Digital Commons Network^™

April 30, 2026, James Madison University

The Breeze, 2020-

The Breeze is the student newspaper of James Madison University in Harrisonburg, Virginia.

The House Capstone Project, Josh Delange

Celebrating Scholarship and Creativity Day (2018-)

Capstone project on The House

Inconsistent Post-Fall Follow-Up And Documentation In A Skilled Nursing Facility, Brooke Beier

Celebrating Scholarship and Creativity Day (2018-)

Falls remain a significant safety concern in skilled nursing facilities and are associated with increased morbidity, hospitalization, and loss of independence among older adults. While fall prevention strategies are widely implemented, inconsistent post-fall follow up and incomplete documentation can negatively impact residents and the facility. At a moderate-sized skilled nursing facility in central Minnesota, a review of recent fall reports identified inconsistencies in post-fall follow-up documentation, as well as gaps in staff education and the absence of a clearly defined post-fall documentation policy. The facility experienced 44 resident falls in the month of January alone, highlighting the urgency of addressing …

Implementation Of Positive Reinforcement To Promote Staff Adherence To Bowel And Bladder Plans At A Long-Term Care Facility, Alfonso Segura Sanchez

Celebrating Scholarship and Creativity Day (2018-)

Background: Bowel and bladder plans (BBPs), also known as toileting programs, are individualized restorative nursing programs that have strategies to promote continence in residents and reduce the negative consequences of incontinence (Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual Version 1.20.1, 2025). Purpose: Senior nursing students implemented positive reinforcement in a quality improvement (QI) project to reduce rates of incontinence and inconsistent adherence to BBPs at Elim Wellspring, a skilled nursing facility for long-term care in Princeton, MN. According to the Minnesota Department of Human Services and Minnesota Department of Health, the most recent report on quality indicators for …

Improving Reflective Practice And Care Consistency In The Mental Health Connect Line: Addressing Compassion Fatigue Through A Quality Improvement Initiative, Chloe Parkin

South West Clinical School Journal

#400WORDS: QUALITY IMPROVEMENT REPORT

The Lived Experience Of Vicarious Trauma In Specialist Nurses Facilitating Organ Donation: A Narrative Review, Sharon Johnson, Kevin Hambridge

South West Clinical School Journal

#400 words: knowledge and action

The Use Of Thickener In Dysphagia Management: An Evaluation Of Current Practice, Morgane Griffiths

South West Clinical School Journal

#400WORDS: EVIDENCE INFORMED CHANGE PROJECT

Improving Reflective Practice And Care Consistency In The Mental Health Connect Line: Addressing Compassion Fatigue Through A Quality Improvement Initiative, Lauren Collier, Chloe Parkin

South West Clinical School Journal

#400WORDS: QUALITY IMPROVEMENT REPORT

Effects Of Phosphate-Solubilizing Fungi On Phosphorus Availability, Retention, And Soil Chemical Properties In Shallot Cultivated On Andisols Of North Sumatra, Agustina Erlinda Marpaung, Tengku Sabrina, Abdul Rauf, Dwi Ningsih Susilowati

Jurnal Kultivasi

The availability of phosphorus (P) is one of the main limiting factors for plant productivity in Andisol soils due to the strong fixation of P by allophane clay minerals, aluminum and iron oxides. Giving the phosphate solubilizing fungi (PSF) is an alternative to increase available P which plants can use to increase the yield. This study aimed to evaluate the effectiveness of phosphate-solubilizing fungi (PSF) in improving P availability on Andisol. The experiment used a block randomized design (BRD) with three replications. The first factor is Andisol soil origin (Soil 1 and Soil 2) and the second is isolate of …

Estimating Leaf Area In Velvetleaf (Limnocharis Flava) And Kangkong (Ipomea Aquatica): A Precise And Non-Destructive Approach For Wetland Vegetables, Anggrika Riyanti, Benyamin Lakitan, Momon Sodik Imanudin, Muhammad Yazid

Jurnal Kultivasi

Developing a leaf-area estimation model for vegetable cultivars in wetlands is essential to optimizing agricultural cultivation practices. This study aims to develop a non-destructive model for leaf area estimation in wetland vegetable cultivars (velvetleaf (Limnocharis flava) and kangkong (Ipomoea aquatica)) using regression-based models. The plants were cultivated in a wetland system. Measurements of leaf length and width were taken on all leaves of each plant, using the product of length and width (L×W) as predictor. The regression models for estimating leaf area were adjusted from linear, zero-intercept linear, quadratic, and power. The optimal model was evaluated using the determination coefficient …

Human And Geographic Dimensions Of Heat Risk: Progress, Challenges, And Opportunities, Olga V. Wilhelmi, Mary H. Hayden, Peter D. Howe, Jennifer K. Vanos, Sara Meerow, Dana Habeeb, V. Kelly Turner, Cenlin He, Ulrike Passe, Tian Yao, Rodrigo Leal, Rajesh Kumar, Benjamin Crawford, Kevin Lanza, Alamin Molla, Andrew J. Newman, Amanda L. Laverty, Jean Claude Iradukunda, Carly Frank, Tammie Visintainer

Faculty Research, Scholarly, and Creative Activity

No abstract provided.

Multicultural, Trauma‑Informed Feeding Protocols For Children With Spd In Student‑Led Ot Clinics, Matt Crummel

Capstone Projects

This capstone project aims to develop and implement feeding protocols for children with sensory processing disorders in a student-led occupational therapy clinic, emphasizing trauma-informed care and multicultural practices. By creating evidence-based interventions and fostering interdisciplinary collaboration, the project seeks to enhance therapeutic outcomes while providing OT students with hands-on learning experiences. OT is a healthcare profession that enhances individuals’ independence in daily activities through personalized interventions targeting physical, sensory, and cognitive skills. Student-led OT clinics offer a valuable learning environment where students work under licensed clinicians to provide therapeutic care.

Sensory processing disorders (SPD) significantly impact feeding behaviors, often leading …

Re: Comment Letter For The Draft Final Butte Priority Soils Operable Unit (Bpsou) Insufficiently Reclaimed Sites Bres No. 30 – Atlantic 1 Remedial Action Work Plan (Rawp) (Dated March 24, 2026), Molly Roby

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Re: Approval Letter For The Butte Priority Soils Operable Unit (Bpsou) Revised Draft Final Insufficiently Reclaimed Sites Joesphine Shaft (Bres No. 37) – Remedial Action Work Plan (Rawp) (Dated March 24, 2026), Molly Roby

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Re: Comment Letter For Draft Final 2026 Interim Site-Wide Groundwater Monitoring Quality Assurance Project Plan (Dated April 17, 2026), Emma Rott

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Montana Kaimin, April 30, 2026, Students Of The University Of Montana, Missoula

Montana Kaimin, 1898-present

Student newspaper of the University of Montana, Missoula.

Kenyon Collegian - April 30, 2026

The Kenyon Collegian

No abstract provided.

Supporting Parents Of Young Children With Type 1 Diabetes Through Telehealth: Randomized Controlled Trial Of The Reducing Emotional Distress For Childhood Hypoglycemia In Parents Intervention., Susana R. Patton, Nicole Kahhan, Holly O'Donnell, David D. Williams, Mark Clements, Kimberly Driscoll

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Parents of young children with type 1 diabetes (T1D) are vulnerable to experiencing fear of hypoglycemia (FH), an emotional condition that includes persistent and intense worry about hypoglycemia and/or use of unhealthful behaviors to avoid hypoglycemia. Despite greater uptake of continuous glucose monitors (CGMs) and automated insulin delivery systems, FH remains prevalent and under-addressed in parents of young children. As such, we developed Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP), a video-based telehealth intervention designed to reduce FH in parents by providing T1D education and teaching parents how to apply evidence-based strategies from cognitive behavioral therapy and …

Evaluation Of A Wearable Wireless Respiratory Monitoring System (Rms) For Detecting And Predicting Clinical Deterioration, Shreya Kolipaka, Jeffrey I. Joseph, Do

Student Papers, Posters & Projects

Introduction & Objectives

- Mortality within 30 days after major surgery is the third leading cause of death worldwide.¹

- Post-operative adverse events leading to mortality include pneumonia, respiratory failure, sepsis, kidney failure, pulmonary embolism, and major cardiac events.^2,3

- Early warning signs of clinical deterioration are commonly missed due to infrequent clinical assessments, delaying timely diagnosis and intervention.^2,4

- On the general hospital floors, vital signs are monitored every 4 to 8 hours, suggesting patients could be unmonitored 96% of their hospital stay.¹

- Changes in respiratory rate (RR) are the earliest and most sensitive …

Factors Affecting Purchase Intention Toward Second Hand Clothes, Soumaya Mounir Kaakour, Fouad Saad

BAU Journal - Society, Culture and Human Behavior

Although the purchase of second-hand clothing remains a debated research topic, it is widely acknowledged that second-hand clothing (SHC) benefits society by reducing the waste of natural resources and promoting sustainability, however, it is yet to be determined whether the motivation behind buying second-hand clothing is driven by concerns for self, community, and nature.

This research aimed to investigate the impact of the five following factors frugality, perceived environmental knowledge, attitude, environmental concern, and mindful consumption on the purchase intention of second-hand clothing. A quantitative approach was used, and data was gathered online using Google Forms, where 308 responses were …

Global Distribution And Origin Of Manganese Deposits: Insights Into Oman's Role In Production And Economic Significance, Abdulrahman Kayode Shehu, Salah Al-Khirbash, Mohammed Farfour

Sultan Qaboos University Journal For Science

Manganese is a globally significant industrial metal essential for steelmaking, battery technologies, and emerging green-energy applications. As demand increases, understanding the geological diversity, distribution, and economic context of manganese deposits is critical. Manganese deposits occur in a range of tectonic settings and include hydrogenetic, diagenetic, and hydrothermal–exhalative systems associated with ophiolites, mid-ocean ridges, back-arc basins, and sedimentary basins. These genetic types exhibit distinct mineralogical, geochemical, and isotopic signatures that reflect processes such as hydrothermal precipitation, hydrogenetic crust formation, and diagenetic remobilization. These different genetic Mn types have distinct mineralogy, major and trace element compositions, REE geochemistry, and isotopic compositions, reflecting …

Isolation Of Stigmasterol, Α –Amyrin And Lupeol Acetate From The Hexane Extract Of Calatropis Procera Leaves, Saleh N. Al-Busafi, Al-Hawraa Al-Harthi, Azhaar Al-Mufargi, Wid Al-Saadi, Sharif Al-Hashmi

Sultan Qaboos University Journal For Science

In this paper we report the isolation, purification and characterization of three triterpenes, stigmasterol (1), α -amyrin (2), and lupeol acetate (3) from the hexane extract of Calatropis procera leaves. These three natural compounds have been identified before from C. procera and from other plants. The compounds 1, 2 and 3 were isolated from C. procera in the Sultanate of Oman for first time. The structures of the isolated triterpenes were identified by different spectroscopic methods.

Determination Of Antioxidants, Fatty Acids And Mineral Content Of Cherry Tomatoes (Solanum Lycopersicum Var. Cerasiforme) Grown In The Kingdom Of Bahrain, Neda Almubarak, Hawra Abdulhussain, Mona Aljar, Simone Perna, Afnan Freije

Sultan Qaboos University Journal For Science

Cherry tomatoes (Solanum lycopersicum var. cerasiforme) are small, nutrient-rich fruits, with vibrant colors, sweet flavor and health-promoting components. This study aims to investigate the fatty acids, mineral content and antioxidant properties of red, orange, yellow, and purple varieties grown in Bahrain, providing the first biochemical assessment of locally cultivated cherry tomatoes under arid conditions. Fatty acids were extracted, methylated, and analyzed using gas chromatography. The mineral content was assessed through sample digestion followed by inductively coupled plasma-optical emission spectroscopy (ICP-OES) analysis. Antioxidant properties, including total antioxidant capacity (TAC), reducing power (RP), ferric-reducing antioxidant power (FRAP), and 2,2-diphenyl-1-picrylhydrazyl (DPPH), were evaluated …

Enhancing Provider Engagement Through Peer-To-Peer Coaching: The Provider Ambassador Program, Jason Vallee, Jodi Stewart, Sam Verkhovsky, Steve Del Giudice, Janet Aug, Amanda Higgins, James Perry, Alice Kennedy, Brant Oliver

Patient Experience Journal

Provider burnout and disengagement are associated with diminished patient satisfaction, reduced clinical quality, and adverse organizational outcomes. Peer-to-peer coaching has emerged as a promising, scalable intervention to support provider engagement and improve the patient care experience. This study evaluates the effectiveness of the Provider Ambassador Program, a structured peer-to-peer coaching initiative designed to improve patient satisfaction by enhancing provider communication, professional behavior, and patient engagement skills. A pre-post quasi-experimental design was used to assess changes in provider CG-CAHPS ``Provider Overall'' top-box scores following coaching. Eligible providers (n = 83) across five BLANK Health locations were identified based on top-box scores …

A Hybrid Coaching Model In A Multi-Center Networked Care Experience Learning Collaborative, Elizabeth Rizzo, Victoria Adams, James Perry, Nicole Szalay, Samuel Verkhovsky, Megan Morse Holthoff, Alice Mae Kennedy, Brant Oliver

Patient Experience Journal

Coaching teams and leaders conducting quality improvement (QI) has shown to be an effective method for project success. Our coaches were well versed in Lean Six Sigma and IHI Model for Improvement methods. Certified Lean Six Sigma Blackbelts coaches were assigned to project teams. Routine participation in project team meetings and one-on-one coaching sessions reenforced tools necessary to complete improvement work. Additionally, coaches met with one another to discuss their methods, work through challenges, and celebrate successes. Fourteen improvement teams led work in Care Experience related projects. Eleven project leaders certified in Lean Six Sigma methodology through the Value Institute …

Documentation And Dashboard Driven Quality And Safety Improvement In Interpreter Services For Limited English Proficient Patients, Richard T. Dillehay, Samuel Verkhovsky, Andrew Bohm, Harley Friedman, Dawn Welshman, Ann Morong, Vidya Karthikeyan, Jessica Dampier, Amanda Racine, Brant Oliver

Patient Experience Journal

Limited English Proficiency is known as an independent driver of disparities in patient's access to healthcare and their healthcare outcomes. The Joint Commission standards require that health systems document language services delivery to patients with limited English proficiency in a systematic way. Our health system had not historically utilized a methodical system for documenting language services utilization prior to the launch of this initiative. By utilizing a Lean Six Sigma approach, a project team comprised of leaders from interpreter services, operations, data analytics, and data informatics codesigned an Epic SmartForm data collection instrument and series of Tableau dashboards to monitor …

``We'll Be Right With You'', Improving Patient Experience With Complaint Management Within A Learning Health System Collaborative, James J. Perry, Mackenzie Hahn, Angela Kmiec, Brant J. Oliver

Patient Experience Journal

An improvement team at Cheshire Medical-Dartmouth Health participated in the Care Experience Collaborative aimed at enhancing the patient and workforce experience. Utilizing a hybrid Lean Six Sigma DMAIC approach alongside modified Institute for Healthcare Improvement learning techniques, local teams were coached by quality improvement specialists. The project's focus was on improving the complaint management process to boost hospital ratings and recommendations. Initial assessments revealed significant inefficiencies, such as delays in response times and poor tracking of complaint resolutions. Implementing a new digital monitoring system in conjunction with standardized training resulted in substantial improvements: complaint resolution times decreased by 53%, while …

From Talking The Talk To Walking The Walk: Reflection On Dartmouth Health's Care Experience Week, Rosie Bartel, Corey Kimpson, Tanya Lord, Victoria Lyons, Tony Serge, Brant Oliver

Patient Experience Journal

This article explores the participation of expert members from the Beryl Institute's Global Patient and Family Advisory Board (GPFAB) during Dartmouth Health's Care Experience Week, under the theme ``From Talking the Talk to Walking the Walk.'' This week aligns with the national Patient Experience Week. The Patient Family Advisor (PFA) presenters and authors of this article have shared their lived experience locally, nationally, and internationally through conferences, webinars, podcasts, videos, blogs, white papers, journal articles, books, and in many other ways for and as PFA members of a multitude of healthcare organizations co-create change that improves outcomes for all human …

Improving Human Experience In Health Care: Leveraging ``Humanistic Learning Health Systems'' To Accelerate Change At Scale, Brant J. Oliver, Jason A. Wolf

Patient Experience Journal

Included in a special segment in this issue of the Patient Experience Journal, are a series of reports on improving HX in healthcare supported by a humanistic LHS– the Dartmouth Promise Partnership Coproduction Learning Health System in New Hampshire, USA. Promise is a strategic partnership between a medical school and a multi-center rural academic health system. It integrates translational science education and research, data informatics, and scaled and networked humanistic applied change initiatives. One of these initiatives is the Care Experience Collaborative, a multi-center improvement initiative across the health system focused on improving HX. This special segment includes five reports …

Patient Engagement In Developing Radiology Patient Education Materials, T Arleo, Harrisd Harrisd, J Hislop, J Moon, H Li, N Kadom

Patient Experience Journal

Purpose: This initiative aimed to engage patients in the process of developing patient education materials (PEM) on the major imaging modalities at our institution. Materials and Methods: PEM were created for computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), fluoroscopy, and radiography. Content was sourced from various sources, consolidated into a draft, and iteratively updated: They were simplified using a ChatGPT-4.0 prompt designed to achieve a 7th grade reading level; they were reviewed for accuracy by subject matter experts (SME); they were assessed for readability and understandability using the Flesch-Kincaid Grade Level (FKGL) and the Patient Education Materials Assessment …