Digital Commons Network^™

Implementation Of An Updated Opioid Overdose Response Policy To Address Xylazine-Involved Overdoses In A Federally Qualified Health Center, Dana Umbro

DNP Projects

The increasing prevalence of non-opioid adulterants like xylazine, a veterinary tranquilizer, has introduced significant challenges in overdose recognition and management. Non-opioid adulterants cause central nervous system depression, respiratory compromise, and severe soft tissue injury that is not reversed by naloxone. Many healthcare organizations lack standardized clinical guidance for managing overdoses involving non-opioid adulterants, resulting in variability in care and increased risk for adverse outcomes. The purpose of this Doctor of Nursing Practice project was to update and implement an opioid overdose response policy incorporating evidence-based guidance for the recognition and management of overdoses potentially involving non-opioid adulterants. This was conducted …

Transitional Care Model Telehealth Calls To Improve Hospital Follow-Ups In A Community Health Center: A Quality Improvement Project, Veronica Dejesus

DNP Projects

Title: Transitional Care Telehealth Calls to Improve Hospital Follow-Up in a Community Health Center: A Quality Improvement Project

Background/Introduction: Transitions from hospital to primary care are a vulnerable period associated with missed follow-up appointments, poor patient outcomes, and increased readmissions, particularly in underserved populations. Internal data identified gaps in timely post-discharge follow-up, while external evidence supports structured transitional care interventions, such as telephone outreach within 48–72 hours, to improve patient engagement and continuity of care.

Objective/Purpose: The purpose of this quality improvement project was to evaluate whether structured, nurse-led transitional care telehealth calls improve completion of primary care follow-up visits …

Improving Nasal Decolonization Rates In The Inpatient Medical-Surgical Setting, Francesca Annunziato Royer

DNP Projects

Background/Significance

Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) remains a significant cause of morbidity, mortality, and increased healthcare costs. Alcohol-based nasal decolonization is an evidence-based strategy to reduce MRSA transmission; however, staff compliance with decolonization protocols is often suboptimal, limiting effectiveness in inpatient medical-surgical settings.

Purpose

The purpose of this evidence-based quality improvement (EBQI) project was to evaluate whether implementing a structured, evidence-based nasal decolonization protocol improved staff compliance and reduced missed administrations and patient refusals among eligible medical-surgical inpatients.

Methods

This EBQI project was implemented on five inpatient medical-surgical units at a large academic medical center. Interventions included standardized staff education, …

Leveraging Technology To Improve Throughput: A Qi Project Utilizing Electronic Sbar, Suzy Candito

DNP Projects

The DNP practice site, a high-acuity Level I trauma center and regional referral hub, experiences persistent emergency department (ED) crowding and prolonged admission throughput times. Regional data show average ED wait-times near 252 minutes, underscoring the urgency of reducing delays between bed assignment and bed occupancy (assigned-to-occupied time). Inefficient or varied written handoffs contribute to calls for clarification, omissions, and transition delays, where structured, electronic SBAR tools are associated with improved completeness, standardization, and workflow efficiency. At the systems level, prolonged ED boarding is linked to higher daily hospital costs and safety risks, making communication optimization an operational and patient-safety …

Enhancing Postoperative Outcomes: The Impact Of Instruction Format On Patient Satisfaction In Ambulatory Surgery An Evidence-Based Quality Improvement Project, Gillian Shelby

DNP Projects

Background

Effective postoperative discharge communication is essential in ambulatory surgery centers, where short recovery periods and rapid patient turnover increase the risk of misunderstanding postoperative care instructions. Inconsistent delivery of discharge education may contribute to decreased patient satisfaction and reduced adherence to postoperative plans. Project Goals

The goals of this DNP quality improvement project were to: (1) implement standardized dual-format postoperative instructions using written and verbal education reinforced with the teach-back method, and (2) improve patient satisfaction and confidence in understanding postoperative care instructions. Methods

Following IRB exempt approval on September 10, 2025, implementation occurred from November 20,2025 to February …

Beyond The Uniform: Supporting Veterans Through Mental Health And Recovery Education, Ja'liah Williams, Lillie Ray, Joaquin Babinecz, Amiya Shepherd, Merritt Christian, Diego Nieto

DC Health and Academic Prep Program (DC HAPP)

Northern Virginia veterans face critical gaps in mental health and substance abuse support. This program outlines a targeted outreach and education campaign designed to increase resource utilization and reduce stigma. Utilizing community surveys to identify deficits in access and deploy pamphlets and digital surveys for our veterans to complete. In doing this, we aspire to partner with various organizations to help promote stability within their community.

Ttt Sahur- Team Traveling Therapist Supporting Allies In Health Urban Residents, Victoria Chan, Allison Gonzalez, Neri Nchami, Addisen Suber, Jerry Wang, Christopher Celarie

DC Health and Academic Prep Program (DC HAPP)

High levels of employee burnout and turnover are prevalent within mental health clinics across DC 1. High employee burnout and turnover affect both employees and patients. It delays care for patients because of the smaller number of employees and impedes the quality of care patients receive. It also adds to the stress that the employees are experiencing with the new workload, causing more burnout and continuing the cycle of high employee turnover 2 . This project is aims to address the employee burnout and turnover of mental health clinics by bolstering the current workforce. In this project, second year master …

Preventing Complications Of Childhood Asthma In Ward 8 With Mobile Resources And Education, Nahome Worku, Cara Segur, Arav Shah, Elhadji Ndiaye, Deivaanai Palaniappan, Marcus Odin

DC Health and Academic Prep Program (DC HAPP)

Childhood asthma remains a major public health concern in Ward 8 of Washington, D.C., where asthma rates exceed district and national averages. The program proposes a mobile medical clinic that would provide free screenings, inhalers and referrals, including education and community advocacy to improve access to care and overall quality of life for children in Ward 8.

By bringing services directly to underserved communities, the program will aim to reduce asthma attacks, school absences, and childhood asthma-related deaths. The program’s success will be evaluated through participant surveys which will measure health outcomes and overall satisfaction.

Beyond The Bars: Reimagining The Dc Correctional System As The Frontline For Hepatitis C Elimination, Rahimatu Jalloh, Amber Munoz, Riyan Lee, Kristen Martinez, Malia Allen, Gerard Lin

DC Health and Academic Prep Program (DC HAPP)

Hepatitis C is a major public health concern among incarcerated populations, who are infected at rates approximately 10 times higher than the general U.S. population. In Washington, D.C., an estimated 12,700 people are living with hepatitis C, and the District has one of the highest HCV prevalence and mortality rates in the nation. Although hepatitis C is highly curable, many incarcerated individuals do not receive treatment despite having enough time to complete therapy while incarcerated.

This project proposes a comprehensive hepatitis C program for the D.C. prison system that addresses HCV through prevention, intake screening, treatment during incarceration, and post-release …

Town Of Gilmanton Annual Reports Of The Officers, Trustees, Agents, Committees, And Organizations Of The Town Of Gilmanton, New Hampshire For The Year 2025, Gilmanton Town Representatives

Gilmanton, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

Town Of Groton New Hampshire 2025 Annual Report, Groton Town Representatives

Groton, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

Shaping The Future: Emerging Technologies And Their Role In Industry 4.0 And Beyond, Liuliu Qin

Information Technology & Decision Sciences Faculty Publications

This paper provides a comprehensive review of emerging technologies driving the transition from Industry 4.0 to Industry 5.0. It examines the foundational concepts and pillars of Industry 4.0 and explores the transformative roles of Artificial Intelligence (AI), Extended Reality (XR), Collaborative Cobots (Cobots), Brain–Computer Interfaces (BCIs), quantum technologies, and next-generation connectivity (5G/6G). By integrating technological, human-centric, and sustainability perspectives, the study outlines how these emerging technologies reshape industrial systems and enable intelligent, adaptive, and inclusive futures.

Annual Report Of The Town Of Stratham, New Hampshire By The Select Board, Town Clerk, Tax Collector, Town Treasurer, And Other Town Departments, Boards And Commissions, And Reports Of School Districts And Sau #16 December 31, 2025 With The Vital Statistics For 2025, Stratham Town Representatives

Stratham, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

Digital Speech Biomarkers Of Cognitive Functioning In Multilingual Kenyan Adults, Adolfo M. Garcia, Levi Muyela, Alejandro Sosa Welford, Matías Caccia, Anne Njoki Gitere, Anne Nyambura, Erick Muhando, Zul Merali, Chinedu Momoh, Karen Blackmon

Brain and Mind Institute

Background: Digital speech biomarkers show promise as cost-effective and scalable diagnostic tools for cognitive decline and dementia in African research and healthcare settings. However, significant gaps remain in language-specific normative data, cross-linguistic validation, and standardized protocols for multilingual populations. Targeting cognitively unimpaired multilingual Kenyan adults, here we aim to validate speech timing features from natural language, against performance on standardized culture-sensitive neuropsychological measures.

Method: This study was funded by Davos Alzheimer's Collaborative and took place in an outpatient clinic at the Aga Khan University in Nairobi, Kenya. Participants completed culturally adapted tests tapping on word list learning, visual memory, …

Longitudinal Implementation Of A Neurodevelopmental Screening Program For Children Born To Mothers Living With Hiv In Maternal–Child Clinics In Kenya: A Mixed Methods Study, Megan S. Mchenry, Eren Oyungu, Amina Abubakar, Ananda Roselyne Ombitsa, Micaela Gaviola, Cleophas Cherop, Beatrice Kaniaru, Carolyne Jerop, Alan Mcguire, Rachel C. Vreeman

Institute for Human Development, East Africa

Background: Children with perinatal HIV exposure are at increased risk for neurodevelopmental (ND) delays, yet little is known about ND screening implementation for this population.

Methods: This longitudinal study evaluated ND screening implementation at a health clinic in Kenya, from 9/2021 to 8/2023. Children aged 18-36 months with perinatal HIV exposure were screened using a 12-item general ND tool. Implementation outcomes—acceptability, feasibility, fidelity, and sustainability—were assessed through time-motion observations, clinic records, and semi-structured interviews with caregivers and staff.

Results: Of 507 eligible children, 405 (80%) were screened. Screening rates were consistent over 24 months, with average time …

Doing Drag: Exploring The Experiences Of Drag As An Occupation For Performers In California, Alicia Montes, Anna Ranario, Lilibeth Rosales, Eileen Spahle, Nathan Gelman, Laura Greiss Hess, Karen Mccarthy

Occupational Therapy | Faculty Scholarship

Background: Drag is a performative art where individuals explore identity, challenge societal norms, and foster community through exaggerated gendered performance. Drag in the United States is facing potential restrictions and remains underexplored in occupational science and occupational therapy literature.

Methods: This qualitative study explored the experiences of drag performers in California, applying an occupational perspective through the framework of form, function, and meaning. Five drag performers were interviewed. Reflective thematic analysis was used to interpret qualitative data.

Findings: Identity was the central theme, interconnected with form, belonging, non-belonging, meaning and motivation, and resistive occupation. Findings highlight drag …

Acuity-Based Staffing Tool: Improving Patient Outcomes And Nurse Wellbeing In A Local Critical Care Unit, Grace Watson, Rachel Nazha, Madeline Ruffin, Evvy Lewis

SPARK Symposium Presentations

This change project proposes implementation of the CAMEO (Complexity Assessment and Monitoring to Ensure Optimal Outcomes) acuity-based staffing tool in a local critical care unit to improve patient safety, nurse wellbeing, and organizational outcomes (Hurtig et al., 2021). Current staffing practices rely on floating nurses from other units during census fluctuations, creating skill mismatches, increased burnout, and risk for adverse events. Evidence links inadequate staffing with increased mortality, infections, length of stay, and nurse turnover, revealing the need for a more systematic approach (Elmdni, 2025). The CAMEO tool quantifies cognitive workload across 18 domains of care and aligns nurse expertise …

A New Framework For Drug Pricing Law And Policy, Rachel E. Sachs

Indiana Law Journal

Scholars and policymakers have expressed concern about the impact of high prescription drug costs on patients and healthcare budgets. This Article presents a new theoretical framework for evaluating both the problem to be addressed by drug pricing reforms as well as the efficacy of potential solutions. In seeking to solve “the drug pricing problem,” our legal system has given primacy to competition rather than regulation to drive down drug prices. This Article disaggregates the broader concept of drug competition into four steps, each of which must be addressed and each of which elevates different institutional actors to key roles. In …

When Death Is Not Binary, Teneille R. Brown

Indiana Law Journal

There are few dichotomies more recognized than the one between life and death. Given the many legal rights that pivot on this distinction, one would think that the law has exceptionally clear standards for diagnosing death. It may surprise you then to learn that the line between legal life and death is no longer so obvious. That is, in a growing number of cases, there is now disagreement about whether someone is legally dead or alive. This is due to two things: the development of medical devices that can breathe for patients with severe brain injuries, and neuroimaging technology that …

The Fiduciary Game, Lauren R. Roth

Indiana Law Journal

Fiduciary duties are supposed to bridge the gap between public and private law. Private actors who engage in “public or quasi-public” functions (e.g., corporate directors and pension administrators) are often subject to fiduciary constraints to protect vulnerable parties who lack power in relationships with these actors. Recently, scholars have argued that both courts and legislatures have inappropriately expanded the use of fiduciary duties to purely private relationships. But what if the problem is not the expansion of fiduciary duties to private relationships, but the increasing delegation of public powers to private actors whose behavior cannot be adequately constrained by fiduciary …

Virtual High School Classes And The Impact On Rural Students And Teachers, Ashley M. Storck

All Electronic Theses and Dissertations

This literature review examines the impacts, advantages, and disadvantages of virtual high school classes on rural teachers and students. The review examines research on academic outcomes, instructional models, funding structures, stakeholder dynamics, and the effects of the COVID-19 pandemic. Virtual learning can expand access to courses and provide flexibility to students, especially in the case of credit recovery. Full-time virtual schooling is frequently associated with weaker long-term outcomes in comparison to traditional brick-and-mortar education. These findings are often intensified in rural settings where there are broadband insufficiencies as well as existing deficiencies in institutional capacity and student support systems. The …

Predictors Of Increased Length Of Stay And Cost In Readmissions For Spinal Surgical Site Infections, Matthew Giammanco, Alex Zhang, Phillip Alexeev, Ryan Snowden

SPARK Symposium Presentations

Abstract:

Background

Surgical site infection (SSI) following spinal surgery remains a costly and morbid complication, frequently necessitating hospital readmission and operative management. While prior studies have characterized the overall economic burden of spinal SSI, the specific drivers of cost during SSI-related readmissions are poorly defined. The primary research question of this study was to identify clinical, operative, and microbiologic factors associated with increased hospital cost, length of stay, and financial margins during readmission for operative management of spinal SSI.

Methods

We performed a retrospective cohort study of adult patients readmitted for surgical management of spinal SSI at a single tertiary …

Table Of Contents, Loyola University Chicago Law Journal

Loyola University Chicago Law Journal

No abstract provided.

Ai Deference, Kevin Frazier

Loyola University Chicago Law Journal

Existing AI tools allow administrative agencies to chart a more aggressive regulatory path. AI can identify which statutes and regulations, if reinterpreted, would further the agency's agenda. AI can also draft new regulations and forecast their likely effects.

No laws explicitly ban agencies from using AI. In fact, successive presidential administrations have encouraged agencies to increase their use of AI. Cities and states have already been integrating AI into ever more substantive governance tasks. Governments around the world are likewise finding novel ways to incorporate AI into drafting, enforcing, and adjudicating laws. In short, it is a matter of when, …

Impacts Of Native And Nonnative Plant Species On Avian Community Diversity, Matty John Mackay, Steven Van Dang, Brandon Lee Corn

SPARK Symposium Presentations

Avian communities play an essential role in maintaining a healthy ecosystem dynamic by regulating insect populations, assisting in plant pollination, and seed dispersal. These contribute to the overall health of natural ecosystems and mitigate ecological disruptions that would arise in their absence. However, the introduction of non-native invasive plant species can interrupt the balance avian communities bring to ecosystems by reducing availability of food sources, altering habitat structures, increasing competition among individuals, and disrupting ecological relationships through rapid invasion of ecological spaces. Point count observations of birds at Shelby Bottoms Park, Nashville, Tennessee in areas dominated by non-native privet and …

The Rise Of Right-Wing Populism Among Young Men, Oliver Lorgen

SPARK Symposium Presentations

Since the end of World War II, young people of Western Liberal Democracies have generally leaned left, holding views of reform, social progression, and policies that lead to a general increase in quality of life through social programs (Universal healthcare, food programs, public housing, etc). With unprecedented economic security, many people, especially younger ones, refocused their priorities away from ones of survival through strict authority and toward left-liberal positions of individual autonomy, civil rights, and redistribution of wealth and power. This trend continued throughout the 20th century. However, as instability begins to plague Western Liberal Democracies in the 21st century, …

Arkansas Women's Tennis Record Book, 2025-2026, University Of Arkansas, Fayetteville. Athletics Media Relations

Arkansas Women's Tennis

No abstract provided.

The Reckoning: A Mostly Lamentable Tragedy Comedy Of One Christopher Marlowe (...), Mac F. Mitchell

Playwriting (MFA) Theses

The Reckoning is a play by Mac Mitchell in completion of his MFA in Playwriting from Hollins University. It is a farce set in the Elizabethan Era inspired by the life of Christopher Marlowe and his involvement in the complex world of Elizabethan espionage. After investigating a counterfeiting plot designed to bankroll an assassination plot on Queen Elizabeth's life, he unwittingly implicates himself in the plot.

Marlowe will dropkick the fourth wall and, with a team of crackpot actors, attempt to set the record straight. He most certainly did not have anything to do with it and will prove his …

Backward, Benjamin W. Abbott

Playwriting (MFA) Theses

Backward is a solo show about a man who, when he turns forty-five, starts living backward in time. Every day he wakes up, he has traveled back to the day before the one he just lived and there's nothing he can do to stop it. As he relives his life in reverse, he must confront his failures as a husband and father. Even as he learns the lessons necessary to repair them, those relationships get left behind in the future. He continues moving backward and eventually must confront the most difficult relationship of them all: his relationship with his own …

Rainbows And Shades Of Gray, Lillian I. Savage

Playwriting (MFA) Theses

Rainbows and Shades of Gray is an original musical that explores the complexities of addiction, memory, and grief through a nonlinear, liminal narrative structure. The story follows Aaron, a deceased veteran, father, and musician forced to confront moments from his life as he grapples with the impact of his addiction on his relationships with his wife, Danielle, and daughter, Natalia. Through a series of fragmented scenes spanning past and present, the musical examines the emotional aftermath of trauma and the ways in which love persists despite harm.

Blending dialogue and original music, the piece uses song as a narrative device …