Digital Commons Network^™

Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis

Walden Dissertations and Doctoral Studies

Employee engagement among hospital-based nurse case managers is important because these nurses support discharge planning, utilization management, care coordination, and safe patient transitions. Although leadership style has been studied in nursing, limited research has examined its relationship to engagement among nurse case managers. The purpose of this quantitative, nonexperimental, correlational study, using House’s path-goal theory, was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and employee engagement among hospital-based nurse case managers. Data were collected from 89 registered nurse case managers in acute care settings in the United States, who completed the Multifactor Leadership Questionnaire, Short Form, …

Comments Re: Commonsense Policy Options To Lower Drug Prices For Patients, Fred D. Ledley M.D., Edward Zhou Pharm. D.

CISI Publication

Thank you for the opportunity to provide written comment in response to the Senate Finance Committee Minority Staff’s “Request for Information: Commonsense Policy Options to Lower Drug Prices for Patients.” We are answering as academic researchers with experience in medicine and the biopharmaceutical industry. This comment will focus on sections I and III of the RFI.

We applaud the accomplishment of the Inflation Reduction Act (IRA) in establishing the precedent for the government to negotiate “fair market” prices for drugs on terms that address both patients’ needs for affordability and industry’s need for a reasonable return on investment. Our analysis …

Staff Education On Frailty And Senior Surgical Safety, Kimberly Buhay Gibu

Walden Dissertations and Doctoral Studies

This staff education doctoral project addressed a practice gap involving limited education on frailty assessment and senior surgical safety within the general surgery department of a large, integrated healthcare system. Frailty is associated with increased postoperative complications, hospitalizations, readmissions, and mortality among older adults, making early recognition essential to improving surgical outcomes. The practice-focused question project was: Does education on frailty screening and senior surgical safety improve the knowledge, confidence, and intent of general surgery staff in a large, integrated health system? The purpose was to develop, implement, and evaluate an evidence-based educational intervention. The project was guided by the …

Staff Education To Improve Blood Pressure Reassessment And Referral Practices In An Urgent Care Setting, Carolyn Denise Kluttz

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education and quality improvement initiative designed to improve blood pressure (BP) reassessment and referral compliance among adult patients presenting with elevated BP readings in an urgent care setting. Elevated blood pressure is frequently identified during urgent care visits; however, provider responses and follow-up recommendations are often inconsistent, creating missed opportunities for early identification and intervention. The practice-focused question guiding this project was: In adult patients presenting to urgent care settings, how does implementing a standardized nurse-led hypertension screening and referral protocol, compared with usual care, affect the identification and follow-up …

Staff Education For Medication Adherence Among Adults With Major Depressive Disorder In A Private Outpatient Psychiatric And Mental Health Practice, Judith Timbui Eta

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a staff education initiative to improve medication adherence among adults with major depressive disorder (MDD) in a private outpatient psychiatric and mental health practice. Medication nonadherence remains a significant barrier to effective depression treatment and is associated with symptom relapse, increased healthcare utilization, and poorer patient outcomes. Evidence supports provider education as an effective strategy for improving adherence-related practices. The project examined whether a targeted educational intervention could improve staff knowledge and confidence in promoting medication adherence over a 12-week implementation period. Guided by the Johns Hopkins Evidence-Based Practice Model and the …

Heartland Virus Preclinical Research Project, Brian B. Gowen

Funded Research Records

No abstract provided.

Probable Renal-Limited Sarcoidosis Presenting With Tubulointerstitial Nephritis Without Granulomas On Renal Biopsy: A Diagnostic Challenge, Jawahar Hamood Alnoumani, Muhammad Shoaib, Asma Marzouqi, Ali Al Lawati

Sultan Qaboos University Medical Journal

Sarcoidosis is an idiopathic multisystem inflammatory disorder characterised by non-caseating granulomas and a wide range of reported prevalence. Renal-limited sarcoidosis is a rare manifestation of sarcoidosis which remains a diagnostic challenge due to lack of extra renal manifestation and specific diagnostic criteria. We report a 37-year-old man who presented to a tertiary care hospital, Muscat, Oman, in 2024, with a two-month history of fever, weight loss, hypercalcaemia, high-to-normal 1,25-Vitamin D, high angiotensin-converting enzyme levels and acute kidney injury. His renal biopsy showed evidence of tubulointerstitial nephritis without granulomas or nephrocalcinosis. After exclusion of infectious, malignant, drug- related and autoimmune causes, …

The Cul-De-Sac Paradox: The Relationship Between Walkability, Playability, And Children’S Physical Activity, Lydia Reader

McKelvey School of Engineering Graduate Student Theses & Dissertations

Walkability and playability are two constructs on how the built environment can support physical activity, the former most relevant to adults and the latter designed with children in mind. There are concerns that walkability and playability are intrinsically in competition with one another, with urban forms supportive of physical activity for adults detrimental toward the physical activity of children and vice versa. This thesis explores this conflict using agent-based modeling as a tool for refining the theoretical constructs behind playability and children’s physical activity. We examine the state of the current evidence for the relationship between walkability and children’s physical …

Data-Driven Staging Of Neurodegenerative Pathology Related To Alzheimer’S Disease, Thomas Earnest

McKelvey School of Engineering Graduate Student Theses & Dissertations

Alzheimer’s Disease (AD), the most common cause of dementia, is a dual proteinopathy exhibiting deposits of extracellular amyloid-beta (Aβ) and intracellular tau in brain tissue. Models which describe the spatial and temporal trajectories of these pathologies have been invaluable for understanding AD and have the potential to support diagnosis, disease monitoring, and treatment development. Disease staging systems, which provide protocols for assessing individual disease severity based on their extent of brain pathology, have been crucial for explaining and diagnosing AD. However, these systems have been primarily informed by post-mortem histological assessments and are not directly applicable to disease assessment in …

Poppers Maculopathy Due To Alkyl Nitriteinfused Candle: A Case Report, Tori Sayers, Murtaza K. Adam

School of Medicine Publications

Recreational inhalation of alkyl nitrites (“poppers”) is associated with a characteristic toxic maculopathy presumably due to ischemic changes in the central macula. Alkyl nitrite candles are available for purchase online and do not appear to be regulated. We report a unique retrospective case of vision loss following second-hand inhalation of vapor from a “poppers” candle in which a 29-year-old Hispanic male with no previous medical history presented with acute bilateral vision loss after attending a party at a nightclub. The patient denied sungazing, exposure to lasers, and a family history of inherited retinal disease. History was significant for use of …

Staff Education On Improving Medication Adherence, Oneil Dobgima Galega

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in an outpatient behavioral health setting involving inconsistent use of structured communication strategies to support medication adherence among psychiatric patients. Although nurses routinely provided medication instructions, approaches such as motivational interviewing and psychoeducation were underutilized, limiting patient engagement, understanding, and adherence, and ultimately affecting care continuity and outcomes. The purpose of the project was to improve psychiatric nurses’ knowledge and intent to use motivational interviewing and psychoeducation to enhance medication adherence. The guiding practice-focused question examined whether a structured educational intervention could strengthen nurses’ competencies in these communication strategies. …

Staff Education To Improve Nursing Knowledge On Pressure Injury Prevention, Kheeda Kimberly Gopaul

Walden Dissertations and Doctoral Studies

Staff education in this project was focused on improving nursing staff’s knowledge on pressure injury prevention, inspired by the persistent care quality gap. The gap in practice as of 2024 related to hospital-acquired pressure injury (HAPI) at the host health organization was reported to be approximately 0.2 per 1,000 discharges. It was apparent that education could benefit the nursing staff to improve their knowledge in pressure injury prevention. The education in service focused on continuous nursing skin assessments, to ensure over prolonged hospitalization, patients’ skin does not deteriorate with the development of pressure injuries or advancing of pre-existing pressure ulcers. …

Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David

Walden Dissertations and Doctoral Studies

Opioid overdose deaths increased significantly from 2020 to 2021, with Milwaukee County experiencing higher rates than the national and state averages. African American and Hispanic residents faced disproportionately high fatal overdose rates. The purpose of this quantitative retrospective cross-sectional study was to examine the associations among socioeconomic status, race, age, access to treatment (measured by emergency medical services [EMS] naloxone administration), and opioid overdose mortality among underserved minority populations in Milwaukee County. Guided by the social-ecological model, the study analyzed data from the Milwaukee Health Department and the Milwaukee County Medical Examiner's Office across 34 ZIP codes. Inclusion criteria for …

Sbirt Staff Education To Registered Nurses In The Emergency Department, Rosemary Thuet

Walden Dissertations and Doctoral Studies

Summary The project hospitals have, on average, 2,400 emergency department (ED) visits a month. Although patients receive a social screening, there are no specific assessments to determine if the person is at risk for alcohol use disorder (AUD). The lack of screening is a missed opportunity to provide a Screening, Brief Intervention and Referral to Treatment (SBIRT) assessment of over 2,400 patients a month or 48,000 people annually. Although several screening tools could be used for an SBIRT assessment, the recommendation of ED nursing leadership is to implement the tool known as the CAGE Questionnaire (Cut down, Annoyed, Guilty, and …

Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron

Walden Dissertations and Doctoral Studies

African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …

Improving Advanced Care Planning Conversations And Documentation Through App Education And Standardized Epic Workflow: A Quality Improvement Initiative, Michelle N. Rutter, Emily Goldstein

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Advance care planning (ACP) is essential for ensuring (GOC), particularly in acute care settings, defined in this paper as inpatient hospital environments, including critical and intensive care units (ICU), where a patient’s decision-making capacity could become impaired. ICU patients are often critically ill and may lose the ability to make health care decisions. Family uncertainty regarding patient preferences frequently exacerbates psychological distress regarding GOC. Restricted access to ACP may result in non-concordant medical care, as well as elevated healthcare expenditures driven by the underutilization or inappropriate allocation of critical resources. Despite the recognized importance of ACP and …

Racial Trauma And Posttraumatic Growth: Implications For Counselors, Margaret M. Poandl, Nowoola Awopetu, Paul C. Harris Dr.

Journal of Counselor Preparation and Supervision

Racial trauma is ubiquitous among Black, Indigenous, and People of Color (BIPOC) and people who belong to other marginalized groups. It is likely that counselors will work with individuals who have experienced racial trauma. Aligned with the counseling profession’s values, counselors can take a strengths-based approach that incorporates facilitation of a historical trauma posttraumatic growth (HT-PTG) framework. This paper presents evidence-informed practices that can foster growth on individual and collective levels. A case example is provided that integrates individual- and collective-level interventions bidirectionally, along with implications for counselor training pedagogically, through supervision, and continuing education. Counselors can identify, encourage, and …

The Safe Fishbowl Model: Psychological Safety By Design In Counseling Skills Training, Mike Mariska

Journal of Counselor Preparation and Supervision

Skills training in counselor education can be constrained by performance anxiety, which may reduce participation, limit deliberate practice repetitions, and shift demonstrations to the instructor. This applied-practice manuscript introduces the SAFE (Structured Avatar and Feedback Experience) Fishbowl model, a simulation architecture designed to address performance anxiety while scaling participation. SAFE Fishbowl integrates rotating counselor roles, a real-time coaching loop, structured observation grounded in experiential learning theory, and purposeful debriefing. An implementation example for group counseling leadership skills is provided, along with adaptation guidance across multiple skill domains and delivery modalities. Descriptive course-evaluation feedback illustrates feasibility and perceived usefulness. Implications include …

Integrating Consensual Non-Monogamy In Counselor Education: Practical Guidelines And A Pilot Descriptive Study, Yun-Zhuo (Zoey) Liu, Lena Salpietro

Journal of Counselor Preparation and Supervision

Consensual non-monogamy (CNM) is a prevalent and diverse relationship structure, yet mononormative assumptions persist in counselor training and practice, contributing to stigma and inadequate care. Research indicates that counselors’ CNM-specific knowledge and attitudes are critical to positive therapeutic outcomes (Schechinger et al., 2018), highlighting the need for clear guidance. In response, this paper presents Guidelines for Incorporating CNM in Counseling Curricula. Three domains are grounded in multicultural and social justice principles: foundational knowledge and terminology, challenging bias and promoting self-reflection, and application informed by attachment theory. Additionally, findings from a survey of counselor educators (N = 54) are presented. Results …

U.S. Service Member To Counseling Student, Nicole Marie Arcuri Sanders, Kellie Forziat-Pytel

Journal of Counselor Preparation and Supervision

This qualitative descriptive study examines the absence of military career pathways for licensed mental health counselors (MHCs) and the impact of this structural limitation on service members' career transitions. Findings indicate that both combat and non-combat veterans pursued mental health counseling due to personal service-related mental health experiences and dissatisfaction with available care while in service. Despite these challenges, many participants expressed a strong desire to continue serving their country as professional counselors. Over half of the participants reported separating from the military because no occupational role existed for licensed MHCs. At the same time, most indicated they would have …

Modernizing Career Counseling In Counselor Education: A Conceptual Exploration, Yuhyun Park, Se Hoon Kim, Rasheed Adeyemo, Sarah Ebner, Mallory Redmond, Breeana Donayre, Carly Steves

Journal of Counselor Preparation and Supervision

Career development is often confined to a single course despite its relevance across counseling practice. This conceptual article reframes it as an integrative foundation for counselor preparation, supervision, and professional identity. It examines connections among work, mental health, education, disability, relationships, and social context across counseling specializations. The article also considers doctoral training and the ethical use of artificial intelligence in career-related practice. Recommendations address curriculum design, supervision, and future research on integrated career preparation.

Developing Grief-Informed Counselors: A Reflexive Thematic Analysis Of Counselors-In-Training’S Learning Experiences, Katherine Atkins, Sonya Lorelle, Jennifer Slawson

Journal of Counselor Preparation and Supervision

Grief remains underrepresented in counselor education despite its relevance across the lifespan and its inclusion in the 2024 Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards. This qualitative study explored how counselors-in-training (CITs) conceptualized grief and their developing professional role following participation in a structured grief education series. Eleven master’s-level CITs engaged in didactic instruction, experiential grief interventions, and reflective focus groups. Using reflexive thematic analysis, four interrelated themes were constructed that addressed grief conceptualization, counselor role development, integration of the personal self, and educational supports for grief competence. Findings reflected shifts toward relational, culturally responsive, and …

Management Of Advanced Periodontal Disease In A Patient With Down Syndrome-A Case Report, Robert T. Verceles

Oral Health

Down Syndrome is a common developmental disability.  Patients with DS may have many co-morbities associated with the condition, which include cardiac abrnormalities and severe periodontal disease.  This case illustrates how a patient with advanced periodontitis was treated in the Special Care Clinic at UOP, Dugoni School of Dentistry.

Hemodynamic Characterization Of Cardiac Dysfunction After Traumatic Brain Injury Using A Controlled Cortical Impact Model In Male Rats, Preston So, Amit Iyengar, Noah Weingarten, Mrinal Patel, Jessica Dominic, Andrew Belec, Joyce Ho, Samuel Shin, Pavan Atluri

Division of Cardiology Faculty Papers

Traumatic brain injury (TBI) is associated with cardiovascular dysfunction that worsens clinical outcomes, yet the underlying mechanisms are poorly under stood. Clinical studies are limited by heterogeneity, highlighting the need for con trolled experimental models. Controlled cortical impact (CCI) provides precise control of injury severity, and invasive pressure- volume (PV) loop analysis allows detailed hemodynamic assessment. Adult male Wistar rats underwent sham op eration or mild or severe CCI- induced TBI. PV- loop assessment and transtho racic echocardiography were performed at 8 or 24 h after TBI or sham. Serum epinephrine (EPI) and norepinephrine (NE) were quantified by ELISA. At …

Relational Reasoning Across Cultures: Consistency And Variation In South Korea, The United States, And China, Alexandra Carstensen, Minju Kim, Youngon Choi, Caren M. Walker

Psychology Faculty Articles and Research

Abstract reasoning in early childhood is often described as following a “relational shift,” over which children become increasingly sensitive to relations. However, recent work has challenged the generality of this account, showing that children in the US and China follow distinct trajectories in a relational match-to-sample task. This difference aligns with multiple cultural and linguistic factors implicated in relational reasoning, where the US and China appear at opposite ends of a continuum, focusing on objects (US) versus relations (CN). This raises the possibility that differences in culture and language may shape variation in the development of abstract reasoning. Here, we …

Maternal Sjögren's Disease And Its Long Shadow: Adult-Onset Seronegative Lupus Nephritis Following Congenital Heart Block, Tatiana Dacak, Abelardo Rodriguez, Luisa Fernanda Gomez, Corey Haines, Nida Asif

School of Medicine Publications

Congenital complete atrioventricular block (CCAVB) is a well-recognized manifestation of neonatal lupus erythematosus (NLE), caused by transplacental transfer of maternal anti-Ro/Sjögren's Syndrome Type A (SSA) and anti-La/Sjögren's Syndrome Type B (SSB) antibodies. Although non-cardiac manifestations of NLE typically resolve within the first year of life, the long-term autoimmune risk in affected offspring remains unclear. We report a 24-year-old woman with CCAVB secondary to maternal Sjögren's disease who presented with acute heart failure, nephrotic-range proteinuria, bicytopenia, pericardial effusion, and findings concerning for Libman-Sacks endocarditis. Despite negative conventional lupus serologies, renal biopsy demonstrated Class IV/V lupus-like immune-complex glomerulonephritis with full-house immune complex …

Dnp Final Report: Medication Errors: Decreasing From Day One Through Online Learning Module And Incident Reporting, Marsha Pohorelsky

DNP Final Reports

Medication administration errors remain a significant patient safety concern in healthcare and nursing education. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the implementation of a standardized medication safety learning module and incident reporting process to improve medication safety awareness, medication administration competency, and error reporting among second-semester Bachelor of Science in Nursing (BSN) students. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Kotter's 8-Step Change Model, the project incorporated medication safety education, simulation-based learning, and near-miss reporting to promote a culture of safety. Although competency outcomes were similar to previous student cohorts, participants demonstrated increased …

Integrative Rna-Seq Analysis Reveals Stress Type-Dependent Lncrna-Centered Co-Expression Networks Across Human Cellular Stress Contexts, Christina Anastasiadi, Aggeliki Kasapi, Ioannis Sentementes, Vasileios Gouzouasis, Margaritis Tsifintaris, Antonis Giannakakis

Computational Medicine Center Faculty Papers

Long non-coding RNAs (lncRNAs) are emerging as important regulators of cellular adaptation to environmental and molecular stress, but the extent to which their responses remain reproducible and stress-type-dependent across human stress conditions remains unclear. Here, we performed an integrative transcriptomic meta-analysis of human stress-response datasets from ASTRA and GEO, focusing on normal, non-cancerous, wild-type human cell lines exposed to oxidative stress (H2O2), hypoxia, heat stress, or UV-induced DNA damage. Gene Ontology (GO) enrichment analysis of differentially expressed (DE) protein-coding mRNAs confirmed that the resulting stress-stratified comparison captured biologically coherent transcriptional programmes to oxidative stress signaling, hypoxic and metabolic adaptation, heat-induced …

Hiking For All: An Adaptive Hiking Program For Disabled Individuals, Anna Grigg

Occupational Therapy Doctoral Capstones

Hiking is a valued activity in the lives of many people. Possessing or acquiring a disability should not prevent or limit someone from participating in hiking; however, many disabled individuals will avoid hiking due to the lack of hiking trails that are accessible to them or the lack of adaptive hiking skills that they have. The purpose of the Doctoral Capstone project was to promote occupational engagement in hiking for disabled individuals, advocate for increased access to hiking resources and information, and facilitate safety during adaptive hiking.

Building Bridges: A Culturally Inclusive, Education-Based Program For A Pediatric Outpatient Therapy Clinic, Sarah Morgan

Occupational Therapy Doctoral Capstones

The purpose of the Doctoral Capstone Project is to develop and implement a culturally inclusive, education-based program, to address current gaps in pediatric outpatient occupational therapy and to allow the population to overcome challenges inhibiting their occupational adaptation and occupational fulfillment.