
    The challenges women in academia who also identify as mothers, are robust in their presentation and overall outcomes (Williams, 2015). These challenges include the limited ability for these women to integrate their emotional, intellectual, and physical selves within their professional and personal lives (Moustafa, 2020). In addition to navigating multiple roles, these academics face gender bias, unequal pay, and a lack of transparency surrounding university policies (Little & Tingstrom, 2004). Trainers in psychology take on the responsibility of developing psychologists in the areas of assessment, behavior and counseling through techniques that promote a biopsychosocial model (Boccio, 2016). Women who are mothers and trainers of psychology offer a unique perspective to this pedagogy as they are distinctive from their male counterparts. The investigation of women who are mothers and trainers of psychology and their perception of their levels of depression, anxiety, and stress was warranted to assist in determining the type of interaction, either positive or negative, they have on their overall wellbeing. The information gathered further provided the lived experience these women describe to better explain how this group of women view their wellbeing and the impact it has on the navigation of these multiple roles. In addition to their perception of their overall wellbeing, this research provided information adding to current literature on the shortage of female psychology trainers at the university level.
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    Towards a post-oppositional womanist pedagogy
    (10/25/2021) Martin, Jennifer V; Keating, AnaLouise
    Building on the definitions and work of womanist scholars such as Alice Walker, Layli Maparyan, and AnaLouise Keating, this dissertation explores the possibility of a post-oppositional womanist pedagogy that can serve as a potential solution to the oppositional pedagogies and hyper individualistic cultures in Western education systems. This research discusses the following themes that emerged from interviews: (1) womanism draws people in/feels welcoming because of the spiritual component; (2) spirituality is an important aspect of personal choices, pedagogical choices, and worldviews; (3) self-care and community care are deeply connected; and (4) dialogue and an understanding of interconnectedness/interrelatedness are components of post-oppositional pedagogies. This dissertation offers a more expanded definitions of womanism and explores some possible ways of shifting teaching practices to a more post-oppositional approach.
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    Expression levels of ALDH1A2 and ALDH1A3 are altered in human tissue biopsies in invasive squamous cell carcinoma
    (9/1/2021) Newman, Regina; Everts, Helen B
    The regulation of gene expression by retinoids has been shown to be profoundly altered in various types of precancerous and cancerous lesions, including cutaneous squamous cell carcinoma (cSCC). Aldehyde dehydrogenase family 1, subfamily members A2 (ALDH1A2) and A3 (ALDH1A3) participate in the oxidation of retinal to retinoic acid and their expression has been implicated in various types of cancers. The purpose of this study is to compare the intensity and localization of ALDH1A2 and ALDH1A3 in various stages of cSCC. Forty-two diseased biopsies and 32 healthy controls were used in this study. Immunohistochemistry was used to detect the immunoreactivity and localization of ALDH1A2 and ALDH1A3. Results showed percent ALDH1A2 positive cells were significantly higher in the tumor and stroma of actinic keratosis and invasive SCC groups than other groups. ALDH1A3 expression levels were significantly higher in tumors of all stages of cSCC compared to the epidermis of the control group.
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    Hikikomori: A multitheoretical approach
    (9/8/2021) Nation, William; Porras Pyland, Claudia
    Hikikomori is a mental health concern first identified in Japan that appears to be an increasingly global phenomenon. Researchers have attempted to address key points about hikikomori with mixed results. There is a lack of unified thought and conceptualization about hikikomori, as well as overarching treatment methods and strategies. With an increasing number of cases being identified around the world, it is prudent to develop more comprehensive and unified views and knowledge of hikikomori. Currently there is disagreement and many unanswered questions about hikikomori, including how to appropriately conceptualize, assess, and treat it. The present study explored the school of thought that hikikomori is an international phenomenon, whether any differences might exist between hikikomori across cultural or national groups and whether hikikomori experience their isolation with emotional distress and somatic symptoms. Participants were asked to complete an assessment of hikikomori, a measure of emotional experiences, a somatic symptom questionnaire, and demographic questions. Results were analyzed using correlation, multiple regression, and t-test analyses. Findings indicated that there was a significant positive correlation between hikikomori symptoms and experiences of negative emotion, and also between hikikomori symptoms and introversion. There was also a significant difference between levels of hikikomori symptoms across national groups. The relationship between hikikomori and other factors was also significant when controlling for introversion. These findings will aid in future conceptualization and treatment of hikikomori.
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    Examining the effects of consuming muffins containing brewer's spent grains on fiber intake, healthy eating index scores, and inflammatory biomarkers in healthy adults
    (9/20/2021) Grams, Marley E; Broughton , Shane
    Brewer’s spent grain (BSG) is the barley byproduct that is created during the beer brewing process. This nutrient-dense waste product is not only rich in dietary fiber, but also protein. This study evaluated the impact of consuming BSG on dietary fiber intake, Healthy Eating Index (HEI) scores as well as the pro-inflammatory cytokines IL-6, IL-1beta, and anti-inflammatory cytokine IL-10 in healthy adults (n = 37; 26.0 ± 4 y; BMI 22.9 ± 3 kg/m2) using secondary data from a single-blinded, randomized, controlled study. Diet records were collected for two weekdays and one weekend day at three timepoints from participants who either consumed muffins with 0 g BSG (control; n =18) or 10.4 g BSG (treatment; n=19) daily for eight weeks. These diet records were evaluated to determine dietary fiber intake as well as HEI scores. The inflammatory cytokines were analyzed using fasting serum samples collected at baseline and final time points of the study. While the mean dietary fiber intake was increased within the BSG group (5g/day, 26% p = .003), no significant effects were found on HEI scores, IL-6, IL-10, and IL-1b. Though significance was not achieved, within-group IL-10 and IL-1b increased in concentration were approaching significance (p = .060 and p = .066) in the treatment group. There were also moderate to strong, positive, and significant correlations observed between the change within the interleukins as well as between moderate correlations between fiber and HEI scores. In conclusion, BSG does not significantly affect inflammatory biomarkers, fiber intake, or contribute to improvements in overall healthy diets in a healthy population in an 8-week timeframe while consuming this amount.
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    Influence of health locus of control on physical activity levels and health-related quality of life among Seventh-day Adventist adults
    (12/2/2021) Feiler, Kimberly E; Mann, Mark
    The purpose of this quantitative study was to (a) examine the impact of health locus of control (HLOC: internal, external-chance, external-powerful others, and God/God locus of health control [GLHC]) on physical activity (PA) levels of adults at Seventh-day Adventist institutions of higher education in California, and (b) examine health-related quality of life (HRQoL: physical function and general health) as first related to HLOC, then with PA, in the same population. Subjects included a convenience sample of participants (aged 22-81) employed by or attending one of three SDA higher education institutions in California during the 2020-2021 academic school year, a year that was affected by the COVID-19 pandemic. The participants identified their role as either part-time or full-time student, staff, or faculty. Four surveys were combined into one questionnaire for participants to respond to: (1) Multidimensional Health Locus of Control (MHLC) scale to measure HLOC, (2) GLHC scale added to MHLC, (3) International Physical Activity Questionnaire to measure PA, and (4) Short Form 36 to measure HRQoL. Multiple regression analyses were performed and results indicated the following. (1) HLOC’s internal category was a significant positive predictor of HRQoL - general health, (2) HLOC’s external-powerful others category was a significant negative predictor of HRQoL - physical functioning, and (3) none of the HLOC categories (internal, external-chance, external-powerful others, God/GLHC) was a significant predictor of PA. In this sample, 66% of the respondents in this study reported high levels of PA (achieving at least 3,000 METS per week), 28% obtained moderate levels of PA (at least 600 METS per week), and 5% obtained low amounts of PA (less than 600 METS per week). Additional stand-out results indicated that part time (PT) staff (as a group) had the most amount of high PA levels, full time students had the highest scores for HLOC’s God/GLHC scale; and PT faculty had the highest scores for HRQoL - general health. Through better understanding of people’s PA, HLOC, and HRQoL, health interventions can be designed and implemented to more appropriately target the desired behavior change and thereby improve people's health and health outcomes.
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    An integrated model of functional status and socioeconomic factors affecting hospital length of stay and 30-day readmission risk in individuals with heart failure
    (11/22/2021) Tran, Vinh Q; Lin, Suh-Jen
    Background: Acute management of heart failure (HF) is a high-cost enterprise. Cost-effective management of acute HF hinges upon hospital outcomes such as length of stay (LOS) and 30-day readmission (30dRA) rate. Literature has produced regression models that predict these hospital outcomes; however, existing models use a limited scope of traditional medical predictors resulting in weak predictive ability. Functional status (FS) and socioeconomic factors (SEFs) have been found to predict various hospital outcomes in patients with HF; however, existing model performance is limited in its scope. Therefore, a modernized, holistic approach through the integration of FS and SEFs into existing medical predictor based regression models may better predict LOS and 30dRA rate in HF. Purpose: To determine the predictive utility of a model utilizing FS, SEFs, and traditional medical variables on hospital LOS and 30-day re-admission rate (30dRA) in individuals with HF. Methods: Secondary data for 2016 to 2020 calendar years was gathered from a Trauma Level I, safety-net hospital. Hospital admissions with a primary diagnosis of HF were included. Subjects under 18 years old at admission and death during hospitalization were excluded. A total of 2204 medical records were analyzed using hierarchical linear regression on log-transformed LOS data and 1953 records were analyzed using logistic regression on 30dRA data. Results: A LOS model utilizing FS, SEFs, and traditional medical factors was found to be significant (r2 = .207, adjusted r2 = .204, F(8, 2195) = 71.579, p < .001). A 30dRA model utilizing SEFs and traditional medical factors was found to be significant (χ2(10) = 43.185, df = 10, p < .001). Within the 30dRA model, FS was found to be not statistically significant (OR: .996, 95% CI [.985 to 1.007], p = .449). Conclusion: A model utilizing FS, SEFs, and traditional medical factors can predict hospital LOS. FS appears to be less contributory to a 30dRA model compared to SEFs and traditional medical factors.