Matching Items (10)
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Two studies were conducted to test a model to predict healthy lifestyle behaviors, physical activity, and body mass index (BMI) in Taiwanese adolescents by assessing their physical activity and nutrition knowledge, healthy lifestyle beliefs, and perceived difficulty in performing healthy lifestyle behaviors. The study drew upon cognitive behavioral theory to

Two studies were conducted to test a model to predict healthy lifestyle behaviors, physical activity, and body mass index (BMI) in Taiwanese adolescents by assessing their physical activity and nutrition knowledge, healthy lifestyle beliefs, and perceived difficulty in performing healthy lifestyle behaviors. The study drew upon cognitive behavioral theory to develop this study. The pilot study aimed to test and evaluate psychometric properties of eight Chinese-version scales. The total sample for the pilot study included 186 participants from two middle schools in Taiwan. The mean age was 13.19 for boys and 13.79 for girls. Most scales including Beck Youth Inventory self-concept, Beck Youth Inventory depression, Beck Youth Inventory anxiety, healthy lifestyle beliefs, perceived difficulty, and healthy lifestyle behaviors scales Cronbach alpha were above .90. The Cronbach alpha for the nutrition knowledge and the activity knowledge scale were .86 and .70, respectively. For the primary study, descriptive statistics were used to describe sample characteristics, and path analysis was used to test a model predicting BMI in Taiwanese adolescents. The total sample included 453 participants from two middle schools in Taiwan. The mean age of sample was 13.42 years; 47.5% (n = 215) were males. The mean BMI was 21.83 for boys and 19.84 for girls. The BMI for both boys and girls was within normal range. For path analysis, the chi-square was 426.82 (df = 22, p < .01). The CFI of .62 and the RMSEA of .20 suggested that the model had less than an adequate fit (Hu & Bentler, 1999). For alternative model, dropping the variable of gender from the model, the results indicated that it in fact was an adequate fit to the data (chi-square (23, 453) =33.75, p> .05; CFI= .98; RMSEA= .03). As expected, the results suggested that adolescents who reported higher healthy lifestyle beliefs had more healthy lifestyle behaviors. Furthermore, adolescents who perceived more difficulty in performing healthy lifestyle behaviors engaged in fewer healthy lifestyle behaviors and less physical activity. The findings suggested that adolescents' higher healthy lifestyle beliefs were positively associated with their healthy lifestyle behaviors.
ContributorsChan, Shu-Min (Author) / Melnyk, Bernadette Mazurek (Thesis advisor) / Belyea, Michael (Thesis advisor) / Chen, Angela Chia-Chen (Committee member) / Dodgson, Joan (Committee member) / Arizona State University (Publisher)
Created2012
Description
Significance Background: Human papilloma virus (HPV) is the most common sexually transmitted infection, affecting 79 million Americans today and an additional 14 million Americans becoming infected with HPV each year. HPV infection may lead to the development of genital warts and several types of cancers including both cervical and oropharyngeal

Significance Background: Human papilloma virus (HPV) is the most common sexually transmitted infection, affecting 79 million Americans today and an additional 14 million Americans becoming infected with HPV each year. HPV infection may lead to the development of genital warts and several types of cancers including both cervical and oropharyngeal cancers. The promotion of currently available HPV vaccines is important to prevent HPV transmission and reduce the prevalence of the comorbidities associated with infection. Promotion to Vietnamese-Americans in particular is important because of the increased rates of cervical cancers seen in this population. As Vietnamese-American mothers often act as the primary healthcare decision maker for their children, they were chosen as the target population for this intervention. Purpose: This study aims to (1) develop personal digital stories about HPV and HPV vaccination among Vietnamese women with adolescent children who are vaccinated against HPV; and (2) share these stories with a group of Vietnamese American mothers and assess the effect of the stories in changing the attitudes, beliefs, and intention to vaccinate for HPV. Methods: This study used a two-step process to design, implement, and evaluate digital stories to improve Vietnamese mothers' attitudes, beliefs, and intention to vaccinate their adolescent children against HPV. The first step was a formative research design to develop the digital stories. The second step was quasi-experimental with a pre and posttest design to evaluate the effect of the stories. Results: The first phase has produced two digital stories which will be screened recruitment has been completed for phase two. Content analysis showed the importance of community resources, the desire to protect children, a history of familial and/or personal cancer, concerns about side effects, and the influence of healthcare providers as themes in both stories. Recruitment efforts are underway to recruit eligible Vietnamese mothers to assess the effect of these stories. Data collection is ongoing. Conclusions and lessons learned: The project has yielded two digital stories and recruitment for phase two is underway. This project has been successful in obtaining IRB approval, recruiting phase one participants, holding a digital storytelling workshop, designing the phase two survey, and beginning data collection efforts. The phase two recruitment has been challenging and will necessitate a change in strategy to find participants.
Created2017-05
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Spirituality has been studied in relation to psychological factors in health for the past decade and has been found to promote positive affect while possibly benefiting health. However, multiple dimensions of spirituality need to be examined systematically before much can be concluded regarding the influence of spirituality on health. One

Spirituality has been studied in relation to psychological factors in health for the past decade and has been found to promote positive affect while possibly benefiting health. However, multiple dimensions of spirituality need to be examined systematically before much can be concluded regarding the influence of spirituality on health. One purpose of this study was to test the validity of the four factors of the Psychomatrix Spirituality Inventory (PSI) developed by Wolman using confirmatory factor analysis (CFA): divinity, mindfulness, extrasensory perception, and intellectuality. In addition, the moderation effects of these factors on stress, assessed by cortisol levels, and on perceived cold symptoms induced by a bogus cold viral challenge were investigated among 100 participants as part of a larger study conducted by Nemeroff to identify psychological factors related to perceived cold susceptibility under a bogus viral challenge paradigm. The analysis of CFA among 265 participants indicated that the four-factor Pyscholmatrix Spirituality model did not provide a good fit to the data collected by Nemeroff. The shared variances among factors could be the explanation for failure to confirm these four factors. Women developed more cold symptoms than did men post bogus exposure. Mindfulness and extrasensory perception factors buffered the adverse effects of stress on cold symptoms. A three-way-interaction among gender, stress, and mindfulness indicated that the buffering effects of mindfulness on stress and cold symptoms were stronger for women than for men, and the effects were stronger when the stress levels increased. A three-way-interaction was also found among gender, stress, and extrasensory perception, with the moderation effects of extrasensory perception on stress and cold symptoms stronger for women than for men, and these effects becoming stronger as stress levels elevated. This study is an important step for understanding the relationships among gender, spiritual factors and cortisol levels under laboratory-induced stress. These results have implications for developing preventions or interventions that incorporate mindfulness practices and take extrasensory perception beliefs into consideration for stress reduction and health promotion.
ContributorsChung, Kuo-Yi (Author) / Robinson Kurpius, Sharon E (Thesis advisor) / Nemeroff, Carol (Committee member) / Chen, Angela Chia-Chen (Committee member) / Kinnier, Richard (Committee member) / Arizona State University (Publisher)
Created2010
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Introduction. Human papillomavirus (HPV) is the most common sexually transmitted infections globally. HPV is responsible for several health concerns including genital warts, cancer of the cervix, vulva, penis, anus, and oropharynx. In China, HPV infection accounts for 69.1% of invasive cervical cancer. Currently, there is no treatment for HPV infection,

Introduction. Human papillomavirus (HPV) is the most common sexually transmitted infections globally. HPV is responsible for several health concerns including genital warts, cancer of the cervix, vulva, penis, anus, and oropharynx. In China, HPV infection accounts for 69.1% of invasive cervical cancer. Currently, there is no treatment for HPV infection, but HPV vaccination has been proven to be effective against HPV-related diseases. Given the highest rate of contracting HPV and suboptimal vaccination rate in college students including international students in the U.S., it is important to investigate key factors associated with vaccine uptake among Chinese international students. Purpose. This study aimed to investigate knowledge and awareness of HPV and the vaccine, attitudes, and vaccination intention in this population. We conducted a cross-sectional online survey via REDCap. Methods. Participants who were (1) Chinese international student at Arizona State University; (2) 18 and older; (3) able to read, speak and write in Chinese or English were recruited from Arizona State University. Descriptive statistics (mean, standard deviation, frequency) and inferential statistics (Chi-square test, independent t-test) were conducted using SPSS 26.0. Results. One hundred and ten participants were included in this study (56.4% female, mean age = 24, SD = 3.7). Female students had significantly higher HPV vaccination rate than males (p = 0.000). The mean knowledge score was 8.09 (SD = 1.35); female students were more likely to receive HPV education than males (p = 0.001). The most common source of education was friends (50.7%). Three most common perceived risks were not being sexually active, being male, and not having any physical signs and symptoms. The three most common facilitators were infection prevention, access to vaccination, and ability to afford vaccination. The three most common barriers were the cost, safety, and efficacy of HPV vaccine. In conclusion, gender disparities exist among Chinese<br/>international students’ HPV vaccine uptake and HPV related education. Implication. Although Chinese international students possess moderate to high level of knowledge about HPV and HPV vaccines, they lack education from credible sources. Culturally and gender appropriate education is needed in order to address barriers of getting HPV vaccination.

ContributorsChen, Weiqi (Author) / Chen, Angela Chia-Chen (Thesis director) / Reifsnider, Elizabeth (Committee member) / Han, SeungYong (Committee member) / Edson College of Nursing and Health Innovation (Contributor, Contributor) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new

Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new cases yearly. Certain types of HPV have been significantly associated with cervical, vaginal, and vulvar cancers in women; penile cancers in men; and oropharyngeal and anal cancers in both men and women. Despite HPV vaccination being one of the most effective methods in preventing HPV-associated cancers, vaccination rates remain suboptimal in adolescents. Game-based intervention, a novel medium that is popular with adolescents, has been shown to be effective in promoting health behaviors. <br/>Methods: Sample/Sampling. We used purposeful sampling to recruit eight adolescent-parent dyads (N = 16) which represented both sexes (4 boys, 4 girls) and different racial/ethnic groups (White, Black, Latino, Asian American) in the United States. The inclusion criteria for the dyads were: (1) a child aged 11-14 years and his/her parent, and (2) ability to speak, read, write, and understand English. Procedure. After eligible families consented to their participation, semi-structured interviews (each 60-90 minutes long) were conducted with each adolescent-parent dyad in a quiet and private room. Each dyad received $50 to acknowledge their time and effort. Measure. The interview questions consisted of two parts: (a) those related to game design, functioning, and feasibility of implementation; (b) those related to theoretical constructs of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). Data analysis. The interviews were audio-recorded with permission and manually transcribed into textual data. Two researchers confirmed the verbatim transcription. We use pre-developed codes to identify each participant’s responses and organize data and develop themes based on the HBM and TPB constructs. After the analysis was completed, three researchers in the team reviewed the results and discussed the discrepancies until a consensus is reached.<br/>Results: The findings suggested that the most common motivating factors for adolescents’ HPV vaccination were its effectiveness, benefits, convenience, affordable cost, reminders via text, and recommendation by a health care provider. Regarding the content included in the HPV game, participants suggested including information about who and when should receive the vaccine, what is HPV and the vaccination, what are the consequences if infected, the side effects of the vaccine, and where to receive the vaccine. The preferred game design elements were: 15 minutes long, stories about fighting or action, option to choose characters/avatars, motivating factors (i.e., rewards such as allowing users to advance levels and receive coins when correctly answering questions), use of a portable electronic device (e.g., tablet) to deliver the education. Participants were open to multiplayer function which assists in a facilitated conversation about HPV and the HPV vaccine. Overall, the participants concluded enthusiasm for an interactive yet engaging game-based intervention to learn about the HPV vaccine with the goal to increase HPV vaccination in adolescents. <br/>Implications: Tailored educational games have the potential to decrease the stigma of HPV and HPV vaccination, increasing communication between the adolescent, parent, and healthcare provider, as well as increase the overall HPV vaccination rate.

ContributorsBeaman, Abigail Marie (Author) / Chen, Angela Chia-Chen (Thesis director) / Amresh, Ashish (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Recommended first-line treatment with atypical antipsychotic medication for management of schizophrenia and other psychotic disorders is contributory to weight gain and associated comorbidities. Beyond comorbid conditions – weight gain can lead to poor self-image, poor compliance and treatment outcomes in an already stigmatized population. Caregivers were selected as participants as

Recommended first-line treatment with atypical antipsychotic medication for management of schizophrenia and other psychotic disorders is contributory to weight gain and associated comorbidities. Beyond comorbid conditions – weight gain can lead to poor self-image, poor compliance and treatment outcomes in an already stigmatized population. Caregivers were selected as participants as they are a primary support in this population. In alignment with the Health Belief Model the purpose of this evidence-based intervention was to increase risk awareness, increase knowledge of strategies to offset risk, increase confidence and self-efficacy and empower health related behaviors among caregivers.

Participants were identified by providers in an outpatient mental health clinic as caregivers of patients prescribed atypical anti-psychotic medications adults aged 18 and above, able to read and understand English, and agree to provide consent. They were asked to:

1. Complete a demographic and knowledge pre-test, gauge perceived knowledge/confidence.
2. View an educational PowerPoint focused on atypical anti-psychotic medications, benefits, risks and strategies to mitigate weight-gain.
3. Complete a knowledge post-test and gauge perceived knowledge/confidence.

Descriptive statistics were used to examine distribution of variables, due to small sample size, Wilcoxon Signed Ranks test was used to compare outcomes. Qualitative data was also gathered to further develop interventions and inform practice. Comparison between pre- and post-test analysis demonstrated improvement in all areas of knowledge, perceived knowledge, and perceived confidence. Statistical analysis demonstrated statistical significance and high practical significance. One-hundred percent of participants recommended the intervention and provided qualitive feedback, and suggestions that may be used to inform practice.

ContributorsGraeber, Laura (Author) / Chen, Angela Chia-Chen (Thesis advisor)
Created2018-04-30
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The utilization of suicide risk assessment tools is a critical component of a comprehensive approach to suicide risk assessment. However, some professionals hesitate to utilize screening tools routinely in practice. A project was undertaken to determine if the utilization of the Columbia-Suicide Severity Scale (C-SSRS) improved staff confidence in assessing

The utilization of suicide risk assessment tools is a critical component of a comprehensive approach to suicide risk assessment. However, some professionals hesitate to utilize screening tools routinely in practice. A project was undertaken to determine if the utilization of the Columbia-Suicide Severity Scale (C-SSRS) improved staff confidence in assessing suicide risk. Professionals within a psychiatric urgent care in Scottsdale, Arizona were provided with
training on the C-SSRS. Participants then utilized the C-SSRS at triage with patients presenting with depression and/or suicidality over a two-month period.

Self confidence in assessing suicide risk was evaluated utilizing The Efficacy in Assessing and Managing Suicide Risk Scale (SETSP-S). The acceptability and usability of the C-SSRS was evaluated utilizing The System Usability Scale (SUS). Findings of the Wilcoxon Signed Ranks test indicated changes in pre and posttest assessment scores as significant in seven of the eight assessment parameters. In addition, Cohen's effect size value suggested medium or large clinical significance in these same assessment parameters.

Evidence suggests that efficient and effective assessment can improve staff confidence in assessing for suicidality and may improve morbidity and mortality rates for patients. The utilization of tools such as the C*SSRS could reduce health care costs associated with unnecessary hospital admissions as well as rehospitalizations. The routine utilization of assessment tools such as the C-SSRS many also be beneficial to healthcare specialties outside of behavioral health such as emergency departments and urgent care settings.

ContributorsBerry, Robin (Author) / Chen, Angela Chia-Chen (Thesis advisor)
Created2018-04-28
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Purpose: The purpose of this project was to examine if a relationship existed between the changes in attitude and knowledge of a mental health care provider, before and after an educational intervention was given on how to identify sex trafficking victims.

Background: According to the National Trafficking Hotline (2017), last year

Purpose: The purpose of this project was to examine if a relationship existed between the changes in attitude and knowledge of a mental health care provider, before and after an educational intervention was given on how to identify sex trafficking victims.

Background: According to the National Trafficking Hotline (2017), last year there were over 5,000 cases of sex trafficking reported. Lederer & Wetzel (2014) discuss that more than 88% of victims interact with a health care provider while being trafficked at least once. A majority of cases, mental health care providers were informed that their patient was a sex trafficking victim through collaboration of other services. Without this collaboration, many providers would have never
known that they had interacted with a victim (Domoney, Howard, Abas, Broadben, & Oram, 2015).

Methods: The participant population consisted of psychiatrists, psychiatric nurse practitioners and psychologists working in acute and out patient settings.
A pre survey was given to identify the participant’s knowledge of sex trafficking and their awareness of available resources and tools to help screen as well as treat victims of sex trafficking. After completion, the participants viewed an educational voice over presentation that educated them on how to identify current sex trafficking victims, what screening tools are available, the mental health risk factors and how to protect both the victim and provider from potential danger from the alleged trafficker. A post survey was then given to assess their knowledge after the presentation intervention, how much they retained and their confidence in being able to assess and treat sex trafficking victims. All surveys and the presentation were available online for participant convenience via a private link.

Results: The knowledge posttest score was higher than the pretest (Z=-2.694, p<0.007).
The confidence score on treating sex trafficking victims was higher posttest (Z=-2.251, p<0.024) No significant change in attitudes for advocating for sex trafficking victim care. All providers agreed that this high-risk vulnerable population needs advocates (Z=4.67, p<0.707).

Conclusion: All providers agreed for the need to advocate for victim care prior to the educational intervention. The results suggest that mental health providers are more knowledgeable posttest about risk factors, have a higher level of confidence in treating sex trafficking victims and have a higher confidence in their ability to protect victims and provide adequate care.

ContributorsChang, Lillian (Author) / Chen, Angela Chia-Chen (Thesis advisor)
Created2018-04-29
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2019 coronavirus disease (COVID-19) remains a pressing health concern, especially with lagging youth vaccination rates despite its evident benefits. Given the significant role of vaccination in safeguarding individual and community health, this dissertation sought to explore how the use of serious games may offer hope for addressing the COVID-19 vaccine

2019 coronavirus disease (COVID-19) remains a pressing health concern, especially with lagging youth vaccination rates despite its evident benefits. Given the significant role of vaccination in safeguarding individual and community health, this dissertation sought to explore how the use of serious games may offer hope for addressing the COVID-19 vaccine coverage gap among youths. This dissertation collected, appraised, and synthesized existing evidence on serious game-based vaccination interventions, finding increased youths’ vaccine knowledge but limited effectiveness in boosting their vaccination intentions and uptake. Using serious game in youth health education considered key attributes including gamification, game mechanics, educational, health-related content, and objective, tailored for youth and adaptability, real life relevance, engagement, interactivity, safe environment, feedback, and assessment. Stemming from technological advances and interdisciplinary collaborations, these games provided experiences that resonated with diverse populations. Outcomes from such educational games have shown improved health knowledge, attitudes, and behaviors, improved self-efficacy and reduced health disparities. The dissertation also presented a pilot study randomization control trial (RCT) on a COVID- 19 game-based intervention (vs. usual care) targeting unvaccinated youth, showing its feasibility, acceptability and positive influence on vaccine knowledge, vaccination intention and uptake. Partnering with key stakeholders and adapting game designs for ongoing relevance could contribute to intervention effectiveness in promoting youth vaccination, catering to diverse needs and preferences.
ContributorsOu, Lihong (Author) / Reifsnider, Elizabeth (Thesis advisor) / Chen, Angela Chia-Chen (Committee member) / Todd, Michael (Committee member) / Amresh, Ashish (Committee member) / Mun, Chung Jung (Committee member) / Arizona State University (Publisher)
Created2023
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Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT)

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT) provides an evidence-based (EB) framework to detect and treat SU. Evidence shows that mental health (MH) providers are not providing EB SU management. Federally grant-funded SBIRT demonstrated evidence of decreased SU and prevention of full disorders. Implementation outcomes in smaller-scale projects have included increased clinician knowledge, documentation and interdisciplinary teamwork.

Objective: To improve quality of care (QOC) for adolescents who use substances in the inpatient psychiatric setting by implementing EB SBIRT practices.

Methods: Research questions focused on whether the number of SBIRT notes documented (N=170 charts) increased and whether training of the interdisciplinary team (N=26 clinicians) increased SBIRT knowledge. Individualized interventions used existing processes, training and a new SBIRT Note template. An SBIRT knowledge survey was adapted from a similar study. A pre-and post-chart audit was conducted to show increase in SBIRT documentation. The rationale for the latter was not only for compliance, but also so that all team members can know the status of SBIRT services. Thus, increased interdisciplinary teamwork was an intentional, though indirect, outcome.

Results: A paired-samples t-test indicated clinician SBIRT knowledge significantly increased, with a large effect size. The results suggest that a short, 45-60-minute tailored education module can significantly increase clinician SBIRT knowledge. Auditing screening & BI notes both before and after the study period yielded important patient SU information and which types of SBIRT documentation increased post-implementation. The CRAFFT scores of the patients were quite high from a SU perspective, averaging over 3/6 both pre- and post-implementation, revealing over an 80% chance that the adolescent patient had a SU disorder. Most patients were positive for at least one substance (pre- = 47.1%; post- = 65.2%), with cannabis and alcohol being the most commonly used substances. Completed CRAFFT screenings increased from 62.5% to 72.7% of audited patients. Post-implementation, there were two types of BI notes: the preexisting Progress Note BI (PN BI) and the new Auto-Text BI (AT BI), part of the new SBIRT Note template introduced during implementation. The PN BIs not completed despite a positive screen increased from 79.6% to 83.7%. PN BIs increased 1%. The option for AT BI notes ameliorated this effect. Total BI notes completed for a patient positive for a substance increased from 20.4% to 32.6%, with 67.4% not receiving a documented BI. Total BIs completed for all patients was 21.2% post-implementation.

Conclusion: This project is scalable throughout the U.S. in MH settings and will provide crucial knowledge about positive and negative drivers in small-scale SBIRT implementations. The role of registered nurses (RNs), social workers and psychiatrists in providing SBIRT services as an interdisciplinary team will be enhanced. Likely conclusions are that short trainings can significantly increase clinician knowledge about SBIRT and compliance with standards. Consistent with prior evidence, significant management involvement, SBIRT champions, thought leaders and other consistent emphasis is necessary to continue improving SBIRT practice in the target setting.

Keywords: adolescents, teenagers, youth, alcohol, behavioral health, cannabis, crisis, documentation, drug use, epidemic, high-risk use, illicit drugs, implementation, mental health, opiates, opioid, pilot study, psychiatric inpatient hospital, quality improvement, SBIRT, Screening, Brief Intervention and Referral to Treatment, substance use, unhealthy alcohol use, use disorders

ContributorsMaixner, Roberta (Author) / Guthery, Ann (Thesis advisor) / Mensik, Jennifer (Thesis advisor) / Uriri-Glover, Johannah (Thesis advisor)
Created2019-05-02