Digital Commons Network^™

Medical Tourism Patient Guidance: A Content Analysis Of Risk Reduction Guidelines Available To Global Health Seekers., Alicia Mason, Angela Ashmore

Faculty Submissions

This study examines medical tourism (MT) patient guidance messages intended to reduce procedural risks—those directly related to biomedical treatments—and process risks, which involve logistical, administrative, and interpersonal challenges of seeking healthcare abroad. The analysis focuses on print and digital publications authored by individuals independent of the MT industry, including policy researchers, travel health experts, lifestyle reporters, and consumer-focused medical travel writers. Using a two-phase digital and database search strategy, 27 publications from 2009 to 2024 were identified and analyzed using exploratory content analysis methods. Findings reveal important differences in the scope and depth of guidance aimed at reducing risks for …

Staff Education To Increase Knowledge Of Universal Protocol And Surgical Readiness Documentation Among Ambulatory Surgery Staff, Miranda Gould

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project evaluated the impact of a structured staff educational intervention on ambulatory surgery center (ASC) staff knowledge of Universal Protocol and SOAP (Surgeon, Operating Room, Anesthesia, and Preprocedure Ready) documentation. A practice gap was identified in staff knowledge of perioperative safety processes that are essential for preventing surgical safety events. The purpose of this doctoral project was to improve ASC staff knowledge of Universal Protocol and SOAP readiness documentation through an evidence-based educational intervention designed to strengthen perioperative safety practices. The practice-focused question was: According to the evidence, in multi-specialty ASC staff, what is …

Training Strategies For Employees To Use Electronic Human Resource Management Systems, Anita Wright

Walden Dissertations and Doctoral Studies

Ineffective electronic human resource management (e-HRM) training can weaken HR employees’ ability to use digital human resource (HR) systems that support HR operations, employee services, and workplace efficiency. HR managers in small to medium-sized enterprises (SMEs) recognize that poor e-HRM training undermines employees’ confidence, consistency, and accuracy in HR tasks. Grounded in the technology acceptance model (TAM), the purpose of this qualitative pragmatic inquiry project was to identify and explore the effective strategies some SME HR managers use to train HR employees to use e-HRM systems. The participants were eight SME HR managers in the southeastern United States with experience …

Multimodal Digital Libraries: A Response To Culturally And Linguistically Sustaining Classrooms, Abigail Lopez

Masters Projects

Poorly represented minority groups fail to connect reader identity backgrounds

with the characters in texts due to curriculum traditionally relying on English dominant

translations. This system challenge deficit fails students by placing limitations on the

exposure of rich vocabulary, cultural awareness and sets up lack of engagement. This

project is grounded in Culturally and Linguistically Sustaining Pedagogy, Sociocultural

Theory, Constructing Reader Identities and Engagement theories that transforms

student diversity into an instructional practice that empowers multilingual learners.

To empower students, this digital culturally relevant library optimizes educator

planning time. This digital library provides immediate access to multicultural books

alongside a …

Mitigation Of The Seductive Details Effect In Children, Allison S. Dobuler

Electronic Theses and Dissertations 2020 - Present

The present thesis examines if interspersing guiding questions between sections of an expository text can mitigate the seductive details effect, in which the addition of interesting but tangentially related information to the base text may hinder the ability to learn the essential material, for typically developing children. Participants were given two passages to read, one with seductive details and one without. They either had no guiding questions for both passages or guiding questions interspersed between the text of both passages. They were given retention and comprehension assessments for both passages. While the guiding questions did not mitigate the seductive details …

A Comprehensive In-Silico Pipeline For The Discovery Of Non-Toxic, Stable Antimicrobial Peptides From Databases For Targeting Multi-Drug Resistant K. Pneumoniae, Pranab D. Sharma, Abdullah A. Noman, Al Hafiz

Faculty Articles

The rapid emergence of multidrug-resistant Klebsiella pneumoniae has significantly reduced the effectiveness of conventional antibiotics, highlighting the need for alternative therapeutic strategies. This study employed a comprehensive in silico pipeline to identify antimicrobial peptides (AMPs) targeting the essential DNA replication initiator protein DnaA. A total of 28,361 peptide sequences were collected from publicly available AMP databases and sequentially filtered based on peptide length, net charge, GRAVY score, instability index, antimicrobial activity, toxicity, hemolytic potential, aggregation propensity, sequence similarity and favorable amphipathic properties. Four peptides satisfied all selection criteria and were subjected to structural prediction, membrane-binding analysis, protein–DNA docking, protein–peptide docking, …

Experiences Of Novice Assistant Principals: Perceptual Evidence From Texas, Gregory Vidal

Electronic Theses and Dissertations

Assistant principals play essential roles in supporting instructional leadership and campus operations. However, limited research has examined how novice assistant principals experience their transition into administration and interpret their preparation and support. This study addressed the gap in understanding how novice assistant principals in a suburban Texas public school district made sense of their preservice preparation and early leadership practice, and how these experiences shaped their perceptions of training and organizational supports. The purpose of this qualitative, experiential, phenomenological study was to explore the lived experiences of novice assistant principals during their first three years in the role. The study …

Lessons Learned For The Independent Panel For Evidence For Action Against Amr From Previous International Science Panels: Stakeholder Views From The 2025 Lagos Workshop, Iruka N. Okeke, Anthony Mcdonnell, Ayodele A. Akinyele, Javier Guzman, Kevin Outterson

Faculty Scholarship

In September, 2024, the UN General Assembly assigned the Quadripartite Joint Secretariat on Antimicrobial Resistance (AMR) the task of establishing an Independent Panel for Evidence for Action against AMR (IPEA). To promote stakeholder views and input around the constitution and functioning of this Panel, which could feed into the Quadripartite Joint Secretariat’s consultation process, we independently commissioned seven papers to examine the lessons that could be learned from other high-level scientific panels. We then convened 85 stakeholders, primed with the background papers. The Workshop, held in Lagos, Nigeria in April, 2025, drew representation from around the world, particularly low-income or …

Shared Neural Geometries For Bilingual Semantic Representations In Human Hippocampal Neurons, Xinyuan Yan, Ana G Chavez, Melissa Franch, Kalman A Katlowitz, Ivy Gautam, Brian Kim, Aaditya Krishna, Aadit Shrivastava, Katie Van Arsdel, James Belanger, Assia Chericoni, Taha Ismail, Elizabeth A Mickiewicz, Danika Paulo, Hanlin Zhu, Alica M Goldman, Vaishnav Krishnan, Atul Maheshwari, Eleonora Bartoli, Nicole R Provenza, Seng Bum Michael Yoo, Benjamin Y Hayden, Sameer A Sheth

Duncan NRI Faculty and Staff Publications

The human brain has the remarkable ability to comprehend and express similar concepts in multiple languages. To understand how it does so, we examined responses of hippocampal neurons during passive listening, directed speaking, and spontaneous conversation in both English and Spanish in a small group of balanced bilinguals. We found a small number of putative "cross-language neurons," whose responses to equivalent words (e.g., "tierra" and "earth") are correlated. However, neurons' semantic tunings differed substantially by language, suggesting language-specific neural implementations. Instead, the crucial driver of translation was a preserved geometric organization of neural responses between the two languages, one that …

Plan Of Day | Plan Of Stay: How Inter-Disciplinary Communication Improved Patient Experience And Hospital Throughput, Theresa Jean Dionne, Felicia Hurst, Danna Qunibi, Lauren Lazar, Sydney Mccurdy, Ashlyn Coenraad, Brittney Ward, Whitney Black, Ashley Nelson, Judd Salem, Luisa Restrepo

Patient Experience Journal

Background: Effective communication among healthcare team members is critical for delivering high-quality, patient- and family-centered care while optimizing hospital operations. This case study examines the implementation of a structured ``Plan of Day | Plan of Stay'' model, leveraging bedside whiteboards to enhance inter-disciplinary communication in a pediatric hospital setting. By providing a clear, visual summary of daily care plans, care team members, and discharge goals, whiteboards foster transparency, empower patients and families, and facilitate coordinated clinical decision-making. Purpose: This quality improvement initiative evaluated the implementation of a standardized Plan of Day | Plan of Stay communication model on a pediatric …

Self-Medication Experience And Healthcare Trust Among Youth: A Regionally Concentrated Digital Survey In Indonesia, Wahyudi Wahyudi, Azra Muzaiyana Nasution, Arini Dwi Rahmadani, Alysa Rahmadani Hasibuan

Patient Experience Journal

Self-medication has become a central experience for youth transitioning toward independent medical decision-making. In the digital era, young people must navigate a complex landscape of health information while seeking independent health solutions. This study investigates self-medication experiences and healthcare trust among youth, utilizing a regionally concentrated digital survey approach in Indonesia. Data were collected via a cross-sectional approach using digital platforms (Instagram, TikTok, and Twitter/X), facilitated by 76 trained enumerators. While respondents from all 38 provinces participated, the sample (N = 2,790) exhibits a major geographical concentration in the Sumatra region. The study employed a validated 16-item instrument to evaluate …

From Hospital To Home After Lower-Extremity Open Reduction And Internal Fixation: Patients' Experiences Of Pain Self-Management And Trust-Building Discharge And Follow-Up Support, Sahrudi Sahrudi, Achmad Fauzi Kamal, Masfuri Masfuri, Kasiyah Junus

Patient Experience Journal

After lower-extremity open reduction and internal fixation (ORIF), patients often return home while pain, wound care, mobility restrictions, medication routines, and follow-up needs are still evolving. During this transition, trust in discharge information may shape how patients interpret symptoms, use analgesics, mobilise, involve family members, and decide when to seek help. This qualitative descriptive study explored patients' experiences of pain self-management after lower-extremity ORIF in an Indonesian public hospital context, with attention to trust-building needs across discharge and early follow-up. Eighteen adults participated in individual face-to-face semi-structured interviews at an orthopaedic outpatient clinic. Interviews were audio-recorded, transcribed verbatim, and analysed …

Nurses' Perceptions Of Medical Services In Acute Care Hospitals In The Post-Covid-19 Era, Yoko Nakano, Tomoya Yokotani, Rika Nakajima, Hidemi Yoshii

Patient Experience Journal

Purpose: This study aimed to clarify nurses' perceptions of healthcare services in acute care hospitals. Methods: A cross-sectional, anonymous, web-based questionnaire was conducted using SurveyMonkey. Participants were selected using convenience sampling. The survey included questions about the participants' basic attributes and the 22-item M-SERVQUAL scale (a modified multiple-item scale for measuring consumer perceptions of medical service quality). Data analysis involved age-based comparisons using the Kruskal–Wallis test, followed by multiple comparisons using the Bonferroni method. The significance level was set at p < 0.01. Results: The survey was distributed to 1,542 participants, yielding 566 valid responses, with an effective response rate of 36.7%. …

Pathways To Patient-Provider Conflict In Nigeria: A Structural Equation Model Of Expectations, Communication, Trust, And Organizational Constraints, Akaninyene O. Unaam, Christie Divine Akwaowo, Edidiong A. Unaam

Patient Experience Journal

Objective: This study empirically investigated the drivers of patient-provider conflict and tested a conceptual model linking treatment expectations, communication, trust, and organizational constraints to conflict intensity in Nigerian tertiary care. Methods: A cross-sectional survey of 400 patients (response rate 82.3%) and 150 healthcare providers (response rate 71.2%) from three Nigerian tertiary hospitals was conducted using stratified random sampling. Validated, culturally adapted scales measured unrealistic treatment expectations, communication barriers, organizational constraints, trust, and conflict intensity. Data were analyzed using Structural Equation Modeling (SEM) with maximum likelihood estimation and bootstrapping for mediation testing. Multi-group confirmatory factor analysis established measurement invariance across samples. …

A Modern Playbook For Trust Across The Health Ecosystem, Erin O'Malley

Patient Experience Journal

Public trust in health care delivery, public health, and biomedical innovation is at a historic low. While many place the blame on the COVID-19 pandemic and the proliferation of social media, the reality is that distrust is a deeply rooted structural challenge that has plagued the U.S. for centuries. It is tied to historical movements for medical freedom and centuries of systemic discrimination and earned mistrust among minoritized communities. Today, this crisis is compounded by a lack of shared values and facts and the rising dominance of tribal identity over objective science. The Coalition for Trust in Health & Science …

The Registered Dietitian Nutritionist’S Implementation Of Dysphagia Screening In Clinical Practice: A Commentary, Nicole Wiksten, Holly Estes-Doetsch, Laura C. Boucher, Sarah Rusnak, Kristen M. Roberts

Journal of Dietetic Education

Background: The Accreditation Council for Education in Nutrition and Dietetics (ACEND) amended the competencies for the future education model (FEM) in dietetic education to include competency 3.6 stating that the Registered Dietitian Nutritionist (RDN) must be able to "Initiate and conduct bedside swallow screenings". There is no clear process for RDNs to implement dysphagia screening in practice or academia. The aim of this review is to inform clinicians and educators on current literature discussing current RDN and speech language pathology approaches to dysphagia screening and to provide a proposed curriculum for implementation of competency 3.6 in clinical practice and academia.

Assessing And Addressing Cultural Competence And Cultural Humility In Dietetic Education, Zoe Duran, Nicholas Slagel, Lisa Caldwell, Katie Kage

Journal of Dietetic Education

Limited theory-informed, dietetic-specific resources are available to guide the development, evaluation, and refinement of culturally competent (CC) curricula. This pilot study used a mixed-methods, theory-informed approach to evaluate CC integration within an undergraduate dietetics curriculum and examine the applicability of existing CC self-assessment tools for dietetic students. A senior-level undergraduate community nutrition curriculum was evaluated using the Tool for Assessing Cultural Competence Training (TACCT), guided by the Campinha-Bacote Model of Cultural Competence in Healthcare Delivery. James Banks’ Model of Multicultural Curriculum Reform was then applied to refine curricular content and learning activities. In addition, 74 students enrolled in a didactic …

Letter From The Professor

Scientific Kenyon: The Neuroscience Edition

No abstract provided.

A Case For Societal Provenance: Marguerite Harper As Told By The Men She Represented, V. Emily Cranwell Deinert

Journal of Contemporary Archival Studies

This paper argues for making societal provenance the grounding framework for archival descriptive standards to ensure that important voices already present in archives are no longer buried. This study reclaims from archival obscurity the career of literary agent Marguerite E. Harper to illustrate the need for this expansion. Harper proves strikingly absent from some of the archives for the authors she represented. Likely an unwitting omission from archivists that uncritically accepted the narratives of these male authors, Harper’s erasure provides a potent example of the ways that archival descriptive standards may unintentionally further silence historically marginalized voices within archives. The …

Exploring The Situation Of Health Literacy Promotion To Delay Kidney Disease Progression In Older Adults With Chronic Kidney Disease: A Convergent Parallel Mixed-Method Study, Kritanon Janthasri, Ladawan Panpanit, Khanitta Nuntaboot

Journal of Health Research

Background: Health literacy (HL) is crucial for delaying chronic kidney disease (CKD) progression, yet evidence on HL promotion among older adults with early-stage CKD is limited. This study examines HL level and explores the situation of HL promotion for delaying kidney progression among older adults with CKD.

Methods: A convergent parallel mixed-methods design was employed. The quantitative phase, 297 older adults with CKD complete a questionnaire. The qualitative phase, 50 participants then took part in interviews to explore their experiences. Quantitative data were analyzed using descriptive statistics, and qualitative data through content analysis. Findings were integrated to identify …

Contract Theory In The Saudi Civil Transactions Law “A Critical Comparative Study”, Mohamad Arfan Alkhatib

BAU Journal - Journal of Legal Studies - مجلة الدراسات القانونية

This comparative critical study provides an in-depth doctrinal and analytical examination of contract theory under the Saudi Civil Transactions Law, situating its analysis within the broader framework of the modern law of obligations. The inquiry is structured around two interdependent axes. The first considers the determinants of contracting, analysed through the dual categories of contractual autonomy and the binding normative force of contract (force obligatoire). The second addresses the requirements of contracting, focusing on the constituent essentialia negotii and the extent to which such elements may be subject to curative mechanisms within the applicable invalidity …

The Computed Microwave Spectrum Of The Protonated Fullerene C60H+, Laszlo Nemes, Jos Oomens, Vincent J. Esposito, Vincent Boudon, Alexander G. G. M. Tielens

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

The largest known molecule in the interstellar medium of galaxies, C₆₀, has been detected in its neutral and cationic form through its vibrational, UV-driven fluorescence emission spectrum and its electronic absorption spectrum, respectively. The detection of several polycyclic aromatic hydrocarbon molecules through their pure rotation spectrum in cold, dense, molecular cloud cores suggests that C₆₀ might be present in these environments as well. The low flux of UV pumping photons in molecular cloud cores and the absence of suitably bright background stars, make detection of C₆₀ and its cation through the commonly used methods impractical. As …

Christopher Mbewe V. Superintendent Mahanoy Sci

2026 Decisions

USDC for the Middle District of Pennsylvania

Ronald Alonzo V. Joe Terra

2026 Decisions

USDC for the Eastern District of Pennsylvania

Emotion-Attention Relationships In Anxiety: A Multimodal Psychophysiological Network Analysis, Kyle O'Brien

Clinical Psychology Dissertations

Anxiety has long been associated with changes in attention processing, emotional salience detection, and emotional affect. Traditional methods of measuring anxiety frequently utilize self-report symptom measures, behavioral performance measures, and psychophysiological indicators. The current study integrates behavioral accuracy, self-report measures of psychological distress and well-being, and event-related potential markers of attention processing into an exploratory multimodal psychological network analyses to identify meaningful patterns across these indicators. The final sample of nonpatients included 36 anxious (low depression) and 24 control (low anxiety and depression) participants who completed an Emotion Attention Blink task while EEG data were collected to assess early, more …

Fraction-Seq: An Integrated Experimental And Computational Workflow For Determining The Localization And Abundance Of Small Non-Coding Rnas In Subcellular Compartments, Siddhartha Shah, Tess Cherlin, Yi Jing, Stepan Nersisyan, Benjamin E. Leiby, Isidore Rigoutsos

Computational Medicine Center Faculty Papers

Small non-coding RNAs (sncRNAs) have garnered considerable attention in recent years, following accumulating evidence of their critical roles in many cellular processes. Among sncRNAs, microRNAs (miRNAs) and their isoforms (isomiRs), tRNA-derived fragments (tRFs), rRNA-derived fragments (rRFs), and Y RNA-derived fragments (yRFs) account for more than 95% of all sncRNAs found in cells. Despite their critical regulatory roles, most sncRNAs remain uncharacterized because their functionalization is a lengthy and challenging undertaking. Knowing an sncRNA's abundance helps prioritize among the various choices, while knowing where it localizes in the cell greatly limits the number and identity of its potential targets and helps …

Real Bullets, Plastic Guns: Evaluating The Strength Of 3-D Printed Gun Parts, Maria Latenia Mayol

Student Theses

Privately made firearms (PMFs), often referred to as “ghost guns,” are firearms manufactured or assembled by individuals rather than federally licensed manufacturers. Although the terms are frequently used interchangeably, “ghost gun” more specifically describes an unserialized firearm, whereas PMFs include a broader range of firearms produced through nontraditional manufacturing methods. PMFs may be entirely 3-D printed, assembled from partially completed firearm kits, or constructed by integrating additively manufactured components with commercially manufactured firearm parts. The increasing accessibility of additive manufacturing and widespread dissemination of computer-aided design files have raised concerns about concealment, regulation, and forensic evasion, particularly when factory-manufactured components …

Impacts Of Storms On Great Bay Water Quality And Estimating Discharge In Great Bay Tributaries, Jody D. Potter, William H. Mcdowell, Michelle Daley Shattuck, Kalle Matso

PREP Reports & Publications

No abstract provided.

From Curriculum To Career: A Grounded Theory Of Ai-Driven Employability In Higher Education, Sandra Baroudi, Christina Davison, Maryam Juma

All Works

This study examines how undergraduate students navigate employability within an AI-driven labor market, highlighting the role of digital social capital, personal branding, and multicultural identity management in a rapidly modernizing, culturally diverse setting. Employing a constructivist grounded theory approach, semi-structured interviews were conducted with 12 undergraduates across STEM and humanities disciplines. Data were coded iteratively using constant comparative methods until theoretical saturation. Five major categories emerged: experiential learning, professional networking, digital self-promotion, cultural identity tensions, and technological adaptability. The study proposes an ‘AI-Driven Employability Framework’ that integrates Human, Social, and Cultural Capital theories and develops two context-specific extensions: digital social …

The Screening Tool Of Behavioral Self-Regulation “Head-Toes-Knees-Shoulders” Task: A Preliminary Adaptation To Greek Older Adults, Eleni Rachanioti, Dimitra Magkavila, Olga Fragkomichelaki, Magda Dinou, Effie Katsadima, Theodora Foti, Anastasia Tzalla, Anna Dougali, Christina Bourmpou, Maria Staikopoulou, Aphrodite Papantoniou, Fotini Varlami, Irene Dinaki, Maria Tsiountala, Konstantinos Staikopoulos, Tryfon Mavropalias, Efthymia Efthymiou, Demetra Tomprou, Maria Georgiadi, Dimitra Katsarou, Georgios Kougioumtzis, Ioanna Giannoula Katsouri, Harilaos Zaragas, Despina Moraitou, Maria Sofologi, Georgia Papantoniou

All Works

The aim of the present study was to examine the psychometric properties of the Head-Toes-Knees-Shoulders (HTKS) behavioral self-regulation (executive function) measure in a sample of Greek older population. Specifically, 88 cognitively healthy Greek older adults over the age of 65 participated in the study. The Greek version of HTKS was administered along with the Greek versions of the Mini-Mental State Examination (MMSE), the Raven's Educational CPM, the Number Series (NS) test, the Positive and Negative Affect Scale (PANAS), the Barratt Impulsiveness Scale (BIS-11) and the Impulsive Behavior Scale (UPPS-P). Exploratory factor analysis supported the unidimensional structure of the HTKS. The …