Digital Commons Network^™

Quality Improvement Project: The Impact Of Hypertension Management Education In Primary Care, Toyin K. Aliu

Doctor of Nursing Practice Projects

Hypertension (HTN) is one of the leading causes of clinic visits and prescription medication use in primary care settings. Despite the availability of evidence-based guidelines to improve HTN management, adherence in clinical practice is often lacking. At the project site, 30% of patients have uncontrolled HTN. This is attributed to providers’ inadequate knowledge of the JNC-8 HTN management guidelines and inconsistent adherence to them. This project aimed to improve hypertension management in a primary care setting by educating providers on the JNC-8 guidelines to enhance adherence to evidence-based practices over six weeks. The purpose was to align medical providers with …

Improving Benzodiazepine Refill Workflow And Communication Via Telehealth Using A Standardized Sbar Protocol, Hendricks Agwu

Doctor of Nursing Practice Projects

The development in telehealth operations in outpatient mental health care has enhanced access to care at the expense of creating challenges in communication and workflow, especially when it comes to dealing with high-risk substances like benzodiazepines. The role ambiguity, inaccurate refill timeline, documentation lapses and high chances of medication errors are caused by inconsistent communication during the process of telehealth refills. This quality improvement project was aimed at assessing the effects of applying a standardized Situation, Background, Assessment, Recommendation (SBAR) communication and documentation protocol to workflow efficiency, interprofessional communication, and medication safety when making benzodiazepine refills in a telehealth outpatient …

The Rider (2026-02-16), Daniela Chapa-Reyes

The Rider Archives

Vol. 11, No. 19

Disproportionality Of Multilingual Learners In Special Education: A Mixed Methods Study Exploring The Relationship Between Teacher Self-Efficacy And Sheltered Instruction, Jessica Braynor

Theses and Dissertations

Abstract Jessica Braynor DISPROPORTIONALITY OF MULTILINGUAL LEARNERS IN SPECIAL EDUCATION: A MIXED METHODS STUDY EXPLORING THE RELATIONSHIP BETWEEN TEACHER SELF-EFFICACY AND SHELTERED INSTRUCTION 2025-2026 Hajime Mitani, Ph.D. Doctor of Education in Educational Leadership This study addressed the issue of disproportionality of multilingual learners (MLs) in Special Education. Using mixed-methods explanatory sequential design, the study examined the relationship between sheltered instruction implementation, domain-specific self-efficacy (pedagogical-content, linguistic, and sociocultural), and referrals of MLs to Intervention & Referral Services (I&RS) and Special Services. Quantitative data were collected from general education teachers using measures of Sheltered Instruction Observation Protocol (SIOP) implementation and self-efficacy, along …

Non-Canonical Role Of Dna Mismatch Repair On Sensory Processing In Mice, Sadia N Rahman, Demetrios Neophytou, Siboney Oviedo-Gray, Bao Q Vuong, Hysell V Oviedo

2020-Current year OA Pubs

DNA repair mechanisms are essential for cellular development and function. In post-mitotic neurons, deficiencies in DNA damage response proteins can lead to severe neurodegenerative and neurodevelopmental disorders. One highly conserved factor involved in DNA repair is MutS Homolog 2 (Msh2), which is responsible for correcting base-base mismatches and insertion/deletion loops during cell proliferation. However, its role in mature neurons remains poorly understood. This study investigates the impact of Msh2 loss on sensory processing in mice. Using electrophysiological and molecular assays, we identifiedsignificant deficits in cortical and thalamic sound processing in Msh2

Social Prescribing For Refugee Populations: A Protocol For A Rapid Realist Review Of International Evidence, Victoria Touzel, Anna-Lena Esser, Kerryn Husk, Doreen Reifegerste

Peninsula Medical School

BackgroundSocial prescribing addresses complex individual health and social needs through person-centered referral from healthcare into community settings, supporting wellbeing and integrated care. While evidence for majority populations continues to expand, no review has yet synthesized evidence specifically for refugee populations, despite this group facing profound social and systemic barriers. As such, this protocol defines the research objectives for a rapid realist review that will identify what approaches to social interventions work for refugee populations, for whom they are effective, and under which circumstances.MethodsA rapid realist review will be conducted to identify relevant evidence from both social prescribing interventions and social …

Electrocatalytic Degradation Of Methylene Blue Using Rgo, Sb2o3, And Rgo-Sb2o3 Composite Ink-Based Electrodes, Maria Irene Myers Armas, Andrea M. Fletes, Thomas Eubanks, Arnulfo Mar, Jason Parsons, Helia Magali Morales

School of Integrative Biological & Chemical Sciences Faculty Publications

Water pollution from industrial dyes is a critical challenge due to the resistance of these types of compounds to degradation and potentially harmful effects on living organisms and human health. In this study, the electrochemical degradation of methylene blue (MB) was investigated using ink-based copper foam electrodes with reduced graphene oxide (rGO), antimony trioxide (Sb2O3), and rGO/Sb2O3 composites. The materials used to synthesize the electrodes were characterized by X-ray diffraction (XRD), which showed the successful synthesis of GO, rGO, and the Sb2O3-rGO composite. Additionally, the synthesized electrodes were examined using SEM. The MB degradation was studied using kinetic behavior and …

Examining How The Strive+ Intervention Affects Caregivers' Comfort Levels And Behaviors: A Quantitative Study, Nastacia Taylor

Creating Healthy Work Environments (CHWE)

Support To Reunite, Involve, and Value Each Other (STRIVE) is a five-session manualized psycho-educational family intervention that incorporates cognitive behavioral therapy strategies to facilitate communication skill development, problem solving, and creating a positive family atmosphere. This strengths-based dyadic intervention has been shown to reduce delinquency, drug use, and high-risk sexual behaviors among disadvantaged adolescents aged 13 to 17 years with lived experience of homelessness.

The updated STRIVE+ was tested to investigate the possibility for lowering youth risk factors for commercial sexual exploitation. Adolescent behavioral family treatments are an effective strategy to intervene to prevent adverse developmental consequences. The STRIVE+ intervention …

Metformin Exposure After Glioblastoma Diagnosis And Mortality: A Large Population-Based Study, Vittorio Maio, Roshani Shah, Manisha Lin, Patrick J. Moeller, Iyad Alnahhas, Richard Hass, Wenyin Shi, Scott W Keith

College of Population Health Faculty Papers

BACKGROUND: Glioblastoma (GBM) is an aggressive primary brain malignancy with limited therapeutic options and poor survival outcomes. Recent real-world studies and early-phase clinical trials evaluating metformin have yielded mixed findings. This study assessed the association between post-diagnosis metformin exposure and all-cause mortality in a large population-based cohort of older adults with GBM.

METHODS: A retrospective cohort study was conducted utilizing the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Adults aged ≥66 years diagnosed with GBM between 2007 and 2018 were included, excluding those with other malignancies or diagnoses made by autopsy or death certificate. Metformin exposure was modeled as …

Synthetic Blood Data Generation For Fair Machine Learning, Sahithi Makam Ramakrishna, Fernando Perez-Tellez

Research Outputs: 2025-Present

Synthetic data generation is a promising solution to privacy concerns in healthcare analytics, particularly when working with sensitive patient information. This study evaluates the performance and fairness of generative models in creating realistic synthetic datasets derived from blood test and demographic data. Three distinct medical datasets are used, including anonymised clinical data from a public hospital in Ireland, a public UCI medical dataset, and a Korean National Health Insurance dataset from 2002. Seven generative models - CTGAN, TVAE, Gaussian Copula, CopulaGAN, MedGAN, DiscGAN, and FASTML - are applied to generate synthetic records. The quality of these records is assessed using …

Implementation Of Adverse Childhood Experiences Screening In Pediatric Primary Care, Megan Nicole Waite

Creating Healthy Work Environments (CHWE)

Introduction: Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood including abuse, neglect, and household dysfunction. They are highly prevalent among children, especially those that are racially, ethnically, or socioeconomically disadvantaged. ACEs are negatively associated with unfavorable health outcomes in children including behavioral problems, cognitive delays, and poor physical health. Various governing bodies recommend routine screening for ACEs in pediatric primary care, but some studies report screening rates as low as 4%.

Aims: The aim of this quality improvement doctor of nursing practice (DNP) project was to implement an evidence-based ACE screening protocol and referral to behavioral …

Fostering Civility Between Nursing Faculty, Students, And Clinical Partners To Promote Positive Patient Outcomes, Breanne N. Wilburn, Kathryn A. Osteen, Christine J. Oliver, Courtney K. Brandt

Creating Healthy Work Environments (CHWE)

Nurse educators contribute to healthy practice environments and positive patient outcomes in part by educating students on civil practice in didactic and clinical environments (Foreman, 2023; Naseri et al., 2022). Incivility among students, nursing faculty, and clinical partners is a growing concern in the nursing profession (Foreman, 2023; Hajira et al., 2022). Nursing educators serve as examples for students through participating in culturally inclusive civil discourse (Meires, 2018). Further, student incivility in the academic setting could lead to future workplace incivility and is tied to unhealthy practice environments and negative patient outcomes (Park & Kang, 2020; Wei et al., 2018). …

“It Takes A Special Person” --Exploring Undergraduate Nursing Students’ Emotional Needs While Providing End-Of-Life Care, Kalei H. Kowalchik

Creating Healthy Work Environments (CHWE)

Background: Navigating end-of-life (EOL) care as a nursing student can results in intense emotions such as grief and despair and there is limited research on undergraduate nursing students’ thoughts and experiences on the need for emotional support resources when caring for patients and families at the EOL.

Purpose: To explore undergraduate nursing students’ experiences and their perceived need for integrating emotional and psychological support services while caring for dying populations.

Theoretical Framework: The Nerstrom Transformative Learning Model was used to guide this research which identifies how adult learners interact in their environment with a limited worldview that is …

Quality Improvement Project: The Influence Of Education On Provider Self-Efficacy And Utilization Of The Columbia Suicide Severity Rating Scale (C-Ssrs), Doreen Nwaogwugwu

Doctor of Nursing Practice Projects

Suicide remains one of the leading causes of death worldwide, underscoring the critical need for consistent, evidence-based suicide risk screening in mental health facilities. Despite being a validated, evidence-based tool, the use of the Columbia Suicide Severity Rating Scale (C-SSRS) is often hindered by inadequate provider training. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of provider education on self-efficacy and utilization of the C-SSRS in an outpatient mental health clinic. This quality improvement project used a quasi-experimental, one-group pretest-posttest design guided by the Health Belief Model, Lewin’s Change Theory, and the …

Relationship Between Navigation Success, Diagnostic Accuracy, And Ventilation Strategy: Retrospective Chart Review Of 224 Consecutive Navigational Bronchoscopic Procedures Performed Under General Anesthesia, Basavana Goudra, Prarthna Chandar, Divakara Gouda, Harrison Yang, Ganan Muhunthan, Suvan Sundaresh, Michael Stuart Green

Department of Medicine Faculty Papers

Background: Navigational bronchoscopy (NB) enables precise sampling of peripheral and central pulmonary nodules using shape-sensing or electromagnetic guidance. A major challenge is anesthesia-induced atelectasis, which alters lung anatomy, reduces registration accuracy, and is known to lower diagnostic accuracy. To counteract this, ventilatory protocols such as the Ventilatory Strategy to Prevent Atelectasis (VESPA) and the Lung Navigation Ventilation Protocol (LNVP) have been recommended. Their adoption and clinical impact, however, remain uncertain. Methods: We conducted a retrospective review of 224 consecutive NB procedures performed under general anesthesia at a single academic medical center (January 2020–August 2024). Demographic, anesthetic, and ventilatory data were …

Understanding Perceptions Of A Peruvian Local Market Program: A Reflexive Thematic Analysis, Rosmery Ramos-Sandoval Dr., Jano Ramos-Diaz

The Qualitative Report

Despite growing global interest in short food supply chains (SFSCs), little is known about how consumers in developing countries perceive these models, especially through digital platforms like social media. This study investigates how Twitter users represent and perceive SFSCs in the context of the Peruvian government´s “De la Chacra a la Olla” program. The study analyzed 1,167 tweets from Peruvian Twitter users referencing the hashtag #DeLaChacraALaOlla between 2014 and 2020, using reflexive thematic analysis within an exploratory case study framework to examine consumer perceptions of SFSCs. The analysis revealed three key themes in consumer perceptions of SFSCs on Twitter: direct …

Communicative Legitimacy: The Supreme Court's Hidden Cultural Binaries In The U.S. Civil Sphere, Steven Arrigg Koh

Faculty Scholarship

How does the U.S. Supreme Court establish its legitimacy? Over the last two hundred years in U.S. society, the Court has interpreted the U.S. Constitution on watershed issues such as slavery, segregation, and marriage equality. And yet the Constitution is just 7,591 words. A puzzle thus emerges: how does the Court intelligibly interpret this short text for U.S. society? This article develops a new theoretical and empirical cultural sociological account of such Supreme Court decision-making, which it calls “communicative legitimacy.” According to this theory, which draws on Jeffrey Alexander’s civil sphere theory, the Court consistently and inevitably draws on a …

Device Manager: Bundle Implementation For Reducing Device-Related Pressure Injuries, Sierra Holloway

Creating Healthy Work Environments (CHWE)

Background: Pressure injuries (PIs) are a continuing global problem in healthcare and worse for critically ill patients, costing up to $30 billion annually in the United States and are not reimbursable. Medical devices provide life support and healing in hospitalized patients but can also cause harm. Approximately 30-60% of PIs come from medical devices, causing pain, discomfort, and patient dissatisfaction while worsening patient outcomes.

Problem: The practicum site saw increased MDRPIs over two years, over the hospital average, due to a lack of standardization and knowledge for preventing MDRPIs. This led to extended lengths of stay, increased healthcare costs, and …

Implementation Of A Dedicated Rapid Response Nurse, Brandie Kopsas-Kingsley

Creating Healthy Work Environments (CHWE)

Background/Significance of problem: Rapid Response Teams have been used to reduce the incidence of intrahospital decline. While these teams excel at providing emergent responses during times of critical illness, they generally lack a proactive approach.

Clinical question/project purpose: Is a dedicated Rapid Response Nurse role effective in improving the culture of safety and reducing Rapid Response Team activations? The purpose of this project is to implement a dedicated Rapid Response Nurse (RRN) role that aids nurses in identifying patients at risk of decline or who are currently declining.

Search of literature/best evidence: A literature search was completed for full-text, …

Screen And Intervene: Assessing Knowledge, Preparedness, And Confidence In Managing Postpartum Depression, Caroline Everly Quinn

Creating Healthy Work Environments (CHWE)

Postpartum depression (PPD) is a mental health condition where a parent experiences intense and ongoing depressive symptoms such as sadness, anxiety, lack of energy, suicidal thoughts and actions, and more. One in seven people who give birth will experience PPD. Furthermore, suicide is a leading cause of death in the perinatal period, accounting for 20% of postpartum deaths. Though PPD is common, there are many barriers to screening, managing, and treating this condition.

This evidence-based quality improvement (QI) project aimed to assess nursing students’ and nurses’ levels of knowledge and readiness to screen, intervene, and manage patients with PPD in …

Veterans’ Living To Create Healthy Environments And The Meaning Of Their Well-Being: A Phenomenological Inquiry, Cheryl L. Birmingham

Creating Healthy Work Environments (CHWE)

The Veterans reside in a unique environment influenced by past military experiences that may have positive and negative effects on their well-being as Veterans. With nearly half of the 18.4 million Veterans in the United States living beyond 61 years the physical and mental health conditions may desolate the Veterans’ well-being. Promoting Veterans’ well-being has been studied extensively but scant research has been done on the environmental influences and how it helps to define It is critical to understand how Veterans define well-being to inform future program development addressing mental health needs. The purpose of this study is to discover …

Implementation Of A Mindfulness Intervention Among Professional Firefighters And The Effect On Perceived Stress Levels, Rachel L. Mowry

Creating Healthy Work Environments (CHWE)

Problem Statement: Firefighters experience high levels of stress related to their occupation that negatively impacts their physical and mental health and can lead to loss of occupation, decreased work productivity, and suicide. Occupational stress in firefighters impacts firefighters as individuals, as well as their places of work and communities; therefore, this phenomenon should be investigated further. Mindfulness is a strategy which is shown to be effective in the reduction of occupational-related stress. Mindfulness-based strategies can be delivered through a variety of methods including mindfulness-based stress reduction, mindfulness-based cognitive therapy, virtual mindfulness interventions, and other structured programs. Increased mindfulness has been …

Understanding Treatment Adherence Among Patients With Pulmonary Hypertension, Justin Wilson, Jill Cox, Rula Btoush

Creating Healthy Work Environments (CHWE)

Several effective treatment options are currently available for patients with pulmonary hypertension (PH), including pharmacologic therapies such as breakthrough prostacyclin infusions, the use of durable medical equipment’s, and a myriad of lifestyle modifications. In spite of the availability of these treatment options, many patients remain unsure about their disease and the regular use of recommended treatment. Treatment adherence is defined as the extent to which a person's medication taking behavior, diet, and lifestyle changes corresponds with agreed health care providers recommendations (Burkhart & Sabaté, 2003). Even though a plethora of research has addressed treatment adherence among patients with various diagnoses, …

The Double-Edged Sword Of Ai In Elections: Navigating Risks And Opportunities In Washington State, Payvand Khastkhodaei

Seattle Journal of Technology, Environmental, & Innovation Law

No abstract provided.

Deepfake Danger: The Urgent Need For Federal Protections Against Ai-Generated Pornography, Benjamin Comfort

Seattle Journal of Technology, Environmental, & Innovation Law

No abstract provided.

Roles And Strengths Of Therapeutic Recreation Professionals In Service Provision: A Strengths-Based Approach, M. Rebecca Genoe, Linda Ostryzniuk, Kathy Park, Sherri Nelson, Douglas G. Cripps, Donna Boser

The Qualitative Report

Therapeutic Recreation professionals work in healthcare and community-based settings where they utilize recreation and leisure to improve quality of life. Despite their contributions, Therapeutic Recreation often goes unrecognized as an important component of the healthcare team. The purpose of this study was to explore the strengths and successes of Therapeutic Recreation professionals. We aimed to explore how Therapeutic Recreation professionals identify and perceive their roles, and what strengths they use within their roles. Data was collected through 19 individual interviews and eight focus groups with Therapeutic Recreation professionals and analyzed thematically. The theme of “nurturing well-being through leisure” was generated …

Adapting To Cultural Diversity At Work: A Thematic Analysis Of Resources Mobilized By Local And Posted Agricultural Workers In France, Alexandrine Ceschiutti, René Mokounkolo

The Qualitative Report

When workers have to adapt to a new culture, they develop intercultural skills as cultural intelligence (CQ), which is the ability to show an interest and act effectively in an environment characterized by cultural diversity. There has been little research on this subject in France, and studies have focused on expatriates, while acculturation also affects people from the local community. This is the case for local agricultural workers (LW), whose perceptions we compare with those of foreign posted agricultural workers (PW) in France. Our study had two aims: (a) to explore the personal resources that these workers perceive as necessary …

Qualitative Methods For Health Research, 5th Edition: A Review, Rikki Mangrum

The Qualitative Report

Qualitative Methods for Health Research (5^th ed.; Green et al., 2025) is an introductory textbook that provides an overview of qualitative methodology as it is used in health-related fields, including public health, healthcare delivery, and medical science. It provides instruction on theoretical principles, core methods and their implementation, and related topics such as developing research proposals and publishing study results. This new addition includes updated content and new content pertinent to recent developments that have affected health research practices, such as the COVID-19 pandemic and broader awareness of the impact of colonialism and racial discrimination.

Sting-Induced Blood-Brain Barrier Opening Combined With Radiotherapy Potentiates Antitumor Response In A High-Grade Glioma Model, Shashwat Tripathi, Hinda Najem, Lisa Hurley, Ruochen Du, Crismita Dmello, Heba Ali, Kathleen Mccortney, Karl J Habashy, Peng Zhang, Craig M Horbinski, Lara Leoni, Ryan J Avery, Rimas V Lukas, Timothy L Sita, David R Raleigh, Sean Sachdev, Roger Stupp, Maciej S Lesniak, David M Ashley, Daniele Procissi, Michael A Curran, Irina Balyasnikova, Amy B Heimberger

Faculty, Staff and Student Publications

Radiation therapy (RT) is the standard of care for glioblastoma but is not curative. Triggering the cGAS/stimulator of interferon genes (STING) pathway with potent agonists, such as 8803, exerts activity across high-grade glioma preclinical models. To determine if the combination of 8803 with RT warrants consideration in the up-front treatment setting and to clarify the underlying mechanisms of therapeutic activity, C57BL/6J mice harboring intracerebral CT-2A or QPP8v gliomas were treated with RT, intratumoral 8803, or both. The treatment with the combination resulted in 80% long-term survival in the CT-2A model but not in the radiation-resistant QPP8v model. This therapeutic effect …

Automated Quantification Of Movement Qualities In The Human Upper Extremity After Stroke Using A Wearable Robot., Yoon No Gregory Hong, Kyoungsoon Kim, Sheng Li, Marcia K O'Malley, Ashish D Deshpande, Jinsook Roh

Faculty, Staff and Student Publications

Background: Stroke is a leading cause of long-term adult disability, with approximately 80% of survivors experiencing upper extremity (UE) motor impairments. Conventional tools like the Fugl-Meyer Assessment (FMA) are widely used but limited by ordinal scales and subjective visual observation. While wearable robotics offer high-resolution data, their clinical translation is hindered by a lack of standardized protocols and limited interpretability for clinical decision-making.

Objective: This study aimed to develop an objective, standardized, and clinically interpretable method to quantify UE motor qualities by integrating wearable robotic technology with traditional clinical assessment tasks.

Methods: Ten healthy individuals and ten stroke survivors performed …