Digital Commons Network^™

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 …

Lactate Dehydrogenase-To-Albumin Ratio As A Novel Prognostic Biomarker For 28-Day Mortality In Thoracic Trauma: A Single-Center Retrospective Cohort Study ​, Özgür Ömer Yildiz, Şükrü Yorulmaz, Eray Çinar, Hüseyi̇n Mutlu, Rami̇z Yazici, Ayşenur Gür, Medi̇ne Akkan Öz, Bensu Bulut, Mustafa Sirri Kotanoğlu, Hakan Güner

Turkish Journal of Medical Sciences

Background/aim: Thoracic trauma accounts for approximately 25% of all trauma-related deaths and remains a significant public health challenge. Early identification of high-risk patients is essential for improving clinical outcomes. The present study evaluates the prognostic value of the lactate dehydrogenase-to-albumin ratio (LDAR) in predicting 28-day mortality in patients with thoracic trauma.

Materials and methods: This retrospective observational study was conducted at a Level 1 trauma center between September 2022 and February 2025, and included adult patients presenting with thoracic trauma who underwent thoracic computed tomography. Demographic characteristics, clinical parameters, laboratory values, and 28-day mortality were analyzed. Receiver operating characteristic (ROC) …

Male Osteoporosis: Pathophysiology, Risk Assessment, And Evidence-Based Management, Seli̇n Teki̇n, Alper Gürlek

Turkish Journal of Medical Sciences

Osteoporosis in men is a common yet underrecognized condition associated with substantial fracture-related morbidity and excess mortality. Although men generally attain higher peak bone mass than women, age-related changes in bone microarchitecture, progressive cortical bone loss, declining sex steroid bioavailability, and a high prevalence of secondary causes contribute to a significant lifetime fracture risk. Importantly, a large proportion of fragility fractures in men occur at bone mineral density (BMD) values above the osteoporotic threshold, highlighting the limitations of BMD-based diagnosis alone. This review provides a comprehensive overview of the epidemiology, pathophysiology, and clinical characteristics of osteoporosis in men, with particular …

Comparative Analysis Of Corticosteroid Injection Alone Versus Combined Corticosteroid And Radiofrequency Ablation For Plantar Fasciitis: Short- And Medium-Term Outcomes ​, Nevci̇han Şahutoğlu Bal, Emel Başar, Hati̇ce Babaoğlan, Ülkü Sabuncu, Mustafa Cem Yilmaz, Şükri̇ye Dadali, Erkan Yavuz Akçaboy

Turkish Journal of Medical Sciences

Background/aim: Plantar fasciitis (PF) is a common cause of heel pain and may lead to functional impairment and reduced quality of life. This study aimed to compare the short- and medium-term clinical outcomes of corticosteroid injection (CSI) alone versus combined radiofrequency ablation (RFA) and CSI in patients with PF refractory to conservative treatment.

Materials and methods: This single-center retrospective comparative study included patients diagnosed with PF between 1 January 2021 and 1 January 2025. Patients who underwent either CSI alone or combined RFA and CSI after failure of conservative management were included. Pain intensity was assessed using a visual analog …

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 …

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 …

Thyroid Function In Children With Attention-Deficit/Hyperactivity Disorder And Specific Learning Disorder: A Retrospective Comparative Study, Gül Trabzon, Seda Aybüke Sari, Servet Yüce, Şeyma Demi̇ray Güllü

Turkish Journal of Medical Sciences

Background/aim: This study analyzes thyroid function parameters (free T₃, free T₄, TSH) in children with attention-deficit/hyperactivity disorder (ADHD), ADHD with specific learning disorder, and healthy controls, to determine whether subtle thyroid dysregulation contributes to the phenotypic heterogeneity of ADHD.

Materials and methods: This retrospective, cross-sectional study included 135 children aged 6–18 years: 62 diagnosed with ADHD (38 isolated ADHD and 24 ADHD+SLD) and 73 healthy controls. Demographic, anthropometric, and thyroid function data (free T₃, free T₄, TSH) were extracted from medical records. Group comparisons were conducted using independent samples t-tests, ANOVA, and ANCOVA adjusted for age, sex, and treatment status. …

Sarcopenia Risk In Women With Postmenopausal Osteoporosis: A Sarc-F-Based Assessment ​, Burak Kami̇l Turan, Ayşe Adi̇le Küçükdeveci̇, Zafer Günendi̇, Ayşegül Yaman, Oya Özdemi̇r, Jale Meray, Fatma Yeşi̇m Gökçe Kutsal

Turkish Journal of Medical Sciences

Background/aim: Osteoporosis and sarcopenia are diseases of bone and muscle tissue, respectively. Studies reported that these disorders were interrelated. However, this relation was explored in older adults and/or with certain comorbidities, and information about nonelderly postmenopausal women is scarce. This study’s objectives were to investigate the relationship between osteoporosis and SARC-F-defined sarcopenia risk in postmenopausal women aged ≤70 years and to examine the effect of other factors on this risk.

Materials and methods: This multicenter case-control study included postmenopausal women aged 45–70 years. Dual-energy X-ray absorptiometry was utilized to diagnose osteoporosis. Sociodemographic and clinical variables, sarcopenia risk (SARC-F), muscle strength …

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) …

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 …

Definitive Radiation Therapy For Schneiderian Inverted Papilloma Of The Soft Palate And Uvula., Rahul Sinha, Arianne J Abreu, Christopher E Fundakowski, Robert T Sataloff

Otolaryngology (ENT) Resident Research

Schneiderian inverted papilloma is a benign, locally aggressive tumor that typically arises in the respiratory mucosa of the nasal cavity and paranasal sinuses. These tumors are often asymptomatic but can cause unilateral nasal obstruction, discharge, hyposmia and epistaxis. They warrant attention particularly due to the potential for malignant transformation. They are treated most often with surgical excision. This case report describes a patient with Schneiderian inverted papilloma arising outside its usual location and managed with definitive radiation therapy instead of surgical excision due to concerns for functional impairment. Remission was obtained with radiation therapy, although the patient experienced treatment-related side …

A Dosimetric Comparison Of 6-Mv Flattening Filter And Flattening Filter-Free Photon Beams For Stereotactic Body Radiation Therapy Of Adrenal Tumors, Sarah Mcintosh

Masters Projects

Purpose: This study aimed to compare dosimetric characteristics and treatment delivery efficiency between 6-MV Flattening Filter (FF) and Flattening Filter-Free (FFF) photon beams for adrenal Stereotactic Body Radiation Therapy (SBRT). While FFF beams have demonstrated dosimetric and efficiency advantages at other SBRT sites, there is limited data about their use in adrenal SBRT.

Methods and Materials: A retrospective dosimetric comparison was performed using 10 patients previously treated with adrenal SBRT. For each patient, two Volumetric Modulated Arc Therapy (VMAT) plans were generated in Eclipse: one using 6-MV FF beams and one using 6-MV FFF beams, resulting in 20 total treatment …

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 …

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 …

Staff Re-Entry Plan — Indian Trail, Flett, Woodridge, Travis Schulhauser

Spokane Wildfire Academic Consortium Repository

Following the downgrade of Level 3 Evacuation orders at Flett Middle School and Indian Trail and Woodridge elementary schools on Aug. 9, district staff worked with Fulcrum Environmental Consulting to conduct visual inspections and air-quality testing at these sites. More than 100 interior and exterior locations were tested, with indoor air quality within the Good-to-Moderate range under the EPA Air Quality Index. Inspectors also found no indication of unusual ash, soot or other settled particulates inside or outside the buildings.

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 …

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 …

Effect Of Rangeland Quality On Rumen Development Of Angora (Mohair) Goat Kids And Bucks, Betül Zehra Sariçi̇çek

Turkish Journal of Veterinary & Animal Sciences

This study was conducted to determine the effect of rangeland quality on the rumen development of Angora goat kids and bucks. Twenty male singleton Angora goat kids with similar birth dates and birth weights were selected from each farm in an area with three different rangeland quality levels (good, medium, or poor) in Ankara Province. The kids were weaned at 60 days of age and then grazed completely on rangeland until slaughter. Rumen volumetric and papillary development of animals slaughtered at 4 and 7 months of age were determined. Empty rumen length, width, and weight were affected by rangeland quality …

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 …

Analyzing Fungal Growth Dynamics Under Different Environmental Conditions Using A Lotka–Volterra Competition System, Maria Ordonez, Fabrio Araujo

Discovery Day - Daytona Beach

Fungi play a critical role in ecosystems as decomposers that recycle nutrients and maintain environmental balance. Their populations are influenced by multiple environmental factors such as temperature, humidity, nutrient availability, and interactions with other organisms. In this project, the Lotka–Volterra model is used to analyze how competing fungal species interact and how these interactions influence population dynamics over time. By modeling two fungal populations competing for the same limited resources, the equations illustrate how environmental conditions and competition coefficients determine whether one species dominates; both species coexist, or one species becomes extinct. The model provides insight into how changes in …

Assessing The Impact Of Various Factors On Hypoxic Response, Reese Kim, Allysa Hayden

Discovery Day - Daytona Beach

Hypoxia is a condition in which the body’s tissues are deprived of oxygen and has deleterious effects on cognition, perception, and performance. Hypoxia has a myriad of symptoms such as euphoria, difficulty concentrating, headache, fatigue, nausea, dizziness, tunnel vision, and more. Outward signs of hypoxia include cyanosis (blueing of the fingertips and lips), tremors, loss of coordination, pallor, and complexion change, and can be used to notice the onset of hypoxia in others. Many factors are known to contribute to the manifestation of hypoxia, namely altitude, exposure duration, and certain physiological conditions such as heart problems and low blood flow …

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 …

Draining The Risk, Holding The Line: A Nurse-Driven Approach To Catheter-Associated Urinary Tract Infection Prevention, Thy Nguyen

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over …

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 …

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, …

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 …