Digital Commons Network^™

Association Between Social Isolation And Risk Of Hypertension Among The Middle-Aged And Older: A Propensity Score–Matched Cohort Study, Yiting Kang, Minchao Liu

Journal of Health Research

Background: Social isolation has emerged as a growing public health concern and may be an underrecognized risk factor for hypertension. However, evidence on its longitudinal association with hypertension remains limited and inconsistent.

Methods: The data of the national cohort study were collected from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. A total of 3280 participants aged 45 years and older without hypertension at baseline were included. Propensity score matching (PSM) was applied to balance covariates between socially isolated and non-isolated groups. Cox proportional hazards models were used to estimate the association between social isolation and …

Effectiveness Of Self-Management Education On Behavior Improvement Among Stroke Survivors In Indonesia: A Randomized Controlled Trial, Yurike Septianingrum, Ratna Yunita Sari, Lono Wijayanti, Rizqa Septiana, Andis Yuswanto, Ah Yusuf, Ika Yuni Widyawati, Nor Aziyan Yahaya

Journal of Health Research

Background: This study aimed to investigate the impact of stroke self-management education (SSME) on improving self-management behaviors among stroke survivors.

Methods: An individual randomized controlled trial was conducted from June to August 2024 in an educational hospital in Surabaya, Indonesia. Participants were selected based on the inclusion and exclusion criteria and then randomly assigned via computer-generated randomization to the intervention and control groups. After 3 weeks of intervention, the self-management behavior of stroke survivors was evaluated using the Stroke Self-Management Behavior Questionnaire (SSMBQ). A per-protocol analysis was used to compare the intervention groups, which included only those patients who completed …

Attitude And Confidence In Managing Pre-Existing Type 2 Diabetes Mellitus During Pregnancy Among Thai Women, Ratchanok Phonyiam, Chiao-Hsin Teng, Catherine S. Sullivan, Aunchalee E.L. Palmquist, Eric A. Hodges, Yamnia I. Cortés, Marianne Baernholdt

Journal of Health Research

Background: The trend of rising T2DM prevalence is more pronounced in females and is of particular concern for pregnancy. The rate has jumped from 0.7% to 1.5% of all pregnancies over the past 14 years. Additionally, pregnancies affected by T2DM have higher rates of abortion and perinatal mortality compared to those with type 1 diabetes mellitus and gestational diabetes mellitus. The objective of the study was to explore the attitudes and confidence in managing T2DM among Thai women during pregnancy.

Methods: This qualitative study was a part of a parent study using a convergent parallel mixed-methods design. A purposive sampling …

A Hybrid Roberta–Rule-Based Aspect-Based Sentiment Analysis Model For Hospital Patient Reviews: Development, Validation, And Case Application In India, Akash Gajanan Prabhune, Karpaga Priya P S, Vinay R Sri Hari, Akhila Rayampalli, Ankur S Thakur, Ebin M Yohannan

Journal of Health Research

Background: Patient Online Reviews (PORs) provide real-time, unsolicited feedback that complements traditional satisfaction surveys. However, existing sentiment analysis tools often handle only monolingual data, broad sentiment categories, or lack review authenticity checks. This study develops a hybrid Aspect-Based Sentiment Analysis (ABSA) model combining RoBERTa with a rule-based aspect detection layer to extract fine-grained sentiment insights from Indian hospital reviews.

Methods: We curated and manually annotated 4,862 Google Maps reviews from 25 Indian hospitals across six aspects—Doctor Behavior, Staff Behavior, Cleanliness, Facility Experience, Cost, and Waiting Time. Though the scheme included positive/negative/neutral labels, the final model used binary polarity (positive vs. …

Prediction Of Lung Vital Capacity Value From Thoracoabdominal Expansion In Young Adults, Aung Myo Htun, Aung Aung Nwe, Chatchaya Jaimanee, Thiwaphon Chatprem, Saowanee Nakmaroeng, Chatchai Phimphasak

Journal of Health Research

Background: Vital capacity (VC) is a fundamental indicator of pulmonary health, but its routine assessment often depends on spirometry devices that may be unavailable (i.e. because of access, cost) in many clinical or community settings. In contrast, lower costal (LC) and upper abdominal (AB) expansions are simple, equipment-free methods commonly used in physiotherapy.

Method: This cross-sectional study was aimed at developing prediction equations for VC using LC or upper AB expansion alongside demographic and anthropometric variables. The study involved 116 healthy nonsmokers (53 male and 63 female individuals) aged 18–39 years. VC was measured via spirometry using a …

Research On Cable Force Optimization Of Long-Span Cable-Stayed Bridges Based On Rbfnn+Improved Parti Cle Swarm Optimization Algorithm, Deng Da, He Bowen, Liu Guokun

Journal of China & Foreign Highway

In view of the cable force optimization problem of long-span cable-stayed bridges,a cable force optimization method considering the reliability index of stay cables was proposed based on the response surface fitted by the radial basis function neural network (RBFNN ).The RBFNN-based response surface model for solving the reliability index was established by fitting the structural implicit function through RBFNN training.The improved particle swarm optimization algorithm was used to search for the optimal solution of the cable force optimization model considering the reliability index.The research results show that RBFNN can accurately predict the structural responses and fit the structural implicit performance …

Research And Applicat Ion Of Ultra Large-Scale Consolidated Under-Reamed Drilled Shaft Technology Under Special Environmental And Geological Conditions, Ding Yi, Yu Kun, Shi Haiyang, Pei Xiaofeng, Zhu Bo

Journal of China & Foreign Highway

This article aims to add ress the poor economic efficiency of large-diameter and ultra-long piles,the high risk of hole collapse in thick sandy soil,and the limited space across the canal faced by the Bridge over Yellow River Diversion to Qindao Canal on Zhanhua ‒ Linyi Expressway.According to the comparison of conventional drilled cast-in-place piles with combined pile-end and pile-side post-grouting,the industry ’s under-reamed drilled shaft foundation with the largest disc diameter (4.5 m) and the largest single-pile volume (456 m3) was proposed and designed.At the same time,supporting devices such as three-arm rotary cutting drill bits and long arm borehole diameter …

Absolute Extraction: Utilizing Rural Critical Criminology To Examine Appalachia’S Toxic Dependence On Extractive Industries, Andrew Kennedy

The Mid-Southern Journal of Criminal Justice

Brought forth by common rhetoric, Appalachia is often viewed as the closest space to that of an empyrean domain. Separated from the sleepless city, its allure rests in its created identity of a quiet, green escape from the city, which offers serenity on all fronts. Although Appalachia can fulfill this profile, such an ascension ignores the burning yellow grass below. The purpose of this paper is to examine the history of the destruction of Appalachia through the lens of extractive industries and the region’s designation as a sacrifice zone. Through the application of rural critical criminology, this paper holds that …

Lost In Translation: How Health Literacy Impacts Pharmaceutical Transactions From Healthcare Professionals To Patients, Grace Nwaege

2025 Fall Honors Capstones Projects - Archive

Health literacy is a core element of public health, involving the ability to access, understand, evaluate, and use information to maintain well-being. In the United States, it aligns with an average reading level of about an eighth grader, which continues to decline over time. As pharmacists serve as the final point of contact in most outpatient settings, their ability to communicate effectively at this literacy level is crucial. This study examines how pharmacies address this challenge using qualitative methods, including health literacy assessments of patient consent forms and stakeholder interviews with pharmacy technicians about resource use. Findings show materials higher …

Teachers' Perspectives On Humane Education Implementation, Rebecca Ann Bartaway

Walden Dissertations and Doctoral Studies

Humane education (HE) encompasses multiple concepts, including animal ethics, ecological environment, and social justice. The problem prompting this study was that individuals who have graduated from a higher education HE program face challenges in successfully integrating HE into their K–12 classrooms. Grounded by Weil's solutionary approach to HE, the purpose of this basic qualitative study was to explore the teaching experiences of individuals who graduated from a higher education HE program and successfully integrated HE into their classrooms. Participants were purposefully sampled from a small population of educators who completed a U.S. degree or certificate program in HE and successfully …

Leadership Strategies For Capturing And Transferring The Knowledge Of Experienced Workers In Canadian Higher Education Organizations, Dean Allan Bulloch

Walden Dissertations and Doctoral Studies

Higher education institutions face a risk of knowledge loss when they fail to implement strategies for transferring knowledge from experienced to less experienced employees. Canadian higher education managers are particularly concerned about the adverse impact of losing explicit and valuable tacit knowledge. Grounded in the socialization, externalization, combination, and internalization model, this qualitative pragmatic inquiry study identified and explored successful strategies employed by eight Canadian higher education managers to capture and transfer knowledge from experienced employees, thereby sustaining performance. Data were collected through semistructured interviews and a review of public documents, including strategic plans, annual reports, and accountability statements. Through …

Resting Autonomic Activity, Emotional Reactivity, And Executive Function In Preschool-Age Children Who Stutter, Dana J. Meyerson

Theses - ALL

Purpose: This study investigated whether preschool-aged children who stutter (CWS) differ from children who do not stutter (CWNS) in autonomic physiological reactivity and regulation during a phrase-repetition task paired with affective image-viewing conditions. Additionally, the study investigated whether individual differences in executive function skills, specifically inhibitory control, predicted variability in physiological responses across participants. Methods: Forty-three preschool-aged children (18 CWS, 25 CWNS) completed three laboratory visits that involved collection of electrocardiogram (ECG) recordings at rest and during a phrase-repetition task paired with visual stimuli of either neutral (fixation cross) or negative (IAPS) emotional valence. Inhibitory control was assessed using the …

Intersectionality, Epistemic Injustice, And Silencing: The Operationalization And Reification Of Intersectionality In Academic Research And Institutional Practices, Emery Lockwood

Theses - ALL

Intersectionality is a powerful analytic tool that can be used to better understand the role that oppression plays in society and how it shapes the way people affected by multiple systems of oppression interact with society. Recently, the unit of analysis for intersectionality has started to shift from intersecting systems of oppression to overlapping identities, which has changed intersectionality from being a tool used to analyze systemic oppression to individual’s experiences. This work explores the implications this shift has on academic research and the practice of several disciplines. Using a lens of epistemic injustice through theories of hermeneutical bastardization (Drury, …

Exploring The Role Of Astrocyte System Xc– In Excitatory/Inhibitory Balance, Samantha Olivia Sutton

Theses - ALL

Astrocytes play a central role in maintaining excitatory/inhibitory (E/I) balance in the central nervous system by supporting intracellular glutathione (GSH) synthesis and regulating extracellular glutamate. System xc– (Sxc–), an obligate cystine/glutamate antiporter encoded by SLC7a11, couples the import of L-cystine with the export of L-glutamate. It is highly expressed throughout the cortex, hippocampus, striatum, and cerebellum, where its activity provides cystine—the rate-limiting substrate for cysteine-dependent GSH production—and contributes to ambient glutamatergic tone. Although global loss of Sxc– alters seizure threshold and redox homeostasis, whether these effects arise specifically from the loss of astrocytic Sxc– has remained unresolved. This thesis examined …

Investigating The "Tend-And-Befriend" Stress Response As A Risk Factor For Sexual Victimization Among College Women, Emily Kathleen Presutti

Theses - ALL

Sexual victimization of college women is a significant public health concern on U.S. college campuses. Traditional research on the human stress response has focused on the "fight-or-flight" model, which may not adequately capture female-typical responses in stress-inducing situations. Using a mixed-methods design, we sought to determine whether the "tend-and-befriend" stress response serves as a potential correlate of sexual victimization among college women and examine whether it contributes additional variance beyond established correlates of sexual victimization such as alcohol use, history of sexual victimization, and involvement in campus party culture. The study was conducted in two phases. In Phase I, 128 …

Operational Context's Impact On Cockpit Behavior: Case Studies In Aviation, Nick Mehrdad Loghmani

Dissertations - ALL

This thesis examines instances where pilots in a tightly regulated environment, the modern airline cockpit, exhibit diverging responses when presented with identical information. Despite explicit standardization of procedures, instrumentation, and Crew Resource Management, observable patterns of operational divergence persist. The study adopts distributed cognition (Hutchins, 1995) as the primary lens and analyzes the crew–procedures–artifacts system using cockpit transcripts and flight data. Operational context is the evolving set of roles, procedures, cognitive artifacts (including automation), constraints, and environmental conditions, while the operational configuration denotes its time-indexed instantiation at moment t. Within this frame, the thesis documents when cues do—and do not—propagate …

Utilization Technology And Compaction Quality Control Of Hardened Layer In Beam Yard Of Rock-Filled Roadbed, Cheng Xiaoliang, Tian Wendi, Gao Mengke, Zhou Xujia

Journal of China & Foreign Highway

To investigate the utilization technology and compaction quality control of hardened layers in the beam yard of rock-filled roadbed,the optimization design and construction control methods for rock-filled roadbed under different conditions were proposed based on a highway project in Guangdong Province.When the elevation of the hardened layer was lower than the top surface elevation of the roadbed and the top surface bending and settlement value of the hardened layer was less than that of the rock-filled roadbed,the gravel material could be filled directly on the hardened layer to the top surface elevation of the roadbed,and acceptance and pavement design could …

Research On Pavement Roughness Evaluation Method Based On Smartphones, Siriguleng Bai, Yili Guoqi, A Rong, Guo Guoying, Wang Jing

Journal of China & Foreign Highway

To address the low efficiency and high cost of current detection methods,as well as the insufficient accumulation of pavement damage data on rural low-grade roads,this study developed a vehicle vibration data acquisition application based on smartphones and proposed a conversion method for calculating an index equivalent to the international roughness index (IIRI).Vertical acceleration signals collected during vehicle travel were proposed through high-pass filtering and denoising to calculate the vertical displacement,from which a converted I'IRI was derived.Experimental results show that although the data collected by smartphones has slightly lower accuracy than that collected by professional detection equipment,the proposed I'IRI exhibits a …

Road Performance And Water-Softening Characteristics Of Stabilized Soil Under Cyclic Loading, Hu Hong, Li Zongheng, Feng Yong, Cao Zhigang, Liu Yaoxing

Journal of China & Foreign Highway

To effectively deal with waste soil and reduce environmental pollution,this paper took a road engineering project in Shaoxing as the research object and conducted a cyclic triaxial incremental loading test on the undisturbed lime soil under undrained conditions to study the effects of confining pressure,cyclic stress ratio,and water immersion on its performance.The results show that when the cyclic stress ratio increases from 1 to 4,the cumulative strain and resilient strain increase rapidly in the initial loading stage,showing a trend of “stepwise” increase.The cumulative strain produced at a cyclic stress ratio of 2 is about twice that at the cyclic stress …

Comparison Of Calculation Methods For Local Scour In Bridge Pier Foundation Of Piles-Cushion Cap, Liu Hui, Jiang Yanhua, Yan Jiechao

Journal of China & Foreign Highway

In order to analyze the calculation methods for local scour in bridge pier foundation of piles-cushion cap,this paper listed the six common Chinese and foreign calculation methods,described their calculation process and selection of calculation parameters,and analyzed the difference of the calculation methods according to typical engineering examples.The results show that there are differences in the selection of parameters in the calculation methods for local scour in bridge pier foundation of piles-cushion cap in Code for Survey and Design on Hydrology of Railway Engineering (TB 10017—2021 ) and Hydrological Specifications for Survey and Design of Highway Engineering (JTG C 30—2015 ),and …

A Method For Determining Integrity Degree Of Tunnel Surrounding Rock Based On Mobilenet, Liu Houxiang, Yang Caixia

Journal of China & Foreign Highway

To determine the integrity degree of tunnel surrounding rock more efficiently,a precise determination method for the integrity degree of tunnel surrounding rock based on the lightweight neural network MobileNet-v 2 was proposed.Firstly,the image was grayscaled and denoised,and the edges of cracks were detected.Then,the lightweight neural network MobileNet-v 2 model was pre-trained on the ImageNet dataset,and combined with transfer learning to complete data detection on the training,validation,and testing sets.Finally,a comparative experiment was conducted with traditional neural networks RestNet- 50 and VGG 16.By identifying the area,width,and length of cracks,the crack ratio Ks was introduced as an indicator to evaluate the integrity of …

Policies Of Pain: Neoliberal Rhetorics Of The Opioid Epidemic In Culture And Policy, Gina Arlene Stinnett

Dissertations - ALL

This dissertation outlines and examines the Neoliberal rhetorics of choice and responsibility, and how these rhetorics are utilized in policy and culture related to the Opioid Epidemic in the United States. Through this examination of neoliberal rhetorics in policy and culture, I unpack the circular influence these two have on each other—i.e., cultural assumptions inform policy decisions, and established policy can slowly influence cultural assumptions. The key area in which these two influence each other is through rhetoric, therefore I argue that in addition to an economic and cultural structure, neoliberalism is a rhetorical structure—it shapes our society specifically through …

Effective Strategies For Minimizing Employee Turnover To Enhance Profitability In Micro, Small, And Medium Enterprises, Catherine Nyambura Mbugua

Walden Dissertations and Doctoral Studies

Abstract Employee turnover in micro, small, and medium enterprises (MSMEs) is a persistent business problem that can negatively impact financial performance. Business owners are concerned about employee turnover because it disrupts operations, weakens customer relationships, and reduces profitability. Grounded in social exchange theory, the purpose of this qualitative, pragmatic inquiry was to explore the strategies that business owners use to minimize employee turnover and enhance profitability. The participants were six business owners of MSMEs who successfully implemented practices that reduced employee turnover. Data were collected through semistructured interviews and a review of organizational documents related to employee management and retention. …

Intercultural Communicative Competence (Icc) Among Efl Learners And Teachers And The Potential For Ai As A Guide, Zeynep Saka

Theses - ALL

This study investigates the Intercultural Communicative Competence (ICC) of English as a Foreign Language (EFL) students and instructors in Turkey by examining both perceived and observed aspects of ICC, as well as the potential role of Artificial Intelligence (AI) in supporting intercultural communicative competence education. Guided by Byram’s (1997) model and informed by Speech Act Theory (Searle, 1969) and Politeness Theory (Brown & Levinson, 1987), the study adopted a mixed-methods design including 89 students and 46 instructors from nine state universities. Data were collected through a 25-item ICC questionnaire and a series of Discourse Completion Tasks (DCTs) completed under self-guided …

Assessing The Gender Differences In Mental Health Access And The Intersectionality Of Depression, Anxiety, Stress Between Black Men And Black Women During Covid-19, Turquoise Ef'e Pipes

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic, which emerged in the past five years, has had a particularly severe impact on well-being, mental health, and access to care for Black communities. Therefore, the purpose of this quantitative study, grounded in intersectionality theory was to assess gender differences between Black women and Black men confronted with depression, anxiety, stress symptoms and mental health access during the crisis of COVID-19, which has been under researched within this demographic. The study sample included participants from various cities across the United States who lived through the COVID-19 pandemic from March 2020 to March 2023 (n= 104). A MANOVA …

Virtually Present In The Vastness: Vr’S Pathway To Awe And Appreciation, David Paul Peters

Dissertations - ALL

This dissertation explores how spatial presence in Virtual Reality (VR) creates awe and appreciation through the role of perceived vastness. 92 participants played a custom-built VR game (VR Nature Photographer) in three environments designed to be low, medium, and high in vastness. A repeated-measures design measured spatial presence, vastness, awe, and appreciation across conditions. Results showed higher vastness increased all four outcomes, with awe and vastness having the largest effect sizes and presence and appreciation medium sized. Mediation analyses showed perceived vastness fully mediated the effect of spatial presence on awe in all vastness conditions and partially mediated its effect …

Robust Security Assurance In Cyber-Physical Systems: From Attack Diagnosis To Attack Resilience, Zifan Wang

Dissertations - ALL

Cyber-Physical Systems (CPS) have become integral to critical infrastructure, from autonomous vehicles to industrial control systems. However, their increased connectivity and sophistication introduce new vulnerabilities, making security a paramount concern. This dissertation presents a comprehensive pipeline for enhancing CPS security, focusing on accurate diagnosis of trustworthy time frames and subsystems, followed by system resilience measures to restore safe states. The foundation of system resilience lies in an advanced checkpointing protocol for real-time multi-process systems. A novel three-step approach uniquely addresses both logical and timing correctness, which are crucial for modern CPS applications. By partitioning processes into directed acyclic graphs, implementing …

Essays On Housing Choices, Neighborhood Quality, And Urban Blight, Samuel Saltmarsh

Dissertations - ALL

This dissertation contains two chapters related to housing choices of low-income families, neighborhood quality, and the remediation of urban blight. The first chapter examines the effectiveness of Detroit's 2014–2022 residential demolition program in addressing neighborhood blight and vacancy in a shrinking city context. Using a stylized model of durable housing with downward price frictions, I combine parcel-level data on vacancies, blight, and demolitions to estimate the causal effects of demolition exposure on vacancy rates for non-demolished, single-family homes. Employing a difference-in-differences design, I find that the program as a whole did not reduce vacancies, and instead slightly increased them by …

Using A Heuristic Tool To Improve Symptom Self-Management In Adolescents And Young Adults With Cancer: Protocol For A Randomized Controlled Trial., Suzanne Ameringer, Grace Hodges, R K Elswick, Lauri Linder, Catherine Fiona Macpherson, Kristin Stegenga

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Adolescents and young adults (AYAs) with cancer experience multiple distressing symptoms during treatment, yet few developmentally relevant resources have been developed to help them self-manage their symptoms. Empowering patients to have a more active role in self-management during cancer treatment may lessen their symptom severity and distress.

OBJECTIVE: The aim of this study is to test an intervention designed to improve symptom self-management, the Computerized Symptom Capture Tool (C-SCAT), by helping AYAs understand their unique symptom experience and discuss it with their health care providers.

METHODS: We are conducting a multisite, 2-group randomized controlled trial to evaluate the effects …

Feasibility Of Exercise And Mindfulness Intervention For Improving Psychological Symptoms In Female University Students With Smartphone Addiction: A Pilot Study, Huange Liu, Kim Geok Soh, Shamsulariffin Samsudin, Suriyan Somphong, Ranintya Meikahani, Nugroho Puji Santoso

Modern Sport

The prevalent use of smartphones has raised significant concerns regarding smartphone addiction among university students. This addiction can lead to a range of psychological problems, which may ultimately affect their academic performance and overall well-being. Engaging in exercise has been linked to improved mental well-being, mainly by regulating endorphin levels, which can help reduce feelings of anxiety and depression. Mindfulness-based interventions (MBIs) have become effective strategies for tackling different psychological challenges. Evidence indicates that mindfulness practices can significantly decrease stress, anxiety, and depression levels. Combining exercise with mindfulness (EM) techniques can boost their overall effectiveness and provide additional mental health …