Digital Commons Network^™

Disease Burden Attributable To Intimate Partner Violence Against Females And Sexual Violence Against Children In 204 Countries And Territories, 1990–2023: A Systematic Analysis For The Global Burden Of Disease Study 2023, Luisa S. Flor, Cory N. Spencer, Jack Cagney, Gabriela Fernanda Gil, Hasan Aalruz, Samar Abd Elhafeez, Siddig Ibrahim Abdelwahab, Meriem Abdoun, Mesfin Abebe, Yonas Abebe, Armita Abedi, Roberto Ariel Abeldaño Zuñiga, Alemwork Abie, Olumide Abiodun, Richard Gyan Aboagye, Lucas Guimarães Abreu, Rana Kamal Abu Farha, Bilyaminu Abubakar, Sawsan Abuhammad, Meshack Achore, Lisa C. Adams, Babatope Oluwadamilare Adebiyi, Kamoru Ademola Adedokun, Oluwatobi E. Adegbile, Nurudeen A. Adegoke, Olumide Thomas Adeleke, Makinde Adebayo Adeniyi, Zahir Vally

All Works

Background Violence against women and against children are human rights violations with lasting harms to survivors and societies at large. Intimate partner violence (IPV) and sexual violence against children (SVAC) are two major forms of such abuse. Despite their wide-reaching effects on individual and community health, these risk factors have not been adequately prioritised as key drivers of global health burden. Comprehensive x§and reliable estimates of the comparative health burden of IPV and SVAC are urgently needed to inform investments in prevention and support for survivors at both national and global levels. Methods We estimated the prevalence and attributable burden …

Implementing An Anxiety Management Bundle In Long-Term Nursing Facilities, Sundan G. Bryson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

There is currently a gap in accurate screening and treatment of anxiety in Long-Term Care (LTC) nursing facilities. The question for this quality improvement project was: Will implementing interventions for long-term care residents aged 65 and older improve anxiety screening, non-pharmacological interventions, and mental health referrals by 10% compared to current practices? Interventions to enhance anxiety screening included the Geriatric Anxiety Scale-Long Term Care (GAS-LTC) tool to assess and score anxiety. In addition, a Non-Pharmacological Intervention (Non-PI) tool was created to evaluate interventions performed by facility staff. Referrals to the mental health care provider were submitted if a resident scored …

The Association Between Personal Particulate Matter Exposures And Cognitive Function Among Stroke Patients, Kentucky, Usa, Nana Afua Ankomah Dei

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Stroke, a major cause of long-term disability and cognitive problems in the U.S., significantly affects people’s quality of life. Exposure to particulate matter (PM_2.5) may result in systemic inflammation and oxidative stress, which can worsen the cognitive function of post-thrombectomy stroke patients. This project thus assessed the relationship between PM_2.5 exposure and its effect on the cognitive function of post-thrombectomy stroke patients. Fifteen stroke patients (9 non-Appalachian and 6 Appalachian) undergone thrombectomy were recruited. Personal PM_2.5 exposure was measured using wearable sensors for a week during the study period. Montreal Cognitive Assessment (MoCA) scores and covariates …

Guidelines For Community Engaged Health Research, Carrie Leach, Hayley Thompson, Alex Sass, Patricia Wren, Rodlescia Sneed, Rhonda Dailey, Elizabeth Towner, Maha Albdour, Carla Caringi, Alyssa W. Beavers, Theresa A. Hastert, Vanessa Rorai, Peter A. Lichtenberg, Angulique Outlaw, Ijeoma Nnodim Opara

Institute of Gerontology

Executive Summary:

Wayne State University’s Guidelines for Community Engaged Health Research provide a practical framework for designing, conducting, and evaluating ethical, equitable, and impactful health research that engages community experts in projects that advance health equity in Detroit.

Purpose 

Developed for WSU faculty, staff, and research teams, the guidelines support the meaningful involvement of community experts across all phases of research. They respond to common challenges in community-engaged work, including limited experience with engagement approaches, the need for reflexive and equitable practices, and the time and coordination required for authentic collaboration.

The document defines Community-Engaged Research (CEnR) as collaborative work …

The Impact Of Heavy Resistance Training On Type Ii Muscle Fibers Throughout Female Reproductive Stages, Lily G. Colberg

Scripps Senior Theses

Type II muscle fibers, also known as fast-twitch muscle fibers, are reliant on aerobic glycolysis and are crucial for high-force contractions, mobility, and rapid movements, such as fast reflexes. Heavy resistance training has been found to increase type II muscle fiber concentration in young, middle-aged, and elderly individuals. However, there have been few studies conducted on female-only sample populations. In women, the impact of heavy resistance training on type II muscle fibers is affected by the progressive decline of estrogen that defines the transition throughout the four female reproductive stages: premenopause, perimenopause, late-transition menopause, and postmenopause. Menopausal estrogen depletion causes …

Implementation Of A Turn Team To Reduce Hospital-Acquired Pressure Injuries In A Medical Intensive Care Unit, Heather A, Adair

Doctor of Nursing Practice Final Project Abstract

Implementation of a Turn Team to Reduce Hospital-Acquired Pressure Injuries in a Medical Intensive Care Unit

PURPOSE

The project aimed to reduce hospital-acquired pressure injury (HAPI) rates in a Medical Intensive Care Unit (MICU) by improving nurses' knowledge of the Braden Scale and implementing a structured two-nurse turn team workflow to reposition high-risk patients every two hours.

RESULTS

Repositioning compliance improved substantially and consistently exceeded the project goal of 90% after implementing a pod-based workflow. The HAPI prevalence rate decreased from a baseline of 8% to below the project goal of ≤5% during implementation but was not sustained in the …

Embodied Aging: Older Adults’ Gendered Participation In Physical And Recreational Activity In Assisted Living, Gavin Anderson

Self-Designed Majors Honors Papers

This study examines how older adults interpret their experiences with physical and recreational activity in assisted living, and how these interpretations influence how they engage in their everyday social and physical contexts. In the fall of 2025, eleven older adults—nine women and two men—living in an assisted living facility in a coastal city in Southeastern Connecticut participated in in-depth semi-structured interviews. The facility provides both short-term post-acute care and long-term residential care, offering structured opportunities for physical and recreational engagement.

Past research demonstrates that participation in physical and recreational activity provides substantial benefits for older adults; yet, the lived experience …

Transitional Care Model Telehealth Calls To Improve Hospital Follow-Ups In A Community Health Center: A Quality Improvement Project, Veronica Dejesus

DNP Projects

Title: Transitional Care Telehealth Calls to Improve Hospital Follow-Up in a Community Health Center: A Quality Improvement Project

Background/Introduction: Transitions from hospital to primary care are a vulnerable period associated with missed follow-up appointments, poor patient outcomes, and increased readmissions, particularly in underserved populations. Internal data identified gaps in timely post-discharge follow-up, while external evidence supports structured transitional care interventions, such as telephone outreach within 48–72 hours, to improve patient engagement and continuity of care.

Objective/Purpose: The purpose of this quality improvement project was to evaluate whether structured, nurse-led transitional care telehealth calls improve completion of primary care follow-up visits …

Preparing For Change: Supporting Dementia Transitions Through Occupational Therapy And Caregiver Education, Kelly Ann Mooney

OTD Capstones

This capstone project focused primarily on supporting caregivers of individuals living with dementia within a continuing care retirement community (CCRC). Caregivers of spouses with dementia often experience increased burden, stress, and difficulty navigating the transition from independent living to higher levels of care. Guided by principles of occupational therapy, this project aimed to enhance caregiver knowledge, confidence, and overall well-being through the development and implementation of targeted educational resources and support strategies. 

Interventions included the creation of evidence-based educational handouts addressing common challenges for caregivers such as activities of daily living (ADLs), sleep, mealtime, and behavioral changes. Additionally, a structured …

Enhancing Wheelchair Education Throough Technology, Anna Elizabeth Voegel

Occupational Therapy Capstones

Purpose: The World Health Organization states there are more than 65 million wheelchair users worldwide, with the number expected to grow (Gilani, 2023). Many wheelchair users face challenges with not knowing how to properly maintain their equipment or develop the skills needed to navigate their environments (Boccardi et al., 2022; Morgan et al., 2015; Smith et al., 2016; Toro et al., 2017). This product aims to provide practitioners with accessible educational materials that address commonly encountered barriers, usable in the clinic setting or for patients and caregivers to access from a distance.

Methods: A needs assessment was conducted, which included …

Enhancing Leisure For Older Adults In Senior Living Communities, Hannah Louise Street

Occupational Therapy Capstones

Introduction: Older adults living in senior living communities are at an increased risk of social isolation, depression, boredom, and decreased quality of life (Donovan & Blazer, 2020; du Toit et al., 2019). Increasing access to meaningful, person-centered leisure activities can improve life satisfaction and overall quality of life for older adults (Chang et al., 2021; Shryock & Meeks, 2020). The purpose of this project was to develop a product to increase meaningful leisure engagement amongst older adults living in senior living communities for an overall improved quality of life.

Methodology: The model of human occupation (MOHO) was utilized as the …

Effect Of Antipsychotic Medication Use And Type On Mortality And Cardiovascular Risks In Nursing Home Patients With Dementia, Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan

Glennan Center for Geriatrics and Gerontology Faculty Publications

Introduction

Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. This study assessed the association between APM use and mortality, stroke, and myocardial infarction (MI) compared to non-use, as well as differences between first- and second-generation APMs.

Methods

A serial cross-sectional study using Medicare data examined outcomes from 2012 to 2015 in a national sample of 328,138 US NH residents aged 50 and older with dementia. Multivariate logistic regressions were used to analyze risk.

Results

APM use was associated with increased mortality in all years (odds ratio [OR] range: 2.39 to 1.23, all …

Occupational Therapy: There Through It All, Leanne Bates

Occupational Therapy Doctorate Capstone Posters

'Occupational Therapy: There Through It All' is a Doctor of Occupational Therapy Capstone project in collaboration with VNA Health at Home in London, Kentucky. The Applied Leadership Experience focused on patients, and their family members or caregivers, receiving home hospice care. The primary ACOTE focus areas were education, advocacy, and clinical practice. The purpose of the project was to facilitate an increased quality of life in home hospice patients by determining the gaps of care present for patients that do not receive occupational therapy (OT) services, provide education about OT’s role in hospice care, and creating educational resources for patients …

Exploring The Impact Of Age On Traumatic Brain Injury Cause And Recovery In Arkansas: A Retrospective Review, Abby Jones, Steven Wheeler, Jessica Danley

2026 Honors Symposium

Traumatic brain injuries (TBIs) remain a major public health concern, and increasing evidence goes to show the significance of the effect of age in quality of care, diagnosis, and recovery outcomes. In rural states, such as Arkansas, where research has shown a lack of resources and higher fatality rates among TBI patients, healthcare professionals can become better informed and equipped as a result of research efforts to uncover the effects of age on cause and recovery for inpatient TBI individuals in the early stages (Daugherty et al., 2022). Current research and prior evidence suggests that older individuals are more likely …

Inpatient Stroke Quality Improvement, Briyawna N. Wyatt

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Inpatient nursing documentation for stroke care is essential for meeting quality metrics, maintaining continuity, and supporting timely decisions. Gaps can lead to inconsistent care, metric failures, and reduced staff confidence. This quality improvement initiative aimed to improve metric compliance, documentation consistency, and nursing knowledge and satisfaction. A three-part intervention included targeted education, a standardized documentation verification form, and ongoing feedback from stroke champions. Outcomes measured were metric compliance, knowledge (pre/posttests), documentation completeness (Venous Thromboembolism (VTE), education, Modified Rankin Scale), and staff satisfaction. Results showed significant improvement in nursing knowledge (p < .005), reduced metric fallouts, and better documentation across all indicators. Staff satisfaction increased by about 20%. Overall, combining education, standardized tools, and continuous feedback improved documentation practices, enhanced compliance with stroke metrics, and increased nursing knowledge and satisfaction, supporting better care processes and patient outcomes.

Multisystem Predictors Of Dynamic Gait Stability Across Fall Risk In Older Adults, Ashwini Kulkarni, Neda Moghim, Ross Gore, Soumya Banerjee, Christopher K. Rhea, Brittany Samulski

Rehabilitation Sciences Faculty Publications

Gait stability arises from interactions between physiological, cognitive, and psychological systems, yet these domains are often assessed in isolation. This study examined multisystem predictors of anteroposterior margin of stability during walking (MoSAP) in community-dwelling older adults. Of 340 participants, 143 were retained after data quality screening (105 females; age: 70.8 ± 7.8 years). Participants completed the Physiological Profile Assessment (PPA), cognitive testing using Montreal Cognitive Assessment (MoCA), fear-of-falling evaluations using Modified Falls Efficacy Scale (MFES) and a biomechanical gait assessment during preferred and fast speeds. Participants were stratified into four PPA-based fall-risk groups: low, mild, moderate, and high risk. MoSAP …

Enhancing Leisure Opportunities For People With Disabilities In Rural Communities, Joslyn Mary Nordmark

Occupational Therapy Capstones

Purpose. The purpose of this scholarly project was to promote access to leisure opportunities for people with disabilities in rural areas. The author addressed unmet needs among this population considering personal, occupational, environmental, cultural, and socioeconomic factors. The goal was to develop a product that provided opportunities regardless of abilities to promote leisure exploration and participation, social engagement, and life skill development for people with disabilities

Methods. The author conducted a needs assessment through a literature review following the Model of Human Occupation (MOHO), collaborations with site staff, and an on-site observation and environmental analysis. Data was examined to identify …

Increasing Leisure Exploration In Older Adults As They Age, Jackie Middendorf

Occupational Therapy Capstones

Background: As individuals age, it is common for them to experience deficits that impact how and where they age (Dieuleveult et al., 2017; Nakahara & Yokoi, 2024; Park et al., 2021; Rimland et al., 2016; Szanton et al., 2016). These deficits commonly impact functional mobility and their ability to complete self-cares, leading to them having to leave their homes or receive services (Dieuleveult et al., 2017; Feller & Baker, 2022; Lindquist et al., 2021; Mayo et al., 2021; Spang et al., 2024). Along with deficits with functional mobility and self-cares, older adults experience decreases in their social engagement and leisure …

Quality Of Life Of Individuals Residing In Senior Living Facilities, Meagan R. Danda

Occupational Therapy Capstones

Introduction: Formal caregivers play an essential role in supporting residents’ physical, emotional, and social needs which contribute to overall health and well-being (Spilsbury et al., 2024). Due to these responsibilities, caregivers need to be properly equipped with the knowledge and skills necessary to perform clinical duties with confidence. The purpose of this scholarly project is to develop a product that increases caregiver confidence by providing caregivers with occupational therapy informed education. By enhancing caregivers’ knowledge and skill set, this product may contribute to a supportive environment that fosters resident engagement in meaningful occupations and promotes improved quality of life (QoL) …

Evaluating The Burnout Mitigating Effects Of A Structured Mentorship Program In Newly Hired Advanced Practice Providers, Melissa Soper

DNP Projects

Importance: Burnout is a leading driver of clinician intent to leave, lower productivity, increased medical errors, and increased resource use.

Objective: The purpose of this project was to evaluate the effects of an evidence-based mentorship program on newly hired advanced practice providers’ (APPs’) level of stress, burnout, and professional fulfillment.

Results: At baseline, APPs demonstrated higher stress levels, moderate professional fulfillment, and low burnout. Outcomes showed improvement at the end of a mentorship program.

Conclusion: Longitudinal studies with larger sample sizes are needed to determine the true effect of a 6-month mentorship intervention on APP burnout, stress, and professional fulfillment.

Designing Narrative-Based Ai Assistance For Sensemaking In Collaborative Environments: Case Studies In Education And Dementia Care, Dylan Edward Moore

Dartmouth College Ph.D Dissertations

This thesis addresses a gap in the human-computer interaction literature regarding the design, development, and evaluation of narrative-based AI assistance for collaborative, complex problem solving. I explore this design space through three case studies across the domains of education and dementia care. This work encompasses multi-year industry partnerships and longitudinal fieldwork, user-centered design, dataset curation, model training, and system evaluation.

Specifically, the first case study considers a story-based web platform for teaching AI literacy through peer-generated, personalized narrative scaffolding. Learners on the platform showed significant knowledge gains and other learning-related outcomes. To describe the novel design of this system, I …

Adipose Tissue-Derived Small Extracellular Vesicles In Plasma Reveal Molecular Circuitries Underlying Glucose Intolerance, Shalini Mishra, Yixin Su, Ashish Kumar, Sangeeta Singh, Brian S. Finlin, Fang-Chi Hsu, Jingyun Lee, Cristina M. Furdui, Philip A. Kern, Swapan K. Das, Gagan Deep

Internal Medicine Faculty Publications

Objective: Glucose tolerance (GT) is a major effector for adipose tissue (AT) remodeling in obesity, yet its molecular mechanisms remain incompletely defined. We hypothesized that the biophysical and molecular profiles of AT-derived small extracellular vesicles (sEV^AT) change in response to glucose availability and differ by GT status.

Methods: sEV^AT were isolated from plasma of individuals with normal GT (NGT) and impaired GT (IGT) (n = 5/group) at fasting (0 h) and 1 h post glucose challenge during oral glucose tolerance test (OGTT). sEV^AT were characterized for size, concentration, surface expression of insulin receptor-α (INSRα), proteome, …

Expanding The Boundaries Of Bedside Practice: Transport Nursing As A Living Model Of Clinical Nurse Specialist Competencies, Ian A. Lane

Faculty Publications (Peer-Reviewed)

Objectives: The purpose of this paper is to argue that clinical nurse specialist (CNS) education represents the most conceptually and professionally continuous advanced practice pathway for critical care transport nurses, and to highlight transport nursing as an underrecognized practice context that aligns closely with CNS competencies and warrants deliberate attention from CNS educators and programs.

Description:  This paper presents a conceptual analysis of transport nursing through the CNS spheres of influence, emphasizing continuity with bedside nursing expertise while extending into quality improvement and systems leadership. This perspective examines how transport nurses routinely navigate high-acuity clinical cases and interfacility system constraints. …

Increased Mortality And Reduced Survival In Nonagenarians With Hip Fractures: Implications For Geriatric Care, Roman Austin, Julio Avila, Audrey Wassef, Kate Parker, Katherine Gavin

Western Journal of Orthopaedics

Background: Hip fractures in nonagenarians (patients aged ≥ 90 years) are becoming increasingly common as the population ages, yet outcomes in this group remain poorly characterized. This study compared in-hospital mortality and survivorship at three months, six months, and one year after hip fracture surgery in nonagenarians with a younger elderly cohort aged 65 years to 89 years. Secondary outcomes included fracture characteristics, surgical management, and discharge disposition. Methods: A retrospective chart review was conducted on patients who underwent hip fracture surgery at a single Level I Trauma Center from August 2019 to December 2021. Patients were grouped into nonagenarians …

Resilience Shields And Grit Intensifies Subjective Cognitive Decline In Middle‐To‐Older Aged Black Americans, Sunkanmi Folorunsho, Maria Clark, Obinna Odo, Yolanda L. Jackson, Candidus C. Nwakasi, Darlingtina K. Esiaka

Behavioral Science Faculty Publications

Background: There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differential effects on subjective cognitive decline (SCD) in Black American adults remain understudied. The purpose of this study is to help fill this gap.

Methods: The study utilized a cross-sectional research design. Black American participants (N = 242; Mean age = 44.32) responded to a survey assessing SCD, grit, resilience, and sociodemographic factors. Linear regression analysis was performed to test the associations between grit and resilience and SCD, and to …

Aging With Mercy, Thriving In Place, Emma Layne Katzman, Karen Weis, Jennifer Rugletic Washko

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

Occupational engagement, spirituality, and quality of life are recognized as important dimensions of aging, however, these factors remain underexplored among older adults residing within faith-based communal living environments. This doctoral capstone experience, Aging with Mercy, Thriving in Place, consisted of two distinct but complementary components: an Institutional Review Board (IRB)-approved mixed methods research study and a quality improvement initiative. The purpose of the research study was to explore occupational engagement, occupational role transitions, spirituality, identity, and perceived quality of life among older adults residing within a faith-based communal living environment. Quantitative data were collected using the World Health Organization Quality …

The Sequence (S) Index As A Marker Of Diminished Step-To-Step Transition Efficiency In Older Adults, Elham Alijanpour, Ashwini Kulkarni, Peter G. Adamczyk, Daniel M. Russell

Rehabilitation Sciences Faculty Publications

Introduction: Age-related declines in walking efficiency are often attributed to musculoskeletal and neuromuscular changes, yet the mechanisms underlying these inefficiencies remain poorly understood. One key contributor is the step-to-step transition (STST), during which the center of mass (CoM) is redirected between limbs. The Sequence (S) index quantifies the temporal overlap between push-off and collision forces during STST, with higher values indicating greater mechanical energy loss. This study investigated whether aging affects STST efficiency, as quantified by the S index, and examined the timing and impulse characteristics underlying observed differences.

Methods: Thirteen young and eleven older healthy adults walked at five …

To Treat Or Not To Treat: Evaluating Antipyretic Use And Patient Outcomes In Febrile Care, Nico Teodosio, Brynley Harris

Williams Honors College, Honors Research Projects

This honors project aims to critically examine the evidence-based practice use of antipyretics in fever management, questioning whether suppressing fever is truly in the patient's best interests and if it benefits patient outcomes. Grounded in nursing, past nursing courses, and emerging research, this project aims to answer the following PICOT question: In febrile patients, how does withholding, or not administering, antipyretics compared to administering antipyretics affect patient outcomes during hospitalization? Through a literature review, this project will analyze studies from databases like PubMed and Google Scholar, focusing on outcomes like recovery time, symptom severity, complications, and mortality. Using the PRISMA …

The Interplay Between Loneliness, Cortisol, And Nk Cell Function: The Role Of Cortisol In Nk Cell Dysfunction, Abhinav Saurabh, Yvonne Baumer, Laurel G. Mendelsohn, Elizabeth M. Aquino Peterson, Dana Sadler, Shirley J. Lopez De Leon, Ayushi Dave, Andrew S. Baez, Lola R. Ortiz-Whittingham, Mario A. Pita, Manuel A. Cintron, Hannatu A. Tarfa, Sandy T. Reynolds, Shelby R. Hicks, Sonal Sharda, J. Eleanor Seo, Maria Lopez-Ocasio, Pradeep K. Dagur, Skyler A. Kuhn, Neelam R. Redekar, James F. Troendle, Ayanna L. Wells, Marie Marah, Katherine J. Tolentino, Michael J. Corley, Alika K. Maunakea, Lynnette K. Nieman, Marcus R. Andrews, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

Chronic psychosocial stressors contribute to cardiovascular disease (CVD) and related risk factors, particularly in under-resourced communities. Psychosocial stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, leading to sustained cortisol action on immune cells. Natural killer (NK) cells are altered in distribution and function in cardio-metabolic diseases; however, pathways linking cortisol as a marker of chronic stress to NK cell dysfunction remain understudied. We recruited 186 African American women from the Step It Up Community-Engaged, Digital Health Physical Activity Intervention study and collected cortisol, NK cell measures, and psychosocial stress measures using validated questionnaires, including chronic stress and loneliness. Plasma cortisol levels were …

Kidney Dysfunction, Biochemical Changes, Dna Alteration, And Mapks Regulation Following Chronic Exposure To Regular And Occasional Hookah Smoke In Mice, Naserddine Hamadi, Anas Nemmar, Sumaya Beegam, Nur Elena Zaaba, Ozaz Elzaki, Abderrahim Nemmar

All Works

Regular hookah smoking (Reg-HS) has become a major global public health issue, linked to significant health risks, including kidney damage. A less frequent pattern of use, known as occasional hookah smoking (Occ-HS), is also common; however, there has been little progress in understanding the direct impact of Occ-HS on kidneys. To investigate how varying frequencies of HS inhalation affect the kidney, we exposed mice to nose-only HS under two regimens, occasional (30 min once weekly) and regular (30 min five times per week) for a duration of 6 months. This study explored the impact on renal damage, inflammatory responses, oxidative …