Digital Commons Network^™

Improving Antihypertensive Medication Adherence Through Education And Follow- Up Phone Calls In A Primary Care Setting, Sarah Peterson

Doctor of Nursing Practice Final Manuscripts

Hypertension affects nearly half of adults and significantly increases the risk of stroke and cardiovascular disease; however, poor medication adherence remains a primary barrier to effective blood pressure management. The purpose of this evidence-based practice (EBP) project was to improve antihypertensive medication adherence among adult patients in a primary care setting. Guided by the Iowa Model of Evidence-Based Practice to Promote Quality Care, the project utilized a pre-test/post-test design at a private practice clinic. The sample included adults with a hypertensive diagnosis and active prescriptions. Medication adherence was defined as the Morisky Medication Adherence Scale (MMAS-8) scores, measured before and …

Closing The Gap: Integrating A Standardized Depression Screening In Primary Care, Cyndy Marie Oreas

Doctor of Nursing Practice Final Manuscripts

Objective: The purpose of this evidence-based practice (EBP) project is to implement the routine use of the Patient Health Questionnaire-9 (PHQ-9) screening instrument in the primary care setting to improve early diagnosis, treatment, and referrals to mental health.

Background: Depression is frequently underdiagnosed in primary care despite its significant impact on health outcomes. Inconsistent screening practices and a lack of standardized workflows contribute to missed opportunities for early identification and intervention. Routine PHQ-9 screening has been shown to improve detection and facilitate timely referral to behavioral health services.

Methods: A standardized PHQ-9 screening was implemented for adult patients aged 18 …

Reducing Preoperative Anxiety In Patients Undergoing Gynecologic-Oncology-Related Surgeries, Iman Sean Lavine-Richardson

Doctor of Nursing Practice Final Manuscripts

Elevated levels of preoperative anxiety are associated with adverse effects in the postoperative period. Evidence demonstrates the effectiveness of incorporating multimedia into preoperative education to alleviate preoperative anxiety. This project aims to decrease preoperative anxiety levels and increase satisfaction and feelings of preparedness in patients scheduled to undergo gynecologic-oncology-related procedures through the implementation of an evidence-based practice (EBP) informational video. The San Diego 8A’s EBP model was utilized to guide this project. Data was collected, anonymously, through online questionnaires which included the Anxiety Specific to Surgery Questionnaire (ASSQ) to assess anxiety levels and Likert-scale questions to assess satisfaction and feelings …

Implementation Of Symptom Management Standing Order Sets In An Ambulatory Palliative Care Clinic, Anna Manfreda

Doctor of Nursing Practice Final Manuscripts

Background: As outpatient palliative care expands, the need for timely, evidence-based symptom management has become increasingly critical. In many ambulatory settings, triage nurses are the first point of contact for patient symptom reporting; however, without standing orders, management may vary by provider availability and individual practice patterns, leading to potential treatment delays and inconsistencies in care from evidence-based recommendations.
Purpose: The purpose of this Doctor of Nursing Practice project was to improve the workflow and quality of gastrointestinal (GI) symptom management in an ambulatory palliative care clinic.
Framework: This project was guided by the Iowa Model Revised: Evidence-Based Practice to …

Text Message Delivery Of Pre-Procedural Recommendations Prior To Lip Augmentation With Hyaluronic Acid Filler: An Evidence-Based Pilot Project, Jenna De Jonge

Doctor of Nursing Practice Final Manuscripts

Patients seeking lip augmentation procedures commonly experience self-resolving soft-tissue complications such as swelling and bruising. There are many widely accepted pre-procedural recommendations available to help patients minimize the risk of these undesirable outcomes. At a Medical Aesthetics practice in Southern California, lip augmentation patients often arrived to their appointment non-adherent to pre-procedural recommendations that were available on the practice website. Text message delivery systems have been used to improve patient adherence to healthcare instructions across a variety of healthcare settings. To address this gap, I implemented text message delivery of pre-procedural recommendations to lip augmentation patients prior to their appointment. …

Optimizing Lactation Support: Enhancing Patient-Centered Care And Breastfeeding Self Efficacy Through Data-Driven Survey Analysis, Jessica L. Doshay

Doctor of Nursing Practice Final Manuscripts

Objective: The objective of this project was to implement evaluation of an integrated lactation support model within a multi‑site pediatric primary care organization to assess patient experience and breastfeeding confidence associated with a lactation consultation.

Background: Optimizing the patient experience is an indicator of healthcare quality. Improving breastfeeding outcomes remains a national priority. Structured lactation support delivered by International Board-Certified Lactation Consultants (IBCLCs) enhances breastfeeding outcomes, the impact of this is often undocumented in primary care settings.

Methods: This quality improvement project was conducted within the lactation department of a multicenter pediatric clinic in Southern California. Pediatric clinicians who were …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

"It's Such A Natural Fit": Integrating Reggio Emilia And Head Start For Emergent Multilinguals, Christina Bohr

Graduate Doctoral Dissertations

Early childhood education classrooms reflect the increasing cultural and linguistic diversity of the United States where many children are raised speaking more than one language. Teachers in the early education field play a critical role in supporting children’s development of language and identity. Head Start, who serves a large population of emergent multilinguals (mls), plays an essential role in offering learning environments that foster language development in both English and their home language, among many other critical skills. The Reggio Emilia philosophy is a child-centered and community-oriented approach that promotes children’s independence, exploration, and intellectual development, and is frequently integrated …

Academic Identity Construction Among 1.5-Generation Students In Esl Business Communication Courses At A U.S. University, Rachel K. La Russo

Graduate Doctoral Dissertations

Although 1.5-generation students complete most of their K-12 schooling in the United States, at the university level they are often placed in ESL courses due to deficit views of multilingualism that assess their writing as grammatically inaccurate. Research shows ESL courses often fail to foster 1.5-generation students’ academic development, resulting in low educational achievement and high drop-out rates (Barsony, 2016; di Gennaro, 2016; Marchese, 2021; Uman, 2018). The purpose of this qualitative study is to investigate academic identity construction among 1.5-generation students enrolled in two de facto ESL Business Communication courses at a large urban university in Fall 2022. Drawing …

The Marginalizing Effect Of Special Education: Investigating The Overrepresentation Of Black Males Identified With Emotional Impairment In A Separate School In An Urban Setting, Cindie Neilson

Graduate Doctoral Dissertations

The American public education system relies heavily on normed and standardized mechanisms to define competence, behavior, and academic success. By design, such systems cannot accommodate the full range of human variation and instead reproduce expectations rooted in dominant culture norms. When embedded within a racially stratified educational system, Special Education, while intended to provide access and opportunity for students with disabilities, can function as a mechanism through which inequality is reproduced. This qualitative study examined the persistent overrepresentation of Black males identified with Emotional Impairment in highly restrictive separate day school settings. The research was conducted in a public separate …

Talk To Me: Exploring The Sociocultural Ecology Of Home Language And Literacy Practices Of Families In India, Surbhi Puri

Graduate Doctoral Dissertations

Existing research highlights the role of home language and literacy environments (HLLE) in shaping early language and literacy development, yet few studies have examined the practices of multilingual families in India. While home environments offer rich learning opportunities, broader sociocultural and policy contexts influence how families support literacy and language development. Families’ insights into home language use, literacy routines, and cultural practices remain underexplored in early childhood education research.

The purpose of this qualitative multiple case study was to explore the HLLE of preschool-aged children in India and examine how families support early language and literacy development within multilingual home …

Whose Knowledge Is Sustained?: Dominican Students’ Cultural And Linguistic Experiences Navigating White, Female, And Monolingual Pedagogical Spaces, Carminia Lissette Castillo

Graduate Doctoral Dissertations

This qualitative study examined how Dominican newcomer youth experience schooling in U.S. secondary schools, with emphasis on language, curriculum, identity, belonging, and students’ visions for more humanizing educational environments. Grounded in student testimonios, the study explored how school structures, pedagogical practices, and teacher–student relationships shape students’ academic engagement, emotional well-being, and sense of recognition as they navigate migration, language transition, and racialized identity formation. Informed by raciolinguistic, culturally sustaining, and critical interpretive frameworks, this study centered Dominican students’ voices as sources of knowledge about schooling, exclusion, and possibility. The findings comprise three central themes. First, students described raciolinguistic schooling …

Developing The Evidence And Associated Service Models To Improve Pain Management In Older People Living With Frailty: A Synopsis Of The Poppy Mixed Method, Co-Design Study: Poppy, Patricia Schofield

School of Nursing and Midwifery

Background: Frailty increases vulnerability to adverse events (falls, illness) resulting in poorer health outcomes in later life. Persistent pain is common and impactful in older adults with frailty. Pain impact is potentially modifiable, and addressing it is important for supporting this population. The Pain in Older People with Frailty study aimed to generate evidence and develop service models to improve pain management for older adults with frailty and inform service provision for this underserved population. Objective(s): Phase 1: Map research evidence and synthesise findings from randomised controlled trials of multi-component pain management programmes and psychological therapies for community-dwelling older adults. …

Rethinking Flow: The Paradox Of Renoprotection Without Increased Renal Blood Flow In Cardiopulmonary Bypass, Shiksha Mohan, Ronald A Shaju, Sharan Misra, Titiksha Sharma, Veeraj K Sirivolu, Abhinav Rajkumar, Anthony Rodas-Camacho, Aizah Zaidi, Dhruv Dhingra, Ilma Khan, Rishav Bhattacharya, Vishal Pancholy, Shivam Banerjee, Shreyo Ghosh, Shiyi Li, Kenneth K Liao, Carl P Walther, Nandan K Mondal

Faculty, Staff and Students Publications

No abstract provided.

Perinatal Mental Health Screening And Care Among Those With Pregnancy Complications, Alison N Goulding, Terri L Fletcher, Emily S Miller

Faculty, Staff and Students Publications

Perinatal mental health conditions are common and, without effective treatment, can contribute to adverse maternal and child outcomes. In the United States, mental health conditions are a leading cause of maternal morbidity and mortality, contributing to over 20% of pregnancy-related deaths. This expert review aims to assess current literature and provide recommendations regarding mental health care in high-risk patients who experience pregnancy complications. Individuals experiencing pregnancy complications are at increased risk for perinatal mental health conditions, including depression, anxiety, and post-traumatic stress disorder, as compared to those with uncomplicated pregnancies. Despite this increased disease burden, there is limited research on …

Profil Kemampuan Awal Keterampilan Produktif Bahasa Jerman Mahasiswa Pemula Pada Level A1 Cefr, Femmy Angreany, Arlian Fachrul Syaputra

Journal of Language, Literature, and Arts

This study aims to describe the initial profile of German productive skills among first-year students of the German Language Education Study Program, Faculty of Languages and Literature, Universitas Negeri Makassar, based on the A1 level of the Common European Framework of Reference for Languages (CEFR). The study employed a quantitative approach with a descriptive design to systematically portray students’ abilities without applying any specific treatment. The participants consisted of 40 first-semester students from two classes. Data was collected through documentation of the Final Semester Examination results in speaking (Sprechen) and writing (Schreiben) skills, which were adapted from the Goethe-Zertifikat A1: …

Knowledge And Perception Of Patients Regarding A Postpartum Standardized Hypertensive Disorder Educational Program, Arin Everett, Niranjana Balu, Santiago Ortiz Barragan, Marly Azzi, Sanela Potchileev, Courtney Bisson, Ariel Mueller, Lea Runesha, Sajid Shahul, Sarosh Rana

Graduate Medical Education Research Journal

Background. Hypertensive disorders of pregnancy (HDP) are a major contributor to rising maternal mortality in the United States. The postpartum period represents a critical window to provide education aimed at reducing the risks of complications. This study evaluates the patients’ understanding of HDP and their retention of key education concepts during the first six weeks postpartum after participation in a structured quality improvement program.

Methods. Prospective cohort study of patients diagnosed with HDP were enrolled in the remote blood pressure monitoring program (RPM) and delivered between June 2023 and January 2024. Baseline surveys were administered prior to discharge and repeated …

A Literature Review Of Burnout And Associated Tools In Residency Programs, Foluso Obisanya, Fatima Mncube-Barnes, Kudiratu A. Proctor, Charles A. Mcdaniel, Donna M. Alexander, Tyrece D. Hunter

Graduate Medical Education Research Journal

Background. Burnout poses considerable challenges in workplaces, particularly for resident physicians. This intricate phenomenon stems from a myriad of factors that include, but are not limited to, staff shortages, excessive workloads, specific job responsibilities, work environments, and individual psychological factors. The Accreditation Council for Graduate Medical Education encourages institutions to incorporate wellness as a fundamental component of residency training programs.

Methods. The aim of this review was to investigate burnout among resident physicians via a comprehensive literature review to elucidate this significant issue and identify potential preventative intervention strategies. We analyzed the issue of burnout across various residency specialties, providing …

Recent Progress In Aircraft Structural Health Monitoring: Sensors, Data And Intelligence, Abeer Kadhum Abd, Qasim Abbas Atiyah, Imad Abdulhussein Abdulsahib

Engineering and Technology Journal

Structural Health Monitoring (SHM) systems are essential technologies that contribute to enhancing the safety, reliability, and efficiency of aircraft structures throughout their operational lifespan. With the increasing use of lightweight materials and complex structural designs, coupled with longer maintenance intervals, traditional scheduled inspection methods have become insufficient, leading to a shift towards continuous, sensor-based monitoring systems. This research aims to provide a systematic and comprehensive review of the latest developments in aircraft structural health monitoring, focusing on sensing technologies, data collection methods, and intelligent processing techniques based on artificial intelligence. This study is based on a systematic analysis of the …

Towards Sustainable Agentic Artificial Intelligence In Medical Diagnosis For Autonomous Heart Disease Prediction, Thura J. Mohammed, Dhiaa M. Abed

AUIQ Humanities and Social Sciences

Diagnosis of heart disease is a procedure that requires fast, accurate predictions and conventional fixed machine learning (ML) pipelines may not fully accommodate. Although models, such as Logistic Regression and Naïve Bayes are effective on structured clinical data however they do not have self-assessment or adaptive reasoning mechanisms. In this work, we present an agentic AI framework that turns the classical models into self-evaluating diagnostic agents managed by a performance conscious supervisory component. We trained and tested the system on the UCI Heart disease dataset over three different splits (70:30, 80:20, 85:15) to test its diagnostic stability with respect to …

Software Engineering: Ai-Enhanced Full Stack Development, Huixin Wu, Haiying Xiao

Open Educational Resources

This course provides instruction in full‑stack web application development using modern JavaScript technologies. Students design, implement, and deploy web‑based solutions while applying AI‑assisted development tools in an ethical and effective manner. The curriculum emphasizes problem‑solving, system design, teamwork, and industry‑standard best practices, with dedicated focus on cloud‑native development—including containerization, distributed services, and modern deployment pipelines—as well as API‑first architecture, enabling students to build scalable, maintainable, and interoperable applications aligned with current industry expectations.

Mri-Based Deep Learning Radiomics Model For Automated Classification Of Disc Degeneration In The Lumbar Spine, Shiv Patil, Om Gandhi, Mert Karabacak, Matthew Carr, Konstantinos Margetis

Student Papers, Posters & Projects

Disc degeneration in the lumbar spine is a major cause of low back pain (LBP). The accurate grading of disc degeneration on magnetic resonance imaging (MRI) is critical for clinical management and patient selection for spine surgery. This study aims to develop and evaluate machine learning (ML) models that combine features from deep learning (DL) and radiomics for the automated prediction of Pfirrmann grade (PG), a measure of disc degeneration, using multi-parametric lumbar spine MRI. Sagittal T1, T2, and T2 SPACE MRIs of 218 patients with LBP were acquired from the SPIDER dataset. For each intervertebral disc and available sequence, …

Is Trimethylamine N-Oxide A Friend, Foe, Or Hormetic Agent In Patients With Parkinson’S Disease: A Focused Review Of One Microbial Metabolite, Abraham B. Alton

Student Works

This review synthesizes recent literature examining trimethylamine N-oxide (TMAO) synthesis and its potential role in Parkinson’s Disease (PD) pathology. An increase in TMAO plasma and CSF concentration is associated with PD progression and severity. TMAO biosynthesis is a two-step process. First, precursors including carnitine and choline are converted to trimethylamine (TMA) by gut microbes. Second, TMAO is oxidized to TMAO in the liver. Once absorbed into circulation TMAO crosses the blood brain barrier and may influence PD disease pathology by increasing neuroinflammation and astrocyte activation and damaging the cerebral lymphatic system. These mechanisms may contribute to the cognitive and motor …

A Call To Action: Towards A Compendium For Culturally Responsive And Inclusive Pain Management, Arvie Vitente, Rob Sweet, Lester Jones

Philippine Journal of Physical Therapy

Introduction: Pain is a pervasive global health problem, yet its assessment and management remain shaped by biomedical, monolingual, and culturally narrow assumptions that do not fully reflect the lived realities of diverse populations. Although contemporary pain science recognizes pain as a personal experience influenced by biological, psychological, and social factors, inequities persist across racial, ethnic, linguistic, and cultural groups.

Main Body: These inequities affect how pain is expressed, interpreted, documented, and treated, particularly among Indigenous peoples, migrants, refugees, and patients with limited English proficiency. In this perspective, we call for the development of a comprehensive compendium on culturally responsive and …

Leveraging Social Media Recruitment In Health Science Education: A Scoping Review, Crystalyn Richard, Natalie Nguyen, Luong Thien Nguyen, Alison Hansen

Philippine Journal of Physical Therapy

Background: Equitable recruitment practices are essential to the diversification of health science educational applicant pools. This scoping review aimed to understand the existing literature supporting the use and implementation of SM (SM) for recruitment in various health science educational programs. Methods: A comprehensive search utilizing the PRISMA Extension for Scoping Reviews (PRISMA-ScR) framework was used to collect and analyze existing articles. Keyword selection followed by an iterative process for article inclusion using Covidence application for article analysis and inclusion/exclusion. A thematic analysis method was employed to synthesize findings from the studies that met our inclusion criteria. Results: The initial keyword …

Self-Reported Gum Bleeding, Oral Health Behaviors, And Cardiovascular Risk Indicators Among Adults Aged 45-70 In A Community Dental Setting., Kimberleigh Edwards

Population Health Leadership and Analytics Theses

Cardiovascular disease remains a leading cause of morbidity and mortality among adults in the United States, particularly during midlife and older adulthood. Periodontal inflammation and poor oral hygiene behaviors have been linked to increased cardiovascular risk through systemic inflammatory pathways. This exploratory cross-sectional study described patterns of self reported gum bleeding, oral hygiene behaviors, and cardiovascular risk factors among 29 adults aged 45 to 70 at a community dental clinic using the researcher-developed Oral and Heart Health Study Questionnaire. Fourteen participants reported both gum bleeding and at least one cardiovascular risk factor. Participants who reported inconsistent flossing and infrequent professional …

Cultural Determinism, Leadership Identity, And Psychological Outcomes Among Emirati Women School Principals: A Convergent Mixed Methods Study, Saeed Mobarak Alkaabi

All Works

Background/problem: Despite state-led empowerment reforms in the United Arab Emirates (UAE), Emirati women school principals experience tension between leadership roles and entrenched cultural expectations. Norms related to family honor, modesty, male guardianship, and relational harmony, continue to shape leadership identity formation, agency, and psychological outcomes, influencing leadership legitimacy and professional identity. Objective/purpose: This study examines how cultural determinism influences leadership identity, agency, and psychological well-being among Emirati women school leaders on the East Coast of the UAE. Design and Methodology: A convergent parallel mixed methods design was implemented. Correlation and regression analysis were used to test the influence of cultural …

Iterative Cannabis Care Plans Are Associated With Higher Rates Of Symptom Relief And Lower Side-Effect Burden In Oncology Patients, Brooke Worster, Md, Kristen Parton, Mba, Gregory Garber, Msw

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Background/Research Objective

Cannabis is increasingly used to manage cancer-related symptoms including pain, sleep disturbance, anxiety, and appetite or gastrointestinal complaints. However, patient responses are highly variable, clinicians report limited confidence in guiding use, and optimal dosing is difficult to predict from baseline characteristics. We evaluated whether an iterative, guided cannabis care model incorporating ongoing patient feedback and care-plan adjustments is associated with improved symptom relief and lower side-effect burden in a real-world oncology population.

Simplification Of Technical Language In Tagesschau News For B1-Level German Vocabulary Learning, Syaula Qonit Helga, Dewi Kartika Ardiyani

Journal of Innovation and Teacher Professionalism

This study aims to identify and categorize the types of Fachsprache (specialized language) found in simplified Tagesschau news and to explore their potential use for B1-level German vocabulary learning. The study employs a qualitative descriptive approach using content analysis. Data were collected from news videos available on the Tagesschau YouTube channel and analyzed according to three categories: (1) CEFR level, (2) subject area, and (3) usage context. The data were processed through data reduction techniques to simplify Fachsprache terms at higher CEFR levels, followed by data display and interpretation to examine the identification results, and finally, conclusion drawing. The findings …

Can Behavioral Interventions Promote Health Equity In Pediatric Type 1 Diabetes? A Narrative Review Of Promising Treatments, Paul T. Enlow, Jaquelin Flores Garcia, Julia Price, Kristen A. Torres, David V. Wagner

Department of Pediatrics Faculty Papers

Purpose of review: Synthesize data on whether existing behavioral interventions can improve health equity among youth with type 1 diabetes.

Recent findings: While existing behavioral interventions demonstrated efficacy in improving health and/or psychosocial outcomes, evidence that these same interventions may improve health equity were lacking. Most interventions were evaluated using predominantly White and affluent samples and some studies did not report on racial, ethnic, or sociodemographic characteristics of their sample. Only a few interventions have been adapted for youth from minoritized backgrounds. Recent multisystemic and technology/mHealth interventions recruited samples that were sociodemographically representative of youth experiencing disparities, suggesting that these …