Digital Commons Network^™

Exploring Health Access In Nyalenda, Kisumu County: Barriers To Care, Impact Of Community Health Promoters, And Recommendations For Improvement, Emmanuella Osei

Kenya: Global Health and Human Rights

Access to quality healthcare remains a persistent challenge in informal settlements, where structural, economic, and social barriers shape how and when individuals seek care. This mixed-methods study explored health-seeking behaviors and perceived barriers to accessing healthcare among residents of two community units (Got Owak and Nanga Dunga) in Nyalenda B of Kisumu, Kenya. Quantitative survey data (n=82) were collected from community members complemented by qualitative interviews with two Community Health Promoters (CHPs) to provide deeper contextual understanding. Descriptive findings indicate that long waiting times, high costs of services, and lack of available drugs were the most frequently reported barriers to …

Effects Of The Kcnq (Kv7) Channel Opener Ezogabine On Resting-State Functional Connectivity Of Striatal Brain Reward Regions, Depression, And Anhedonia In Major Depressive Disorder: Results From A Randomized Controlled Trial, Sara Hameed, Yael Jacob, Ramiro Salas, Dan V Iosifescu, Ming-Hu Han, Alan Swann, Sanjay J Mathew, Laurel Morris, James W Murrough

Faculty, Staff and Students Publications

Background: Major depressive disorder (MDD) is a leading cause of disability worldwide, with available treatments often showing limited efficacy. Recent research suggests that targeting specific subtypes of depression and understanding the underlying brain mechanisms can improve treatment outcomes. This study investigates the potential of the potassium KCNQ (Kv7) channel opener ezogabine to modulate the resting-state functional connectivity (RSFC) of the brain's reward circuitry and alleviate depressive symptoms, including anhedonia, a core feature of MDD.

Methods: A double-blind, randomized, placebo-controlled clinical trial in individuals with MDD ages 18 to 65 years compared daily dosing with ezogabine (n= 19) with placebo (n …

Barriers And Best Practices In Diversity, Equity, And Inclusion (Dei) Initiatives: A Case Study From The United States Aerospace And Defense Industry, Jeremy A. Bailey

Doctoral Dissertations and Master's Theses

The main objective of this study was to unpack the barriers around diversity, equity, and inclusion (DEI) initiatives, and then provide best practices to improve DEI efforts in the aerospace and defense (A&D) industry. There has been a multitude of research conducted on DEI in the past few years. However, very little research has focused on DEI practices in the A&D industry. This case study focused on one large company in this industry to explore and understand various aspects of DEI initiative implementation. As organizations strive to meet industry and client objectives, as well as address employee needs, two research …

Biomass Materials And Their Application In 4d Printing, Zhongda Yang, Jian Li, Yanling Guo, Yangwei Wang, Wen Zhao, Wei Zhao, Yanju Liu, Laichang Zhang

Research outputs 2022 to 2026

Four-dimensional (4D) printing technology is a revolutionary development that produces structures that can adapt in response to external stimuli. However, the responsiveness and printability of smart materials with shape memory properties, which are necessary for 4D printing, remain limited. Biomass materials derived from nature have offered an effective solution due to their various excellent and unique properties. Biomass materials have been abundant in resources and low in carbon content, contributing to the then-current global green energy-saving goals, including carbon peaking and carbon neutrality. This review focused on different sources of biomass materials used in 4D printing, including plant-based, animal-based, and …

Montebello Islands Marine Sediment Retains Nuclear Weapons-Derived Radionuclide Contamination 70 Years After Detonations, Madison Williams-Hoffman, Mathew P. Johansen, Piers Larcombe, David P. Child, Michael A.C. Hotchkis, Oscar Serrano, Paul S. Lavery, Sangeeth Thiruvoth, Pere Masqué

Research outputs 2022 to 2026

Three nuclear weapons tests were conducted in the 1950s at the Montebello Islands, an Indian Ocean archipelago in NW Australia. Anthropogenic radionuclides were introduced into the surrounding waters, where little quantification of the marine environment has occurred since. Here, we assess the distribution of anthropogenic radionuclides and plutonium (Pu) atom ratios in marine sediment throughout the Montebello Islands and the Western Australian (WA) coastline. Surface sediment was analysed for ⁹⁰Sr, ¹³⁷Cs, ^{238,239,240,241}Pu and ²⁴¹Am, alongside ²⁴⁰Pu/²³⁹Pu and ²⁴¹Pu/²³⁹Pu atom ratios. The highest activity concentrations in sediment were from ^239,240Pu, …

Co-Designing A Resilience-Based Mentoring Program For Novice Midwives: A Participatory Action Research Approach, Dianne Bloxsome, Tracy Martin, Kaoru Nosaka, Sara Bayes

Research outputs 2022 to 2026

Aim: To co-design a resilience-based mentoring program for novice midwives in Western Australia, informed by the experiences of past midwifery graduates and the perspectives of midwives in senior roles. Background: Effective workforce planning and retention strategies are essential in preventing the continued loss of midwives and in attracting newly qualified midwives to healthcare organisations. Transitioning from student to registered midwife is a known period of vulnerability that requires structured, evidence-informed support. Design: A Participatory Action Research (PAR) approach was adopted to collaboratively develop a mentoring program tailored to the transition needs of newly qualified midwives. Methods: Fourteen participants contributed to …

Understanding Interprofessional Co-Debriefing Practices Within Large Scale Ward-Based Simulation, Melanie Barlow, Robyn Dickie, Alycia Jacob, Shari Maver, Nick Flynn, Alison Blunt, Susan Darzins, Hugh Davies, Michelle Smith-Tamaray, Elisabeth Jacob

Research outputs 2022 to 2026

Background: Despite growing use of interprofessional simulation in healthcare education, there is a lack of published frameworks to guide structured, co-facilitated debriefing between professions. This study explored how nursing and allied health facilitators engage in interprofessional co-debriefing within a large-scale, ward-based simulation program involving over 2000 health students. Methods: Twelve interprofessional co-debriefings were observed and assessed using the debriefing assessment for simulation in healthcare (DASH) tool, with both rater (observer) and instructor (debriefer) versions. Mean debriefing assessment for simulation in healthcare (DASH) scores were compared across five core elements. Qualitative data from instructor short-answer responses and observer field notes were …

Calcium Supplementation And The Risk Of Dementia In The Perth Longitudinal Study Of Aging Women: A Post-Hoc Analysis Of A Randomised Clinical Trial For Fracture Prevention, Negar Ghasemifard, Joshua R. Lewis, Simone Radavelli-Bagatini, Simon M. Laws, Blossom C.M. Stephan, Jonathan M. Hodgson, Kun Zhu, Richard L. Prince, Marc Sim

Research outputs 2022 to 2026

Background: Concerns have been raised around whether calcium supplements increase dementia risk. This post-hoc analysis of a five-year double-blind, placebo-controlled randomised trial of calcium supplements for primary fracture prevention evaluated the long-term risk for dementia in older women, randomised to either calcium supplements or placebo. Methods: 1460 community-dwelling dementia-free Australian women (≥70 years) were randomised to 1200 mg/day calcium carbonate (n = 730) or placebo (n = 730) for five years and were observed for an additional 9.5 years afterwards. Over 14.5 years, all-cause dementia events (comprising dementia-related hospitalisations and/or deaths) were identified from linked health records. The influence of …

Design Of A Robust Adaptive Cascade Fractional-Order Proportional–Integral–Derivative Controller Enhanced By Reinforcement Learning Algorithm For Speed Regulation Of Brushless Dc Motor In Electric Vehicles, Seyyed Morteza Ghamari, Mehrdad Ghahramani, Daryoush Habibi, Asma Aziz

Research outputs 2022 to 2026

Brushless DC (BLDC) motors are commonly used in electric vehicles (EVs) because of their efficiency, small size and great torque-speed performance. These motors have a few benefits such as low maintenance, increased reliability and power density. Nevertheless, BLDC motors are highly nonlinear and their dynamics are very complicated, in particular, under changing load and supply conditions. The above features require the design of strong and adaptable control methods that can ensure performance over a broad spectrum of disturbances and uncertainties. In order to overcome these issues, this paper uses a Fractional-Order Proportional-Integral-Derivative (FOPID) controller that offers better control precision, better …

Knowledge + Innovation = Power: A Protocol For Implementing Aboriginal Data Sovereignty In An Aboriginal Medical Service For Service Delivery Reform, Emma Haynes, Lesley Nelson, Heather D'Antoine, Judith Katzenellenbogen, Elizabeth Armstrong, Lindey Andrews, Jasmin Brown, Nicole Bowser, Roz Walker, Ingrid Stacey, Jessika Purnomo, Dawn Bessarab

Research outputs 2022 to 2026

Context Comprehensive Primary Health Care (CPHC) is an interconnected, holistic, and strengths-based health and wellbeing approach fundamental to Aboriginal Community Controlled Health Organisations (ACCHOs) in Australia. However, policy and funding trends increasingly threaten the capacity of ACCHOs to deliver CPHC by imposing burdensome administrative and accountability requirements. A central constraint is the marginalisation of culturally informed data measures and tools that could enable improved development, implementation, evaluation and reporting of CHPC services and programs. To mitigate this, ACCHOs must be enabled to take charge of collecting and using meaningful data to increase self-determination and drive impactful policy and service delivery. …

Peritoneal Immunosurgery: Immunotherapy Augmented Surgery For The Treatment Of Peritoneal Cancers, Malcolm K Brenner, Alastair M Thompson

Faculty, Staff and Students Publications

Peritoneal malignancy often indicates disruptions in multiple physiological systems resulting from widespread cancer. The heterogenous origin and dynamic nature of peritoneal cancer make it difficult to treat with standard approaches that fit into guidelines. We describe how successful treatment should address the underlying pathology, the systemic response to surgical treatments and target the immune perturbations that facilitate the establishment and propagation of this multifaceted disease.

Exploring Patients' Perceptions Of An Advance Care Planning Intervention In The Emergency Department: A Qualitative Study, Hannah Oelschlager, Lucy Kiernat, Anita N Chary, Anna C Revette, Adrian Haimovich, Smit Desai, Kai-Wei Chang, Shan W Liu, Maura Kennedy, Mara A Schonberg, Kei Ouchi

Faculty, Staff and Students Publications

Objectives: Emergency department (ED) visits offer opportunities for seriously ill patients to formulate future medical care goals, yet ED clinicians lack practical strategies for these conversations. ED GOAL, a behavioral intervention, engages seriously ill yet clinically stable older adults in the ED to address advance care planning (ACP) with their outpatient clinicians. In a randomized trial, goals-of-care documentation was significantly higher in the intervention group compared to controls after three (24.3% vs. 9.9%, p = 0.03) and 6 months (31.4% vs. 12.7%, p < 0.01). This study is a sub-analysis to learn about intervention arm participants' perceived benefits and obstacles of the intervention.

Methods: We conducted semi-structured interviews between October 2022 and August 2024 (N = 52) with intervention-arm patients …

The Value Of Patient Safety Learning Laboratories

Faculty, Staff and Students Publications

No abstract provided.

Plasma Proteome Correlations With Liver Stiffness In Pediatric Cholestasis Implicate Epithelial To Mesenchymal Transition, Sridevi Devaraj, Juliet Emamaullee, Jeremy Schraw, Philip J Lupo, Jorge A Bezerra, Kathleen M Loomes, John C Magee, Ronald J Sokol, Kasper S Wang, Alyssa Kriegmeier, Evelyn Hsu, Jean P Molleston, Philip Rosenthal, Rohit Kohli, Saul J Karpen, Simon P Horslen, M Kyle Jensen, Arianna Barbetta, Cristian Coarfa

Faculty, Staff and Students Publications

Background: Pediatric cholestatic liver diseases can be characterized by rapidly progressive fibrosis. A multicenter cross-sectional analysis of vibration-controlled elastography in biliary atresia (BA), alpha-1 antitrypsin deficiency (A1AT), and Alagille syndrome (ALGS) was leveraged to interrogate the plasma proteome relative to liver stiffness measurements (LSM).

Methods: Slow off-rate modified aptamer scanning profiling of >7000 proteins in plasma from 187 children with BA (n=93), A1AT (n=31), ALGS (n=46), and healthy pediatric controls (n=17) was performed, and correlations with LSM were undertaken.

Results: There was an abundance of LSM correlated proteins (BA n=2720, A1AT n=694, ALGS n=5968). Interestingly, a distinct plasma proteome was …

Cytokine Variations After Positive Oral Food Challenges In Adult-Onset Food Protein-Induced Enterocolitis, Paulina Gallego-Velez, Cristina Sanchez-Fortun, Teodorikez-Wilfox Jimenez-Rodriguez, Francisco Marco De La Calle, Javier Fernandez, Jordi Barrachina

Faculty, Staff and Students Publications

No abstract provided.

Exploring Positive Psychology And Goal Setting In Esports Coaching: A Thematic Analysis Of Professional Fortnite Coaches, Samuel Jaffe, Nigel Jackson, Jonathan Rhodes

School of Psychology

This study investigates how professional Fortnite coaches integrate positive psychology, specifically Seligman’s PERMA (positive emotion, engagement, relationships, meaning, and accomplishment) model and goal-setting frameworks, to enhance player performance and well-being. Through semistructured interviews with 16 esports coaches, the research examines how psychological strategies influence motivation, resilience, and long-term success in a highly competitive, digital coaching environment. Using Braun and Clarke’s reflexive thematic analysis, three key themes were constructed: defining and measuring success, goal-setting practices, and balancing positive versus pressured coaching styles. Coaches defined success beyond tournament outcomes, emphasizing player development, consistency, and psychological resilience. Goal-setting strategies were highly individualized, blending …

Law Grapples With Its Achilles’ Heel? Uncertainties, Digital Experiments, And The Ai Frontier, Heng Wang

Research Collection Yong Pung How School Of Law

The governance of digitalization— which encompasses developments such as artificial intelligence (AI) and central bank digital currencies (CBDCs) — confronts serious challenges. At the core of the challenges are uncertainties, which form the central obstacle to effective governance. These uncertainties range from cyber risks to shifting societal responses. Law, as an institutionalized framework of governance, faces mounting pressure and wrestles with a fundamental vulnerability: traditional legal frameworks struggle to address uncertainties in digitalization.

To tackle the pervasive challenges of uncertainties, this article addresses two connected questions: What uncertainties does law face in governing digitalization shaped by emerging technologies? How can …

Precipitated By The Pandemic: From Remote Witnessing To Electronic Wills, Edward Ti, Hang Wu Tang

Research Collection Yong Pung How School Of Law

The COVID-19 pandemic exposed the rigidity of will-making laws requiring in-person witnessing. Jurisdictions responded differently: some introduced temporary measures, others implemented permanent reforms allowing remote witnessing. This article compares responses in England and Wales, selected Australian states, Singapore, and Hong Kong SAR, tracing developments toward potential recognition of electronic wills. The central argument is that law reform should balance accessibility with safeguards against fraud and undue influence, avoiding overly burdensome formalities that deter compliance. The article concludes by examining how national digital identity systems could be used for the execution of electronic wills.

Interpreting The Private‑ And Public‑Sector Service Criteria For Singapore’S Aspiring Presidential Candidates, Benjamin Joshua Ong

Research Collection Yong Pung How School Of Law

The Singapore President's role is not only ceremonial: from 1991, it has encompassed the substantive function of serving as a guardian of public reserves and the integrity of the public service. A person must meet certain qualifying criteria in order to run in a Presidential election. This article focuses on one set of qualifying criteria, namely, the "service criteria": the requirement that candidates have had certain experience in serving in certain roles in the public sector or the private sector. The service criteria were last amended in 2016, and came to the fore in the 2023 Presidential Election following George …

The Excellent Legal Scholar, Seow Hon Tan

Research Collection Yong Pung How School Of Law

The Excellent Legal Scholar: This article considers how virtues pan out in the life of the legal scholar, bearing in mind the purpose of legal scholarship and the identity of the legal scholar, who plays multifarious roles in today's research landscape. I consider how vision is important for the excellent legal scholar, bearing in mind that an aretaic account should be attentive to eudaimonia. I conclude with soul-searching questions for the legal scholar who endeavours to live an examined life that stands up to aretaic appraisal.

Beneficial Ownership In Domestic Tax Legislation, Some Clarity, But Far From ‘Well Established’: Hargreaves Property Holdings Ltd V Hmrc [2024] Ewca Civ 365, Vincent Ooi

Research Collection Yong Pung How School Of Law

The concept of beneficial ownership is extensively used in domestic tax legislation, but several decades ofinconsistent case law have muddied the waters as to exactly what it means. With the leading casesstopping short of the apex court, it is difficult to reconcile the cases and come up with a clear definition ofbeneficial ownership. The recent Hargreaves decision by Falk LJ (with whom Nugee and Peter JacksonLJJ agreed) represents the most structured judicial attempt to rationalise the concept to date. This notesuggests that, contrary to Falk LJ’s statement that the concept is ‘well established’, the law pre-Hargreaveswas far from clear. This …

Integrating Demand Forecasting And Deep Reinforcement Learning For Real-Time Electric Vehicle Charging Price Optimization, Monowar Mahmud, Tarek Abedin, Md Mahfuzur Rahman, Shamiul Ashraf Shoishob, Tiong Sieh Kiong, Mohammad Nur-E-Alam

Research outputs 2022 to 2026

The rapid growth of electric vehicles (EVs) demands efficient, grid-friendly charging systems. This study introduces a dynamic pricing framework combining short-term demand forecasting and deep reinforcement learning. Using Adaptive Charging Network (ACN) data, XGBoost predicts charging demand accurately (R² = 0.84, MAE = 0.45 kW). Compared to a uniform rate applied to all charging usage, set at 0.15 USD/kWh across all hours, with no adjustment for system demand conditions or time-of-day, the optimized strategy enhanced total daily revenue by 133 % and diminished load variance by 72.37 %. The PPO agent also surpassed traditional Time-of-Use and demand-based pricing models …

Morphometric Analysis Of Spina Bifida After Fetal Repair Shows New Subtypes With Associated Outcomes., L K Mann, S Pandiri, N Agarwal, H Northrup, K S Au, Elin Grundberg, E P Bergh, M T Austin, R Patel, B Miller, S Zhu, J S Feinberg, D Lai, K Tsao, S A Fletcher, R Papanna

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The binary classification of spina bifida lesions as myelomeningocele (with sac) or myeloschisis (without sac) belies a spectrum of morphologies. This study aimed to characterize types of spina bifida lesion and correlate them with preoperative presentation and postoperative outcome.

METHODS: This was a secondary analysis of a prospective cohort of patients referred for fetal spina bifida who underwent fetoscopic repair between 2020 and 2023 at a single center. We evaluated lesion morphology on high-resolution intraoperative images and videos to categorize lesions based on placode exposure and nerve root stretching. The reproducibility of lesion classification was assessed using the Kappa …

“A Blessing And A Curse”, Danielle M. Davidov, Caterina Defazio, Desireé N. Williford, Emily R. Clear, Heather M. Bush, Ann L. Coker

Biostatistics Faculty Publications

Purpose: Examining the influence of policy change and socio-political factors is paramount for contextualizing and addressing sexual violence. The purpose of this paper is to provide findings from a secondary qualitative analysis of the impacts of national and local high-profile events on the dialogue and actions surrounding violence prevention and response on college campuses. Methods: Data from mcBEE, a Centers for Disease Control and Prevention-funded project exploring the adoption and implementation of violence prevention programming on multiple college campuses in the United States were used for this analysis. Data include responses from 60-min telephone interviews with key informants (i.e., campus …

Alternative Polyadenylation Contributes To Fibroblast Senescence In Pulmonary Fibrosis, Scott D Collum, Rene A Girard, Hydia Puente, Seung-Hee Yoo, Rahat Hussain, Jayeshkumar Patel, Manish Patel, Eric J Wagner, Hari Krishnayalamanchili, Harry Karmouty-Quintana, Zheng Chen, Tingting Mills

Faculty, Staff and Students Publications

Idiopathic pulmonary fibrosis (IPF) is a prevalent and deadly age-related disease characterized by chronic, progressive, and irreversible fibrosis. A key effector cell population in the fibroproliferative response is the fibroblasts. Fibroblast cell senescence gradually worsens during aging, and the acquisition of a senescence-associated secretory phenotype (SASP) turns senescent fibroblasts into pro-inflammatory cells. However, the mechanism promoting senescence in IPF, especially at the post-transcriptional level, is poorly understood. We recently discovered that Nudix Hydrolase 21 (NUDT21, also named CFIm25), an RNA-binding protein, plays a critical role in regulating the expression of SASP factors through alternative polyadenylation (APA). APA allows adding poly(A) …

Is Bedtime Use Of Kratom (Mitragyna Speciosa) A Sleep Aid Or Disruptor? Examining Its Daily Effects And Individual Differences, Christopher D Verrico, Ynhi T Thomas, C Austin Zamarripa, David H Epstein, Kirsten E Smith

Faculty, Staff and Students Publications

Kratom (Mitragyna speciosa) is a psychoactive botanical native to Southeast Asia increasingly used in the U.S. for various self-reported benefits, including sleep improvement. However, empirical evidence concerning kratom’s effects on sleep is limited. Here, we examined the association between bedtime kratom use and self-reported sleep outcomes in naturalistic settings across consecutive days, while also exploring sex and chronic pain status as potential moderators. A secondary analysis was conducted using the data from a 15-day ecological momentary assessment (EMA) study of 357 U.S. adults who reported regularly using kratom. Participants made daily reports of their bedtime kratom use and …

Vascular Video Ipsilateral Hybrid Repair Of A Combined Type Ib And Iii Endoleak After Fenestrated-Branched Endograft And Bilateral Iliac Branch Endoprosthesis, Bernardo C Mendes

Faculty, Staff and Students Publications

No abstract provided.

Nonexposed Endoscopic Full Thickness Resection Of Residual Disease After Definitive Chemoradiation For Locally Advanced Gastric Cancer, George Chen, Yvonne H Sada, Wasseem Skef

Faculty, Staff and Students Publications

Salvage endoscopic resection of residual esophageal neoplasia for patients that prefer to avoid surgery or are poor surgical candidates has been reported. We report a case of gastric signet ring cell carcinoma with residual disease after definitive chemoradiotherapy, that was treated with nonexposed endoscopic full thickness resection. This endoscopic resection achieved negative margins, with postresection surveillance endoscopy and imaging showing no evidence of disease. This case highlights the potential use of salvage endoscopic resection as a therapy for residual gastric cancer after chemoradiation in patients where surgery is not an option.

Neuroleukemiosis Masquerading As Drug Toxicity In An Adolescent With Refractory Aml, Jill Ann Jarrell, Alexandra Rodriguez-Hernandez, Sandra Aziz, Karen K Moeller, Joanna S Yi, Suzanne Woodbury, Andrea N Marcogliese, Zoann E Dreyer, Eric S Schafer

Faculty, Staff and Students Publications

No abstract provided.

Unravelling The Distinct Effects Of Vhl Mutations And Chromosome 3p Loss In Clear Cell Renal Cell Carcinoma: Implications For Prognosis And Treatment, Lang Wu, Cheng Chao

Faculty, Staff and Students Publications

No abstract provided.