Digital Commons Network^™

Supportive And Palliative Care: Addressing The Unspoken Burden Of Cancer On Significant Others, Esmeraldo C. De Las Armas Iv

Jurnal Keperawatan Indonesia

A diagnosis such as cancer can cast a long-lasting gloom that affects not only the patient but also their loved ones. This concept analysis represents an effort to understand and explore the nuanced world of supportive and palliative care for significant others of cancer patients, a population that has often been overlooked. Rodgers’ evolutionary model of concept analysis was utilized to examine the concept of supportive and palliative care for significant others of cancer patients. Positive outcomes for both significant others and patients included improved coping mechanisms, reduced caregiver burden, enhanced communication, and better quality of life. However, several challenges …

Effects Of Montessori-Based Stimulation On Fine And Gross Motor Development Among Children With Stunting: A Quasi-Experimental Study, Indah Rahmadaniah, Tukimin Bin Sansuwito, Rini Anggeriani, Rinda Lamdayani, Ade Marlisa Rahmadayanti, Aris Citra Wisuda

Jurnal Keperawatan Indonesia

Stunting affects not only physical growth but also several aspects of child development, including gross and fine motor skills. Early stimulation interventions, such as Montessori-based activities, have been proposed to enhance developmental outcomes through structured sensorimotor experiences. This study aimed to evaluate the effects of Montessori-based stimulation on motor development among children with stunting and to compare its outcomes with those of conventional stimulation. A quasi-experimental study with intervention and control groups was conducted among 120 children with stunting aged 36–59 months. Participants were allocated to either a Montessori group (n = 60) or a conventional stimulation group (n = …

Evaluating Mobile Palliative End-Of-Life Advanced Care Enhancement (Mpeace) Usability And Technology Acceptance: Mixed-Methods Design, Ni Luh Putu Inca Buntari Agustini, I Gede Putu Darma Suyasa, Israfil Israfil

Jurnal Keperawatan Indonesia

Palliative End-of-Life Care (PEoLC) is a process requiring timely assessment, effective communication, and personcentered decision-making to support patients and families. Although the process can be strengthened through digital health innovations such as Mobile Palliative End-of-Life Advanced Care Enhancement (M-PEACE), its use in PEoLC remains limited. Therefore, this study aimed to evaluate M-PEACE usability and technology acceptance through an explanatory sequential mixed-methods design and explore user experiences in describing quantitative results. The quantitative phase was conducted to assess usability through an adapted System Usability Scale (SUS), and technology acceptance was measured using a modified Technology Acceptance Model (TAM) questionnaire. A total …

Knowledge, Attitudes, And Practices By Women In Cartagena Regarding Breast Self-Examination, Rafael Arnedo Martínez, Keidis Ruidiaz Gómez

Jurnal Keperawatan Indonesia

Breast self-examination (BSE), especially when adopted by vulnerable populations, serves as a vital mechanism for the timely detection of breast abnormalities indicative of cancer. As a result, this decreases the public health burden associated with treatment at advanced stages. Therefore, assessing knowledge, attitudes, and practices (KAP) regarding this simple early detection method is a priority. This study examines the relationship between KAP concerning BSE among women in Cartagena, Colombia. A cross-sectional correlational study was conducted with 322 women attending a healthcare facility. Data were gathered using two tools: a sociodemographic profile and a KAP questionnaire. Results showed that most participants …

Evaluation Of A Streamlined Insurance Advocacy And Pre-Authorization Process For Hormone Replacement Therapy, Ellison Edwards

Walden Dissertations and Doctoral Studies

This organizational process evaluation project addressed the high rate of insurance denials for hormone replacement therapy (HRT) for women with symptomatic menopause and "normal" laboratory values within a private primary care setting. The practice problem involved bureaucratic barriers in the front office and a lack of structured advocacy, which delayed patient access to evidence-based care. The purpose of this project was to evaluate the impact of a streamlined insurance advocacy and pre-authorization process on access to therapy. The project utilized a standardized "Insurance Advocacy Toolkit" and evidence-based templates aligned with the 2023 North American Menopause Society (NAMS) guidelines. Analytical strategies …

Staff Education To Improve Geriatric Mental Health Screening And Pharmacotherapy, Andy Wu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project addressed the lack of standardized workflows and clinical confidence regarding geriatric mental health screening and safe antidepressant initiation at a rural primary care clinic. Utilizing the FOCUS-PDSA framework, a 15-minute staff education module and a clinical pocket guide were implemented to train Medical Assistants (MAs) on integrating PHQ-9 and GAD-7 screenings during triage, and to equip providers with EHR SmartPhrases and 2023 AGS Beers Criteria prescribing guidelines. A pre- and post-intervention 5-point Likert scale survey evaluated the knowledge and clinical confidence of the clinic staff (n = 12). Results demonstrated a …

“It’S Not Just Cost”: Barriers To Mammography Screening Access Among Low-Income Women In The United States—A Scoping Review, Julia Messerman, Callia Nickels, Nigel C. James

Health Studies Faculty Publications

Despite the recognized importance of early detection, disparities in mammography access persist among low-income women in the United States. While financial barriers are often emphasized, less is known about how multiple barriers interact to shape access to screening. We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines to synthesize evidence on barriers to mammography access among low-income women in the United States. A systematic search of PubMed, CINAHL, and Google Scholar identified peer-reviewed studies published between 2010 and 2025, of which 47 met inclusion criteria. Extracted barriers were categorized into …

Mll3 And Mll4 Sustain Hematopoietic Stem Cell Multipotency By Opposing A B-Cell Default State, Helen C Wang, Ran Chen, Wei Yang, Rohini Muthukumar, Tingting Hu, Riddhi M Patel, Emily B Casey, Elisabeth Denby, Run Zhang, Guojia Xie, Kai Ge, Grant A Challen, Jeffrey J Bednarski, Jeffrey A Magee

2020-Current year OA Pubs

Hematopoietic stem cells (HSCs) and multipotent progenitors (MPPs) are sustained by networks of transcription factors and epigenetic regulators that prime lineage-specific programs yet maintain multipotency. Two epigenetic regulators, MLL3 and MLL4, play important but distinct roles in maintaining this balance. MLL3 promotes HSC differentiation, whereas MLL4 opposes differentiation. These activities are essential for both normal homeostasis and leukemia suppression, yet it is not clear how MLL3 and MLL4 regulate HSC and MPP gene expression to control HSC/MPP fate decisions. To resolve these mechanisms, we performed an extensive series of single-cell genomic studies after conditionally deleting Mll3, Mll4 or both genes …

Rehcardicare: A Digital Telerehabilitation Platform For Cardiac Recovery Following A Coronary Artery Bypass Graft, Elvipson Sinaga, Khairunnisa Batubara

Jurnal Keperawatan Indonesia

Post-coronary artery bypass graft (CABG) patients often experience decreased cardiac output, which slows recovery and increases the risk of cardiovascular complications. This research and development study evaluated the preliminary effectiveness of the REHCARDICARE application in increasing cardiac output, a key indicator of successful cardiac rehabilitation. The research also assessed user satisfaction to determine the feasibility of broader implementation. The findings can inform further development of the application. The application development used the (Analysis, Design, Development, Implementation, Evaluation) ADDIE model. The study subjects consisted of 30 post-CABG patients purposively selected at the North Sumatra Integrated Heart Center. An application-based resistance and …

Loss Of Pleasure (Anhedonia): A Sex-Dependent, Cross-Species Consequence Of Unpredictable Signals To The Perinatal Brain, Anna M. Zhou, Madison R. Tetzlaff, Laura M. Glynn, Curt A. Sandman, Hal S. Stern, Tallie Z. Baram, Elysia Poggi Davis

Psychology Faculty Articles and Research

Reward seeking is an essential component of human behavior. Anhedonia (reduced motivation for and pleasure in reward) is a core feature of several mental illnesses. Early life adversity associates with later impairments in reward behaviors and related psychopathology; however, specific aspects of early adversity that lead to disrupted reward behaviors are unknown. Capitalizing on evidence that unpredictable signals to the developing brain constitute adversity and influence neurodevelopment, we examined whether exposure to perinatal unpredictable maternal signals associated with diminished reward responsivity, and probed causality using experiments in mice. We analyzed a longitudinal human study (N=158 mother/child dyads) and a …

Development Of A Culturally Tailored Care Model For Chronic Disease Management In The Coastal Community: A Modified Delphi Study, Laode Saltar, Heltty Heltty, Sitti Mikarna Kaimuddin

Jurnal Keperawatan Indonesia

Chronic noncommunicable diseases (NCDs), particularly hypertension and type 2 diabetes mellitus, are increasing in Indonesia’s coastal communities including the Bajo population in Southeast Sulawesi. Limited healthcare access, cultural barriers, and low preventive health engagement exacerbate the disease burden in these communities. Culturally tailored interventions are needed to enhance self-awareness and improve chronic disease management. This study aimed to develop and validate a culturally sensitive care model for chronic disease management in the Bajo coastal community. A three-round modified Delphi method was used with 26 panelists representing health professionals, community leaders, policymakers, and family members recruited through community health centers and …

Intermembrane Coupling Between Bcl-Xl And The Ip3 Receptor Supports Local Ca2+ Transfer At Er-Mitochondrial Contacts, Arijita Ghosh, David Weaver, Chi Li, György Hajnóczky

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Bcl-xL, an anti-apoptotic Bcl-2 family protein, engages laterally with Bak/Bax in the outer mitochondrial membrane (OMM) to inhibit apoptosis and interacts with the IP₃ receptor Ca²⁺ channels (IP3Rs) in the endoplasmic reticulum (ER) membrane to control Ca²⁺ release. It is unknown if OMM-localized Bcl-xL can also interact in trans with IP3Rs at ER-mitochondrial contacts to form a tethering complex that supports IP3R-mediated local Ca²⁺ transfer from ER to mitochondria. We establish that IP3R-mitochondria Ca²⁺ signal propagation depends on Bcl-xL. By targeting Bcl-xL specifically to different subcellular compartments, we find that OMM-localized Bcl-xL increases the efficacy …

Early Post-Cesarean Anxiety, Nausea, Vomiting, And Pain Under Spinal Anesthesia: Trajectories And Modifiable Predictors, Indah Susanti, Eza Kemal Firdaus, Septian Mirova Sebayang, Amelia Andini, Alicia Dumes Berg, Margaret Atwood, Rantiningsih Sumarni, Mesya Mesya, Asmat Burhan

Jurnal Keperawatan Indonesia

Recovery after caesarean under spinal anesthesia remains a quality gap, with scarce evidence on modifiable anesthetic practices improving recovery. Data linking the neuraxial technique, nausea, anxiety, and pain remain limited. The objective of this study was to describe postoperative nausea and vomiting, anxiety, and pain at 6, 12, and 24 hours after caesarean section under spinal anesthesia and to examine whether intrathecal adjuvant use, sensory block level, fasting duration, and American Society of Anesthesiologists (ASA) physical status were associated with these outcomes. Cross-sectional study across five hospitals; 534 women undergoing caesarean under spinal anesthesia. Exposures: intrathecal adjuvant, sensory level (≤ …

Emotional Intelligence, Work Engagement, And Turnover Intention Among Hospital Nurses: A Hierarchical Component Analysis, Catrin Catrin, Christopher Wisnu, Pauline Henriette Pattyranie Tan

Jurnal Keperawatan Indonesia

High turnover intention among hospital nurses poses serious challenges to healthcare organizations, affecting service quality and workforce stability. Understanding the psychological and organizational factors associated with turnover intention is essential for developing effective retention strategies. This study aimed to examine the relationships among emotional intelligence, work engagement, and turnover intention among hospital nurses, including health-promoting leadership, workload, and burnout as contextual variables within the model. A cross-sectional study was conducted among 98 nurses working in inpatient units using validated questionnaires. The data were analyzed using partial least squares structural equation modeling (PLS-SEM) with hierarchical component analysis. Emotional intelligence significantly predicted …

Cracking The Code: The Systematic Development Of A Coding Matrix For Qualitative Data Analysis, Greta Gray, Marie-Christine Potvin

Department of Occupational Therapy Faculty Papers

A systematic approach was used to develop a coding matrix for a qualitative study with the intent to strengthen the credibility and dependability of the findings. Coding matrixes are commonly used in qualitative studies to organize data into meaningful units of text to be interpreted by the researchers. Current methods of coding matrix development can be problematic as they may introduce biases in the results and have limited reproducibility. A novel approach was employed to address this need with the “a priori” development of a coding matrix using a multi-step deductive and inductive process with multi-coders (n=5).  The coders who …

Dosimetric Impact Of Eclipse’S Entrance Avoidance Tool On Salivary Gland Sparing In Head And Neck Vmat Plans, Shannon Diederichs

Masters Projects

Medical dosimetry is constantly evolving as new techniques emerge to improve plan quality. The Eclipse treatment planning system (TPS) is equipped with the entrance and exit dose avoidance tool commonly used to prevent beam interaction with implanted metals or steer the beam away from anatomical regions. Current literature shows this tool has not been thoroughly investigated for more fundamental applications such as routine organ at risk (OAR) sparing. Xerostomia remains a lasting side effect for head-and-neck cancer (HNC) patients after the salivary glands receive substantial radiation. This study takes a more detailed look at the tool’s effectiveness when applied to …

Demographic And Socioeconomic Factors Related To Visceral Leishmaniasis Infection In South Sudan, Duncan Ochieng Ochol

Walden Dissertations and Doctoral Studies

Visceral leishmaniasis, a severe parasitic disease that is invariably fatal, is characterized by frequent outbreaks, and is associated with poverty. South Sudan is among the countries with the highest burden of visceral leishmaniasis. However, few studies have investigated factors associated with visceral leishmaniasis in the country. This study investigated demographic (age, gender, marital status, education level and occupation) and socioeconomic factors (transport, access to health services and residence) that may be associated with visceral leishmaniasis infection in South Sudan. The study was anchored on the socioecological model conceptual framework, which describes the interaction between individual and their social environment and …

A Perfect Storm In Advanced Aids: Severe Acute Respiratory Distress Syndrome From Pneumocystis Jirovecii And Mycobacterium Avium Complex Coinfection, Abdel Martinez, Abelardo Rodriguez, Conrad Chouinard, Fatimah Bello

School of Medicine Publications

Advanced HIV infection is associated with profound immunosuppression, predisposing patients to opportunistic infections such as Pneumocystis jirovecii pneumonia (PJP) and Mycobacterium avium complex (MAC). PJP can cause severe respiratory disease, including acute respiratory distress syndrome (ARDS), while disseminated MAC may contribute to systemic illness and pulmonary complications. Concurrent infection with both pathogens is uncommon but may precipitate severe pulmonary failure. A man in his 40s presented with unintentional weight loss, fatigue, oral thrush, and progressive dyspnea. On arrival, oxygen saturation was 86% on room air, requiring high-flow nasal cannula. Laboratory evaluation revealed profound immunosuppression (CD4 7 cells/mm3, HIV RNA 123,000 …

Implementing A Research Best Practices Training For Community Health Workers And Promotoras At Multiple Sites: A Mixed Methods Evaluation, Alexandra E. Harper, Analay Perez, Gretchen Piatt, Gina M. Jay, Jasmine J. Opusunju, Lakeisha M. Batts, Giselle M. Garza, Tania Terezon, Candace Robledo, Loren Clark

School of Medicine Publications

Introduction: We previously developed and tested a peer-led research best practices training for community health workers and promotoras (CHW/Ps) to enhance the capacity of a workforce that is increasingly important for community-engaged research. This paper explores results of training implementation at 4 additional sites – 3 academic institutions and 1 community-based organization.

Methods: Forty-two CHW/Ps were trained over 6 trainings and 10 site staff participated. We used a mixed methods design consisting of surveys and interviews to assess site staff’s perceptions of the training and its implementation. Survey data were examined using basic statistics and thematic content analysis. Two coders …

Environmental Exposure Risk Education To Enhance Chronic Kidney Disease Prevention And Screening For Nurse Practitioners, Kelsea J. Carrier

Doctor of Nursing Practice Scholarly Projects

Chronic kidney disease (CKD) affects approximately 36 million adults in the United States, with nearly 90% of individuals unaware of their diagnosis until advanced stages. While diabetes and hypertension remain the primary causes, increasing evidence highlights environmental exposures as significant and underrecognized contributors to CKD onset and progression. Exposures such as heavy metals, per- and polyfluoroalkyl substances (PFAS), air and water pollution, microplastics, and heat exposure have been linked to impaired renal function. Despite this growing body of evidence, environmental health content remains limited in nursing education, resulting in gaps in environmental health literacy (EHL) among nurse practitioners (NPs) and …

Limited Australian Clinical Guidelines For Pain Assessment In Hospitalized Older Adults With Cognitive Impairment: Implications For Safe And Quality Care, Rosemary Saunders, Kaoru Nosaka, Seng Giap Marcus Ang, Natasya Raja Azlan, Aaron Alejandro, Rohini Sharma Bhardwaj, Olivia Gallagher, Irene Ngune, Amineh Rashidi, Yan Hui Celestine Wee, Nilufeur Mckay

Research outputs 2022 to 2026

Introduction – Pain assessment remains challenging in healthcare settings in patients who are unable to self-report their pain. More than 50% of individuals with dementia and other forms of cognitive impairment (CI) experience pain daily. However, pain is frequently overlooked and inadequately assessed by healthcare professionals due to their lack of knowledge and guidelines to inform pain assessment. Pain is also a leading cause of hospital presentation and inappropriate pain assessment can impact on pain management and compromise safe and quality care. Evidence-based guidelines that inform appropriate pain assessment and management are therefore essential. This scoping review aimed to explore …

Clinical Phenotypes Associated With Nrxn1 Deletions In Five Children With Autism Spectrum Disorder In Oman, Samira Said Alhousni, Ahmed Idris, Watfa Al-Mamari, Abeer Al-Sayegh

Sultan Qaboos University Medical Journal

NRXN1 (2p16.3) is essential for synaptic function and has been implicated in autism spectrum disorder (ASD) and other neurodevelopmental disorders. However, the phenotypic features associated with NRXN1 copy number variants remains incompletely characterised, which complicates risk assessment in genetic counselling. This case series describes five children, who were evaluated at the Genetics and Developmental Pediatrics Clinic of a tertiary care hospital in Muscat, Oman, from 2011 to 2023, with rare NRXN1 deletions (57–150 kb). All met DSM-5 criteria for ASD and had speech and language delays with cognitive impairment. Consanguinity was reported in three of the families and two had …

Bridging The Gap In Science Research: Preparing Students For College- Level Research In The Sciences, Victoria Helwig, Yaoguang Li

UConn Library Presentations

Many first-year students enter college unprepared to fully engage with scientific literature and academic library resources. Drawing on experiences from academic librarians working with STEM students, this session explores common gaps in science research skills, including navigating databases, identifying scholarly sources, and understanding the structure of scientific literature. Participants will be introduced to practical strategies and classroom-ready activities to better prepare students for college-level research. Discussion questions: What science research skills do students struggle with most when entering college? How can high school instruction better support these skills? Where can librarians and educators collaborate to support student success?

Comment On: Managing Sickle Cell Disease And Related Complications In Pregnancy: Results Of An International Delphi Panel, Deva Sharma, Ilknur Pamuk, Kenneth I. Ataga, Alexandra Benachi, Selim Büyükkurt, Sophie Lanzkron, Hakan Ozdogu, Shivan Pancham, Lydia H. Pecker, Susan E. Robinson, Safak Yilmaz Baran

Cardeza Foundation for Hematologic Research

Consensus-based recommendations on managing sickle cell disease in pregnancy were recently published in a hematology journal. As this topic is also of great interest to obstetricians and gynecologists, we summarize some of these recommendations, while highlighting the challenges of providing evidence-based medical care to pregnant individuals with sickle cell disease.

From Fields To Flu: Mapping H5n1 Zoonotic Risk In California Rice Fields, Mariati Messinger

Walden Dissertations and Doctoral Studies

Highly Pathogenic Avian Influenza (HPAI) H5N1 threatens agriculture, wildlife, and public health in California, where flooded rice fields in the Central Valley provide surrogate wetland habitat for migratory waterfowl and may create ecological interfaces for viral spillover into poultry systems. This quantitative ecological study examined whether county-level rice acreage, Lesser Snow Goose activity, and their interaction were associated with poultry HPAI H5N1 outbreak incidence during complete winter seasons available for analysis. Guided by One Health and disease ecology frameworks, secondary data from USDA, eBird, PRISM, and public surveillance sources were analyzed for 36 county-winter observations using negative binomial regression, logistic …

Examining Variations In Non-Conventional Health Care Utilization Among Students At A Hispanic-Serving Institution, Monideepa B. Becerra, Karina E. Corral

Journal of Social, Behavioral, and Health Sciences

The use of non-conventional health care, such as complementary and alternative medicine (CAM) and traditional healing practices, is increasing in the United States. Little is known, however, about its prevalence and influencing factors among college students—especially of varied racial/ethnic background. This study examined these patterns among college students using a cross-sectional survey conducted at a Hispanic-serving institution. Participants reported their use of non-conventional care, and demographic and motivational factors were analyzed using descriptive and bivariate analyses. Of the 641 participants, a majority reported CAM use (96%) and visits to a traditional healer (83%), with higher prevalence among Hispanic and female …

"It's Probably Like A Web": Complex Relationships Between Pain And Mental Health Among Bisexual+ Women With Chronic Pain, Aster Harrison, Mansha Mirza

Department of Occupational Therapy Faculty Papers

INTRODUCTION: Bisexual+ women experience higher rates of both mental illness and chronic pain when compared to either straight or lesbian women. Their experiences of the relationship between their mental health and chronic pain remain underexplored. This article presents an intersectional Interpretive Phenomenological Analysis of the experiences of six bisexual+ women with chronic pain.

METHODS: Each woman completed two semi-structured interviews. Interviews were analyzed with Interpretive Phenomenological Analysis, beginning with in-depth case study analysis of each person's interviews before moving to comparison across cases.

RESULTS: Results indicated a complex web of multidirectional relationships between mental health and chronic pain. These relationships …

Supporting Recovery: Intersections Of Health, Belonging, And Help Seeking After A Campus Mass Casualty Event, Sharon Jalene, Jason A. Ciccotelli, Lauren Gatto, Christian Ison, James Carbajal, Andrew Hooyman

Physical Therapy Faculty Articles and Research

Mass casualty events (MCE), such as campus shootings, can severely impact the mental health of students, faculty, and staff. This study examined the psychological effects of an MCE at a minority-serving institution and explored how sense of belonging, cardiorespiratory fitness, and treatment preferences influenced recovery. To measure the impact of the MCE on mental health an anonymous survey was administered four to five months post-MCE to university students, faculty and staff. Within the survey, participants were asked to retrospectively report their depression (PHQ-9) and anxiety (GAD-7) symptoms as they recalled them two weeks prior to the MCE, and as they …

Spae: Deciphering Cell Cycle Dynamics And Cell States In Single-Cell Rna-Seq Data, Jiahao Yi, Jiajia Liu, Peng Guo, Yuan-Nong Ye, Xiaobo Zhou

Faculty, Staff and Student Publications

Rapid advances in single-cell RNA sequencing (scRNA-seq) technology have enabled the investigation of gene expression changes at the single-cell level, particularly for elucidating the heterogeneity among cells and complex biological processes. This technique reveals subtle molecular differences within individual cells, thereby offering a unique viewpoint for the investigation of cell cycle progression, cellular differentiation, and disease pathogenesis. However, accurately identifying and analyzing cell cycle dynamics in scRNA-seq data remains challenging due to the complexity of the data and the subtle differences between cell states. To address this challenge, we developed the integrated Sinusoidal and Piecewise AutoEncoder (SPAE), an autoencoder-based piecewise …

Acute Opioid Responses Are Modulated By Dynamic Interactions Of Oprm1 And Fgf12, Paige M Lemen, Alexander S Hatoum, Arpana Agrawal, Et Al.

2020-Current year OA Pubs

We generated time-series data for 105 morphine- and naloxone-related traits across ~700 BXD mice (64 diverse strains for both sexes) for 3 hr after a single morphine injection. Variations in responses were mapped using genome sequencing-based genotypes. The locomotor responses to morphine mapped to the µ opioid receptor gene (