Digital Commons Network^™

A Longitudinal Analysis Of Hospital Consumer Evaluation In Virginia, Tulay Akmandor Inac

Health Services Research Dissertations

Suboptimal patient experience signals a need to improve clinical efficacy, patient safety, and healthcare quality. The COVID-19 pandemic intensified hospital resource and staffing demands, reducing hospitals’ capacity to invest in patient experience improvement. Prior studies remain limited because many lack longitudinal structure and organized theoretical models, making temporal inference difficult and weakening analyses of patient experience disparities. To address these limitations, this dissertation incorporates three studies examining patient experience and pandemic-related effects.

In state-level markets comparable to Virginia, limited research has examined longitudinal patient experience trends across regional hospital systems using HCAHPS scores. The first study uses descriptive trend analysis …

A Trombone Studio Teacher's Guide To Non-Injury-Related Embouchure Changes, Austin A. Handley

Dissertations

This dissertation is a pedagogical guide for trombone studio teachers who will lead students through embouchure changes. These changes and adjustments are normal in brass pedagogy, but there is limited literature that addresses how teachers should identify the need for change, initiate the process, and support students through it. There are a growing number of resources available about embouchure injury and dysfunction, rehabilitation, and long-term prevention. This leaves a gap for teachers who are trying to help students using an inefficient embouchure setup.

The purpose of this study is to provide a practical resource for teachers by examining the experiences …

Empirical Rhetorical Modeling: New Analytical Tools To Evaluate The Intensity Of Rhetoric, August Immel

English Theses & Dissertations

Since 2020, the United States has experienced a surge of incendiary rhetoric in contemporary political discourse, which exacerbates societal polarization and incites violence as evidenced by heightened politically motivated attacks. Numerous actors characterize the impetus of such violence as “extreme rhetoric.” No standard definition exists for such a term, and this gap necessitates the central research question of this dissertation, which interrogates how rhetoric can be systematically evaluated for “extremeness.” I propose that the issue of extreme rhetoric can be fruitfully examined from within the context of rhetorical theory, but instead of attempting to create a new definition of “extreme …

The Association Between Prenatal Nicotine Exposure And Postpartum Depression, Reem Ali Sharaf-Alddin

Health Services Research Dissertations

Postpartum Depression (PPD) is the most common mental health complication of childbirth with 17% of women globally and 13% in the US experience PPD. The pathophysiology of PPD is not yet fully understood, with psycho-social, biological, and environmental factors, interplaying together and predisposing to PPD. One key modifiable risk factor is prenatal exposure to nicotine (PEN) including Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), and Electronic Nicotine Products (ENPs). Several studies investigated the association between prenatal ATS or SHS and PPD, however the findings were inconclusive. There is a lack of studies that assessed the overall PEN, and none of …

Masthead & Table Of Contents

Dalhousie Law Journal

No abstract provided.

Legitimacy, Legality, And Canadian Climate Laws, Adebayo Majekolagbe

Dalhousie Law Journal

In 2021, the Supreme Court of Canada, in the References re Greenhouse Gas Pollution Pricing Act, confirmed that global climate change is real, human activities are the main cause, and climate impacts will be especially severe and devastating in Canada. Against this backdrop, the Court upheld the federal government's authority to set a nationwide minimum standard for the stringency of greenhouse gas pricing. Years after the Court endorsed the GGPPA, the legislation and its carbon pricing policy have struggled to gain legitimacy, meaning the acceptance and support of Canadians. In 2025, the carbon charge component of the law was suspended, …

Timely Trials, Costly Remedies: Remedial Deterrence After Jordan, Maggie Morris

Dalhousie Law Journal

This article critiques the Supreme Court of Canada’s ceiling–stay regime under sections 11(b) and 24(1) of the Canadian Charter of Rights and Freedoms, which imposes a presumptive limit on trial delay and mandates a stay when the ceiling is breached. The regime’s design is best understood through the analytical lens of remedial deterrence, which examines how the cost of a strong remedy shapes judicial interpretation of a right. I argue the automatic stay has produced meaningful gains by forcing governments and justice actors to internalize the costs of delay, but its rigidity has also encouraged doctrinal adjustments that risk narrowing …

Visual Cues Attract Adult Tunga Penetrans (Siphonaptera: Tungidae), Ayako Hyuga, Paul Ouma, Lynne Elson, Kazuchiyo Miyamichi, Satoshi Kaneko, Kensuke Goto, Tullu Bukhari, Jürgen Krücken, Ulrike Fillinger

All Peer-Reviewed Publications

Tunga penetrans (Linnaeus, 1758) (Siphonaptera: Tungidae) is an ectoparasitic flea whose adult females cause tungiasis by embedding into the host’s skin. Environmental, social and financial challenges in tungiasis endemic areas have left this disease neglected and lacking locally available control measures. One possible approach for controlling T. penetrans targets its off-host stages; however, surveillance tools for adult fleas are still lacking. Moreover, host-seeking cues and behaviour of adult T. penetrans remain largely unknown. In this study, we show that visual cues are attractive to adult T. penetrans. Newly emerged T.penetrans responded to light stimuli across a broad spectrum, ranging from …

Machine Learning In Flow Cytometry For Acute Myeloid Leukemia Diagnosis: A Scoping Review, Katrina Jezzela M. Dela Pena Md, Mls (Ascp)

Other Specialties

Manuscript version:

Introduction: Flow cytometry is essential for the diagnosis of acute myeloid leukemia (AML), but conventional analysis is labor-intensive, operator-dependent, and increasingly complex. Machine learning (ML) may support automated analysis; however, its readiness for clinical implementation remains unclear. This scoping review mapped ML approaches applied to flow cytometry for AML-related diagnosis.

Methods: PubMed was searched for English-language primary studies applying artificial intelligence, ML, or deep learning to human flow cytometry data for AML diagnosis or classification. Eligible studies reported diagnostic performance metrics. Study characteristics, preprocessing, data representation, model architecture, validation strategy, performance metrics, interpretability, and implementation considerations were descriptively …

Remote Assessment And Management Of Physical Function In Older Adults (Ramp): An International Expert Delphi Process, Jack Dalla Via, Hurst, Elsa Dent, Jackson J. Fyfe, Paul Jansons, Eleanor J. Hayes, Marc Sim, Mylene Aubertin-Leheudre, Alex Barreto De Lima, Lucimere Bohn, Sabine Britting, Fanny Buckinx, Gavin Connolly, Lora Giangregorio, Duarte Henriques-Neto, Jennifer R.A. Jones, Robert Kob, Suzanne N. Morin, Girish N, Lucas B.R. Orssatto, Maria Pearson, Daniel Pinto, Esmee M. Reijnierse, Catherine M. Said, Mohamed Salem, Gary Skinner

Research outputs 2022 to 2026

Background: Remote methods may help older adults improve their physical function, but understanding the perspectives of experts who deliver this care is critical. This modified Delphi process aimed to develop expert consensus on effectiveness, feasibility and implementation of remote assessment and management of physical function in older adults. Methods: This online Delphi process included experts involved in supporting older adults to maintain or improve their health. The Round 1 survey presented 33 Delphi statements assessed using an 11-point Likert scale (0–10; ≥7 indicated agreement). Statements with strong (≥80 %), moderate (50–<80 %) and low (<50 %) agreement were accepted, revised, or rejected, respectively. Revised statements were presented in Round 2, and accepted statements were consolidated into key messages. Results: In total, 108 respondents (67 % female; mean [SD] age 41.4 [10.9] years) from 16 countries (five continents) completed Round 1. Fourteen statements were accepted (88–100 % agreement) and 10 were rejected (8–39 % agreement). The remaining nine statements (52–69 % agreement) were revised, and two new statements were developed for Round 2, which was completed by 89 (82 %) respondents. Five Round 2 statements were accepted (82–93 % agreement). Seven key messages were developed from 19 accepted statements, highlighting that remote care should be accessible to older adults with requisite capabilities, is feasible for older adults and health professionals with adequate support and training, and requires guidelines, policies, and further research to support wider adoption. Conclusions: The findings of this Delphi process can inform the implementation of remote care approaches for assessing and managing physical function in older adults.

Multistage Integrated Systems For Wastewater Treatment And Resource Recovery: A Systematic Process Design Framework, Mahsa Golmohammadi, Ensiyeh Taheri, Ratish Ramyad Permala, Sebastien Allard, Mehdi Khiadani, Amir Razmjou

Research outputs 2022 to 2026

The wastewater treatment paradigm is shifting from pollutant removal toward integrated systems that simultaneously achieve contaminant treatment and resource recovery. Despite extensive literature on individual technologies, systematic frameworks for designing multistage integrated wastewater treatment and resource recovery systems remain notably absent. This review addresses this gap by developing a comprehensive decision framework that guides designers from influent characterization through technology selection across pretreatment, main process, and post-treatment stages. The framework accommodates diverse integration strategies, ranging from fully unified treatment processes to stage-specific configurations where each treatment stage employs technologies tailored to its designated function. Rather than optimizing for a single …

Sarcopenic Obesity And Dementia Risk: Primary Associations And Landmark Analyses Of Muscle Strength And Body Composition Trajectories, Zhongyang Guan, Blossom C.M. Stephan, Lorenzo M. Donini, Justyna Godos, Giuseppe Grosso, Leticia Radin Pereira, Carla M. Prado, Carlos J. Toro-Huamanchumo, Jonathan C.K. Wells, Marc Sim, Mario Siervo

Research outputs 2022 to 2026

Background and aims: Sarcopenic obesity (SO) has been proposed as a risk factor for cognitive impairment. Yet evidence is inconsistent and often limited by heterogeneous definitions and lack of longitudinal assessments. This study aimed to examine associations of SO with all-cause and subtype-specific dementia, and to assess dose–response patterns and how longitudinal changes in body composition and muscle strength relate to dementia risk. Methods: We included 489,972 adults (mean age 56.5 ± 8.1 years) followed for a median of 13.6 years. SO was defined using the Sarcopenic Obesity Global Leadership Initiative (SOGLI) criteria. Cox models estimated hazard ratios (HRs) for …

Acute And Chronic Leukemia In Sub-Saharan Africa: A Systematic Review, Allwell A. Ayirebi, Stephen Twumasi, Linda K. Olaga, Benedict Sackey, Daniel N.M. Antonio, Richard O. Ansah, Eugene A. Ansah, John A. Sah, Enoch O. Anto, Yvonne Anang-Quartey, Antoinette Koomson, Angela Opoku, Godfred A. Donkor, Paulina Duah, Ama G. Boadu, Samuel Essien-Baidoo, Wina I.O. Boadu, Lilian A. Boateng

Research outputs 2022 to 2026

Background: The four primary subgroups of leukemia include chronic myeloid leukemia (CML), acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic lymphocytic leukemia (CLL). Very little is known about the regional variation of leukemia and subtypes in sub-Saharan Africa (SSA).

Aims: This systematic review focused on the prevalent cases reported in sub-Saharan Africa, throwing more emphasis on treatment outcomes, follow up time and survival rates.

Methods: A systematic review of studies on acute and chronic leukemia in sub-Saharan Africa (SSA) was conducted using articles retrieved from PubMed, Scopus, Google Scholar, Embase and African-specific databases such as African Journals Online …

The Future Midwife: A Prisma Scoping Review Of Education, Transition, And Work Readiness Among Midwifery Students, Danielle Gleeson, Tracey Tulleners, Jessica Elliott, Dianne Stratton-Maher, Liz Ryan, Jillian Mcculloch, Geraldine Roderick, Thenuja Jayasinghe, Joanne Buckley, Jamie May Newman, Helen Nutter, Jo Southern, Lisa Beccaria, Georgina Sheridan, Tess Trinder, Haiying Wang, Tao Wang, Sita Sharma, Linda Ng, Jing Yu Tan, Daniel Terry

Research outputs 2022 to 2026

Background: Preparing midwifery graduates to be confident, competent, and resilient is essential for workforce sustainability, yet students report a disconnect between academic preparation and clinical realities. Increasing care complexity, workforce shortages, and variable clinical learning environments globally highlight the need to examine how educational strategies support effective transition to practice. Objective: To map and synthesise the evidence regarding educational approaches, learning experiences, and transition-to-practice factors that influence preparedness for professional practice among midwifery students, and to identify gaps in the existing literature to inform a coherent and future-ready educational framework.

Methods: A PRISMA-ScR-guided scoping review was conducted across seven databases. …

Recompression Improves Release Success In Pollack (Pollachius Pollachius): A Step Towards Assessing Post Release Mortality In A Recreational Fishery, T. Stamp, R. Mawer, R. Conlon, A. E. Hall, P. Davies, R. Nesbit, D. Uren, T. Morris, S. Sullivan, S. Thomas, B. D. Stewart, H. Rudd, K. Hyder, T. Osmond, S. Reynell, E. V. Sheehan

School of Biological and Marine Sciences

The recreational fishery for pollack (Pollachius pollachius) in the northeast Atlantic is impacted by the species' high sensitivity to barotrauma. When captured at depth and brought to the surface, gas expansion within the peritoneal cavity can cause a variety of injuries and hinder release. Via an experimental weighted cage, this study evaluated the efficacy of releasing Pollack at depth as a barotrauma mitigation strategy. We found that depth-release significantly increased the probability of released Pollack displaying an active escape response to 83%, compared to 56% for surface-released fish; however, increased capture depth and fish size negatively affected success. Camera observations …

A Review Of Blue Carbon Credit Projects' Socio-Economic Activities, Nata Tavonvunchai, Holly J. Niner, Abigail Mcquatters-Gollop, Siân E. Rees

School of Biological and Marine Sciences

Coastal ‘blue carbon’ ecosystems (mangroves, seagrasses and saltmarshes) are critical for climate regulation and biodiversity, yet significant funding gaps persist in marine conservation. While blue carbon credits are increasingly used to bridge these gaps, concerns remain regarding their efficacy in delivering socio-economic benefits. Based on lessons from terrestrial carbon markets, failing to prioritise local community needs can lead to inequitable outcomes and externally mandated constraints, which undermine the legitimacy of nature-based solutions. This research seeks to add to the centralised understanding of the social dimension of blue carbon by delivering a comprehensive review of 77 publicly listed projects from global …

Visually Guided Foraging In Virtual Worlds: Domain-General Properties Of Search Behaviour, Sarah Salo, Alastair Smith

School of Psychology

Everyday human behaviour involves economically driven search for visually relevant targets in complex three-dimensional environments. However, psychological research has typically examined visual search and foraging mechanisms separately, with insights into search emphasising attentional efficiency, and accounts of foraging highlighting decision-making and cognitive control. In order to more closely examine the interrelation between these processes in fully motile environmental search, we devised a novel virtual reality paradigm that required participants to physically explore a large-scale 3D environment and collect multiple visually defined targets. The search environment was organised in patches, with search arrays presented across multiple tables. In single feature search, …

Gaming The Marketplace: Consumer Opportunism And Beliefs About Societal Hierarchy, Shilpa Madan, Aparna Labroo, Constantine S. Katsikeas

Research Collection Lee Kong Chian School Of Business

Consumers often behave opportunistically, taking more than what fair marketplace exchange warrants (e.g., taking excess samples, returning used items). While each individual transgression may be minor, cumulatively they can undermine firm profitability. Thus, addressing consumer opportunism is an important managerial concern. We identify a novel antecedent of consumer opportunism: consumers’ acceptance of societal hierarchy (i.e., power distance belief [PDB]), including firms’ higher position in it than consumers. Nine studies (plus two supplementary studies) employing archival, correlational, and experimental data provide converging evidence that, in marketplace interactions, this belief evokes a need to feel clever (i.e., to feel smart and knowledgeable …

Of Cables And Threads: Reweaving The Urban Fabric At The Edge Of Bogotá, Federico Pérez Fernández

University Honors College Faculty Publication and Presentations

Over the past two decades, gondola lifts have become central to interventions in urbanLatin America’s auto-constructed peripheries. As cable car urbanism reshapes the city’sedge, it raises fundamental questions about the notion of the “urban fabric” as a socio-material practice, an epistemology, and a site of politics. In Bogotá, the city’s first aerialcable car line has been integrated into the sprawling district of Ciudad Bolívar, revealinga dialectical process of urban fabrication—a form of urban weaving, in the language ofboth experts and residents, that bridges technical retrofits and popular logistics. Thesestate-community interfaces operate beyond the binaries of compromise and dissent, co-optation and …

Validation Of A Portable Electrochemical Sensor For Real-Time Soil Nitrate Monitoring In Cotton Rhizosphere, Mohammad Solaiman, Elvis D. Sangmen, Ali Reza Galib, Tushar C. Sarker, Anil C. Somenahally, Shawana Tabassum

Electrical Engineering Faculty Publications and Presentations

Soil nitrate (NO3) exhibits rapid spatial and temporal variability that conventional point-sampling methods cannot effectively capture, limiting timely nutrient management and plant stress detection. This study aimed to validate a low-cost, threedimensional- printed electrochemical NO3 sensor for continuous in-soil monitoring and to evaluate whether sensor-derived NO3 dynamics reflect plant physiological responses. For this purpose, cotton (Gossypium hirsutum L.) plants were grown in pots under greenhouse conditions. The sensor was evaluated in two sequential phases: an initial calibration phase to characterize sensor response across a broad NO3 concentration range, followed by a validation phase in the cotton plant rhizosphere. In the …

Modeling The Psychological And Technical Factors Influencing The Use Of Artificial Intelligence Tools Among Non-Native Arabic Learners: A Comparative Study In Egypt, Saudi Arabia, And Jordan., Mohammad Odeh, Alaa Al Din Musa, Ahmed Ragab Ali Ghalish, Montaser Adel Sayed Ahmed

All Works

This study aimed to develop a predictive longitudinal model of the psychological and technical factors influencing the use of artificial intelligence tools among non-native Arabic learners (international students) in three Arab countries: Egypt, the Kingdom of Saudi Arabia, and Jordan. The study adopted an extended Technology Acceptance Model (TAM) incorporating two psychological variables: trust in artificial intelligence and artificial intelligence anxiety. A quantitative longitudinal design with two time waves (T1 and T2) over a full academic semester was employed using Hierarchical Multiple Regression Analysis and PROCESS Macro for mediation. The sample consisted of 812 international students from public universities in …

The Feeding Ecology, Habitat Use, And Monitoring Of Juvenile Alosines: Alewife (Alosa Pseudoharengus), Blueback Herring (A. Aestivalis), And American Shad (A. Sapidissima) In The Kennebec River, Maine, Brian Determan

All Student Scholarship

The Kennebec River, Maine is home to three species of anadromous fish of the genus Alosa: alewife (A. pseudoharengus) and blueback herring (A. aestivalis), jointly referred to and managed as river herring, as well as American shad (A. sapidissima). These ecologically, economically, and culturally important fish populations are depressed compared to historic levels and have been subject to extensive restoration efforts. While spawning adults have been well-studied, much less is known about the juveniles including whether they engage in resource partitioning to minimize competition and facilitate coexistence. In Chapter 1, I use stomach contents to compare diets as well as …

Flipping The Script: An Osint-Driven Framework For Smb Cyber Resilience, James A. Herrick

All Student Scholarship

Small and medium-sized businesses (SMBs) are critical economic drivers, yet they remain prime targets for cyber-attacks. Frequently operating under constraints involving financial resources, personnel, technical expertise, and time, SMBs have difficulty recognizing cybersecurity as a business risk warranting the expenditure of resources. Traditional cybersecurity consulting approaches meet with organizational resistance and fail to gain acceptance due to the SMB’s general underestimation of their own risk. This paper introduces a novel structured, repeatable framework designed to introduce a fresh mindset to conventional consulting. It repurposes Open-Source Intelligence (OSINT) reconnaissance - a toolset typically used by adversaries - for a constructive, empathetic …

Temporal Dynamics Of Sensorimotor Integration For Auditory And Proprioceptive Target Information During Movement Preparation And Execution, Ivan Camponogara

All Works

Actions toward non-visual targets exhibit modality-specific patterns of endpoint variability, with movements toward auditory targets being more variable than those toward proprioceptive or multisensory targets. However, whether such modality-specific effects emerge already during movement preparation and how they evolve across movement execution remains unclear. The present study addressed this question by asking participants to perform reaching movements toward auditory, proprioceptive, or audio-proprioceptive targets while electromyography and movement kinematics were recorded. Movement preparation and initiation was assessed by analyzing two temporal components of reaction time, premotor and motor, together with movement kinematics at peak acceleration. Movement execution was investigated by analyzing …

The Problems Of Philosophy: Student Edition, Bertrand Russell, Landon D.C. Elkind Ed.

Philosophy & Religion Faculty Publications

This is a very lightly edited open educational resource version of The Problems of Philosophy by Bertrand Russell. It is lightly edited to approach (without yet meeting) the “truer” text of The Problems of Philosophy indicated by Kenneth Blackwell in the journal Russell.1 Student notes from the editor are included to make the text more suitable for college (or high school) students.

The basis for this edition is this 2004 version available in HTML through Project Gutenberg, produced by Gordon Keener and David Widger. After using Pandoc to convert this HTML file into TeX, I made some aesthetic edits (like …

Relationship Between Socioeconomic Status And Incidence Of Specific Learning Disability, Nora Nevarez, Ralph Carlson, John Lowdermilk, Paul Sale

Human Development and School Services Faculty Publications

This quantitative study examined the relationship between socioeconomic status (SES), operationalized as child poverty levels, and the incidence of specific learning disability (SLD) using simple linear regression. Data were aggregated from publicly available Texas state databases across the 20 Texas Education Service Centers (ESCs). Analysis revealed a strong positive correlation between poverty rates and SLD placement rates ( 𝑅=.90, 𝑅²=.81, 𝑝< .01), indicating that poverty explained 81% of the variance in SLD identification. The null hypothesis was rejected. Findings suggest higher poverty levels are strongly associated with increased SLD placement rates. Implications for educational policy, resource allocation, trauma-informed practices, and future research are discussed. Limitations include reliance on state-specific aggregate data and a cross-sectional design.

The Supreme Court And The Constitution, Tom Rozinski

Open Touro Created

2026

The Supreme Court and the Constitution is a casebook for undergraduate students who want to earn about the Constitutional structure of the US government. Since the Supreme Court is responsible for interpreting the Constitution, the book begins with a history of the Court before examining the processes and methods it uses to decide cases. There is also a unit on the development of judicial review and the limitations on the scope of the Court’s actions. One major unit examines the powers of the president in both foreign and domestic affairs, and includes a section on presidential immunities. Another major …

Bridging The Gap: Educator Experiences Supporting Students During The Transition From Middle To High School, Sarah Little

Electronic Theses and Dissertations

The purpose of this phenomenological qualitative study was to examine the lived experiences of middle and high school educators supporting students during the transition from middle to high school. This study contributes to the literature of middle to high school transition practices by focusing on districts with a single high school and two middle schools. Coherence Theory was the primary framework for understanding how transition systems function in practice, while Transition Theory and Constructivism provided a supporting lens to provide further context to ground the research in analysis of organizational, developmental, and cognitive alignment.

Data collection strategies included one-on-one semi-structured …

Higher Education And Resilience: An Exploration Of Sexual Misconduct Survivors' Lived Experiences And The Impact On Their Educational Journey, Patricia Denise Williams

Theses & Dissertations

HIGHER EDUCATION AND RESILIENCE: AN EXPLORATION OF SEXUAL

MISCONDUCT SURVIVORS’ LIVED EXPERIENCES  AND

THE IMPACT ON THEIR EDUCATIONAL JOURNEY

Patricia Williams, PhD

University of the Incarnate Word, 2026

This study explored the lived experiences and resilience of victims/survivors of sexual misconduct while pursuing education at an Institution of Higher Learning (IHL). Students between the ages of 18 and 24 are more likely to be sexually victimized than be victims of robbery at IHLs (RAINN, n.d.). The impact of sexual misconduct can leave victims/survivors with long-term trauma, causing negative academic outcomes and a host of behavioral and emotional issues (Banyard et …

Genwriter 2.0: A Hybrid Case-Based And Llm Rewriting Approach For Mitigating Implicit Gender Cues In Text, Shweta Soundararajan, Sarah Jane Delany

Conference papers

Gendered language is the use of words or phrases that indicate an individual's gender. Although useful in some contexts, gendered language can reinforce gender stereotypes and introduce bias, particularly in machine learning models for tasks involving people such as recruitment or occupation classification. When textual content about individuals, such as biographies, contain gender cues, models can learn spurious associations between gender and other characteristics of individuals, such as profession, potentially resulting in unfair outcomes such as reduced hiring opportunities for women.

To address this challenge, we propose GenWriter 2.0, a hybrid approach that integrates Case-Based Reasoning (CBR) with Large …