Digital Commons Network^™

Bridging The Gap: Improving Medication Communication Through The Teach-Back Method At Discharge, Sangeeta Biju Varghese

Doctoral Dissertations and Projects

Patient experience and hospital readmission rates are both key performance indicators in value-based reimbursement, as defined by the Centers for Medicare & Medicaid Services. Both these indicators have a negative impact not only on patients but also on hospital profitability, and they are closely tied to discharge education. Lack of proper discharge instructions, especially about medication regimen, can result in adverse effects in patients post-discharge, which could have been prevented had they gotten adequate discharge instructions. Research has shown that almost 20% of patients leaving the hospital have an adverse drug event after discharge. Nurses have a key role in …

Examining The Relationships Among The Cognitive, Emotional, Social, And Physical Domains Of Listening-Related Fatigue For U.S. Adults Between The Ages Of 30 And 50 With Hearing Loss, Nichole Marie Wooton

Doctoral Dissertations and Projects

Adults with hearing loss (AHL) frequently report high levels of listening-related fatigue (LrF). This has mainly been attributed to the increased biopsychosocial demands involved in communication efforts for those with hearing loss (HL). Such fatigue can be measured objectively using the Vanderbilt Fatigue Scale for Adults (VFS-A-40) (Hornsby et al., 2021a). This quantitative survey study explored the relationships among gender, type of HL, and socioeconomic status (SES) and their complex connections among the four domains as defined by the VFS-A-40: cognitive, emotional, social, and physical. Using an online survey method, this research employed a strictly quantitative design to examine differences …

Analyzing Discipline Rates For Students In Grades 6-12 With Emotional Disturbances: A Comparative Study Of Four Years Before And After The Covid-19 Pandemic., Maegan N. Ramsey

Doctoral Dissertations and Projects

This dissertation investigated the trends in discipline rates for students in grades 6-12 with emotional disturbances. It compared data from the four years prior to the COVID-19 pandemic (2016-2019) to the four years following its onset (2021-2024). Emotional disturbances can significantly affect students' behavior, often leading to higher rates of disciplinary actions within school settings. However, the impact of COVID-19 on these students, particularly in terms of remote learning, school closures, and shifts in behavioral norms, has yet to be fully explored. Using archival data from multiple middle and high schools, this study examined variations in suspensions and other disciplinary …

Enhancing Spiritual Care In Medical Missions Through A Contextual Apologetic Workshop, Jacob G. Caraotta

Doctoral Dissertations and Projects

There is a lack of resources and a gap in the literature for training prayer teams for medical mission endeavors. The Contextual Apologetic Workshop, an intervention project, was designed to fill the gap in the literature by training participants in prayer, evangelism, and apologetics. It utilized the Contextual Apologetic System, a framework built around the Contextual Triad, which includes the cultural context, setting, and endemic religions that inform outreach dynamics and preparation. The cultural context identifies if the population is high- or low-context, and includes the subcultures. The setting refers to outreach types, such as medical missions or construction projects. …

A Case Study Exploring Lecanemab Antibody Infusion And Reminiscence Therapy For Early Alzheimer’S Disease, Martina Masry

Doctoral Dissertations and Projects

This case study examined whether a 12-month combined therapy (RT-L), which includes reminiscence therapy and lecanemab monoclonal antibody infusion therapy, will clear beta amyloid accumulation in the brain, slow cognitive decline, decrease depression, reduce anxiety, and increase the quality of life in a participant with mild cognitive impairment due to early Alzheimer’s dementia. The sample included one White female (age = 68) with mild cognitive impairment due to early Alzheimer’s disease who is currently being treated by a geriatrician at a facility in the Midwest. The outpatient treatment included a lecanemab antibody infusion of 10mg/kg every two weeks for 12 …

Culturally Relevant Project-Based Learning: A Quasi-Experimental Study Of The Effect Of Playwriting Instruction On Student Perceptions Of School Racial Climate, Gerald W. Aungst

Doctoral Dissertations and Projects

The purpose of this quantitative, quasi-experimental posttest-only nonequivalent control group study with matched comparison groups was to determine if any differences exist in perceptions of school racial climate in four areas—quality of interaction, promotion of cultural competence, cultural socialization, and critical consciousness socialization—among middle-school students receiving culturally relevant project-based writing instruction, standard project-based writing instruction, and traditional writing instruction when controlling for prior English language arts achievement. A convenience sample of at 83 middle school students in two urban schools in Pennsylvania were given project-based playwriting instruction by a nonprofit arts organization. One similar school served as a control. Student …

Millennials, Work Motivation, And Leadership Transition, Ngozi Maduagwu

Doctoral Dissertations and Projects

The workforce has evolved and this path was accelerated by the aftermath of the global COVID pandemic starting 2019. Traditionalist and Baby Boomer employees have been rapidly transitioning out of the workforce, which has created a need to find motivated workers and leaders to fill vacated positions. Millennials have been surveyed for their potential to fill these leadership vacuums, yet the research suggested that they present differently from other generational cohorts in terms of their motivation to work and their motivation to lead in the workplace. The purpose of this mixed methods study was to determine whether any relationship could …

Exploring The Perceptions Of Community College Leaders: Active Learning Strategies For Enhancing Student Engagement And Learning Outcomes, Bradley Robbins

Doctoral Dissertations and Projects

The purpose of this case study is to understand the perceptions of community college leaders about active learning strategies and their role in implementing these strategies on the campus of a rural community college in the east-central region of a southern state in the United States. The theory guiding this study is the self determination theory by Deci and Ryan as it frames the exploration within the fundamental psychological needs of autonomy, competence, and relatedness. The central research question of this study is: What do community college leaders perceive about active learning strategies and their impact on student learning outcomes? …

Training Timothy: An Analysis Of Discipleship And Leadership Development In Multicultural Churches, Philip Thomas

Doctoral Dissertations and Projects

As America’s social and cultural landscape continues to diversify, churches face the challenge of fostering contextually relevant, biblically grounded communities characterized by unity in Christ. Church leaders play a crucial role in this process by articulating a shared mission that transcends humanistic cultural differences and working towards a unifying biblical culture, based on a common understanding and vocabulary. The purpose of this qualitative phenomenological study was to examine how church leaders were selected, developed, and mobilized in Protestant multicultural churches in America to create a unifying biblical culture through biblical discipleship in a multicultural context. For this study, discipleship was …

Left Of The Boom: Addressing Burnout Before It Occurs, William S.D. Vernon

Doctoral Dissertations and Projects

This study examined healthcare burnout, focusing on both organizational and individual factors that contribute to it, as well as mitigation strategies. Healthcare burnout increases the risk of harm to healthcare workers as well as their patients. Participants of the study included healthcare workers with direct experience in burnout. The aim was to understand their personal experiences, the actions, both individual and organizational, that contribute to burnout, and the methods that have been used with varying success to address it. The study also explored the connection between self-determination theory and the areas-of-work-life model, along with participants’ insights into contributing actions and …

Ancient Astronaut Theory And Christian Belief Among Evangelical Millennials: A Quantitative Exploratory Cross-Sectional Study, Richard Barry Bazzell

Doctoral Dissertations and Projects

The purpose of this quantitative, exploratory, non-experimental, cross-sectional study was to explore the possible influence of the Ancient Astronaut Theory upon Evangelical Christian millennials in the aspects of their biblical worldview, belief in the triune God, and Christian praxis. The researcher structured the study upon four pillars: (a) Evangelical millennials, (b) Evangelical theology, (c) Lev Vygotsky’s social constructivism, and (d) Eric Von Däniken’s Ancient Astronaut Theory. The study population was Evangelical millennials in the state of Texas. The study’s instrumentation was a researcher-designed 5-point Likert scale survey titled Ancient Astronaut Theory–Evangelical Christian Millennials (AAT–ECM). Because the respondents were fewer in …

Exploring The Relationship Between Becoming A Parent, Goal Orientation, And Productivity, Among Self-Employed Entrepreneurs, Andrew Dean East

Doctoral Dissertations and Projects

This quantitative study explored the relationship between parenting status and goal orientation and productivity among self-employed entrepreneurs. Using a sample of 471 participants, the study compared entrepreneurs with and without children under five years of age living at home to examine group differences, relational patterns, and potential moderation effects. No statistically significant differences were found in goal orientation or productivity between parents and non-parents, indicating that early-stage parenting does not inherently hinder these traits. However, a small but statistically significant positive correlation was observed between goal orientation and productivity, suggesting that individuals with higher internal motivation reported slightly greater productivity, …

A Practical Primer On How To Detect And Treat Depression In Ckd, L Parker Gregg, Lynnel Goodman, Ella Q Carroll, S Susan Hedayati

Faculty, Staff and Students Publications

Detection and management of depression have special considerations in people with kidney disease. Screening should be done every 6-12 months using a self-reported questionnaire. Clinicians should rule out symptoms from medical conditions such as dialysis inadequacy or hypothyroidism and confirm the presence of sadness or anhedonia. Sertraline has shown limited efficacy and an increased risk for adverse effects such as gastrointestinal symptoms, so cautious, gradual dose titration is warranted. Cognitive behavioral therapy has potential benefit for depressive symptoms in people with kidney disease. Current trials are evaluating behavioral activation therapy. Physical activity has many benefits and likely improves depression.

Design, Optimization, And Development Of Ripk1 Degraders With Improved Pharmacokinetic And Pharmacodynamic Properties, Dong Lu, Xin Yu, Hanfeng Lin, Ran Cheng, Bin Yang, Min Zhang, Jingjing Chen, Feng Li, Xiaoli Qi, Jin Wang

Faculty, Staff and Students Publications

Pharmacological degradation of receptor-interacting protein kinase 1 (RIPK1) offers a compelling therapeutic strategy to overcome its scaffolding role in tumor resistance and to enhance the efficacy of immune checkpoint blockade (ICB) therapies. In this study, we report the discovery of a novel RIPK1 degrader, LD5097(24b), developed through systematic optimization of its precursor compound, LD4172—specifically refining the linker, RIPK1 warhead exit vector, and VHL ligand components. LD5097(24b) exhibits potent and selective RIPK1 degradation, triggering rapid and efficient downregulation of RIPK1 and significantly enhancing TNFα-mediated apoptosis in Jurkat cells. Compared to LD4172, LD5097(24b) demonstrates markedly improved metabolic stability and pharmacokinetic properties. In …

Culture-Independent Meta-Pangenomics Enabled By Long-Read Metagenomics Reveals Associations With Pediatric Undernutrition, Jeremiah J Minich, Nicholas Allsing, M Omar Din, Michael J Tisza, Kenneth Maleta, Daniel Mcdonald, Nolan Hartwick, Allen Mamerto, Caitriona Brennan, Lauren Hansen, Justin Shaffer, Emily R Murray, Tiffany Duong, Rob Knight, Kevin Stephenson, Mark J Manary, Todd P Michael

Faculty, Staff and Students Publications

The human gut microbiome is linked to child malnutrition, yet traditional microbiome approaches lack resolution. We hypothesized that complete metagenome-assembled genomes (cMAGs), recovered through long-read (LR) DNA sequencing, would enable pangenome and microbial genome-wide association study (GWAS) analyses to identify microbial genetic associations with child linear growth. LR methods produced 44-64× more cMAGs per gigabase pair (Gbp) than short-read methods, with PacBio (PB) yielding the most accurate and cost-effective assemblies. In a Malawian longitudinal pediatric cohort, we generated 986 cMAGs (839 circular) from 47 samples and applied this database to an expanded set of 210 samples. Machine learning identified species …

Culture-Independent Meta-Pangenomics Enabled By Long-Read Metagenomics Reveals Associations With Pediatric Undernutrition, Jeremiah J Minich, Nicholas Allsing, M Omar Din, Michael J Tisza, Kenneth Maleta, Daniel Mcdonald, Nolan Hartwick, Allen Mamerto, Caitriona Brennan, Lauren Hansen, Justin Shaffer, Emily R Murray, Tiffany Duong, Rob Knight, Kevin Stephenson, Mark J Manary, Todd P Michael

Faculty, Staff and Students Publications

The human gut microbiome is linked to child malnutrition, yet traditional microbiome approaches lack resolution. We hypothesized that complete metagenome-assembled genomes (cMAGs), recovered through long-read (LR) DNA sequencing, would enable pangenome and microbial genome-wide association study (GWAS) analyses to identify microbial genetic associations with child linear growth. LR methods produced 44-64× more cMAGs per gigabase pair (Gbp) than short-read methods, with PacBio (PB) yielding the most accurate and cost-effective assemblies. In a Malawian longitudinal pediatric cohort, we generated 986 cMAGs (839 circular) from 47 samples and applied this database to an expanded set of 210 samples. Machine learning identified species …

Genetic And Embryonic Transcriptome Analyses Reveal The Molecular And Developmental Basis Of Mayer-Rokitansky-Küster-Hauser Syndrome, Na Chen, Xi Cheng, Sen Zhao, Hengqiang Zhao, Chenglu Qin, Yaru Zhang, Xijuan Lin, Qing Li, Yuan Wang, Jia Kang, Jing Yu, Jianbin Guo, Qianqian Gao, Jiali Duan, Yuchen Niu, Jianzhong Su, Zhihong Wu, Terry Jianguo Zhang, Wanlu Liu, Pengfei Liu, Shan Deng, Nan Wu, Lan Zhu

Faculty, Staff and Students Publications

Background: Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) is characterised by aplasia of the uterus, cervix and upper part of the vagina. The genetic aetiology remains incompletely understood.

Methods: We performed gene-level and gene set-level burden analyses based on exome sequencing/genome sequencing data from 727 probands with MRKHS and 2504 female control individuals. Single-cell RNA sequencing (scRNA-seq) was performed on human and mouse embryonic metanephros at different developmental stages. Genetic and transcriptomic data were integrated to prioritise suboptimal genetic signals, identify relevant cell types and determine key developmental stages. Potential digenic inheritance was assessed and prioritised using coexpression patterns from scRNA-seq data.

Results: We …

Come, Heavy Sleep: Motive And Metaphor In Britten’S Nocturnal, Opus 70, Stephen Goss

Soundboard Scholar

"The prevailing melancholy [of Britten’s Nocturnal] is as natural to the guitar’s sonorities as it is appropriate in a tribute to John Dowland."

—Peter Evans, The Music of Benjamin Britten.

Such summary remarks characterise what little has been written about Britten’s Nocturnal outside the guitar world. The reader’s reaction might be one of passive agreement or mild irritation, but there is rarely dialogue because discourse is limited: Nocturnal after John Dowland is often passed over by Britten scholars with scant discussion or no mention at all. In fact, little has been added to Evans’ reliable commentary, written only three …

What Are The Barriers And Facilitators To The Acceptance Of Information And Communication Technology-Based Interventions For Improving Resilience And Mental Health Of Healthcare Workers: A Scoping Review Protocol, Elisabete Alves, Ricardo Rodrigues, César Fonseca, Manuel Lopes, Inês Faria, Nina Dalkner, Paul Barach, Frans Folkvord, Jim Ingebretsen Carlson, Eva Reininghaus, Michele Wessa, Yvonne Prinzellner, Vanessa Leung, Eva Turk, Lara Guedes De Pinho

College of Population Health Faculty Papers

INTRODUCTION: Healthcare workers (HCWs) report overwhelming demands and experience crisis levels of burnout and unique challenges that further impair their mental health. Promotion of mental health among HCWs using information and communication technology (ICT) has received little empirical research attention and interventions for improving mental health resilience in HCWs are not well established.

DESIGN: Scoping review to map existing evidence and identify gaps for future research regarding the main barriers and facilitators of the acceptance of ICT-based interventions for improving resilience and mental health among HCWs working in all healthcare settings.

METHODS AND ANALYSIS: This protocol was developed in accordance …

State-Level Progress And Setbacks In Influenza Vaccination Among Adults ≥65: A Fifteen-Season Analysis From 2009/10 To 2023/24, Luigi Russo, Sara Farina, Raffaele Angelo Macri, William Alan Pentecost, Alessandra Maio, Leonardo Villani, Vittorio Maio, Stefania Boccia, Walter Ricciardi

College of Population Health Faculty Papers

INTRODUCTION: Influenza is a contagious respiratory infection with substantial health and economic consequences worldwide. Annual vaccination is the most effective preventive strategy; however, coverage among older adults remains suboptimal and varies considerably across the United States. This study aimed to examine state-level trends in influenza vaccination coverage among adults aged ≥65 years across fifteen influenza seasons (2009/10-2023/24).

METHODS: State-level vaccination coverage data for adults aged ≥65 years were obtained from the CDC FluVaxView platform, which reports annual estimates by influenza season. The analysis covered the 2009/10 through 2023/24 influenza seasons. Joinpoint regression was used to assess temporal trends and estimate …

Distinguished Ornithologist 2024: Mark Peck, Jean Iron, Gerard Binsfeld, John Carley

Ontario Birds

No abstract provided.

An Unusual Northern Mockingbird Nest In York Region, Ontario, Roy B.H. Smith

Ontario Birds

No abstract provided.

First Limpkin Sighting In Ontario, Josh Mandell

Ontario Birds

No abstract provided.

An Unusual Case Of Common Terns Nesting On A Rooftop In Ontario And An Attempt To Relocate The Colony, David J. Moore, Jeffrey N. Costa, Alexis L. Stupich

Ontario Birds

A variety of gull and tern species have adapted to urban environments by nesting on rooftops and other human-made structures. Previous reports of Common Terns (Sterna hirundo) breeding on rooftops have generally involved small numbers of nests (≤25). Here, we report an occurrence of an unusually large number of Common Terns nesting on a rooftop in Port Credit, Ontario, in 2013. A complete survey of the roof was conducted on 31 May, when 1,011 Common Tern nests were counted. A similar number of breeding pairs used this roof in 2014, but the site was largely abandoned by 2015, due to …

Table Of Contents, Ontario Field Ornithologists

Ontario Birds

No abstract provided.

Full Issue, Ontario Field Ornithologists

Ontario Birds

No abstract provided.

Cover, Barry Kent Mackay

Ontario Birds

No abstract provided.

A Review: Tree Swallows As Indicators Of Environmental Contaminants, Kailee Hopkins, Melissa Mckinney, Kim Fernie

Ontario Birds

No abstract provided.

Ontario Bird Records Committee Report For 2023, N. Anthony Kaduck, Nicole M. Richardson, Alvan D. Buckley, Amanda C. Guercio, Kiah R. Jasper, Dan J. Macneal, Michelle A. Martin, David E. Szmyr

Ontario Birds

No abstract provided.

Photographic Confirmation Of Dark-Winged Variant Bonaparte’S Gull In Canada, Mick Dryden

Ontario Birds

No abstract provided.