Digital Commons Network^™

Apea: A Type 1 Diabetes Self-Management Ambient-Ai Assistance Tool That Bridges Trajectory Prediction, Interactive Explanation, And Just-In-Time Adaptive Intervention Action., Kun-Yi Chen, Erin M. Tallon, Chi-Ren Shyu

Manuscripts, Articles, Book Chapters and Other Papers

Helping patients self-managing diseases like type 1 diabetes (T1D) requires informatics tools delivering real-time predictions with explainable, actionable guidance. However, many healthcare AI solutions lack actionable recommendations and user-friendly explanations, limiting clinical impacts. We introduce APEA, a pediatric T1D self-management Ambient-AI assistance tool, integrating glucose multi-trajectory-scenarios Prediction, interactive, context-aware large language model Explanations, and just-in-time adaptive intervention policy optimization for Actionable real-time suggestions through reinforcement learning. Using T1DEXIP dataset (262 pediatric T1D patients, multi-center), our results showed improved glucose control outcomes: 45% over human management, 69% over infusion-pump management. Although constrained by small sample size and …

Early Neonatal Admissions With Feeding Difficulties To Acute Paediatric Services At A Tertiary Paediatric Hospital In England: Sequential Audits Pre-Covid-19 And During The Covid-19 Pandemic, Kalvin Lee, Thomas Frederick Dunne, Mary Masoud, Hayley Gleig, Heidi Stott, Helen Nabwera, Halina Kamarova

Centre of Excellence in Women and Child Health

Introduction: Our objective was to describe the population of infants < 7 days of age admitted to the acute general paediatric services at Alder Hey Children’s Hospital and ascertain the proportion with feeding difficulties amenable to community-based support.

Methods: Sequential retrospective audits of all infants < 7 days of age admitted to acute paediatrics at Alder Hey Children’s Hospital, Liverpool, England, from March to September 2019 (pre-COVID-19) and March to September 2020 (during COVID-19). All the infants were born and discharged from maternity units in Merseyside, Northwest England. Anonymised data were extracted from the electronic clinical records by three members of the clinical team.

Results: Pre-COVID-19, 38.6% (93) of the 241 admissions to acute general paediatric services had feeding difficulties. 31.2% (29) presented solely with feeding difficulties and 31.2% (29) were exclusively breastfed. However, during COVID-19, although there were fewer admissions (104), more than half (51%, 54) had feeding difficulties and for 54% (29), this was the only reason for admission. Over half (53.7%, 29) were exclusively breastfed.

Conclusion: Our audits showed that at least a third of infants < 7 days of age admitted with feeding difficulties did not have any other features of severe illness. These admissions unnecessarily expose infants to hospital-acquired infections while disrupting the opportunity for families to build close and loving relationships that enhance the establishment of breastfeeding. Co-designing infant feeding strategies with the mothers and stakeholders will be a crucial next step to enhance infant feeding support, particularly in impoverished communities in the region.

“Now That The Baby Is Out, I Can Be Vaccinated”: A Qualitative Study On Covid-19 Vaccine Hesitancy In Pregnant Women In Kilifi, Kenya, Angela Koech, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Richmond Mdindi, Peter Mwangome, Rachel Craik, Marianne Vidler, Mai-Lei Kinshella, Marleen Temmerman

Centre of Excellence in Women and Child Health

COVID-19 vaccines are safe and effective in pregnancy, but vaccine hesitancy limits uptake and effectiveness. This study explored COVID-19 vaccine hesitancy in pregnancy in Kilifi, coastal Kenya, to elicit reasons for vaccine hesitancy and acceptance, and to compile misconceptions around vaccination in pregnancy. Twenty-three in-depth interviews were conducted with pregnant women, mothers who had given birth in the previous 2 years and health workers (community health promoters, nurses, and supervisors). Data were analyzed using thematic template analysis based on the Vaccine Hesitancy Determinants Matrix. Concern about vaccine safety for the unborn baby was a major driver of hesitancy. Many pregnant …

The Comparator Argument In Trans-Healthcare Ban Cases, Craig Konnoth

UC Law Journal

As states have increasingly restricted gender affirming care for minors across the nation (reinforced by a recent Executive Order by President Trump), and though the Supreme Court ruled on one such state ban, a powerful argument has largely been overlooked. This argument emphasizes the fact that transgender minors are not alone in receiving gender affirming care. Cisgender minors also receive such care for precisely the same reasons as transgender minors— unwanted breast tissue development, undesired hair growth, unusual vocal development, and puberty onset. Indeed, cisgender children receive such care at higher numbers than trans children, and many of the medications …

A Case Against Mass Deportation: The Japanese American Internment Camps And Recent Treatment Of Korematsu, Isaac Bloch

UC Law Journal

The large-scale deportation of non-citizens has become a preeminent policy issue. Unfortunately, executive curtailment of immigrant communities’ liberty is not without historical parallels. During World War II, federal officials sent individuals of Japanese descent to internment camps through a series of executive orders and military proclamations. Although attorneys in the Department of Justice believed aspects of these actions were unconstitutional at the time, the administration prevailed at the nation’s highest court. Can recognition of this past wrong aid challenges to contemporary immigration enforcement regimes? How do our courts formally account for the most egregious jurisprudential errors of the past, and …

The Effects Of A Viniyoga-Based Practice On Mental Health Clinicians' Perceived Stress, Burnout, And Quality Of Life, Julie Pate

Dissertations

Psychotherapists often experience stress when treating distressed or emotionally troubled patients due to the emotionally taxing nature of their work, which can lead to burnout and other negative consequences (Bell et al., 2023; Maslach & Leiter, 2016; Simionato & Simpson, 2018) Therapists find it challenging to maintain regular self-care routines (Driscoll, 2023; Baker & Gabriel, 2021; Posluns & Gall, 2020). With the constant demand for counselors (Bureau of Labor Statistics, U.S. Department of Labor, 2024), there is a critical need for effective stress management strategies to mitigate burnout risks (Substance Abuse and Mental Health Services Administration [SAMHSA], 2022; Sibitz, Pils, …

Finding Luis: A Creative Nonfiction Account Of Law & Society, Jason M. Leggett

Dissertations, Theses, and Capstone Projects

This essay explores the contradictions in legal theory and human experience through creative nonfiction. Its main purpose is to argue that a truly just society requires acknowledging the profound influence of individual narratives on the law. This is supported by blending personal narratives, critical analysis, and philosophical inquiry to reveal the gap between codified law and lived realities for marginalized individuals. This unique Legal Poetics methodology employs a series of six vignettes, such as the author's and Luis's shared experiences with traumatic brain injury and the denial of justice, as data. By integrating autoethnography, law as narrative, and performativity theories, …

Towards Ecological Validity When Assessing Adhd Symptoms: Patterns In Automatically Collected, Real-World Pc Activity Data, Matheus B. Da Costa, Elizabeth S.M. Chan, Joshua Langberg, Isabelle Cuber, Fatemeh Jamalinabijan, Aleksander Kurgan, Thomas Fritz, David C. Shepherd

Department of Psychology Faculty Scholarship and Creative Works

Neuropsychological tests assessing attention and executive function (EF) in individuals with ADHD demonstrate little to no association with real-world ratings of ADHD behaviors. To address this critical gap, this study developed metrics that can analyze automatically collected data to measure levels of attention, motivation, and effort in emerging adults with ADHD. Specifically, we used virtual reality to simulate a study space and collect in-the-moment computer activity data while university students with ADHD (N = 21; 38% female) engaged in 12 sessions (total 180 h) of real-world tasks. To identify common sequences we performed a qualitative analysis of this work session …

Imagined Nations: Ireland, Palestine, And The Politics Of Anti-Colonial Memory, Grace P. Wingerter

Armstrong Undergraduate Journal of History

This paper covers the life and career of notable IRA operative Brendan “the Dark” Hughes and how his thoughts on the “Armed Struggle” or “Cause” changed over time. Brendan Hughes was forced to frequently deal with violent and heavy handed discrimination from Protestants, which led to him joining the Paramilitary movements as a result of frustration and misplaced youthful vigor. Brendan played a major role in the Troubles through his planning of prolific violent attacks such as the Four Square Laundry attack, Bloody Friday, and the H Block blanket protest and subsequent hunger strike in the Maze Prison. Brendan’s disconnect …

Voices In Transit: Intersectionality, Silence, And Political Engagement In Ride-Sharing, Soran Tarkhani

Commonwealth Review of Political Science

Abstract This study examines Uber as a digitally governed “third space” for political discourse. Based on 4,716 ride observations from Louisville–Southern Indiana—3,676 collected in 2023–2024 and 1,040 in 2025—it uses a mixed-methods design combining multinomial logistic regression and qualitative observation. Political conversations are defined as discussions of parties, elections, policies, or major social issues. Results show that White and male passengers were most likely to initiate such talk, while African American and female riders often remained silent, consistent with Noelle-Neumann’s spiral of silence. African American women faced the strongest intersectional constraints. Women and LGBTQ passengers leaned liberal, while men displayed …

Bare-Knuckled Public Service: Donald Rumsfeld’S Political Ideology Before The War On Terror, Chris Paskewich

Commonwealth Review of Political Science

Abstract Donald Rumsfeld (1932-2021) is perhaps most well known for being Secretary of Defense under President George W. Bush. However, he had a nearly fifty-year career in public and private sector work at the highest levels. Research into his political ideology, especially prior to his time under Bush, has never been undertaken. This article outlines Rumsfeld’s ideology for the first time, and shows it is a distinct strain of limited-government conservatism that I term “managerial conservatism.” Managerial conservatism aims to manage public resources well, maximize the gains from the public’s tax dollars, and make sure the federal government is only …

Engineering Enac Constructs To Examine Pip2 And Ubiquitin Competition On Enac Regulation And Stability, Lacie Johnson

Chemistry & Biochemistry Undergraduate Honors Theses

The epithelial sodium channel (ENaC) plays a critical role in sodium homeostasis, fluid balance, and blood pressure regulation. ENaC activity is tightly controlled by post-translational mechanisms, including ubiquitination-mediated degradation and phosphatidylinositol 4,5-bisphosphate (PIP2) dependent channel activation. PIP2 is a phospholipid necessary to facilitate the maximal channel opening. Previous studies suggest that intracellular PIP2 binding sites are located in proximity to ubiquitination sites on ENaC subunits, raising the possibility of PIP2 binding to influence channel stability and function. This thesis aimed to engineer and validate molecular tools capable of examining the interplay between PIP2 binding and ubiquitination in ENaC regulation. A …

Bridging Policy And Grassroots Action With Technology: A Framework For Civic Engagement In Environmental Sustainability, Mikhail Ola Adisa, Sonny Rosenthal, Shola Oyedeji, Ifeoma Adaji, Jari Porras

Research Collection College of Integrative Studies

Grassroots and civic organizations are increasingly recognized as “middle actors” in sustainability, leveraging ICT-driven solutions to bridge top-down policies with bottom-up citizen engagement and behavioral change. This study examines how civic organizations in Finland and Singapore integrate digital tools to support sustainable waste management practices aligned with Sustainable Development Goals 11, 12, and 17. Guided by a Design Science Research (DSR) approach and drawing on Middle-Out and multi-level governance theories, we developed and validated the Integrated Sustainability Engagement Framework (ISEF) based on interviews with 21 civic organizations and iterative feedback. Findings highlight the central roles of policy translation, localized practices, …

The Affective Economy Of Toxic Atmospheres: Sensory Governance, Ecological Intelligences And The Performative Politics Of Urban Mosquito Management, Orlando Woods, Creighton Connolly

Research Collection College of Integrative Studies

This paper considers how atmospheres can play a powerful role in troubling the management of nature in the multispecies city. It brings the cyclical nature of atmospheric effects, the affective values and il/logics that determine human responses to non-human threats, and the misguided and potentially deleterious health outcomes that ensue into one analytical frame. Drawing on the empirical case of urban mosquito management in Singapore, it considers how the creation of toxic atmospheres through fogging – blowing insecticides into the air in a bid to kill mosquitoes – is ineffective and sets in motion a cascading series of socio-environmental consequences. …

Cartels As Foreign Terrorist Organizations? How Mexican Americans Think About U.S. Security Policy, Jesus J. Garcia-Gomez

Dissertations, Theses, and Capstone Projects

This thesis examines the political, social, and security implications of the U.S. government’s designation of cartels as Foreign Terrorist Organizations (FTOs), with a particular focus on its effects on U.S.–Mexico relations and Mexican American communities. While existing research has extensively analyzed counterterrorism and cartels, there is still an open debate regarding the justification to designating cartels as FTOs. Additionally, there is a gap in the scholarship focus on Mexican American communities’ opinion. This study addresses both gaps by analyzing how terrorism labels reshape security cooperation, legal authorities, and public perceptions of cartels, violence, and drug addiction in Mexico and the …

The Radical Political Possibilities Of Asexuality And Aromanticism, Kirty Singh

Dissertations, Theses, and Capstone Projects

This study explores the radical political potential of Asexuality and Aromanticism within queer theory, emphasizing their roles in destabilizing normative constructs of sexuality and romantic relationships. Employing mixed methods, including literature review, digital ethnography of online communities, and analysis of graphic narratives, the research examines how these identities challenge systemic systems such as compulsory sexuality, amatonormativity, and racialized discourses. Findings reveal that Asexual and Aromantic communities utilize flexible definitions and taxonomies to assert their identities, disrupt hegemonic gender and sexual norms, and foster coalitional politics that advocate for systemic change. The study underscores the importance of recognizing Asexuality and Aromanticism …

Development Of The Active Participle Denoting Ongoing Aspect In Heritage Speakers Of Levantine Arabic In The Us, Reem Kanjawi-Faraj

Dissertations, Theses, and Capstone Projects

This study investigated the acquisition, development, and productivity of اسم الفاعل “ism il-fA؟el”, Active Participle (AP) when denoting ongoing aspect in the comprehension and production of heritage speakers (HSs) of Levantine Arabic (LA^[1]).  Ongoing aspect is mainly realized in Arabic by an inflected imperfective verb preceded by a progressive particle (PROG.V) and in certain cases b AP. Our study is comprised of four sub-studies: a Syrian Levantine Arabic (SLA) adult corpus analysis (production of PROG.V and AP/ CACeC template); a cross-sectional LA child heritage comprehension and production experiment (PROG.V and AP/ CACeC template) ; a longitudinal study of …

Species-Dependent Gazing Behavior Of Emotional Facial Expressions In Dogs (Canis Familiaris) And Adult Humans (Homo Sapiens)., Heini Törnqvist, Gray S. Atherton, Liam Cross, Sanni Somppi, Jarkko Hautala, Miiamaaria V. Kujala

School of Psychology

Emotional expressions play an important part in social communication of dogs and humans, but comparative studies between dogs and humans are rare. In addition, little is known about how emotions are perceived across species and how attention is divided among different parts of faces. Here, we compared the gazing behavior of dogs and adult humans toward emotional dog and human facial expressions. Dogs mostly gazed at the eye and nose areas, whereas the humans’ focus also included the mouth area. The gazing behavior of both species was affected by the facial expressions and species presented, and they gazed at emotional …

Youth Development Programs Critical Analysis, Rethinking Real Sustainability Measures. Focus On Middle-Eastern And African Contexts., Rasha As Salem

Theses and Dissertations

Abstract Using a systematic review of 18 research papers, policy documents, and evaluation reports, the study examines youth development programs sustainability through four aspects. First, the review explores how definitions of marginalized youth are applied in Middle East and African contexts. Furthermore, the review focuses on how programmatic suitability is discussed and implemented through the concepts of localization and contextualization. Additionally, the importance of locally grounded evidence as much as rigorous evidence and finally the implementation tactics. The review uses frameworks of ecological systems theory and empowering management approaches to analyze the data. The findings reveal significant variation in how …

“Language Learners As Ethnographers: A Case Study On A Pedagogical Approach To Developing Intercultural Communicative Competence”, Nihal El-Gameel

Theses and Dissertations

Despite the extensive theoretical models and frameworks for Intercultural Communicative Competence (ICC), pedagogical approaches to teaching culture remain underexplored. This study examined the effectiveness of integrating a pedagogical framework—the OSEE framework developed by Deardorff (2000)—within a language classroom context. Using a mixed-methods approach, data were collected through audio-recorded reflections, a questionnaire, an interview, and a final project video presentation in a single-case study design. Data analysis followed Miles and Huberman’s (2014) model of qualitative analysis, employing a funneling approach tailored to each research question: the first applied Chen and Starosta’s ICC model (1996;1999) the second used deductive thematic analysis to …

Assessing The Effectiveness Of A Habit Recording Tool To Improve Mental Health Of University (Auc) Students, Noran Nounou

Theses and Dissertations

Introduction: According to previous research, the mental health of university students has become an alarming public health concern worldwide. Most of the mental disorders begin among young adults, attributed to the transition to university and increased financial and societal pressure. Despite the important effect of daily habits on mental health, there still remain research gaps in Egypt in exploring their effect among university students and exploring the potential opportunities to support their well-being. Objectives: To assess depression rates among AUC students and to evaluate the effectiveness of a newly designed habit recording board, Make an Impact (MAI) to improve depression …

Legal Reform And Cultural Resistance: Examining The Role Of Law And Custom In Ending Fgm In Egypt, Souhaila Hafez Abo Seada

Theses and Dissertations

This thesis examines the persistent gap between legal reform and social practice in efforts to end Female Genital Mutilation (FGM) in Egypt. Although FGM has been criminalized since 2008, with stronger penalties introduced in 2016 and 2021, the practice continues, revealing the limits of law when it operates alongside powerful social, religious, familial, and medical norms. Using a qualitative case-based approach grounded in legal pluralism and Feminist Critical Discourse Analysis, the study draws on 11 semi-structured interviews with participants from civil society, religious institutions, the legal profession, the medical sector, and communities where FGM persists, alongside legislative, demographic, and documentary …

Reaching The People: Prosocial Witnessing And The Church, Karl G. D. Bailey

Faculty Publications

No abstract provided.

Exploring The Process Of Professional Identity Development For Generation Z Counselors-In-Training Enrolled In Cacrep-Accredited Master's Programs In The Northeastern United States Coun, Jordan G. Shaw

Dissertations

Professional identity development is a central outcome of counselor preparation programs, yet how Counselors-in-Training (CITs) experience this process, particularly during internship, remains underexplored. This qualitative study examines the lived experience of professional identity development among Generation Z CITs enrolled in master’s programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) in the Northeastern United States, with specific attention to the implications for counselor education and supervision in a shifting professional landscape.

Using an existential-phenomenological framework and Interpretive Phenomenological Analysis (IPA), in-depth semi-structured interviews were conducted with participants born between 1995 and 2010 who were completing …

Perceptions Of Game-Based Assessments: The Role Of Test Takers' Occupational Background, Marie L. Ohlms, Klaus G. Melchers, Filip Lievens

Research Collection Lee Kong Chian School Of Business

Game-based assessments (GBAs) have become increasingly popular in personnel selection. However, research on perceptions of GBAs has yielded mixed results, highlighting the need to explore variables that may shape perceptions of GBAs. Therefore, we examined whether test takers' occupational background and other person-related characteristics (i.e., gender, age, video game usage, openness to experience) are associated with their perceptions of GBAs. N = 179 individuals from technical and social occupational backgrounds rated their perceptions of GBAs and non-gamified tests. We found that GBAs were generally rated more positively than non-gamified tests in terms of organizational attractiveness, behavioral intentions toward the organization, …

Impact Of The Lace Index Scoring Tool On Sepsis Readmissions, Tabitha M. Keaty Sheppard

Electronic Theses and Dissertations

Sepsis is a life-threatening medical emergency that negatively affects patients and healthcare organizations worldwide. Consequently, sepsis survivors are presented with even greater health risks following acute hospitalizations, and the financial implications on healthcare organizations increase with each patient readmission. This quality improvement project studied the impact of the LACE Index Scoring Tool on sepsis readmissions within a single healthcare organization in the southern region of the United States. Per quality metric data, sepsis readmissions have remained a prevalent issue at the project site. The purpose of this doctoral project was to reduce 30-day sepsis readmissions following the implementation of the …

Longevity, Resilience, And Thriving Of Women In Ministry: A Case Study Of Women In Ministry From A United Pentecostal Holiness Church, Eunice Cheryl Feltus Little

Electronic Theses and Dissertations

Abstract

The problem of ministry attrition caused by burnout is well documented. Research attributes the impact of burnout on the resilience, longevity, and thriving of ministry workers to role-related stress and adversity. High attrition rates throughout religious organizations and a lag in longevity and resilience contribute to a shortage of ministry workers. Some ministry workers leave the vocation because of stress and burnout, yet others persevere. Despite the possible adverse effects, many men and women find a sense of well-being and joy in ministry work. This qualitative distributive case study focused on those who stayed in ministry and the strategies …

Leader Rounding For Outcomes To Improve Employee Retention, Laura R. Escobar

Electronic Theses and Dissertations

Intention to leave a nursing staff position, if not addressed, may lead to an increased rate of nursing turnover. High turnover rates can negatively affect staffing patterns, increase organizational costs, and disrupt the continuity of patient care. A quantitative quasi-experimental pre-/posttest design was used to evaluate the impact of the High Reliability Organization Leader Rounding for Outcomes tool to reduce the intent-to-leave scores, as measured by the Turnover Intention Scale (TIS-6), compared to current practice over 12 weeks. Implementation of the tool provided a structured leader rounding process designed to strengthen communication, recognize staff contributions, and proactively identify workplace concerns. …

Patient Wait Time And Throughput Interventions In The Cardiology Outpatient Setting, Chioma Ohiri Tawose

Electronic Theses and Dissertations

Healthcare collaboration and patient care require effective communication. Poor communication impacts wait time. Inadequate communication in the outpatient cardiology clinic can lead to disruptive patient throughput, or workflow, and extend patient length of visit. The purpose of this project was to implement a means of communication for clinicians and healthcare assistants to improve patient flow and cut down idleness, ultimately reducing patient wait time. The project established the incorporation of a built-in electronic health record communication notification system, the Event Button, for asynchronous communication between staff. A quantitative quality improvement design was used to conduct this project. Inferential and descriptive …

Cybersecurity Threats In Public Transit Systems, Jodi Godfrey, Gennaro Saliceto

CUTR Internal Grant Research Program

Public transit agencies are increasingly reliant on digital systems, making cybersecurity a critical component of operational safety and reliability. This study examines how transit agencies detect, assess, and mitigate cyber threats within a rapidly evolving technological environment, with a specific emphasis on rural transit environments. Through a comprehensive literature review and a national survey of transit agency representatives, the research identifies both advancements in cybersecurity practices and persistent challenges that hinder sector-wide resilience.

Survey findings reveal that many agencies have adopted foundational protections such as layered defense strategies, risk assessments, and security awareness training; however, significant gaps remain in advanced …