Digital Commons Network^™

When Systems Fail: The Impact Of Protocol On Physician Moral Distress, Aya Dudar

Clinical Research in Practice: The Journal of Team Hippocrates

Physicians often face the decision between following rigid hospital protocol and doing the right thing for the patient, creating moral distress and contributing to burnout. This letter describes a case in which an elderly patient with COVID-19 pneumonia and a DNI order developed worsening hypercapnia and required noninvasive ventilation. Despite clinical appropriateness, hospital policy prohibited BiPAP use in obtunded patients due to aspiration risk - even when the resident offered continuous bedside monitoring. This case highlights the ethical tension that arises when rigid hospital policies prevent physicians from making real-time exceptions in appropriate situations. Empowering physicians to make context-driven decisions …

Tadalafil Monotherapy Is A Reasonable Alternative For The Treatment Of Lower Urinary Tract Symptoms In Patients With Comorbid Benign Prostatic Hyperplasia And Erectile Dysfunction, Daniel M. Ibrahim, Anam Ahmed, Swetha Reddy, Meet S. Patel, Nabeel Sumbal, Adam Chaban, Aminah I. Fayyaz

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomized, parallel, placebo-controlled clinical trial. Eur Urol. 2012;61(5):917-925. https://doi.org/10.1016/j.eururo.2012.01.0131

for a vigorous 75-year-old man with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) who discontinued dutasteride due to intolerable sexual side effects.

Tetramethylbenzidine Loaded Pva Nanofibers Strip For Visual Detection Of Hydrogen Peroxide Via Cu2+ Catalysis And Its Applications, Samar A. Salim

Nanotechnology Research Centre

Background Advancements in sensor technology have facilitated the development of cost-effective and highly sensitive sensors which have significantly improved the detection of biological analytes in various fields. This study presents a novel approach for the detection of hydrogen peroxide (H₂O₂), a critical analyte in both biological and environmental systems. A simple and sensitive colorimetric sensing platform was developed based on polyvinyl alcohol (PVA) nanofibers loaded with tetramethylbenzidine (TMB). Results The nanofibers were characterized using scanning electron microscopy, confirming the formation of smooth, spindle-shaped fibers with diameters from 324 to 551 nm. The colorimetric detection method utilized TMB, which undergoes oxidation …

Staff Education For Hypertension Diagnosis, Management, And Treatment, Philomena Ifeyinwa Chinemelu

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is a significant public health concern, and educating nursing staff is crucial to improving patient outcomes and supporting public health initiatives. This staff education project focused on improving the quality of hypertension management by empowering nurses to provide evidence-based, patient-centered care. The practice-focused question is as follows: Will HTN education improve staff knowledge of HTN diagnosis, treatment, and management? I employed a quantitative pre-test/post-test design to measure changes in staff (n = 10) knowledge before and after training. Descriptive statistics measure knowledge gain and the effectiveness of educational strategies. The pre-test percentage of correct answers improved from 79% …

Staff Education To Reduce Compassion Fatigue In Acute Care Staff Nurses, Kamala C. Mcgee

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF), burnout, and moral distress are common in high-acuity nursing environments, yet nurses are rarely taught how to recognize or manage these challenges. The guiding question for this staff education project was about whether education focused on CF and mindfulness-based coping strategies would improve nurses’ knowledge and attitudes in an acute care VA medical center. Posteducation results (n = 20) showed meaningful, statistically significant improvements. Familiarity with CF increased from baseline (M = 2.35; SD = 1.04) to post implementation (M = 3.75; SD = .91), t(19) = −5.085, p < .001. Confidence in recognizing CF in oneself improved from baseline (M = 2.6; SD = .875) to post implementation (M = 3.60; SD = .821), p = .004. Confidence in recognizing CF in colleagues increased from baseline (M = 2.40; SD = .821) to postimplementation (M = 3.15; SD = .671), p = .012. Agreement that seeking help is a sign of weakness decreased from baseline (M = 2.00; SD = .503) to postimplementation (M = 1.40; SD = .951), p = .024. Although perceptions of organizational support did not change, nurses reported greater use of mindfulness, peer support, and boundary setting, supporting nurse wellbeing and psychological safety. Several recommendations emerge from this project. CF education should be integrated into routine staff development, annual competencies, and onboarding for new nurses. By reducing stigma around seeking help and promoting peer awareness, this work supports fostering a workplace culture where all nurses feel safe, supported, and valued, a positive social change.

Effective Mentoring Strategies For Career Advancement For Mid- And Senior-Level Scientific Professionals In The Biotechnology Industry, Rachel Ayekor Hanson

Walden Dissertations and Doctoral Studies

Leaders of biotechnology organizations struggle to retain and promote experienced scientific professionals, thereby weakening innovation and long-term competitiveness. Biotechnology leaders are concerned about the successful development and retention of mid- and senior-level professionals as they move from technical to leadership roles to improve innovation and long-term competitiveness. Grounded in Kram’s mentoring theory and Ragins’s diversity and inclusion framework, the purpose of this qualitative pragmatic inquiry was to identify and explore mentoring strategies effectively implemented for biotech organization leaders, tailored to mid- and senior-level scientific professionals, to promote career progression and contribute to organizational performance. The participants were six biotechnology leaders …

Raising The Standard In Transition To Practice With Interprofessional Collaboration In A Healthy Work Environment, Grace Sekayan, Ghada Dunbar

Creating Healthy Work Environments (CHWE)

The success of the Perinatal Transition to Practice (TTP) Program across a multi-site integrated health system is built on the pillars of The Standards of Healthy Work Environments, American Nurses Credentialling Center (ANCC) Practice Transition Accreditation Program (PTAP)² domains, and Interprofessional Education Collaborative ⁴ (IPEC). This glimpse of the Perinatal TTP Program will provide insight on three of the six American Association of Critical-Care Nurses essential standards¹ that support communication, professional development, and the essence of nursing excellence. To support the transition of experienced nurse from novice to expert⁷ in a new specialty setting Skilled Communication, True …

Even In That Silence: Ignatian Retreats In The Transformation Of Teacher Spiritual Identity, Nancy Lourdes U. Toledo

eJournal of Catholic Education in Australasia

A teacher continues to navigate and develop one’s personal and professional identity as one interacts with one’s students, peers, mentors, and school. Schools with religious affiliation add another layer of complexity to this interaction as their education paradigm focuses not just on a teacher’s professional identity but one’s spiritual identity as well. Through an in-depth interview of four in-service teachers in a Jesuit school in the Philippines, this study aimed to discover how Ignatian retreats can effect transformation in teacher spiritual identity. The study employed the phenomenological analysis in educational qualitative research. The data were analysed using Castleberry and Nolan’s …

Gli Weekly, February 24, 2026, Franke Global Leadership Initiative

GLI Weekly

Advising Information -- Beyond the Classroom Experience Planning -- We're recruiting a VISTA for the Franke GLI -- Graduating Senior Corner -- Flathead Biological Station Summer '26 Courses: Application Now Open! -- Food and Agriculture Organization Internship Program -- Eating with Understanding -- Bee Positive Missoula -- Rooted: Connect with Nature -- Soft Landing Volunteer Opportunity -- SpectrUM Cultural Ambassador -- VolunteerUM -- BASL Night with the BSU & Signing Grizz -- SARC, "What Were You Wearing?" -- Bear Necessities, Is it your first time on Earth? Us, too! -- UM Choral Program: Stronger Together -- Vista opportunities, including with …

Microbiome-Responsive Hydrogels: From Biological Cues To Smart Biomaterials, Rajesh Vadlapatla, Amir Nasrolahi Shirazi, Ajoy Koomer, Judy Weng, Matthew Ernest Ghilarducci, Alai Qudus, Keykavous Parang

Pharmacy Faculty Articles and Research

Background: Stimuli-responsive hydrogels (SRHs) are smart polymeric materials that undergo reversible physicochemical changes in response to abiotic cues and externally applied fields, enabling applications in drug delivery, wound healing, and tissue engineering. However, they exhibit limited biological specificity and do not adequately reflect the dynamic, disease-relevant complexity of native tissue microenvironments. Microbe-colonized tissues display distinctive biochemical features driven, shaped by microbial metabolism, including localized pH gradients, short-chain fatty acid production, secretion of quorum-sensing molecules, biofilm formation, and expression of specialized enzymes. These endogenous, spatiotemporally regulated signals are closely linked to host physiology and pathology but remain underutilized in hydrogel …

Pd-L1 Is An Intrinsic Switch For Natural Killer Cell-Mediated, Trail-Dependent Antiviral Function., Kayla Frank, Himani Sharma, Efthymios Motakis, Nooshin Nourbakhsh, Shawn Abeynaike, Tridu R Huynh, Cheryl A Jones, Scott K Johnson, S Mark Tompkins, Silke Paust

Faculty Research 2026

Each year, influenza A virus (IAV) infection of the lung causes half a million deaths worldwide. Patients with compromised immunity experience distinct influenza pathogenesis; however, most IAV-related research is done with wild-type mice or people who are otherwise healthy. We utilize a model of immunocompromised recombination-activating gene 1 (Rag1)-knockout (KO) mice to discover natural killer (NK) cell activation and regulation mechanisms during IAV infection. The treatment of IAV-challenged Rag1-KO mice with a monoclonal antibody (mAb) targeting programmed death ligand 1 (PD-L1) triggers NK cell-intrinsic signaling of PD-L1 and significantly delays lethality. This treatment upregulates tumor necrosis factor-related apoptosis-inducing ligand on …

Evidentiary Standards For Newly Approved Antibiotics For Uncomplicated Urinary Tract Infections, Rosa Rodriguez-Monguio, Enrique Seoane-Vazquez, John H. Powers Iii

Pharmacy Faculty Articles and Research

Importance: Uncomplicated urinary tract infections (uUTIs) are among the most common bacterial infections and are typically treated with existing oral antibiotics. In 2024–2025, the FDA approved two new oral agents, sulopenem etzadroxil/probenecid and gepotidacin, via expedited review pathways, for the treatment of uUTIs. Objective: To assess the clinical significance and regulatory evidence supporting FDA approval of sulopenem/probenecid and gepotidacin for uUTI, and to analyze the adherence of pivotal phase III trials to regulatory standards for approval and FDA guidelines. Design, Setting, and Participants: Comparative descriptive analysis of publicly available data from phase 3 randomized, double-blind, active-controlled clinical …

The Impact Of Simulation-Based Education On Novice Nurses’ Knowledge Of Pressure Injury Prevention, Michelle "Mikki" Cantu

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries remain a significant patient safety concern in acute care settings despite the availability of evidence-based prevention guidelines. Novice nurses, who often have limited clinical experience and exposure to wound care education, may be less prepared to consistently identify risk factors, accurately stage pressure injuries, and implement appropriate preventive strategies. Simulation-based education offers an experiential learning approach that supports the translation of evidence-based knowledge into clinical practice. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the effectiveness of simulation-based education in improving novice nurses’ knowledge of pressure injury identification and prevention. The …

Quality Improvement Project: Enhancing Self-Efficacy Through Inacsl Standards Training, Amy Bortner

Doctor of Nursing Practice Projects

Simulation-based education (SBE) is a widely used instructional strategy in nursing curricula; however, formal training for faculty and staff who implement it may be inconsistent or limited. Current literature supports the need for structured, evidence-based training to ensure effective use of simulation-based education and promote best practices in teaching and learning. The Doctor of Nursing Practice (DNP) project aims to improve perceptions and self-efficacy regarding the use of the International Nursing Association of Clinical Simulation and Learning (INACSL) standards, which guide simulation education. Driven by Kurt Lewin’s change theory and Jeffries Simulation Theory, twelve volunteers completed the Faculty Attitude and …

Zinc Imbalance And Its Effect On Nutritional Status, Behavior, Gut Microbiota, And Inflammatory Biomarkers In Btbr T+Itpr3tf/J And C57bl/6j Mice: Insights Into Autism Spectrum Disorder, Asma Nasrullah Ahmadani

Thesis/ Dissertation Defenses

Background: Autism spectrum disorder (ASD) has been associated with altered zinc homeostasis and disruptions in the gut microbiota. Zinc is a vital trace mineral involved in multiple biological processes such as inflammatory regulation, intestinal integrity, and neurobehavioral function, and has an important role in influencing microbial activity along the gut–brain axis. Both deficiency and excess of zinc can alter microbial balance. However, their collective effects on behavior, overall physiology, and mineral status in ASD-relevant models are not yet fully understood.

Aim: This comprehensive study explored the effect of dietary zinc variation on body weight, food intake, behavior, gut microbiota composition, …

Optimizing Gamma Radiation Shielding Of Low Bismuth Borate Glass Via Antimony Addition: Optical And Physical Insights, Shaimaa Hafez, Elsayed Salama, Wesam Omar

Basic Science Engineering

This study reports the fabrication and characterization of novel bismuth borate-based glass systems doped with varying concentrations of antimony oxide (Sb₂O₃) for gamma radiation shielding applications. Using the melt-quenching method, the glass systems [0] with x = 0, 1, 3, and 5 mol% were prepared. Density measurements, X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and UV–Vis–NIR spectroscopy were employed to analyze the structural, physical, and optical properties systematically. The results show that increasing Sb₂O₃ content raises the glass density, refractive index, and oxygen packing density, while reducing the molar volume and optical band gap. These changes contribute to forming a …

February 24, 2026 Ereporter, University Of Alabama At Birmingham

eReporter (campus newsletter)

No abstract provided.

[Excerpt From] Taking Action: Top 10 Priorities For Nurses To Protect Health In A Changing Climate, Susan B. Hassmiller

Sigma Publications: Book Excerpts

Taking Action: Top 10 Priorities for Nurses to Protect Health in a Changing Climate offers nurses a clear, evidence-based road map for responding to one of the most significant public health challenges of our time. Written as a practical and nonpolitical guide, the book translates the latest science into actionable strategies, helping nurses understand and address the ways climate-driven events affect the health of the public. Authors Sue Hassmiller and Katie Huffling—together with distinguished experts across nursing and environmental health—provide concrete recommendations for strengthening climate resilience, implementing effective clinical and community interventions, advancing sustainability within healthcare systems, and advocating for …

Liposclerosing Myxofibrous Tumor Of The Foot: A Case Report, Mohammad Junayed Khan, Sufiyan Mannan Ahmed, Asad Mustafa, Sairah Asghar, Mohammad Tanjim Hossain

School of Podiatric Medicine - Student Research

Statement of Purpose: This case presents a rare sclerosing-type atypical lipomatous tumor with myxomatous features—the first and only known reported case of an ALT in the foot—along with its pathology, treatment, and management.

Case Study: Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) represents the most common liposarcoma subtype, with recurrence and dedifferentiation risk influenced by tumor location. Retroperitoneal tumors recur frequently, while those in the lower extremity rarely do. Liposarcoma of the foot is exceedingly rare.

A 61-year-old male presented with a slowly enlarging, mildly tender lump on the right plantar heel. Radiographs demonstrated a 3 cm oval soft-tissue thickening without calcification. …

Evaluating Factors Associated With Increased Citations Of Publications In The Journal Of Foot And Ankle Surgery, Asad Mustafa, Sarah Weisbrodt, Demian Rodriguez, Naohiro Shibuya

School of Podiatric Medicine - Student Research

Introduction: As the field of foot and ankle surgery advances, it is valuable to identify qualities of research publications that get more attention. Evaluating the factors that contribute to the traction would also help emerging authors identify areas of focus to improve visibility of their work in the profession. Our study aims to evaluate the relationship between the number of citations by articles published in the Journal of Foot and Ankle Surgery (JFAS) and the level of clinical evidence (LOE), article access level, the type of publication, the authors’ institution, and the country of submission.

Methods: We used Scopus to …

Child Development Accounts Reduce Adolescent Behavior Problems, Jin Huang, Yingying Zeng, Michael Sherraden

Center for Social Development Research

Adolescence can be a challenging time, and a body of research has investigated options for addressing adolescent behavior problems. This brief presents findings from a new line of inquiry. The analyses presented here draw upon data from the SEED for Oklahoma Kids experiment, a test of a statewide Child Development Account (CDA) policy in Oklahoma. The findings indicate that CDAs positively shape the frequency of adolescent behavior problems.

Multiplanar First-Ray Deformity And Its Impact On Tibial Sesamoid Assessment: A Radiographic Analysis​, Yasim Zafar, Madelaine Adkins, Jessica Sima

School of Podiatric Medicine - Student Research

This study evaluated whether discrepancies in tibial sesamoid position (TSP) between anteroposterior (AP) and sesamoid axial radiographs are associated with first-ray deformity parameters: first metatarsal rotation angle (MRA), sesamoid rotation angle (SRA), intermetatarsal angle (IMA), and hallux valgus angle (HVA). We hypothesized that increased frontal-plane external rotation of the first metatarsal would be the primary contributor to AP–axial TSP mismatch.

This secondary analysis used deidentified radiographs from Shibuya et al. (J Foot Ankle Surg. 2019). Adults aged 18–80 with measurable TSP on both AP and axial views were included; patients with prior foot trauma or osseous surgery were excluded. Only …

Midfoot Reconstruction For Avascular Necrosis Of The Navicular Bone​, Jessica Sima, Srilalitha Lanka, Merlin Sajeev, Shannon Rush, Graham Hamilton

School of Podiatric Medicine - Student Research

Background: Avascular necrosis (AVN) of the tarsal navicular, particularly with collapse, presents a complex surgical challenge due to compromised vascularity and the need to restore medial column length. This retrospective case series evaluates three distinct surgical approaches to midfoot reconstruction in patients with navicular AVN.

Methods: Three patients with navicular AVN were treated using individualized grafting strategies. Etiologies included chronic protease inhibitor use for HIV, Müller-Weiss syndrome, and post-resection of a giant cell tumor. All procedures utilized a medial utility incision with debridement to viable bleeding bone. Two cases were reconstructed using a combination of proximal tibial autograft, patellar allograft, …

Retrospective Narrative Analysis Of Perceived Manifestations Of Burnout Among Emergency Physicians Amid Covid-19 Pandemic, Nicole Jauregui

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic has placed stress on healthcare systems globally, with emergency department (ED) physicians experiencing an acute impact due to their frontline role. Burnout, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, has been widely reported by healthcare providers during the pandemic. However, the specific manifestations of burnout among ED physicians remain underexplored, particularly from their own perspectives. This study is grounded in Maslach’s Multidimensional Theory of Burnout and Alan Card’s theory of Avoidable versus Unavoidable Suffering, providing a framework to interpret ED physicians’ experiences and distinguish between the inherent challenges of frontline work and …

Using Fire Investigators' Narratives To Explore Serial Firesetting Behaviors, Alisha Jones-Creel

Walden Dissertations and Doctoral Studies

This qualitative narrative inquiry examined how fire investigators share tacit knowledge related to threat assessment and risk management in cases of serial firesetting. Data were derived from eight semi-structured interviews with fire investigators from Louisiana, Mississippi, and Texas who had investigated firesetting incidents within the past five years. Narrative analysis was used to identify cross-case patterns in how investigators recognize offender characteristics, assess contextual risk factors, and detect early warning signs across incidents. Analysis identified three themes addressing how lived experience informs peer understanding of offender behavior, risk indicators, and warning signs, and three themes addressing how narrative experience guides …

Understanding The Lived Experiences Of Black Males Successfully Reintegrating Post Incarceration, Ashley Smith

Walden Dissertations and Doctoral Studies

Black males remain incarcerated at higher rates than any other race. Those individuals trying to reintegrate into society face many challenges with little mental and emotional rehabilitation support. The purpose of this hermeneutic phenomenology study was to improve the understanding of what contributes to successful reintegration and the mental health and emotional needs of formerly incarcerated Black males. Critical race theory (CRT) was used as a secondary lens to examine how race, systemic racism, and structural inequities shaped participants' experiences. This study examined the following research question: What are the experiences of Black males who were previously incarcerated and have …

Strategies For Reducing Fraud In Corporate Organizations, Tarshall Horton Mccauley

Walden Dissertations and Doctoral Studies

Financial statement fraud has been a persistent problem that poses risks to corporations globally. Business leaders are concerned about financial statement fraud due to its potential to weaken financial stability, erode stakeholder confidence, and create conditions that may lead to significant financial distress or organizational collapse. Grounded in the fraud triangle theory, the purpose of this qualitative pragmatic inquiry research was to explore internal control strategies corporate leaders use to reduce financial statement fraud risk. The participants were 11 financial leaders in North Carolina, the District of Columbia, and Virginia who practiced effective internal controls to minimize financial fraud. Data …

A Nurse-Led Clinical Practice Guideline To Improve Medication Adherence Among Psychiatric Home-Health Patients, Amber Murillo - Alonzo

Walden Dissertations and Doctoral Studies

Medication nonadherence among psychiatric patients receiving home-health services contributes to symptom relapse, preventable hospitalizations, and decreased quality of life. Inconsistent medication education and adherence monitoring within home-health settings may further exacerbate this problem. The purpose of this Doctor of Nursing Practice project was to develop and evaluate a nurse-led clinical practice guideline (CPG) designed to improve medication adherence among psychiatric home-health patients. The practice-focused question asked: What evidence, based on content expert review using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, supports the quality and usability of a CPG to improve medication adherence in a …

Algorithmic Opacity In Opioid Risk Scoring And The Need For Transparent Ai Regulation, Sherry Yun Wang, Ryan Stofer, Zhouzhou Chu, Xiao Huang, Ang Li

Pharmacy Faculty Articles and Research

NarxCare®, a proprietary opioid risk scoring system embedded in Prescription Drug Monitoring Programs (PDMPs), has generated significant patient complaints. We adhered to the technical specifications and applied them to PDMP and IQVIA PharMetrics® Plus Closed Health Plan claims database. Despite adding socioeconomic covariates, precision (0.01–0.32) was far below the reported benchmark of 0.75, and F1 scores (0.02–0.39) were also substantially lower than the benchmark value of 0.65, across all our reconstructed models.

The Effect Of St. John’S Wort Solution On Climbing Activity Reflecting Depressive-Like Behavior In Drosophila Melanogaster To Model Seasonal Depression In Low Sunlight Exposure, Madison Simon

Journal of the South Carolina Academy of Science

Although depression is a known substantial threat to public health, seasonal affective disorder (SAD) is under-researched. SAD refers to recurrent seasonal patterns of depression. This depressive disorder has few accepted treatments. The purpose of this study was to test whether St. John’s Wort (SJW), a natural supplement with researched antidepressant properties, could be a cheaper alternative with fewer limitations for treating SAD. SJW’s efficacy as a seasonal depression inhibitor was tested through a Drosophila depression-like model using climbing activity to reflect depressive behavior. It was hypothesized that as the concentration of SJW solution increases, the climbing activity of stressed Drosophila …