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 …

Posttraumatic Stress In Newly Diagnosed Epilepsy: Associations With Early Maladaptive Schemas, Anxiety, And Quality Of Life In A 6-Month Prospective Study ​, Mehmet Öztürk, Pinar Öztürk, Fügen Sönmez Çeti̇nkaya, İlker Özdemi̇r

Turkish Journal of Medical Sciences

Background/aim: Epilepsy is a chronic neurological disorder that significantly affects psychosocial functioning, self-perception, and quality of life. Emerging evidence suggests that posttraumatic stress (PTS) symptoms may be more prevalent in individuals with epilepsy than previously recognized, particularly following seizure-related experiences perceived as traumatic. The aim of this study was to evaluate short- and long-term PTS levels in individuals with newly diagnosed epilepsy and examine their associations with anxiety, depression, early maladaptive schemas, and quality of life.

Materials and methods: In this prospective study, 31 individuals with newly diagnosed epilepsy were enrolled. Participants completed a sociodemographic data form, the Post-Traumatic Stress …

Influenza, Covid-19, And Pneumococcal Vaccination Status Among Adults In Türkiye ​, Gamze Şanlidağ İşbi̇len, Serap Gençer, Hüsnü Pullukçu, Meltem Taşbakan, İftahar Köksal

Turkish Journal of Medical Sciences

Background/aim: Vaccines reduce morbidity and mortality caused by infectious diseases that threaten public health. Lifelong immunization programs are essential for the entire population. This study assessed adult vaccination uptake for influenza, pneumococcal, and coronavirus disease 2019 (COVID-19) vaccines in Türkiye and examined the barriers and factors influencing vaccination decisions.

Materials and methods: This cross-sectional survey was designed and conducted by the Immunization Working Group of the Turkish Society of Clinical Microbiology and Infectious Diseases. A 19-item questionnaire was administered to individuals aged 18 years or older to assess influenza, pneumococcal, and COVID-19 vaccination status. The questionnaire collected data on demographic …

Nationwide Characteristics Of Infectious Disease Patients Transported By Helicopter In Türkiye, Ayşe Gülden Bekgöz, Kerem Dost Bi̇lmez, Muhammed Saltuk Deni̇z

Turkish Journal of Medical Sciences

Background/aim: To evaluate the clinical, demographic, and operational characteristics of patients with infectious diseases transported by helicopter ambulance and to examine differences in the transfer patterns, flight durations, and diagnostic categories.

Materials and methods: Registry data of patients with infectious diseases transported by helicopter ambulance were analyzed. Demographic characteristics, diagnoses, referring and receiving hospital types, intraprovincial and interprovincial transfer status, flight durations, and temporal distribution of transfers (hours, days, and months) were evaluated. Flight duration was calculated in minutes and compared between intraprovincial and interprovincial transfers.

Results: A total of 543 patients with infectious diseases were transported by helicopter ambulance. …

Motherhood-Defining Memories And Narrative Identity Awareness In Relation To Psychological Wellbeing And Maternal Functioning Following A Parenting Program, Christin Camia, Antje Von Suchodoletz, Michelle P. Kelly

All Works

Introduction – Drawing on previous research showing that self- and relationship-defining memories relate to psychological and relational functioning, this study began to explore motherhood-defining memories and their relation to psychological wellbeing and maternal functioning within a parenting program context. The study aimed to examine whether participation contributes to the narrative coherence of motherhood-defining memories. Methods – Participants were 155 mothers from diverse cultural backgrounds (M age = 32.85 years, SD age = 5.20) residing in the United Arab Emirates (UAE). Seventy-five mothers participated in an eight-session parenting program, and 80 mothers served as controls in a comparison group. Motherhood-defining memories …

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 …

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 On Fall Reduction For Residents Of Long-Term Care Facility, Lauretta Ifeoma Iwuala-Mcwilliams

Walden Dissertations and Doctoral Studies

Falls pose a major safety risk for elderly individuals living in long-term care facilities, leading to injuries, hospitalizations, loss of autonomy, increased healthcare expenses, and higher morbidity and mortality rates. In the facility involved in this project, the incidence of falls was above anticipated benchmarks. Factors such as high staff turnover and reliance on agency staff resulted in inconsistent knowledge among personnel regarding fall prevention measures. Purpose: This Doctor of Nursing Practice quality improvement initiative aimed to implement and assess an evidence-based educational program designed to enhance staff understanding and skills related to fall-risk assessment, the identification of both intrinsic …

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 …

Hard Palate Morphology In The Anatolian Water Buffalo (Bubalus Bubalis), Mehmet Can, Şükrü Hakan Atalgin, Mehmet Faruk Aydin, Soner Bekmezci̇

Turkish Journal of Veterinary & Animal Sciences

This study aimed to examine the morphological and histological features of the hard palate in the Anatolian water buffalo through light and scanning electron microscopy, complemented by gross and morphometric evaluations. Eight hard palates were used in the study. A total of eight Anatolian water buffalo heads from healthy adult female water buffaloes were collected immediately after slaughter from various slaughterhouses in Balıkesir, Türkiye. After analyzing and identifying the obtained hard palate samples, measurements were taken and documented through photography. The papilla incisiva, located in the middle of the caudal concave edge on the ventral surface of the pulvinus dentalis, …

Urine Good Care: Catheter-Associated Urinary Tract Infection Prevention At The Bedside, Ruby Yost

Master's Projects and Capstones

Catheter-Associated Urinary Tract Infections (CAUTIs) have been associated with increased morbidity, mortality, healthcare costs, and length of stay and is one of the most common healthcare-acquired illnesses accounting for up to 40% of hospital-acquired infections (Rubi et al., 2022). Because 65-70% of CAUTIs are preventable, reducing the incidence has become a focus area for infection control and nursing quality management among hospital organizations (Tang et al. 2025). CAUTIs are urinary tract infections that occur in patients with indwelling urinary catheters and are typically associated with bacterial colonization of the urinary tract. The aim of this QI Project is to increase …

Reducing Variation, Improving Outcomes: Standardizing Gestational Diabetes Mellitus Education In A Clinical Microsystem, Thanh Le

Master's Projects and Capstones

Objective: Variations in referral, scheduling, delivery of educational information, patient materials, and documentation hampered the quality of gestational diabetes mellitus (GDM) education in the outpatient maternal-fetal medicine clinic. Purpose: The aim of the quality improvement project was to boost adherence to a standardized GDM group education framework from 0 to 50% in the course of 12 weeks and assess attendance at group visits. Methods: The microsystem analysis was conducted based on observations of group visits conducted in Spanish and English, examination of current processes and resources in use, educator pre-survey, SWOT analysis, and cause and effect analysis. The implementation of …

Standardizing Group Visits For Gestational Diabetes Education: A Quality Improvement Initiative In An Outpatient Maternal-Fetal Medicine Clinic, Nha Nguyen

Master's Projects and Capstones

Objective: At an outpatient maternal-fetal medicine clinic in Northern California, gestational diabetes mellitus (GDM) education is delivered inconsistently across nurse practitioners (NPs) and registered dietitians (RDs), with no standardized curriculum, referral criteria, or educational materials. Aim: By August 12, 2026, this project aimed to develop and implement a standardized GDM group visit framework for NPs, RDs, and scheduling staff in maternal-fetal medicine clinic, increasing compliance with standardized referral, enrollment, and educational processes from a baseline of 0% to 50%. Methods: Using baseline observations, workflow assessment, stakeholder input, and a literature review, the QI team developed standardized bilingual slide …

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) …

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

Journal of Human Sciences and Extension

No abstract provided.

Impact Of Stress & Fatigue On Cardiovascular Function In Young Pilots: A Thematic Review, Swarna Manoj

Discovery Day - Daytona Beach

Impact of Stress & Fatigue on Cardiovascular Function in Young Pilots: A Thematic Review   Authors: Swarna Manoj, Scott Ferguson   Keywords: pilot, stress, fatigue, heart rate variability (HRV), cardiovascular disease (CVD) Aviation is expanding globally and young pilots are the major workforce, yet FAA protocols require mandatory ECG only from age 35, with annual cardiac screening after age 40. Over the past five years, a pattern of sudden cardiac arrests in pilots particularly aged 30-40 has urged safety concerns. Despite the existing literature examining fatigue, burnout, stress, sleep hygiene and circadian disruption, only few studies systematically examine how these factors impact …

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). …

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 …

Race And Ethnicity And Overall Survival In Pediatric Acute Myeloid Leukemia, Daniel J. Zheng, Long Khuong, Catherine Aftandilian, Kira Bona, Emi H. Caywood, Caitlin W. Elgarten, Brian T. Fisher, Cody-Aaron L. Gathers, Taumoha Ghosh, M. Monica Gramatges, Gary Hettinger, Meret R. Henry, Yuan-Shung V Huang, Yimei Li, Kelly Maloney, Amir Mian, Tamara P Miller, Arunkumar Modi, Rajen Mody, Regina M. Myers, Haley Newman, Jose Ortiz, Alix E. Seif, Caroline Smith, Jamie Stokke, Naomi Winick, Jennifer J. Wilkes, Victor Wong, Richard Aplenc, Kelly D. Getz

Department of Pediatrics Faculty Papers

IMPORTANCE: Hispanic and non-Hispanic Black (hereafter, Black) children with acute myeloid leukemia (AML) have historically experienced worse survival outcomes compared with non-Hispanic White (hereafter, White) children. Understanding specific intermediate pathways underlying these outcome disparities is a critical step to directing interventional efforts and resources.

OBJECTIVE: To compare survival outcomes by race and ethnicity in a large contemporary cohort of pediatric patients with AML and to examine presentation acuity, frontline organ toxic effects, and relapse as potential mediators of any observed outcome disparities.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was analyzed from April 2025 to January 2026 and included …

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, …

Telomere-To-Telomere Genome Assembly And A Pangenome For The Rat, Kai Li, Julia L Ciosek, Sergey Koren, Adam M Phillippy, Yaming Zhu, William A Lauer, Shelise Y Brooks, Gerard G Bouffard, Brandon D Pickett, Beth L Dumont, Melissa L Smith, Theodore S Kalbfleisch, Peter A Doris

The Brown Foundation: Institute of Molecular Medicine

We report a complete rodent telomere-to-telomere genome assembly from the brown rat, Rattus norvegicus. Annotation was enriched with multi-tissue long-read RNA sequencing and uncovered numerous novel genes. Assembly of both sex chromosomes reveals the absence of gene coding in the presumed pseudo-autosomal regions and the presence of centromeric satellite repeats on distal chromosome Y (chrY). We provide evidence of meiotic conjunction between Xp and Yq. The genome assembly reveals several expanded autosomal regions enriched for testis-expressed genes. Finally, we have generated a pangenome from recent high-quality assemblies of 8 distinct inbred rat strain genomes. This allows the strain-specific distribution of …

Development Of A Clinical Practice Guideline For Hpv Vaccination In Low-Income Adolescents Using The Agree Ii Framework, Jariatu Fatu Bundu

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) vaccination is an effective strategy for preventing HPV-related cancers; however, vaccination initiation and series completion remain suboptimal among adolescents, particularly those from low-income and underserved populations. This Doctor of Nursing Practice project addressed an evidence-to-practice gap involving the absence of a standardized clinical practice guideline (CPG) for HPV vaccination in a family practice setting serving predominantly low-income adolescents. The purpose of the project was to develop and validate an evidence-based CPG to standardize provider recommendations and support improvement in HPV vaccination initiation and series completion. Evidence was appraised and synthesized using the Johns Hopkins Evidence-Based Practice Model, …

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 …

Resource-Conscious Care: Time To Pregnancy And Iui Cycle Outcomes In Female Same-Sex Couples, Lea George, Devika Sachdev, Kassie Bollig

Department of Medicine Faculty Papers

RESEARCH QUESTION: Does the clinical pregnancy rate (CPR) for the first cycle, time to pregnancy, and cumulative CPR up to six consecutive cycles differ between female same-sex couples undergoing intrauterine insemination (IUI) alone and those undergoing IUI with ovarian stimulation?

DESIGN: This retrospective cohort study evaluated 554 female same-sex couples undergoing IUI alone (n = 264) or IUI with ovarian stimulation (n = 290) at a single centre using cryopreserved donor spermatozoa from January 2012 to January 2022.

RESULTS: Overall, CPR for the first cycle was 17.9% (99/554). In adjusted analyses, there was no significant difference in CPR in IUI …

Stemless Arthroplasty For Avascular Necrosis Of The Humerus: Implant Survival And Outcomes, Alyssa R. Henriquez, Damon V. Briggs, Eoghan T. Hurley, Samuel Lorentz, Christopher S. Klifto, Michael A. Moverman, Oke Anakwenze

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Avascular necrosis (AVN) of the humeral head often affects younger patients and may lead to progressive pain and functional deficits. While stemmed hemiarthroplasty and total shoulder arthroplasty (TSA) are established treatments for advanced-stage AVN, stemless arthroplasty offers potential advantages including bone preservation and facilitation of future revision. However, the impact of bone necrosis on stemless humerus fixation is yet to be elucidated. Therefore, the purpose of this study was to evaluate the outcomes of stemless hemiarthroplasty and TSA in treating humeral head AVN and, further, to determine if stemless humeral fixation is appropriate in this population.

METHODS: This retrospective …

Transient Activation Of Potent Progenitor Cells Is Required For Spinal Cord Regeneration, Chase Alexander Weinholtz

Arts & Sciences Graduate Student Theses and Dissertations

Mammalian spinal cord injury is an intractable biomedical problem driven by interlocking maladaptive cellular responses that prioritize acute stabilization over long-term recovery. However, this deficient regenerative capacity is not an inherent limitation. The zebrafish, for example, capably regenerates and regains motor function with 2 months of a full transection injury. This ability is thought to rely on the transient expansion of stem cell-like progenitors marked by sox2 expression. Yet our understanding of the identities and contributions of this crucial population remains limited. Here, we determine the molecular identities and cellular contributions of sox2+ progenitors during innate spinal cord repair in …

Runx1+23 Enhancer Marks Erythro-Megakaryocyte Lineages In Early Waves Of Hematopoiesis In Human Esc Differentiation, Chika Nishida, Michihiro Kobayashi, Alina Syed, Philipp Kramer, Haizi Cheng, Pamela L Wenzel, Motomi Osato, Jason David Chobirko, Andrew Grimson, Igor I Slukvin, Brian R Davis, Momoko Yoshimoto

The Brown Foundation: Institute of Molecular Medicine

No abstract provided.