Digital Commons Network^™

The Real Truth About Popular Mindfulness Apps: Mindfulness Or Market Share?, Jeremy T. Yencer

Mindfulness Studies Theses

The rapid expansion of mindfulness applications raises important questions about their authenticity. A central concern is whether these digital interventions are primarily motivated by genuine mindfulness education or by commercial interests seeking to maximize commercial metrics. This thesis addresses this issue by comprehensively assessing these applications against established ethical and educational standards. The study introduces the Alaya conceptual model, a novel evaluative framework that adapts the six domains of the MBI:TAC and incorporates two additional domains focused on commercial integrity, governance, and ethics. The Alaya framework utilizes a deterministic scoring mechanism to evaluate the integrity of digital applications, specifically their …

2026 Suffolk University Commencement Program, College Of Arts & Sciences And Sawyer Business School, Suffolk University

Suffolk University Commencements

Suffolk University commencement programs detail the location, date, order of exercises, academic honors, speakers, administration, graduates, and other related information.

Minimizing The Incidence Of Falls On An Adult Inpatient Cardiac Step-Down Unit, La’Tricia Danielle Harvey

Doctor of Nursing Practice (DNP)

Background: Inpatient falls are a significant risk to patient safety in acute care settings. Local Problem: A 24-bed adult cardiac step-down unit with elevated fall rate lacked standardized fall risk protocols. Methods: Iterative Plan-Do-Study-Act (PDSA) cycles were used to implement, evaluate, and refine a structured workflow over 12 weeks. Interventions: A protocol-guided fall prevention checklist was deployed, supported staff education, peer coaching and leadership audits. Results: Nursing protocol knowledge increased from 83% to 93.11%, checklist compliance averaged 90%, and these process improvements correlated with a 83.3% reduction in the overall unit fall rate. Conclusions: Standardizing care via a protocol-guided fall …

Legal Professional Identity Development: An Exploration Of The Social And Emotional Processes By Which Law Students Transition From Novices To Professionals, David Hall Abney Ii

Theses and Dissertations--Communication

This dissertation seeks to heed the call for expansion of instructional communication research (ICR) beyond the undergraduate classroom and undergraduate learning objectives by exploring older learners and higher-order affective learning objectives. Legal professional identity development (LPID) is a discipline-specific type of higher-order affective learning that is conceptualized as a continuous nonlinear process that begins in law school and extends throughout a lawyer’s career, involving the internalization of the legal profession’s core values and norms and their integration with an evolving identity. Using a pragmatic ICR approach and a mixed-methods design, Phase 1 employed individual interviews and focus groups to investigate …

Can Love Bloom On A Battlefield: An Analysis Of Queer Militaristic Fanfiction, Brandon Bost

Theses and Dissertations--Communication

It is noted that readers and fans hold unique and valid interpretations of texts, interpretations that become expressed in fan works like fan art, memes, or the subject of this study, fanfiction. This study performs textual analysis on queer fanfiction in Metal Gear Solid and Code Geass fandoms. It examines the unique relationship militarism holds with intimacy, and how intimacy intersects with violence and control in unique ways in these fan texts. Within these fanfics, militarism can serve as a barrier to intimacy, forcing relationships to adapt to militaristic structures within these fan interpretations.

Exploring The Relationship Between Self-Esteem And Communication Among Equestrians In Facebook Groups, Jenna Young

Theses and Dissertations--Communication

People’s interpersonal relationships and social groups are connected to their self-esteem. Equestrians, a social group unified around riding or working with horses, form identities based on their involvement in the equine industry, whether that be recreationally or professionally. Equestrians’ subjective views of self-esteem may be related to their overall well-being. Theories related to self-esteem and identity indicate that communication within social relationships, like within the equine industry, may impact an individuals’ sense of self-worth. Facebook groups have increased in popularity in the equine industry due to the ease of communication between equestrians. Therefore, this study investigated the relationship between self-esteem …

Conflict Management In Heterosexual Romantic Relationships: A Cognitive Dissonance Perspective, Benjamin Grissom

Theses and Dissertations--Communication

This paper examines how cognitive dissonance corresponds with conflict management strategies in heterosexual romantic relationships from the perspective of romantic partners. The paper synthesizes current findings on how conflicting beliefs and attitudes impact partners' approaches to handling disagreements. Patterns are identified in how cognitive dissonance co-occurs with competition, avoidance, accommodation, compromise, and collaboration. Findings suggest that the discomfort arising from holding conflicting cognitions corresponds to their conflict management approaches depending on the degree of discomfort. Additionally, relationship length is examined as a moderator of the connection between cognitive dissonance and conflict management. Understanding these perceptions can provide insights into enhancing …

Students As Information Responders – Extending Our Understanding Of Students At A Pwi, Anyiah S. Chambers

Theses and Dissertations--Communication

As school shootings continue to rise across the United States, understanding how students respond to and share information during crises has become a critical concern for higher education institutions. While prior research has examined the role of students as first information responders (FIRs) during emergencies, few studies have investigated how these processes unfold among Black and non-Black students at predominantly white institutions (PWIs). This mixed methods study is a replication and extension of Omilion-Hodges and Edwards (2021), examining how undergraduate Black and non-Black students at PWIs evaluate, construct, and disseminate crisis-related messages, particularly during active-shooter events. Grounded in channel specification …

Unlocking The Power Of Cxcr2 Inhibition To Overcome Gemcitabine Resistance In Pancreatic Cancer, Caitlin Molczyk, Reegan Sturgeon, Sugandha Saxena, Esther Johnson, Rakesh Bhatia, Namita Bhyravbhatla, Sushil Kumar, Surinder K. Batra, Rakesh K. Singh

Journal Articles: Biochemistry & Molecular Biology

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related mortality, characterized by intrinsic resistance to conventional therapies and limited effective treatment options. In this study, we investigated the role of the CXCR2 axis in PDAC therapy resistance. CXCR2, a chemokine receptor, is actively involved in inflammation, tumor angiogenesis, and metastasis. Our working hypothesis is that CXCR2 contributes to PDAC chemotherapy resistance. To test this, we generated gemcitabine-resistant (GemR) lines using T3M4 and CD18/HPAF (CD18) cell lines. Baseline expression of CXCL1, CXCL5, and CXCL8 ligands was higher in GemR cells compared to parental cells. Upon gemcitabine treatment, parental cells …

Midkine (Mdk) As A Central Regulator Of The Tumor Microenvironment: From Developmental Cytokine To Therapeutic Target, Hareesh B. Nair, Ajay Nair, Ya-Guang Liu, Dileep K. Vijayan, Ramadevi Subramani, Rajkumar Lakshmanaswamy, Suryavathi Viswanadhapalli, Gangadhara R. Sareddy, Surinder K. Batra, Ratna K. Vadlamudi

Journal Articles: Biochemistry & Molecular Biology

Midkine (MDK) is an oncofetal, heparin-binding cytokine that is re-expressed across diverse cancers and correlates with aggressive disease and treatment resistance. This review synthesizes current evidence on MDK as a coordinator of tumor-intrinsic signaling and microenvironmental remodeling. We summarize MDK structural features, extracellular matrix interactions, and receptor systems that mediate MDK signaling, highlighting LRP1 and PTPRZ1 with context-dependent participation of ALK, nucleolin and integrins. Downstream, MDK engages MAPK, PI3K-AKT, STAT3 and NF-κB pathways to promote tumor cell survival, epithelial-mesenchymal plasticity, and therapeutic stress tolerance. We then focus on tumor microenvironment (TME) programs shaped by MDK, including angiogenesis, fibroblast activation and …

Addressing Obesity And Diabetes In Appalachian Kentucky, Hannah E. Orens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Type 2 diabetes and obesity are major public health concerns in Appalachian Kentucky. Populations in this region experience much higher rates of chronic disease than the rest of the state, have limited access to preventive care, and ongoing economic challenges that affect health. Many rural counties face increased poverty, transportation challenges, and shortages of healthcare professionals, all of which contributed to poor health outcomes and reduced access to evidence-based prevention programs. As a result, there is a strong need for focused, feasible, community-based interventions that improve access to evidence-based prevention while addressing the social and economic factors influencing health in …

Purchasing A Healthier Future: A Nutrition-Focused, Community-Centered Approach To Reduce Obesity And Diabetes In Graves County, Kentucky, Marissa Stephens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Obesity and type 2 diabetes are among the most significant public health challenges in the United States, with Kentucky consistently ranking among the states with the highest prevalence of both conditions. Together, these conditions contribute to reduced quality of life, rising healthcare costs, and increased morbidity and mortality, underscoring the need for targeted, community-centered interventions. The disease burden of obesity and diabetes is particularly pronounced in rural areas, including the state’s westernmost region, the Jackson Purchase. Among rural populations, chronic disease risk is driven by a combination of factors, including low socioeconomic status, limited access to healthcare/supermarket options, and food …

Challenging Cases In Infection Prevention And Control: Proceedings From Shea Spring 2025., Jessica Seidelman, Tsun Sheng N Ku, Anna Lafountaine, Curtis J Donskey, Edo-Abasi U. Mcgee, Rachel Pryor

PCOM Scholarly Works

Hospital epidemiologists and infection prevention professionals are frequently required to make high-stakes decisions in complex clinical scenarios where evidence-based guidance is limited or absent. These decisions often carry significant implications for patient safety, healthcare worker protection, hospital operations, and legal or financial risk. This article presents three challenging cases originally featured during the "Interesting Cases" session at the Society for Healthcare Epidemiology of America (SHEA) Spring 2025 Conference, with the goal of sharing practical lessons learned and contributing to the evolving literature in healthcare epidemiology. The first case describes the intraoperative contamination of a polyethylene liner during emergency revision total …

Anchoring Roots And Spreading Branches: The Growth And Regulation Of Art Therapy In Singapore, Christine Phang

Art Therapy | Doctoral Dissertations

The development of art therapy in Singapore has advanced rapidly over the last two decades. Yet, to date, there has not been a comprehensive overview of art therapy in Singapore. Additionally, more research is needed to understand how the complex component of regulation can benefit the profession of art therapy. This study therefore set out to paint a picture of art therapy in Singapore, capture the art therapy community’s thoughts and opinions concerning regulation, and identify actionable ways to advance the profession. A mixed method design was employed which utilized a survey and interviews to gather quantitative, qualitative, and arts-informed …

Creativity In A Flash: Exploring The Perceived Therapeutic Effects Of Combining Creative Arts Therapies And Flash Technique, Celia J. Gagnon

Art Therapy | Doctoral Dissertations

Since the onset of the COVID-19 pandemic, research has revealed a significant strain on mental healthcare systems and healthcare professionals. Concurrently, there has been a rapid escalation in the prevalence of anxiety, depression, loneliness, and adolescent suicide rates, all of which have reached critical levels (World Health Organization, 2025; World Health Organization, 2022; Institute for Health Metrics and Evaluation, 2025; American Psychiatric Association, 2024). Post-pandemic, these statistics continue to rise across all nations and socioeconomic groups (WHO, 2025). Consequently, there is an urgent need to intensify research that supports the enhancement of mental health services globally (Institute for Health Metrics …

Enhancing Self-Acceptance And Reducing Anxiety Through Tree Ring Self-Portraits In Art Therapy: A Mixed-Methods Study, Stacey Kamp

Art Therapy | Doctoral Dissertations

This mixed-methods dissertation examined the therapeutic potential of the Tree Ring Self-Portrait, a novel art therapy intervention designed to enhance self-acceptance and reduce anxiety through symbol-based, life-phase self-portraiture grounded in narrative meaning-making and image-based processing (White & Epston, 1990; Moon, 2010; Hinz, 2020). Adults who self-identified with anxiety-related concerns were recruited through community and clinical referral sources and completed a standardized three-session intervention involving reflective mapping of life phases, a watercolor-based concentric-ring self-portrait process, and a guided review of the completed artwork with semi-structured interviews. The final sample (n = 20; ages 22–74) included participants with varied engagement in psychotherapy …

Improving Hypertension Management With An Educational Patient Intervention Bundle, Gertie Silva

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

Uncontrolled hypertension remains a significant risk factor for cardiovascular disease. This quality improvement project aimed to improve hypertension knowledge and blood pressure control among adults with uncontrolled hypertension by implementing lifestyle counseling, home blood pressure monitoring, and regular follow-up.

Design

This quality improvement project used a pre- and post-intervention design.

Methods

Forty-one adults with uncontrolled hypertension took part in an eight-week educational program. Outcomes measured included weight, systolic and diastolic blood pressure, and HK-LS scores. Descriptive statistics and paired-samples t-tests analyzed the results.

Results

Participants showed significant improvements in weight, blood pressure, and hypertension knowledge. Mean weight decreased from …

Reducing Live Discharges In Hospice Care Through A Bundled Intervention, Fiona P. White

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction

 Among Medicare fee-for-service hospice beneficiaries, the national live discharge rate increased from 16.9% in FY2021 to 19.1% in FY2025. At a Medicare-certified hospice agency in a southern state, the pre-intervention live discharge rate of 35.3% substantially exceeded national norms, with 68.7% of events representing patient-initiated revocations.

Methods

 A pre-post quality improvement design guided by the Plan-Do-Study-Act framework was implemented over 8 weeks at a single site with 106 newly admitted hospice patients and 15 clinical staff. The four-component bundled intervention comprised Revocation Risk Assessment administration within 24 hours of admission, structured patient and caregiver education within 72 hours of …

Toolkit To Prevent Venous Thromboembolism Among Surgical Patients, Carine Wawa

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: According to the Centers for Disease Control and Prevention, approximately 900,000 people in the United States are affected annually by venous thromboembolism (VTE) (CDC, 2025). The surgical patient population is vulnerable to VTE due to factors such as immobility, tissue injuries, and inflammatory responses. The lack of standardized protocols for surgical patients causes practice variability among healthcare providers and potentially increases the risk for preventable VTE events.

Methods: A toolkit to prevent VTE was developed utilizing the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC). A literature review was conducted, reviewed, and graded using the …

Increasing Compliance In Pain Reassessment And Documentation In An Acute Care Facilityy, Kriss S. Jones

Doctor of Nursing Practice (DNP) Scholarly Projects

Purpose: This guideline-directed project aimed to increase registered nurse (RN) compliance with documenting pain reassessment in an adult medical-surgical unit at an acute care facility.

Background: Proper documentation is crucial for clinical decision-making and legal and ethical reasons. The Joint Commission (TJC) has standardized pain documentation requirements to ensure consistent assessment, recording, and management across healthcare settings. Non-compliance can lead to misdiagnosis, inadequate treatment, patient dissatisfaction, and legal consequences. Accreditation bodies audit medical records, and non-compliance may result in penalties, financial losses, or loss of accreditation. Adherence is a clinical best practice and strategic necessity for healthcare organizations. Methodology: A …

Enhancing Breast Cancer Screening Uptake In Hispanic Women Residing In Rural Texas Through A Quality Improvement Project, Bianca Batchelor-Salazar

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Breast cancer remains a leading cause of cancer-related mortality among women in the United States. Despite the effectiveness of mammography in early detection, Hispanic women in rural communities experience lower screening rates due to socioeconomic, cultural, and access-related barriers. At a rural South Texas clinic, the baseline screening rate among Hispanic women aged 50–74 years was 70.6%, below national benchmarks.

Purpose: To increase breast cancer screening compliance among Hispanic women aged 50–74 years in a rural South Texas family practice clinic.

Methods: Guided by the Lean A3 quality improvement framework, this project implemented a multifaceted intervention bundle that included …

Early Pressure Injury Identification And Intervention In Emergency Department Older Adults Who Are Admitted Into A Community Hospital Intensive Care Unit, Lisa M. Britt

Doctor of Nursing Practice (DNP) Scholarly Projects

A clinical gap was identified when reviewing a hospital acquired pressure injury (HAPI) dashboard from a 369- bed, acute care community hospital located in North Texas. Fifty percent of HAPIs acquired occurred in older adults, aged 60 or higher, who were admitted into the intensive care unit (ICU) from the emergency department (ED). A retrospective review of the electronic health records (EHR) demonstrated that none of the patients had received HAPI prevention interventions while they were in the ED and the inconsistent document of skin assessments resulted in identification of few HAPIs present on admission (POA). The purpose of this …

Front Matter

Lewis & Clark Law Review

Front Matter contains Table of Contents, Masthead, and faculty for Lewis & Clark Law Review, Volume 29, Issue 4.

Let Them Hear It: Peaceful Protests Near The Homes Of Supreme Court Justices, Srikanth Reddy

Lewis & Clark Law Review

All of us—not just attorneys and politicians—need to be more critical and skeptical of the Supreme Court. Criticism by ordinary people is good and appropriate, even if it hurts the Justices’ feelings. That includes public protests. When a case matters enough to them, members of the public can and should criticize the Court and its Justices, including by peacefully gathering and protesting near a Justice’s home, or when a Justice appears out in the world.

Oregon’S History Of Using The Law To “Stack The Deck” In Favor Of White Males, Janet Steverson

Lewis & Clark Law Review

The United States has a sordid, racist history that permeates society still today. The State of Oregon has its own racist history, systematically excluding persons of Black African ancestry in its early years. This Essay explains this history and how seemingly historical practices continue to provide advantages to some, while detrimentally impacting others. This history is put in context by providing explanations of particular terms and this Essay further explains why examining these historical laws are critical in moving forward.

Catching The Forgotten: Repairing The Safety Net For Cofa Migrants In The United States, Brian Aguilar

Lewis & Clark Law Review

Citizens of the Freely Associated States—the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Belau—are permitted to live and work in the United States without a visa under the Compacts of Free Association (COFA). Yet, for nearly three decades, COFA migrants were excluded from the federal public benefits safety net. This exclusion, a product of legislative oversight in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, devastated communities like the Marshallese in Springdale, Arkansas, who endured dangerous working conditions, poverty, and severe health vulnerabilities without access to critical federal benefits programs. While …

Shared Decision-Making To Improve The Vaccination Rate Among Older Patients, Muxian Chen

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Vaccines recommended for patients over the age of 50 include those for influenza (Flu), COVID-19, respiratory syncytial virus (RSV), pneumococcal disease, shingles, hepatitis A, hepatitis B, and a booster dose of the Tetanus, diphtheria, and pertussis (Tdap) vaccine every 10 years (American Association of Retired Persons, 2025). Unfortunately, these vaccines are often not adequately discussed during patient visits or are mentioned only briefly, without a clear plan for administration (American Association of Retired Persons, 2025). A vaccination bundle, which included resources for all vaccines and the opportunity to receive vaccines such as flu, COVID-19, RSV, Pneumococcal, Tdap, shingles, and …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

Reclaiming Connection: Narrative Differences Between Traumatic And Positive Birth Experiences, Ryan O. Sesker

Undergraduate Honors Theses

Traumatic birth experiences can disrupt mental health and maternal bonding between mother and infant. While clinical outcomes often prioritize infant health, less attention has been given to how birth experiences shape maternal confidence and feelings of confidence and adequacy as a new parent. This study examines what factors within birth experiences influence maternal self-perception and confidence during the postpartum period. Drawing on Maternal Role Attainment Theory and self-efficacy theory, this research explores how perceived loss of control, medicalization, provider interactions, and emotional support affect maternal identity formation. Using a qualitative approach, this research analyzes publicly available birth stories shared on …

Vacuum Wars: The Belt & Road Initiative’S Rise In The Arab League, Corabeth R. Pierce

Undergraduate Honors Theses

The world has shifted and changed in the last decade, resulting in a new world order. The Middle East and North Africa region houses the Arab League, which has drawn the attention of several states throughout the world. China has shown particular interest in the region since its Belt and Road Initiative (BRI) was first created in 2013. The BRI demonstrates how China has become more involved in the region and that these Arab states are more interested in what China has to offer compared to other countries. With the United States developing more nationalist policies, the European Union facing …