Digital Commons Network^™

Effectiveness Of Medical Clowns In Improving Emotion For Children Undergoing Invasive Treatments, Pao-Li Pan, Wei-Wen Wu, Cheng-Shi Shiu, Meng-Yao Lu, Leigh Lu

International Nursing Research Congress (INRC)

Background and Objective: Children diagnosed with cancer often find hospitalization and medical procedures confusing and distressing due to limited developmental understanding. Hospitalized children frequently experience heightened anxiety, especially during invasive procedures. Among psychosocial interventions, medical clowning has emerged as effective in improving emotional well-being. In Taiwan, past study suggested group-based medical clown services improve children’s emotional well-being, but evidence for individualized services—recently adopted in Taiwan—is limited. In other countries, individualized clown interventions before procedures, such as intravenous insertion or surgery, significantly reduce anxiety and distress. This study aims to evaluate the effectiveness of individualized medical clown services in enhancing the …

From Tradition To Transformation: Hybrid Clinical Experiences, Simone Chinnis, Janelle Akomah, Angela Capello, Diana-Lyn Baptiste

International Nursing Research Congress (INRC)

Background: The clinical practicum in the final semester of pre-licensure programs is a hallmark experience in nursing education, bridging academia and professional practice by providing students with immersive, hands-on experiences. Such experiences foster the development of essential competencies--e.g., clinical reasoning, communication, professionalism, collaboration, & leadership. Capstone experiences lead to the application of theory to practice under precepted experiences.

Preceptorships during the final practicum assist with the transition from student to novice nurse by enhancing readiness for independent practice in a psychologically safe environment. According to the Accreditation Commission for Education in Nursing (AACN), clinical learning experiences must align with anticipated …

Using Greater Resilience Information Toolkit As A Transformative Strategy For Native American Women, Kathy Prue-Owens, Marie Zephier, Lauren Shaw, Nicole Weis

International Nursing Research Congress (INRC)

Background/Purpose: Native Americans (NAs) exhibit lower quality of life due to poverty, inadequate health services, historica/ongoing discrimination. NA women are underrepresented when it comes to the epidemic of violence, mental health and wellness outcomes.The purpose of this mixed method study was to explore the relationship between Native American (NA) women cultural beliefs, attitudes, and perceptions by gathering cultural input on the Greater Resilience Information Toolkit (GRIT) program.

Methods: This is a mixed-method community-based participatory research (CBPR) study. Self-efficacy is the theoretical framework. Upon Institutional Review Board approvals, flyers were posted at the tribal wellness center. Prior to focus groups, participants …

Global Nursing Education And Collaboration - A Peru Study Abroad Experience, Tuong Vi Ho, Jeri Striplin, Alicia Ramirez, Anh Tuyet Le, Van Nguyen

International Nursing Research Congress (INRC)

Background: To increase cultural competency in nursing students and to collaborate with other nursing schools globally, a study abroad program was established. This program focuses on the Peruvian culture and the improvement of the quality of life for the Peruvian population. Students were to gain insight into the differences and similarities of Peruvian and US healthcare issues, and immerse themselves in the Peruvian health care system with clinical practice alongside Peruvian nurses.

Method: This is a descriptive study. The group consists of 4 faculty and 32 students, from undergraduate to doctoral students. An in-country university collaborated with the group to …

Optimizing Nurse-Led Heart Failure Clinic Referrals Using A Heart Failure Readmission Risk Score, Marianne Rusin Borkosky

International Nursing Research Congress (INRC)

Background: Heart failure (HF) readmissions result in patients’ poor quality of life, depleted healthcare resources, reduced quality scores, and poor payor reimbursement, affecting healthcare systems’ financial stability. This is alleviated by referral to the HF Clinic. The project aims to compare HF Clinic referral rates after risk-assessing admitted HF patients with the European Collaboration on Acute Decompensated Heart Failure (ELAN-HF) risk tool to referral rates before the intervention. A goal is to utilize the ELAN-HF risk stratification tool to identify patients with the highest risk of readmission, refer them to the nurse-led HF Clinic, and provide self-care education and clinical …

Factors Influencing Quality Of Life In Liver Transplant Recipients: A Cross-Sectional Study, Jyun-Sian Wu, Yu-Ling Chang, Li-Chueh Weng, Kang-Hua Chen

International Nursing Research Congress (INRC)

Background: Liver transplant recipients must adapt to significant physiological and psychological challenges following surgery, including the side effects of immunosuppressants and the burden of chronic treatment. These stressors often cause symptom distress and impair quality of life (QoL). The sense of coherence (SOC), a psychological construct reflecting an individual’s ability to perceive life as comprehensible, manageable, and meaningful, has been associated with better coping and higher QoL. However, few studies have examined how SOC and symptom distress jointly influence QoL among liver transplant recipients.

Purpose: This study aimed to explore the relationships among demographic and clinical characteristics, symptom distress, SOC, …

Icare System Implementation For Phlebitis Prevention: A Quality Improvement Study, Rini Rachmawaty, Agussalim Bukhari, Elly Wahyudin, Indra Gaffar, Sarah Bernadette L. Balena, Gulzar Malik

International Nursing Research Congress (INRC)

Background: Healthcare-associated phlebitis remains a critical challenge in Indonesian hospitals, where incidence rates reach 31.7%, dramatically exceeding the national benchmark of less than 1%. A major contributing factor is poor adherence to integrated clinical pathways, particularly concerning incompatible intravenous drug combinations such as ceftriaxone administered with calcium-containing solutions.

Objective: We aimed to reduce phlebitis incidence through implementation of an online integrated clinical pathway compliance system (iCare System) among patients with high-volume, high-risk, high-cost conditions at provincial government hospitals in South Sulawesi.

Methods: This prospective quality improvement study was conducted at Indonesian regional hospital, located in Makassar, between April and July …

Incorporating Global Perspectives Through Coil In Reproductive Health Nursing Education, Catherine Crawford, Rhonda Lanning, Elisabeth Hemnes Aanensen, Grethe Aarreberg

International Nursing Research Congress (INRC)

Global learning is based on the principle that the world is a collection of interdependent systems and that higher education plays a vital role in fostering learners' ability to advance equity and justice (Zhou, 2022). Collaborative Online International Learning (COIL) is a pedagogical approach which allows students to participate in virtual global learning activities encouraging development of critical thinking, creativity, problem-solving and teamwork skills, while enhancing recognition of diverse and global perspectives (Shaw et al., 2025) viewed as essential for safe patient care (Te et al, 2019). COIL has been in use in many universities in the United States and …

Psychometric Evaluation Of The 28-Item Brief Cope Scale Among Low-Income Parents, Jiying Ling, Dongjuan Xu, Yingcen Xie, Wen Liu

International Nursing Research Congress (INRC)

Purpose. The 28-item Coping Orientation to Problems Experienced Inventory (Brief COPE) is a widely used instrument assessing coping strategies among adults, but its reported factor structure has ranged from 2 to 15 factors across populations (Solberg et al., 2022), raising concerns about structural stability. Only one study has applied item response theory (IRT) to examine item-level performance in cancer patients and caregivers (Baumstarck et al., 2017). Thus, this study evaluated the psychometric properties of the Brief COPE among low-income parents using factor analysis and IRT.

Methods. We analyzed baseline data from three clinical trials conducted between 2021 and 2024. Participants …

Minerals Rock!: Improving Audience Engagement And Interest In Stem Through Enhancement Of The In-Person And Online Mineral Collection At Ursinus College, Juliette Lyons

Environment and Sustainability Summer Fellows

Museums are a vital source of educational resources for the general public. They provide information on a variety of topics and disciplines and encourage visitors to be excited about and engaged in learning something new. As we work to comprehend key topics such as climate change, it is especially important for the broader public to better understand science, including geology. While the geological collection at Ursinus, Pieces of Earth’s History, is not in a museum, implementing methods that museums use can improve the reception of the collection. Through the application of research gathered through articles, journals, books, and talking with …

Simbinder-If: Structure-Aware Antibody Affinity Optimization Via Efficient Preference Learning, Xinyan Zhao, Yi-Ching Tang, Rivaaj Monsia, Victor J Cantu, Ashwin Kumar Ramesh, Siyu Yang, Xiaozhong Liu, Zhiqiang An, Xiaoqian Jiang, Yejin Kim

The Brown Foundation: Institute of Molecular Medicine

Motivation: Antibody therapeutic efficacy depends on high-affinity target engagement, yet laboratory affinity maturation is slow and costly. Most protein language models (PLMs) lack explicit training for high affinity, and current preference optimization methods introduce computational overhead without clear affinity improvements. Therefore, structure-aware and parameter-efficient approaches for antibody affinity optimization are urgently needed.

Results: We propose SimBinder-IF, a structure-aware antibody optimization model trained by freezing the Evolutionary Scale Modeling inverse folding (ESM-IF) structure encoder and fine-tuning only its decoder via Simple Preference Optimization (SimPO) to prefer stronger binders. In generalization tests across seven held-out complexes (93 477 mutants), SimBinder-IF shows a …

Higher Mortality And Distinct Complications After Anterior Cervical Discectomy And Fusion In Dialysis Patients, Despite Improvements Over Prior Decade: A National Inpatient Study, Mitchell K. Ng, Leonidas E. Mastrokostas, Paul G. Mastrokostas, William A. Green, Joshua Mathew, Gregorio Baek, Yasmine Eichbaum, Yulia Lee, Morgan Hitchner, Jonathan Dalton, Adam Fano, Alec Giakas, Rajendra Singh, Brendan Reitman, Afshin E. Razi, Daniel R. Fassett, Alan S. Hilibrand, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder, Andrew P. Alvarez

Rothman Institute Papers

Introduction: Dialysis patients undergoing anterior cervical discectomy and fusion (ACDF) face elevated perioperative risk due to complex comorbidities. This study aimed to (1) identify associations between dialysis status and perioperative complications after ACDF, (2) quantify differences in length of stay (LOS), hospitalization costs, and discharge disposition, and (3) provide a contemporary national benchmark for outcomes in this high-risk population. Materials and Methods: The 2016–2022 National Inpatient Sample was queried for adult elective ACDF cases. Dialysis dependence was identified through International Classification of Diseases-10 codes for end-stage renal disease with hemodialysis or peritoneal dialysis. Demographics, comorbidities, complications, LOS, costs, and discharge …

20260724: Journalism & Media, 1961-1962, College Of Liberal Arts

Guides to University Archives

These items include materials from the department of Journalism at Marshall University from 1961-1962. Items were received in at an earlier date (likely in the 1980s) and include notable materials from events on campus such as the dedication of Prichard Hall, the Men's Physical Education Building, the signing of Marshall University Bill, and a talk that President Stewart Smith gave on Human Rights in the Campus Christian Center.

In Re: Jayden Martin

2026 Decisions

USDC for the District of New Jersey

Leaving Against Medical Advice In The Ed: Understanding A Preventable Threat To Patient Safety, Chhaya Gupta, Shakti Shishodia, Pallavi Sehgal, Deborah Eke

URGENT Matters

No abstract provided.

Self-Prescribed Antibiotics Before The Ed Visit: A Hidden Driver Of Antimicrobial Resistance In Acute Gastroenteritis, Rohan Sahebrao Baviskar, Saloni Paranjape, Gurbachan Singh, Mallika Manyapu

URGENT Matters

No abstract provided.

How Christians Get "Calling" Wrong, David J. Mulder

Faculty Work Comprehensive List

"How can you faithfully follow Jesus, using what God has given you to joyfully work towards addressing... broken places?"

Posting about Christian vocation from In All Things, a blog which highlights the shared faithful and orthodox Reformed Christian perspective of our writers, exploring how to fearlessly engage with every aspect of modern life—until all is made new.

How Christians Get "Calling" Wrong

Time Series Analysis Of Temperature And Pollen Exposure On Asthma Outcomes In Atlanta, Georgia, Victoria Okereke-Viktorsson

Walden Dissertations and Doctoral Studies

The effects of climate change contribute to volatile temperature changes, which coupled with pollen exposure pose a significant threat to asthmatic people, potentially impacting methods for asthma management. The purpose of this ecological time-series study was to use the carbon dioxide theory of climate change, Dutch hypothesis, and social ecological model to estimate the relationship between average temperature and average pollen concentrations on average asthma morbidity outcomes for adults living in metropolitan Atlanta from 2020 to 2022 (N = 37,913). Results varied in terms of years, socioeconomic status (SES) vulnerability, gender, and racial group. Overall, a linear regression model revealed …

Can Machines Testify? Llms And The Boundaries Of Testimonial Epistemology, Michael J. Cummins

Philosophy Summer Fellows

As Large Language Models and AI chatbots become increasingly prevalent, pressing questions are raised about whether beliefs formed through LLM interactions carry the same epistemic weight as beliefs formed through human testimony. How we answer this question depends on whether LLMs can function as testifiers, a role which is typically assumed to require a human or human-like agent. This assumption has gone largely unexamined, yet its consequences are significant: if LLM outputs cannot constitute testimony, then the justificatory tools of testimonial epistemology are unavailable to any beliefs formed through LLM interaction. This paper challenges that assumption. It first argues that …

Dnp Final Report: Improving Length Of Stay Outcomes Using Structured Barrier Rounds: A Quality Improvement Project, Martha Kwamboka Apella

DNP Final Reports

Prolonged length of stay (LOS) in the acute care setting is a challenging issue driven by multiple factors. Increased LOS is associated with mortality, hospital-acquired infections, patient safety events, functional impairment, decreased quality of life, social isolation, and increased cost of care. The causes of increased LOS in the medical-surgical unit are unclear, necessitating an evidence-based project to address the problem. The purpose of this quality improvement initiative was to implement structured interdisciplinary barrier rounds and evaluate their effect on LOS, opportunity days, and estimated cost of care in a medical-surgical unit. The facility complex care coordinator (CCC) was identified …

Economic Warfare: A Foundation For Twenty-First-Century Strategic Practice, Greg Kennedy, Antulio J. Echevarria Ii, Anna Brinkman-Schwartz

Books, Monographs & Collaborative Studies

For over a decade and a half, concerns and tensions between states have been arising over the use of the economic domain in the peer-to-peer competition between large powers. Through this competition, powers aim to gain an economic advantage in their relative positions in the international order. The peer-to-peer competition between large powers has been seen as a growing facet of the strategic competition between the United States and China. The beginning of the Russia-Ukraine War in February 2022 elevated the Sino-American peacetime economic competition from one that could be classified as a hybrid form of warfare, a condition of …

Is Originalism Orthodoxy?, Neel Sukhatme

Articles

What theory of constitutional interpretation has the Supreme Court followed? We search Supreme Court opinions for a wide range of sources that originalists identify as central to their methodology, over the entire universe of cases beginning in 1791. We find that for much of Supreme Court history, conventional indicators of originalist practice--citations to Founding-era sources--are largely absent, raising questions about originalism's past orthodoxy. Originalist citation practices are absent for much of the 19th century and grow sharply in the late 20th century. The Article elaborates the implications of these findings for debates in constitutional law.

Effects Of Non-Surgical Periodontal Therapy On Dental Plaque Microbiome, Qingguo Wang, Bing-Yan Wang, Derek Wilus, Hua Xie

Faculty, Staff and Student Publications

Periodontitis, a chronic inflammatory disease affecting approximately 40% of U.S. adults aged 30 years and older, is characterized by dysbiosis of the dental plaque microbiome. However, although scaling and root planing (SRP) is the cornerstone of periodontal treatment, its effects on the taxonomic composition and functional potential of the dental plaque microbiome remain incompletely understood. In this study, we used whole-metagenome shotgun sequencing to characterize taxonomic composition and functional potential in dental plaque microbiomes collected from 39 patients with Stage II or III generalized periodontitis before and 3–4 months after SRP. Consistent with clinical improvement, periodontal therapy significantly reduced probing …

Enhancing Chronic Kidney Disease Awareness And Early Identification Through Community Health Worker Education In Rural Arkansas, Samantha L.M. Smith

Walden Dissertations and Doctoral Studies

The doctoral project was focused on improving staff education and development to prevent chronic kidney disease (CKD) through community health worker (CHW) education. The practice problem was the delayed identification of CKD risk factors and late referral to nephrology services, particularly among rural and underserved populations. Because CKD often progresses without symptoms, early education and awareness are critical to improving outcomes and reducing disease progression. The purpose of the project was to develop and implement a structured CKD educational curriculum for CHWs to improve their confidence in kidney health, CKD risk factors, prevention strategies, early identification, and referral awareness. The …

Hospital-Acquired Infections Among Hispanic Diabetic Patients: Considering Geographic And Substance Use Factors In Southern Puerto Rico, Fabian A. Ramirez Rivera

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs) remain a major cause of preventable morbidity, mortality, and healthcare utilization among hospitalized patients. Limited research has examined the relationship between diabetes and HAIs in Puerto Rican populations. The purpose of this quantitative cross-sectional study was to examine the prevalence of type 2 diabetes mellitus (T2DM) and its association with HAI characteristics and hospitalization outcomes among patients in southern Puerto Rico. The chronic care model provided a framework for evaluating whether diabetes status, geographic location, and substance use were associated with outcomes. Data were obtained through retrospective review of electronic health records from N = 846 patients …

July 24, 2026 Ereporter, University Of Alabama At Birmingham

eReporter (campus newsletter)

No abstract provided.

From Seductress To Sovereign: A Reassessment Of Cleopatra Vii’S Power, Gender, And Historic Representation, Jordan L. Myrick

History Theses, Dissertations, and Student Creative Activity

Cleopatra VII is one of the most famous women in history. As Queen of the Ptolemaic Kingdom of Egypt from 51 to 30 BCE and a major player in the Augustan age, she had the power to change the fate of empires. Despite her powerful position in history, however, Cleopatra’s historical narrative is often focused on the alliances that surrounded her. She has been portrayed as a seductive ruler who snared Julius Caesar and Marcus Antonius and whose drive for power led to the downfall of her kingdom. This original image of Cleopatra seems to have stemmed from the Augustan …

Batik Motifs For The Distinctive Jarik Of The Samin Community In Reinterpreting The Essence Of Samin Surosentiko Pitutur Luhur, Sugeng Wardoyo, Aryo Anggorojati, Tri Wulandari

Bahasa dan Seni: Jurnal Bahasa, Sastra, Seni, dan Pengajarannya

The Samin community (Sedulur Sikep) in Margomulyo, Bojonegoro, has the value of Pitutur Luhur inherited by Samin Surosentiko, but it has not been represented in the batik jarik motif as a communal identity. This creation-based research aims to explore this value, realize it in the design of written batik, and examine its philosophical meaning as an effort to preserve intangible cultural heritage. The method used is practice-based research with a qualitative approach through literature study (ethical data), participatory observation, and in-depth interviews with elders (emic data). The creation process refers to the stages of experimentation, manekung, and the formation of …

Development And Psychometric Evaluation Of A Medical Device-Related Pressure Injury Risk Assessment Scale, Ayise Karadag, Aleyna Uçanbelen, Öznur Erbay Dalli

Individual Articles

Medical device–related pressure injuries are a significant and largely preventable patient safety problem, yet existing pressure injury risk scales do not adequately capture device-specific risk factors in adults. This methodological study developed and psychometrically evaluated a standardized risk assessment scale to identify medical device–related pressure injury risk in hospitalized adult patients. An initial item pool was generated from an extensive literature review and clinical expertise, and content validity was assessed by seven experts using the Davis technique (content validity index = 0.96). The scale was administered to160 adults receiving at least one medical device in medical, surgical and oncology wards …

Application Of Palmprint Data For Prediction Of Diabetes, Ramasamy K Mr

Theses and Dissertations

Type 2 diabetes is one among the diabetes mellitus which has strong relation with lifestyle, genetics and metabolic dysfunction. The increasing global prevalence, rising healthcare costs, and high percentage of undiagnosed individuals leads to the need of noninvasive, cost-effective early detection methods. In conventional diagnostic methods, laboratory investigations and periodic clinical visits are needed, which may not be feasible for working and middle-aged populations. To overcome this, the research work proposes an automatic, non-invasive and early prediction of Type 2 diabetes using palmprint image analysis integrated with clinical data for identifying diabetic and non-diabetic individuals. The first proposed method aims …