Digital Commons Network^™

Burnout & Moral Injury Metrics Inform Evidence-Based Nursing Workplace Solutions, Sarrah Spohnholtz, Brian Douthit, Carolyn Audit

Creating Healthy Work Environments (CHWE)

Purpose: To implement real time burnout data that enables nurse leaders to identify and respond based on environmental risk factors.

Background: Burnout and moral injury among nurses are driven by increased demands and emotional toll of care delivery. These conditions compromise nurse well-being and affect patient outcomes and safety.⁴ Many contributing factors stem from under-resourced environments where nurses cannot provide the care they believe patients need. Resilience training can help mitigate stress, but systemic reform is needed to prevent burnout and moral injury before they occur.²

Methods: In September 2025, the WellNurse Program implemented environmental risk metrics into …

Neurodiversity In The Workplace: Organizational Approaches To Supporting Neurodiverse Employees, Madison Vasquez

M.S. in Leadership

Despite growing conversation around neurodiversity in the workplace, many organizations lack clear understanding and structured strategies to support neurodivergent employees. This study examines existing research on how organizations can more effectively support neurodiverse employees across the employee lifecycle. Using a qualitative literature review, this study addresses the research question by examining literature on neurodiversity within workplace contexts. This includes investigating common representations of neurodiversity and reviewing the strengths and challenges of neurodiverse individuals, including those who have autism, ADHD, and other forms of neurodivergence. The study also reviews workplace barriers, support strategies, and organizational outcomes identified across the literature. Key …

Hlafreq: Download And Combine Hla Allele Frequency Data, David A. Wells, Michael Mcauley

Research Outputs: 2025-Present

Human leukocyte antigen (HLA) genes encode cell-surface proteins which play an important role in immunity. Since different HLA alleles enable different immune responses, the population frequency of HLA alleles is often considered when designing vaccines (Gulukota & DeLisi, 1996). Specific HLA alleles have been linked to autoimmune disease (Simmonds & Gough, 2007) and associated with adverse drug reactions (Fan et al., 2017). Further, the success of solid organ and stem cell transplants is related to HLA matching between donor and recipient (Fürst et al., 2019; Morishima et al., 2002). We present HLAfreq, a Python package which can be used to …

Self-Guided Stress Reduction Program Among New Graduate Nurse Residents, Allison A. Norful, Yilei Yang, Simon Paul P. Navarro, Marin Skariah

Creating Healthy Work Environments (CHWE)

Background: Evidence suggests that younger, less experienced nurses have higher burnout risk, thus yielding higher turnover rates, poorer psychological health, and decreased resilience or job satisfaction. To address this, it is critical to support new nurses by providing training aimed at building resilience and stress management. However, formal curricula designed to help nurses adapt to high-stress environments and unexpected changes are limited. Thus, the purpose of this study was to assess the acceptability, feasibility, and preliminary efficacy of an online self-guided resiliency training curriculum.

Methods: Using a pragmatic trial design, we recruited a pilot sample of 26 nurse residents (with …

The Effect Of Stress Hormones On Memory Formation And Academic Performance, Emma L. Hooks

Senior Honors Theses

With chronic stress becoming increasingly prevalent in academic settings, researchers have identified significant effects on learning and academic performance. Cortisol, a glucocorticoid hormone, is released following the activation of the hypothalamic-pituitary-adrenal (HPA) axis and plays a vital role in the stress response. Although acute increases in cortisol can improve attention and memory, sustained activation of the stress response can impair memory, executive functioning, and academic performance. This thesis draws on neuroscience, psychology, and education research to examine how chronic cortisol exposure affects the hippocampus and prefrontal cortex, and how the effects manifest in learning and academic performance, particularly in developmental …

Commencement 2026 (Program And Video), Illinois Wesleyan University

Commencement Ceremonies

No abstract provided.

From Central To Refinery: Labor And Hierarchy In The American Sugar Empire (1919-1962), Ben Woloch

History Honors Projects

From 1919 until 1962, the American Sugar Refining Company (ASRC) oversaw an empire, stretching from two Cuban sugar estates (centrales) to its Brooklyn refinery. The relationship between workers at both poles of the ASRC’s empire constituted a transnational labor hierarchy. Divergent management programs at the Brooklyn refinery and the centrales Jaronú and Cunagua confined the workers to distinct social positions. Brooklyn workers pursued labor-management collaboration in support of the sugar industry’s exploitative system, while workers in Cuba reimagined the sugar empire's power structure. The transnational workforce of the ASRC maintained a disunified relationship, which fractured the possibilities of working-class solidarity.

Annona Muricata (Soursop) And Hematopoiesis: Ethnomedicinal Insights, Immunomodulatory Mechanisms, And Translational Challenges, Fatma Matano, Amiya Patra

Peninsula Medical School

Annona muricata (soursop) is a tropical medicinal plant widely used in traditional medicine across Africa, the Caribbean, and parts of South America. While its ethnomedicinal applications span a range of conditions, including infections, inflammation, and anemia-related symptoms, its potential relevance to hematopoiesis has not been systematically examined. This narrative review synthesizes ethnomedicinal knowledge, phytochemical composition, and experimental evidence to explore the biological plausibility by which A. muricata may indirectly influence hematopoietic processes. Bioactive constituents of A. muricata, including flavonoids, polyphenols, and acetogenins, have demonstrated antioxidant, anti-inflammatory, and immunomodulatory properties in preclinical models. These effects are particularly relevant given the established …

Employing Zebrafish To Understand Genetic Drivers Of Epilepsy-Related Comorbid Behaviors, Chinwendu Ononuju, Kharma Hall, Olivia Beatty, Scott C. Baraban, Colleen Carpenter-Swanson

Biology Faculty Publications

Children with epilepsy frequently experience a range of significant comorbidities beyond seizures, such as motor dysfunction, cognitive impairment, and neurodevelopmental delays. In some cases, these comorbidities contribute more significantly to overall disease burden than the seizures themselves. To improve quality-of-life (QOL) for these children, treatment options should be selected that control seizures and ameliorate comorbidities. Unfortunately, such therapeutics remain largely elusive. Addressing this issue requires suitable preclinical models. Here we used CRISPR-generated zebrafish with single-gene mutations linked to pediatric epilepsy and applied clinically-relevant behavioral assays to study the effects of these mutations. Using high-throughput locomotion-based assays, we uncovered errors in …

A New Day: How The 2026 Joint Commission Performance Indicators Elevate Hospital Staffing Systems, Brittany Nettles, Julie Baker-Townsend, Amy Howell

Creating Healthy Work Environments (CHWE)

As nurses face mounting pressures in clinical environments, challenges such as insufficient staffing ratios, excessive workloads, and limited organizational support contribute to declining employee well-being, increased stress levels, and burnout. These factors not only impact the mental health of nursing professionals but also have significant implications for patient safety, care delivery, and staff retention (Aiken, 2025). Internationally, the burden of excessive workloads negatively impacts patient safety, as each patient added to a nurse's assignment is associated with a 7% increased risk of hospital mortality (Aiken, 2014). A survey conducted by the American Nurses Foundation (2022) found that nine out of …

The Effect Of Organizational Justice On Work Engagement And Burnout Among Hospital Nurses In Japan, Nicholas M. Raposo, Johan Vamstad, Dabin Hwang, Yayoi Saito, Anna Klarare

Creating Healthy Work Environments (CHWE)

Purpose: To examine the effects of organizational justice (OJ) on work engagement (WE) and burnout (BO) among hospital nurses in Japan, and to test whether job satisfaction (JS) moderates these relationships.

Background: Nurse WE and BO affect individual wellbeing, workforce resilience, and healthcare quality and safety.^1,2 OJ, representing workplace fairness and equality, is a key job resource that impacts employee performance and wellbeing.^3,4 In Japan, where WE is relatively low,⁵ the effects of OJ on nurse WE and BO – and how OJ interacts with JS, a salient correlate of WE and BO –^4,6 remain unexplored. …

Development Of Hybrid Self-Cleaning Coating Using Lanthanide-Based Light Spectral Response Material To Enhance Photovoltaic (Pv) Panel Efficiency In Operational Environment, Khishn Kumar Kandiah

Student Works (2020-2029)

The efficiency of photovoltaic (PV) panels is crucial, as solar energy has become an alternative energy source that meets today’s global energy demands. Hence, dust accumulation and spectral mismatch have major effects on the efficiency of PV panels, around 20 %, but in extreme situations, this can reach up to 64 %. Therefore, initiatives are underway to address these issues, including PV cooling systems, conventional cleaning methods, and various coatings to enhance efficiency. In this work, a novel coating is fabricated with high transparency, excellent self-cleaning properties, and good spectral-modifying properties. Two types of powder composites are employed in this …

Examining The Influences Of Citizen Factors On The Co-Creation Behaviors Of Online Public Services In A Smart City, Ratih Dyah Kusumastuti, Nurmala Nurmala, Juliana Rouli

Journal of Environmental Science and Sustainable Development

As smart cities increasingly rely on digital platforms to deliver public services, citizen participation becomes essential for ensuring effective and sustainable service delivery. However, limited research has examined which citizen-related factors drive co-creation behaviors in smart city contexts, particularly in emerging economies. This study aims to investigate the factors that influence the co-creation behaviors of online public services in five smart cities in Indonesia through the city’s digital platform and online social network (OSN). This study analyzes whether citizen factors, namely, perceived benefits over the city and OSN friends, trust in the city and OSN friends, and self-efficacy, affect co-creation …

Effect Of Exergaming Duration On Heart Rat And Caloric Expenditure In Healthy Older Adults, Kathryn Jade Johnson

Honors Capstone Projects and Theses

No abstract provided.

Tractor Workflow: A Scalable Nextflow Framework For Local Ancestry-Aware Genome-Wide Association Studies, Nirav N Shah, Taotao Tan, Jessica Honorato-Mauer, Yi-Sian Lin, Adam X Maihofer, Clement C Zai, Pgc-Ptsd Ancestry Working Group, Marcos Santoro, Caroline M Nievergelt, Elizabeth G Atkinson

Faculty, Staff and Students Publications

Motivation: The routine exclusion of admixed individuals from traditional genome-wide association studies (GWAS) due to concerns about spurious associations has limited multi-ancestry genetic discovery. Tractor addresses this issue by incorporating local ancestry into association testing, enabling the identification of ancestry-enriched signals and generating ancestry-specific summary statistics. However, adoption has been constrained by the complexity of prerequisite steps, including phasing and local ancestry inference, which require substantial bioinformatics expertise and introduce key analytical decision points.

Results: We developed a scalable, automated Nextflow workflow that integrates phasing, local ancestry inference, and Tractor association testing into a reproducible end-to-end pipeline. To demonstrate its …

Isolated Giant Aneurysm Of The Acute Marginal Branch Of Right Coronaryartery Presenting As Nstemi: Successful Direct Surgical Repair Preserving The Native Flow, Sai Kumari Ms., Anbarasu Mohanraj Dr, Saranya Damodaran Ms

Journal Of Indian Physician Associates

Abstract

Background: A “giant” coronary artery aneurysm is variably defined in the literature—commonly as a dilatation of a coronary vessel exceeding four times the diameter of the adjacent normal segment, or exceeding a fixed threshold such as > 8 mm or > 20 mm in diameter^1.

Case presentation: We report the case of a 61-year-old woman with type II diabetes mellitus and systemic hypertension, who presented with breathlessness and chest pain radiating to the back. She had recently suffered a non-ST elevation myocardial infarction (NSTEMI) and was found on coronary angiography to have a large aneurysm of the acute marginal branch …

Extra Of Extracorporeal: Use Of Vv-Ecmo In Complex Tracheal Ring Resection Surgery, Saurabh Ashok Holamb Mr, Ravinath Swami Mr

Journal Of Indian Physician Associates

 Abstract

Background:

Tracheal stenosis may arise from congenital malformation, trauma, prolonged intubation, or malignancy. Surgical correction of such lesions poses a major challenge, especially when airway management becomes difficult due to the location and extent of narrowing.

Case Summary:

We report a case of a 64-year-old male with circumferential thickening of the trachea at the D2–D3 level, exhibiting a 1.3cm long segmental narrowing. The patient underwent tracheal ring resection with veno-venous extracorporeal membrane oxygenation (VV-ECMO) support. Two apnea periods were maintained intraoperatively, totaling 3.5 hours, with stable hemodynamics and 100% oxygen saturation throughout. ECMO support was continued overnight as a …

Stereotactic Radiosurgery For Unruptured Arteriovenous Malformation Of The Left Medial Temporal Lobe In A Young Female, Muhammed Suhail S, Gajalakshmi M Bpa, Danish Ansari Brt

Journal Of Indian Physician Associates

Background

Arteriovenous malformations (AVMs) are congenital vascular anomalies that can be present with seizures or hemorrhage. Management strategies vary based on Spetzler-Martin (SM) grading.

Case Presentation

I report a case of a 22-year-old female presenting with recurrent seizures due to an unruptured AVM (SM Grade 3) located in the left medial temporal lobe. Diagnosis was established using MRI and Digital Subtraction Angiography (DSA).

Intervention

The patient underwent single-fraction stereotactic radio-surgery (SRS) with curative intent using a TrueBeam linear accelerator.

Outcome

Post-treatment course was uneventful, and the patient was discharged in stable condition with excellent seizure control and progressive nidus reduction …

Reimagining Maternal Health: The Crucial Role Of Social And Behavioural Change Communication In Lmics, Sneha Chetri Ms, Monica Koachar

Journal Of Indian Physician Associates

Preventable maternal mortality is still remarkably high in low and middle-income nations, despite growing investments in maternal health systems. Conventional methods have mostly concentrated on expanding access to services, ignoring important social and behavioural factors that affect how people seek health care. In order to bridge the gap between the availability and actual consumption of maternal health treatments, this opinion piece makes the case for the critical role that social and behavioural change communication plays. The article uses real-world examples from Bangladesh, Nepal, India, Ethiopia, Nigeria, Ghana, and Uganda to show how SBCC can empower women, change the dynamics of …

From Confidence To Competence: Embedding Critical Genai Literacy In Physician Associate Education, Chanceeth Chandrakanthan, Amy H. Donaldson-Perrott Mrs, Jane Secker, Julie Voce, Tamara S. Ritsema

Journal Of Indian Physician Associates

Background: Generative artificial intelligence is now embedded in how many healthcare students learn. Tools provide rapid explanations, summaries and practice questions, but use does not equal AI literacy, particularly where accuracy, medicines safety and guideline alignment matter.

Objective: To describe current use of generative AI by Physician Associate students and outline a practical approach to teaching critical AI literacy.

Methods: Educational evaluation using three activities: (1) baseline survey of students about use and attitudes, (2) an embedded compare and critique session in applied pharmacology where small groups assessed AI answers against trusted UK sources, including BNF and NICE guidance, followed …

Navigating The Genetic Frontier: Clinical And Ethical Implications Of Free Genetic Testing In India, Preetha Vijayalakshmi

Journal Of Indian Physician Associates

The expansion of free genetic testing services in India, resulting from government policies like the Ayushman Bharat Digital Mission, corporate-sponsored initiatives, and international collaborations, makes it easier to access genomic services for early identification of inherited disorders such as thalassemia, sickle cell anemia, and certain genetic kidney diseases, particularly in tribal populations. However, this review reveals significant clinical and ethical challenges. Clinically, Western-based genotyping platforms, not tailored to India’s genetic diversity, risk inaccurate results, including false positives and negatives, complicating clinical decision-making. A shortage of genetic counsellors and inadequate post-test care leaves patients, especially in rural areas, struggling within fragmented …

Evaluating The Suitability Of The Berg Balance Scale For Assessing Balance In Diabetes With And Without Prior Covid-19: A Methods-Validation Study, Garima Kaushik Dr, Sheetal Malhan Dr., Apoorva Tiwari Dr, Vishakha Daga Dr

Journal Of Indian Physician Associates

ABSTRACT

Background: Balance impairment in diabetes mellitus is predominantly driven by somatosensory loss secondary to peripheral neuropathy. The Berg Balance Scale (BBS) is widely used to evaluate functional balance, yet it mainly reflects motor performance and may not adequately represent sensory mechanisms. Following COVID-19, additional concerns regarding deconditioning have emerged, but interpretation depends on the measurement tool employed.

Objective: To examine the construct behavior and suitability of the BBS for assessing balance in individuals with diabetes with and without prior COVID-19 infection, and to determine whether the scale reflects known determinants of diabetic imbalance.

Methods: A cross-sectional analysis was conducted …

Exploring Coaching Issues And Feedback Generation During A Virtual International Coaching Exchange, Lori A. Gano-Overway, Ian Hj Cowburn, Liam Mccarthy

Journal of Coach Development

Internship opportunities can provide coaches with the chance to learn through experience and explore their personal theories in practice. However, to effectively develop coaches during internships facilitators of learning need to know more about what student coaches typically perceive and find meaningful to puzzle through to support their learning and developing theory of practice. Grounded in experiential learning theory and the notion of the reflective practitioner, the authors sought to examine how early-career sport coaches identify, frame, and explore practical coaching issues presented through a virtual international coaching exchange. Using a descriptive multiple-case study approach, the authors presented the coaching …

Ischool Student Research Journal, Vol.16, Iss.1

School of Information Student Research Journal

No abstract provided.

Ai And E-Commerce: A Comparative Analysis Of Amazon, Jumia, And Alibaba, Lauren Grace Barden

Honors Projects

Globally there is a great divide between consumer acceptance of artificial intelligence (AI) and the reluctance of the services due to lack of knowledge on its systems. Major global shopping platform, Amazon has adopted the use of AI into their experiences for upholding their pillars of optimization, utilization, and personalization. In the global e-commerce framework,  adoption of AI has been similarly found also in companies like Alibaba (Chinese-based) and Jumia (Kenyan-based). Though these companies have seen customer satisfaction increase with the availability and quality of the service they provide, it is pertinent to note that there are still underlying issues …

Aacn Hwe Standards: Bridging Clinical Excellence And Academic Resilience, Michelle Kidd

Creating Healthy Work Environments (CHWE)

For over 20 years, the American Association of Critical-Care Nurses (AACN) has championed Healthy Work Environment (HWE) standards as essential for nursing excellence. While HWEs improve patient and staff outcomes, they may be underutilized in academia. As faculty and clinical staff face record burnout and turnover, the nursing pipeline's survival depends on a unified HWE approach that bridges clinical practice and academia through intentional collaboration.

Arete - The Balance Of Nature: A Study And Creation Of Greek Tragedy From The Modern World, Grace Margaret Merrill

Honors Theses

This thesis examines the gender roles in ancient Greece through a creative lens. It aims to reach an understanding of the inequalities between men and women. Some of these inequalities involve women’s rights, abortion, and divorce. The main goal of this project is to reveal the discrimination women faced in ancient Greece. Once this is accomplished, I will then use the research to create a play inspired by the traditional Greek tragedy format. This play addresses controversial topics of the time and how individuals would have approached them. While there is ample research into the focus of my topic, there …

Age And Congressional Leader Success: Are They Getting Too Old, Edward N. Drinkwine, Scot Schraufnagel

Honors Capstones

Congressional leaders play a central role in shaping legislative agendas, maintaining party cohesion, and negotiating policy outcomes. Despite the important roles they play, our nation's congressional leaders continue to grow older, and research has rarely examined how age influences their effectiveness in these roles. This study asks whether older congressional leaders are less effective at advancing legislation than their younger counterparts. Using data on leaders serving in the U.S. House and Senate from the 93rd through the 118th Congress, the analysis compares leaders’ ages with their Legislative Effectiveness Score Ratios, controlling for legal experience, state legislative experience, elite education, ideology, …

External Mandate And Strategic Imperative: A Necessary And Sufficient Conditions Approach To Environmental Accounting Adoption In Tanzanian Manufacturing Firms, James Moses Dendula, Helena Thomas Haule

Business Management Review

Environmental Accounting (EA) serves as a strategic tool for organisations to integrate environmental considerations into operations, decision-making, and reporting. However, in emerging economies, its adoption remains uneven and insufficiently explained regarding how institutional pressures and internal capabilities jointly shape these practices. This study examines how institutional pressures and firms’ internal capabilities influence Environmental Accounting Practices (EAP) among 146 Tanzanian manufacturing firms. Anchored in Institutional Theory and the Resource-Based View (RBV), the study adopts a complementary analytical approach by integrating sufficiency and necessity logics using Partial Least Squares Structural Equation Modelling (PLS-SEM) and Necessary Condition Analysis (NCA). The PLS-SEM results indicate …

Embeddedness Of Corporate Social Responsibility Practices Of Listed Local Firms In Tanzania: Analysis Of Communication And Organisation Dimensions, Lilian Julius Kishimbo

Business Management Review

This study explores the embeddedness of Corporate Social Responsibility (CSR) practices among listed Tanzanian firms from 2020 to 2024, focusing on both communication and organisational dimensions within a theoretically grounded framework. The study is guided by Institutional and Stakeholder theories, analysing how CSR is integrated into corporate strategies and operational structures, with particular emphasis on variation across banking and finance, telecommunications, manufacturing, extractive, agriculture, and transport industries. Using a mixed-methods approach combining qualitative content analysis of annual reports with organisational indicators, the study draws on 20 firms (95 firms annual reports) to identify significant industry-specific differences in CSR embeddedness, with …