Digital Commons Network^™

Global, Regional, And National Burden Of Cardiovascular Diseases And Risk Factors In 204 Countries And Territories, 1990-2023, Global Burden Of Cardiovascular Diseases And Risks 2023 Collaborators, Benjamin A. Stark, Nicole K. Decleene, Emily C. Desai, Johnathan M. Hsu, Catherine O. Johnson, Laura Lara-Castor, Kate E. Legrand, Prof Bhoomadevi A, Mohammad Amin Aalipour, Hasan Aalruz, Bedru J. Abafita, Ukachukwu O. Abaraogu, Mohammad Abavisani, Nasir Abbas, Madineh Abbasi, Mohammadreza Abbasian, Hedayat Abbastabar, Abdallah H.A. Abd Al Magied, Samar Abd Elhafeez, Prof Ahmed Abdelalim, Omar M. Abdelfattah, Prof Reda Abdel-Hameed, Mahmoud Abdelnabi, Prof Wael M Abdel-Rahman, Parsa Abdi, Wakgari Mosisa Abdisa, Daba Abdissa, Arman Abdous, Mujahid Abdullah

Peninsula Medical School

Background: Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging. Objectives: We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure. Methods: The Global Burden of Disease (GBD) 2023 study, a multinational …

Final Butte Mine Waste Repository Geotechnical Investigation Work Plan, Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

The Impact Of Infrastructure Construction And Remodeling Of Cities On Its People' Quality Of Life Miraj District-(Madi-Cairo) As A Geological Heritage Area, Ahmed M.E. Hammad

Mansoura Engineering Journal

Rapid urbanization is increasing globally, the urbanization rate expected to rise to more than 66% by 2050. (According to UN estimates) the increasing rates of urbanization in the world means adding 2.5 billion people to the urban population within a short period. Which necessitates increasing the traffic axes and the rest of the networks in terms of lengths and widths within the existing cities, and with the presence of the population during these works - despite their inevitability - the quality of their urban life is affected socially, naturally and economically. the research monitors these effects and the extent of …

Single Compost Application Benefits For Organic Dryland Wheat Production, Shikha Sharma, Matt Yost, Earl Creech, Jennifer R. Reeve, Astrid R. Jacobson, Idowu Ademola Atoloye

All Current Publications

This research highlights the long-term value of compost in dryland wheat systems, where water scarcity and declining soil fertility limit productivity. A single, high-rate compost application (22 tons per acre) can improve soil moisture content, organic carbon content, aggregate stability, and microbial activity. All these benefits contributed to higher and more stable wheat yields, even more than two decades after application. These changes help to make the compost-treated wheat more resilient during dry years. While composting incurs a high upfront cost, its long-term benefits can significantly reduce the need for repeated fertilizer or soil amendments, offering cost and labor savings …

Emphasis On The External: Deceptive Beauty In Lady Audley’S Secret And The Picture Of Dorian Gray, Arden Cravy

Honors Theses

The novels Lady Audley’s Secret by Mary Elizabeth Braddon and The Picture of Dorian Gray by Oscar Wilde both present major themes of beauty, authenticity, and morality while maintaining their didacticism. This thesis comes as a surprise due to the beliefs and intentions of the authors, both of whom claim other motivations than the betterment of their readers. The parallels between these narratives ascribe to the fallible Victorian perspectives regarding external appearance and internal motivations. The danger of assumed authenticity becomes apparent in these authors’ works as they grapple with the realities of human nature. Wilde and Braddon each depict …

States As Shields, Lindsay F. Wiley

Minnesota Law Review Vols. 106:2 onward (2021-present)

State laws that aim to shield providers of reproductive health and gender-affirming care from the punitive actions of out-of-state officials raise thorny questions. Can the federal courts, Congress, or the Trump Administration require New York officials to enforce a Texas ban on abortion or gender-affirming care against a New York doctor who prescribed medication to a patient in Texas via telehealth? If so, how might New Yorkers’ access to health care be affected? If not, will interstate commerce and travel preserve some degree of access for Texans?

Disputes over reproductive health and gender-affirming care are putting new pressure on doctrines …

Quality Improvement Project: Provider Education On An Evidence-Based Clinical Pathway For Diagnosing Adult Attention-Deficit Hyperactivity Disorder, Oluwadayo B. Adeyemo

Doctor of Nursing Practice Projects

Accurate diagnosis of adult Attention-Deficit Hyperactivity Disorder (ADHD) remains challenging in outpatient behavioral health settings, as variations in clinician training, diagnostic tools, and assessment methods can hinder accuracy and delay treatment. At the project site, providers reported low confidence and inconsistent use of standardized tools when evaluating adult ADHD, underscoring a critical need for structured education to improve diagnostic consistency and provider confidence. This quality-improvement (QI) project assessed the impact of an educational intervention on provider knowledge, confidence, and utilization of validated screening tools for adult ADHD. Guided by Donabedian’s Model of Quality Improvement and Lewin’s Change Theory, the project …

Quality Improvement Project: The Impact Of Genetic Testing Education For Mental Health Providers In An Outpatient Clinic, Ifeoma Uzoh-Anigbogu

Doctor of Nursing Practice Projects

Despite growing evidence supporting the use of genetic screening in psychiatric medication management, many mental health providers lack the confidence and knowledge to utilize this tool effectively. This quality improvement (QI) project aimed to enhance provider self-efficacy and increase the utilization of genetic screening through a structured education and training program in an outpatient mental health clinic. The purpose of the project was to determine whether provider education on pharmacogenetic testing improves confidence and screening frequency compared to those who do not receive the intervention. The Donabedian Model guided evaluation of structure, process, and outcome measures, while Rogers’ Diffusion of …

Quality Improvement Project, Communicating With The Dying Patient: A Simulation Experience For Nursing Students, Jason Weger

Doctor of Nursing Practice Projects

Effective communication with patients near the end of life is a crucial yet often underdeveloped skill among nursing students. Previous research highlights a persistent gap in training for end-of-life communication in nursing schools. This quality improvement project implemented a simulation-based educational intervention to improve end-of-life communication skills among first-semester nursing students at a community college in Oklahoma. A needs assessment identified significant gaps in students' readiness for emotionally charged patient interactions. Guided by Prosci’s Change Model and Jeffries Simulation Theory, the project used a faculty-led simulation experience to teach evidence-based communication strategies, including appropriate word choice, therapeutic presence, and active …

Quality Improvement Project: Reducing Hospitalizations In The Long-Term Care Setting, Nenna Nzeocha

Doctor of Nursing Practice Projects

Hospitalizations in the long-term care setting can lead to higher costs incurred by skilled nursing home residents and a poorer quality of life. This quality improvement (QI) project evaluated whether an educational intervention on the Reducing Avoidable Facility Transfers (RAFT) model impacted hospitalization rates in the skilled nursing facility (SNF), while also assessing the confidence level of facility staff on the intervention. The project utilized Lewin’s change theory and the Donabedian model framework and was aimed at developing interventions that impact hospitalizations in the SNF using the RAFT model. A quasi-experimental design was used and consisted of a pre-and-post implementation …

Resiliency For Nurse Educators: Incorporating Resiliency Training For Nursing Faculty, Rachael Holder

Doctor of Nursing Practice Projects

Nursing faculty frequently experience high levels of stress, workload demands, and burnout, which can negatively affect teaching effectiveness and retention. Literature supports resilience as a protective factor that enhances well-being and professional sustainability. The purpose of this quality improvement project was to impact resilience levels among full-time undergraduate nursing faculty through a self-paced online resiliency training program. Guided by Pender’s Health Promotion Model and Lewin’s Change Theory, this pre- and post-intervention design used the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) to assess changes in resilience. Eleven faculty members completed the pre-survey, and two completed the post-survey. The post-survey mean CD-RISC-10 scores …

Quality Improvement Project Implementation Of A Peer Mentoring Program In An Associate-Degree Nursing Program, Heather Baker

Doctor of Nursing Practice Projects

Peer mentoring is recognized as an evidence-based strategy that offers support to students and enhances retention. This project aimed to implement a peer mentoring program based on the Nursing Universal Retention and Success (NURS) model. The Plan-Do-Study-Act (PDSA) framework and Havelock’s Theory of Planned Change guided the implementation process. The goal was to assess the program's impact on first-semester nursing student retention rates and students’ perceptions of success. First-semester nursing students in a traditional associate-degree nursing program volunteered to participate in the peer mentoring program for one semester. At the end of the semester, an anonymous post-survey was distributed to …

Quality Improvement Project: Improving Emergency Medication Administration Safety In An Inpatient Psychiatric Unit, Sandra Anusiem

Doctor of Nursing Practice Projects

Psychiatric emergencies contribute to medication safety issues due to increased stress, inconsistent practices, and communication breakdowns. The problem was high rates of medication errors in psychiatric emergencies due to the lack of a structured, standardized medication management protocol. This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce medication errors in administering emergency medications in an inpatient psychiatric unit by using the Medication Administration Cross-Check (MACC) checklist. The project was completed using a quasi-experimental research design guided by the Donabedian Model of Healthcare Quality and Lewin’s Change Model. Pretest and posttest knowledge, confidence, attitude, and perceptions were obtained …

Kinship Infrastructure Design: Evaluating Diversity And Resilience In Emergency Response Systems Through Agent-Based Modeling, Fayruz Maysha

Doctoral Dissertations and Master's Theses

Traditional infrastructure systems are often designed for predictable scenarios, making them vulnerable to disruption when real-world conditions change unexpectedly. This research addresses that limitation by introducing Kinship Infrastructure Design (KID), a bioinspired framework based on the kinship coefficient (Φ). Adapted from studies of genetic relatedness in eusocial insects, the kinship coefficient (Φ) measures similarity and diversity among system components by calculating the degree to which their functional traits—encoded as a synthetic genome—match. This research investigates whether a system design can achieve a “Goldilocks Zone” of functional diversity where systems achieve optimal adaptability and coordination under uncertainty."

Rather than relying on …

More Girls In The Classroom Improves Adolescent Mental Health, Monica Deza, Maria Zhu

Population Health Research Brief Series

Mental health challenges are common among adolescents in the United States. This brief summarizes findings from a study using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative survey of middle and high school students conducted in 1994-1995. The analysis included over 17,000 students from 133 schools across the United States. The authors find that the mix of boys and girls in a classroom affects adolescent mental health and school satisfaction. When classes have more girls, both boys and girls experience better mental health outcomes. Boys in classes with more female peers are 10% less …

Cybersecurity, Resilience And Sustainability: Evaluating The Role Of Public-Private Partnerships, Katarzyna Chojecka

Yearbook of Antitrust and Regulatory Studies

This article explores the role of public-private partnerships (PPPs) in enhancing cybersecurity as a component of sustainable and resilient development. It argues that cybersecurity is not only vital for digital transformation and economic growth but also closely aligned with the UN Sustainable Development Goals, particularly through its emphasis on resilient infrastructure. The paper offers a legal and policy-oriented analysis of how PPPs can strengthen cybersecurity capabilities by leveraging the combined resources and expertise of governments, businesses, and civil society. The Polish case is also studied and analysed through “PW Cyber" program which exemplifies a local cybersecurity PPP model. The article …

Quality Improvement Project: Nursing Faculty Mental Health Literacy Assessment And Evaluation, Elesha Roberts

Doctor of Nursing Practice Projects

Mental illness is a major healthcare concern affecting young adults enrolled in college. College students enrolled in nursing programs in particular face intense academic pressure due to the demands and rigor of the program. Students commonly report symptoms associated with depression, anxiety, and suicide. Nursing faculty often do not feel comfortable approaching students about these concerns and other related mental health issues. Many faculty members lack the knowledge and skill to identify mental health issues and provide resources to support students in need. Faculty should be mental health literate and aware of campus resources. The purpose of this quality improvement …

Improving Self-Efficacy Among Clinical Instructors: The Impact Of Communication Education On Handling Lateral Violence, Emma Guidry

Doctor of Nursing Practice Projects

The quality improvement (QI) project aims to determine if clinical instructors perceive changes in self-efficacy in communication skills specific to lateral violence (LV) situations secondary to an educational intervention. Currently, clinical nurse instructors lack education specifically addressing communication strategies to utilize when LV occurs in the clinical setting. Banduras Social Cognitive Theory, Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) were employed as frameworks in the development of this project. Methods used in this quasi-experimental design project include administration of the Self Efficacy to Address Disruptive Behaviors Scale (SADBS) survey to project participants, nursing clinical instructors. The evidence-based practice (EBP) intervention …

Quality Improvement Project: Development And Implementation Of A Structured Certification Support Program And The Impact On Nurses’ Confidence And Medical Surgical Certification Rates, Mary Tran

Doctor of Nursing Practice Projects

Professional nursing certification is an important criterion of Magnet designation, and increased certification rates have been associated with positive patient outcomes. The literature supports peer support and group study as beneficial strategies to assist nurses in preparing for certification exams. A quality improvement project among medical-surgical (med-surg) nurses at a community hospital pursuing Magnet redesignation addressed the lack of formal processes and nursing perceived barriers to certification that may contribute to low certification rates. The purpose of this project was to develop and implement a structured medical-surgical certification support program following the Plan-Do-Study-Act (PDSA) cycle utilizing evidence-based strategies, including a …

Quality Improvement Project: Improving Nurse Competency In Caring For Patients With Dementia With Behavioral Disturbances In Long-Term Care, Lashunta Jackson

Doctor of Nursing Practice Projects

Dementia-related behavioral and psychological symptoms (BPSD) present major challenges for nurses in long-term care settings, often leading to inconsistent care, staff stress, and safety risks. Evidence-based, person-centered interventions are proven to improve outcomes but are frequently underutilized due to limited staff training. The purpose of this Doctor of Nursing Practice (DNP) project was to improve nursing staff competency in managing residents with dementia and behavioral disturbances through structured, evidence-based education. The problem identified was a lack of dementia-specific knowledge and confidence among nurses, which contributed to suboptimal care and increased behavioral incidents. A quasi-experimental pre-/post-intervention design guided by Knowles’ Adult …

Quality Improvement Project: Enhancing Diabetes Management Through Continuous Glucose Monitoring Device Education Among Providers Of Underserved Groups, Shaibu Rashid

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance diabetes management among underserved populations by increasing provider confidence and utilization of continuous glucose monitoring (CGM) devices in a Federally Qualified Health Center (FQHC). Despite CGM being recognized as a standard of care for patients requiring intensive insulin therapy, its adoption in FQHCs remains limited due to provider knowledge gaps, financial barriers, and workflow challenges. Based on Kurt Lewin’s change theory, the project employed a quasi-experimental one-group pretest–posttest design to evaluate the impact of an evidence-based educational intervention among six family practice providers. The intervention included interactive sessions on CGM device use, data …

Leveraging Student Data To Assess, Inform, And Develop Teachers Capacities, Nathan D. Koerber, Kenneth J. Fasching-Varner

Northwest Journal of Teacher Education

This quantitative study analyzed 47 survey responses to gauge in-service, pre-licensed teacher, and paraprofessional perceptions of cultural competency. Participants responded to the Central Vancouver Island Multicultural Society’s Cultural Competence Self-Assessment Checklist (Alpha = 0.7) to explore their awareness, knowledge, and skills in cultural competency. Moreover, through the application of Culturally Responsive Teaching (CRT) as a theoretical framework, this study highlighted how these perceptions related to culturally responsive teaching and provided several implications for their future preparation to further develop their cultural competency through the tenets of CRT. The analysis identified participant unfamiliarity with privilege and its impact, as well as …

Allan Leslie Combs: Reminiscence And Recommendation, Jonathan B. Bricklin

Journal of Conscious Evolution

The author recalls his first meeting with Allan Leslie Combs, identifying his defining trait of openness through the lens of the Trickster archetype. Drawing on the philosophy of William James, the essay concludes with a recommendation for a future edition of Combs’s book Synchronicity, specifically regarding the inclusion of precognition.

Keywords: trickster, synchronicity, William James, Allan Leslie Combs, precognition, openness

Quality Improvement Project: Educating Nursing Faculty On Medication Administration Labs To Improve Student Competency, Chelsea Pacheco

Doctor of Nursing Practice Projects

Medication administration errors are a leading cause of preventable harm in healthcare. Faculty play a critical role in ensuring nursing students develop the knowledge and confidence to give medications safely. A needs assessment at the project site revealed that only course coordinators were teaching medication administration and dosage calculation, leaving other faculty uncertain about how to teach these skills. This quality improvement project aimed to strengthen faculty confidence and create consistency in first-year instruction through a recorded educational video. Constructivist Learning Theory provided the foundation for active, experience-based learning. Lewin’s Change Theory guided the structured implementation process to support adoption …

Breaking The Silence: Addressing The Crisis Of Osec & The Knowledge Gap Among Health Professionals, Toni Morris, Elizabeth Ziff

Biennial Convention (CONV)

OSEC is a significant public health crisis globally. It involves the sexual abuse of minors through the internet, including creating, sharing, or possessing sexual material featuring children. OSEC is widespread yet often hidden due to its sensitive nature, making it challenging to address openly. The increasing use of digital technology and social media exacerbates this problem, providing predators with more tools to exploit children.

Children are especially vulnerable, facing serious threats to their physical and emotional well-being. Despite global efforts to combat OSEC, the ubiquity of the internet and advancements in technology have made prevention and intervention difficult. Early identification …

A Double-Edged Sword: Ethical And Psychological Implications Of Apoe Genotype Disclosure Across The Lifespan, Diego Iacono

Department of Neurology Faculty Papers

The apolipoprotein E (APOE) gene is the strongest genetic risk factor for sporadic Alzheimer’s disease (AD), with the ε4 allele increasing risk and decreasing the average age of onset. While APOE genotyping is primarily used in research or clinical settings for patients with memory concerns, interest in disclosing APOE status to asymptomatic individuals—particularly during early adulthood—is growing. This trend is fueled by the rise of direct-to-consumer genetic testing and emerging prevention-focused clinical trials. However, ethical debates remain unresolved about the potential harms of early disclosure, including anxiety, stigma, and misunderstanding of probabilistic risk. Conversely, some argue that knowledge of APOE …

Iso-Detr: A Novel Detection Transformer For Industrial Small Object Detection, Faisal Saeed, Anand Paul

School of Public Health Faculty Publications

Effectively detecting and assessing real-time structural and ecological parameters in contemporary manufacturing environments poses significant challenges, particularly in identifying minute objects within product images. The swift evolution of the industrial sector underscores the necessity for intelligent manufacturing environments to uphold stringent product quality standards. However, accelerating production processes at high speeds heightens the risk of defective product outcomes. This research addresses the challenges inherent in small object detection within industrial contexts, proposing an innovative detection transformer model tailored to modern manufacturing environments. The proposed model integrates a feature-enhanced multi-head self-attention block (FEMSA), merging cross-channel communication network and multiple multi-head self-attention …

Emmett Deur - Senior Recital, Emmett Deur

Honors Theses

As a culmination of three and a half years of study in the Irving S. Gilmore School of music, I, Emmett Deur, have put together a senior recital, performing a variety of works on the euphonium. My studies have included experiences within some of Western Michigan University’s top ensembles, including the Western Michigan University Wind Symphony, the University Symphony Orchestra, and the Western Brass Quintet’s Brass for the Holidays Ensemble. In addition to these ensemble experiences, my studies included regular one-on-one applied lessons with applied Tuba/Euphonium faculty members. With a year of lessons with former Tuba/Euphonium instructor, Professor Chance Trottman-Huiet, …

Between The Calm Lake Waters, Adrian Martinez

Honors Theses

No abstract provided.

Activation Of Pro-Regenerative Gene Programs In The Mature Central Nervous System, Elizabeth Carlisle Batsel

Dissertations (1934 -)

Spinal cord injury (SCI) affects millions of people worldwide. Damage to the spinal cord disrupts the long-distance axon tracts of central nervous system (CNS) neurons. These axons fail to regenerate, leading to permanent dysfunction. Past work has shown that CNS neurons lose the capacity to elongate their axons as they mature. Conversely, after injury, embryonic and peripheral nervous system (PNS) neurons can elongate axons towards target cells, driven by the growth cone at the growing tip of the axon. Previous research has identified transcription factor (TF) families, such as the SoxC family, that contribute to embryonic and peripheral neurons’ high …