Digital Commons Network^™

The Picture Exchange Communication System (Pecs) As A Functional Form Of Low-Technology Aided Augmentative And Alternative Communication (Aac): A Systematic Review, Faith K. Curran

Pacific Journal of Health

This systematic literature review was completed with the aim of investigating the functionality of the low-technology aided Augmentative and Alternative Communication (AAC), Picture Exchange Communication System (PECS). In this review, functionality was defined by how successful AAC users used PECS. Fifteen peer reviewed primary sources which were published between 2020 and 2025 were selected to provide a current and relevant analysis. There was not enough current research to support the use of PECS across various functions of language. However, PECS is mainly used for one to two language functions, object requesting and commenting. Further research studying the success rates of …

The Use Of Video Laryngoscopy In Pregnant Women Undergoing Non-Obstetric Surgery, Samantha Gastaldo

Doctor of Nursing Practice Scholarly Projects

This quality improvement project looks at the proposed implementation of endotracheal intubation guidelines regarding pregnant patients undergoing non-obstetric surgery and how the use of video laryngoscopy versus the traditional practice will affect the first pass rate of the endotracheal tube intraoperatively. Statistics show that 2% of women undergo non-obstetric related surgery during pregnancy. Physiological changes during pregnancy, including increased laryngeal mucosa swelling and higher metabolic oxygen consumption, result in a heightened risk of apnea and hypoxemia during intubation. Pregnant women experience an eightfold higher incidence of failed intubation compared to non-pregnant populations. The number of patients classified as Mallampati 4 …

Co-Active Therapeutic Filmmaking: A Methodology Pilot Project, Blair Webber

Expressive Therapies Theses

This pilot project examined the intersection of drama therapy and filmmaking. Drawing on the Co-Active Therapeutic Theater model from drama therapy and digital storytelling and participatory video methods from social work research, this methodology designed and delivered a co-created filmmaking intervention at a residential treatment center for adult men with co-occurring mental health and substance use disorder. Four participants made a seven-minute-long short fictional film based on their definition of active recovery and a theme of recovery they wished to share with an audience. It was screened at the treatment center for staff and their fellow residents. Data collection was …

Improving Restraint Care Plan Documentation Among Nursing Staff, Samson E. Okotie

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project aimed to improve nursing compliance with restraint care plan documentation standards using bundled interventions, including targeted education, electronic health record (EHR) prompts, and unit-based audit and feedback processes. The goal was to achieve at least a 70% improvement in documentation compliance within 12 weeks.

Background: Accurate restraint documentation is essential for patient safety, ethical practice, interdisciplinary communication, and regulatory compliance. Despite existing policies and education, institutional audits revealed compliance rates of 50% or less, demonstrating a persistent gap in practice and the need for structured interventions.

Methodology: The project used the Plan-Do-Study-Act (PDSA) framework across …

Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple

Evidence-Based Practice Project Reports

Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …

Improving Nursing Orientation: A Preceptor-Led Competency Program, Brandy Tanesa Broadway

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education Intervention To Improve Staff Knowledge And Competency In Supporting Patients With Type 2 Diabetes Mellitus Self-Management, Dorothy Chudi-Agbaku

Walden Dissertations and Doctoral Studies

No abstract provided.

Barriers To Palliative Care Access In Rural South Dakota: A Policy And System-Level Analysis, Harshavardhan Kadarkaraisamy

Honors Thesis

Palliative care improves the quality of life for people living with serious illness. It helps by addressing symptoms, improving communication, and providing mental, physical, and spiritual support. However, in South Dakota access to palliative care is limited in rural areas. These challenges include geographic isolation, workforce shortages, healthcare infrastructure, reimbursement, and misunderstandings about palliative care. This thesis examines the key policy barriers that limit access to palliative care in rural South Dakota. This work involves engaging with South Dakota-specific literature, rural health research, policy sources, community education, telehealth expansion, and policy reform. By focusing on the rural context of South …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …

Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik

Evidence-Based Practice Project Reports

Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …

Descriptive Analysis: Effects Of Insufficient Sleep Among College Students Ages 18-22, Divine Ighalo

Honors Theses

Background: Not getting enough sleep is common among college students and is often linked to habits such as screen time, caffeine intake, stress, and irregular routines. This study examined how these lifestyle factors are associated with insufficient sleep among college students ages 18-22 and how poor sleep affects their overall wellbeing. Methods: This study used a cross-sectional survey design and collected data through an anonymous 25 question online Qualtrics questionnaire. This was completed by 150 participants. The survey was designed to be completed in about 5-7 minutes. It included a mix of multiplechoice questions, frequency-based responses and select all that …

Selection Of Graphic Symbol Collections By Speech And Language Pathologists For Students With Autism Spectrum Disorder, Vasiliki Hadjicharalambous, Donald R. Fuller, Eliada Pampoulou

Communication Sciences & Disorders Faculty Publications

Graphic symbol collections are often implemented in assessment and interventions with clients with autism spectrum disorder (ASD). The selection of the optimal collection is considered by speech-language pathologists (SLPs) a challenging task. Since limited literature exists on the factors that guide this selection specifically for clients with ASD, this study aimed to explore those in detail, for which a qualitative design was followed. Semi-structured interviews were conducted with SLPs who shared their views on the factors that affect this selection. A thematic analysis of the interview transcripts took place. The outcomes showed that SLPs focus on multiple factors, grouped as …

Variation In Prevalence Of Participation Limitation, Injury Location, And Training Habits Between Young And Master Runners: A Cross-Sectional Study, Rachel Berns, Jo Armour Smith, Natalia Sánchez, Samantha N. Jeffcoat, Susan Sigward, Andrew Hooyman, Shawn Farrokhi

Physical Therapy Faculty Articles and Research

Background/Objectives

Running is a popular form of physical activity, but its growing participation has been accompanied by high rates of injury that may limit ongoing engagement, particularly in older runners. This study explored differences in running participation limitation, injury location, and training characteristics between young (18–34 years) and master (>35 years) runners.

Methods

A total of 207 runners (105 young, 102 master) completed an online survey assessing demographics, training habits, and injury-related participation limitations using the updated Oslo Sports Trauma Research Center Overuse Injury Questionnaire.

Results

Master runners reported higher rates of injury-related participation limitation than young runners (51% …

Multi-Scale Data Improves Performance Of Machine Learning Model For Long Covid Identification, V Eric Kerchberger, Alyson L Dickson, Emily R Pfaff, Hiral Master, Xin Yi, Melissa Basford, Christopher G Chute, Nguyen K Tran, Salvatore Mancuso, Toufeeq Ahmed Syed, Zhao Zhongming, Feng Qiping, Melissa Haendel, Christopher Lunt, Paul A Harris, Li Lang, Geoffrey S Ginsburg, Joshua C Denny, Dan M Roden, Wei Wei-Qi

Faculty, Staff and Student Publications

Background: Long COVID affects a substantial proportion of the over 778 million individuals infected with SARS-CoV-2, yet predictive models remain limited in scope. While existing efforts, such as the National COVID Cohort Collaborative (N3C), have leveraged electronic health record (EHR) data for risk prediction and identification, accumulating evidence points to additional contributions from social, behavioral, and genetic factors.

Methods: Using a diverse cohort of SARS-CoV-2-infected individuals (n > 17,200) from the NIH All of Us Research Program, we investigated whether integrating EHR data with survey-based and genomic information improves model performance.

Results: Our multi-scale approach outperforms EHR-only model's area under the …

College Student's Ideal Age For Having Children, Corrie Sanders, Melanie Palomares, Kristin Kirchner

Caravel Undergraduate Research Journal

It has been observed that women are beginning to have children at a later age than traditionally seen in history. This study examines college student’s ideal age for having children, and how it compares to the age of their mother when she had her first child. The data was collected mainly from undergraduate students at the University of South Carolina through a survey completed by 39 participants. Through a one-way between-subjects ANOVA, this study found there was not a significant difference of the ideal age to have children between college students ages 19, 20, 21, 22, and 23. The average …

Examining Biobehavioral Indicators Of Adhd In Children With Fxs, Hannah Pressler, Kayla Smith, Ramsey Coyle, Elizabeth Will, Jane E. Roberts

Caravel Undergraduate Research Journal

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and hyperactivity/impulsivity behaviors that are inconsistent with developmental age. Children with fragile X syndrome (FXS), a genetic neurodevelopmental disorder, are often diagnosed with comorbid ADHD (53–59% of males with FXS). Despite the prevalence of ADHD in FXS, little is known about the early manifestation of ADHD. The current project aims to explore group differences in play behaviors between children with FXS and typically developing (TD) children as well as the relationship between infant play behavior and heart activity to future ADHD attention outcomes. Participants included male children with FXS and …

The Effects Of Eating Disorder Knowledge On Dieting Beliefs, Kaitlyn Finn, Melanie Palomares, Kristin Kirchner

Caravel Undergraduate Research Journal

The study at hand was designed to look into the issues of eating disorder awareness and dieting attitudes. Specifically, it was hypothesized that individuals with more knowledge of eating disorders would be less likely to believe in dieting. It was additionally hypothesized that there would be a difference in amount of eating disorder knowledge seen between pre-determined age groupings. This was hypothesized due to the nature of the inception of eating disorders as a clinical diagnosis. Eating disorders did not begin to be added as a category into the Diagnostic and Statistical Manual until the 80’s, suggesting that participants of …

Connecting On Campus: Exploring The Motivations And Behaviors Of College Students On Dating Apps, Emma Doyle, Melanie Palomares

Caravel Undergraduate Research Journal

Dating apps are increasingly popular among young people, including college students. However, these apps can be quite versatile, and there can be a number of reasons why a college student would use them, whether they are looking for a serious relationship, casual sex, or anything in between. Our study evaluated the intents, behaviors, and satisfaction of college students who used dating apps. Using Chi-Square and independent samples t-test analyses, results show that while satisfaction ratings were similar between men and women, more men use dating apps than women, which suggests that women might have a more negative perception of dating …

Evaluating The Role Of Stress, Self-Perceptions Of Health, And Self-Efficacy On Physical Activity Over Time: Results From Project Drive, Ashlynn Riley, Allison Sweeney, Dawn K. Wilson

Caravel Undergraduate Research Journal

Most Americans are not meeting the recommended levels of physical activity. In underserved communities, these inequities are even greater, with African American women being less likely to engage in physical activity and being at greater risk for chronic disease relative to non-minority women. This study seeks to further understand the factors that support or undermine engagement in physical activity among African American women. Specifically, the present study evaluates the impact of stress, self-perceptions of health, and self-efficacy on physical activity engagement in a 10-week physical activity intervention program for African American women. Participants (N = 33) completed measures of …

Dominance Linearity And Steepness In Captive Western Lowland Gorillas, Nate Wichmann

Caravel Undergraduate Research Journal

Many animals live in social groups for a variety of reasons, whether it is for hunting strategies, predator avoidance, or enhanced resource acquisition. These groups often develop a social network and/or dominance hierarchy within the population, with certain individuals gaining advantages or disadvantages based upon one’s rank within a group. Dominance hierarchies can be assessed on the grounds of structure, and, more recently, steepness.  Structure can be assessed by determining and comparing the rank of each individual (quantified by David’s scores). These scores can then be plotted and analyzed to determine the steepness of the dominance hierarchy. A dominance hierarchy …

The Victimization Of Heterosexual Males: A Literature Review On Domestic Violence, Chris Friendly, Christine Palmer Mph, Edd, Ches

Caravel Undergraduate Research Journal

Domestic violence, defined as both emotional and physical abuse in intimate relationships, is a pressing issue in today’s society. Because of its serious nature, domestic violence has become a topic of great interest and concern for many public health researchers. However, an overwhelming degree of the studies conducted by these investigators only examine the effects of domestic violence on the female population. In this literature review, 27 sources, both peer-reviewed articles and literature reviews, were previewed. Of the 27 sources, only four were specific to male victimization. This literature review highlights the research disparity between female and male domestic violence …

Maternal Depressive Symptoms Predicting Development Of Internalizing Behavior Problems In Boys With Fragile X Syndrome, Sara Deal, Mary Blair Dellinger

Caravel Undergraduate Research Journal

Individuals with fragile X syndrome (FXS) often exhibit increased internalizing problem behaviors that substantially impact functioning. Research suggests that maternal depressive symptoms can increase the development of internalizing problem behaviors in their children. The present study examined whether (1) maternal depressive symptoms related to the degree of internalizing behaviors exhibited in their sons with FXS, and (2) age as an influencing factor for the development of internalizing behaviors. Child internalizing behaviors were measured in 49 male children with FXS (range 1.08-5.75 yrs). Maternal depressive symptoms were measured in each of their mothers with the FMR1 premutation (range 20.55-40.74 yrs). Increased …

Dexmedetomidine And The Prevention Of Emergence Agitation In Military Veterans With Post-Traumatic Stress Disorder, Taylor P. Ranegar

Doctor of Nursing Practice Scholarly Projects

Emergence agitation (EA) is a post-anesthetic complication that occurs when the patient is in a self-limited, nonfluctuating state of excitement while transitioning into a state of consciousness. EA can lead to negative adverse outcomes including, accidental invasive line removal, bleeding, respiratory depression, unintentional extubation, and injury to the staff and the patient. EA is often observed in military veterans who have a medical history of post-traumatic stress disorder (PTSD). For patients with a history of military exposure undergoing elective general anesthesia who also have PTSD, anxiety, and or depression, the incidence of EA was estimated to be around 27%. The …

Occupational Therapy Program Development In Unhoused Communities, Abbigayle Jackson, Emma Pacheco, Mariko Turley, Jennifer Wickham, Tina M. Deangelis, Edd, Ms, Otr/L, Faota

Doctorate of Occupational Therapy Program Capstone Presentations

Objectives

- Outline the Modified Delphi process and its purpose for manual development

- Describe foundational elements of occupational therapy (OT) program development for unhoused populations

- Illustrate a program's community and societal impact

Nurturing The Nurturers: Caritas Literacy Wellness Program, Pakeeza Ali

Doctoral Projects

Burnout, compassion fatigue, and emotional exhaustion remain significant concerns among oncology staff in high-demand ambulatory settings. This quality improvement project implemented the Caritas Literacy and Resilience Training Program (CLARITY), a microlearning-based intervention grounded in Watson’s Caring Science Theory, to support self-caring behaviors and emotional resilience among oncology staff in an ambulatory cancer center. A quasi-experimental, mixed-methods design was used, incorporating pre- and post-intervention survey data and qualitative focus group feedback. Quantitative outcomes were assessed using the Watson Caritas Self-Rating Score (WCSR) and post-intervention ratings of perceived effectiveness of the microlearning format. Wilcoxon signed-rank tests were used to examine pre-post change …

Harness The Darkness! Blackout Poetry And Drama Therapy For Systemic Existential Dread: A Proposed Methodology, Kerry Sullivan

Expressive Therapies Theses

This thesis explores the intersection of drama therapy and blackout poetry as a therapeutic intervention to address systemic existential dread (SED) among emerging adults. The proposed methodology is titled "Bringing Blackout Poetry to Life" and consists of five sessions designed to explore the participants’ SED and generate poetry, culminating in a public performance. By integrating elements from psychodrama and drama therapy with the therapeutic process of blackout poetry, the intervention intends to aid processing on all levels of the expressive therapies continuum (ETC), strengthen tolerance for uncertainty, and facilitate sustainable community action. This theoretical framework is supported by a wide-ranging …

Staffing And Workflow Of An Interactive Telehealth Antimicrobial Stewardship Program With The Veterans Health Administration, Amanda Vivo, Jason P Burnham, Et Al.

2020-Current year OA Pubs

OBJECTIVE: Describe the workload associated with using telehealth to support Antimicrobial Stewardship efforts at Veterans Affairs Medical Centers (VAMCs) without local infectious diseases (ID) expertise.

DESIGN: A mixed-methods process assessment to evaluate workload and workflow associated with Videoconference Antimicrobial Stewardship Teams (VASTs).

SETTING AND PARTICIPANTS: Rural VAMC champions paired with ID consultants at geographically distant VAMCs to form VASTs.

METHODS: Total workload estimates were based on time that champions and ID consultants allocated to VAST activities. Clinical Procedural Terminology (CPT) codes were used to estimate the workloads for clinical encounters. Role-based process maps were developed to understand variation in implementation …

2025 Nursing Annual Report, Children's Health System Of Texas

2025

No abstract provided.

Miracles Or Mirages? Miracle Language In Medical Communication, Thomas Yu

Senior Honors Theses

The current study seeks to understand how miracle language exists as a persuasive tool by examining the usage of miracle language in the discourse surrounding the release of Xolair for individuals with food allergies. This was accomplished by conducting a qualitative analysis of the miracle language employed by those engaged in the Xolair discourse. An extensive literature review was conducted to gain a foundational understanding of medical persuasion and miracle language, as well as an understanding of the theoretical foundations of this study. Twenty-four pieces of literature from pharmaceutical companies, and food allergy community members were chronicled and studied utilizing …

Knowledge Of Advance Care Planning And Advance Directives Among Us Adults: Implications For Health Policy And Practice, Anisah Bagasra, Gretchen Agans

Faculty Articles

Background:

Objectives: