Digital Commons Network^™

Ebp Project In A Primary, Foster Care Medical Home: Implementation Of The Ages & Stages: Social Emotional Screener, Sara Moore

2026

Background: Children in the foster care system have increased diagnoses, mental health concerns, and developmental delays.
Purpose: The pilot used the ASQ-SE to determine if the protocol was feasible and if the screener identified social-emotional difficulties in a primary care clinic that serves children in foster care. 
Method: A pilot was created, and the ASQ-SE was administered to 33 patients during well-child visits (ages 2 months-70 months) over six weeks.
Results: Implementing a social-emotional screener was feasible in the foster care primary care clinic. The infants and toddlers screened (N=33) were grouped by referral status: 57.6 % (19) …

Effective Resilience Of African American Adolescent Mothers In Urban Communities, Charlene Spicer-Harmon

Walden Dissertations and Doctoral Studies

No abstract provided.

The Lived Experiences Of Mental Health Clinicians Treating Adolescents Diagnosed With Oppositional Defiant Disorder, Gilbert Hernandez

Walden Dissertations and Doctoral Studies

No abstract provided.

The Intersection Of Religion & Politics In The United States: Analyses At The Federal And State Level, Cristina Melissa Pimenta

Electronic Theses and Dissertations

This project examines the intersection of religion and politics in the United States, particularly concerning Christian Nationalism. Existing scholarship has linked the religio-political ideology to several culturally relevant issues, including xenophobia and nativism, racism, homophobia and transphobia, and anti-vaccine rhetoric. My dissertation continues this research by exploring the impact of Christian Nationalism on reproductive rights and, in turn, on gender equality. I assert that as the saliency of Christian Nationalism in the United States has increased, gender equality has decreased. I also argue that the higher the saliency of Christian Nationalism in an individual state, the lower the gender equality …

Challenges To Artificial Intelligence-Enabled Digital Technology Adoption In Farms: A Multi-Method Approach, Guoqing Zhao, Shaofeng Liu, Xiaoning Chen, Huilan Chen, Xinyi Li, Guoste Pivoraite

Plymouth Business School

Artificial intelligence (AI)-enabled digital technologies have the potential to transform agriculture by supporting decision-making and automating operations. However, their limited adoptions and scholars’ atheoretical explorations constrain our understanding. Drawing on the technology-organization-environment (TOE) framework, we investigate the challenges hindering the AI-enabled technology's adoption in farms using a multi-method approach, including semi-structured interviews, thematic analysis, total interpretive structural modeling, and fuzzy cross-impact matrix multiplication applied to classification analysis. Our finding shows novelty in several aspects. First, we identify 13 challenges, some of which are underexplored, such as the absence of effective intermediaries in promoting agricultural technology. Second, we developed a hierarchical …

Investigating Causal Associations Among Inflammatory Proteins, Blood Metabolites, And Alzheimer’S Disease Risk, Shuai Liu, Jingjing Zhu, Hua Zhong, Dan Zhou, Quan Long, Zichen Zhang, Xiaochen Yang, Qing Wu, Chao Cheng, Jianyong Wu, Hung N Luu, Jing Wang, Bingxin Zhao, Chong Wu, Youping Deng, Lang Wu

Faculty, Staff and Students Publications

Alzheimer's disease (AD) is a prevalent degenerative neurological disorder with limited treatment options. Prior studies reported specific metabolites and inflammatory proteins to be related to AD risk. However, the intricate relationship between inflammatory proteins, blood metabolites, and AD risk in European population remains unclear. Genetic instruments for 1,091 metabolites and 736 inflammatory proteins were derived from two recent comprehensive genome-wide association studies. Univariable Mendelian Randomization was employed to assess potential causal effects of metabolites on AD risk, potential effects of inflammatory proteins on metabolites, and effects of inflammatory proteins on AD risk. Multivariable MR (MVMR) was further applied to disentangle …

Syrah: A Pipeline To Maximize Spatial Transcriptomics Data Output, Carolyn Brewster, Frederick G Mann, Blair Benham-Pyle, Alejandro Sánchez Alvarado

Faculty, Staff and Students Publications

Spatial analysis of gene expression patterns has been a key technique for revealing the potential functions of genes. Traditionally, these analyses conducted using in-situ hybridizations and other labor-intensive protocols were constrained to examining only a few candidate genes per sample. However, the advent of spatial transcriptomic techniques like Slide-seqV2 has transformed this field, enabling massively parallel exploration of gene expression patterns within their tissue contexts by pairing spatial locations with RNA sequencing. Despite its potential, Slide-seqV2 datasets often produce fewer usable reads than expected. We have identified that a significant source of errors in the technology stems from the chemical …

Mogad Is The Most Common Cause Of Isolated Optic Neuritis In Children, Chaitanya Aduru, Akansha Chandrasekar, Kyla Blasingame, Jonathan Rosen, Jesse M Levine, Karla Salazar, Madhuri Chilakapati, Rod Foroozan, Victoria Hardwick, Jonathan M Yarimi, Nikita Shukla, Timothy E Lotze, Kristen S Fisher, Alexander J Sandweiss

Faculty, Staff and Students Publications

Objectives: The study aimed to characterize the clinical features, etiologies, and outcomes of isolated, first-time pediatric ON in the post-MOG-IgG era.

Methods: This was a single-center retrospective cohort study at Texas Children's Hospital of patients diagnosed with first-time ON between 2018-2024, with follow-up data collected through 2025. Inclusion criteria required monocular or binocular subacute vision loss with supportive paraclinical signs. Subjects were excluded if they had a prior history of demyelinating disease or extra-orbital demyelinating lesions on initial brain/spine MRI. Primary outcomes were the proportion of MOG-IgG seropositivity, retinal nerve fiber layer thickness, and visual acuity at onset and most …

Re: Conditional Approval Letter For Final Silver Bow Creek Conservation Area (Sbcca) Construction Quality Assurance Plan And Draft Final Silver Bow Creek Conservation Area (Sbcca) Construction Monitoring Quality Assurance Project Plan (Dated April 7, 2026), Emma Rott

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Diabetic Nephropathy Masquerading As Systemic Disease: The Critical Role Of Renal Biopsy In A Young Uninsured Woman With Nephrotic Syndrome, Yolanda V. Gutierrez, Alexis Vargas Del Toro, Cristina Kochi Yamamoto, Jose Loayza Pintado, Andres Suarez-Parraga

School of Medicine Publications

Nephrotic syndrome can have overlapping features across multiple diseases, making diagnosis difficult without tissue confirmation. We describe a 30-year-old uninsured Hispanic woman with type 1 diabetes, hypertension, and CKD3B who presented with nephrotic syndrome, sepsis, and progressive muscle weakness. Her pleural effusions, periorbital changes, elevated free light chains, and dysphagia raised concern for systemic conditions such as amyloidosis or polymyositis, especially given inconsistent outpatient follow-up. Because her management would differ significantly depending on the underlying cause and due to the high risk of loss to follow-up, a renal biopsy was pursued. Serologic studies were unremarkable, and biopsy ultimately confirmed diabetic …

Neural Mechanisms Underlying Jung’S Active Imagination: A Review And Hypothesis, Charles R. Fox

Journal of Conscious Evolution

Active imagination is a key technique of Jungian analysis. Despite its centrality, and its potential importance beyond Jungian psychology to the area of systems neuroscience, psychology, and consciousness studies, there are no known neurological mechanisms underlying this psychological phenomenon. There is a history of using the types of mental imagery used in active imagination to explore consciousness. The development and use of active imagination is briefly reviewed, and a case is developed that the neurology underlying active imagination would be fruitfully explored by considering it a special case of mystical experience. Active imagination primarily uses the right hemisphere processing of …

Teaching Isixhosa As A First Additional Language In Former Model C Schools: Implications For Educator Experiences In The Harry Gwala District, Kwazulu-Natal, South Africa, Lundi Nomlala, Lwandile Ncam

Jurnal Pendidikan: Teori, Penelitian, dan Pengembangan

This paper explored educators' experiences of teaching isiXhosa as First Additional Language (FAL) in former Model C schools in the Harry Gwala District, KwaZulu-Natal, South Africa. The study aimed to understand practical teaching approaches that enhance linguistic diversity and improve IsiXhosa proficiency while addressing systemic challenges. A qualitative case study design was employed, using semi-structured interviews with five IsiXhosa FAL teachers across three schools. The findings revealed the need for partnerships between schools and communities, curriculum revision, including mentorship and professional development for teachers, collaborative learning, and the effective use of technology. However, challenges such as unequal language recognition, insufficient …

Obesity And Cardiometabolic Risks In Thai Children: A Comprehensive Cross-Sectional Analysis, Nitiroj Bongkotwilawan, Nantika Paiboon, Therdpong Tempark, Orapa Suteerojntrakool, Chansuda Bongsebandhu-Phubhakdi

Journal of Health Research

Background: Childhood overweight and obesity are increasing globally, posing significant cardiometabolic risks. Despite extensive studies in developed countries, data on the prevalence and risk profiles of cardiometabolic abnormalities in children from Southeast Asia remain limited

Methods: This cross-sectional study involved 270 Thai children aged 6–13 years, recruited from primary schools in Bangkok. Anthropometric measurements were performed to determine weight, height, and BMI. Blood pressure and fasting blood samples were analyzed for lipid profiles, glycated hemoglobin (HbA1c), and serum glutamic pyruvic transaminase (SGPT) levels. Participants were categorized into normal weight, overweight, and obese groups based on BMI standard deviation scores (SDS). …

A Case Study Of Faculty Perspectives On Teaching Across Borders, Lucy Matthews, Diane R. Edmondson, Tammy Bahmanziari

Atlantic Marketing Journal

This study explores the differences between faculty who have and have not led study abroad programs at a southeastern U.S. public university. Using survey responses from 133 faculty members, the research examines professional and motivational variables that influence participation. Findings reveal that those who have led study abroad programs tend to be satisfied with their experiences, report higher perceptions of student cultural competency gains, and are more likely to recommend such programs to peers. Additionally, experiential learning emerged as a central theme, with faculty highlighting the pedagogical value of immersive global education. Barriers to participation were also investigated. The study …

A Captured Audience: How Job Stress Leads Employees To Online Shopping Via Cyberloafing, Seth Williams

Atlantic Marketing Journal

This paper investigates the hyper-connected workplace and how the modern employee deals with job stress in their work environment. Using the theory of compensatory consumer behavior and partial least squares structural equation modeling, we investigate how job stress impacts employees in the workplace to shop online. This shopping is done via cyberloafing, which is using the internet for personal reasons at work. Psychological detachment is also studied as a mediator. Theoretical and practical implications are discussed for managers in the workplace as well as businesses marketing to individuals taking a break on the clock.

A Cross-Cultural Investigation Of Consumer Hoarding Behavior During Covid-19: Differences Between Sweden And The United States, Christy M. Cook, Pia A. Albinsson, James E. Stoddard

Atlantic Marketing Journal

This study is a cross-cultural exploration of consumer hoarding behavior during Covid-19; specifically, a comparison between Sweden and the United States. This research analyzes whether Swedish and American consumer hoarding behavior factors of prosocial orientation, consumer resilience and consumer risk-taking propensity reflect identical relationships during less predictable environmental forces (i.e., Covid-19 or global pandemic). Results from Partial Least Squares-Structural Equation Modeling (PLS-SEM) show that consumer prosocial orientation is negatively related to consumer hoarding and prosocial orientation is positively related to consumer resilience. In turn, both prosocial orientation and consumer resilience exhibit a positive relationship towards consumer hoarding. Consumer resilience is …

Evidence-Based Clinical Practice Guidelines For Postspinal Hypotension In Pregnant Women, Grace Mackey

Doctor of Nursing Practice Scholarly Projects

Abstract

Postspinal hypotension (PSH) in pregnant women undergoing a cesarean delivery is a common yet significant problem for the safety of the mother and fetus. The physiological effects of a spinal injection may compromise uteroplacental flow, predisposing the fetus to hypoxia and acidosis. Maternal consequences of prolonged hypotension include unstable hemodynamics, loss of consciousness, and nausea. Historically, healthcare providers have used crystalloid preloads and reactive phenylephrine boluses to correct hypotension. However, recent evidence suggests that these interventions have limited effectiveness. Thorough research led to the development of clinical guidelines that propose providing a 500 mL 6% hydroxyethyl starch preload or …

Evidence-Based Practice Guidelines For The Risk Stratification And Anesthetic Management Of Geriatric Surgery Patients At High Risk For Postoperative Cognitive Dysfunction Undergoing Non-Cardiac Surgery, Patrick M. Garvey

Doctor of Nursing Practice Scholarly Projects

As the global geriatric surgical population rapidly expands, managing complications like postoperative cognitive dysfunction is increasingly essential, given its adverse impacts on recovery, quality of life, and healthcare costs. Postoperative cognitive dysfunction can lead to extended hospital stays, delayed recovery, and significant cognitive decline, particularly among elderly patients exposed to general anesthesia. This quality improvement final scholarly project develops and hypothetically implements evidence-based practice guidelines for anesthetic management in geriatric patients at high risk for postoperative cognitive dysfunction undergoing non-cardiac surgery. This Doctor of Nursing Practice (DNP) project uses preoperative cognitive assessments, such as the Mini-Cog tool, to identify patients …

Practice Considerations For Perioperative Ondansetron Use In Parturients Undergoing Cesarean Sections With Spinal Anesthesia, Mackenzie Glaros

Doctor of Nursing Practice Scholarly Projects

Elective cesarean sections are often performed with spinal anesthesia, a form of neuraxial anesthesia that offers superior pain relief and reduces the risks associated with general anesthesia. However, over 50% of parturients experience side effects from spinal anesthesia, including shivering, hypotension, nausea, and vomiting, which can cause both physiological and psychological issues for the laboring mother and be detrimental to the fetus. Preventing these side effects is vital for improving safety, patient satisfaction, and minimizing complications. While various interventions and medications have been explored to manage these effects, no standardized guidelines exist for their prevention. A review of existing literature …

Proposed Evidence-Based Practice Consideration: The Use Of Remimazolam Tosilate Instead Of Propofol For Endoscopic Procedures Under Monitored Anesthesia Care In The Elderly Population, Tayler Lynn Detwiler

Doctor of Nursing Practice Scholarly Projects

Endoscopic procedures are essential for diagnosing and managing gastrointestinal conditions, particularly in a growing elderly population. The selection of sedative agents significantly influences patient safety and procedural outcomes. Propofol, the traditional choice, is successful but associated with risks such as hypotension, bradycardia, and respiratory depression, particularly in elderly patients. This hypothetical Doctor of Nursing Practice (DNP) project explores the use of remimazolam tosilate (RT), a novel ultra-short-acting benzodiazepine, as an alternative to propofol during monitored anesthesia care (MAC) for elderly patients undergoing endoscopic procedures. The project utilizes a randomized controlled trial (RCT) design to compare RT and propofol regarding hemodynamic …

Evidence-Based Practice Guidelines For Lung Protective Ventilation In Adult Patients Undergoing Abdominal Laparoscopic Surgery, Marco A. Spada

Doctor of Nursing Practice Scholarly Projects

The rise in abdominal laparoscopic surgeries has underscored the need for improved ventilation strategies to reduce postoperative pulmonary complications, such as atelectasis, ventilator-induced lung injury, and pneumonia. These complications can increase hospital stays, healthcare costs, and mortality. This final scholarly project investigates the impact of lung protective ventilation in adult patients undergoing abdominal laparoscopic procedures and proposes guidelines for implementation. Lung protective ventilation strategies, including low tidal volume ventilation, individualized positive end-expiratory pressure, and recruitment maneuvers. Current research shows potential in mitigating postoperative pulmonary complications by improving intraoperative oxygenation and lung compliance. Using the Johns Hopkins Evidence-Based Practice model, this …

Evidence-Based Guidelines For Intraoperative Quantitative Neuromuscular Monitoring, Noah Graham

Doctor of Nursing Practice Scholarly Projects

Nondepolarizing neuromuscular blocking agents are routinely used medications vital to anesthetic care. When administering neuromuscular blocking agents, monitoring neuromuscular blockade depth and degree of recovery is a standard of nurse anesthesia practice to facilitate adequate recovery. If not adequately reversed, postoperative residual neuromuscular blockade can cause severe complications. Traditional qualitative neuromuscular monitoring practices largely contribute to the continuing high incidence of postoperative residual neuromuscular blockade, as supported by research that qualitative monitoring methods are insensitive to the depth of blockade and clinical situations, providing unreliable physiologic information. As recommended in practice guidelines by the American Society of Anesthesiologists, quantitative neuromuscular …

Implementation Of Evidenced Based Practice Guidelines For Reducing Emergence Delirium In Elderly Patients Undergoing A Total Hip Replacement, Luke D. Kleinfelder

Doctor of Nursing Practice Scholarly Projects

A total hip replacement is a common surgery for the elderly population, as it is a successful treatment option for hip fractures and end-stage osteoarthritis, a common condition associated with aging. Recovery from surgery is critical, and any postoperative complication can delay recovery, increase cost, lengthen hospital stay, and lead to a poorer long-term surgical outcome. One of the most common and severe postoperative complications for elderly patients following general anesthesia is emergence delirium. Traditional practice focuses on treating the symptoms of emergence delirium reactively instead of proactively and lacks standardized guidelines. Recent literature found a promising decrease in the …

Integrating The Transversus Abdominis Plane Block Into An Eras Protocol For Bariatric Surgery Patients, Jordan Neibarger

Doctor of Nursing Practice Scholarly Projects

This Doctor of Nursing Practice (DNP) project investigates the integration of the Transversus Abdominis Plane (TAP) block into Enhanced Recovery After Surgery (ERAS) guidelines for bariatric surgery patients, aiming to improve postoperative outcomes by reducing opioid consumption, time to ambulation, and hospital length of stay (LOS). Bariatric patients who undergo sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) frequently encounter challenges with postoperative pain, increasing opioid use, delaying postoperative time to ambulation, and increasing postoperative hospital LOS. Prolonged postoperative hospitalization increases the financial impact on the healthcare system, and bariatric patients who have a longer postoperative LOS have a higher rate …

Proposed Evidence-Based Practice Guidelines For Using Esmolol To Blunt The Sympathetic Stress Response To Laryngoscopy And Intubation, Maya Kurdi

Doctor of Nursing Practice Scholarly Projects

Direct laryngoscopy (DL) and endotracheal intubation (ETI) are standard procedures performed during general anesthetic induction, which provoke a sympathetic stress response that can result in intraoperative hemodynamic instability. Traditional agents like lidocaine and fentanyl, commonly used to mitigate the stress response, have limitations and can lead to adverse effects. Recent literature suggests that esmolol, an ultra-short-acting, cardio-selective beta-1 adrenergic receptor antagonist, may be an effective alternative due to its rapid onset, short duration, and minimal side effects. This final scholarly project (FSP) aims to develop evidence-based practice guidelines for using esmolol as an adjunctive induction agent. A systematic literature review …

Parenting Practices And Support Towards Learning On Kindergarteners’ Behavioral And Social-Emotional Outcomes, Natalie J. Cassady

Honors Capstones

The relationship between parents and children have been found to be predictive of children’s socialization. Children’s behavior and social interactions are significant factors that shape their school experiences, which may be influenced by parents’ involvement and support towards their child’s education. This investigation studies the influence of parenting practices and parental support for learning on children’s internalizing and externalizing behaviors, inattention, and social competence. This study uses data from 181 kindergarten students, in which caregivers and teachers completed various questionnaires regarding aspects of specific parenting behavior, types of parental involvement, and children’s social skills and behavior. Using multiple linear regression …

Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego

Honors Capstones

This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …

The Healing Huddle: Preventing Nurse Second Victimization Through Post-Event Debriefing, Sidia Scott

Creating Healthy Work Environments (CHWE)

Background: Nurses regularly encounter traumatic situations that can leave enduring scars, and without a formalized opportunity to reflect on these experiences, the repercussions can be severe, affecting personal health, team unity, and the standard of patient care. Healthcare workers who suffer from traumatic events are dubbed “second victims”. The patients and their families are the first casualties. Nurse leaders may lack insight into how debriefing impacts their teams’ quality of life at work and would benefit from additional clarity of how to incorporate consistent debriefing into their culture and workflows.

Purpose: This integrative review aims to explore the evidence regarding …

Interventions Targeting Nurse Burnout: A Review Of Current Strategies With Future Recommendations, Hannah Grace Shipp, Katherine Christine Hall

Creating Healthy Work Environments (CHWE)

Intro: Patient care delivery is at risk when nurses experience unmanaged burnout (World Health Organization, 2019). Burnout affects approximately 30% of nurses worldwide (Ge et al., 2023) and 65% in the United States (Cross Country Healthcare, 2025). Researchers posit that burnout is primarily driven by systemic issues rather than individual deficiencies (Cao et al., 2025; O’Hara et al., 2024). Research on interventions to treat nurse burnout is abundant yet there is a gap regarding the translation of current evidence to practical recommendations.

Purpose: To (1) summarize existing systematic reviews on interventions addressing nurse burnout, and (2) translate this evidence into …

Bring The Heat, Bring The Savings: Supporting Strategic Growth For A Minnesota-Based Energy Efficiency Nonprofit, Abigail P. Oldenberg

Strategic Communication Master of Arts Thesis Projects

The Minnesota-based nonprofit organization Center for Energy and Environment (CEE) exists to deliver effective energy solutions to cold-climate states. Its primary mission is to make energy more affordable for residents and businesses, promote environmental equity, and lower carbon footprints. This project considers the social and political landscape in the United States and its impact on environmental nonprofits. Given the status of grants allocated for energy efficiency programs, while prioritizing the organization’s business development goals, Center for Energy and Environment must diversify its revenue streams. Primary and secondary research conducted for this project includes annual impact reports, social media and website …