Digital Commons Network^™

Opioid Use Knowledge And Attitudes Among U.S. Adults, Jadyn E. Knox

Master's Theses

The opioid epidemic remains a public health crisis, with overdose rates continuing to rise. Associations between individuals opioid use and knowledge of and attitudes toward opioid substances and overdoses have been investigated to inform educational interventions. However, many studies utilize college student or adolescent samples, and findings remain inconclusive. An assessment of opioid knowledge and attitudes across broader adult populations is lacking. Concurrently, replication literature in the social sciences is limited, therefore, the present study replicated and expanded upon Williams et al. (2013) and Vyas et al. (2023) studies. Reliability and validity of the Opioid Knowledge scale, Opioid Overdose Knowledge …

Quality Improvement Project: Impact Of Mindfulness-Based Stress Reduction On Nurse Burnout In Skilled Nursing Facilities, Chinenye Okafor

Doctor of Nursing Practice Projects

Burnout is a persistent and critical problem in skilled nursing facilities, contributing to reduced job satisfaction, increased turnover, and compromised quality of care. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of a Mindfulness-Based Stress Reduction program on burnout among registered nurses in a skilled nursing facility. Guided by the Job Demands–Resources framework and Lewin’s Change Theory, a quantitative pretest–posttest design was implemented using the Plan–Do–Study–Act. Ten nurses consented to participate in an eight-week intervention, and four completed both pre- and post-intervention measures. Burnout was measured using the Maslach Burnout Inventory–Human Services …

Nursing Education & Burnout: Secondary Analysis Of Nssrn, Bridget M. Webb, Jennifer Mallow

Creating Healthy Work Environments (CHWE)

Background: Burnout is a risk factor for nurse turnover and intent to leave. Burnout impacts nurse outcomes including incivility, fatigue, and decreased self-esteem, while patient outcomes are adversely impacted as well, including increased mortality, hospitalizations, and emergency department visits. The level of nursing education could impact nursing burnout and turnover.

Purpose: To examine the differences in self-reported burnout and level of education related to nurses:1) leaving their primary nursing position, 2) intent to leave primary position, 3) not working in nursing, and 4) employment change in the National Sample Survey of Registered Nurses (NSSRN).

Methods: The 2018 (pre-pandemic) NSSRN data …

Quality Improvement Project: Improving Pneumococcal Vaccination Rates Through Provider Education In Primary Care, Leikasha Allen

Doctor of Nursing Practice Projects

Pneumococcal disease remains a major cause of illness and mortality among adults aged 65 years and older, leading to severe pneumonia, bacteremia, and meningitis, particularly in vulnerable populations. Although effective vaccines and clear Centers for Disease Control (CDC) and Advisory Committee Immunization Practice (ACIP) guidelines, vaccination in this age group remains inadequate. This Doctor of Nursing Practice (DNP) quality improvement project aimed to determine the impact of pneumococcal vaccination compliance through evaluating provider knowledge, confidence, and adherence to evidence-based guidelines through targeted education. Guided by Rogers’ Diffusion of Innovation Theory and the Health Belief Model, a 20-minute evidence‑based educational session …

Implementation Of A Mentoring Toolkit: A Quality Improvement Project, Joshlyn Neu

Doctor of Nursing Practice Projects

Nursing faculty mentorship is an essential component of professional development, job satisfaction and faculty retention. However, many schools lack a structured approach to preparing their faculty members to act as mentors. This quality improvement project set out to determine whether the implementation of a formal mentoring toolkit would improve nursing faculty members perceived competency to act as mentors. Guided by Bandura’s Social Cognitive Theory (SCT), Lewin’s Change Theory, and the latest evidence-based research, this project sought to answer the following question: In full-time nursing faculty members teaching in a BSN program at a small, private college (P), how does the …

Challenges, Stressors, And Resilience Resources Experienced By Older Black Women In Rural South Carolina Throughout The Covid-19 Pandemic, Arielle N'Diaye, Camryn Garrett, Sarah Wilcox Phd, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Background

Resilience has been established as a protective factor against mental health challenges (e.g., anxiety, depression). From an intersectional perspective, the stressors experienced by Black women living in rural communities are likely to have been exacerbated during the COVID-19 pandemic. This study aims to identify the challenges and stressors experienced and the resilience resources available to and relied upon by rural, Black women, during the pandemic.

Methods

Individual, in-depth, structured interviews (n = 24) were conducted among Black women living in rural South Carolina, recruited by local community health workers, from January to April of 2024. All interviews were recorded, …

Staff Education To Improve Psychiatric Nurses’ Use Of Evidence-Based Strategies For Supporting Medication Adherence In Outpatient Settings, Lilian Ndifon

Walden Dissertations and Doctoral Studies

Psychiatric medication nonadherence remains a persistent barrier to effective outpatient mental health care and contributes to relapse, rehospitalization, and disrupted continuity of care. In outpatient psychiatric settings, nurses are often responsible for patient education and follow-up, yet many lack formal training in evidence-based strategies to support medication adherence. This staff education project was implemented at an outpatient psychiatric facility to address this practice gap. The practice-focused question asked whether a structured staff education intervention would improve outpatient psychiatric nurses’ knowledge of evidence-based medication adherence strategies. Twelve outpatient psychiatric nurses participated in a one-hour educational session focused on motivational interviewing, psychoeducation, …

Strategies To Reduce Prolonged Emergency Department Length Of Stay And Improve Outcomes For Elderly Patients, Shameeka Shonta Mcduffie

Walden Dissertations and Doctoral Studies

Prolonged emergency department (ED) length of stay (LOS) among elderly patients is a complex and escalating challenge that calls for immediate strategic action from healthcare administrators seeking to improve outcomes and system efficiency. The purpose of this integrative review is to identify evidence-based strategies to optimize emergency department quality of care for elderly patients in acute hospital settings by examining systemic, clinical, and operational contributors to extended ED stays. A comprehensive review of literature published between 2021 and 2025 was conducted using systematic search and appraisal methods. Findings from the 12 peer-reviewed studies included in the final analysis were appraised …

Effective Human Resources Strategies For Flexible Parental Leave Applications, Omolola Balogun

Walden Dissertations and Doctoral Studies

A lack of flexibility in the application of human resources (HR) parental leave policy can negatively affect employee capacity and organizational sustainability. HR leadership policymakers are concerned that parental leave policies fail to accommodate individual employee circumstances, limiting effective workforce support and retention. Grounded in the resource-based view theory, the purpose of this qualitative pragmatic inquiry was to identify and explore the effective strategies that HR leadership policymakers use to develop and implement flexible parental leave HR policy applications tailored to individual employee situations, thereby supporting improved employee capacity and the overall success and sustainability of the business. The participants …

Challenges And Supports Of Principals’ Implementation Of Social-Emotional Learning, Nikomar Mosley

Walden Dissertations and Doctoral Studies

School districts throughout the United States are increasingly implementing social and emotional learning (SEL). The problem addressed in this study is that K-12 principals are struggling with the mandated implementation of SEL at Northeastern School District (NSD), a large, diverse urban school district. Guided by the collaborative for academic, social, and emotional learning competency and implementation frameworks, the purpose of this qualitative study was to explore K-12 principals’ experiences with the mandated implementation of SEL at NSD. For this basic qualitative study, semistructured interviews were conducted with 10 principals. Through thematic analysis, the following themes emerged: (a) SEL is not …

Feasibility, Acceptability And Implementation Of A Whole-Family Mental Health Intervention For Displaced Adolescent Girls In Colombia: A Mixed-Methods Pilot Randomized Controlled Trial, Ilana Seff, Arturo Harker Roa, Byron Powell, Natalia Cordoba, Carolina Rodriguez, Julianne Deitch, Elvia Tamaity Ariza Pena, Feven Gebrekidan, Lindsay Stark

2020-Current year OA Pubs

Adolescent girls affected by displacement face substantial mental-health risks. The Sibling Support for Adolescent Girls in Emergencies (SSAGE) is a 12-week, gender-transformative, family-based program designed to improve adolescent girls' mental health in humanitarian settings. This mixed-methods pilot randomized controlled trial (RCT) assessed SSAGE's feasibility, acceptability and potential effects among 186 Venezuelan migrant and Colombian returnee families in Colombia. Adolescent girls aged 13-19 years, their male siblings and caregivers participated in parallel sessions on gender dynamics, communication and relationships. Implementation outcomes drew on the Mental Health Implementation Science Tools (acceptability and feasibility subscales), attendance records and qualitative interviews. Analyses followed an …

Benefit Of Rituximab Maintenance After First-Line Bendamustine-Rituximab In Patients With Mantle Cell Lymphoma, Yucai Wang, Imran A Nizamuddin, Brad S Kahl, Et Al.

2020-Current year OA Pubs

The benefit of rituximab maintenance after first-line (1L) bendamustine-rituximab (BR) in patients with mantle cell lymphoma (MCL) remains uncertain, with inconsistent results from the phase 2 MAINTAIN trial and several retrospective studies. We conducted a large retrospective study at 27 US and Canadian academic centers to examine the benefit of rituximab maintenance after BR. A total of 911 patients received 1L BR between 2010 and 2020, and 703 had an objective response and no evidence of disease progression at the 3-month post-BR landmark. Among those, 394 (56%) received rituximab maintenance and 309 (44%) did not, with largely similar baseline patient …

Hybrid Vision Transformer–Cnn Framework For Alzheimer’S Disease Cell Type Classification: A Comparative Study With Vision–Language Models, Md Easin Hasan, Md Tahmid Hasan Fuad, Omar Sharif, Amy Wagler

School of Mathematical & Statistical Sciences Faculty Publications

Accurate identification of Alzheimer’s disease (AD)-related cellular characteristics from microscopy images is essential for understanding neurodegenerative mechanisms at the cellular level. While most computational approaches focus on macroscopic neuroimaging modalities, cell type classification from microscopy remains relatively underexplored. In this study, we propose a hybrid vision transformer–convolutional neural network (ViT–CNN) framework that integrates DeiT-Small and EfficientNet-B7 to classify three AD-related cell types—astrocytes, cortical neurons, and SH-SY5Y neuroblastoma cells—from phase-contrast microscopy images. We perform a comparative evaluation against conventional CNN architectures (DenseNet, ResNet, InceptionNet, and MobileNet) and prompt-based multimodal vision–language models (GPT-5, GPT-4o, and Gemini 2.5-Flash) using zero-shot, few-shot, and chain-of-thought …

Tendon Transfers After Midfoot Amputations: Limb Salvage, Erin Finn, Steven Smith, Brandon Kunz

Advocate GME

No abstract provided.

Healthy Work Environment: A Positive Change In The Healthcare System, Rajveer Kaur, Jiji Andrews

Creating Healthy Work Environments (CHWE)

It empowered the nurses through structural and psychological infrastructure, paying attention to the detailed work, applying the knowledge from other disciplines to incorporate in the nursing science for evidence-based practice, and utilizing skills in the nursing practice for healthy work environment engagement. Due to the nursing shortage, nursing leaders must understand a healthy workplace for clinical nurses and drive a positive change in the environment by using educational programs. A study was conducted in the hospital on a medical-surgical unit to evaluate the effects of Authentic leadership and actions producing positive patient outcomes. The study results include psychological empowerment, improved …

Green Nanoremediation Of Phytogenic Copper Oxide Nanoparticles For Concurrent Organic Pollutant Degradation In Industrial Wastewaters And Antibacterial Activity, Adel Hussain Talib, Wijdan Hameed Al-Kubaisi, Safaa A. S. Al-Qaysi, Zainab Anwar Ali

Baghdad Science Journal

In the present investigation, culture A. niger was used for the biosynthesis of CuO-NPs using mango (Mangifera indica) leaves aqueous extract. This method of green synthesis is simple, more environment friendly and easy to scaled up. The obtained CuO-NPs were characterized using FT-IR, XRD, TEM, EDX and DLS to evaluate their structure, morphology, elemental composition, and particle size distribution. These findings verify the generation of spherical, crystalline CuO-NPs with an average size of 35.1 nm. The biosynthesized plant-based CuO-NPs showed potential antimicrobial and catalytic, with the higher concentration (till 6.0 mg/mL) having effect better the effect. When used for wastewater …

Nursing Student Perceptions Of Clinical Experiences With Practicing Nurses: A Descriptive Research Study, Carolyn E. Smith, Jenna E. Davis

Creating Healthy Work Environments (CHWE)

Clinical education is an essential part of the nursing curriculum contributing to critical thinking skills and nursing judgment. The students’ experiences within the clinical setting sets a precedence for their future careers and how they interact with their peers and interprofessional team members (Mamaghani et al., 2019). Communication between the bedside nurses and the students is a key factor to student success and confidence at the bedside. The tone, topic, and timing of the conversation between students, nurses, and/or peers, may impact the student view of bedside nursing. Positive interactions and supportive feedback leads to improved patient care, clinical judgment, …

Student’S Experience With Cognitive Rehearsal To Address Incivility, Penny A. Sauer, Margaret M. Verzella

Creating Healthy Work Environments (CHWE)

Nurses need to be able to advocate for their patients, even if they face verbal abuse or incivility. Current literature indicates that 66.2%-95.1% of nurses experience verbal abuse (Dadfar & Lester, 2021) with younger, inexperienced nurses having higher levels of abuse (Zulfan et al., 2022). Nurses who face workplace violence, including verbal abuse, have higher levels of stress, impacting their mental and physical health (Sauer & McCoy, 2017).

A mixed-method study was conducted with undergraduate nursing students to determine their response to a simulation that included difficult communication with a healthcare provider. Students were provided with tools and strategies to …

Theoretical Contributions To A Positive Work Environment, Sharon Prawl

Creating Healthy Work Environments (CHWE)

Objectives: Examination of the success of nurse preceptors is moving toward the need for co-creation between nurse leaders and nurses in the role of nurse preceptors. The current nursing workforce has five generations in the cohort of healthcare workers: Silent Generation, Baby Boomers, Generation X, Millennials (Generation Y), and Generation Z (Bacon, 2023). Each group may have different characteristics and traits; supporting them can be challenging. As noted, the demographics of the workforce have changed. Therefore, Nurse Leaders (NL) must demonstrate inclusive leadership behaviors that result in practice environments where all individuals, diverse in their ages, experiences, and education, …

Organizational Trust And Burnout Among Registered Nurses And Patient Care Aides: A Qualitative Study, Katherine C. Brewer, Andrew Dierkes, Allison A. Norful

Creating Healthy Work Environments (CHWE)

Background: Healthcare worker wellbeing has emerged as a pivotal topic in workforce research. Organizational factors may impact well-being as much as individual and personal factors. One organizational determinant of well-being includes institutional trust; specifically, how the relationship between clinician and employer influences well-being (e.g., burnout). Institutional trust is an important factor in human caring professions, due to the moral and emotional nature of the work and the expectation for safety and provision among clinicians by employers. Existing clinician well-being research rarely studies institutional trust among registered nurses (RNs) and patient care aides (PCAs), despite their important frontline role in patient …

The Path Forward For T Cell Engagers In Patients With Prostate Cancer, Sumit K. Subudhi, Bilal A. Siddiqui, Kevin K. Zarrabi, William K. Kelly, Charles G. Drake

Department of Medical Oncology Faculty Papers

T cell engagers (TCEs) recruit T cells to the tumor microenvironment (TME) to induce antitumor immune responses. TCEs have demonstrated promising clinical responses in patients with metastatic castration-resistant prostate cancer and have advanced into phase 3 clinical trials. Here we provide an overview of the mechanisms of action of TCEs, including both CD3-targeted and CD28-targeted agents, and review the clinical development of these agents for prostate cancer. We propose a path forward for TCEs in prostate cancer, in which innovative clinical trials will facilitate a biological understanding of mechanisms of efficacy and toxicity to inform: (1) development of predictive biomarkers …

Musculoskeletal Infection Reporting And Data System (Mski-Rads): Reviewed And Explained, Angela He, Flavio Duarte Silva, Mina Guirguis, Erin F. Alaia, William B Morrison, Avneesh Chhabra

Department of Radiology Faculty Papers

A standardized guideline and scoring system are recommended for the imaging evaluation of musculoskeletal infections on MR imaging. The Musculoskeletal Infection Reporting and Data System (MSKI-RADS) is a recently developed and validated classification system using MR imaging that can be used to classify the severity and extent of musculoskeletal infections, improve radiology-pathology concordance, and outline the corresponding management recommendations. This review article explains MSKI-RADS and discusses the different elements of this system in detail with a review of pertinent literature so that the readers can apply it in their practices. The work outlines the technical considerations for optimal MR imaging …

Cle Program: Putting People At The Center Of Representation 2-24-2026, Roger Williams University School Of Law

School of Law Conferences, Lectures & Events

No abstract provided.

Concordance Analysis Of Dna And Rna Profiling: The Md Anderson Impact2 Study In Precision Oncology, Stephanie T Schmidt, Mehmet A Baysal, Siqing Fu, David S Hong, Sarina A Piha-Paul, Aung Naing, Jordi Rodon Ahnert, Timothy A Yap, Ecaterina Elena Dumbrava, Jennifer Beck, Funda Meric-Bernstam, Apostolia Maria Tsimberidou

Faculty, Staff and Student Publications

DNA profiling is an established method for cancer treatment selection, while RNA profiling remains investigational. We explored associations between DNA and RNA alterations and between the number of genes with altered expression and overall survival (OS) using patient data from IMPACT2 (NCT02152254), a randomized study evaluating molecular profiling for guiding cancer therapy across tumor types. Molecular profiling, including DNA next-generation sequencing, was performed on all 829 patients in the IMPACT2 study. RNA profiling was performed by Tempus for 253 of 829 patients. We evaluated the concordance between DNA and RNA profiling, analyzed OS in 217 treated patients with …

Inferential Study Using Neutrosophic Imputation Techniques In Two-Phase Sampling, Alia A. Alkhathami, Salemah A. Almutlak, Showkat Ahmad Lone, Vinay Kumar Yadav

Neutrosophic Sets and Systems

No abstract provided.

A Neutrosophic Soft Set-Based Approach For Anemia Diagnosis: Managing Uncertainty In Medical Decision-Making, Ümit Karabıyık, Metin Bağcı

Neutrosophic Sets and Systems

No abstract provided.

Risk Stratification Of Low-Dose Cytarabine And Venetoclax In Patients With Aml Ineligible For Intensive Chemotherapy, Andrew H Wei, Panayiotis Panayiotidis, Pau Montesinos, Kamel Laribi, Vladimir Ivanov, Inho Kim, Jan Novak, Rebecca Champion, Walter Fiedler, Maria Pagoni, Julie Bergeron, Stephen B Ting, Jing-Zhou Hou, Takahiro Yamauchi, Jianxiang Wang, Stephen A Strickland, Michael R Savona, Tara L Lin, Anoop Enjeti, Ing Soo Tiong, Sangmin Lee, Gail J Roboz, Relja Popovic, Qi Jiang, Zihuan Liu, Yan Sun, Wellington Mendes, Brenda Chyla, Courtney D Dinardo

Faculty, Staff and Student Publications

Prognostic risk categorization aids treatment selection for patients with acute myeloid leukemia (AML). Although the European LeukemiaNet (ELN) classifications (2017 and 2022) for AML have been used to stratify outcomes for patients receiving intensive chemotherapy, their application to patients receiving less intensive therapy, such as azacitidine plus venetoclax, has been less satisfactory. In response, a 4-gene classifier that stratifies older patients with AML unfit for intensive chemotherapy into those with higher benefit (wild type), intermediate benefit (FLT3-internal tandem duplication [ITD] or NRAS/KRAS mutation), or lower benefit (TP53 mutation) after azacitidine plus venetoclax treatment was developed. We hypothesized that this 4-gene …

Winner's Curse Free Robust Mendelian Randomization With Summary Data, Zhongming Xie, Wanheng Zhang, Jingshen Wang, Chong Wu

Faculty, Staff and Student Publications

In the past decade, the increased availability of genome-wide association studies summary data has popularized Mendelian Randomization (MR) for conducting causal inference. MR analyses, incorporating genetic variants as instrumental variables, are known for their robustness against reverse causation bias and unmeasured confounders. Nevertheless, classical MR analyses using summary data may still produce biased causal effect estimates due to the winner’s curse and pleiotropy issues. To address these two issues and establish valid causal conclusions, we propose a unified robust Mendelian Randomization framework with summary data, which systematically removes the winner’s curse and screens out invalid genetic instruments with pleiotropic effects. …

Safety And Feasibility During Early Implementation Of Robotic-Assisted Percutaneous Coronary Intervention, Dung Thuong Ho, Manh Cuong Nguyen, Tran Tran Nguyen, Long Tran, Huy Nguyen, Dil Mai, Tuong Mien Ngo, Duc Chinh Nguyen, Chi Cuong Tran, Khiem D. Ngo

School of Medicine Publications

Background: Robotic-assisted Percutaneous Coronary Intervention (R-PCI) is an advanced technique offering potential advantages for both patients and interventional cardiology practices. In 2023, Can Tho S.I.S General Hospital implemented its first robotic system for PCI procedures. This study aimed to evaluate the safety and clinical outcomes during the early learning curve of R-PCI.

Methods: This prospective study included all patients undergoing R-PCI with the CorPath GRX Vascular Robotic System at Can Tho S.I.S General Hospital from April to September 2023. Baseline patient characteristics, procedural details, and six-month follow-up data were collected. Primary outcomes included Clinical Success, defined as < 30% residual diameter stenosis in the target vessel without major adverse cardiovascular events (MACE) during hospitalization (e.g., death, myocardial infarction, target-vessel revascularization, stroke), and robotic success, defined as achieving clinical success with partial manual support or no manual support.

Results: Thirty-one patients …

Correlation Between Prevalence Of Some Colibactin Genes, Biofilm Formation, And Antimicrobial Resistance In Uropathogenic E. Coli In Iraq, Rukiya Saad Jassam, Husam Sabah Auhim

Baghdad Science Journal

Colibactin is a genotoxin produced by Enterobacteriaceae via a polyketide synthase (pks) island cluster. There is less knowledge regarding the distribution of colibactin genes in E. coli isolates in Iraq and its correlation with biofilm and antibiotic susceptibility. Therefore, this study aimed to investigate the frequency of some colibactin genes (CIbA and CIbQ) in uropathogenic E. coli in Iraq and evaluate the correlation with biofilm and antimicrobial resistance. Between October 2023 and January 2024, 70 E. coli isolates were isolated from 120 females diagnosed with UTIs. Isolates were identified first by biochemical methods and confirmed molecularly by amplification …