Digital Commons Network^™

A Five-Country Comparison Of Midwifery Students' Confidence In Facilitating Normal Labor And Birth, Juliet Wood, Jalana Lazar, Barbara Baranowska, Clare Davison, Debora Dole, Cindy L. Farley, Jane Fry, Maria Healy, Felicity Agwu Kalu, Urszula Tataj-Puzyna, Emma Ritchie, Maria Wegrzynowska

Research outputs 2022 to 2026

Introduction: Midwifery students need confidence in recognizing and supporting normal birth, the backbone of the midwifery professional role. Developing this confidence in the face of decreasing rates of physiological birth worldwide is a critical challenge. Midwife researchers from Australia, England, Northern Ireland, Poland, and the USA investigated midwifery student confidence for supporting normal birth and explored enhancing and detracting factors. Methods: A cross-sectional survey design was undertaken with 570 midwifery students at 8 academic midwifery programs across 5 countries The Student Confidence for Supporting Normal Birth Questionnaire with free text and Likert-type questions on a 1 (least influential) to 4 …

Adaptive Security Metric For Optimizing Post-Quantum Cryptography In Constrained Iot Devices, Aisha Nasser Ahmed

Theses

Quantum Computing poses real threat to Classical Public-Key Cryptography requiring the use of Post-Quantum Cryptography for all Internet of Things Devices. However, there are greater computational, memory and communication overheads in PQC algorithms that create additional burdens on resource constrained IoT devices. At this time, there are no standard measures for systems developers to determine optimal PQC settings for the various IoT Device Classes. This Thesis develops a new framework of metrics for determining the most suitable PQC settings based on Security Strength, Performance Indicators (Latency, Memory, Energy), Communication Overhead and Reliability for each IoT device class. The Research introduces …

In The Name Of Awareness: Audience, Venue, And The Politics Of Witnessing Human Rights Violations, Barberán Reinares, Eunah Lee

Publications and Research

Human rights scholar Wendy Kozol has posed a series of challenging questions regarding women’s human rights: “How are experiences of suffering represented? By whom? In what venues? And for which audiences?” This article seeks to address Kozol’s inquiry regarding representations of sexual violence and context by considering the Comfort Women Wanted installation at the Museum of Sex in New York City. The curators of this exhibit, partly sponsored by the Sex Workers Project, seem to have framed this art display within the conflicting feminist debates on sexual slavery and sex work, thus conflating “comfort women” survivors with sex workers within …

African American Female College Students’ Experiences At Predominately White Institutions, Sh'nita Louise Mitchell

Electronic Theses and Dissertations

African American women who attend predominantly White institutions (PWIs) have historically encountered systemic challenges that include racial isolation, microaggressions, a lack of cultural understanding, and insufficient institutional support. These barriers often impact their sense of belonging, academic persistence, and overall success. I aimed to explore the lived experiences of African American women who graduated from PWIs to understand how these women navigate institutional structures and sustain their academic journeys. I aimed to examine the unique challenges and supports experienced by African American women, and to identify factors that contribute to or hinder their persistence and success at their PWI. The …

The Relationship Between Emotional Intelligence, School Culture, And School Leadership, Virginia Lorean Smith

Electronic Theses and Dissertations

Abstract

This study was a qualitative instrumental single holistic case study as outlined by Robert Stake in

1995. It focused on three research questions. The goal was to gain perspectives from teachers

and a principal on teacher retention and the culture of a campus. The emotional level of the

principal was evaluated on social awareness, self-awareness, relationship management, and self-

management by the principal taking part in an emotional intelligence assessment. The single

holistic case study approach was used, which had six phases of analyzing the data. The results

were then compared to the teachers’ interviews and surveys that were …

Understanding Digital Communication Gaps With Hispanic Families In A Charter School In South Texas, Ruby Cabrera Aguilar

Electronic Theses and Dissertations

Now that access to technology is prevalent, digital communication in school districts and between schools and parents should be of high priority. Since schools do not emphasize digital communication policies and practices, a problem seen is a lack of communication across districts involving school staff, parents, and students. Determining school leaders’ roles in closing digital communication gaps through policies and procedures deserves further study because effective communication leads to awareness, involvement, relationship building, and student success. In this study, the knowledge gap theory and qualitative action research through reports and interviews assisted in understanding the perspectives of six school staff …

Beyond Leadership Turnover: Examining The Relationship Between Principal Supervisor Coaching And Student Academic Performance, Margo L. Nottingham

Electronic Theses and Dissertations

Schools that maintain stable leadership report increased student achievement outcomes. The problem is that over 21% of U.S. principals leave their positions in the first year in high-poverty contexts. Principals leave their roles due to high job demands, inadequate support, and limited professional development, leading to decreased performance and poor school culture. The problem examined in this study was the lack of evidence on whether coaching principal supervisors contributed to improved student achievement outcomes. The study aimed to determine whether coaching principal supervisors through a regional service center was associated with higher student achievement in low-performing elementary and middle schools. …

"Are We Okay?": Exploring Departmental Leadership Behavior In Higher Education Organizational Crises, Melody Y. Zuniga

Electronic Theses and Dissertations

This qualitative study explored how faculty in higher education institutions experienced their department leaders during organizational crises. With academic department leaders often appointed with little training for the role’s administrative challenges, they can be underprepared when a crisis befalls their institutions. A qualitative narrative design allowed 10 social work faculty from nine Christian institutions across the United States to share their stories of navigating internal and external crises. Data collection occurred primarily through semistructured interviews, with questions allowing for narrative elements of time, place, and sociality to emerge. Through reflexive thematic analysis, findings revealed four themes in faculty’s experiences with …

Leading Employees Remotely In A Post-Covid-19 Era: A Phenomenology Study Of Remotely Working Employees, George M. Hardy Jr

Electronic Theses and Dissertations

The problem addressed in this study was that remote working employees felt disconnected from their organizations, leading to post-COVID-19 studies on phenomena such as quiet quitting and the great resignation. The purpose of this study was to investigate remotely working employees’ perspectives on connectedness to gain an understanding of commitment within their organization that ultimately leads to the decision to remain or leave. A qualitative phenomenology study was used with data collected from 12 remotely working participants across multiple industries and states. Data were transcribed, coded, and analyzed using a thematic approach with member-checking and triangulation to ensure credibility. Two …

Advancing Medical Education With Lifestyle Medicine: A Comprehensive Program Evaluation Using The Kirkpatrick Framework, Shanna L. Mello

Electronic Theses and Dissertations

This dissertation examined how a U.S. national lifestyle medicine residency curriculum influenced resident learning and practice using a program evaluation paradigm with a convergent mixed methods design guided by Kirkpatrick’s four-level evaluation model. The problem addressed was the persistent gap between evidence for lifestyle interventions and the limited preparation residents receive to deliver lifestyle counseling in routine care. The purpose of the study was to evaluate changes in residents’ reactions, learning, and clinical behaviors and to identify early patient-level signals and the implementation conditions that enabled or constrained behavior change. Quantitative methods analyzed archived pre- and posttraining surveys from 148 …

Closing The Graduation Gap: Factors That Impact The Graduation And Enrollment Rates Of First Generation African American Male Students At Predominantly White Christian Universities, Byron C. Johnson Jr

Electronic Theses and Dissertations

First-generation African American male students encounter unique challenges on their journey through higher education. These challenges include inadequate academic preparation, limited family support, financial hardships, and difficulties in finding a sense of belonging. Additionally, factors such as race and religion present significant barriers that hinder their ability to persist in and graduate from colleges and universities without institutional support. Strategic initiatives, programs, and services that address the specific needs of these students are crucial for promoting their academic and social integration, ultimately influencing their success in higher education. This study focused on the experiences of successful first-generation African American students …

Tess Light Curves And Period Changes In Low-Mass Eclipsing Binary Bb Persei, Marek Wolf, Petr Zasche, Miloslav Zejda, Martin Mašek, Andrej Mudray, Hana Kučáková, Waldemar Ogłoza, Jaroslav Merc, Jan Kára, Vojtěch Dienstbier

Physics & Astronomy Faculty Publications

We present a detailed analysis of the low-mass detached eclipsing binary system BB Persei, which contains two K-type stars in a circular orbit with a short period of 0.4856 d. We used light curves from the Transiting Exoplanet Survey Satellite (Tess), which observed BB Per in five sectors, to determine its photometric properties and a precise orbital ephemeris. The solution of the Tess light curve in Phoebe results in a detached configuration, where the temperature of the primary component was fixed to T 1 = 5 300 K according to Lamost, which gives us T 2 = 5 050 ± …

Six New Doubly Eclipsing Quadruples In A 2+2 Architecture, Petr Zasche, Hana Kučáková, Jan Kára, Jaroslav Merc, Z. Henzl, Martin Mašek, L. Červinka, Vojtěch Dienstbier

Physics & Astronomy Faculty Publications

The study presents a confirmation of six quadruples with two sets of eclipses that have the 2+2 architecture. These so-called doubly eclipsing systems still present a quite rare group of stars. We collected all available photometric data and carried out a detailed analysis of them. In addition to the precise TESS photometry used to model the light curves for both inner eclipsing binaries, photometric survey data were also used, and more than 100 nights of our own dedicated observations were carried out. These were mainly used for the detection of the long-term evolution of orbital periods. Thanks to these data, …

What Time Is It? It Is 8 And 1/2 Time: A Rare Case Of Ischemic Stroke Consistent With Eight-And-A-Half Syndrome, Jessica Daza, Marcelo Bedoya-Sommerkamp, Eunbee Cho, Celia Patricia Daza, Francisco Gomez, Fatimah Bello, Jia Lin

School of Medicine Publications

Eight-and-a-half syndrome is a rare neuro-ophthalmic syndrome characterized by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia, and ipsilateral facial nerve palsy. It results from a lesion affecting the paramedian pontine reticular formation, the medial longitudinal fasciculus, and the abducens nucleus of the same side, at the level of the lower pons. We present a case of a 49-year-old man with 2-week diplopia and 3-day right-sided facial droop, drooling, and dysarthria. CT angiography of the head and neck revealed atherosclerotic disease, with decreased caliber of the basilar artery at the level of the pons. Brain MRI showed a subacute ischemic lesion …

Patient-Defined Outcomes In Adults With Hip Dysplasia: What Activities Do Patients Hope To Improve With Treatment?, John Gaddis, Martin Salgado-Flores, Seunghoon Lee, Syed Ghazi, Hunter M. Butler, Edward P. Mulligan, Charles South, Joel Wells

School of Medicine Publications

Introduction: Patient-reported outcome measures have widely been used in the field of orthopaedics to determine treatment outcomes; however, they may not always align with the patient's goals for improvement following treatment. Therefore, we introduced the concept of patient-defined outcomes (PDOs): pretreatment goals or activities patients wish to improve following treatment, along with the patient-perceived difficulty and importance of these activities. This study aimed to evaluate PDOs in adults with hip dysplasia across 3 age groups while assessing patient variables for potential associations with choosing specific categories of activities.

Methods: We analyzed PDOs in 180 adults diagnosed with hip dysplasia, stratified …

Triple Air Leak Syndrome In Cannabinoid Hyperemesis: A Diagnostic Challenge Managed Conservatively, Kashif Ali, Aresha Masood Shah, Arsalan Hyder, Valeska Balderas

School of Medicine Publications

Cannabinoid hyperemesis syndrome (CHS) is a condition marked by recurrent nausea, vomiting, and abdominal pain in chronic cannabis users. Rarely, severe vomiting can lead to complications such as spontaneous pneumomediastinum, pneumopericardium, and pneumoretroperitoneum. We present a case of a 21-year-old woman with CHS who developed a rare triad of spontaneous pneumomediastinum, pneumopericardium, and pneumoretroperitoneum. Initial findings raised concern for Boerhaave syndrome; however, imaging ruled out esophageal perforation. The patient was managed conservatively with bowel rest, intravenous fluids, electrolyte correction, antiemetics, and antibiotics, resulting in full recovery. This case highlights the diagnostic challenges in distinguishing CHS common nonserious complications from more …

The Association Of Cancer-Preventive Lifestyle With Colonoscopy Screening Use In Border Hispanic Adults Along The Texas-Mexico Border, Paul Gerardo Yeh, Audrey C. Choh, Susan P. Fisher-Hoch, Joseph B. Mccormick, David R. Lairson, Belinda M. Reininger

School of Medicine Publications

Purpose: The relationship between engaging in two domains of cancer-preventive behaviors, lifestyle behaviors and colonoscopy screening, is unknown in Hispanic adults. Accordingly, the study examined the association between lifestyle and colonoscopy screening in Hispanic adults along the Texas–Mexico border, where there is suboptimal colorectal cancer prevention.

Methods: Lifestyle behavior adherence and compliance with colonoscopy screening schedules were assessed using 2013–2023 data from the Cameron County Hispanic Cohorta populationbased sample of Hispanic adults living along the Texas–Mexico border. The 2018 World Cancer Research Fund scoring system characterized healthy lifestyle engagement. Multivariable logistic regression quantified the association between lifestyle behaviors and colonoscopy …

Loma Linda Nurse - Vol. 34, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | Jordan Robison Profile

6 | LLUSN Mission Service— A Living Legacy

10 | Steps to a New School

12 | Entry Level Master’s at Murietta

LLUSN HIGHLIGHTS

14-21 | ALUMNI NEWS

22-27 | ACADEMICS

28-33 | HOMECOMING

34-37 | FACULTY UPDATES

Factors Associated With Medication Adherence Among Patients With Attention-Deficit/Hyperactivity Disorder (Adhd), Linh Nguyen, Yen-Chi L Le, Hannah Reygaerts, Todd R Johnson, Cesar A Soutullo

Faculty, Staff and Student Publications

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common behavioral health condition that impacts 5% to 8% of children and 2.5% of adults worldwide. The symptoms of ADHD are effectively managed with medication, yet patients with ADHD may inconsistently take their medication. We assessed medication adherence among patients with ADHD and identified factors associated with medication adherence that may be utilized to optimize adherence.

Method: This is a retrospective, observational study among patients aged 4 years and older with a diagnosis of ADHD at primary care and multispecialty outpatient clinics during May 2021 to May 2023. We assessed sociodemographic characteristics, stratified by …

A Risk-Averse Data-Driven Distributionally Robust Optimization Method For Transmission Power Systems Under Uncertainty, Mehrdad Ghahramani, Daryoush Habibi, Asma Aziz

Research outputs 2022 to 2026

The increasing penetration of renewable energy sources and the consequent rise in forecast uncertainty have underscored the need for robust operational strategies in transmission power systems. This paper introduces a risk-averse, data-driven distributionally robust optimization framework that integrates unit commitment and power flow constraints to enhance both reliability and operational security. Leveraging advanced forecasting techniques implemented via gradient boosting and enriched with cyclical and lag-based time features, the proposed methodology forecasts renewable generation and demand profiles. Uncertainty is quantified through a quantile-based analysis of forecasting residuals, which forms the basis for constructing data-driven ambiguity sets using Wasserstein balls. The framework …

Temporal Eating Patterns And Ultra-Processed Food Consumption Assessed From Mobile Food Records Of Australian Adults, Janelle D. Healy, Satvinder S. Dhaliwal, Christina M. Pollard, Amelia J. Harray, Lauren Blekkenhorst, Fengqing Zhu, Deborah A. Kerr

Research outputs 2022 to 2026

Background/Objective: Temporal eating patterns and ultra-processed food (UPF) consumption have independently been associated with obesity and non-communicable diseases. Little is known about the temporal patterns of UPF consumption, as data is challenging to collect. Temporal data can be extracted from mobile food records (mFRs). The aim of this study was to identify the temporal eating patterns of those consuming UPFs using an mFR. Methods: A combined sample of 243 young (18–30 years) and 148 older (>30 years) adults completed a 4-day mFR. The time of eating was extracted from the mFR image metadata. UPFs were identified using the NOVA …

Effect Of Sdf Application Versus Diode Laser Irradiation On Incipient Carious Lesion’S Progression In Primary Molars: A Randomize Clinical Trial, Islam Yehia, Noha Samir Kabil, Basma Gamal

Dentistry

The present study aimed to investigate the effect of two different preventive measures a) Silver diamine (SDF) application, b) Diode laser irradiation, on caries progression of incipient carious occlusal lesions in primary second molars. This clinical trial included two equal study groups of patients, for applying; Group I: SDF application, Group II: Diode laser irradiation, the included second primary molars for intervention were selected with incipient carious lesions graded by International Caries Detection & Assessment System (ICDAS)with scores (0,1,2). The involved molars were followed up for 3, 6, 12 months and ICDAS scores were graded to check for caries progression …

Effect Of Acid-Containing Drinks On Surface Roughness And Bacterial Accumulation Of Different Types Of Denture Base Materials, Sara Fikry Dr, Ayman Amin, Eman Khedr, Fatma Makkeya

Dentistry

No abstract provided.

Design Of A Maintenance Protocol Based On Bipolar Neutrosophic Analysis For Severe Depression, Karina Alejandra Álvarez Lino

Neutrosophic Sets and Systems

Severe depression has been one of the leading causes of disability worldwide and maintains a high risk of relapses even after successful treatment, especially in medium-sized cities in Latin America. Therefore, this study focused on the design of a clinical maintenance protocol based on Acceptance and Commitment Therapy (ACT), aimed at young adults residing in Ambato, Ecuador, who had previously received Cognitive-Behavioral Therapy (CBT). To this end, a bipolar neutrosophic analysis of depression was conducted to determine the attributes that impact the identified patients and define the design of the proposal. The designed protocol was structured into eight group sessions, …

Risk Prediction In Dental Implants With Bone Substitutes Using A Hybrid Neutrosophic-Logistic Model: Managing Uncertainty In Clinical And Biomechanical Variables, Mónica Sofía Pallo Sarabia, Darwin Josue Cubi Masaquiza, Favio Nicholas Zúñiga Calderón, Luis Acosta Rueda

Neutrosophic Sets and Systems

Predicting risk for bone substitutes when using dental implants is a complicated task as no one can determine all clinical and biomechanical factors that will/may contribute to a successful treatment outcome. Yet the discipline has been establishing various means of prediction through traditional logistic regression. However, many do not acknowledge the unknowns--potential developments of one's biological response or biomaterial characteristics. This work seeks to adjust this issue through a novel approach to traditional logistic regression and neutrosophic logic, which, combined, can calculate levels of certainty, indeterminacy and uncertainty from one dataset. In this example, for example, the variables used for …

Neutrosophic-Logistic Hybrid Model To Evaluate The Effectiveness Of Penitentiary Policies And Their Impact On Criminal Recidivism In Ecuador, Ignacio Fernando Barcos Arias, Jennifer Angelina Almagro Triana, Ariana Michelle Mazacón Campoverde, Jason Guayaquil Cobo

Neutrosophic Sets and Systems

This study aims to develop a hybrid model that combines neutrosophic logic with logistic regression to evaluate the effectiveness of prison policies in Ecuador and their impact on criminal recidivism. The central problem lies in the inefficiency of the Ecuadorian prison system, characterized by high levels of intra-prison violence, deficiencies in rehabilitation and social reintegration programs, and a rising recidivism rate among inmates. This situation is exacerbated by the employment discrimination that ex-offenders face when reintegrating into society, which limits their opportunities and encourages the repetition of criminal behavior. The methodology applied was a mixed approach, with a non-experimental cross-sectional …

Structural Equilibrium In Universities: Quality, Finance And Sustainability From An Empirical Perspective: An Integrative Analysis With Neutrosophic Cognitive Maps, Claudio Ruff, Herminia Gavilán, Juliana Vassileva, Bastián Gutiérrez

Neutrosophic Sets and Systems

This study explores the structural relationships between institutional financial health and academic quality in Chilean higher education institutions (HEIs) by applying multivariate tools such as the dynamic HJ- Biplot and fixed-effects regression models for panel data, complemented by neutrosophic cognitive maps (NCMs). Using data from the 2016–2023 period, differentiated institutional trajectories are analyzed based on their membership in free tuition policies, university type (CRUCH, private), and financial structure. The results show that variables such as student retention, physical infrastructure, and academic training significantly influence key financial indicators such as liquidity, leverage, and operating margin. NCMs reveal degrees of indeterminacy in …

Contributions Of Educational Investment To International Student Mobility: A Multivariate And Neutrosophic Analysis Of Educational Service Quality In Oecd Data, Alexis Matheu Pérez, Roberto Cortés, Alain Carrier, Carlos Sebrango

Neutrosophic Sets and Systems

This article examines the impact of educational investments in higher education on student international mobility from 39 OECD countries between 2013 and 2020 through multivariate statistical analyses and neutrosophic modeling of the SERVQUAL Neutrosophic Model. The findings, based on principal component analysis, biplot conclusions, and multiple linear regressions, suggest that there is a complicated, mixed relationship between investment per student, investment as a percentage of higher education, and part-time employment. However, findings establish that educational investments (in unconditional numbers) have a direct nexus to international mobility, linking biometrics to positive human well-being efforts, sustainability of academic disciplines, and responsible, relative …

Digital Divide In Latin America: A Multivariate And Neutrosophic Delphi Analysis For Inclusion And Public Policy, Cristian Cornejo Gaete, Viviana Tartakowsky Pezoa, Claudio Ruff Escobar, Jaime Zañartu Reyes

Neutrosophic Sets and Systems

This study examines access to digital connectivity in Latin America, highlighting both progress and persistent structural inequalities. In the context of the pandemic, the internet has consolidated its position as an essential tool for daily life, highlighting deep gaps between countries, urban and rural areas, and different socioeconomic groups. Using the graphical multivariate HJ-Biplot method, complemented by a Neutrosophic Delphi approach to model indeterminacies in digital inclusion policies, the research question is addressed: How are Latin American and Caribbean countries grouped according to their level of access to digital connectivity, considering socioeconomic, age, ¿and geographic differences? The hypothesis guiding this …

Predictive Model Of School Dropout In Higher Education Through Learning Analytics With Neutrosophic Plithogenic Hypotheses, David Núñez, Purificación Galindo-Villardón

Neutrosophic Sets and Systems

Higher education dropout rates are an international problem, as many people abandon their studies, especially in the early years. This problem affects institutions, causing significant losses. In this context, it is essential to consider methods that allow for predicting dropout rates and taking rapid and effective measures. Objective: The main objective is to analyze prediction models using Learning Analytics, integrating neutrosophic plithogenic hypotheses, to identify early the risk of dropout in higher education. This provides institutions with useful tools to implement actions that help retain more students, considering uncertainty and complex interactions between academic and non-academic factors. Methodology: The method …