Digital Commons Network^™

Sulfated Dietary Fiber Protects Gut Microbiota From Antibiotics, Fuqing Wu, Xiaoqian Annie Yu, David Angeles-Albores, Susan E Erdman, Eric J Alm

Faculty, Staff and Student Publications

Background: Antibiotics, while essential for combating pathogens, also disrupt commensal bacteria, leading to gut microbiota imbalance and associated diseases. However, strategies to mitigate such collateral damage remain largely underexplored.

Result: In this study, we found that fucoidan, a marine polysaccharide derived from brown seaweed, provides broad-spectrum growth protection against multiple classes of antibiotics for human gut microbial isolates in vitro and for fecal communities ex vivo. This protective effect is dependent on the structural integrity, molecular weight, and sulfur content of the polysaccharide. Transcriptomic analysis showed that while fucoidan had minimal impact on baseline gene expression, it counteracted about 60% …

Development Of A Customizable Web-Based Dashboard For Remote Blood Pressure Monitoring: Feasibility And Usability Implementation Study, Joshua Wollen, Thuy Nguyen, Charles Coton, Gina Dewildt, Gabretta Cooksey, Audrey Cohen, Nicholas Hoang, Munachi Okpala, Michael Gonzalez, Mengxi Wang, Chigozirim Izeogu, Elmer Bernstam, Charles Green, Sean Savitz, Jose-Miguel Yamal, Anjail Sharrief

Faculty, Staff and Student Publications

Background: Effective blood pressure (BP) management is essential for several disease states, including secondary stroke prevention. Remote BP monitoring used in combination with an electronic data capture (EDC) system offers potential for improved BP control for patients. While such systems currently exist, there are many patient-, provider-, and system-specific challenges these systems currently do not address. In addition, such systems are rarely described transparently and comprehensively in the literature with enough detail to be reproduced by other clinicians.

Objective: This study aims to describe the development and design of a web-based EDC system tailored for remote BP monitoring and management …

Evaluating The Effectiveness Of The Comprehensive Unit-Based Safety Program In Reducing Hospital-Acquired Infections, Peta Ann Anderson

Walden Dissertations and Doctoral Studies

This doctoral project is an evaluation of a quality improvement initiative that applied a mixed method approach to evaluate the impact of the Comprehensive Unit-based Safety Program (CUSP) on hand hygiene (HH) compliance and healthcare-associated infection rates. The project was conducted in the United States of America (USA), Florida in an acute care hospital. The practice problem addressed was the persistent low adherence to HH protocols among healthcare staff, a critical issue in nursing practice due to its direct link to preventable patient harm. Quantitative data demonstrated a substantial reduction in infection rates following the implementation of the CUSP program. …

Staff Education To Improve Stroke Management Knowledge Among Medical-Surgical Emergency Department Overflow Staff Nurses, Andrea Terri Branch

Walden Dissertations and Doctoral Studies

Summary This quality improvement initiative aimed to enhance stroke knowledge through an evidence-based staff education program for medical-surgical emergency department (ED) overflow nurses. The impetus for the project stemmed from recognition of the need for enhancing prompt response and communication during acute stroke events. Variations in stroke knowledge among nursing staff contributed to delays in recognizing and responding to stroke symptoms. The practice-focused question guiding this Doctor of Nursing Practice (DNP) project addressed whether the implementation of an evidence-based stroke education program could improve nursing knowledge. The purpose of the project was to evaluate whether an evidence-based stroke education program …

Correctional Officers’ Perceptions Of Personal Safety Equipment Effectiveness, Tiffany Haigler-Sion

Walden Dissertations and Doctoral Studies

The United States has the largest correctional system and the highest incarceration rate in the world. Within this system, correctional officers (COs) serve as the primary point of contact with inmates. Existing literature suggests that the nature of inmates’ offenses often influences COs’ perceptions. Moreover, safety equipment plays a critical role in maintaining security within prison environments. Understanding COs’ experiences and perceptions regarding their safety equipment is therefore essential. The research problem is that little is known about COs’ lived experiences with and perceptions of the safety equipment they carry to keep safe from inmate severe assault. The purpose of …

The Experiences Of Physical Therapists Trained In Instrument Assisted Soft Tissue Mobilization For Self-Care, Edward Bezkor

Walden Dissertations and Doctoral Studies

Physical therapists and physical therapy students are susceptible to overuse and postural-related injuries related to computer work, lifting, and transferring patients. An effective technique for musculoskeletal dysfunction is instrument assisted soft tissue mobilization (IASTM) self-care. The purpose of this phenomenological qualitative study was to better understand the lived experiences of physical therapists and physical therapy students who are trained in IASTM self-care. The theoretical foundation for this study was the health belief model (HBM), which proposes that one’s beliefs strongly influence behavior change. In alignment with HBM, research questions related to the participants’ beliefs regarding the perceived threat of not …

Msw Degree Completion: Foster Care Alumni’S Perceptions Of Barriers, Resilience, And Success, Christa Martinez

Walden Dissertations and Doctoral Studies

This capstone research project involved examining foster care alumni who successfully graduated from Master of Social Work (MSW) programs as full-time students. The purpose of this study was to address resilience factors and this population’s perceptions of barriers, resilience, and success in terms of completing full-time MSW programs and career outcomes. The resiliency theory and a strength-based-perspective were frameworks for this research. This basic qualitative research study involved using purposive sampling, and 11 foster care alumni were interviewed who graduated from full-time MSW graduate programs in the United States. Through thematic analysis, themes emerged were lack of economic resources impacting …

Staff Education To Address Medication Noncompliance In Outpatient Behavioral Health Settings, Elmase Nicolas Toussaint

Walden Dissertations and Doctoral Studies

This quality improvement project is a staff education initiative designed to address psychotropic medication noncompliance in an outpatient behavioral health clinic setting. The project arose from the identification of a significant gap in staff knowledge and confidence related to medication adherence strategies. Medication noncompliance in psychiatric care is associated with symptom exacerbation, increased hospitalization, and poorer patient outcomes, making it a critical issue in nursing practice. The practice-focused question guiding the project was: In an outpatient behavioral health clinic setting, does implementing a structured staff education program improve staff knowledge and confidence in addressing medication noncompliance? Analytical strategies included a …

The Association Between Unemployment, Income, Education, Healthcare Access, Mental Health And High-Risk Hiv Behavior In The United States, Tia Smith

Walden Dissertations and Doctoral Studies

High-risk HIV behavior remains a critical public health concern in the United States, particularly among socioeconomically and psychologically vulnerable populations. Despite extensive prevention efforts, a gap persists in understanding how structural and mental health factors jointly contribute to HIV risk. This study addresses that gap by examining the association between socioeconomic status (SES), including income, education, employment, and healthcare access, and mental health status (diagnosis of depression and days of poor mental health) on high-risk HIV behavior at the individual level. Guided by the social determinants of health (SDOH) theoretical framework, the study utilized secondary data for over 40,000 adults …

Improving Self-Care In Nursing Professionals, Tina R. Kinnear

Master's Projects and Capstones

Abstract

Background: Nurses in high-acuity settings like telemetry units face intense physical and emotional demands, often leading to burnout and secondary traumatic stress. This project aimed to integrate self-care into nursing culture through leadership and evidence-based strategies to support resilience and well-being.

Problem: At a telemetry unit in Stanislaus County, 67% of nurses reported burnout or secondary traumatic stress despite institutional focus on well-being. Barriers like high patient acuity and lack of standardized self-care practices persist. In addition, the unit has consistently scored below the 65% benchmark on the Glint People Pulse “Culture of Health Index,” with survey engagement …

Implementation Of A Triage System For The Residents At A Residential Facility To Improve Triage Assessment Skills Of The Staff As Well As Improve The Level And Timeliness Of Care, Andrew J. Choi Rn, Neha Gopal Rn, Andres N. Padilla Rn, Dana Son

Master's Projects and Capstones

Triage is an integral part of the clinical process which involves assessing patients and determining their level of care in order to get them appropriate, timely treatment. Several countries utilize a standardized triage system with established criteria to aid staff in their decision-making during assessments (Peta et al., 2023). The Nursing and Residential Triage (NaRT) tool, from the Manchester Triage System (MTS), was shown to enhance staff clinical assessment skills and help avoid inappropriate ED transfers during a study among older adults in a residential facility (Markey et al., 2024). For this project, the main issue identified at the residential …

Enhancing Patient Safety: Fall Prevention Through Video Education, Fithawit T. Zere

Master's Projects and Capstones

Abstract

Problem: Globally, hospital falls remain a leading cause of injuries, increased costs, short and long-term disability and emotional impact on patients/families. Despite required prevention measures, a local hospital experienced rising fall rates during 2024 (n=71);13 of these occurred in the Med-telemetry microsystem. Although multiple strategies and financial investments occurred, nursing compliance with the fall prevention “bundle” remained suboptimal.

Context: Thirteen falls resulted in $182,000 in 2024. A quality improvement (QI) project was initiated over 12 weeks after routine audits revealed inconsistency in application of several components of the required bundle: particularly, the fall prevention video upon admission.

Interventions: A …

Office Of Research, Economic Engagement And Outreach Update, August 6, 2025, Office Of Research, Economic Engagement And Outreach

Office of Research, Economic Engagement and Outreach

No abstract provided.

The Impact Of Culturally Grounded Breastfeeding Programs On Black Maternal And Infant Outcomes: A Scoping Review, Kelsey B. Green

Master's Projects and Capstones

Abstract

Background: The lack of culturally grounded breastfeeding programs and understanding of their impact on Black breastfeeding initiation, duration, and health outcomes hinders improving Black breastfeeding rates in the U.S.

Research aim: This scoping review examines the impact of culturally grounded breastfeeding programs on Black mothers' and infants' health, and factors contributing to their success.

Methods: A scoping review of the literature was conducted using the CINAHL and SCOPUS databases. In the end, 34 scholarly articles were chosen for this review because they examined the impact of culturally grounded breastfeeding programs on Black breastfeeding rates and health outcomes.

Results: Culturally …

Biomarkers In Renal Cell Carcinoma: A Systematic Review And Immunohistochemical Validation Study, Brett Berezowski, Robert Boothe, Billy Chaplin, Sharon J Del Vecchio, Zakariya Fares, Tyrone L R Humphries, Keng Lim Ng, Taylor Noonan, Hemamali Samaratunga, Aaron Urquhart, David A Vesey, Simon T Wood, Glenda C Gobe, Robert J Ellis

Faculty, Staff and Student Publications

The worldwide incidence of renal cell carcinoma (RCC) rose by 22% between 2012 and 2022. In Australia, RCC accounted for 2.8% of all cancer diagnoses and contributing to 1.8% of cancer-related deaths. Identification of RCC biomarkers may aid in diagnosis and management. Methods: A systematic review of immunohistochemical markers of RCC studies published between 1990 and 2019 was undertaken to select candidate biomarkers of RCC. Immunohistochemical staining of 73 clear cell RCC tumors and paired normal tissue was undertaken using selected markers. Semi-quantitative and quantitative analysis of staining intensity between paired samples was undertaken to evaluate utility as potential …

Immunomodulatory Effects Of Gold Nanoparticles: Impacts On Immune Cells And Mechanisms Of Action, Khadijeh Koushki, Prapannajeet Biswal, Geraldine Vidhya Vijay, Mahvash Sadeghi, Sajad Dehnavi, Ngoc Tuyet Tra, Sai Kumar Samala, Mahdieh Yousefi Taba, Arjun Balaji Vasan, Emily Han, Yuri Mackeyev, Sunil Krishnan

Faculty, Staff and Student Publications

Traditional anti-inflammatory medications-such as corticosteroids, biological agents, and non-steroidal anti-inflammatory drugs-are commonly employed to mitigate inflammation, despite their potential for debilitating side effects. There is a growing need for alternative next-generation therapies for symptomatic, unchecked, and/or detrimental inflammation with more favorable adverse effect profiles. The long history of use of gold salts as anti-inflammatory agents and the more recent exploration of gold nanoparticle (AuNP) formulations for clinical indications suggest that the targeted delivery of nanoparticles to inflammatory sites may be a promising approach worth investigating. Coupled with peptides that specifically target immune cells, AuNPs could potently counteract inflammation. Here, we …

Exploring Factors Affecting The Adoption And Use Of Digital Health Technologies Among Older Adults With Cancer: A Qualitative Study, Misun Hwang, Youmin Cho, Katie Gahn, Heidi Mason, Milisa Manojlovich, Yang Gong, Yun Jiang

Faculty, Staff and Student Publications

Purpose: Although digital health technologies (DHTs) are promising to improve health outcomes in older adults with cancer, the low adoption and limited use remain significant gaps in their effective digital health care. Little is known about their concerns about adopting and using DHTs in routine life, particularly in the continued use phase. This study aims to explore factors affecting the initial adoption and continued use of DHTs among older adults with cancer.

Methods: A secondary analysis of qualitative data was conducted based on interviews with 21 older adults (≥ 65 years) with breast, prostate, lung, or colorectal cancer. The transcripts …

Second Amended Disclosure Statement

Catholic Dioceses in Bankruptcy

No abstract provided.

Racial And Ethnic Disparities In Receipt Of Guideline-Concordant Pancreatic Cancer Care Among Older Adults In The United States, Joshua Herb, Kai-Ping Liao, John K Lin, Kever A Lewis, Sharon H Giordano, Matthew H G Katz, Rebecca A Snyder

Faculty, Staff and Student Publications

Purpose: Patients racialized as Black experience a higher mortality from pancreatic cancer (PC). Worse survival outcomes may relate to differences in delivered treatment. This study examined differences in receipt of guideline-concordant care (GCC) among older adults with PC according to race and ethnicity.

Methods: Patients 65 years and older with incident PC racialized as non-Hispanic White (NH-White) or racialized as NH-Black or of Hispanic ethnicity were identified in the SEER-Medicare database from 2004 to 2019. The primary outcome was receipt of stage-specific GCC. Multivariable logistic regression identified factors associated with GCC. Oaxaca-Blinder decomposition examined the contribution of measured and unmeasured …

Faculty Experiences With Evaluation Practices Within A Community College, Janie Dobbins Hamrick

Doctoral Dissertations and Projects

The purpose of this phenomenological study is to understand faculty experiences with evaluation practices for teachers within two-year higher education institutions in the Southeast region of the United States. The theory guiding this study is transformational leadership theory as it aids in understanding the problem that some faculty experience with evaluation practices established by ineffective leadership. By researching transformational leadership theory, researchers have determined that leadership style influences faculty experiences with teacher assessment procedures like evaluation and observation practices. The Central Research Question is, how are teaching evaluation experiences of community college faculty influenced by perceived supervisor leadership style? The …

Improving The Medication Communication Domain Of The Hospital Consumer Assessment Of Healthcare Providers And Systems Survey In A Pediatric Hospital, Bailey N. Godwin

Doctoral Dissertations and Projects

Patient education is a key responsibility of nurses. Providing education is the most effective when the teach-back method is used in combination with tangible education materials. Patient satisfaction in the pediatric setting is measured using the Child Hospital Consumer Assessment of Healthcare Providers and Systems survey (Child-HCAHPS). This evidence-based practice project aimed to improve patient/caregiver satisfaction scores for medication education on the Child-HCAHPS survey through comprehensive medication education and improved usage of patient education materials at discharge. Three pediatric units within an academic health institution in central North Carolina were identified for participation in the intervention by their managers and …

Investigating The Role Of Student-Instructor Connectedness And Student Thriving In Living A Calling, Whitney Claire Cranford

Doctoral Dissertations and Projects

This mixed-methods study explored student-instructor connectedness and student thriving as predictors of living a calling for graduates of four-year higher education institutions. It also investigated which aspect of student thriving - academic, emotional, or social - is most predictive of living a calling. While research addresses these variables individually, limited research has been conducted to address their interconnection and the results for four-year higher education graduates. All variables were measured using established scales. The mixed-method approach encompassed qualitative data from surveys and quantitative data from interviews with graduates of four-year higher education institutions. A total of 79 participants were recruited …

A Quantitative Examination Of School Psychologists And The Relationships Between Work-Life Balance, Burnout, And Turnover Intentions, Brittany Leigh Storti

Doctoral Dissertations and Projects

Research for the past twenty-five years has documented that there is a national shortage of school psychologists across the United States. It is vital to study the magnitude of school psychologists working in the educational field and the impact of work-life balance has on burnout and turnover intentions. The study surveyed 75 school psychologists who work in a brick-and-mortar, hybrid, and virtual setting across the United States to compare the relationships and to determine if there is a difference between turnover intentions based on work setting. A moderation analysis and an ANOVA determined that the research failed to reject the …

Social Networks And The Demand For Credence Agricultural Technologies, Yurani Arias-Granada, Jonathan Bauchet, Jacob Ricker-Gilbert, Kajal Gulati

Department of Agricultural Economics Faculty Publications

Little is known about the adoption of agricultural technologies that enhance unobservable attributes, such as food quality and food safety. Social networks can potentially be a key tool to disseminate information about such technologies, because informal discussions among network members could counter the lack of observability and awareness of the benefits of such technologies. To inform this issue, we conducted a field experiment that included experimental auctions and a lottery to estimate how social networks influence the demand for Aflasafe, a new food safety-enhancing technology, among smallholder farmers in Senegal. Aflasafe is an agricultural input that controls aflatoxins, which are …

Use Of Single Bout Exercise On Symptoms Of Burnout In Secondary Teachers, Robert A. Campos

Doctoral Dissertations and Projects

Increased levels of stress, anxiety, and burnout among educators within the United States educational system have contributed to elevated attrition rates and diminished student outcomes. This study investigates the effects of single-bout exercise sessions on reducing of burnout, specifically emotional exhaustion, depersonalization, and lack of personal achievement among secondary public-school teachers. Using the Maslach Burnout Inventory – Educators Survey (MBI-ES), this correlational study used a repeated-measures design in which 36 secondary teachers participated in a control (no exercise), aerobic exercise, and anaerobic exercise sessions. Pre- and post-exercise session scores were analyzed to evaluate the immediate effects on burnout elements. Findings …

A Qualitative Study On Retention And Engagement At A Private Historically Black College And University Among First-Year African American Students From Rural Communities, Miquelle Latoine Fields

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to understand how the intersection of rural culture and race influences the lived experiences of first-year African American students at a private Historically Black College and University (HBCU). Moustakas's theory on phenomenological research methods, based on Husserl's transcendental phenomenology framework, guided the study. The research focused on how cultural context intersects with the lived experiences of first-year African American students from rural areas. It examined how this diversity affects their retention and engagement at a private HBCU. The central research question was: How do the lived experiences of first-year African American college students …

Vulnerable Student Populations’ Understanding Of Title Ix, Campus Support, And Supportive Resources: A Hermeneutical Phenomenological Study, April Lynn Wright

Doctoral Dissertations and Projects

This hermeneutical phenomenological study examined how vulnerable student populations on college campuses perceived Title IX, campus support, and campus resources. The theory guiding this study is Homans’s social exchange theory, which connects the three pillars of rules, resources, and social relationships. The connection between the theory and the study is that while Title IX has guidelines established to support students after a campus sexual assault, the guidelines do not mean much if a student who has experienced a campus sexual assault is unsure of the support and resources that are available to them. While social exchange theory highlighted the rules, …

Where Words Fail Music Speaks: A Qualitative Exploration Of Uses And Gratification Theory And How Music Influences College Students In Their Daily Productivity, Relationships And Self-Perception, Abagayil E. Hatt

Doctoral Dissertations and Projects

The dissertation project explores the music consumption of college students aged 18 - 24 and its influence on them. The study focus is how music impacts daily productivity-related decisions, relationships, and self-perception. Through ZOOM interviews and personal logs, this qualitative dissertation explored the influence music has on college students aged 18 – 24. This study contributes to the field of communication by revealing how music influences young adults’ communication, decisions, and identity. This study highlights the need for a more nuanced understanding of how music shapes behavior and identity.

The Exploration Of Self-Management Support Programs For African American Adults Ages 18 To 75 In Harnett County, North Carolina, Moya Camille Henny

Doctoral Dissertations and Projects

This phenomenological study explored the health needs and self-management experiences of African American adults ages 18 to 75 living with type 2 diabetes and hypertension in Harnett County, North Carolina. The study aimed to understand how self-management support programs could be better tailored to meet the cultural, social, and behavioral needs of this population, who face a disproportionate burden of these chronic conditions. Guided by Critical Care Theory, Chronic Care Model, and Social Cognitive Theory, the research examined how systemic inequalities, community resources, and personal beliefs shaped participants’ ability to manage their health. Data were collected through in-depth, semi-structured interviews …

Pass It On: Developing Children's Identity With Biblical Storytelling At First Baptist Church Of Sanford, Caleb Mccord

Doctoral Dissertations and Projects

In a culture where many youths are not only leaving the church but also facing psychological issues like identity crises, it is important that children develop their identity as God’s Word prescribes rather than the preference-based identities pushed by secular parties. To best ensure this development, then it is essential that children receive biblical storytelling from both the church and also the parents at home, the latter of which is underutilized in many modern Christian homes. This thesis posits that if parents are made aware of the need for biblical identity development and trained to do so, then they will …