Digital Commons Network^™

Human Trafficking In The Er: Will You Recognize The Signs?, Lauren Neff

Doctor of Nursing Practice Projects

Current data reveals that 88% of human trafficking (HT) victims seek some form of health care while being trafficked. More specifically, 63% seek care in the emergency department setting (McAmis et al., 2022). A recent literature review indicates that regarding human trafficking and healthcare, there is a lack of awareness and knowledge on the issue. Healthcare team members often have little to no education or knowledge of potential signs and symptoms of a victim in a trafficking situation. The purpose of this DNP project was to increase healthcare staff knowledge of human trafficking (HT) and, more specifically, nurses in an …

Educational Sessions On Opioid Use Disorder In A Rural Community: A Faith-Based Approach, Tarrelle Reade

Doctor of Nursing Practice Projects

This scholarly project aimed to evaluate the effectiveness of a faith-based community education program regarding opioid use disorder (OUD) in a rural area of Person County, North Carolina. Through 4 weekly sessions hosted at Lattisville Grove Missionary Baptist Church, the program provided education on the signs and symptoms of opioid misuse, associated risks, available treatment options, support resources, and the use of Narcan. A pre- and post-survey design using a Likert scale measured changes in knowledge and confidence across five key domains. Data from participants (n = 54 total) showed statistically significant improvements in awareness and self-efficacy in most areas, …

Implementing A Pressure Injury Prevention Bundle On A Medical Surgical Unit: A Quality Improvement Project, Katrina Daye-Whitehead

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) continue to be one of the biggest challenges healthcare facilities face which has required increased attention on prevention. The national cost of treating HAPIs ranges from approximately $3 billion to $22 billion annually and as a result, hospitals have faced a tremendous financial burden, which has led hospitals to strengthen reduction strategies (Padula & Delarmente, 2019). The aim of this evidence-based project was to increase nurses’ knowledge about HAPI prevention bundles and increase the compliance with a HAPI prevention bundle implemented within 8 hours of admission or transfer to the unit. The preventative HAPI bundle consists …

Stress To Success: The Impact Of Aromatherapy On Nursing Students With Test Anxiety, Patricia A. Mullens

Doctor of Nursing Practice Projects

Test anxiety has been identified as a significant problem in pre-licensure nursing students. This project aims to investigate how aromatherapy can alleviate the stress and anxiety associated with lower test scores and the emotional and psychological impacts it has on students' overall well-being. A literature review supported that students who experience test anxiety characteristically scored lower on high-stakes nursing exams than students who did not experience the same stress. The potential results of this project are multifaceted and include improved test scores, enhanced students’ psychological well-being, and completion of their nursing degree.

Affecting Test Anxiety In Nursing Students, Michelle S. Porterfield

Doctor of Nursing Practice Projects

Nursing students often face significant test-taking anxiety, which negatively impacts both their academic performance and overall well-being (Samuel et al., 2022). This project aims to explore the effects of mindfulness coloring with mandalas on reducing pre-test anxiety among pre-licensure nursing students. The intervention, spanning one semester, will assess changes in anxiety levels and student academic test performance. The anticipated outcome is a reduction in pre-test anxiety, leading to improved academic performance and enhanced mental well-being. The findings will provide valuable insights into non-pharmacological strategies for managing anxiety in students.

Overdose Response Training For Volunteers In A Homeless Shelter, Heather Lynne Smallwood

Doctor of Nursing Practice Projects

The opioid overdose epidemic is a critical health crisis across the country. The homeless population is substantially more at risk of overdose death compared to the general public. Naloxone is a life-saving medication for reversing opioid overdose and is available to ambulance and emergency care services, but support persons are also in regular contact with opioid users and training (Fine et al., 2022). This DNP Project was created to educate volunteers at a homeless shelter in the event of an opioid overdose. The objective of the project was to increase the knowledge of opioid overdose signs and symptoms and naloxone …

Enhancing Health Literacy Using Video Education And The Teach-Back Method For Hypertension And Diabetes Mellitus Type 2, Shelly-Ann M. Malcolm-Padilla

Doctor of Nursing Practice Projects

Diabetes type 2 and hypertension are chronic illnesses that have both physical and psychological impacts on an individual. Primary care providers play an important role in the management of chronic illness, specifically type 2 diabetes and hypertension. Changing behavior with a commitment to compliance with the treatment plan and living a healthy lifestyle can decrease disease complications for both diabetes and hypertension. With the use of educational videos and the teach-back method to confirm understanding of disease management, the goal of this quality improvement project was to contribute to positive health and lifestyle change for patients, their caregivers, clinical staff, …

Rare Case Of Osteomyelitis Caused By Achromobacter Xylosoxidans, Christopher P. Girgis, Tyler L. Coye, Elizabeth Ansert, Amanda L. Killeen, Peter A. Crisologo

School of Podiatric Medicine Publications

Achromobacter xylosoxidans is a rare opportunistic aerobe that has rarely been documented in the literature as a causative agent for osteomyelitis. It can present with antibiotic resistance, making treatment without operative management challenging. We present the case of a 51-year-old male with a past medical history of uncontrolled type 2 diabetes. The patient presented to a clinic with a grade 2 infection to the right fifth digit, as defined by the International Working Group on the Diabetic Foot, and was subsequently admitted for intravenous antibiotics and operative management. Magnetic resonance imaging revealed abnormal signal of the phalanges of the fifth …

Comparative Effectiveness Of Conservative Versus Early Surgical Treatments On Wound Healing Outcomes Of Diabetic Foot Ulcers: A Literature Review, Paul Tran, Yasim Zafar, Andrea Piña, Stephanie N. Campbell

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus and the leading cause of lower extremity amputations worldwide. Peripheral neuropathy and peripheral arterial disease secondary to complications of diabetes mellitus may result in ulcers going unnoticed, increasing the risk of severe osteomyelitis, necrotizing infection, hospitalization, amputation, and sepsis. While conservative management of DFUs remains the first-line approach—emphasizing wound care, infection control, glycemic management, and offloading—there is growing debate about whether delaying simple surgical interventions worsens long-term outcomes. Surgeries such as tenotomy, digital amputation, and tendo-Achilles lengthening are minimally invasive options that can correct deformities, prevent recurrence, and promote …

Cerebroplacental Doppler Ratio For The Prediction Of Adverse Perinatal Outcomes In Late-Onset Fetal Growth Restriction, Sonia Sajja, Onur Turkoglu, Torey Asao, Perry Friedman, Ray Bahado-Singh

Conference Presentation Abstracts

Objective: Late-onset fetal growth restriction (LO-FGR), defined as onset 3 32 weeks gestation, is the more common subgroup of FGR. The umbilical artery Doppler is usually unaffected. There are no subgroup-specific guidelines for monitoring pregnancies affected by LO-FGR. We compared the utility of the cerebroplacental Doppler ratio (CPR) to the Biophysical Profile (BPP), a widely endorsed FGR monitoring tool, for the prediction of adverse perinatal outcomes (APO). Study Design: This is a retrospective cohort study of LO-FGR, defined as estimated fetal weight < 10th%, from 2013-2018. Using logistic regression analysis, we determined whether low CPR < 5th% and BPP score £ 6 significantly independently predicted the composite APO defined as one or more complications: cord pH < 7.20, 5-minute Apgar score of < 5, operative or cesarean delivery secondary to non-reassuring fetal heart tracing, assisted respiration at birth, NICU admission, and/ or perinatal death. Secondarily, we also evaluated prediction of severe neonatal morbidity (SNM) defined in Table 1 (legend). Results: There were 233 cases of LO-FGR of which 76 (34%) had a low CPR percentile and 28 (13%) had a low BPP score. There were 22 (9.9%) cases with SNM of which 5 (2.1%) had a low CPR percentile and 4 (1.8%) had a low BPP score. A low CPR was associated with a significantly higher rate of individual and composite APO than cases with normal CPR percentile (p < 0.001) [Table 1]. Both a low CPR percentile and a low BPP score significantly predicted APO overall. CPR appeared to be a better predictor of the APO, controlling for gestational age at testing [Table 2]. Only BPP significantly predicted SNM: CPR (OR = 4.64, p = 0.13) and BPP (OR = 4.11, p = 0.038). Conclusion: A low CPR percentile was a significant independent predictor of perinatal complications in LO-FGR, including abnormal fetal heart rate tracing, smaller birthweight percentile, and NICU admission. CPR appeared superior to BPP overall. CPR should be considered as a fetal surveillance tool in LO-FGR.

Artificial Intelligence System Accurately Detects Fetal Ultrasound Findings Suspicious For Major Congenital Heart Defects, Carolyn M. Zelop, Jennifer Lam-Rachlin, Alisa Arunamata, Rajesh Punn, Sarina K. Behera, Matthias Lachaud, Nadine David, Greggory R. Devore, Andrei Rebarber, Sara Garmel

Conference Presentation Abstracts

Objective: Prenatal detection of congenital heart defects (CHD) improves patient outcomes. Despite advances in imaging techniques and equipment, prenatal diagnosis remains low. We evaluated the accuracy of an artificial intelligence (AI) system to detect 2nd trimester (2T) ultrasound studies suspicious for CHD. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of a study and detects 8 morphological findings suspicious for CHD. The findings were selected such that most major forms of CHD would feature at least one such finding, and the presence of any of these would flag the study for referral for further examination. We retrospectively …

Ai Significantly Improves Detection Of Prenatal Ultrasounds Suspicious For Major Congenital Heart Defects By Obgyn/Mfms, Jennifer Lam-Rachlin, Rajesh Punn, Sarina K. Behera, Miwa Geiger, Matthias Lachaoud, Nadine David, Sara Garmel, Matthew K. Janssen, Kendra Sylvestser, John Kennedy

Conference Presentation Abstracts

Objective: Congenital heart defects (CHDs) are a leading cause of infant morbidity and mortality partly due to low prenatal detection rates. We evaluated whether an artificial intelligence (AI) system can improve the detection of CHDs on fetal ultrasound exams among both general OBGYNs and MFM specialists. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of an exam and detects 8 morphological findings associated with severe CHDs. The presence of any such finding should justify patient referral for further examination. The AI system identifies each finding as present, absent or inconclusive, and highlights frames where findings can be …

Shared Generator-Based Serverless Multimodal Federated Learning For Medical Image Analysis, Mohammed Adel Al-Shahe, Ahmed Saihood, Mustafa Asaad Hasan

Mesopotamian Journal of Big Data

Medical image analysis constitutes the foundation of the diagnosis of potential life-threatening conditions such as lung cancer. Nevertheless, AI model construction in this context is hindered by strict privacy regulations (e.g., HIPAA, GDPR), the variability of imaging protocols, and the paucity of large annotated datasets. These barriers constrain centralised machine learning and dampen interdisciplinary research. To overcome such barriers, this paper introduces shared generator-serverless federated learning (SGS-FL), a decentralised multimodal medical imaging framework. By employing a shared generator and multidiscriminator architecture, SGS-FL eliminates centralised dependency via cross-modal synthesis, while the communication burden is reduced by embedding a sharing protocol. By …

Retinal Vessel Image Segmentation Based On Guided Filter And Neural Networks, Ibrahem Al-Jadir, Jawad S. Hameed, Husam Yahya, Dalia N. Al-Oboudi

Mesopotamian Journal of Artificial Intelligence in Healthcare

Accurate segmentation of retinal blood vessels is essential for the early diagnosis and monitoring of various ophthalmic and systemic diseases. This work shows how to use a modified U-Net architecture to improve how retinal blood vessels are segmented. The method uses rolling guidance filters with two different sets of parameters to make the edges of the vessels sharper and make it easier to tell them apart. Separate U-Net models process each filtered image independently, and then the outputs are combined to make the final segmentation result. Both networks are trained at the same time using a shared loss function. Tests …

Front Matter, Editors Of Jcwre

Journal of Contemporary Water Research and Education

No abstract provided.

Perceptions Of Influence And Collaboration Amongst Healthcare Providers, Nurses And Allied Health Professionals, Barbara Harrison

Dissertations

Problem

While attention to interprofessional collaboration is increasingly present in academic settings and in clinical practice, there is little understanding of the role power, specifically the scope of influence, plays in interprofessional collaboration.

Method

Targeted cross-sectional sampling was used to select possible candidates to participate in this quantitative study. An email invitation was sent to healthcare providers, nurses and allied healthcare professionals in a multi-hospital healthcare system in the mid-western United States of America. Willing participants proceeded to the Microsoft Forms survey via an embedded link which was available to them for eight days. The survey sought demographic information, and …

Burnout And Quality Of Life As Predictors Of Compassion Fatigue In Inner-City Teachers In The United States, Helen Richelle Ceballo-Hernández

Dissertations

Problem

Teachers are under great stress which can result in burnout and the feeling of being overloaded with work. In turn, burnout can induce compassion fatigue. Compassion fatigue is often referred to in the literature as repeated exposure to others’ trauma endured by first responders, nurses, and other medical professionals as well as others in the helping profession such as therapists and social workers. The empathy of helping professionals incites compassion fatigue for those whom they help. Teachers, though not originally classified as part of the helping professions, are susceptible to compassion fatigue due to their empathy and the amount …

The Role Of Support And Prayer In Enhancing The Psychological Well-Being Of Cancer Patients In Canada, Emmanuel N. Mbah

Dissertations

Purpose of the Study

The purpose of the study was to investigate the role of family support, friends' support, community support, and prayer on the psychological well-being of cancer patients in Canada.

Methodology

A survey research method was used in this study. The survey was distributed through the QuestionPro audience and had 721 viewers, 674 respondents, and 400 participants (i.e., those who completed the survey). The survey completion rate was 59.35%, with an average completion time of 9 minutes. Most participants were Christians (62.0%), some were unaffiliated (29.5%), and the remaining participants were either Muslims, World Religion, Buddhism, Hinduism, etc. …

Exploring Educator Burnout: Experiences And Perceptions Of Teachers And Principals In Canadian K-12 Seventh-Day Adventist Schools, David Anthony Elias

Dissertations

Problem

Burnout among educators is a growing concern, particularly within faith-based school systems where teachers often balance high professional expectations with spiritual commitments. In K-12 Canadian Seventh-day Adventist (SDA) schools, limited research has explored how burnout manifests, the factors contributing to it, and its impact on teacher retention. This study aimed to examine the levels and causes of burnout among SDA educators, as well as the systemic factors influencing their experiences.

Method

This study employed an explanatory sequential mixed-methods design. Quantitative data were collected using the Maslach Burnout Inventory – Educators Survey (MBI-ES) to measure emotional exhaustion, depersonalization, and reduced …

Inner Life, Spiritual Leadership, And Spiritual Well-Being As Predictors Of The Organizational Performance Of Employees At A Seventh-Day Adventist University In Latin America, Patricio Ordoñez

Dissertations

Problem

While traditional leadership models, such as transactional and transformational leadership, have shown success, recent research highlights the need for leadership approaches that address the spiritual and ethical dimensions of individuals in the workplace. Leaders who fail to integrate spiritual leadership risk negatively impacting employee satisfaction, creativity, and overall organizational performance. Despite the well-established concepts of inner life and spiritual well-being, more research is needed to understand their effects on employee performance in faith-based institutions. This study sought to fill that gap by examining the relationship among inner life, spiritual leadership, and spiritual well-being as predictors of organizational performance among …

Perceived Social Support And Religious Attitudes As Correlates Of Spiritual Well-Being Among Senior Undergraduate Students At Northeast Brazil Adventist University, Hebert Davi Liessi

Dissertations

Problem

Even though the study of spirituality has been a recurrent theme in academia, in Brazil there has been little emphasis on the analysis of spiritual well-being in the context of university students. Few studies have examined the correlation of spiritual well-being with perceived social support or religious attitudes among university students, and most of these have been in the fields of health care or health recovery. Some research has indicated that religious attitudes may be partially disconnected from improvements in the level of spirituality. -- This study aimed to verify whether this disconnection is real or relevant, and assumed …

Developing The Leadership Competency Of Critical Thinking In College Students: A Quasi-Experimental Mixed Methods Study At A Small Christian College, Norberto Restrepo

Dissertations

Our world of constant change and complex challenges requires citizens who know how to exercise higher-order thinking skills, and individuals who have developed their metacognitive abilities to a higher extent are better prepared to perform effectively as leaders. This quasi-experimental mixed methods study employed a pre and posttest design to determine whether the critical thinking skills of students at Hartland College could be improved over the course of a one quarter ten week term through the use of biblical worldview instructional approaches such as biblical worldview development, faith learning integration, and deep Bible study that had critical thinking activities embedded …

Imagine For Tomorrow, What You Cannot Feel Now – The Role Of Anhedonia In Imagery-Enhanced Behavioral Activation, Max Heise, Julie L. Ji, Jessica Werthmann, Fritz Renner

School of Psychology

Preliminary evidence suggests that mental imagery-based elaboration of rewarding activities enhances anticipated pleasure, motivation, and behavioral engagement in non-clinical samples, but its effects in individuals experiencing anhedonia (loss of pleasure/interest) is unclear. Study 1 (N = 90) contrasted imagery-enhanced activity scheduling with two scheduling-only control conditions (Reminder/No Reminder Control) in an unselected sample. Study 2 (N = 108) compared imagery-enhanced activity scheduling with two control conditions (Neutral Imagery/Motivational Verbal Reasoning) in individuals experiencing mild to moderate anhedonia. Both studies measured changes in activity appraisal (anticipated pleasure, anticipated reward/mastery, motivation) in the lab, and behavioral engagement across a subsequent 7-day period. …

Posting About Goals On Social Media: The Unexpected Effect Of Posting Goal-Intention Photos Rather Than Goal-Pursuit Photos On Goal Attainment, Kelly Eunjung Yoon, Cornelia Pechmann

Atlantic Marketing Journal

Can posting photos online help individuals achieve their goals? Past research has generally found that posting about goals on social media increases motivation to achieve those goals. However, little is known about the consequences of posting different types of goal-related content. This research uses real-world Instagram data to test the effects of posting photos about goal pursuit (i.e., goal enactment behaviors) versus goal intention (i.e., goal planning or setting) on goal attainment. Our findings indicate a positive and significant relationship between posting goal-pursuit photos and goal attainment. Conversely, posting goal-intention photos yields no measurable effect. This finding challenges the generalized …

An Immanent Postfoundational Methodology For Researching The Violent Trans-Sections Of Ableism, Classism And Sexism, Elizabeth Done, Cara Baer

School of Law, Humanities and Social Sciences

This paper charts the unfolding of a small-scale qualitative study, presented at institutional ethical approval stage as drawing on posthumanist theorising and seeking to (re)configure the concept of intersectionality, and focusing on the lived experience of postgraduate students of lower socio-economic status with disabilities. The self-selected sample comprised six women, three of whom volunteered accounts of sexual violence that complicated their experiences of dis-ability and class, and highlighted the complexity of their lived experience of intersectionality. We describe a research process in which interviewing became intra-viewing, lived experience came to be understood through Deleuzian and Deleuzo-guattarian concepts and intersectionality became …

Exploring Islamophobia Through Intersectionality., Suparna Bagchi

School of Law, Humanities and Social Sciences

No abstract provided.

Provision Of A Daily High Protein And High Energy Meal: Effects On The Physical And Psychological Wellbeing Of Community-Dwelling, Malnourished Older Adults; A Randomised Crossover Trial, Lauren Struszczak, Mary Hickson, Irene Mcclelland, Brad Metcalf, Manuela Barreto, Luciana Torquati, Jon Fulford, Rachael Allen, Claire Hulme, Mary F. O'Leary, Joanna L. Bowtell

School of Health Professions

Objectives: To determine whether daily provision of a high protein, high energy meal for 12-weeks to under-nourished older adults living independently in the community can improve physical, physiological, and psychological outcomes. Design: A randomised crossover trial. Setting: Participant homes within a 15-mile radius to meal supplier; Dartmoor Community Kitchen Hub. Participants: Fifty-six community dwelling older adults (82 ± 7 years, 70% female) were randomised (stratified for baseline mini nutritional assessment (MNA) score and cohabiting or living alone) to receive 12-weeks of meal provision followed by 12-weeks no intervention (meals first group, n = 28), or, 12-weeks without intervention followed by …

Vestibular Rehabilitation In Multiple Sclerosis: Randomized Controlled Trial And Cost-Effectiveness Analysis Comparing Customized With Booklet Based Vestibular Rehabilitation For Vestibulopathy, Jonathan Marsden, Rachel Dennett, Jennifer Freeman

School of Health Professions

Background:Vestibular dysfunction occurs in 30% to 70% of cases with multiple sclerosis (MS).Objective:To compare the clinical and cost-effectiveness of a customized vestibular rehabilitation (VR) program with a generic booklet-based VR intervention in people with MS with clinical signs of vestibulopathy.Methods:People with MS and symptoms of vertigo and/or imbalance were screened for vestibulopathy (n = 73). Seventy recruited participants were randomly allocated to a 12-week generic booklet-based home program with telephone support (n = 35) or a 12-week customized VR program (n = 35, 12 face-to-face sessions and a home exercise program). The primary clinical outcome was the Dizziness Handicap Inventory …

The Current Clinical Practice And Experiences In Buccal Midazolam Prescribing In Community For Status Epilepticus Termination In The United Kingdom: The Rescue Epilepsy Medication And Training (Remit) Study, Rohit Shankar

Peninsula Medical School

Background: Epilepsy is one of the commonest neurological conditions worldwide and confers a significant mortality risk, partly driven by status epilepticus (SE). Terminating SE is the goal of pharmaceutical rescue therapies. This survey evaluates UK-based healthcare professionals’ clinical practice and experience in community-based rescue therapy prescribing. Methods: A cross-sectional, 21 item questionnaire composed of Likert-style and free-text based questions was administered online. It was distributed through a non-discriminative snow-balling methodology to members of the Epilepsy Specialist Nurses’ Association (ESNA) and the British International League Against Epilepsy (ILAE). Quantitative analysis used Chi-squared, Fishers’ exact and Mann-Whitney tests. Qualitative data were analysed …

Serious Games For Constipation Management For People With Intellectual Disabilities: A Scoping Review And Narrative Synthesis, Serena Daniel, Ruth Bishop, Ellie Killner, Alison Whight, Sarah Lennard, Stephen Howard, Richard Laugharne, Rohit Shankar

Peninsula Medical School

Introduction: People with intellectual disability (PwID) are 2% of the UK population. Constipation and bowel movement (BM) problems (diarrhoea/faecal incontinence etc.) affects over a third of PwID and is a serious cause of morbidity and mortality. Pw ID rely heavily on outside support (family/professional carers/healthcare professionals), many of whom are ignorant to bowel related harms. There is significant stigma to discuss BM particularly constipation. Serious Games (SG) are increasingly used for education of health needs. This review examines if game-based technology can assist improving knowledge and reducing stigma of BM problems particularly constipation. Objective: To identify and gain evidence of …