Digital Commons Network^™

Enhancing Rn Confidence In Early Recognition And Treatment Of Sepsis, Tiffany Lee Gossai

Walden Dissertations and Doctoral Studies

Background: Sepsis is a leading cause of mortality in U.S. hospitals, with delays in recognition and treatment significantly contributing to poor patient outcomes. Nurses are essential to early identification and timely intervention; however, gaps in confidence and preparedness persist, particularly among newly hired staff. Traditional educational approaches may be insufficient to support rapid clinical recognition and evidence-based management. Purpose: This staff education project evaluated whether participation in a virtual sepsis escape room during general nursing orientation improved newly hired nurses’ confidence in early identification and treatment of sepsis. Methods: A virtual escape room was integrated into an existing general nursing …

Better It Disaster Recovery And Procedures To Improve Response After Computer Crime, Allan Eduardo Arroyo-Melendez

Walden Dissertations and Doctoral Studies

A lack of an effective disaster recovery plan (DRP) can negatively impact business outcomes following a cyberattack. Information technology (IT) managers are concerned that the lack of DRP may increase the risk of ransomware, fines, and public distrust. Grounded in the unified theory of acceptance and use of technology, the purpose of this qualitative pragmatic inquiry study is to explore strategies that some IT managers use to implement a DRP. The participants are four IT managers in the southeast United States. Data were collected through semistructured interviews and a review of publicly available documents. Through thematic analysis, three themes were …

Clinical Practice Guidelines For Suicide Risk Assessment, Jelitta Cleatus

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed a clinical practice guideline (CPG) to address the lack of a standardized suicide risk assessment protocol at a Texas mental health clinic. At project initiation, suicide risk assessment at the facility was inconsistent due to the absence of a CPG. The guideline incorporated the Columbia-Suicide Severity Rating Scale (C-SSRS), a validated instrument that improved early detection of suicidal ideation and behaviors, which were often under recognized in older adults. This inconsistency led to the following clinical question, Does the evidence support the development of a CPG for assessing suicide risk among high-risk patients using …

Improving Early Detection Of Lung Cancer In Underserved Primary Care Settings, Trent Arden Goode, Ii

Walden Dissertations and Doctoral Studies

Lung cancer is the leading cause of cancer-related mortality in the United States, with underserved populations experiencing higher rates of late-stage diagnosis and preventable death. Despite established screening guidelines, adherence within primary care remains inconsistent, particularly in safety-net settings, reflecting a healthcare administration problem driven by organizational structures and care processes. The purpose of this integrative review was to identify administrative interventions that improve primary care provider adherence to lung cancer screening referral guidelines in safety-net healthcare settings. Guided by the Donabedian Quality Framework, a systematic integrative review was conducted to examine how healthcare structures and processes influence screening implementation. …

The Environmental Mental Health Services Needed For Youth Ages 18-25 Aging Out Of The Foster Care System, Keelin Leger

Walden Dissertations and Doctoral Studies

Youth transitioning out of foster care experience increased mental health challenges that affect their ability to age out successfully to independence. In this qualitative modified action study, the environmental mental health services needed for adolescents, aged 18 to 25, aging out of the foster care system in Lafayette Parish, Louisiana were explored. This study was guided by the Families Rising framework. Purposeful sampling was used to recruit 20 participants who provided insights to this study. Participants were reached by posting flyers on social media and the online platform forums, and they signed the consent form to participate. The data were …

Staff Education On Medication Adherence, Jerome Obiagba

Walden Dissertations and Doctoral Studies

Summary The Doctor of Nursing Practice (DNP) project focuses on improving medication adherence in mental health settings, where many patients do not take medications as prescribed, leading to worsening symptoms, relapse, frequent hospitalizations, higher healthcare costs, and reduced quality of life. This problem mainly affects individuals with anxiety, bipolar disorder, major depressive disorder, and schizophrenia, and is often related to poor understanding of treatment, cultural beliefs, or limited access to care. Because nurses play a key role in medication monitoring, education, and patient support, the project examined whether staff education improves nurses’ knowledge, confidence, and effectiveness compared to standard practice …

Staff Education To Streamline Congestive Heart Failure Education, Shannon Hunter

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive disease that affects a diverse population. Patient-centered education is key to lowering rehospitalizations and mortality rates. Although nurses are essential providers of patient-centered education, those in acute care settings often have unclear directions for implementing and documenting CHF education. Multiple educational materials within electronic health record (EHR) systems further complicate the process and highlight the practice gap. The aim of this Doctor of Nursing Practice (DNP) project was to streamline CHF education by clarifying the role of nurses in education delivery and documentation, potentially enhancing nurse confidence and improving patient health outcomes, with …

Optimizing Patient Intake Efficiency: Integrating Data Accuracy And Workflow Improvement Strategies, Breanna Virginia Martin

Walden Dissertations and Doctoral Studies

For a professional therapist, social worker, psychologist, or psychiatrist, improving the quality and effectiveness of patient care is a central responsibility. This qualitative single-case study examined how WGGX, a nonprofit behavioral health organization in South Philadelphia, addressed challenges within its patient intake process to improve workflow efficiency, data accuracy, and the client onboarding experience. Guided by the Baldrige Health Care Criteria for Performance Excellence, the study explored how leadership practices, workforce engagement, and process management influenced organizational effectiveness related to intake operations. Data were collected through semistructured, in-person interviews with six organizational stakeholders and a review of organizational documents and …

Staff Education To Improve Nurse Use Of Teach-Back In Outpatient Diabetes Care, Latoya Hodge-Curtis

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is a prevalent chronic condition in the United States, with ineffective patient education and low health literacy linked to poor glycemic control, preventable complications, and increased health care utilization. At the project site, a practice gap was identified related to a lack of knowledge among nurses regarding the use of teach-back strategy for use with Type 2 diabetes education. The practice-focused question was: Does educating nurses on the teach back strategy for Type 2 diabetes improve knowledge as evidenced by pre- to post-survey? This project was implemented using the ADDIE (analysis, design, development, implementation, and evaluation) …

Enhancing Medication Adherence In Home-Based Hypertension Care Through Targeted Staff Education, Marie Lunie Bazile

Walden Dissertations and Doctoral Studies

Summary In this practice-based, quality improvement project, I incorporated a one-group, pre-/posttest design with the aim to evaluate a staff education intervention, reflecting on key principles in improving practice, including continuous evaluation and informing locally based change. This Doctor of Nursing Practice (DNP) project addressed the issue of inconsistent adherence to medication and the lack of staff skills in home-based hypertension management. Notably, the nurse plays an important role in medication adherence to care and in the consistent, evidence-based care with chronic diseases. The practice-focused question was: For home health staff, how does participation in an evidence-based medication adherence education …

Oncofetal Reprogramming: A New Frontier In Cancer Therapy Resistance, Anh Nguyen, Molly Lausten, Bruce M. Boman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Oncofetal reprogramming has recently emerged as a critical concept in translational cancer research, particularly for its role in driving therapeutic resistance across a variety of malignancies. This biological process refers to a pattern of gene expression that is restricted to embryogenesis, but becomes expressed again in a subpopulation of cancer cells. These genes are typically suppressed after embryogenesis, and their aberrant re-expression in tumors endows cancer cells with stem-like properties and enhanced adaptability. The goal of this review is the following: (i) comprehensively examine the multifaceted nature of oncofetal reprogramming; (ii) elucidate its underlying molecular mechanisms, including its regulators and …

Updating Misev: When, What, How, And Why?, Naveed Akbar, Dylan Burger, Benedetta Bussolati, Edit Buzás, Randy Carney, Young-Eun Cho, Tom Driedonks, Juan Manuel Falcon-Perez, Yu Fujita, Deborah Goberdhan, An Hendrix, Yiyao Huang, Suresh Mathivanan, Mỹ Mahoney, Sujata Mohanty, Andreas Möller, Nicole Noren Hooten, Stefano Pluchino, Carlos Salomon, Ana Claudia Torrecilhas, Sara Veiga, Kenneth Witwer

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

No abstract provided.

Connecting Through Creativity: Enhancing Pediatric Care With Playful Ppe, Betty Abraha, Lauren Burns, Alayna Smith

2025

No abstract provided.

Trapped And Traumatised: A Scoping Review Of The Psychological Sequelae Of Entrapment Following Motor Vehicle Collision, Thomas A.M. Dixon, Kara Hole, Louise Johnson, Tim Nutbeam

Peninsula Medical School

Background: Motor vehicle collisions (MVCs) are a significant public health challenge, resulting in substantial mortality and morbidity. Entrapment occurs in 12–33% of all MVCs and is associated with greater injury severity, longer on-scene time, and increased mortality. However, the psychological consequences of entrapment remain poorly characterised. Objectives: This scoping review seeks to establish the current understanding of the psychological sequelae of entrapment following MVCs and draws on insights from related fields of study in order to inform future research and clinical practice. Methods: A scoping review was undertaken following established methodological guidance. Searches were completed on NHS Knowledge and Library …

The Perception Of Fentanyl’S Harm, Rachel Antenucci

ETDs from 2020-2029

While drug overdose deaths have generally decreased in the past year, close to 60,000 overdoses involving opioids occurred in 2024. The opioid crisis has lasted over two decades and is now in the fourth wave. The fourth wave has been characterized by overdoses resulting from fentanyl adulteration in the drug supply and polysubstance overdoses involving fentanyl. The purpose of the current study is to compare the perceived harm of fentanyl to other drugs of abuse and identify differences in the perceived harm of fentanyl between groups of people who use substances. An online survey was conducted across 15 states in …

Nilotinib-Mediated Reprogramming Of Bone Marrow Macrophages Alters Hematopoietic Stem Cell Fate In Chronic Myeloid Leukemia, Tiffany Davia Ricketts

ETDs from 2020-2029

Tyrosine kinase inhibition (TKI) is highly effective and promotes favorable long-term outcomes for many patients with chronic myeloid leukemia (CML). However, many patients experience treatment resistance or recurrence after TKI cessation due to leukemic stem cell (LSC) persistence within the hematopoietic stem cell (HSC) niche. Within the niche, macrophages adopt different activation states to alter HSC function, however, CML disrupts niche signals to selectively support LSCs and macrophages may contribute to this process. We hypothesize that macrophages contribute to pro-inflammatory activation within the niche to promote LSC development and nilotinib will reprogram macrophages to selectively support non-leukemic stem cells. To …

Conserved Chromatin Programs Orchestrate Cardiac Cell States In Health And Disease And Drive Cardiomyocyte Proliferation After Injury, Xiaoxiao Geng

ETDs from 2020-2029

Chromatin structure is a central regulator of gene expression and cellular identity, yet the chromatin structural factors driving cardiac disease and regeneration remain incompletely defined. This dissertation investigates how modulation of chromatin architecture shapes pathological and regenerative cardiac phenotypes through integrated single-cell transcriptomic, epigenomic, and functional analyses. To determine whether chromatin structural regulators distinguish healthy from diseased cardiac states, we curated a comprehensive list of chromatin structural genes and applied it to single-nuclei RNA sequencing datasets from human hearts with and without dilated cardiomyopathy (DCM). Chromatin structural gene expression effectively stratified cardiomyocyte and fibroblast populations by disease status. Diseased cardiomyocytes …

Montana Kaimin, January 29, 2026, Students Of The University Of Montana, Missoula

Montana Kaimin, 1898-present

Student newspaper of the University of Montana, Missoula.

Risk Awareness Of Alcohol Related Car Fatalities In Whatcom County, Tayler Wilson

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

My goal to address alcohol-related traffic fatalities in Whatcom County is to reduce the prevalence of these fatalities by 20% over two years through preventative community education and targeted enforcement programs to decrease high-risk drinking behaviors in college-age youth.

Significant Findings

There has been a significant rise in alcohol-related traffic fatalities within Whatcom County, upwards of 50% of fatal car accidents in 2024 involving alcohol; 67.8% higher than the national average (CDC, 2024; Starks et al.,2025). The population most impacted by this public health risk is 21-24 year-olds, especially young men, who are four times more likely to …

A Prevention Model For Delaware: Reducing Opioid Relapse After Release From Incarceration, Jaime Basara

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

The goal of this Social Change Portfolio is to reduce relapse risk among individuals with opioid use disorder who are reentering society after their release from a Delaware correctional facility, by enhancing clinical continuity of care, including counseling, relapse-prevention planning, and linkage to community-based treatment programs.

Significant Findings

This portfolio aims to raise the awareness that justice-involved individuals with opioid use disorder in Delaware face extremely high rates of relapse, overdose, and death during the post-release period, particularly within the first few weeks and months after reentering society. This is often due to abrupt discontinuation of treatment, reduced …

Elite Bankruptcy, Laura N. Coordes

BYU Law Review

“The influence of bankruptcy lawyers over bankruptcy law seems almost inevitable.” —David Skeel

In Debt’s Dominion, David Skeel wrote that bankruptcy professionals have played a key role in shaping U.S. bankruptcy law. He predicted that these professionals would continue to shape the bankruptcy process long into the future. Today, we can see that Skeel’s prediction has come true. Although Congress has yet to overhaul the Bankruptcy Code, bankruptcy professionals have succeeded in their own form of overhaul by creating what this Essay calls “elite bankruptcy:” a type of bankruptcy accessible only to the rich and powerful. Elite bankruptcy is practiced …

Kenyon Collegian - January 29, 2026

The Kenyon Collegian

No abstract provided.

Structural Empowerment And The Work Environment Of Nursing Home Care Workers In China, Yawen Ou

Lingnan Theses (MPhil & PhD)

China is experiencing a profound demographic transformation as its population ages rapidly, driven by declining fertility, increased longevity, and long-term effects of the One- Child policy. Traditional family-based elderly care has become increasingly unsustainable due to the pressures of the “4-2-1” family structure and the rising prevalence of empty-nest households. In this context, there is an increasing trend in institutionalized elderly care, accompanied by a growing demand for Nursing Home Care Workers (NHCWs). In spite of their vital importance, NHCWs often face heavy workloads, poor compensation, low recognition, and limited professional autonomy. This study explores the work environment and structural …

Comparative Outcomes Of Abdominal, Laparoscopic, And Vaginal Sacral Colpopexy: A National Analysis Of Apical Suspension Procedures (2014–2022), Smit Bharat Solanki, Apurva B Pancholy, Vishal Pancholy

Faculty, Staff and Student Publications

Objective: Sacral colpopexy is a well-established procedure for apical suspension, but the relative outcomes of abdominal, laparoscopic, and vaginal approaches remain debated. This study compared perioperative outcomes across these surgical routes using a national database and evaluated trends in robotic assistance.

Materials and methods: We analyzed sacral colpopexy cases from the American College of Surgeons National Surgical Quality Improvement Program between 2014 and 2022. Patient demographics, complication rates, and surgical outcomes were compared among abdominal, laparoscopic, and vaginal procedures. Relative risks (RR) were adjusted for confounders. The utilization of robotic systems in laparoscopic procedures was examined.

Results: Among 61,524 cases, …

Seipin Expression In Hepatocytes Impairs The Assembly Of Vldls And Exacerbates Steatohepatitis, Qianqian Dong, Yidan Ma, Xin Chen, Xiaowei Wang, Ziwei Liu, Chenxi Liang, Liwen Qiu, Jinye Tang, Jin Wu, Yang Liu, Xiaoqin Wu, Yaru Zhou, Mingming Gao, Hongyuan Yang

Faculty, Staff and Student Publications

VLDLs are crucial for maintaining liver and whole-body lipid homeostasis. Limited knowledge exists regarding the lipidation process of VLDL. Endoplasmic reticulum (ER) luminal lipid droplets (LLDs) have been suggested to provide lipids for VLDL lipidation and maturation. Seipin, an integral membrane protein of the ER, plays key roles in the formation of cytoplasmic LDs (CLDs) and adipocyte differentiation. Surprisingly, seipin is hardly detectable in hepatocytes. Given the critical contribution of seipin in forming CLDs, we hypothesize that the absence of seipin in hepatocytes might ensure the proper formation of LLDs and the lipidation and assembly of VLDLs. To explore the …

Downregulation Of Slc40a1 Leads To Iron Accumulation In Fibrotic Lung Fibroblasts, Quanjin Dang, Chaoqun Huang, Yurong Liang, Akshaya Surendran, Dharanya Muthiah, Kishore Vaddadi, Sankha Hewawasam, Tingting W Mills, Lin Liu

Faculty, Staff and Student Publications

Iron is an essential nutrient for almost all organisms. However, excess iron generates reactive oxygen species and causes tissue injuries. Iron is implicated in idiopathic pulmonary fibrosis (IPF). In this study, we examined iron accumulation in fibrotic lung fibroblasts and the underlying mechanisms. We hypothesize that the downregulation of Solute Carrier Family 40 Member 1 (SLC40A1) results in iron accumulation in lung fibroblasts of IPF patients. Using a Prussian Blue iron staining, we found that iron accumulated in the fibrotic region of the lungs from IPF patients and bleomycin- and asbestos-induced lung fibrosis mice. Iron was partially co-localized with the …

An Application-Based Ontological Knowledge Base Of Medications To Support Health Literacy And Adherence For The Consumer Population: An Aging Population Use Case, Clifford Chen, Muhammad Amith, Kirk Roberts, Rebecca Mauldin, Renata Komalasari, Cui Tao

Faculty, Staff and Student Publications

No abstract provided.

The Origin Of Hepatocellular Carcinoma Depends On Metabolic Zonation, Jason Guo, Roger Liang, Andrew Chung, Zhijie Li, Boyuan Li, Eric Chen, Lin Li, Jingjing Wang, Meng-Hsiung Hsieh, Ivy Xiangyi Fang, Benjamin Kroger, Yunguan Wang, Min Zhu, Xiongzhao Ren, Greg Mannino, Yuemeng Jia, Yonglong Wei, Stephen Moore, Daniel J Siegwart, Stephen S Chung, Zixi Wang, Tripti Sharma, Suman Komjeti, Yi Han, Purva Gopal, Guanghua Xiao, Tao Wang, Hao Zhu

Faculty, Staff and Student Publications

The origin of cancer is poorly understood because premalignant cells are rarely followed in their native environments. Although the spatial compartmentalization of metabolic functions is critical for proper liver function, it is unknown whether cancers arise from some zones but not others and whether there are metabolic determinants of cancer risk. Zone-specific, mosaic introduction of Ctnnb1 (catenin beta 1) and Arid2 (AT-rich interaction domain 2) mutations, commonly co-mutated genes in hepatocellular carcinoma (HCC), in mouse models showed that position and metabolic context determine clone fates. Ctnnb1/Arid2-driven cancers were much more likely to arise in zone 3. The …

Quaker Campus, January 29, 2026 (Vol. 24, Issue 7), Whittier College

Quaker Campus

No abstract provided.

2026-01-29 Faculty Senate Meeting Minutes, Morehead State University. Faculty Senate.

Faculty Senate Records

Faculty Senate meeting minutes from January 29, 2026.