Digital Commons Network^™

Pit Stop: Improving Resuscitation Efforts Within A Level Iv Nicu, Sierra Pharr, Kendall Shaw, Hannah Biscardi

2025

No abstract provided.

Association Between Opioids And Leukemia/Lymphoma In Adults Living In The United States, Brenda Sue Newberry-Colasanti

Walden Dissertations and Doctoral Studies

Opioid prescribing rates and opioid misuse remain high throughout the United States. Exposure to opioids has been positively associated with various cancers; however, research evaluating associations between opioid exposure and hematologic cancers like leukemia and lymphoma is limited. Using the Socio- Ecological Model as a foundation, this quantitative cross-sectional study aimed to analyze the association between medicinal opioid use, opioid misuse, and leukemia/lymphoma while exploring how selected social determinants of health (SDOH) may modify that relationship. Secondary data were pooled from the 2015–20-year United States National Survey on Drug Use and Health (NSDUH). One thousand three hundred and twenty binary …

Association Between Resource Availability And Wellbeing Of Autism Patients In Ghana, Kwabena Aduse-Poku

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that presents significant challenges for children and families in Ghana, where resources remain limited. Grounded in the social ecological model, this quantitative cross-sectional study examined the associations between autism management programs and wellbeing, defined briefly as independent functioning in daily life and learning of autism patients enrolled in selected institutions in Accra and Kumasi, Ghana. Data were collected from N=122 autism patients using structured questionnaires that were completed by caregivers and program staff. Binary logistic regression analyses were conducted to assess relationships between program type, regional location, and years of enrollment and …

Health Literacy And Diabetes Self-Care Behavior, Eucharia Amaefule

Walden Dissertations and Doctoral Studies

Limited health literacy is a significant barrier to effective diabetes self-management among adults with type 2 diabetes mellitus (T2DM), yet nationally representative evidence using comprehensive health literacy measures remains limited. Guided by the health belief model, the purpose of this quantitative, secondary data analysis using cross-sectional data was to examine the relationship between health literacy and diabetes self-care behaviors among U.S. adults with T2DM and determine whether education level moderated this relationship. Data from the 2016 Behavioral Risk Factor Surveillance System were analyzed for U.S. adults (N = 9, 535) with self-reported T2DM. Diabetes self-care behaviors included blood glucose monitoring, …

A Program Proposal For A Leadership-Driven, Evidence-Based, Intentional Rounding Playbook, Jacqueline Butler Brown

Walden Dissertations and Doctoral Studies

Patient experience is a key indicator of healthcare quality. In an acute care hospital in Northeast Georgia, intentional rounding is an established practice. Inconsistent communication, variable leadership engagement, and limited accountability are practice gaps that have reduced its effectiveness in improving patient experience outcomes. A comprehensive literature review using PubMed, CINAHL, MEDLINE, and the Cochrane Library yielded 15 peer-reviewed studies that consistently support intentional rounding as an evidence-based strategy for improving patient satisfaction. As the team leader for this Executive Leadership System Improvement Project, I proposed the development of an Evidence-Based, Leader-Driven Intentional Rounding Program Playbook to standardize enhanced rounding …

Exploring Nursing Students' Experiences Of Simulation-Based Learning In Developing Critical Thinking, Clinical Reasoning And Clinical Judgment In The Management Of Mental Health Patients: A Qualitative Case Study, Irene Bellew

Doctoral Dissertations and Projects

The purpose of this case study was to explore how simulation-based learning experiences shape the development of critical thinking, clinical reasoning, and clinical judgment for associate degree nursing students when caring for patients with mental health needs. It addressed the need to narrow the gap between theoretical knowledge and practical application in clinical settings, enhancing the preparedness of novice nurses. By positioning nurse educators as facilitators of innovative strategies, this study advocates for the integration of simulation-based learning within nursing curricula. Roy’s adaptation model guided the study, and data were collected through observation of simulation sessions, semi-structured interviews, and reflective …

Exploring The Motivations And Educational Needs For Undergraduate Nursing Students To Enter Into Critical Care: A Qualitative Study., Christina S. Pradhan

Doctoral Dissertations and Projects

Critical care nursing is a specialty that demands a high level of skill and dedication. In this high-stress, fast-paced environment, nurses must think fast and act decisively with sound clinical judgment and knowledge. The purpose of this hermeneutic phenomenological qualitative study was to understand the motivating factors that cause nurses to enter the field of critical care, as well as to explore the ways in which undergraduate nursing studies may be improved to better prepare future critical care nurses. Knowles’ adult learning theory was well suited for nursing students bound for a critical care path. Students at two different baccalaureate …

Pedagogy Challenged: A Phenomenological Examination Of Teaching Through A Prolonged Technological Disruption, Jerry Cervantes

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to examine the lived experiences of nursing faculty in a pre-licensure Bachelor of Science in Nursing program who taught during a prolonged technological disruption caused by a ransomware attack at a private college in Ohio. The theories guiding this study were transformative learning theory and resilience theory as they relate to how educators make meaning of disorienting events and sustain professional functioning when established systems fail. Data were collected through semi-structured interviews, a focus group, and reflective journals from purposively selected nursing faculty participants and were analyzed according to the phenomenological procedures …

Identifying The Effects Of Racial Bias On Levels Of Medical Mistrust Among Black And White Young Adults, Clayton L. Westmoreland

Doctoral Dissertations and Projects

The purpose of this quantitative, non-experimental, cross-sectional group comparison was to examine whether differences exist in levels of medical mistrust, healthcare avoidance, and preference for racially concordant providers between young Black adults and young White adults residing in Texas. An electronic, pilot-tested survey was distributed via social media and included demographic items and Likert-scale measures to assess trust levels and healthcare decision-making behaviors. Independent samples t-tests were conducted using IBM SPSS software to compare group means. Results indicated statistically significant differences across all three variables. Young Black adults reported significantly higher levels of medical mistrust (lower scores indicating greater mistrust; …

Experiences Of Cholesterol Management Among Obese Individuals: A Qualitative Exploration Of Statin Use, Diet, And Physical Activity, Ke'andra S. Foggie

Doctoral Dissertations and Projects

The prevalence of hypercholesterolemia has increased over the past decade, with obesity identified as a major contributing factor. This study examined how individuals with obesity and hypercholesterolemia managed cholesterol and experienced related challenges within their daily lives. Guided by the Chronic Care Model, the research explored participant-reported experiences of statin therapy and lifestyle practices, including dietary behaviors and physical activity, as components of cholesterol management. Qualitative data were collected through semi-structured interviews, observations, and document analysis to analyze participant-reported barriers, supports, and contextual factors that shape how these practices are incorporated into daily routines. Although extensive research has examined statin …

Loss Of Atp-Dependent Citrate Lyase Drives Left Ventricular Dysfunction By Metabolic Remodeling, Shijie Liu, Seth T Gammon, Lin Tan, Yaqi Gao, Kyoungmin Kim, Mahmoud H Elbatreek, Adrian Arrieta, Ian K Williamson, Rebecca L Salazar, Janet Pham, Angela Davidian, Radhika Khanna Neicheril, Benjamin D Gould, Heidi Vitrac, Alia Sadiq, An Q Dinh, Evan C Lien, Francisca N De Luna Vitorino, Joanna M Gongora, Sara A Martinez, Melanie T Odenkirk, Anna K Boatman, Jessie R Chappel, Lawrence S C Czer, Evan P Kransdorf, David J Lefer, Blake M Hanson, Benjamin A Garcia, Erin M Baker, Matthew G Vander Heiden, Philip L Lorenzi, Heinrich Taegtmeyer, David Piwnica-Worms, James F Martin, Anja Karlstaedt

Faculty, Staff and Student Publications

Background: Metabolic adaptation and maladaptation are hallmarks of the failing heart and may be a target for therapeutic interventions. For example, sustained glucose oxidation during cardiac stress is associated with increased activity and abundance of ACL (ATP-dependent citrate lyase, Acly), which produces acetyl-coenzyme A (CoA) from citrate and CoA and supports de novo lipid synthesis. However, our understanding of how ACL supports cardiac metabolic adaptation and its potential to modulate disease pathophysiology has not yet been investigated.

Methods: We used human heart tissue samples from healthy donors and patients with nonischemic cardiomyopathy. Next, we used CRISPR (clustered, regularly interspaced …

Molecular Mechanism Leading To Human Coronary Atherosclerosis Assessed By Proteomic Analysis And Rna Sequences, Sarah J Parker, Chunhong Mao, David L Caudell, Austin Lyle Seals, Yizhi Wang, Thomas D Green, Joseph M Mcclung, Joshua T Maxwell, Jacolby T Roddey, Kiarash Shakeriastani, Chiung-Ting Wu, Yingzhou Lu, Do-Kyun Kim, Justyna Fert-Bober, Dongping Du, Archana Bhat, Niveda Sundararaman, Matthew Ayres, Rakhi Pandey, Saurabh Bhardwaj, Genesio M Karere, Dana Troxclair, Fannie Jackson, Gordon L Love, Richard Vander Heide, James Hixson, Jennifer E Van Eyk, Yue Wang, David Herrington

Faculty, Staff and Student Publications

Background and aims: Atherosclerosis results from cellular and extracellular changes in the arterial wall, preceded by molecular shifts that initiate disease and drive tissue conversion, yet these changes are not yet fully described. More data are needed concerning these early changes in the coronary artery molecular landscape that signify the initiation of atherosclerosis and the subsequent tissue pheno-conversion to atherosclerotic plaque. This report summarizes results from a large biorepository of human coronary artery tissue, applying state-of-the-art omics technology, advanced data analytic methods, and an arterial organoid model system to predict molecular dynamics and identify potential regulatory mechanisms that could interrupt …

Unpredictability Is A Childhood Adversity That Contributes To Mental Health Problems, Laura M. Glynn, Sabrina R. Liu, Charles Golden, Michael Weiss, Candice Taylor Lucas, Louis Ehwerhemuepha, Hal S. Stern, Tallie Z. Baram

Psychology Faculty Articles and Research

Although adverse childhood experiences (ACEs) increase risk for mental illness at the population level, existing ACEs screens are less helpful in forecasting individual outcomes, suggesting they may not capture significant elements of childhood adversity. We have previously identified unpredictable parental and household experiences as an ACE that portends poorer cognitive and mental health. However, the contribution of unpredictability to established ACEs in real-world settings is unknown. Here, leveraging existing ACEs screening in California, we added the five-item Questionnaire on Unpredictability in Childhood (QUIC-5) in 19 pediatric clinics spanning broad sociodemographic constituencies and compared in ~30,000 children the link of each …

The Effects Of Anti-Gdnf On The Sensory And Autonomic Nervous System In The Heart, Tryphosa Konadu

Honors Theses

Heart disease is the number one leading cause of death; about 1 in every five deaths is due to heart disease. “Heart disease” is a catch-all phrase that encompasses a variety of conditions that affect the heart’s structure and function. Many of these symptoms can be attributed to dysfunction within the parasympathetic, sympathetic, and sensory nervous systems. Neurotrophic factors like GDNF (Glial cell line-derived neurotrophic factor), BDNF (Brain-derived neurotrophic factor), and NGF (Nerve growth factor) promotes neuronal survival, and regeneration of the nerve fibers of the heart, especially sensory and autonomic nerve fibers. Studies have suggested that increased expression of …

Recognizing Ibd In Kids: What Every Pediatrician Should Know, Mike Smith, Julie A. Bass

Pediatrics in Practice: A CME Podcast

This episode walks through how to identify inflammatory bowel disease in children, the key red flags that matter, and practical steps primary care providers can take before referral. It’s essential because earlier recognition of pediatric IBD can prevent growth problems, nutritional deficiencies, and serious complications. Guest: Julie Bass, DO, Medical Director of the Inflammatory Bowel Disease Program at Children’s Mercy and Professor of Pediatrics, offers clinical tips from years in pediatric gastroenterology. You’ll hear about stool testing like fecal calprotectin, basic blood work including CBC and CRP, growth monitoring, and when to consider colonoscopy or urgent referral for suspected Crohn’s …

Identification Of Acute Kidney Injury In African Children Hospitalized With Malaria: A Multinational Individual Participant Data Meta-Analysis, Caitlin Bond, Anthony Batte, Folake Afolayan, Nicholas M Anstey, Quique Bassat, Philip A Bejon, James A Berkley, Rhys D R Evans, Stuart L Goldstein, Michael T Hawkes, Olayinka Ibrahim, Peace Imani, Chandy C John, Kevin C Kain, Claire Liepmann, Kevin Marsh, Ruth Namazzi, Margaret Nakuya, Nicole O'Brien, Lere P Oluwadare, Robert O Opoka, Jonathan Sserunkuuma, Hunter Wynkoop, Andrea L Conroy, Malaria Associated Kidney Injury And Disease Consortium In Africa (Makid-Africa)

Faculty, Staff and Students Publications

Background: Historically, acute kidney injury (AKI) has been an underappreciated complication in children with severe malaria. We conducted an individual patient data meta-analysis to model the impact of AKI and its complications on inpatient mortality in African children hospitalized with malaria.

Methods: Studies were identified using MEDLINE, EMBASE, Scopus, and PubMed with no language restrictions, as well as through outreach at scientific meetings. Investigators were contacted about participation in the study. Eligible studies included African children hospitalized with Plasmodium falciparum malaria, a serum creatinine measurement, and mortality assessed. The primary exposure was AKI, defined using Kidney Disease Improving Global Outcomes …

A Connection A Day Keeps The Patient Away: How Remote Patient Monitoring Connected To The Internet Of Things Will Change Us Healthcare Into The Us Healthcare System, Ethan Sinn

Doctoral Dissertations and Projects

The importance of this study was due to the market inefficiencies hindering US healthcare. The three market inefficiencies of excessive cost, access challenges, and low outcome yields have puzzled industry stakeholders for years. These inefficiencies continue gobbling up resources now accounting for around 20% of American GDP. The inefficiencies are symptomatic results of two surface level problems in the US healthcare market: financial misalignments and informational fragmentation. The financial mismatches and informational gaps have caused havoc to the natural market’s daily flow since making their way to the surface and remain firmly connected to the root cause of US healthcare’s …

Effective Strategies To Improve Telemedicine Services For Veterans In Baltimore, Maryland: A Qualitative Single-Case Study, Dolapo Uthman

Doctoral Dissertations and Projects

This qualitative single-case study investigated the inefficiency and limited accessibility of telemedicine services within a selected healthcare organization located in Baltimore, Maryland. The purpose of this study was to investigate how telemedicine services can be improved to enhance healthcare outcomes for patients and their overall quality of life. The data were collected using semi-structured interviews with 16 participants, supported by fieldnotes, and publicly available documents, and analyzed using reflexive thematic analysis. Methodological triangulation was used to validate the findings to ensure credibility and consistency. The research indicated that telemedicine enhances access to healthcare and supports continuity of care, especially for …

Internalized Colorism As A Gendered Barrier To Skin Cancer Information Avoidance Among Hispanic College Students, Soo Yun Kim, Wan-Lin Chang

Communication Faculty Publications

Skin cancer disparities persist among racial and ethnic minority populations, yet sociocultural factors shaping engagement with preventive health information remain understudied. This study examines whether internalized colorism functions as a barrier to skin cancer information avoidance among Hispanic college students and whether these associations differ by sex. Using survey data from 300 undergraduates at a Hispanic-serving institution, hierarchical regression analyses examined how three dimensions of colorism, including self-concept, attractiveness, and upward mobility, were associated with skin cancer information avoidance. Results indicated that only the attractiveness dimension predicted information avoidance. This association was moderated by sex, such that attractiveness-based colorism was …

Rsv Can Infect The Human Nasal Epithelium Via The Basolateral Route And Shows Distinct Subgroup Infectivity And Basal Cell Tropism, Ashley Murray, Divya Nagaraj, Emily M Schultz, Gina Aloisio, Erin Nicholson, Sarah E Blutt, Vasanthi Avadhanula, Pedro A Piedra

Faculty, Staff and Students Publications

Respiratory syncytial virus (RSV) causes millions of lower respiratory tract infections (LRTIs) in young children, older adults, and immunocompromised populations every year. RSV infection initiates in the upper respiratory tract and can progress to the lower airways, resulting in bronchiolitis, pneumonia, and even death. RSV primarily infects epithelial cells apically, but we hypothesized that basolateral exposure of the respiratory epithelium could provide an alternative mechanism of infection that contributes to LRTI development. Using a human nose organoid-air-liquid interface (HNO-ALI) model, we performed apical and basolateral inoculations with contemporaneous RSV strains (RSV/A/Ontario [RSV/A/ON] and RSV/B/Buenos Aires [RSV/B/BA]) representing the two RSV …

Using Polygenic Risk Scores To Evaluate Definitions Of Self-Reported Sleep Phenotypes Across Cohorts, Annah B Wyss, Michael Brown, Xiang Li, Brian W Spitzer, Zhijie Huang, Heming Wang, Richa Saxena, Linda Gallo, Qibin Qi, Wassim Tarraf, Robert Kaplan, Melissa Lamar, Hector M González, Charles Decarli, Myriam Fornage, Jerome I Rotter, Stephen S Rich, Kent D Taylor, Xiuqing Guo, Alexis C Wood, Peter Y Liu, Susan R Heckbert, Chloé Sarnowski, Jan Bressler, Alanna C Morrison, Bing Yu, Pamela L Lutsey, Carmen R Isasi, Susan Redline, Tamar Sofer

Faculty, Staff and Students Publications

Study objectives: Since genome-wide association studies (GWAS) of sleep phenotypes have been conducted in differing populations and definitions of sleep phenotypes vary across studies, we investigated associations between several polygenic risk scores (PRSs) and potential sleep definitions among multiethnic cohorts.

Methods: Using data from four cohorts (HCHS/SOL, ARIC, MESA, BHS, N = 16 895), we considered multiple definitions of short and long sleep, insomnia, and excessive daytime sleepiness (EDS). PRSs were developed based on summary statistics from GWAS in European ancestry individuals from the UK Biobank (UKB) and from GWAS conducted in a multiethnic population from the Million Veteran Program …

Understanding The Experience Of Separation On The Substance-Exposed Mother-Infant Dyad, Tamara Lee Depascale

Electronic Theses and Dissertations

Maternal-infant separation following birth is a profoundly distressing experience that may have significant emotional, relational, and health implications for mothers with substance use disorders (SUD). Guided by Caring Science and Swanson’s Theory of Caring, the purpose of this qualitative descriptive study was to explore the dimensions of the health challenge associated with maternal-infant separation among mothers with SUD following birth and the approaches mothers used to navigate and respond to that experience. Data were collected through semi structured interviews with mothers who had experienced separation from their infants following birth and analyzed using deductive and inductive thematic analysis. Findings revealed …

Awareness Of The Medicare Diabetes Prevention Program Among Healthcare Providers Caring For Older Adults, Anannya Pushkarna, Melanie Turk

Graduate Student Research Symposium

Introduction:

Prediabetes is a prevalent condition among older adults and represents a crucial opportunity where early interventions can help prevent the onset of type 2 diabetes mellitus. Lifestyle modifications are first-line management. The Medicare Diabetes Prevention Program (MDPP), a 12-month lifestyle change program initiated in 2018, is fully covered by Medicare, yet uptake remains limited. This study assessed healthcare providers’ beliefs about prediabetes and awareness of the MDPP.

Methods:

A cross-sectional survey was administered electronically to a national sample of physicians, nurse practitioners (NPs), and physician assistants (PAs). Questions addressed beliefs about prediabetes, barriers to care, and knowledge/awareness of the …

Beyond The Classroom: Five Considerations For Actualizing Social Justice In Practicum Education, Priscila Llamosa

Journal of Justice-Informed Social Work Practice and Research

Social justice, a core tenet of social work, is variably integrated into education programs' explicit curricula, leaving students with a limited conceptual understanding. Practicum[1] education, crucial for theory-practice integration, offers opportunities for developing social work skills while upholding social justice principles. This paper addresses how practicum instructors can nurture students’ social justice-oriented practice by presenting a framework for practicum education and examining its five components. Drawing from theory, empirical literature, and practice experience, the author suggests ways for practicum instructors to engage each component. Incorporating these into practicum education can enable students to actualize ADEI values in practice and …

A Critical Review On Enhancing Equity Of Mental Health Treatment Of African American Families Through Social Support And Social Capital, Julie Radlauer-Doerfler, Morgan E. Cooley, Heather M. Thompson, Atensia Earp Bowen, Gabe Caress, Alicia Best

Journal of Justice-Informed Social Work Practice and Research

African American adults and children experience both disproportionality and disparity when in contact with the mental health delivery system. There are a number of contextual factors that influence the treatment of African American families, such as systemic oppression or racism in both society and the behavioral health system or individual expressions of mental health symptomology. This review will provide an overview of how mental health disparities crossover systems, perceptions of mental health and mental health treatment among African American families, provide some context for why this review was written, as well as discuss the context of social support and social …

Breaking Barriers: A Student Led Racial Equity Assignment, Emily Murphy, Carol Bennett- Speight, Cecily Mitchell-Harper

Journal of Justice-Informed Social Work Practice and Research

This paper presents an innovative student led racial equity assignment in a small bachelor’s in social work program in the New York metropolitan area. This paper will define epistemological racism and utilize concepts from Narrative Theory and Critical Race Theory, to critically analyze what is taught about the pioneers of social work, identifying the stories and narratives that are told and the ones that are not told. This operationalization of the theories in practice with students will cultivate mindset shifts and strategies that enable participants to engage in social work practice that fully embodies the core values of the profession. …

Screening And Treatment Protocols Used In Nicus Across Minnesota For Perinatal Mood & Anxiety Disorders (Pmads), Rachael Witt

Journal of Justice-Informed Social Work Practice and Research

Parents of infants with prolonged neonatal intensive care unit (NICU) hospitalizations are a population that is overlooked in recommended routine screening for perinatal mood and anxiety disorders (PMADs), yet this population is at greater risk for developing diagnosable mental health disorders. Previous research shows that across the US, PMAD screening and treatment practices vary widely, with many NICUs not providing any routine PMAD screening, psychoeducation, or treatment options to parents. The objective of this study was to explore the current mental health screening and treatment protocols used in NICUs across the state of Minnesota to learn if there are areas …

Utilizing Personal Stories Of Race In Child Welfare Education, Laura D. Boltz, Veronica Knowles, Amari Cooper

Journal of Justice-Informed Social Work Practice and Research

Families of color are overrepresented in the child welfare system. This is an issue that needs to be addressed in multiple ways, including social work education. However, policy changes may make it more difficult to address race in the classroom in a way that doesn’t attract attention. One of the ways that educators can address this is by using personal stories from their own practice experience to educate their students. In this study we discuss the literature around using personal stories and include our own personal stories that we have used in the classroom to have difficult discussions surrounding race …

Evaluating The Authentic Family Engagement And Strengthening Approach, Morgan E. Cooley, Vaughn J. Crichlow, Gabriel T. Cesar, Marianna L. Colvin, Corey B. Best, Kristin Smyth, Robin Jimenez-Bean

Journal of Justice-Informed Social Work Practice and Research

Persistent racial disproportionality of Black and brown families in the child welfare system across decades and generations highlights the need for a comprehensive understanding of the consequences of child removal and the urgency of authentic family engagement initiatives. The primary purpose of this study was to examine whether a group of child protective investigators who received (1) specialized training and (2) monthly family engagement and antiracism coaching during supervision sessions demonstrated fewer monthly removals of children from families compared to a group of investigators in the same service area who did not receive specialized training or coaching. The secondary purpose …

Uncovering The Path To Diagnosis Among Adults With Attention-Deficit/Hyperactivity Disorder: A Constructivist Grounded Theory Mini-Study, Jeffrey D. Whitaker, Rick Zoucha, Melissa Kalarchian

Graduate Student Research Symposium

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, yet many adults are first diagnosed only after years of functional strain, compensation, and alternative explanations for their difficulties. Purpose: This study explored how adults first diagnosed with ADHD in adulthood described navigating the process of obtaining a formal diagnosis. Methods: A constructivist grounded theory mini-study was conducted with seven adults, ages 27 to 43, who reported receiving their first formal ADHD diagnosis at age 18 or later. Participants completed semi-structured Zoom interviews focused on early experiences, symptom interpretation, help-seeking, and formal assessment. Data were analyzed using initial, focused, and theoretical …