Digital Commons Network^™

The Revolving Door Of Epilepsy Emergencies, Sarah Lennard

School of Health Professions Theses

This thesis explores the revolving doors of epilepsy emergencies, focusing on the key factors that contribute to repeated attendances at emergency departments (ED) following seizures. The study is based on five peer-reviewed journal articles that provide a comprehensive review of current evidence, risk factors for ED attendance, clinicians' perspectives, and the use of technology in epilepsy management. The research identifies several critical factors influencing ED attendances, including mental health issues, medication adherence, and social determinants such as deprivation and homelessness. The findings highlight the need for integrated care pathways, improved communication between healthcare providers, and targeted interventions for vulnerable populations. …

A Critical Exploration Of Social Transformation Through Occupation, Miranda Cunningham

School of Health Professions Theses

Background: In occupational therapy and occupational science, scholars and practitioners advocate for a stronger focus on social transformation. However, there is limited evidence on how occupation-based interventions contribute to addressing inequalities and fostering change for marginalised populations. Methods: This study applied critical occupational science and realist theoretical frameworks to examine the use of arts-based occupations for social transformation. It comprised three strands: (1) a narrative review of arts-based occupations in social change, (2) a realist review of participatory photography, and (3) a realist evaluation of a socially engaged art group in primary schools. Findings: Arts-based occupations have been employed by …

Investigating The Link Between The Oral Microbiome And Cardiovascular Health In Regards To Nitrate/Nitrite Metabolism., Lisa Du Toit

School of Health Professions Theses

This thesis evaluated nitrate metabolism and the link between cardiovascular health and periodontal disease. The first study compared effects of high-nitrate vegetables and pharmacological salt supplementation on the oral microbiome composition in hypertensive individuals. Seventy participants (50-70-y-old, clinical systolic BP (SBP) 130-159 mmHg, diastolic BP (DBP) <110 mmHg) were randomly allocated to group 1 (n = 24) consuming 300 mg/d nitrate in green leafy vegetables form, group 2 (n = 23) consuming 300 mg/d potassium nitrate in form of pills and low-nitrate vegetables, and group 3 (n = 23) consuming potassium chloride pills (placebo) and low-nitrate vegetables. Groups 1 and 2 showed similar microbial salivary changes, increased Neisseria species, and decreased Veillonella species post treatment, suggesting nitrate-dependent changes.The second study investigated oral health and microbiome composition of pregnant women with pre-eclampsia (n = 10, SBP = 150 ± 8 mmHg, DBP = 98 ± 9 mmHg) compared to normotensive pregnancies (n = 11, SBP = 111 ± 5 mmHg, DBP = 80 ± 9 mmHg). Pregnant women with pre-eclampsia showed higher plaque levels compared to normotensive pregnant women (P = 0.038), although activity of oral nitrate-reducing bacteria (P = 0.088) was not statistically significant. Plasma nitrate levels were significantly were lower in women with pre-eclampsia (P = 0.024). The third study evaluated the effect of chlorhexidine (CHX-M n= 21) and propolis (PROP-M n= 24) mouthwashes on abundance and activity of nitrate-reducing bacteria in healthy individuals. CHX-M increased relative abundance of nitrate-reducing bacteria (P < 0.001), but significantly impaired nitrate-reducing activity (P < 0.001) compared to baseline and PROP-M. PROP-M significantly increased plasma nitrate levels (P = 0.047) and reduced systolic BP (P = 0.022).The fourth study compared the effect of CHX-M, PROP-M, amoxicillin (AMX) and metronidazole (MTZ) on salivary nitrate-reducing activity within a 24-hour period using an in-vitro protocol. Results showed that MTZ significantly increased nitrate-reducing activity after 24-hours (P = 0.001) compared to all the other treatments (AMX, P = 0.025; CHX-M, P = 0.01; PROP-M, P = 0.023). Overall, this thesis suggests that poor oral health may impair the oral nitrate–nitrite pathway, thereby reducing nitrate bioavailability in women with pre-eclampsia. Diets rich in high-nitrate vegetables showed beneficial changes in the oral microbiome; however, these were not associated with blood pressure reduction. In contrast, use of propolis mouthwash increased plasma nitrate bioavailability, contributing to blood pressure reductions. Finally, it was observed metronidazole significantly enhanced nitrate-reducing activity.

Factors Affecting Metabolism And Metabolic Control In Phenylketonuria, Alex Amorim Pinto

School of Health Professions Theses

Phenylketonuria (PKU) is an inherited metabolic disorder treated by a phenylalanine restricted diet in order to avoid neurocognitive impairment. Blood phenylalanine is the main outcome marker which is modulated by many dietary factors. Traditionally, L-amino acid-based protein substitutes are the main nitrogen source but more recently glycomacropeptide-based protein substitutes (GMP) have been introduced and are associated with several health benefits. The following aspects were studied in this thesis: 1) metabolic control achieved in patients with PKU compared with the European PKU guidelines; 2) life-long change in natural protein tolerance; 3) impact on metabolic control of different natural protein sources (animal …

Trajectories Of Post Intensive Care Syndrome In Children During First Six Months Post-Discharge., Pei Fen Poh, Rehena Sultana, Joseph C. Manning, Matt Carey, Jos Latour

School of Nursing and Midwifery

Background and Aims: Health outcome trajectories in critically ill children remain poorly described. We aimed to examine the trajectories of post-intensive care syndrome within six-months post-pediatric intensive care unit (PICU) discharge.Methods: Data were collected upon PICU admission, discharge and at 1-, 3-, and 6-months post-discharge using the Pediatric Quality-of-Life scale (PedsQL™), Young Child PTSD Screen, and Functional Status Scale. Group-based trajectory modelling was used to identify distinct longitudinal health outcome trajectories.Results: 135 children completed follow- up and were categorised into three trajectory groups based on their health outcomes. Theme an (SD) age was 5.6(5.5) years, with PIM III score of …

Empowerment Of Parents In The Intensive Care: A Multicentre Validation Study In Japan, Yujiro Matsuishi, Joseph C. Manning, Haruhiko Hoshino, Yuki Enomoto, Ikkei Munekawa, Ryo Ikebe, Masanori Tani, Naoko Tanaka, Bryan J. Mathis, Nobutake Shimojo, Yoshiaki Inoue, Jos M. Latour

School of Nursing and Midwifery

Background: The importance of assessing family satisfaction in paediatric intensive care units (PICUs) is becoming increasingly recognised. The survey, EMpowerment of Parents in THe Intensive Care “EMPATHIC-30”, was designed to assess family satisfaction and has been translated and implemented in several countries but not yet in Japan. Objectives: The objective of this study was to translate, culturally adapt, and validate the EMPATHIC-30 questionnaire in Japanese and to identify potential factors for family-centred care satisfaction. Methods: We translated and adapted for patient-reported outcome measures via a 10-step process outlined by the Principles of Good Practice. Four paediatric PICUs in Japan participated …

Effectiveness And Safety Of Intravenous Iron Therapy In Outpatient Obstetrical Clinic For Treatment Of Iron-Deficiency Anemia During Pregnancy, Ellen M. Murrin, Olivia S. Lebeau, Lillian Singer, Mark A. Kassab, Peyton Kalan, Julie Costanzo, Scott A. Sullivan, George L. Maxwell, George R. Saade, Antonio F. Saad

Department of Obstetrics & Gynecology Faculty Publications

Background

Iron-deficiency anemia (IDA) affects over one-third of pregnant patients globally, contributing to severe maternal morbidity and adverse neonatal outcomes. Oral iron supplementation, while cost-effective, is limited by poor absorption, significant gastrointestinal side effects, and poor adherence. The use of intravenous (IV) iron addresses many of these concerns, including eliminating GI side effects and the need for daily therapy. However, administration of IV iron in pregnant patients is typically restricted to specialized infusion centers or hospitals due to concerns about acute side effects, cost, resource utilization, the need for fetal heart rate monitoring, and extended infusion times.

Methods

This descriptive …

Llms Enhance Emotional Expression While Maintaining Analytical Depth In News Writing, Samuel Mazzone, Jonah Harlan, Larry Zhiming Xu, Terence T. Ow

Management Faculty Research and Publications

As the impact of generative artificial intelligence (GenAI) becomes increasingly evident in automated journalism, leveraging its potential while mitigating the risks becomes a priority in research. To address this need, our study evaluated the performance of large language models (LLMs) in news writing. We tested 11 LLMs by having them rewrite headlines and content from articles published by Milwaukee Neighborhood News Service (NNS) between 2011 and 2023. The analysis and comparison of 3,623 human-written and 39,853 AI-adapted news pieces showed that different LLMs consistently enhanced emotional expression in headlines (Cohen’s d = .33) and in news content (Cohen’s d = …

The Office Of The South Dakota Senate President Pro Tempore, Lee Schoenbeck

South Dakota Law Review

The South Dakota Senate’s history, challenges, and processes, as carried out by the office of the President Pro Tempore, have never before been collected in one place. This article does that and is designed to be a guide for future legislators as they lead and strengthen the institution of the South Dakota Senate.

Reactive Power Potential: A Contribution Of Hydropower For The Energy Transition, Michael Bohlinger

Plymouth Business School Theses

The growing challenges of climate change and the urgent need to reduce carbon emissions make Germany’s Energy Transition a crucial step in addressing these global issues. Climate change, driven largely by rising CO₂ levels, demands a swift shift to renewable energy to minimise its impact on the environment and society. At the same time, the gradual phase-out of conventional power plants presents significant challenges for the electricity grid, especially in terms of expanding the network and ensuring its reliability. This study explores the critical role of hydropower plants in stabilizing the energy system. In addition to generating renewable energy, hydropower …

Investigating The Impact Of Human Resource Practices On The Experiences Of Nigerian Seafaring Officers: An In-Depth Analysis Of The Shipping Industry In Nigeria, Mariah Adeboboye

Plymouth Business School Theses

The maritime industry, a critical component of Nigeria's economic infrastructure, relies heavily on the expertise and dedication of its seafaring officers. Drawing on motivation and commitment theories, this study offers a thorough analysis of the prevalent shipping industry practices within the Nigerian setting, exploring the complex effects of human resource practices on the experiences of Nigerian seafaring officers. Taking a pragmatic ontological position supported by a mixed-methods approach, this study combined qualitative interviews with forty-five seafaring officers, six former seafaring officers and six maritime industry Human Resource managers, alongside crosstabulation analyses of 174 seafaring officer’s questionnaire responses. This study examines …

The Eastern Mediterranean Sea Energy Diplomacy: The Case Of Lebanon 2012-2022, Hoda Taktak

Plymouth Business School Theses

This thesis explores the geopolitical implications of energy discoveries in the Eastern Mediterranean Sea (EMS) region, with a particular focus on Lebanon's role within this complex dynamic. The research examines how energy governance, security challenges, and regional conflict and cooperation shape Lebanon's ability to leverage its energy resources from 2012 to 2022. Through interviews with thirty top professionals in the field, the study offers an in-depth examination of the evolving geopolitical and geoeconomic dynamics resulting from maritime boundary disputes, regional tensions, and Lebanon’s energy potential.While energy discoveries in the EMS region present significant opportunities, Lebanon faces challenges in unlocking its …

An Analysis Of Container Port Performance In Lower-Middle-Income Countries; A Case Study Of Nigeria Container Ports, Caleb Danladi

Plymouth Business School Theses

Container ports play a vital role in international trade, facilitating the movement of goods and supporting economic development. However, much of the research focus has been on high-income countries, with limited attention given to the performance of ports in LMI countries.This study investigates the performance of container ports in LMI countries, with a specific focus on Nigeria’s container port operations from 2001 to 2012, using a mixed-methods approach. The research is divided into two phases. In the first phase, a two-stage analysis is employed. First, a non-parametric Data Envelopment Analysis (DEA) and the Malmquist Productivity Index (MPI) are used to …

Tourists’ Immersive Experiences At Dark Tourism Destinations: The Role Of The Spiritualist Medium, Andrew Fry

Plymouth Business School Theses

While immersive experience and dark tourism are established fields, little research has examined how spiritualist mediums shape belief-led, emotionally resonant encounters at historically charged sites. This thesis addresses that gap by investigating how mediums influence emotional engagement, interpretive depth, and perceptions of authenticity. Centred on Bodmin Jail’s After Dark Event, the study adopts a sequential mixed-methods design and integrates quantitative patterns with qualitative mechanisms through joint QUAN–QUAL displays. Findings show that mediumship helps convert arousal into reflective meaning through ritual participation, atmospheric design, and interpretive trust. Anticipated theatricality heightened arousal and “staging” attributions, yet felt authenticity was sustained when the …

A Computational Approach To The Game Of Cycles, Jocelyn Garcia, Mike Janssen, Eliza Kautz

Faculty Work Comprehensive List

In Mathematics for Human Flourishing, Francis E. Su introduced The Game of Cycles, a game played on a finite simple planar graph. In game play, opponents alternate adding direction to the edges of the graph with the goal of creating a cycle or making the last legal move. Recent work has sought to determine winning strategies on certain classes of graphs. We introduce a tabular representation of a game state and provide a computer program that determines which player has a winning strategy on any legal game board. The program builds a directed graph of all possible game states, utilizing …

Reproductive Innovation And Reproductive Exceptionalism: How Private Health Insurance Coverage Of Fertility Treatment Complements Hostile Governmental Action And Expands Access To Assisted Reproduction In The United States, Myrisha S. Lewis

Faculty Publications

The use of fertility treatment and assisted reproductive technology (ART) in the United States and globally is increasing over time. As of April 2023, the World Health Organization estimates that approximately one in six individuals have faced infertility globally. Fertility treatment includes the use of drugs to stimulate egg production, in vitro fertilization (IVF), and, for some, the use of gestational surrogacy to aid in childbirth. Debates have abounded and continue to abound in federal legislatures, state legislatures, and society more broadly about the morality of abortion, contraception, and assisted reproduction, as well as whether governments, public insurers, and private …

Parenting Support Groups Outcomes, Christina Howell

Graduate Research Papers

According to the American Psychological Association 48% of parents find their stress to be completely overwhelming as compared to 26% of other adults. Sixty percent of parents struggle to focus, and 41% of parents report feeling so stressed that they cannot function (American Psychological Association (APA), 2024). In this study three questions are addressed 1) Are Online parenting support groups successful at supporting caregivers and children? 2) What are the outcomes for caregivers and their children when their caregivers participate in parenting support groups? 3) Are parenting support groups successful at supporting caregivers who have experienced trauma? The findings of …

Bringing Self-Determination Theory To The Forefront: Examining How Human Resource Practices Motivate Employees Of All Ages To Succeed, Rick A. Laguerre, Janet L. Barnes-Farrell

Management Faculty Research and Publications

Self-determination theory (SDT) is widely used in human resource (HR) practice studies to explain how HR practices impact work outcomes. However, there is little empirical evidence establishing the complete SDT mediational process in the HR domain, which entails basic psychological needs and motivation acting as mediators of relations between HR practices and work outcomes. The present study addresses this issue with a mixed methods approach. Using an item classification task with subject matter experts (N = 48), HR practices were classified as autonomy-, competence-, and relatedness-supportive. Based on this scheme, we tested an SDT-based conceptual model in a three-wave …

Weatherford: Undergraduate Catalog 2025-2026, Southwestern Oklahoma State University

Undergraduate Catalogs

No abstract provided.

Balancing Risk And Reward: Health Insurance And The Financial Stability Of Female Entrepreneurs With Children, Leeanne Lowe Aguilar

Electronic Theses and Dissertations

This study examines the specific influence of health insurance on female entrepreneurs with children, a demographic that has been underexplored in existing research on health insurance and entrepreneurship. The aim is to evaluate whether access to health insurance significantly affects these entrepreneurs' business decisions, financial stability, and overall well-being.

Grounded in job-lock theory and evidence of the gender gap, the research hypothesizes that health insurance enhances entrepreneurial performance, particularly benefiting women with children. It anticipates that female entrepreneurs will encounter more significant challenges than their male counterparts and that those with children may face additional performance barriers, especially when lacking …

Conversion Of Orange Waste To Chemically Modified Activated Carbon Adsorbent Materials For Aqueous Phase Phosphate Removal, Sierra Mugan

Electronic Theses and Dissertations

Phosphorus pollution in surface waters drives harmful algal blooms, creating ecological, public health, and economic risks. This study examined citrus processing waste as a sustainable, low-cost precursor for producing chemically modified adsorbents for phosphorus removal. Orange waste was pyrolyzed, resulting in a carbon-rich material with low ash content, as confirmed by thermogravimetric analysis. The material was modified using lanthanum chloride, iron (III) chloride, and calcium chloride at varying mass ratios and screened under standard conditions (1 mg P/L, 1 g/L dosage, 24-hour contact time). Lanthanum- and iron-modified samples demonstrated the best removal efficiencies and underwent further evaluation. The lanthanum-modified sample …

A Unified, Data-Informed Model For Shoreline Evolution Due To Longshore And Cross-Shore Processes, Mark Davidson, Emily Hunt, Nieves Valiente

School of Biological and Marine Sciences

Due partially to a changing global climate, there is an increasing need to develop a modelling approach capable of providing warnings of coastal evolution, including erosion at storm, interannual and decadal timescales and in complex coastal settings. This research presents a reduced complexity model with a common approach to predicting shoreline change due to cross-shore and longshore processes. The model architecture is designed to be flexible and data-informed, incorporating an Extended Kalman (eKF) for the assimilation of field measurements of shoreline change. Depending on the values of the optimised model free parameters resulting from the eKF assimilation, the longshore and …

The Effect Of Exercise Training On Blood Lipids: A Systematic Review And Meta-Analysis, Neil A. Smart, David Downes, Tom Van Der Touw, Swastika Hada, Gudrun Dieberg, Melissa J. Pearson, Mitchell Wolden, Nicola King, Stephen P.J. Goodman

School of Biomedical Sciences

Background: Dyslipidemia is a primary risk factor for cardiovascular disease (CVD). Exercise training (EXTr) improves some lipid markers but not others; the literature is dated and analyses may be underpowered. Objectives: To clarify which lipid markers are altered with ExTr and establish if information size had yet reached futility. Methods: We conducted a systematic review/meta-analysis, with meta-regression, to establish expected effect size in lipid profile with aerobic (AT), resistance (RT) and combined (CT = AT + RT) ExTr. We conducted trial sequence analysis (TSA) to control for type I and II error and establish if information size had reached futility. …

A Self-Sustaining Autonomous System For Long-Term Arctic Monitoring, Wenqiang Xu

Electronic Theses and Dissertations

The accelerated melting of Arctic sea ice poses critical challenges to global climate stability, marine ecosystems, and navigation safety. To address the need for continuous, high-resolution monitoring of the Arctic environment, this dissertation explores the development and feasibility of a Self-sustaining Autonomous System (SAS) for long-term Arctic observation. The proposed system is designed to overcome the limitations of traditional fixed or drifting buoys, as well as the range and endurance constraints of drones and Autonomous Underwater Vehicle (AUV)s, by utilizing a Small Waterplane Area Twin Hull (SWATH) Unmanned Surface Vehicle (USV) as a core observation platform. The wind-powered SWATH harnesses …

Naming Abilities In Aging Monolinguals And Bilinguals: Longitudinal Analyses Of The Multilingual Naming Test, Kyara Y. Velez

Electronic Theses and Dissertations

Individuals who can speak more than one language may score lower than monolinguals on verbal naming tasks. The Multilingual Naming Task (MINT) is a 32-item assessment that is used at the Alzheimer’s Disease Research Center in the USA. This study looks at the impact of monolingualism and bilingualism on language abilities over three years in three clinical groups (cognitively normal, mild cognitive impairment, and dementia), using the MINT as a measure. The results show that bilingual individuals perform worse on the MINT than monolinguals at each time point, after controlling for demographic factors; however, there is no difference between language …

Ethnozoological Insights For Wildlife Conservation: Exploring Past & Present Uses Of Wild Animals Among Kenya’S Ethnic Groups, Anita Zahra Field

Electronic Theses and Dissertations

Kenya’s conservation efforts lack adequate involvement of local communities, who play a vital role as people who use the natural resources. These communities also have limited access to, and benefits from, these resources, highlighting the need for greater inclusivity. Therefore, I used ethnographic interviews to elicit relational values that can potentially increase understanding between all stakeholders. My objective was to explore the historical and contemporary uses of wild animals among diverse ethnic groups, examining any changes over time and identifying the catalysts driving these shifts. I interviewed 30 individuals from 10 ethnic groups in Laikipia, Samburu, Marsabit, and Kwale counties, …

Graduate Catalog 2025-2026, Southwestern Oklahoma State University

Graduate Catalogs

No abstract provided.

Protocol For Development And Validation Of An Early Intervention Device And Its Influence Using Structured Early Physiotherapy (Preemiestep) Intervention On Neuromotor Development In Preterm Infants, Indira D. B. Naidu Boddapati, Sivakumar Gopalakrishnan, Sonia Khurana, Jayashree Purkayastha, Bhaskar Bhatt, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Early physiotherapy interventions for Moderate to Late Preterm (MLP) infants often lack continuity of care from hospital to home settings. This research aims to develop an Early Intervention (EI) device for home program and determine its influence using STructured Early Physiotherapy (Preemie STEP) intervention in MLP infants. For phase I, qualitative interviews will be conducted with healthcare professionals and parents, to understand user needs on developed prototype. Based on identified needs, an EI device will be developed using a human-centered design approach and iterative design process. In phase II, usability and validity of EI device will be …

Functional Outcome Of Radial Head Replacement And Lateral Ulnar Collateral Ligament (Lucl) Repair In Terrible Triad Injuries Of The Elbow: Can Associated Type I Coronoid Fractures Be Neglected?, Ansarul Haq Lone, Azad Ahmad Shah, Nadeem Ali, Imtiyaz Hussain Dar

Digital Journal of Clinical Medicine

Introduction: Type III coronoid fractures associated with terrible triad injuries of the elbow joint should always be stabilized. However, management of type I and type II fractures is debatable. In this study, we evaluate the functional outcome of neglecting type I coronoid fractures associated with terrible triad injury.

Methods: This prospective study was conducted on 20 patients with a type I coronoid fracture in terrible triad fracture dislocations of the elbow. All the patients were managed by radial head replacement and repair of the lateral collateral ligament without any fixation of the coronoid fracture. All the patients were evaluated clinically …

Adult Attention Deficit Hyperactivity Disorder: A Case Report, Anju Abraham, Kishor M, Bhawna Sharma

Digital Journal of Clinical Medicine

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that manifests in both childhood and adulthood. It is characterized by core symptoms such as inattention, hyperactivity and impulsiveness and impairment persisting into adulthood. Adult ADHD often coexists with other disorders including mood disorders, anxiety disorders, and substance use disorders, which complicate its diagnosis. Adults with ADHD may struggle with difficulties in focusing, organization, planning and impulsivity making it hard to sit still during exams or complete tasks efficiently. Restlessness, verbal outbursts and intrusiveness can strain relationships. These challenges impact academics, interpersonal relationships and daily functioning. Thus, there is a need …