Digital Commons Network^™

Readability Of Dermatology Patient Education Materials: A Comparative Analysis Of Turkish Dermatology Association Brochures And Texts Generated By Chatgpt And Gemini ​, Ahmet Kağan Özdemi̇r, Bengü Reyhan Botsali Özdemi̇r, Akin Aktaş

Turkish Journal of Medical Sciences

Background/aim: In modern healthcare, patient education materials (PEMs) are essential for bridging the gap between clinical knowledge and patient understanding. However, in Türkiye, where 64.6% of the adult population possesses inadequate or problematic health literacy, traditional medical brochures often exceed recommended reading levels. This study aimed to evaluate and compare the readability of Turkish dermatology PEMs prepared by the Turkish Dermatology Association (TDA) with those generated by artificial intelligence (AI) models.

Materials and methods: A total of 68 TDA PEMs were analyzed. Readability was assessed using the Ateşman Readability Index. Responses were generated by AI models to questions extracted from …

Cervical Conjoined Nerve Root Anomalies: Prevalence And Impact On Posterior Cervical Surgery, Ahmet Eren Seçen, Ayfer Aslan, Musa Onur Özbakir, Uğur Kemal Gündüz, Ali̇ Dalgiç

Turkish Journal of Medical Sciences

Background/aim: Anomalous nerve roots (ANRs) are well described in the lumbosacral spine but are rarely reported in the cervical region. The aim of this study was to evaluate the incidence, clinical characteristics, and surgical outcomes of cervical ANRs, with particular emphasis on conjoined nerve roots, in a single-center clinical series.

Materials and methods: A retrospective analysis was conducted of patients who underwent posterior cervical discectomy for cervical disc herniation at our institution between 2010 and 2025. A total of 113 posterior cervical procedures were performed, and seven patients were found to have surgically confirmed cervical ANRs. For these patients, demographic …

Face Mask Littering: Environmental Impacts, Regulatory Challenges, And Ai-Driven Waste Management Strategies For The Post-Pandemic Era, Pri̇yanka Rathee, Sari̇ta Khatkar, Renu Sehrawat, Pooja Rathee, Anurag Khatkar, Esra Küpeli̇

Turkish Journal of Medical Sciences

The widespread use of polypropylene-based face masks during the COVID-19 pandemic created a significant and persistent source of plastic pollution. This review aims to provide an integrative assessment of the environmental, toxicological, and public health implications of face mask litter and evaluate current waste management challenges and emerging technological solutions in the postpandemic context. A narrative review approach was employed, synthesizing literature published between 2020 and 2025 and indexed in major scientific databases including Web of Science, Scopus, and PubMed. Studies were selected based on their relevance to the issues of environmental contamination, microplastic generation, toxicological effects, regulatory frameworks, and …

Digital Markers For Passive Remote Monitoring Of Bipolar Disorder: Systematic Review, Thomas P Kutcher, Isha Chakraborty, Kristin Kostick-Quenet, Akane Sano, Nidal Moukaddam, Jeffrey A Herron, Wayne K Goodman, Sameer A Sheth, Ashutosh Sabharwal, Nicole R Provenza

Duncan NRI Faculty and Staff Publications

Background: Bipolar disorder (BD) features episodic shifts among mania, hypomania, depression, mixed states, and euthymia. Timely detection of mood transitions is difficult due to infrequent clinical touchpoints. Digital health technologies, including wearables and smartphones, offer a unique opportunity to passively and continuously monitor behavior and physiology that could reflect underlying mood dynamics in real-world settings.

Objective: This study aimed to systematically review passively collected digital markers for BD mood states, characterize devices/modalities and analytic approaches, appraise risk of bias, and identify design gaps and priorities for clinical translation.

Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) …

Staff Education To Improve Hand Hygiene And Personal Protective Equipment Compliance, Suliat Oluwa

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education initiative designed to strengthen hand hygiene and personal protective equipment (PPE) practices among interdisciplinary staff in a long-term care (LTC) facility. The practice problem addressed inconsistent hand hygiene and PPE use across shifts and departments, contributing to healthcare-associated infections (HAIs). Because LTC residents are highly vulnerable due to advanced age, multiple comorbidities, and shared living environments, improving adherence to infection prevention practices is essential for enhancing resident safety, reducing preventable infections, and supporting compliance with Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) infection prevention standards. …

Weekly Team Validation Rounding Focused On Chlorhexidine Gluconate Bathing And Bath Completion And Documentation Compliance, La-Toya Therese Fong

Walden Dissertations and Doctoral Studies

This quality improvement project evaluated whether weekly team validation rounding improved chlorhexidine gluconate (CHG) bath completion and documentation compliance among eligible adult inpatients, with particular attention to differences in compliance outcomes between Pod 5C and Pod 4B. Background. Hospital-acquired infections continue to increase morbidity, mortality, length of stay, and healthcare costs. Although CHG bathing is an evidence-based strategy for reducing infection risk and the transmission of multidrug-resistant organisms, inconsistent documentation at the practicum site limited accurate monitoring of compliance across validation data, electronic medical record documentation, and DOMO reports. Method. Participants included eligible adult inpatients admitted within the previous 24 …

Closing The Loop: Strengthening Cauti Prevention With Urinary Catheter Management, Erika N. Braun

Master's Projects and Capstones

Objective: Catheter-associated urinary tract infections (CAUTIs) are among the most common preventable healthcare-associated infections and are associated with significant patient harm and increased healthcare costs. Baseline assessment across five adult cardiovascular and critical care units within a community-based acute care hospital identified four CAUTI events during the first half of 2026 and revealed important nursing knowledge deficits related to bladder scanning protocols and urinary catheter management practices. Aim: This Quality Improvement (QI) Project aimed to improve nursing knowledge of evidence-based bladder scanning protocols and urinary catheter management practices through targeted educational interventions implemented over a 10-week period, with …

Staff Education To Improve Early Identification Of Behavioral Escalation And Timely Clinical Intervention In An Adult Group Home Setting, Gayduo Barr

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project addressed a gap in staff knowledge regarding the early identification of behavioral escalation and timely intervention in an adult group home setting. The practice-focused question was: Does staff education about early identification of behavioral escalation and timely clinical intervention improve the knowledge of staff working in an adult group home setting? The purpose was to improve staff knowledge of behavioral escalation, triggers, trauma-informed care, and intervention strategies. I delivered a structured educational intervention to 14 house managers. Educational content included behavioral escalation stages, triggers, de-escalation techniques, trauma-informed care, documentation, and …

Formative Work To Guide Implementation Of An Evidence-Based Breast And Cervical Cancer Prevention And Early Detection Behavioral Health Program In Clinics: Qualitative Study Guided By The Consolidated Framework For Implementation Research, Marlyn A Allicock, Crystal Costa, Ashley Hedrick Mckenzie, Preena Loomba, Roshanda S Chenier, Ross Shegog, Angelita Alaniz, Maria E Fernandez, Lara S Savas

Faculty, Staff and Student Publications

Background: Salud en Mis Manos (SEMM) is a community health worker-delivered evidence-based intervention shown to increase breast and cervical cancer screening in medically underserved Latinas. Despite SEMM's success in community-based settings, clinic-based implementation is limited.

Objective: This study aimed to identify factors influencing the implementation of SEMM in clinic settings using the Consolidated Framework for Implementation Research (CFIR) to inform and refine implementation strategy development.

Methods: We developed theory-informed (eg, CFIR, Social Cognitive Theory, and Readiness) interview guides to elicit barriers and facilitators of SEMM clinic implementation. We conducted 12 semistructured interviews with clinic leaders, outreach coordinators, and community health …

Staff Education To Improve Diabetic Care In A Primary Care Setting, Sally Uyen Nguyen

Walden Dissertations and Doctoral Studies

Inadequate patient education, inconsistent screening, missed referrals, and follow up with diabetes patients are challenges primary care managers and staff must overcome. Patients may experience negative effects that lead to poor health outcomes, delayed diagnosis, and undertreatment when provider and staff members are not educated about diabetes. The practice-focused question guiding the Doctor of Nursing Practice (DNP) staff education project involved exploring whether a staff education intervention on standardized diabetes care and screening protocols could improve physicians, managers, and medical assistants’ (MAs) knowledge of diabetes care in primary care clinics. The purpose of this project was to enhance staff knowledge …

Staff Education To Improve Staff Knowledge Of Evidence-Based Strategies That Support Medication Adherence Among Patients Diagnosed With Depression In The Outpatient Clinic Setting, Comfort Aziwung Awungafac

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was an evidence-based practice staff education initiative designed to improve staff knowledge of evidence-based strategies that support medication adherence among patients diagnosed with depression in an outpatient clinic. Medication nonadherence is associated with poor treatment outcomes, symptom relapse, and reduced quality of life, highlighting the need for staff education on adherence-promoting interventions. The practice-focused question examined whether a structured educational intervention would improve staff knowledge of evidence-based medication adherence strategies over an 8-week period.

Examining The Association Between Socioeconomic Factors And Cervical Cancer Among Minority Women In The United States, Darla Fils

Walden Dissertations and Doctoral Studies

Cervical cancer remains a significant public health concern, with African American and Hispanic women experiencing disproportionately higher incidence and mortality rates in the United States. Socioeconomic factors, including income, education, employment status, and place of residence, may contribute to these disparities by affecting access to preventive services, timely diagnosis, and follow-up care. This quantitative cross-sectional study examined associations between these factors and cervical cancer incidence among African American and Hispanic women while controlling for age and health insurance status. Guided by the socio-ecological model, the study used 2022 Behavioral Risk Factor Surveillance System data from N = 33,886 African American …

Staff Education To Improve Staff Knowledge On Fall Prevention, Nginjoh Presilia Njofang

Walden Dissertations and Doctoral Studies

Patient safety risks associated with falls are a major issue in adult inpatient medical-surgical environments because nursing inconsistencies with regard to fall risk assessments, individualized fall prevention interventions, and documentation could impede adherence to best practices. To overcome this knowledge gap among RNs in the selected environment, a DNP education project aimed at standardized fall-prevention staff education was initiated. The question for the practice was whether standardized staff education would increase knowledge among nurses regarding fall-risk assessments, preventive measures, and documentation requirements, based on pretest and posttest results. In the course of a one-hour educational session conducted face-to-face, twenty RNs …

Creating Consistency: Standardizing Gestational Diabetes Group Visit Framework In High-Risk Obstetric Care, Danielle Pack

Master's Projects and Capstones

Objective: Gestational diabetes mellitus (GDM) requires timely and consistent education to promote effective self-management and improve maternal and fetal outcomes. Baseline observations at a Santa Clara County high-risk obstetric clinic identified variation in educational materials, educator delivery, referral processes, and workflows between English- and Spanish-language GDM group visits. A review of the literature supported standardized diabetes education and group prenatal care as strategies to improve consistency, efficiency, and patient access. Aim: This quality improvement project aimed to develop and implement a standardized GDM group visit framework for nurse practitioners, registered dietitians, and scheduling staff, with the goal of increasing compliance …

You Haven’T Been Forgotten: Driving Improvements In Trust, Transparency, And Accountability Through A Patient-Centered Communication Initiative In The Emergency Department, Ellie Mead

Master's Projects and Capstones

Objective: In Spring 2026, the Emergency Department (ED) at Hospital X identified difficulties securing high levels of patient satisfaction. Over one third of patients did not feel adequately “informed about delays,” and observation of nurse-patient interactions in front-end care areas confirmed these communication gaps: in 87% of interactions, nurses did not explain next steps to the patient, and in none of the 51 interactions observed did nurses proactively inform patients about possible delays. Aim: This quality improvement initiative sought to improve the patient experience in the ED and drive a 10% increase in Press Ganey patient satisfaction survey results relating …

Trace Elements In Complete Feeds Used In Intensive Rearing Of Cattle, Poultry, And Pigs: Occurrence And Predicted Transferred Concentrations In Animal-Derived Food, Elizabeta Dimitrieska Stojkovikj, Vangelica Enimiteva, Aleksandra Angjeleska, Risto Uzunov

Turkish Journal of Veterinary & Animal Sciences

This study investigated the concentrations of essential (Zn, Cu, Mn, Co, and Mo) and toxic (Pb, Cd, As, and Hg) trace elements in complete feeds used for the intensive rearing of cattle, poultry, and pigs in North Macedonia and predicted their transfer into animal-derived foods. A total of 107 feed samples were collected from 40 farms between May 2023 and April 2024 and analyzed using inductively coupled plasma mass spectrometry. The results revealed that while most essential elements were within the regulatory limits, Co exceeded the maximum level in two cattle feed samples. Zn, Cu, and Mn levels were generally …

Molecular Characterization Of Pasteurella Multocida Capsular Type A Strains Isolated From Different Regions Of Anatolia, Türkiye​, Adam Bashir Tawor, Osman Ergani̇ş, Asli Balevi̇, Suliman Mohamed Yousof Sadam

Turkish Journal of Veterinary & Animal Sciences

Pasteurella multocida serotype A is an important pathogen that causes respiratory illness in both farm animals and poultry, leading to severe economic losses worldwide. This study aimed to isolate P. multocida capsular type A (capA) as well as investigate the virulence-associated genes (VAGs) within the isolates. Samples (n = 250) were collected in the Anatolia region from cattle (n = 130), sheep (n = 70), goats (n = 45), and pet birds (n = 5) with clinical respiratory signs. Polymerase chain reaction (PCR) assays were conducted using kmt1 and capA primers for P. multocida species identification and capsular serogroup A …

Full Issue, Volume 14, Number 1., Donna J. Peterson Dr., Scott Cummings, Elizabeth Gregory North

Journal of Human Sciences and Extension

No abstract provided.

Radiographic Evaluation Of Kidney Size In Cats: Effects Of Sex And Gonadal Status, Somchin Sutthigran, Auraiwan Klaengkaew, Chutimon Thanaboonnipat, Suppawiwat Ponglowhapan, Nan Choisunirachon

The Thai Journal of Veterinary Medicine

Radiographic evaluation of kidney size using the kidney-to-second lumbar vertebral body length (K/L2) ratio is a standard method for assessing kidney size in cats. However, current reference values underdetermine biological factors such as sex and gonadal status, which may influence kidney and lumbar length. Reproductive hormones are known to influence kidney and vertebral development, but their specific effects on radiographic kidney and vertebral measurements in cats are unclear. This retrospective study aimed to assess the effects of gonadal status on kidney length, L2 vertebral length, and the K/L2 ratio in clinically healthy cats. A total of 285 cats were included …

From Crisis To Reform: How The 1918 Influenza And Covid-19 Pandemics Redefined The Relationship Between Nurses And The American Healthcare System., Anh N V Le

Undergraduate Research and Scholarship Symposium

The 1918 Influenza and COVID- 19 pandemic have become two major public health crises that reshaped the role of nurses in the America healthcare system. Although a hundred years apart, both pandemics revealed how deeply the country depends on nurses during emergencies without proper and efficient strategies. This paper argues that these pandemics acted as turning points that redefined the social contract between nurses and the U.S. healthcare system. By examining historical context, nurses’ responsibilities, public perception, and long-term effects, this research show how pandemics expanded nurses’ authority while also exposing long-term weakness of the systems. In 1918, nurses were …

The Chameleon Experience: Queer Identity, Mental Health, And Transformation, Cameron Penny

Communication and Theater Association of Minnesota Journal

In this autoethnographic piece, I examine the correlation between queer identity and mental health through reflective analysis of my own experiences within a Western socio-cultural setting. I expand external perspectives on the queer experience by highlighting the normalization of queer prejudice and its adverse impact on self-image. I share how the religious praxis of Catholicism enforces binary conformity by promoting dichotomous thinking that simultaneously constricts queer expression and subjugates implicit biases. In tandem, I utilize autoethnography as my medium because it provides a unique outlet to raise awareness for chronically stigmatized identities by centering marginalized voices (Atay, 2011; Chavez, 2013). …

Confidence Versus Competence: Addressing Nursing Knowledge Gaps In Catheter Care To Reduce Catheter-Associated Urinary Tract Infections, Leslie Anne Villanueva Bautista

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most prevalent and preventable healthcare-associated infections (HAIs), contributing substantially to patient morbidity, mortality, prolonged hospitalization, and healthcare expenditures. Most hospital-acquired UTIs are related to urinary catheters, and this burden costs the United States alone an estimated $340 to $450 million annually (Yang et al., 2022). CAUTIs are UTIs that occur in patients with indwelling urinary catheters. This quality improvement project aimed to increase adherence to existing bladder scanning protocols and strengthen urinary catheter care to prevent CAUTI. Baseline staff nurse knowledge was obtained, and reinterpretation of the facility’s existing protocols and bundles …

Pre-Implementation Factors For Active Music Engagement (Ame): Barriers And Facilitators To Integrating An Evidence-Based Dyadic Intervention Into Pediatric Oncology Care., Kristin M. Story, Elizabeth Harman, Kristin Stegenga, Jelena Golubovic, Sheri L. Robb

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pediatric cancer treatment is a difficult and distressing experience that often results in sustained, interrelated distress in young children and parents, and traumatic stress symptoms for some parents. Few evidence-based interventions address this dyadic distress. Active Music Engagement (AME) is a manualized, evidence-based music play intervention that significantly reduces distress in child/parent dyads and mitigates traumatic stress and improves well-being among highly distressed parents and those experiencing sociodemographic risk. Successfully integrating AME into standard care requires a systematic understanding of implementation factors. This study aimed to identify site-specific barriers and facilitators that influenced successful AME delivery during a recently …

Standardizing Gestational Diabetes Mellitus Education To Improve Patient Knowledge And Care Consistency In A Prenatal Clinic Setting, Wynn Zara

Master's Projects and Capstones

The gestational diabetes mellitus (GDM) group visit framework aims to improve consistency of GDM education by standardizing referral processes, educational materials, staff workflows, and patient communication. Although evidence-based GDM education supports patient self-management and improved maternal-fetal outcomes, variability in education delivery contributed to inconsistent care within the outpatient maternal-fetal medicine setting. This quality improvement project was conducted in an outpatient maternal-fetal medicine clinic in Santa Clara County serving pregnant patients diagnosed with GDM. To address this gap, a standardized GDM group visit framework was developed and implemented using structured educational resources, referral criteria, and communication workflows. The intervention was evaluated …

Psychological Interventions For Children With Neurodevelopmental Disabilities In The Context Of Neurodiversity: A Systematic Review, Kalliopi Megari, Dimitra V. Katsarou, Evangelos Mantsos, Soultana Papadopoulou, Efthymia Efthymiou, Maria Theodoratou, Maria Sofologi, Eugenia Toki

All Works

Highlights What are the main findings? What is the implication of the main finding?Highlights What are the main findings? What is the implication of the main finding?Abstract Background/Objectives: This systematic review examines psychological interventions for children with neurodevelopmental disabilities within a neurodiversity framework, emphasizing that variations in cognition, behavior, and neurological functioning represent natural forms of human diversity rather than deficits. Methods: A systematic literature search was conducted across the PubMed, PsycINFO, and Google Scholar databases for studies published between 2010 and 2025. Studies were included if they focused on children with autism spectrum disorder (ASD), learning or intellectual disabilities …

Staff Education To Integrate The Cdc Prediabetes Risk Test Into Primary Care Intake, Helen Ndangam

Walden Dissertations and Doctoral Studies

This staff education project involves addressing the gap in using a standardized prediabetes screening protocol at an outpatient primary care clinic in Maryland, which leads to missed early interventions. Standardizing this process is vital for nursing practice to promote preventive care and optimize workflows. The practice-focused question was for medical support assistants (MSAs) at an outpatient primary care clinic: How does implementing a competency-based education program on the Centers for Disease Control and Prevention (CDC) Prediabetes Risk Test (Centers for Disease Control and Prevention [CDC], n.d.) affect staff knowledge, workflow confidence, and screening compliance over a 7-week period? The purpose …

Staff Education To Reduce Burnout Among Psychiatric Nurses Caring For Patients With Schizophrenia, Gloria Laizer

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project addressed occupational burnout among psychiatric registered nurses caring for patients with schizophrenia. Workplace violence, compassion fatigue, emotional exhaustion, and staffing shortages place psychiatric nurses at high risk for burnout, threatening nurse well-being, workforce retention, and patient safety. The practice site lacked a standardized resilience education program. The practice-focused question was, In psychiatric nurses caring for patients with schizophrenia, does implementation of an evidence-based resilience education program, compared with current practice, reduce occupational burnout? The purpose was to implement and evaluate such a program, informed by the Johns Hopkins evidence-based practice (JHEBP) Model …

Staff Education To Improve Hypertension Management Knowledge, Angelor Eliscard

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project, I addressed inconsistent staff knowledge of evidence-based strategies for preventing and controlling hypertension among African American women in an outpatient primary care setting. The practice-focused question was: In an outpatient clinical setting, what was the impact of an evidence-based staff education program on healthcare providers' knowledge of hypertension prevention and control strategies for African American women, as measured by pretest and posttest scores? The purpose of this project was to implement and evaluate a structured staff education program to improve providers' knowledge of evidence-based strategies for preventing and controlling hypertension …

Reducing Live Discharges Using A Tiered Protocol In A Rural Hospice: A Quality Improvement Project, Jemma Lowak

Doctor of Nursing Practice Final Project Abstract

Purpose: To reduce 30-day caregiver-driven hospice revocations by implementing a tiered post-admission nursing visit protocol based on caregiver preparedness. Background: Caregiver distress and inadequate support contribute to hospice revocations and interruptions in care. Increased nursing contact during the first week of enrollment may improve caregiver preparedness and reduce crisis-driven hospitalizations. Methodology: An eight-week quality improvement project using the Plan-Do-Study-Act framework was implemented at a rural hospice agency. Caregivers completed a Caregiver Preparedness Survey to assign preparedness tiers and guide additional nursing visits during the first week. Process measures included survey completion and protocol adherence. Outcome measures included caregiver preparedness and …

Improving Adherence To Remote Patient Monitoring (Rpm) For Patients With Hypertension, Chioma Udegbune

Student Scholarly Projects

Practice Problem: Hypertension is a leading contributor to cardiovascular disease, and suboptimal adherence to remote patient monitoring (RPM) limits opportunities for timely intervention and effective blood pressure management in outpatient primary care.

PICOT: The PICOT question that guided this project was: Among outpatient clinic nursing staff responsible for remote patient monitoring (RPM) in adults with hypertension (P), how does implementation of a structured nurse-led education and reminder protocol (I), compared to standard RPM practices consisting of routine onboarding and passive reminder processes (C), influence patient adherence to RPM protocols (O) over a 10-week period (T)?

Evidence: Evidence supports nurse-led education, …