Digital Commons Network^™

Survey Of Parents Of Children With Intellectual Disabilities And/Or Autism Who Experience Chronic Constipation, James Rooney, Rebecca Hodge, Jade Smith, Kelly Vanstone, Richard Laugharne, Rohit Shankar

Peninsula Medical School

Background: Constipation is common in children with intellectual disabilities and/or autism, but poorly researched. This study looks to understand parental knowledge, attitudes and management practices towards constipation in children with intellectual disabilities and/or autism. Methods: A cross-sectional online survey developed with patient facing organisations was circulated to parents of children with intellectual disabilities and/or autism using an exponential and non-discriminatory snowballing method for recruitment. A smaller sample were purposively sampled for their in-depth experiences. Results: Of 68 responses, people were open to discussing constipation and knowledgeable about risk factors. In the qualitative interviews, of 15 parents, they wanted to be …

Review And Update Of The Health Of The Nation Outcome Scales For People With Learning Disabilities (Honos-Ld), Jon Painter, Nicola Adams, Barry Ingham, Michael James, Madiha Majid, Ashok Roy, Rohit Shankar, Mark Smith

Peninsula Medical School

Background: The Health of the Nation Outcomes Scales for people with Learning Disabilities (HoNOS-LD) is an 18-item measure which provides a structured and standardized approach to rating various clinical and psychosocial outcomes and has been in use nationally since 2002. Aims: To revise and improve the HoNOS-LD’s utility in contemporary intellectual disability (ID) services whilst retaining its original objectives and five-point severity ratings. Method: ID clinicians were invited to complete an online survey, rating each item on the existing measure for being fit for purpose, identifying issues and suggesting improvements based on their experience of using the HoNOS-LD in practice. …

Post-Covid Syndrome And Adults With Intellectual Disability: Another Vulnerable Population Forgotten?, R Shankar, B Perera, A Roy, Et Al

Peninsula Medical School

An area of interest presently is the lingering symptoms after COVID-19, i.e. post-COVID-19 syndrome (PCS). Specifics of diagnosis and management of PCS are emerging. However, vulnerable populations such as those with intellectual disabilities, who were disproportionately affected by the pandemic, risk being ‘left behind’ from these considerations.

Awareness Of Social Care Needs In People With Epilepsy And Intellectual Disability, A. Gabrielsson, S. Tromans, H. Newman, P. Triantafyllopoulou, A. Hassiotis, P. Bassett, L. Watkins, I. Sawhney, M. Cooper, L. Griffiths, A. Pullen, A. Roy, H. Angus-Leppan, Rh Thomas, M. Kinney, P. Tittensor, R. Shankar

Peninsula Medical School

Background: Nearly a quarter of people with intellectual disability (ID) have epilepsy with large numbers experiencing drug-resistant epilepsy, and premature mortality. To mitigate epilepsy risks the environment and social care needs, particularly in professional care settings, need to be met. Purpose: To compare professional care groups as regards their subjective confidence and perceived responsibility when managing the need of people with ID and epilepsy. Method: A multi-agency expert panel developed a questionnaire with embedded case vignettes with quantitative and qualitative elements to understand training and confidence in the health and social determinants of people with ID and epilepsy. The cross-sectional …

Air Quality And Mental Health: Evidence, Challenges And Future Directions, Kamaldeep Bhui, Joanne B. Newbury, Rachel M. Latham, Marcella Ucci, Zaheer A. Nasir, Briony Turner, Catherine O'Leary, Helen L. Fisher, Emma Marczylo, Philippa Douglas, Stephen Stansfeld, Simon K. Jackson, Sean Tyrrel, Andrey Rzhetsky, Rob Kinnersley, Prashant Kumar, Caroline Duchaine, Frederic Coulon

School of Biomedical Sciences

Background Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that affect mental health during the life course. Aims We gather interdisciplinary expertise and knowledge across the air pollution and mental health fields. We seek to propose future research priorities and how to address them. Method Through a rapid narrative review, we summarise the key scientific findings, knowledge gaps and methodological challenges. Results There is emerging evidence of associations between poor air quality, both indoors and outdoors, and poor mental health more generally, as well as specific …

Perceived Value Within An International Hospitality Learning Environment: Antecedents And Outcomes, Abdallah Elshaer, Rong Huang

Plymouth Business School

The number of students attending British universities is rapidly increasing, among them, many are international students. These diverse students pose opportunities and concerns regarding the equitable and efficient delivery of the learning environment. This study examines the perceived value within an international learning environment (ILE) and examines antecedents and outcomes of such value in addressing the students' needs. Structure Equation Modeling (PLS-SEM) was used to analyse 323 online survey responses, and thematic analysis and content analysis were used to examine 35 semi-structured interviews. Work-Integrated Learning, Academic Integration, and Scholarship of Teaching and Learning are established as major value practices that …

Guiding Principles For Effective Collaborative Implementation Strategies For Multisite Hospital Improvement Initiatives: A Mixed-Method Realist Evaluation Of Collaborative Strategies Used In Four Multisite Initiatives At Public Hospitals In New South Wales, Australia, Janet C. Long, Mitchell N. Sarkies, Emilie Francis-Auton, Natalie Roberts, Rebecca Hardwick, Hoa Mi Nguyen, Jean Frederic Levesque, Diane E. Watson, Johanna Westbrook, Peter D. Hibbert, Frances Rapport, Jeffrey Braithwaite

Peninsula Medical School

Objective Large-scale, multisite hospital improvement initiatives can advance high-quality care for patients. Implementation support is key to adoption of change in this context. Strategies that foster collaboration within local teams, across sites and between initiative developers and users are important. However not all implementation strategies are successful in all settings, sometimes realising poor or unintended outcomes. Our objective here is to develop guiding principles for effective collaborative implementation strategies for multi-site hospital initiatives. Design Mixed-method realist evaluation. Realist studies aim to examine the underlying theories that explain differing outcomes, identifying mechanisms and contextual factors that may trigger them. Setting We …

Nurses’ Perceptions Of The Skills, Knowledge And Attributes Required To Optimise Scope Of Practice And Improve Access To Care For People Experiencing Homelessness In Australia: A Cross-Sectional Study, Jane Currie, Lucy Mcwilliams, Martha Paisi, Jill Shawe, Anna Thornton, Matthew Larkin, Joanne Taylor, Sandy Middleton

School of Nursing and Midwifery

Background People experiencing homelessness are less likely to access healthcare, particularly primary and preventive care. Nurses are well placed to improve access to healthcare for this vulnerable population. Aim To explore nurses’ perceptions of the skills, knowledge and attributes required to optimise scope of practice and improve access to healthcare for people experiencing homelessness, to underpin an education framework. Design A cross-sectional national survey of nurses in Australia. Methods Part of a larger study, a 222-item electronic survey was disseminated via social media and nursing colleges and associations. Participants rated the level of priority of specific skills knowledge and attributes …

Fact Sheet, Yale University Office Of Institutional Research

Fact Sheets

No abstract provided.

A Manageable Constitution, Michael Gentithes

Akron Law Faculty Publications

Federal judges frequently avoid constitutional cases that raise difficult issues of public policy, using doctrines like standing and political questions as shields against judicial overreach. But a new and dangerous sword that allows judges to declare constitutional cases nonjusticiable is emerging in federal courts: a manageability prerequisite. The manageability prerequisite that emerged first in the Supreme Court’s gerrymandering jurisprudence and has since spread virulently throughout the circuit and district courts threatens to close the courthouse doors to a wide swath of litigants. Left unchecked, manageability could both significantly weaken the weakest branch and provide judges unbounded discretion to preserve any …

Future Directions In Psychiatric Neurosurgery: Proceedings Of The 2022 American Society For Stereotactic And Functional Neurosurgery Meeting On Surgical Neuromodulation For Psychiatric Disorders, Frederick L Hitti, Alik S Widge, Patricio Riva-Posse, Donald A Malone, Michael S Okun, Maryam M Shanechi, Kelly D Foote, Sarah H Lisanby, Elizabeth Ankudowich, Srinivas Chivukula, Edward F Chang, Aysegul Gunduz, Clement Hamani, Ashley Feinsinger, Cynthia S Kubu, Winston Chiong, Jennifer A Chandler, Rafael Carbunaru, Binith Cheeran, Robert S Raike, Rachel A Davis, Casey H Halpern, Nora Vanegas-Arroyave, Dejan Markovic, Sarah K Bick, Cameron C Mcintyre, R Mark Richardson, Darin D Dougherty, Brian H Kopell, Jennifer A Sweet, Wayne K Goodman, Sameer A Sheth, Nader Pouratian

Faculty, Staff and Students Publications

OBJECTIVE: Despite advances in the treatment of psychiatric diseases, currently available therapies do not provide sufficient and durable relief for as many as 30-40% of patients. Neuromodulation, including deep brain stimulation (DBS), has emerged as a potential therapy for persistent disabling disease, however it has not yet gained widespread adoption. In 2016, the American Society for Stereotactic and Functional Neurosurgery (ASSFN) convened a meeting with leaders in the field to discuss a roadmap for the path forward. A follow-up meeting in 2022 aimed to review the current state of the field and to identify critical barriers and milestones for progress. …

Postsurgical Morbidity And Mortality Favorably Informs Deep Brain Stimulation For New Indications Including Schizophrenia And Schizoaffective Disorder, Judith M Gault, Patrick Hosokawa, Daniel Kramer, Elyn R Saks, Paul S Appelbaum, John A Thompson, Ann Olincy, Nicola Cascella, Akira Sawa, Wayne Goodman, Nidal Moukaddam, Sameer A Sheth, William S Anderson, Rachel A Davis

Faculty, Staff and Students Publications

BACKGROUND: Deep brain stimulation (DBS) shows promise for new indications like treatment-refractory schizophrenia in early clinical trials. In the first DBS clinical trial for treatment refractory schizophrenia, despite promising results in treating psychosis, one of the eight subjects experienced both a symptomatic hemorrhage and an infection requiring device removal. Now, ethical concerns about higher surgical risk in schizophrenia/schizoaffective disorder (SZ/SAD) are impacting clinical trial progress. However, insufficient cases preclude conclusions regarding DBS risk in SZ/SAD. Therefore, we directly compare adverse surgical outcomes for all surgical procedures between SZ/SAD and Parkinson's disease (PD) cases to infer relative surgical risk relevant to …

What Can We Learn From Covid-19?: Examining The Resilience Of Primary Care Teams, Ashley M Hughes, Kelley Arredondo, Houston F Lester, Frederick L Oswald, Trang N D Pham, Cheng Jiang, Sylvia J Hysong

Faculty, Staff and Students Publications

INTRODUCTION: The COVID-19 pandemic continues to place an unprecedented strain on the US healthcare system, and primary care is no exception. Primary care services have shifted toward a team-based approach for delivering care in the last decade. COVID-19 placed extraordinary stress on primary care teams at the forefront of the pandemic response efforts. The current work applies the science of effective teams to examine the impact of COVID-19-a crisis or adverse event-on primary care team resilience.

METHODS: Little empirical research has been done testing the theory of team resilience during an extremely adverse crisis event in an applied team setting. …

The Long History Of Feminist Legal Theory, Tracy Thomas

Con Law Center Articles and Publications

This chapter challenges the conventional idea that feminist legal theory began in the 1970s. The advent of legal feminism is usually placed in the second wave feminist movement, birthed by the political activism of the women’s liberation movement and nurtured by the intellectual leadership of women scholars newly entering legal academia. However, legal feminism has a much longer history, going back more than a century earlier. While the term “feminist” was not used in the United States until the 1910s, the foundations of feminist legal theory were first conceptualized as early as 1848 and developed over the next one hundred …

Queuing Theory In Theme Parks, Matthew J. Watters

All Student Theses and Dissertations

The goal of this project is to find the most efficient way for theme parks to process their guests. There currently exist many types of lines such as standby lines, single rider lines, and fastpass or skip the line queues. We will simulate a single rides queue. This will be a popular roller coaster at the park. Hourly throughputs of rides will be calculated, and a simulation will be created for the ride to start processing guests through different line scenarios. Through this method, we will find the best method for a park to process as many guests as they …

The Concept Of Social Engineering And Cybercrime In The Digital Age, Chaitanya Reddy Eleti

All Student Theses and Dissertations

The increased implementation of digitalization which has come to rise has also raised concerns in terms of privacy and security of the data. Data leaks and stealing of privacy are some of the common practices which have grown over the years. Social engineering majorly depends on the normal human instincts for trusting in stealing personal as well as corporate information which can be implemented for committing the cybercrimes further. The attackers can use social engineering for convincing an employee for divulging the passwords of the company. Hence, there is a need to understand the fact of how social engineering can …

Flawed Feminism: An Exploration Of Femininity In Contemporary Domestic Noir, Tyler Miller

All Student Theses and Dissertations

Crime fiction is a genre whose female characters are often misunderstood, weak, powerless victims. Domestic noir, a subgenre of crime fiction, does the opposite. Authors of domestic noir fiction dig into the female experiences, seeking to understand and write women characters who represent feminism and femininity despite any shortcomings they have. In Big Little Lies by Liane Moriarty, I argue that reading this novel through the Critical Feminist Theory changes the interpretation of the female experience. Instead of reading the book for entertainment, digging into the larger scale issues in this book sheds light on the women’s experiences. Gone Girl …

Mathematics Preparatory Workshops To Foster Student Success, Sandie Han, Diana Samaroo, Janet Liou-Mark, Lauri Aguirre

Publications and Research

Mathematics preparatory workshops were offered to college students at a diverse urban undergraduate institution. The goal was to prepare students for their mathematics course, by offering non-credit bearing and free preparatory workshops. The lack of adequate preparation for mathematics courses is a barrier for student engagement in future STEM courses. We believe that by providing preparatory workshops, we can improve not only the success but access for students in foundational mathematics courses. The workshops allowed students to engage with the course content in a rigorous and intensive manner prior to the start of the semester. Students who participated in the …

La Descortesía En Los Comentarios Digitales De La Prensa Deportiva. El Tenis, Mucho Más Que Un Juego, David Sánchez-Jiménez

Publications and Research

Comments on sports news published on the digital platforms of newspapers have turned these spaces into forums for debate in which homogeneous social communities are established. The aim of this research is to find out how the participants of these platforms interact in the sports press and what impoliteness strategies they use when evaluating the text of the news and the comments of other users. For this purpose, a qualitative textual analysis of a corpus of 1,000 digital comments produced on the Australian Open 2022 final in four of the most widely distributed Spanish newspapers with the highest national circulation, …

Insights: Qualitative Study To Reevaluate And Redesign Online Learning Self-Guided Tools For English First Year Writers Learning Self-Guided Tools For English First Year Writers, Nandi Prince

Publications and Research

The library faculty teaches approximately three hundred one-time instructional classes per year. This study explored the role of the library instructor in support of serving the needs of first-year writers (FYW) in a discourse community (DC). The English faculty teach English Composition I, the FYW develop their writing skills in a community with shared goals and an established means of communicating. This qualitative study explored: (1) in-depth experiences of the English faculty during library one-time instructional classes; (2) their perceptions of what students need most, in the new curriculum; (3) new findings that would guide the design of digital tools …

How Do Higher Education Administrators And Leaders Perceive Academic Persistence And Achievement Of Afro Caribbean Immigrant Students?, Rory T. Richards

Publications and Research

This research looked at Higher Education Leaders’ Perceptions of Persistence and Achievement of Afro Caribbean Immigrant Students. The research was qualitative and took a phenomenological, narrative approach. Sixteen administrators, across three campuses, one private for-profit and two public nonprofits were interviewed. The participants consisted of one President, one Senior Vice President, three Vice Presidents, one Assistant Vice President, three Deans, two Assistant Deans, two Directors, one Department Chair, and one Special Assistant to the President. The participants were also multiethnic, comprising eight Black leaders, five white leaders, two Latino leaders, and one Asian leader. The research found that leaders at …

Multiomics, Artificial Intelligence, And Precision Medicine In Perinatology, Mohan Pammi, Nima Aghaeepour, Josef Neu

Faculty, Staff and Students Publications

Technological advances in omics evaluation, bioinformatics, and artificial intelligence have made us rethink ways to improve patient outcomes. Collective quantification and characterization of biological data including genomics, epigenomics, metabolomics, and proteomics is now feasible at low cost with rapid turnover. Significant advances in the integration methods of these multiomics data sets by machine learning promise us a holistic view of disease pathogenesis and yield biomarkers for disease diagnosis and prognosis. Using machine learning tools and algorithms, it is possible to integrate multiomics data with clinical information to develop predictive models that identify risk before the condition is clinically apparent, thus …

Lookism, Social Media, Beauty Prejudice, Diana Saiki, Alyssa Dana Adomaitis

Publications and Research

"Lookism” is a term to describe appearance discriminationor “the practice of discrimination on the basis of physical appearance in the workplace” (Ghodrati, Joorabchi, & Muati, 2015, p.1). In popular literature, it has been called “beauty prejudice” (Etcoff, 1999, p. 1). The notion that a pleasing appearance results in favorable outcomes (e.g., higherwages, promotions) from others is not necessarily new, as literature on physical attractiveness is rather extensive. The Washington Post Magazine first used the term “lookism” in 1978 (e.g., Ayto, 1999), however, the term “lookism” was first recognized as a form of discrimination by authors of the Oxford English Dictionary …

Protocol For The Promoting Resilience In Stress Management (Prism) Intervention: A Multi-Site Randomized Controlled Trial For Adolescents With Type 1 Diabetes, Maeve B O'Donnell, Samantha R Scott, Britney M Ellisor, Viena T Cao, Chuan Zhou, Miranda C Bradford, Catherine Pihoker, Daniel J Desalvo, Faisal S Malik, Marisa E Hilliard, Abby R Rosenberg, Joyce P Yi-Frazier

Faculty, Staff and Students Publications

BACKGROUND: Adolescents with type 1 diabetes (T1D) are at high risk for elevated diabetes distress, which greatly impacts diabetes management, glycemic outcomes and overall quality of life. Developing protective skills and "resilience resources" to navigate adversity and manage diabetes distress has high potential to help adolescents with T1D achieve optimal behavioral, psychological, and health outcomes. The "Promoting Resilience in Stress Management" (PRISM) program is a manualized, brief, skills-based intervention delivered over 6 months via two 45-60 min one-on-one sessions and a family meeting with a PRISM coach, and supplemented by booster calls and a digital app. This trial (PRISM versus …

Editorial: Surgical Techniques For The Management Of Pain, Anthony K Allam, Ashwin Viswanathan, Jason M Schwalb, Parag G Patil, M Benjamin Larkin

Faculty, Staff and Students Publications

No abstract provided.

Behavioral Improvements Following Lesion Resection For Pediatric Epilepsy: Pediatric Psychosurgery?, Huy Dang, Abdul Basit Khan, Nisha Gadgil, Himanshu Sharma, Cristina Trandafir, Fatema Malbari, Howard L Weiner

Faculty, Staff and Students Publications

Introduction: Resection of brain lesions associated with refractory epilepsy to achieve seizure control is well accepted. However, concurrent behavioral effects of these lesions such as changes in mood, personality, and cognition and the effects of surgery on behavior have not been well characterized. We describe 5 such children with epileptogenic lesions and significant behavioral abnormalities which improved after surgery.

Case descriptions: Five children (ages 3-14 years) with major behavioral abnormalities and lesional epilepsy were identified and treated at our center. Behavioral problems included academic impairment, impulsivity, self-injurious behavior, and decreased social interaction with diagnoses of ADHD, oppositional defiant disorder, and …

Healthcare Workers' Well-Being: A Systematic Review Of Positive Psychology Interventions, Alexandra P Townsley, Jenny Li-Wang, Rajani Katta

Faculty, Staff and Students Publications

Given persistent occupational stressors and multiple challenges in the delivery of healthcare, there is an increased focus on the well-being of healthcare workers. Responding to these challenges will require a multipronged approach, focusing on system level, organization, and individual actions. Positive psychology interventions (PPIs) represent a promising area for individual action. This systematic review indicates that PPI, delivered via many methods, holds promise for improving the well-being of healthcare workers, although there is a clear need for additional randomized controlled trials utilizing defined and standardized outcome measures. In this review, the most commonly evaluated PPIs were mindfulness-based or gratitude-based interventions. …

Emergency Department Presentations Of Diabetic Ketoacidosis In A Large Cohort Of Children, Lise E Nigrovic, Nathan Kuppermann, Simona Ghetti, Jeff E Schunk, Michael J Stoner, Arleta Rewers, Julie K Mcmanemy, Kimberly S Quayle, Jennifer L Trainor, Leah Tzimenatos, Jonathan E Bennett, Maria Y Kwok, Sage R Myers, Kathleen M Brown, T Charles Casper, Cody S Olsen, Nicole S Glaser

Faculty, Staff and Students Publications

Background: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of childhood diabetes. However, the influence of demographic factors on presentation are not well-defined.

Methods: We included children from 12 centers who were < 18 years with DKA (glucose > 300 mg/dL, serum pH < 7.25, or serum bicarbonate < 15 mEq/L) enrolled in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) Trial. Data were also collected for children who presented to the centers during the enrollment period but were not enrolled due to disease or treatment-related reasons. We compared demographic, clinical, and biochemical findings among children with newly and previously diagnosed diabetes and children in different age groups.

Results: Of the 1,679 DKA episodes in 1,553 children, 799 (47.5%) episodes occurred in children with newly diagnosed diabetes and 396 (23.6%) were severe (pH < 7.1). Newly diagnosed children < 6 years of age were not more likely to have severe DKA in terms of pH, but had more severe hypocarbia and higher blood urea nitrogen levels, factors previously associated with the risk of cerebral injury. Lower socioeconomic status (SES) (based on family income and maternal education level) were associated with more severe DKA in new onset children, and recurrent DKA in the previously diagnosed children.

Conclusions: Greater efforts are needed to identify the children with diabetes early and to prevent recurrent DKA, particularly among children in low-SES groups. Young children with DKA may need more intensive monitoring due to higher risk of cerebral injury.

Religion, Spirituality, And Coping During The Pandemic: Perspectives Of Dementia Caregivers, Katherine Carroll Britt, Kathy C Richards, Kavita Radhakrishnan, Andrea Vanags-Louredo, Eunice Park, Nalaka S Gooneratne, Liam Fry

Faculty, Staff and Students Publications

Religious and spiritual (R/S) practices support individuals during difficult situations. The COVID-19 social distancing restrictions may have limited access to R/S practices for older adults with Alzheimer’s disease related dementia (ADRD) and their caregivers, affecting coping and well-being. This qualitative study explored the impact of social distancing on R/S practices and coping in ADRD-caregiver dyads from the perspective of caregivers. Interviews were conducted with 11 family caregivers of older adults with ADRD residing in nursing homes (n = 4) or private homes (n = 7). Caregivers continued individual and started virtual R/S practices which improved their ability to …

Can Mild Traumatic Brain Injury Alter Cognition Chronically? A Limbic-Cenc Multicenter Study, William C Walker, Maya E O'Neil, Zhining Ou, Terri K Pogoda, Heather G Belanger, Randall S Scheibel, Angela P Presson, Shannon R Miles, Elisabeth A Wilde, David F Tate, Maya Troyanskaya, Mary Jo Pugh, Amy Jak, David X Cifu

Faculty, Staff and Students Publications

Objective: While outcome from mild traumatic brain injury (mTBI) is generally favorable, concern remains over potential negative long-term effects, including impaired cognition. This study examined the link between cognitive performance and remote mTBIs within the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) multicenter, observational study of Veterans and service members (SMs) with combat exposure.

Method: Baseline data of the participants passing all cognitive performance validity tests (n = 1,310) were used to conduct a cross-sectional analysis. Using multivariable regression models that adjusted for covariates, including age and estimated preexposure intellectual function, positive mTBI history …