Digital Commons Network^™

Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie

Walden Dissertations and Doctoral Studies

Although the social problem of pediatric HIV disclosure has been studied by researchers internationally, there remains a gap in the experiences of social workers in facilitating this process. The purpose of this generic qualitative study was to explore the experiences and perceptions of social workers in the United States regarding the disclosure process for HIV positive children. This study was grounded in Rosenstock’s health belief model, which posits that an individual will take necessary action to prevent or manage a disease based on their perceptions of health. This model was effective in helping to identify what social workers think about …

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 …

Theology Of The People As Modernity’S Alternative: A Review Essay, William J. Collinge

The Journal of Social Encounters

In Modernity’s Alternative, Rocco Buttiglione presents the Argentinian theology of the people as an alternative to modernity as it has developed in Europe and North America. After an introduction, the first main part of this review essay discusses Buttiglione’s account of the development of the theology of the people and the major figures in it and how the apparition of Our Lady of Guadalupe marks the beginning of an alternative modernity. The second section considers Buttiglione’s parallel between Christian Platonists’ inculturation of Christian faith into Greek culture and Guadalupe’s inculturation of Christian faith into Mesoamerican culture. The third section …

Probiotic Intervention In Colorectal Cancer: The Cytotoxic And Apoptotic Potential Of Lactobacillus Cell-Free Supernatants, Bahar Yilmaz, Berna Erdal

Turkish Journal of Biology

Background/aim: Failures in the treatment of colorectal cancer (CRC) have increased scientific interest in the potential of the bioactive compounds contained in cell-free supernatants (CFSs) obtained from probiotic bacteria for cancer treatment. The aim in this study was to investigate the effects of CFSs obtained from Lactobacillus delbrueckii subsp. bulgaricus (L. bulgaricus) and Lactobacillus paracasei subsp. paracasei (L. paracasei) on colorectal cancer cell lines (HT-29 and Caco-2) and a healthy colon epithelial cell line (CCD841 CoN).

Materials and methods: Cytotoxic effects on the cell lines were determined by MTT assay. In line with the IC50 values obtained, morphological changes were …

Frailty As A Framework To Understand Tuberculosis Severity, Recovery, And Sequelae, Yoscelina Estrella Martinez-Lopez, Benjamin W. Black, Jessica Lee, Brian J. Buta, Lisa Y. Armitige, William A. Fountain, Rafael Samper, Aanand D. Naik, Joanne Turner, Blanca I. Restrepo

School of Medicine Publications

Tuberculosis (TB) causes profound systemic illness, and many survivors experience long-term sequelae associated with disability and premature mortality. Current TB severity indicators capture isolated aspects of disease and may not reflect the integrated physiological impact of infection on the host. Frailty, a multidimensional syndrome characterized by reduced physiological reserve and increased vulnerability to stressors, predicts adverse outcomes and guides clinical management in geriatrics. We propose frailty as an integrative framework for understanding the systemic effects of TB across the life course, encompassing disease severity, recovery, and long-term sequelae. We discuss biological mechanisms through which Mycobacterium tuberculosis infection may erode physiological …

Rickettsia Africae Discovered In A Short-Term Urban Traveller To South Africa: A Case Report, Zunairah Sikder

Binghamton University Undergraduate Journal

Rickettsia Africae is a pathogen that causes African tick-bite fever (ATBF). Transmission typically occurs from ticks within the Central and South African regions. Previous studies suggested that ATBF is not uncommon amongst travelers to rural sub-Saharan Africa, especially during the rainy months of November through April. However, this case report highlights a woman who contracted ATBF in novel conditions. The 70-year-old woman reported travelling strictly to and from the local church and hotel for her four-day stay in July. After returning to America, the patient experienced extreme irritation on her arm, as well as complaints of headaches. She presented to …

Cover And Contents

Turkish Journal of Medical Sciences

No abstract provided.

Lactate Dehydrogenase-To-Albumin Ratio As A Novel Prognostic Biomarker For 28-Day Mortality In Thoracic Trauma: A Single-Center Retrospective Cohort Study ​, Özgür Ömer Yildiz, Şükrü Yorulmaz, Eray Çinar, Hüseyi̇n Mutlu, Rami̇z Yazici, Ayşenur Gür, Medi̇ne Akkan Öz, Bensu Bulut, Mustafa Sirri Kotanoğlu, Hakan Güner

Turkish Journal of Medical Sciences

Background/aim: Thoracic trauma accounts for approximately 25% of all trauma-related deaths and remains a significant public health challenge. Early identification of high-risk patients is essential for improving clinical outcomes. The present study evaluates the prognostic value of the lactate dehydrogenase-to-albumin ratio (LDAR) in predicting 28-day mortality in patients with thoracic trauma.

Materials and methods: This retrospective observational study was conducted at a Level 1 trauma center between September 2022 and February 2025, and included adult patients presenting with thoracic trauma who underwent thoracic computed tomography. Demographic characteristics, clinical parameters, laboratory values, and 28-day mortality were analyzed. Receiver operating characteristic (ROC) …

Transient Bacteremia During Coblation-Assisted Tonsillotomy In Children ​, Yüce İslamoğlu, Sami̇ Berci̇n, Bengi̇ Arslan, Gökhan Ati̇k, Mehmet Emi̇n Ak, Muhammed Fati̇h Ozcan, Selman Secki̇n, Ezgi̇ Erki̇li̇c, Bedi̇a Di̇nc

Turkish Journal of Medical Sciences

Background/aim: The aim of this study was to evaluate the incidence of transient bacteremia after coblation-assisted intracapsular partial tonsillectomy (tonsillotomy) in children.

Materials and methods: This prospective study included 42 children with grade 3–4 tonsillar hypertrophy who underwent coblation-assisted tonsillotomy for obstructive sleep apnea syndrome. Aerobic and anaerobic blood cultures were obtained preoperatively and immediately after tonsillotomy. Intraoperative throat cultures were also obtained before mucosal manipulation.

Results: All preoperative blood cultures were negative. Postoperative blood cultures were positive in two patients (4.8%; 95% CI, 0.6%– 16.2%). Streptococcus pyogenes and Actinomyces spp. were isolated. The patient with S. pyogenes bacteremia also …

A Hidden Danger In Cancer Patients: Intestinal Parasites ​, Asli Geçgel, Ayşe Merve Parmaksizoğlu Aydin, Ahmet Türk, Esra Erdem Kivrak, Gökhan Vatansever, Nevi̇n Turgay, Erdem Göker, Meltem Taşbakan

Turkish Journal of Medical Sciences

Background/aim: Intestinal parasites are a significant cause of morbidity and mortality in immunosuppressed individuals. This study aimed to evaluate the frequency, distribution, and associated clinical factors of intestinal parasite detection among patients with solid tumors who presented with diarrhea over a 10-year period.

Materials and methods: This retrospective study included patients aged ≥18 years with solid tumors who presented with diarrhea and had stool samples examined at the Ege University Medical Parasitology Laboratory between January 2014 and September 2024. Patients with incomplete records or inadequate stool processing were excluded. Demographic, clinical, and treatment data were retrieved from electronic medical records …

Face Mask Littering: Environmental Impacts, Regulatory Challenges, And Ai-Driven Waste Management Strategies For The Post-Pandemic Era, Pri̇yanka Rathee, Sari̇ta Khatkar, Renu Sehrawat, Pooja Rathee, Anurag Khatkar, Esra Küpeli̇

Turkish Journal of Medical Sciences

The widespread use of polypropylene-based face masks during the COVID-19 pandemic created a significant and persistent source of plastic pollution. This review aims to provide an integrative assessment of the environmental, toxicological, and public health implications of face mask litter and evaluate current waste management challenges and emerging technological solutions in the postpandemic context. A narrative review approach was employed, synthesizing literature published between 2020 and 2025 and indexed in major scientific databases including Web of Science, Scopus, and PubMed. Studies were selected based on their relevance to the issues of environmental contamination, microplastic generation, toxicological effects, regulatory frameworks, and …

Influenza, Covid-19, And Pneumococcal Vaccination Status Among Adults In Türkiye ​, Gamze Şanlidağ İşbi̇len, Serap Gençer, Hüsnü Pullukçu, Meltem Taşbakan, İftahar Köksal

Turkish Journal of Medical Sciences

Background/aim: Vaccines reduce morbidity and mortality caused by infectious diseases that threaten public health. Lifelong immunization programs are essential for the entire population. This study assessed adult vaccination uptake for influenza, pneumococcal, and coronavirus disease 2019 (COVID-19) vaccines in Türkiye and examined the barriers and factors influencing vaccination decisions.

Materials and methods: This cross-sectional survey was designed and conducted by the Immunization Working Group of the Turkish Society of Clinical Microbiology and Infectious Diseases. A 19-item questionnaire was administered to individuals aged 18 years or older to assess influenza, pneumococcal, and COVID-19 vaccination status. The questionnaire collected data on demographic …

Nationwide Characteristics Of Infectious Disease Patients Transported By Helicopter In Türkiye, Ayşe Gülden Bekgöz, Kerem Dost Bi̇lmez, Muhammed Saltuk Deni̇z

Turkish Journal of Medical Sciences

Background/aim: To evaluate the clinical, demographic, and operational characteristics of patients with infectious diseases transported by helicopter ambulance and to examine differences in the transfer patterns, flight durations, and diagnostic categories.

Materials and methods: Registry data of patients with infectious diseases transported by helicopter ambulance were analyzed. Demographic characteristics, diagnoses, referring and receiving hospital types, intraprovincial and interprovincial transfer status, flight durations, and temporal distribution of transfers (hours, days, and months) were evaluated. Flight duration was calculated in minutes and compared between intraprovincial and interprovincial transfers.

Results: A total of 543 patients with infectious diseases were transported by helicopter ambulance. …

Staff Education To Improve Hand Hygiene And Personal Protective Equipment Compliance, Suliat Oluwa

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education initiative designed to strengthen hand hygiene and personal protective equipment (PPE) practices among interdisciplinary staff in a long-term care (LTC) facility. The practice problem addressed inconsistent hand hygiene and PPE use across shifts and departments, contributing to healthcare-associated infections (HAIs). Because LTC residents are highly vulnerable due to advanced age, multiple comorbidities, and shared living environments, improving adherence to infection prevention practices is essential for enhancing resident safety, reducing preventable infections, and supporting compliance with Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) infection prevention standards. …

Weekly Team Validation Rounding Focused On Chlorhexidine Gluconate Bathing And Bath Completion And Documentation Compliance, La-Toya Therese Fong

Walden Dissertations and Doctoral Studies

This quality improvement project evaluated whether weekly team validation rounding improved chlorhexidine gluconate (CHG) bath completion and documentation compliance among eligible adult inpatients, with particular attention to differences in compliance outcomes between Pod 5C and Pod 4B. Background. Hospital-acquired infections continue to increase morbidity, mortality, length of stay, and healthcare costs. Although CHG bathing is an evidence-based strategy for reducing infection risk and the transmission of multidrug-resistant organisms, inconsistent documentation at the practicum site limited accurate monitoring of compliance across validation data, electronic medical record documentation, and DOMO reports. Method. Participants included eligible adult inpatients admitted within the previous 24 …

Closing The Loop: Strengthening Cauti Prevention With Urinary Catheter Management, Erika N. Braun

Master's Projects and Capstones

Objective: Catheter-associated urinary tract infections (CAUTIs) are among the most common preventable healthcare-associated infections and are associated with significant patient harm and increased healthcare costs. Baseline assessment across five adult cardiovascular and critical care units within a community-based acute care hospital identified four CAUTI events during the first half of 2026 and revealed important nursing knowledge deficits related to bladder scanning protocols and urinary catheter management practices. Aim: This Quality Improvement (QI) Project aimed to improve nursing knowledge of evidence-based bladder scanning protocols and urinary catheter management practices through targeted educational interventions implemented over a 10-week period, with …

Licensed Counselors’ Professional Well-Being During The Covid-19 Pandemic, Jacqueline Flaherty

Walden Dissertations and Doctoral Studies

According to the American Counseling Association (ACA, 2014) Code of Ethics, professional counselors are responsible to monitor their own impairment. Specific interventions to prevent impairment and foster counselor professional well-being (PWB) and resiliency are imperative in a profession in which it is ethically required to continuously provide competent counseling. The purpose of this study was to explore the narratives of licensed counselors’ PWB during the onset of and successively during the coronavirus disease 2019 (COVID-19) pandemic. The theoretical orientation for this study was Dewey’s theory of experience. Nine counselor participants who were licensed by May 2018 shared detailed accounts of …

Trace Elements In Complete Feeds Used In Intensive Rearing Of Cattle, Poultry, And Pigs: Occurrence And Predicted Transferred Concentrations In Animal-Derived Food, Elizabeta Dimitrieska Stojkovikj, Vangelica Enimiteva, Aleksandra Angjeleska, Risto Uzunov

Turkish Journal of Veterinary & Animal Sciences

This study investigated the concentrations of essential (Zn, Cu, Mn, Co, and Mo) and toxic (Pb, Cd, As, and Hg) trace elements in complete feeds used for the intensive rearing of cattle, poultry, and pigs in North Macedonia and predicted their transfer into animal-derived foods. A total of 107 feed samples were collected from 40 farms between May 2023 and April 2024 and analyzed using inductively coupled plasma mass spectrometry. The results revealed that while most essential elements were within the regulatory limits, Co exceeded the maximum level in two cattle feed samples. Zn, Cu, and Mn levels were generally …

Molecular Characterization Of Pasteurella Multocida Capsular Type A Strains Isolated From Different Regions Of Anatolia, Türkiye​, Adam Bashir Tawor, Osman Ergani̇ş, Asli Balevi̇, Suliman Mohamed Yousof Sadam

Turkish Journal of Veterinary & Animal Sciences

Pasteurella multocida serotype A is an important pathogen that causes respiratory illness in both farm animals and poultry, leading to severe economic losses worldwide. This study aimed to isolate P. multocida capsular type A (capA) as well as investigate the virulence-associated genes (VAGs) within the isolates. Samples (n = 250) were collected in the Anatolia region from cattle (n = 130), sheep (n = 70), goats (n = 45), and pet birds (n = 5) with clinical respiratory signs. Polymerase chain reaction (PCR) assays were conducted using kmt1 and capA primers for P. multocida species identification and capsular serogroup A …

Urine Good Care: Catheter-Associated Urinary Tract Infection Prevention At The Bedside, Ruby Yost

Master's Projects and Capstones

Catheter-Associated Urinary Tract Infections (CAUTIs) have been associated with increased morbidity, mortality, healthcare costs, and length of stay and is one of the most common healthcare-acquired illnesses accounting for up to 40% of hospital-acquired infections (Rubi et al., 2022). Because 65-70% of CAUTIs are preventable, reducing the incidence has become a focus area for infection control and nursing quality management among hospital organizations (Tang et al. 2025). CAUTIs are urinary tract infections that occur in patients with indwelling urinary catheters and are typically associated with bacterial colonization of the urinary tract. The aim of this QI Project is to increase …

Observing Antibiotic Resistance In Bacterial Co-Cultures Under Simulated Microgravity, Tyler Jenkins, Marina Vaden

Discovery Day - Daytona Beach

Bacteria grow in complex natural environments with multiple factors affecting their growth, metabolism, and physiology. While astronauts are still preparing to travel to Mars, scientists must learn how to simulate a more realistic Martian environment. While a small volume of publications investigates the independent effects of microgravity or Martian regolith on microorganisms (Liao et al., 2025; Allen et al., 2022; Naz et al., 2023; Duri et al., 2025), to our knowledge no current experiments exist on the joint effects of microgravity and Martian simulant on a co-culture. This experiment aims to investigate the effect of a microgravity analog on the …

Implementation Of A Standardized Antibiotic Order Set To Improve Evidence-Based Antibiotic Prescribing In Oral Surgery, Lashundra Miles

Walden Dissertations and Doctoral Studies

Inconsistent antibiotic prescribing practices in an oral surgery clinic contributed to variation in antibiotic selection, timing, dosing, redosing when indicated, and duration. This variation limited adherence to evidence-based prescribing recommendations and highlighted the need for a workflow-based strategy to support antibiotic stewardship. The purpose of this quality improvement project was to increase use of a standardized antibiotic order set through reminder-based reinforcement and to improve evidence-based prescribing practices. The practice-focused question examined whether implementing the standardized antibiotic order set, supported by workflow-integrated reminders and ongoing performance feedback, would improve order-set utilization during a 6-week implementation period. The project was guided …

Draining The Risk, Holding The Line: A Nurse-Driven Approach To Catheter-Associated Urinary Tract Infection Prevention, Thy Nguyen

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over …

Improving Rsv Vaccination Uptake Through Nurse-Led Educational Intervention, Lawrence Onuorah

Walden Dissertations and Doctoral Studies

In this quality improvement project, the DNP scholar explored the impact of a nurse-led staff education approach on improving respiratory syncytial virus (RSV) vaccine uptake. RSV disease results in negative health outcomes and even death among vulnerable individuals. Despite the availability of U.S. Food and Drug Administration (FDA)-approved vaccines, uptake remains low due to limited provider knowledge and inconsistent vaccine recommendations. Therefore, the project question addressed whether a staff education program would increase providers’ perceived knowledge of RSV vaccine recommendation and confidence to engage in patient education. The purpose of this quality improvement project was to implement a nurse-led staff …

Confidence Versus Competence: Addressing Nursing Knowledge Gaps In Catheter Care To Reduce Catheter-Associated Urinary Tract Infections, Leslie Anne Villanueva Bautista

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most prevalent and preventable healthcare-associated infections (HAIs), contributing substantially to patient morbidity, mortality, prolonged hospitalization, and healthcare expenditures. Most hospital-acquired UTIs are related to urinary catheters, and this burden costs the United States alone an estimated $340 to $450 million annually (Yang et al., 2022). CAUTIs are UTIs that occur in patients with indwelling urinary catheters. This quality improvement project aimed to increase adherence to existing bladder scanning protocols and strengthen urinary catheter care to prevent CAUTI. Baseline staff nurse knowledge was obtained, and reinterpretation of the facility’s existing protocols and bundles …

Bcg Overexpressing Ag85b Reprograms Host Immune Response Through Coordinated Transcriptional Networks, Vivek Chauhan, Rakesh Kumar, Raja Veerapandian, Enrique I. Ramos, Chinnaswamy Jagannath, Shrikanth Gadad, Subramanian Dhandayuthapani

School of Medicine Publications

Antigen 85B (Ag85B), an immunodominant protein secreted by Mycobacterium tuberculosis (Mtb), induces robust T-cell-mediated immunity in host cells. Previous studies have demonstrated that recombinant BCG strains overexpressing Ag85B (BCG85B) confer significant protection against tuberculosis in mouse models. This study hypothesized that enhanced protection by recombinant BCG85B results from modulation of host immune gene expression by the Ag85B antigen. To test this, RNA-seq analysis was performed on splenocytes from mice immunized with the wild-type BCG (BCG-WT) and BCG85B strains. Differentially expressed genes (DEGs) in the splenocytes of BCG85B-immunized mice indicated upregulation of immune-related KEGG pathways, including Th1/Th2 and Th17 differentiation, NF-kappa …

Contradiction And Critical Consciousness: Engaging Canadian University Students In Racial Dialogue On Anti-Chinese Racism, Dan Cui

Journal of Comparative & International Higher Education

This study examines how Canadian university students perceived and engaged with anti-Chinese racism during the COVID-19 pandemic. Drawing on grounded theory and interviews and written reflections from 28 undergraduates at a predominantly White university, the study analyzes students’ contradictory understandings of racism shaped by media, national narratives, and prior educational experiences. Informed by Bourdieu’s concept of habitus, it conceptualizes these tensions as a contradictory racialized habitus, in which awareness and denial, empathy and distancing, coexist. Three themes emerged: contradictory orientations toward anti-Chinese racism, the transnational influence of U.S. political discourse, and the limited transformative impact of a social justice course. …

Metabolic Regulation And Immunity In The Spaceflight Environment, Graeme Grainger, Riley Dienna, Astrid Senko, Angela Cebula, Arden Rodriguez Arden Rodriguez

Discovery Day - Daytona Beach

Long-duration spaceflight exposes astronauts to chronic ionizing radiation and microgravity that disrupts homeostasis in the immune system and cellular metabolism. While simulated spaceflight models demonstrate altered T-cell polarization and sex-dependent shifts toward regulatory phenotypes, the metabolic mechanisms driving these immune changes remain unclear. Immune cell function is tightly linked to metabolic programming, with effector T cells relying on glycolysis and regulatory T cells favoring oxidative metabolism, making them highly sensitive to shifts in nutrient availability and redox balance. Emerging research further suggests that neutrophils act as metabolic regulators capable of reshaping the immune microenvironment through oxidative stress, cytokine production, and …

Don't Inject, I Object: Exploring Deferral Of Vaccination For Unaccompanied Alient Children In Custodial Care, Michelle Denamur

University of Dayton Law Review

No abstract provided.

An Interprofessional Organization Change Process To Reduce Catheter-Associated Urinary Tract Infections, Bolatito Owolabi

Walden Dissertations and Doctoral Studies

This organization change process initiative addressed a critical safety practice gap regarding catheter-associated urinary tract infection (CAUTI) prevention in a 450-bed acute care facility. This gap was recognized based on evidence that the facility’s CAUTI Standardized Infection Ratio (SIR) was above the national benchmark—and daily necessity assessment compliance of only approximately 50%. This gap was attributed to an organizational interprofessional culture, which hindered timely device removal. Prolonged catheter dwell times increase patient morbidity, extend hospital stays, and expose the organization to severe financial penalties. The project aimed to safely reduce device dwell times by structurally empowering bedside nurses. I used …