Digital Commons Network^™

Understanding Institutional Factors That Hinder Black Students’ Ability To Persist At Community Colleges, Tadael Emiru

University of the Pacific Theses and Dissertations

Community colleges face a significant challenge with high attrition rates, which disproportionately impact Black students compared to other student groups. Hope Community Colleges reflect this trend, with a notable percentage of students dropping out before achieving their academic goals. The implications of this high dropout rate extend beyond individual students, affecting the local, state, and national economies.

Although existing research primarily focuses on students’ personal characteristics that influence their ability to stay in college, there is a noticeable gap in understanding the institutional factors that negatively affect student persistence, particularly for Black students in community colleges. This study sought to …

The Power Of Presence: Body Image In Disney's The Little Mermaid, Megan Chatelain

University of the Pacific Theses and Dissertations

This study explores how body image is represented in Disney’s The Little Mermaid across its 1989 animated film and the 2019 and 2023 adaptations. Grounded in Gerbner’s Cultivation Theory, the research examines how repeated media exposure shapes audience perceptions of morality, beauty, and identity—particularly through the portrayal of body size. Using a triangulated qualitative approach—reflexive journaling, content analysis, and survey responses—the study reveals consistent patterns: thin characters are depicted as virtuous, desirable, and heroic, while larger-bodied characters are often cast as villainous, comedic, or morally flawed. These associations were recognized by participants across all methods and confirmed through both reflective …

Mentors’ Experiences Supporting Beginning Teachers Of Students In High-Needs, Urban Schools, Guy Lamont Ollison

University of the Pacific Theses and Dissertations

Research has consistently demonstrated the positive impact of mentoring on beginning teachers. However, it has also been revealed that teachers serving students in highly-diverse, high-needs, urban, low-income schools often receive inadequate, inconsistent, and low-quality support. In fact, studies indicate that the overall quality of support provided to beginning teachers is closely linked to the income level of the student population they serve (Alkins et al., 2006; Mizrav & Lachlan-Hache, 2019). A lack of meaningful mentor support can negatively affect the learning outcomes of marginalized students of color.

The purpose of this basic qualitative study, guided by a phenomenological approach, was …

Knocking On Resistance’S Door: Investigating The Spread And Drivers Of Kdr Mutations In Northern California Culex Tarsalis, Esther Blankenship-Cutshall

University of the Pacific Theses and Dissertations

Vector-borne diseases are an increasingly relevant threat to public health as climate change alters the ecology of vector populations in relation to humans. One key to combating vector-borne disease is using pyrethroid insecticides against mosquito populations. However, wild mosquito populations have exhibited resistance to those key pyrethroids. One resistance mechanism under investigation is the altering of the voltage-gated sodium channel, which is associated with the genetic mutations known as kdr. The prevalence and history of kdr mutations has been investigated in some populations of Culex pipiens, however, it is unknown in northern California Culex tarsalis populations. This study aims to …

How The Least Restrictive Environment Mandate Is Interpreted By California Special Education Local Plan Agency Directors, Robin Suttle

University of the Pacific Theses and Dissertations

This qualitative case study examines how Special Education Local Plan Agency (SELPA) directors in California interpret and communicate the Least Restrictive Environment (LRE) mandate under the Individuals with Disabilities Education Act (IDEA). The study explores how SELPA directors understand LRE and how this understanding is conveyed to district-level administrators. Data were collected through interviews and document review across selected SELPAs and analyzed thematically using the Boundary Spanning framework. Findings show that SELPA directors view LRE as both a legal obligation and a collaborative, context-dependent process. They act as intermediaries, translating federal and state mandates into locally usable guidance while balancing …

From Street Codes To School Codes: Transformative Educational Intervention For Gang Affiliated Student. An Active Research Study, Alexandra Saldivar

University of the Pacific Theses and Dissertations

Gang-affiliated youth face significant challenges in educational and community settings, often resulting in lower graduation rates, limited career opportunities, and an increased risk for behavioral problems. While gang activity on school campuses has increased in recent years, there is limited research and little effort specifically tailored to meet the needs of this vulnerable population. This study aims to evaluate the effectiveness of the WhyTry intervention, a resilience-focused program designed for at-risk populations, modified with additional counseling and a gang-intervention emphasis to address the unique challenges gang-affiliated students face. The study explores whether the modified WhyTry program can improve academic performance, …

And Yet She Persisted: An Autoethnographic Exploration Of A Mature Doctoral Student Experiencing Grief And Loss During The Doctoral Journey, Jenny Masterman Abbott

University of the Pacific Theses and Dissertations

This evocative autoethnographic study explored the lived experiences of a mature doctoral student navigating grief and loss while progressing through a doctoral program. The research connected the personal narrative of the author a nurse, educator, wife, mother, and widow to broader themes of resilience, identity, and persistence in higher education. Using narrative inquiry and self-reflective vignettes, this dissertation sought to illuminate how grief intersects with academic life, shaping both personal meaning and scholarly perseverance.

The study was guided by four research questions: (1) What does it mean for the mature doctoral student to be successful in negotiating the doctoral journey …

Comparative Evaluation Of Swabbing Sites For Omicron Variant Detection In Pcr Testing, Tom Fowler, Edward Blandford, David Chapman, Matthias E Futschik, Raghavendran Kulasegaran-Shylini, Sarah Tunkel, Carolyn Lewis, Alasdair Fellows, Ellie Sheppard, Leanne Mccabe, Peter Marks, Paul E Klapper, Andrew Dodgson, Malur Sudhanva, Mike Kidd, Andy Vail, Susan Hopkins, Tim Peto

School of Biomedical Sciences

PURPOSE: The Omicron variant of SARS-CoV-2 raised concerns about the best sampling sites for PCR testing, with early indications suggesting throat swab samples were better than nasal swab samples. Our study evaluated the sensitivity of detecting SARS-CoV-2 across different swabbing sites.

METHODS: Participants undergoing testing at NHS Test and Trace sites in England provided self-collected samples using nose only, throat only, and combined nose and throat swabs, which were analysed by realtime PCR.

RESULTS: Among 815 participants, combined swabs had higher viral concentrations than nose only or throat only swabs. Sensitivity for detecting SARS-CoV-2 by PCR was 91 % for …

Rhce Genotyping Using Next Generation Sequencing:Allele Specific Reference Sequences, Wajnat A. Tounsi, Amr J. Halawani, Kelly A. Sillence, Michele Kiernan, Neil D. Avent, Tracey Madgett

School of Biomedical Sciences

BackgroundThe Rh blood group system (ISBT004) is encoded by two homologous genes, RHD and RHCE. Polymorphism in these two genes gives rise to 56 antigens, which are highly immunogenic and clinically significant. This study extended previous work on the establishment of RHD allele specific reference sequences using next generation sequencing (NGS) with the Ion Personal Genome Machine (Ion PGM) to sequence the complete RHCE gene.Study Design and MethodsGenomic DNA (gDNA) samples (n = 87) from blood donors of different serologically predicted genotypes including R1R1 (DCe/DCe), R2R2 (DcE/DcE), R1R2 (DCe/DcE), R2RZ (DcE/DCE), R1r (DCe/dce), R2r (DcE/dce), R0r (Dce/dce), rr (dce/dce), r'r …

The Micronutrient Gap: Understanding Modern Dietary Shortfalls, Kathy Redfern

School of Biomedical Sciences

Nutrition science is a relatively young discipline, yet our understanding of how diet impactshealth, wellbeing, and performance has grown significantly over the past century. Despite thissurge in research and heightened public awareness, many modern diets in developed nationsare falling short in key micronutrients such as vitamin D, vitamin B12, and folic acid (1). Thesetrends are driven by a range of factors, including rising consumption of ultra-processed foods(UPFs), declining nutrient density in produce, reduced sunlight exposure, and chronic stress.

Micro(Nano)Plastics In The Fish Gastrointestinal Tract: A Mini Review And Relevance To One Health Perspective, Farhan R. Khan, Nathaniel Clark, Elvis Genbo Xu

School of Biomedical Sciences

Micro(nano)plastics (MNPs) research in the piscine gastrointestinal tract has been a significant area of study. Understanding the environmental presence of microplastics, their potential for both localised and systemic effects, and their role as a gateway for MNPs and associated chemicals to enter the tissues and the food web, including the human food chain, is crucial. The fish gut, as a critical intersection between environmental, biotic, and human health, aligns with the One Health concept. We review the likely uptake mechanisms and toxicological damage caused by ingesting MNPs and their associated chemicals in fish, contextualised within the realms of digestive physiology …

Multiplex Lateral Flow Test Sensitivity And Specificity In Detecting Influenza A, B And Sars-Cov-2 In Adult Patients In A Uk Emergency Department, Rahul Batra, Edward Blandford, Raghavendran Kulasegaran-Shylini, Matthias E Futschik, Abbie Bown, Matthew Catton, Hermione Conti-Frith, Alexandra Alexandridou, Rebecca Gill, Clara Milroy, Sean Harper, Holly Gettings, Maryann Noronha, Hooi-Ling Harrison, Sam Douthwaite, Gaia Nebbia, Paul E Klapper, Sarah Tunkel, Richard Vipond, Susan Hopkins, Tom Fowler

School of Biomedical Sciences

BACKGROUND: Rapid identification of individuals with acute respiratory infections is crucial for preventing nosocomial infections. For rapid diagnosis, especially in EDs, lateral flow devices (LFDs) are a convenient, inexpensive option with a rapid turnaround. Several 'multiplex' LFDs (M-LFDs) now exist, testing for multiple pathogens from a single swab sample. We evaluated the real-world performance of M-LFD versus PCR testing in detecting influenza A, B and SARS-CoV-2) in the ED setting.

METHODS: After preliminary evaluation of an M-LFD (SureScreen) with laboratory-grown virus and PCR-negative clinical samples, it was evaluated in a real-world setting at the ED of St Thomas' Hospital (London, …

Patient-Reported Outcomes, Postoperative Pain And Pain Relief After Day Case Surgery (Poppy): Methodology For A Prospective, Multicentre Observational Study*, William M. Hare, Martha Belete, Adam B. Brayne, Harriet Daykin, Matthew Everson, Anna Ratcliffe, Katie Samuel, Lexy Sorrell, Mark Rockett

Peninsula Medical School

Background: In the UK, approximately 70% of surgical procedures are undertaken as day-cases. Little information exists about recovery from day-case surgery, yet international data highlights patients are at risk of developing significant longer-term health problems including chronic post-surgical pain and persistent postoperative opioid use. The Patient-reported Outcomes, Postoperative Pain and pain relief after daY case surgery (POPPY) study was a national prospective multicentre observational study, measuring short- and longer-term patient-reported outcomes, postoperative pain and pain relief after day-case surgery. Methods: This was a collaborative project led by resident anaesthetists under the Research and Audit Federation of Trainees umbrella. Adult day-case …

The Current Clinical Practice And Experiences In Buccal Midazolam Prescribing In Community For Status Epilepticus Termination In The United Kingdom: The Rescue Epilepsy Medication And Training (Remit) Study, Rohit Shankar

Peninsula Medical School

Background: Epilepsy is one of the commonest neurological conditions worldwide and confers a significant mortality risk, partly driven by status epilepticus (SE). Terminating SE is the goal of pharmaceutical rescue therapies. This survey evaluates UK-based healthcare professionals’ clinical practice and experience in community-based rescue therapy prescribing. Methods: A cross-sectional, 21 item questionnaire composed of Likert-style and free-text based questions was administered online. It was distributed through a non-discriminative snow-balling methodology to members of the Epilepsy Specialist Nurses’ Association (ESNA) and the British International League Against Epilepsy (ILAE). Quantitative analysis used Chi-squared, Fishers’ exact and Mann-Whitney tests. Qualitative data were analysed …

Mortality Prediction After Major Surgery In A Mixed Population Through Machine Learning: A Multi-Objective Symbolic Regression Approach, Pietro Arina, Davide Ferrari, Nicholas Tetlow, Amy Dewar, Robert Stephens, Daniel Martin, Ramani Moonesinghe, Vasa Curcin, Mervyn Singer, John Whittle, Evangelos B Mazomenos

Peninsula Medical School

INTRODUCTION: Understanding 1-year mortality following major surgery offers valuable insights into patient outcomes and the quality of peri-operative care. Few models exist that predict 1-year mortality accurately. This study aimed to develop a predictive model for 1-year mortality in patients undergoing complex non-cardiac surgery using a novel machine-learning technique called multi-objective symbolic regression.

METHODS: A single-institution database of patients undergoing major elective surgery with previous cardiopulmonary exercise testing was divided into three datasets: pre-operative clinical data; cardiorespiratory and physiological data; and combined. A multi-objective symbolic regression model was developed and compared against existing models. Model performance was evaluated using the …

Serious Games For Constipation Management For People With Intellectual Disabilities: A Scoping Review And Narrative Synthesis, Serena Daniel, Ruth Bishop, Ellie Killner, Alison Whight, Sarah Lennard, Stephen Howard, Richard Laugharne, Rohit Shankar

Peninsula Medical School

Introduction: People with intellectual disability (PwID) are 2% of the UK population. Constipation and bowel movement (BM) problems (diarrhoea/faecal incontinence etc.) affects over a third of PwID and is a serious cause of morbidity and mortality. Pw ID rely heavily on outside support (family/professional carers/healthcare professionals), many of whom are ignorant to bowel related harms. There is significant stigma to discuss BM particularly constipation. Serious Games (SG) are increasingly used for education of health needs. This review examines if game-based technology can assist improving knowledge and reducing stigma of BM problems particularly constipation. Objective: To identify and gain evidence of …

From Attention To Action: Advancing Inclusivity In The Landscape Of Anatomy Education, Siobhan M. Moyes, Lily Evans, Katie Snow, Aiden Jayanth

Peninsula Medical School

Conversations about inclusivity in anatomy education are at a critical juncture. While the need for a more equitable discipline is widely recognised, significant challenges remain. As this project aimed to reimagine what a truly inclusive learning experience could like and how it might be best achieved, an inclusive approach to research methodology was essential to ensure robust and representative results. Due to the paucity in anatomical literature on this topic, the authors applied concepts from sociological research methodology and innovative methods of demographic data collection to their own discipline.

The study utilised questionnaires and focus groups to collect diverse data …

The Added Value Of Narrow Band Imaging In Sinonasal Tumour Resection And Surveillance: Our Experience, Yazan Kanaan, Ra'ed Al-Ashqar, Hisham Khalil, Konstantinos Geronatsios, Marios Stavrakas

Peninsula Medical School

BACKGROUND & PURPOSE: Narrow Band Imaging (NBI), developed by Olympus Medical Systems, has played a role in diagnosing digestive tract lesions and cancers, diagnosing and characterizing bladder cancers during cystoscopy and in the diagnosis and management of Head and Neck cancers. We aim to explore the potential use of NBI in the diagnosis, management, and follow-up of sinonasal tumours.

METHODS: We present a series of cases treated at our institution, where NBI played a crucial role in the diagnosis, surgical management, intraoperative decision-making, and follow-up. The cases include a patient with sinonasal lymphoma, 2 patients with sinonosal malignant melanoma and …

Patterns Of Intra-Cluster Correlation Coefficients In School-Based Cluster Randomised Controlled Trials Of Interventions For Improving Social-Emotional Functioning Outcomes In Pupils: A Secondary Data Analysis Of Five Uk-Based Studies, Kitty Parker, Michael Nunns, Zhi Min Xiao, Tamsin Ford, Paul Stallard, Willem Kuyken, Nick Axford, Obioha C. Ukoumunne

Peninsula Medical School

Background: The cluster randomised trial (CRT) design is increasingly used to evaluate the impact of school-based interventions for improving social-emotional functioning outcomes in pupils. Good knowledge is required on plausible values of the intra-cluster correlation coefficient (ICC) of the outcome to calculate the required sample size in such studies. Using data from five school-based CRTs in the UK, we estimate, and describe patterns in, ICCs for social-emotional functioning outcomes. Methods: Mixed effects linear regression models were fitted to estimate the ICC and variance components. Estimates for baseline data were obtained by fitting “null” models that had no predictor variables; estimates …

Evidence For Alcohol-Mediated Hemolysis And Erythrophagocytosis, Chaowen Zheng, Siyuan Li, Johannes Mueller, Cheng Chen, Huanran Lyu, Guandou Yuan, Ane Zamalloa, Lissette Adofina, Parthi Srinivasan, Krishna Menon, Nigel Heaton, Stephan Immenschuh, Ines Silva, Vanessa Rausch, Seddik Hammad, Steven Dooley, Shilpa Chokshi, Antonio Riva, Songqing He, Sebastian Mueller

Peninsula Medical School

Alcohol-related liver disease (ALD) is the most common liver disease worldwide; however, its underlying molecular mechanisms remain poorly understood. Here, we identify ethanol-mediated hemolysis and erythrophagocytosis as major contributors to ALD pathogenesis using both in vitro and in vivo models, as well as surrogate markers such as heme oxygenase-1 (HO-1) and CD163, a scavenger receptor for hemoglobin-haptoglobin complexes. A key initial observation was the direct optical evidence of serum hemolysis in heavy drinkers, which diminished after one week of alcohol withdrawal. In parallel, soluble CD163 (sCD163) levels declined during alcohol detoxification correlating with liver damage and fibrosis stages. Moreover, red …

Epidemiology Of Thrombotic Thrombocytopenia Syndrome 2011 To 2022: English Sentinel Network Cohort Studies, José M. Ordóñez-Mena, Debasish Kar, Xuejuan Fan, Filipa Ferreira, Sneha N. Anand, Deborah Layton, David Clifton, Mark Joy, Anshul Thakur, Anu Alessi, Andrew Lee, Lisa Mather, Simon De Lusignan

Peninsula Medical School

Background and Objective: Thrombotic thrombocytopenia syndrome (TTS) is a rare condition following vaccination with adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccines. This retrospective analysis of England primary care data aimed to estimate TTS event rates before, during, and after the COVID-19 pandemic, and following AZD1222 (ChAdOx1-nCoV-19) vaccination. Methods: Primary care data on TTS events were collected using the Oxford-Royal College of General Practitioners Research and Surveillance Centre sentinel network. TTS events were defined as thromboembolism with coincident (± 7 days) thrombocytopenia events using Systematized Nomenclature of Medicine clinical terms (the current Brighton Collaboration definition could not be used in the study …

How Epilepsy Risks Might Be Introduced And Discussed In Clinical Consultations, Rohit Shankar

Peninsula Medical School

AbstractAdverse impacts of epilepsy (e.g., injury, depression, and Sudden Unexpected Death from Epilepsy (SUDEP) can be mitigated by factors that patients may control, such as medication adherence, improved sleep and diet, reduced alcohol and taking care around pregnancy. New guidelines state that risk should be discussed at the time of diagnosis but some clinicians express concern about not wanting to raise anxiety.ObjectiveTo explicate practices by which epilepsy expert clinicians broach discussions of risk in specialist epilepsy clinics.Methods24 recordings of initial telephone appointments at specialist clinics where epilepsy is diagnosed from two specialist outpatient epilepsy services in England were subjected to …

Consensus-Based Research Priorities For Post-Collision Care In The Western Cape Province Of South Africa, Naseef Abdullah, Tim Nutbeam, Colleen J. Saunders, Craig Wylie, Nigel Lang, Willem Stassen

Peninsula Medical School

Introduction: Road traffic injuries constitute a significant global health burden, causing 1.3 million deaths and 50million injuries annually, with 92 % of fatalities occurring in low-and middle-income countries (LMICs). Despitethis disproportionate impact, research priorities in post-collision care often reflect high-income country contexts,creating a critical misalignment between evidence generation and contextual realities in LMICs.Methods: This mixed-methods study employed a three-phase approach to identify research priorities for postcollision care in the Western Cape, South Africa. Phase 1 consisted of a comprehensive literature review toidentify preliminary thematic areas and research questions. Phase 2 involved a stakeholder engagement workshop using modified nominal group techniques …

Il-1 Signal Inhibition In Alcohol-Related Hepatitis: A Randomized, Double-Blind, Placebo-Controlled Trial Of Canakinumab, Nikhil Vergis, Vishal Patel, Karolina Bogdanowicz, Justyna Czyzewska-Khan, Rosemary Keshinro, Francesca Fiorentino, Emily Day, Paul Middleton, Stephen Atkinson, Thomas Tranah, Mary Cross, Daphne Babalis, Neil Foster, Emma Lord, Alberto Quaglia, Josephine Lloyd, Robert Goldin, William Rosenberg, Richard Parker, Paul Richardson, Steven Masson, Gavin Whitehouse, Cyril Sieberhagan, David Patch, Nikolai Naoumov, Ashwin Dhanda, Ewan Forrest, Mark Thursz

Peninsula Medical School

Background and Aims: Short-term mortality in alcohol-related hepatitis (AH) is high, and no current therapy results in durable benefit. A role for interleukin (IL)-1β has been demonstrated in the pathogenesis of alcohol-induced steatohepatitis. This study explored the safety and efficacy of canakinumab (CAN), a monoclonal antibody targeting IL-1β, in the treatment of patients with AH. Methods: Participants with biopsy-confirmed AH and discriminant function ≥32 but Model for End-Stage Liver Disease ≤27 were randomly allocated 1:1 to receive either CAN 3 mg/kg or placebo (PBO). Liver biopsies were taken before and 28 days after treatment. The primary endpoint was the overall …

Impact Of Social Deprivation Upon The Preoperative Pathway And Early Surgical Outcomes After Pancreatoduodenectomy For Pdac And Non-Pdac Periampullary Cancer In England: The Surg-Panc-Uk Study, Surg-Panc-Uk Study Group On Behalf Of Augis, Thomas W Thorne, Siobhan C Mckay, Samir Pathak, Richard Wilkin, Jenifer Barrie, John Moir, Keith J Roberts, Somaiah Aroori

Peninsula Medical School

BACKGROUND: Socioeconomic deprivation is linked to poorer outcomes in many cancers, however the impact of social deprivation on survival in resectable pancreatic and other peri-ampullary cancers appears mixed. Moreover, no studies consider the impact of social deprivation on diagnostic pathway length.

METHODS: A retrospective observational cohort study of adults with suspected periampullary cancer undergoing pancreaticoduodenectomy in England. Following surgery, patients were stratified by cancer type (PDAC, duodenal cancer, cholangiocarcinoma and ampullary cancer) and the impact of social deprivation (IMD deprivation quintiles) upon short-term survival and diagnostic pathway length analysed.

RESULTS: 648 patients from England with social deprivation data were identified, …

Education And Eschatology: Why Theological Education Is Necessary, Jiri Moskala

Faculty Publications

No abstract provided.