Digital Commons Network^™

Sustainable Architecture Practice In Indonesia : Navigating Global Standards And Local Knowledge, Dyah Kusuma Wardhani, Himasari Hanan, Firmansyah -

NAKHARA (Journal of Environmental Design and Planning)

This study investigates how Indonesian architects navigate between global green building rating tools (GBRTs) and context-specific design strategies across different project types and scales. Using a comparative analysis of sixteen award-winning projects by six Indonesian architects, the research combines semi-structured interviews with document review and inductive coding to map design logics against core GBRT categories. The analysis is around six themes used by GBRTs—energy efficiency, material resources and cycles, water conservation, sustainable site development, indoor health and comfort, and building resilience and adaptability—and identifies two additional themes central to Indonesian practice yet largely absent from GBRT assessment—social collaboration in the …

Opioid Abuse: Community Education, Meggan N. Wolff-Jackson

Doctor of Nursing Practice Projects

The opioid epidemic in the United States has persisted for over two decades and has become one of the leading causes of accidental deaths nationwide (Robert et al., 2022). The opioid crisis represents a widespread public health emergency that extends beyond individual and community boundaries, imposing burdens on both the national economy and the healthcare system (Kyei et al., 2024). Although the opioid epidemic is a global concern, it is particularly concerning in the target community located in the western part of North Carolina. This region has some of the highest rates of opioid overdoses within the state, with 118 …

Improving Overall Morale Of Nurses By Implementing A Serenity Room, Ruth B. Clarke-Johnson

Doctor of Nursing Practice Projects

Nursing, while a highly respected profession grounded in research and scientific practice, continues to face persistent challenges related to staff retention and morale. Key contributors include burnout related to high workloads, challenging staffing ratios, lack of supportive leadership, and an aging workforce. Together, these factors hinder healthcare organizations’ ability to sustain a stable and experienced staff. The implementation of a serenity or relaxation room is supported by growing evidence highlighting its positive effects on nurse morale and stress reduction. A review by Mileski et al. (2022) found wellness spaces significantly reduced burnout, emotional exhaustion, and stress while improving resilience, job …

Integrating Lactation Education Into Centering Pregnancy To Enhance Maternal Confidence And Lactation Initiation Rates, Courtney Barbee

Doctor of Nursing Practice Projects

Introduction: Breastfeeding remains the gold standard for infant nutrition providing physical and psychological benefits for both mother and baby. The inadequacy of lactation education and support continue to hinder breastfeeding initiation in the rural areas of North Carolina. Integrating a board-certified lactation consultant into the Centering Pregnancy model provides an evidence-based strategy to improve maternal confidence and increase lactation initiation rates within the target community.

Method: Using a quality improvement framework, the project targeted expecting mothers participating in Centering Pregnancy. Pre- and post-surveys assessed confidence levels after receiving two educational sessions with a board-certified lactation consultant.

Results: …

Beat By Beat: Empowering Communities With Lifesaving Cpr Skills, Allyssa Mb Hutchins

Doctor of Nursing Practice Projects

Introduction: This doctoral project was created to increase bystanders' willingness and ability to perform CPR by building their confidence in performing it effectively. A total of 13 participants participated in this project to increase knowledge and confidence in CPR interventions.

Background: Cardiac arrests remain a leading cause of death, yet research indicates that rural communities have lower rates of bystanders trained and willing to assist. Increasing CPR awareness and eliminating barriers to care for classes can improve CPR confidence and have a positive community impact.

Methods: Three 4-hour CPR classes were held in Zirconia, NC, at no …

Safe And Effective Injection Practices For Insulin And Glp-1 Users, Lydia A. Anderson

Doctor of Nursing Practice Projects

Improper insulin and GLP-1 injection techniques can reduce treatment effectiveness in patients diagnosed with diabetes mellitus. This quality improvement project aimed to improve patients' knowledge and safety regarding insulin and GLP-1 medications by conducting an educational session and demonstration of proper injection techniques. The project took place at a community senior center where individuals reported not receiving instruction or education on correct injection practices when prescribed these medications. Pre- and post-intervention surveys assessed changes in patient knowledge, confidence, and understanding of proper injection methods. Results demonstrated clear improvements in patient knowledge, confidence, and technique. This project highlights the significance of …

Enhancing Uncontrolled Hypertension Compliance And Self-Management In A Senior Center, Kimberly D. Strickland

Doctor of Nursing Practice Projects

Hypertension is a complicated, chronic condition that affects individuals worldwide. The prevalence of this condition has increased nearly 48% in the last decade in America. This project served to determine if participants in a targeted area/community would show increased knowledge and awareness of hypertension after implementation of educational sessions. A post-session survey was provided to determine if the educational sessions were effective. Data was collected and analyzed that showed an increase in awareness and knowledge regarding the prevalence of hypertension, diet modification, lifestyle, and compliance.

Increasing Awareness Of Obesity And Its Associated Risks In Adults, Esther E. Bayode

Doctor of Nursing Practice Projects

Obesity is a significant and growing public health concern in a metropolitan area of North Carolina, reflecting statewide and national trends. With 36% of adults in North Carolina classified as obese, the condition contributes to chronic diseases such as hypertension, diabetes, heart disease, and certain cancers. This project targeted adults aged 18 and older within a local faith-based community, where preliminary findings showed a strong association between elevated body mass and increased chronic disease burden. To address this issue, a two-session educational intervention was implemented in partnership with a religious organization to increase knowledge about obesity, its causes, associated risks, …

The Essentials Of Heart Failure Management, Emily W. Greene

Doctor of Nursing Practice Projects

Heart failure remains a leading cause of hospitalization among older adult women, often due to delayed recognition of symptom exacerbation and limited knowledge of self-management strategies. The purpose of this quality improvement project was to evaluate whether a brief educational intervention could improve knowledge of heart failure management among older adult women at a community senior center. The DNP project leader conducted two educational sessions focusing on early recognition of heart failure symptoms, heart-healthy diet, and when to contact a healthcare provider. Participants completed a pre- and post-test survey containing four knowledge questions and one Likert-scale question on perceived knowledge …

Spreading Awareness To College Athletes About Skin Cancer And Improving Sun Protection Habits, Baylee B. Whiteside

Doctor of Nursing Practice Projects

Introduction: The intention of this Doctor of Nursing Practice evidence-based project was to provide education on improving awareness of skin cancer to potentially improve sun protection habits. A total of 100 college athletes participated in this project. The goal was to increase educational knowledge and practice intentional sun protection habits.

Background: One in 5 people will develop a type of skin cancer by age 70 (Skin Cancer Foundation, 2024). Several studies have proven that young adults, ages 15-25, are at an increased risk of sun exposure due to decreased knowledge about skin cancer. Teaching and improving the knowledge in this …

Increasing Teens' Knowledge On The Health-Related Effects Of Vaping, Anteja Gore

Doctor of Nursing Practice Projects

Vaping in teens has become an increasing public health issue related to the growth in the number of teens who are using vapes. Many teens are not aware of the potential associated risk of using vapes, as they perceive them to be a safer alternative to smoking cigarettes. The purpose of this project was to increase the middle school teens’ knowledge of the potential health risks associated with vaping through an educational awareness session. This project was implemented in the middle school setting, targeting students aged 12-14 years. The students who participated completed anonymous pre- and post- questionnaires that evaluated …

Spreading Awareness To Adults About Cardiovascular Disease And Improving Healthy Lifestyle Habits, Madison L. Eldridge

Doctor of Nursing Practice Projects

Introduction: The intention of this Doctor of Nursing Practice evidence-based project was to evaluate if providing education to the target community would increase awareness and knowledge of cardiovascular disease and healthy lifestyle habits. The goal was to increase educational knowledge and promote awareness of cardiovascular disease and healthy lifestyle habits.

Background: Cardiovascular disease (CVD) is a critical health issue that prevails across the state of North Carolina, while continuing to remain one of the leading causes of death across the south-center Piedmont area of North Carolina. Several studies have proven that increasing knowledge on cardiovascular risks, promoting healthy exercise, and …

Effects Of Educational Programs On Reducing Sexually Transmitted Infection Rates, Phierica D. Gardin

Doctor of Nursing Practice Projects

Sexually transmitted infections (STIs) remain a significant public health concern in the United States, with increasing rates reported in many states, including North Carolina. Limited sexual health education, stigma surrounding sexual health discussions, and lack of awareness regarding prevention and screening contribute to ongoing transmission, delayed diagnosis, and potential long-term complications associated with untreated STIs. The purpose of this Doctor of Nursing Practice (DNP) project was to implement a sexual health education program aimed at increasing knowledge of STI transmission, prevention strategies, and the importance of screening among adults aged 18 years and older. Two educational sessions were completed within …

Combating Pressure Injuries In Critical Care: A Dnp Project On Nursing Education And Prevention Strategies In The Icu, Tijuana M. Johnson

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) are preventable complications that significantly increase patient morbidity, mortality, length of stay, and healthcare costs, particularly in intensive care units (ICUs). At a rural 146-bed hospital, the ICU pressure injury rate of 1.17 per 1,000 discharges exceeded the national benchmark of 0.58 per 1.000 discharges, identifying a critical gap in prevention practices. This Doctor of Nursing Practice (DNP) project aimed to improve ICU nurses' knowledge of pressure injury prevention and reduce unit-based educational intervention grounded in Patricia Benner’s Novice to Expert Theory and implemented using the Plan-Do-Study-Act (PDSA) quality improvement framework.

A pre-and post-intervention design was …

Building Clinical Competency In Central Line Care: A Nurse-Focused Initiative To Prevent Clabsis, Glenda A. Robbins

Doctor of Nursing Practice Projects

Central line-associated bloodstream infections (CLABSIs) are a significant yet preventable source of increased morbidity, mortality, and healthcare costs in acute care settings. Despite established evidence-based prevention bundles, inconsistent nursing adherence remains a primary contributor to elevated CLABSI rates. A 241-bed acute care hospital reported CLABSI rates above the national benchmark. This Doctor of Nursing Practice (DNP) project utilized Neuman’s Systems Model. The intervention consisted of a structured educational module on central line care and maintenance, including pre- and post- knowledge assessments. Additionally, standardized daily central line visual audits were reinforced by the Vascular Access Team. A total of 363 bedside …

Diabetes Education In Buncombe County, Deonna Nicole Blount

Doctor of Nursing Practice Projects

The growing number of Americans living with diabetes has reached an all-time high. According to the Centers for Disease Control and Prevention (CDC) (2026), there are 40.1 million people diagnosed with or underdiagnosed with diabetes. Evidence has shown that with education tailored to the patient's lifestyle, changes can be made and healthier lifestyles exhibited. Understanding the why of the patients can assist in changes that are feasible and can be implemented for the now and the future. Several studies outlined by Alonso-Carril et al. (2024), Lander et al. (2022), and Hodges et al. (2019) showed that education was implemented and …

Mental Health First Aid Training In The Community, Vester Agbley Gideon

Doctor of Nursing Practice Projects

Mental health issues impact one in five adults in the United States; however, many individuals lack the requisite knowledge and skills to effectively respond to mental health crises. Mental Health First Aid (MHFA) training empowers individuals to recognize and address mental health concerns, thereby fostering early intervention and support. This review analyses the efficacy of MHFA training, best practices for its implementation, and its influence on mental health outcomes. Empirical evidence indicates that MHFA training enhances mental health literacy, diminishes stigma, and encourages supportive behaviors. Customized approaches for targeted populations, such as youth and older adults, have also shown significant …

Improving Timeliness Of Extubation Post-Cabg: An Educational Intervention Utilizing A Nurse-Driven Checklist, Christy Scott

Doctor of Nursing Practice Projects

Background: Timely extubation following coronary artery bypass graft (CABG) surgery is associated with improved patient outcomes. In a rural six-bed cardiovascular intensive care unit (CVICU) in North Carolina, extubation times were previously reported at approximately 15 hours. A lack of a standardized nurse-driven process and inconsistent familiarity with extubation readiness criteria contributed to variation in practice.

Purpose: The purpose of this DNP project was to implement and evaluate an educational intervention using a nurse-driven extubation checklist to improve nurses' knowledge, confidence, communication, and role clarity related to post-CABG extubation readiness in the CVICU.

Methods: The staff education …

Musical Measures: Nurse Education On Music-Based Interventions To Reduce Patient Restraints, Crystal D. Tucker

Doctor of Nursing Practice Projects

The use of physical restraints in acute psychiatric settings poses significant risks to patient safety, including physical injury and psychological distress. Evidence supports the need for alternative, non-pharmacologic interventions to reduce reliance on restraints. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of an educational intervention on nurses’ knowledge and confidence in implementing music-based interventions, specifically binaural beats, to manage patient anxiety and agitation.

The project was conducted on a medical observation and behavioral health holding unit and utilized a pre- and post-intervention design. Registered nurses participated in educational sessions on music-based interventions and were …

Vision‑Based Online Quality Tracking In Wire Arc Additive Manufacturing Via Hybrid Unsupervised Deep Learning–Statistical Process Monitoring, Giulio Mattera, Yue Cao, Yuming Zhang, Luigi Nele

Electrical and Computer Engineering Faculty Publications

Vision-based monitoring of Wire Arc Additive Manufacturing (WAAM) using supervised deep learning represents the state of the art in anomaly detection, but such approaches require large labeled datasets that are costly to obtain and typically limited to laboratory conditions. To address these limitations, this work proposes a hybrid deep learning–statistical process monitoring (SPM) framework tailored to the stochastic nature of conventional arc welding processes such as GMAW-based additive manufacturing, where existing methods often overfit. The framework integrates a residual convolutional autoencoder (Res-CAE) with skip connections, which jointly analyzes video frames to generate refined latent-space features that are subsequently monitored using …

2026 Volunteer Impact Report, Tennessee. Department Of Disability And Aging

Volunteer Impact Report

This report highlights the accomplishments and statistics concerning volunteer programs for the department.

Identification Of Culturable Moulds, Audrey Bernèche-D'Amours, Thi Thanh Tam Nguyen, Delphine Lanoie

Microbiologiques

Cette méthode est utilisée pour identifier au genre ou à l’espèce des moisissures cultivées à partir d’échantillons d’air, de surface ou de matrices solides ou liquides. Après avoir isolé une souche de moisissure en culture pure, différentes techniques peuvent être utilisées : l’observation des caractères macroscopiques et microscopiques des colonies et leur comparaison à des clés d’identification de référence, la spectrométrie de masse utilisant la technologie MALDI-TOF et le séquençage de type Sanger ciblant différents loci génétiques. Les identifications obtenues par l’une, plusieurs ou l’ensemble de ces techniques sont ensuite interprétées pour rapporter une identification finale.

Abstract

This method is …

Body Wonder: Helping Women Discover The Wonder Of God In Their Female Forms, Kristin Marie Antil

Doctor of Ministry

This project works to address the following need/problem/opportunity (NPO): Christian women in my contexts are hindered from having a positive relationship with their bodies which undermines potential and diminishes self-worth. I observed this problem in the students I counsel in my work as a mental health therapist at Bethel University, but I also noticed a tendency for women in my church and community settings to disregard, disdain, or despise their bodies as well. The research over these three years has helped me see the complexities of the factors that contribute to the negative postures that women hold towards their bodies …

Audacious Saints: A Spiritual Formation Journey Toward Freedom And Flourishing, Carroll Lane Parsons

Doctor of Ministry

This doctoral project addresses a common challenge for many Christian women. In spiritual direction, they often express emotional, spiritual, and psychological pain because their voice, vision, and power are limited in their faith communities. Even though these women are deeply devoted to God and their beliefs, this pain can often make it difficult to experience spiritual confidence, discover their calling, and trust their own discernment. The project explores how engaging with the lives of female saints, alongside contemplative and embodied practices, can offer a healing way forward.

Audacious Saints is a twelve-module spiritual formation program that integrates sacred stories, group …

The Reconnection Experience: A Black Pastor's Journey Back To God And Self, Lindsay Mcghee Alexander

Doctor of Ministry

NPO

The Need/Problem/Opportunity (NPO) statement guiding this project is: Pastors in the 8th Episcopal District of the AME Church feel disconnected from God and themselves.

Key Insights

The research revealed that pastoral disconnection is driven less by lack of skill and more by identity loss, performance pressure, and the absence of safe spaces for vulnerability. Spiritual formation remains largely absent from Black pastors' lives and churches. Cultural and denominational expectations reward quantitative data over spiritual growth. Self-care and inner work are not recognized as integral to ministry success or effectiveness. Many pastors operate from “doing” rather than “being,” leading to …

Equip: Developing Confident, Christ-Centered Volunteers, Alyssa Mclaughlin

Doctor of Ministry

NPO statement: Volunteers within Cedar Hills Church feel unsure of what we believe, unclear on their purpose, and unprepared to disciple others in their specific ministry contexts. Without intentional training and equipping, these barriers keep capable people on the sidelines instead of stepping confidently into the mission of Jesus.

Key benefits or insights that emerged: Research and early implementation showed that volunteers engage more when equipping is relational, practical, and connected to real life. Adults were more willing to participate when they could share from their own experiences and practice their faith, rather than sit through content-heavy teaching. Participants gained …

Renewed: A Journey Toward Resilient And Relational Leadership, Molly Bradley Lacroix

Doctor of Ministry

Adverse religious experiences cause spiritual, emotional, and relational wounds. Research on spiritual harm locates its origins in the misuse of power. High-control religious environments are preoccupied with authority, submission, silencing dissent, and shaming those who question or doubt. Clearly, the nature of leadership is key in addressing and preventing harm. Spiritually safe leaders empower people, lead with humility, seek feedback, and take accountability for mistakes. Research on the role of clergy reveals complex roles, relentless demands, burnout, and the impact of secondary trauma on clergy well-being. Additionally, clergy are often expected to operate beyond their areas of competence and report …

The Sabbath Journey: An Invitation For Pastors And Spiritual Leaders To Find Rest In God, Cody Daniel Ragland

Doctor of Ministry

In the fast-paced ministry of today, non-denominational evangelical pastors in the United States often strive to serve their congregations while neglecting God’s gift of Sabbath rest. Though the Sabbath is deeply rooted in Scripture, it is often misunderstood, minimized, or neglected in the lives of pastors. My NPO seeks to address:

This doctoral project introduces The Sabbath Journey: An invitation for Pastors and Spiritual Leaders to find rest in God. It is a year-long cohort program designed for pastors and ministry leaders to cultivate deep personal relationships and accountability as they develop a weekly Sabbath practice. Through intentional community, …

A Novel Tyrosine Kinase Axis In Innate Immune Signaling, Santanu Das, Pracheta Sengupta, Manoj Veleeparambil, Saurabh Chattopadhyay

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Tyrosine phosphorylation has emerged as a central regulatory mechanism in innate immunity. Building on our recent studies that Syk and EGFR sequentially phosphorylate TLR9 to fully activate it, we discuss how similar mechanisms operate across other Toll-like receptors and the cytosolic DNA sensor STING. Evidence from complementary systems reveals that receptor and nonreceptor tyrosine kinases, including Src-family kinases, Syk, BTK, and EGFR, form an integrated signaling network that triggers receptor activation, trafficking, and downstream gene expression. Scavenger receptors such as SR-A further drive this kinase cascade by coordinating viral recognition to TLR activation. These observations reveal a novel ‘tyrosine kinase …

Maternal Opioid Use Disorder And Hepatitis C Infection In Pregnancy Reshape The Peripheral Immune Landscape At Term, Brianna M. Doratt, Heather E. True, Sheridan B. Wagner, Delphine C. Malherbe, Zachary M. Reynolds, Cynthia Cockerham, John O'Brien, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Background: Pregnancy requires precisely timed immune adaptations to maintain foetal tolerance while enabling timely initiation of labour, a process often conceptualised as the ‘immune clock’ of pregnancy. Disruption of this immune clock contributes to adverse obstetric outcomes. While maternal opioid use disorder (OUD) is a recognised risk factor for poor maternal and neonatal health, its impact on maternal immune landscape at delivery remains poorly understood.

Methods: We analysed peripheral blood collected from pregnant individuals with and without OUD at time of admission for delivery before the onset of active labour. We employed multiparameter flow cytometry, cytokine profiling, and single-cell-RNA sequencing …