Implementing Cbt-I Coach App Education During Initial Psychiatric Evaluations At The Va Pec: A Provider-Facing Quality Improvement Initiative, Sarah J. Kang

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project aims to increase provider implementation of gold standard insomnia treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I), by integrating CBT-I Coach app education into initial psychiatric evaluations within a VA psychiatric emergency clinic (PEC).

Background: Insomnia is highly prevalent among veterans and commonly co-occurs with PTSD, depression, and anxiety. National guidelines from the VA, DoD, and American Academy of Sleep Medicine endorse CBT-I as first-line treatment. Despite this, pharmacotherapy is the dominating intervention in psychiatric emergency settings. The CBT-I Coach app offers evidence-based CBT-I as a free, VA-developed digital tool, but it remains underutilized in acute …

Enhancing Primary Care Provider’S Knowledge And Use Of Long-Acting And Oral Naltrexone In The Management Of Opioid And Alcohol Use Disorder, Ariana Juarez-Moncada

Doctor of Nursing Practice Final Manuscripts

Abstract

Objective: This evidence-based project aimed to enhance primary care provider knowledge and prescription rates of naltrexone and long-acting injectable (LAI) naltrexone in a community healthcare setting.

Background: Naltrexone and LAI naltrexone pharmacotherapy is shown to reduce use of alcohol and opioids and improve client retention in patients with alcohol use disorder (AUD) and opioid use disorder (OUD) (Bahji et al., 2020; Morley et al., 2024; Murphy et al., 2022).

Methods: A 30-minute in-service was provided to 14 family practice providers at the clinic. The prescription rate of naltrexone and LAI naltrexone was evaluated for the baseline period of February …

Empowering Recovery: Implementing Ace Screenings To Enhance Care For Patients With Substance Use Disorders, Joshua Wolf

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project evaluated the impact of implementing adverse childhood experience (ACE) screenings for patients with substance use disorders (SUDs) in an outpatient community behavioral health clinic.

Background: ACEs are strongly associated with an increased risk of developing SUDs, chronic medical comorbidities, and negative treatment outcomes. Despite consistent evidence supporting the need for identification of ACEs and implementing trauma-informed care, standardized ACE screening is not routinely incorporated into outpatient SUD treatment, potentially limiting the identification of the need for education and referrals.

Methods: The ACE Questionnaire for Adults was implemented during routine psychiatric visits for patients diagnosed with …

Deep Cuts: Bearing Witness To The Erosion Of Evidence, Maya Lakshmi Srinivasan Md

Masters Theses

In my Master of Fine Arts thesis in Printmaking at the Rhode Island School of Design, I examine the intersection of my dual practices as a general surgery resident and artist. Both disciplines require precision, incision, and tactility to navigate the human condition. My art practice is a method of processing the emotional toll of surgical training and the simultaneous societal erosion of scientific authority. My thesis work focuses on challenging the rise of medical pseudoscience and anti-intellectualism. The focal piece in this installation, In Tallow We Trust, consists of three woodblock relief prints at the scale of an …

Intimate Partner Violence Screening And Awareness Pilot Project, Eleasha P. Partner

Doctor of Nursing Practice (DNP) Projects

Background: In the United States, one in four women experiences intimate partner violence (IPV), highlighting the critical need for improved screening and intervention within the healthcare system. Routine visits in healthcare settings present a significant opportunity for healthcare providers to identify and address IPV.

Local Problem: A primary care family practice clinic in San Leandro, California , currently lacks a standardized evidence-based screening toolkit for IPV.  The absence of such a toolkit creates a gap in practice, leaving patients at risk of undiagnosed IPV and its related consequences.  To address this gap, there is a pressing need for the development …

Staff Education To Emergency Department Professional Nurses, Florence Chukwuneke Chukwuneke

Walden Dissertations and Doctoral Studies

No abstract provided.

Slouching Towards Inefficiency? The Cardiometabolic And Cognitive Costs Of Poor Posture, Ava Mae Fitzenrider

Honors Projects

Posture affects all of our lives. It is both static and dynamic, adapting continuously to environmental demands. One postural alteration frequently observed in occupational settings is hyperkyphosis, which can be induced by sitting position. During computer use, individuals commonly adopt a slouched posture, which can exacerbate hyperkyphosis, and contribute to dis-ease within the body. Previous research has demonstrated that such postural deviations can negatively affect pulmonary function, as well as other bodily functions. Despite these findings, the effects of acute hyperkyphosis (“slouching”) on cardiometabolic function and cognition remain largely unexplored. Therefore, the purpose of this study was to examine the …

Advancing School-Based Sexual Reproductive Health Education Through A Fifth-Grade Educator Toolkit, Emira Romero

Doctor of Nursing Practice (DNP) Projects

Background: Although sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion, educators remain underprepared to deliver this education. Local Problem: A gap analysis conducted at School A, a public elementary school in the San Francisco Bay Area, revealed the absence of a SRH curriculum for their fifth graders. Methods: A Doctor of Nursing Practice (DNP) student-led quality improvement project to introduce a SRH educator toolkit to increase educator confidence and self-efficacy was conducted at School A among fifth grade teachers. Pre- and post-intervention data were collected on implementation day to evaluate the …

Standardizing Preoperative Screening: A Color-Coded Triage Tool Quality Improvement Project, Lyn Green

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Ambulatory surgery centers (ASCs) require effective preoperative screening to ensure appropriate patient selection and minimize day-of-surgery (DOS) cancellations, which affect patient safety, operational efficiency, and financial performance.

Local Problem: In a Northern California ASC serving a racially diverse, predominantly older-adult population with a high burden of chronic diseases, the DOS cancellation rate was 3.84%, exceeding the 2.3% institutional benchmark. Inconsistent preoperative screening contributed to avoidable cancellations.

Methods: A pre- and post-intervention quality improvement design evaluated the effect of a standardized screening tool and staff education on DOS cancellations.

Interventions: The Preoperative Stoplight Tool, a color-coded triage system classifying …

Psychological Strain And Infrastructure Deficit And The Decision To Migrate Among Healthcare Workers From Lagos, Nigeria, Fatima Adeboye

Walden Dissertations and Doctoral Studies

No abstract provided.

Soft Power, Arab Media And Sports Mega Events: Coverage Of Fifa 2022 And Lessons For Future Arab Hosting, Lynne Kennedy, Maaira Shahbaz, Ala Al Rajabi

All Works

Sport mega-events (SMEs) increasingly transcend athletic competition, functioning as strategic instruments for national identity formation, statecraft, and soft power projection. This dynamic is particularly pronounced in the Gulf, where Qatar’s successful hosting reignited regional rivalries and attracted unprecedented global scrutiny. While existing scholars have extensively examined Western media portrayals of SMEs, a notable gap remains for academic engagement with Gulf media. Dismissed as state-controlled and analytically lacking, we contend that such media offer a rich site for exploring how small states use media as soft power, to construct and contest legitimacy, identity, and global influence. This analysis suggests how state-aligned …

Staff Education On Timely Lab Result Notification And Documentation, Ekaete Eyara

Walden Dissertations and Doctoral Studies

No abstract provided.

Waterway: A Steam-Based Therapeutic Device System, Mingyuan Dong

Masters Theses

Across history and global cultures, water has played a central and often spiritual role in practices of care, from cleansing rituals to saunas and steam therapies. Yet, within contemporary product design, water is typically treated as a utility rather than as an experiential material capable of shaping perception, attention, and well-being. This thesis, Waterway, investigates how water, specifically in its steam state, can be designed as both a therapeutic medium and a ritualized experience that engages the body and mind.

Waterway proposes a steam-based wellness system that addresses physical pain and somatic discomfort while cultivating slower, more attentive interaction. Rather …

Somatic Prosthetics For Planetary Resonance, Disha Dharesh Kumar R

Masters Theses

This thesis investigates how industrial design can transcend extractive technological paradigms in favor of relational interfaces that foster planetary attunement. Framing the climate crisis as a 'crisis of imagination', the research challenges the Western bifurcation of nature and culture by drawing on Indic cosmologies- which recognize stones, plants, and ecosystems as conscious at different levels and participants in a shared cosmic field. By synthesizing research in Biosemiotics, Quantum Information Pansycishm, and Neuroscience, the project redefines intelligence as a distributed, more-than-human phenomenon.

The research materializes as a speculative design artifact: a device that functions as a somatic prosthetic for planetary resonance. …

Structured Sbar Shift Report Education For Improved Handoff Communication, Tatayana Smith

Walden Dissertations and Doctoral Studies

No abstract provided.

Why Theory Matters In Infant And Toddler Practice: Unpacking Pikler, Gerber, Gesell, Piaget, & Vygotsky, Derrick Toups

Spark! Innovations in Early Childhood Education: A Research-to-Practice Journal for Educators

This article is intended to help infant and toddler educators deepen the why behind the what and how of their daily interactions by unpacking and connecting the seminal early childhood theories of Pikler, Gerber, Gesell, Piaget, and Vygotsky, what they look like in the classroom, and why they benefit children.

Enhancing Medical Student Readiness To Provide Care For Youth Involved In The Juvenile Justice System, Tara Rahmani, Noah Kos, Kristen Bartow, Sospeter Machani, Jonathan Hakim, Elyse Vanderwoude, Anastasia Sahu, Abigail Schuch, Jennifer Mendez Ph.D, Laura Benjamins Md,Mph, Faap, Aahivms, Anupama Devara, Adeel Khan D.O.

Medical Student Research Symposium

Title

Enhancing Medical Student Readiness to Provide Care for Youth Involved in the Juvenile Justice System

Authors

Tara Rahmani, Noah Kos, Kristen Bartow, Sospeter Machani, Jonathan Hakim, Elyse VanderWoude, Anastasia Sahu, Abigail Schuch, Jennifer Mendez, Ph.D, Laura Benjamins, MD, MPH, Anupama, Devara, MD, Adeel Khan, DO

Background

Youth involved in the juvenile justice system face profound health inequities with higher rates of mental health needs, substance use, and trauma. Despite this, medical students rarely receive preparation to work in correctional health settings. Prior research has shown that youth in detention often exhibit behaviors shaped by past trauma and neglect, which …

Vaccine Communication Through A Global And Local Health Lens, Ivan Kyagaba, Sydni B. Rosenfeld, Shridula Kotakondla, Sarah M. Okeke, Maria F. Pacheco Martinez, Muhammed Zahriyeh, Danielle J. Santoyo, Atta Illahi, Jennifer Mendez, Anupama Devara, Michal T. Ruprecht

Medical Student Research Symposium

Background:

Public trust in vaccines has plummeted. Physicians serve as trusted voices in their communities, so they should be trained to communicate vaccine science effectively. Tailored communication training can help medical students develop adaptable skills for diverse clinical situations. Vaccine inaccessibility in conflict-affected regions differs from vaccine hesitancy in the Global North. This study examines the impact of medical communication education on medical students’ understanding of immunization challenges in conflict zones and their readiness to communicate confidently with patients domestically.

Methods:

A medical communication curriculum was modeled on the impact of missed vaccinations in underserved communities. The curriculum included one …

Comparing Injury Incidence Between Major League Soccer And The English Premier League During The 2024/2025 Season: A Retrospective Cohort Study, William Gadbois, Youssef Salama, Kevin Reck, Scott Mohamed El-Sayed Yaekle

Medical Student Research Symposium

Background

Major League Soccer (MLS) and the English Premier League (EPL) differ substantially in geographic footprint, travel requirements, competition structure, and scheduling. These structural differences may influence player injury risk, yet no study has directly compared injury incidence between the two leagues within the same competitive season. In 2024, MLS introduced a centralized, standardized injury-reporting system that improved transparency and created a unique opportunity for direct comparison with the EPL.

Methods

This retrospective cohort study will analyze all reported time-loss injuries during the 2024 MLS and 2024–25 EPL seasons. Injury data will be collected from publicly available league reports, club …

Staff Education To Standardize Suicide Risk Assessment Across All Patients, Ebiere Erukanure

Walden Dissertations and Doctoral Studies

No abstract provided.

Evidence-Based Approaches To Managing Adolescent Aggression, April Dade

Walden Dissertations and Doctoral Studies

No abstract provided.

Electronic Research Notebooks And Partnership Checklists: Fostering Cultured Collaboration In Evidence Synthesis Projects Using Labarchives And Swirl-Sr, Gary Kaplan, Mslis, Ahip, Abby Adamczyk, Mlis, Ahip, Emmett Booth, Mlis, Ahip, Stephanie Roth, Mlis, Ahip

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Background

Librarians providing evidence synthesis services often face project management challenges, from tracking progress on search strategy development to clarifying team roles. Librarians have a variety of tools to address these challenges.¹ We propose using electronic lab notebooks (ELNs), which standardize how scientists record research progress. Institutions have adapted ELNs to protect intellectual property and improve rigor and reproducibility.

Although many published systematic reviews report following guidelines such as PRISMA, they still lack rigor and reproducibility.² Therefore, one of the authors developed the Standards for Working with Research Librarians-on Systematic Reviews (SWiRL-SR) checklist to facilitate collaboration and improve …

Community Engagement To Rebuild Confidence In Public Health, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Co-Occurring Clonal Hematopoiesis Exhibits Strong Selection And High Leukemia Risk, Kara M Barnao, Irenaeus C C Chan, Duc Tran, Yin Cao, Kelly L Bolton, Et Al.

2020-Current year OA Pubs

Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have …

Improving Graft-Versus-Host Disease Documentation Through Provider Education On An Epic-Based Gvhd Documentation Flowsheet, Emily Shearon

Doctoral Projects

Graft-versus-host disease (GvHD) is a common and serious complication following allogeneic hematopoietic stem cell transplantation (HSCT). Accurate documentation of GvHD severity and management is essential for clinical decision-making, interdisciplinary communication, and regulatory reporting to organizations such as the Foundation for the Accreditation of Cellular Therapy (FACT) and the Center for International Blood and Marrow Transplant Research (CIBMTR). Despite the availability of structured documentation tools within the electronic health record (EHR), their utilization is often inconsistent. The purpose of this quality improvement project was to evaluate whether a targeted provider-focused intervention could improve completion rates of a standardized GvHD documentation flowsheet …

Axitinib-Pembrolizumab And Adverse Event Management In Patients With Advanced Renal Cell Carcinoma, Neil Shah, Yaa Ababio, Anthony Eccleston, Dharanija Rao, Scott Kelly, Jane Chang, Sarah Lucht, Caleb Paydar, Bryce Van Doren, Emily Bland, William John, Sarah Giegerich, Jalyna Laney, Bruce Feinberg, Kevin Zarrabi

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Understanding approaches to managing treatment-related adverse events (AEs) in immunotherapy and tyrosine kinase inhibitor-based treatments in a clinical setting is critical for reaching optimal patient outcomes.

OBJECTIVE: To investigate the management of AEs in community practices during first-line axitinib plus pembrolizumab therapy for advanced renal cell carcinoma (aRCC).

DESIGN, SETTING, AND PARTICIPANTS: This study comprised a cross-sectional electronic physician survey and a multisite, retrospective cohort study of the medical records of US patients with aRCC who initiated first-line axitinib-pembrolizumab between April 22, 2019, and January 31, 2024. Data were analyzed from September 18 to December 20, 2024.

EXPOSURE: First-line …

Titanium Dioxide: An Inquiry Into The Mechanisms And Implications Of Exposure In Gut Dysbiosis And Metabolic Disorders, Meghan Gardiner

Senior Honors Theses

Titanium dioxide (TiO₂) is one of the most prevalent food additives utilized in commercial products in the United States. While TiO₂ was originally hailed as a nontoxic and cost-effective additive, studies are beginning to reveal that TiO₂ is not as safe as it once seemed. TiO₂ may contribute to the development of insulin resistance and metabolic disorders through direct and indirect mechanisms. The compound induces gut dysbiosis, leading to alterations in bacterial metabolites and pro-inflammatory cytokines, which results in the selective resistance of glucocorticoid receptors. Additionally, TiO₂ itself can translocate from the gut to …

Co-Occurring Clonal Hematopoiesis Exhibits Strong Selection And High Leukemia Risk, Kara M Barnao, Aubrey K Hubbard, Irenaeus C C Chan, Weiyin Zhou, Yasminka A Jakubek, Giulio Genovese, Wendy S W Wong, Rebecca L Kelly, Corey D Young, Derek W Brown, Wen-Yi Huang, Neal D Freedman, Kristine Jones, Amy Hutchinson, Belynda Hicks, Duc Tran, Donna Arnett, Kathleen C Barnes, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, April P Carson, Daniel I Chasman, Michael H Cho, Pinkal Desai, Margaret F Doyle, Myriam Fornage, Xiuqing Guo, Nancy Heard-Costa, Marguerite Ryan Irvin, Andrew D Johnson, Sharon L R Kardia, Charles Kooperberg, Daniel Levy, Joshua P Lewis, Yun Li, Ruth J F Loos, Taralynn M Mack, Rasika A Mathias, Braxton D Mitchell, Kari E North, Nathan Pankratz, Patricia A Peyser, Michael H Preuss, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Albert V Smith, Jennifer A Smith, Adrienne Stilp, Yin Cao, Paul Scheet, Alexander P Reiner, Alexander G Bick, Stephen J Chanock, Paul L Auer, Kelly L Bolton, Mitchell J Machiela

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have …

The Perijunctional Zone Is A Molecularly Distinct Muscle Subdomain Altered In Duchenne Muscular Dystrophy, Seth G Haddix, Chuansheng Zhang, Yanhong Liu, Juan Oses-Prieto, Alma L Burlingame, Matthew N Rasband

Faculty, Staff and Students Publications

The neuromuscular junction (NMJ) is a well-established model for synapse development, structure, and function. Surrounding the NMJ is a narrow perijunctional zone (PJZ), enriched in muscle-specific voltage-gated sodium channels that prevent synaptic fatigue. Despite this role, the PJZ remains poorly characterized. To determine its molecular composition, we engineered mice to express the biotin ligase TurboID fused to the cell adhesion molecule neurofascin (Nfasc), and that localizes to the PJZ through ankyrin scaffolding proteins. Using proximity proteomics, we identify numerous PJZ-associated proteins, including Perilipin 4 (Plin4), that are highly enriched and clustered at the PJZ. We also perform proximity proteomics on …

Using The Socio-Ecological Model To Explore Parents' Resilience And Perceptions Of Adverse Childhood Experiences: A Qualitative Study In The Southeastern United States, Maribel G Dominguez, Christine Markham, Andrew E Springer, Louis D Brown

Faculty, Staff and Student Publications

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience's impact on the parent-child relationship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents' perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic …