Digital Commons Network^™

End-Of-Life Resources And Place Of Death By Community-Based Housing Type, Sojung Park, Borin Kim, Oejin Shin, Jihye Baek, Byeongju Ryu

Faculty Publications - Social Work

As chronic conditions dominate mortality trends, the place of death has emerged as a key marker of end-of-life (EoL) care quality. Although many older adults wish to die at home, structural barriers often lead to institutional deaths, especially among socioeconomically disadvantaged groups. This study investigates how housing types, defined by economic status, affordability, and congregate features, affect place of death in older adults. Drawing on National Health and Aging Trends Study data (N = 3,145), we examine links between housing type, EoL resource access, unmet needs, and death location. Residents of Subsidized Senior Housing (SSH) report more formal support yet …

Occupational Therapy: There Through It All, Leanne Bates

Occupational Therapy Doctorate Capstone Posters

'Occupational Therapy: There Through It All' is a Doctor of Occupational Therapy Capstone project in collaboration with VNA Health at Home in London, Kentucky. The Applied Leadership Experience focused on patients, and their family members or caregivers, receiving home hospice care. The primary ACOTE focus areas were education, advocacy, and clinical practice. The purpose of the project was to facilitate an increased quality of life in home hospice patients by determining the gaps of care present for patients that do not receive occupational therapy (OT) services, provide education about OT’s role in hospice care, and creating educational resources for patients …

Nur 4535 : Population-Based Health Care In Nursing, Nursing

Approved Course Proposals

No abstract provided.

A Tribute To Professor Marie Failinger

Mitchell Hamline Law Review

No abstract provided.

Exploring The Impact Of Age On Traumatic Brain Injury Cause And Recovery In Arkansas: A Retrospective Review, Abby Jones, Steven Wheeler, Jessica Danley

2026 Honors Symposium

Traumatic brain injuries (TBIs) remain a major public health concern, and increasing evidence goes to show the significance of the effect of age in quality of care, diagnosis, and recovery outcomes. In rural states, such as Arkansas, where research has shown a lack of resources and higher fatality rates among TBI patients, healthcare professionals can become better informed and equipped as a result of research efforts to uncover the effects of age on cause and recovery for inpatient TBI individuals in the early stages (Daugherty et al., 2022). Current research and prior evidence suggests that older individuals are more likely …

Reducing 30-Day Readmission Rates In Patients With Heart Failure, Charles Mccoy

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Globally, heart failure affects approximately 54 million individuals and has reached pandemic levels, contributing to elevated 30-day readmission rates (Sa et al., 2024). Background: In the United States, 30-day readmission rates range from 18% to 20%, with similar rates across all states. The current rate was documented as 29% at the study setting hospital. Objective: Implement a Quality Improvement project based on education, evidence-based order sets, and referral to palliative care to reduce 30-day readmission rates among adults with heart failure. Methods: Nursing staff completed education specific to heart failure, and patients received the American Heart Association Self-Check assessment. …

Empowering Patient Engagement In Effort To Reduce Readmissions, Derinda Hugaboon, Msn, Rn

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hospital readmissions among Medicare beneficiaries remain a major quality concern and are often associated with social determinants of health (SDOH) and care transition gaps. Targeted discharge interventions that address self‑management needs and follow‑up barriers may reduce avoidable readmissions. Objective: To reduce readmissions by implementing a bundled intervention addressing social determinants of health (SDOH), care‑transition gaps, and inadequate post‑discharge primary care follow‑up. Methods: Medicare Advantage (MA) members aged ≥45 were included. A total of 249 members accounted for 275 overall admissions during the project period; 191 admissions (69.5%) received at least one intervention component (informational discharge packet, face‑to‑face encounter, and/or …

The First Amendment: Sacrificing The Well-Being Of Minors For The Absolutism Of Freedom Of Speech, Nikki Carr

Student Works

No abstract provided.

External Validation Of A Knowledge-Based Clinical Toxicology Consultant For Diagnosing Single Exposures, Hugo Lerogeron, Joel D. Schipper, Jay L. Schauben, Laurent Guéguen, Valentine Lacotte, Kim An Nguyen

Publications

Introduction

Clinical prediction models assist healthcare providers in estimating disease likelihood using multiple patient-specific factors. While these models are increasingly used, few undergo the essential process of external validation, which limits their clinical utility. In toxicology, timely diagnosis is crucial and expertise scarce, making knowledge-based systems an excellent choice to support medical decision making. A knowledge-based system developed using data from the Florida Poison Information Center Network has shown promise but lacks external validation. This study aims to evaluate its performance using data from the Lyon Poison Information Center to assess its generalizability

Methods

To externally validate the Florida diagnostic …

On Saying Goodbye: Interactional Role Liminality & Post-Death Symbolic Interaction, Deborah Cobb

All Graduate Theses, Dissertations, and Other Capstone Projects

Grief is often understood as a process that culminates in detachment, with "saying goodbye" positioned as both an emotional and social necessity. Yet many bereaved individuals describe a different experience, one in which supernatural post-death contact allows them to receive messages from their deceased loved one. Drawing on 22 in-depth interviews and 47 anonymous open-ended surveys, this study explores how individuals who experience unsolicited post-death communication interpret these encounters and integrate them into everyday life. Analysis revealed three interconnected themes: resistance to saying goodbye, interpretation of encounters as specific messages from the deceased, and emotional stabilization following continued contact. These …

Town Of Merrimack, Nh Annual Report 2025, Merrimack Town Representatives

Merrimack, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

More Than A Meal: What Death Row Last Meals Reveal About Identity, Power, And Humanity, Mackenzie Helbig

Honors Theses - Providence Campus

Last meals on death row may appear to be a small or insignificant part of the execution process, but they can reveal deeper meaning about the individuals who choose them and the system that allows them. Before execution, inmates are often given the opportunity to request a final meal. While this moment is brief, it can carry emotional, cultural, and symbolic meaning. This study explores what last meals reveal about identity, mental state, and personal control in a highly controlled environment.

Using a descriptive qualitative approach, this research analyzes last meal records, academic studies, and inmate reports to identify recurring …

Ensuring Ai Adequacy For Class Members, Alissa Del Riego

Nova Law Review

No abstract provided.

Case Of Toxic Epidermal Necrolysis With High Body Surface Area Involvement And Review Of Predictors Of Severity Of Illness, Hannah R. Riva, Clay J. Cockerell, Muhammad T. Siddique, James M. Cross

North Texas GME Research Forum 2026

BACKGROUND: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare and potentially fatal cutaneous adverse drug reactions. The most common mortality predictor used for TEN is the SCORTEN (Severity-of-Illness Score for Toxic Epidermal Necrolysis). Various scoring systems have been used and are being developed for predicting mortality and guiding treatment in SJS/TEN. We describe a case of TEN with a high body surface area involvement and discuss the scoring predictors for severity of illness.

CASE PRESENTATION: A 63-year-old male was transferred to our burn center for a suspected diagnosis of SJS/TEN. He was intubated prior to arrival. He …

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

Doctor of Nursing Practice Projects

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

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

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

Exploring Cultural Values In Alcohol And Other Drug Use Among African Australian Youth: A Qualitative Study, Abraham Kenin, Justine Dandy, Kwadwo Adusei-Asante, Sonam Pelden

Research outputs 2022 to 2026

The heritage cultural values of Sub-Sahara African (SSA) migrants in the Australian sociocultural context could offer insights into understanding the problem of Alcohol and Other Drug (AOD) use among SSA Australian youth. This study explored the conceptualization of SSA cultural values in Australia, and to establish how they relate to AOD use among SSA Australian youth. Utilizing convenience sampling, one-on-one interviews were conducted with a total of 18 SSA Australians. The participants comprised 9 youth (aged 18–30; 4 females, 5 males), and 9 community leaders (aged 35–74; 4 females, 5 males). Based on a reflexive thematic analysis of the data, …

Exploring Factors Affecting The Use Of Blended Diets For Children And Young People In Health, Education And Social Care Settings In The Uk: The Protocol For A Realist Mixed Methods Study, Gemma Phillips, Jane Coad, Mary Hickson, Joseph C. Manning

School of Health Professions

Background Enteral tube feeding provides supplementary or alternative nutrition for individuals who cannot meet their nutritional needs orally and remains essential for a number of children and young people with complex health needs. Commercial formula remains standard practice in the UK, although increasing numbers of children and their families are choosing a blended diet and reporting significant physical and social benefits. However, support for families in using blended diets varies across health, education and social settings in the UK. Aim To explore factors affecting the use of blended diets in health, education and social care settings. Methods This sequential mixed …

Innovative Strategies For Incorporating Clinical Experiences Into An Rn To Bsn Program, Angie Hensley, Jessica Rice, Brooke Kuns-Adkins

Nursing Faculty Publications

Curricula for Registered Nurse to Baccalaureate (RN to BSN) programs need to enhance nurse’s scope of practice, critical reasoning, and analytical skills. The purpose of this paper is to demonstrate how one RN to BSN program innovatively integrated clinical experiences into the curriculum.  Students enrolled in the RN to BSN program were required to complete 40 hours of an on-site practice experience that integrated classroom learning with direct clinical experiences incorporated into the Capstone course.

Implementing An Evidence-Based Wound Care Protocol For Inpatient End-Of-Life Residents That Aligns With Hospice Comfort Care Goals, Oge C. Okeke, Oge C. Okeke

Doctor of Nursing Practice Final Project Abstract

Abstract uploaded

Music Is Medicine: Addressing Legal Challenges In An Emerging Clinical Practice, Basha Goldwater

Fordham Intellectual Property, Media and Entertainment Law Journal

Music is universally experienced, and most will recognize its profound personal impact; yet, music’s broader influence on society is yet to be fully explored. People may listen to music when they are sad, when they are seeking motivation, or as a way to relax. However, music extends beyond expression, entertainment, and an outlet for emotions. Research indicates that music can offer substantial benefits to patients in a plethora of medical situations.

Part I of this Note will explain the usefulness of music as medical care, its advantages, and the broad range of institutional support music-based medicine has garnered. Part II …

Exploring Detached Concern, A Dual-Process Emotional-Regulation Strategy, Among Intensive Care Nurses Providing End-Of-Life Care In The United States, Melissa Milton Miasek

Dissertations

Intensive care unit (ICU) nurses repeatedly provide end-of-life care (EoLC) and experience significant emotional distress, burnout, and moral distress that can lead to leaving the profession. Detached concern (DC), a dual-process emotional-regulation strategy which balances empathetic concern with emotional detachment, may support ICU nurses' emotional well-being; however, DC among nurses remains vastly understudied. This qualitative descriptive study gained deeper understanding of DC among ICU nurses providing EoLC in the United States. The study was guided by a conceptual model adapting Lampert and Glaser's dynamic DC process within Elfenbein's emotional regulation framework. The overarching research question explored ICU nurses' perspectives on …

Spillover Effects Of Medicare Advantage On Fee-For-Service Post-Acute Care Spending, Nyel Bangash

Honors Theses

Does the growth of Medicare Advantage reduce fee-for-service post-acute care spending through practice-pattern spillovers, or do observed spending differences primarily reflect favorable selection? Using a county-level panel of roughly 2,700 counties (2014–2023) and a two-way fixed effects specification, I find that a one percentage-point increase in MA penetration is associated with $9.54 less per-capita standardized FFS spending. Spending per episode falls while participation rates remain stable, consistent with practice-pattern spillovers rather than compositional changes from selection. Welfare indicators from County Health Rankings, CDC PLACES, and CMS Care Compare show no evidence that spending reductions harm health or care quality. The …

Imperfections And Scars: The Aesthetics Of Curated Decay In Urban Conservation: The Aesthetics Of Curated Decay In Urban Conservation, Ioana Moldovan, Connell Vaughan, Michael O’Hara, Silivan Moldovan, Ioana Cecălășan

Research Outputs: 2025-Present

This paper explores the value of imperfections and curated decay in the conservation of architecture and public art as vehicles of cultural memory. While conventional heritage practice treats physical degradation as a threat, newer conservation ethics argue for embracing material impermanence within an aesthetics of care. We examine how acknowledging patina, weathering, and even structural decline can become an act of care, maintaining the “spirit” and authenticity of a place. The theoretical framework integrated the aesthetics of imperfection, including concepts like the Japanese wabi-sabi, which finds beauty in the incomplete and impermanent, critical heritage theory (which questions whose memories and …

Spiritual And Religious Lay Community Support For Informal Caregivers Of Adults At The End Of Life: A Literature Review, Rachel Lenko

University Faculty Publications and Creative Works

• Informal caregivers of adults at the end of life often experience significant physical, psychological, and economic burden because of their caregiving and bereavement (Schulz et al., 2003; Skantharajah et al., 2022) 
• Prior evidence suggests that spirituality and/or religiosity contribute to positive religious coping and improved adjustment to bereavement (Damianakis et al., 2012; Stelzer et al., 2020) 
• Spiritual and religious communities often provide practical and social, in additional to spiritual/religious, support to their members 
• There is limited evidence describing practical and social support from spiritual/religious lay communities for informal caregivers of patients in the terminal phase of a disease

Body Mass Index Has No Impact On Complications And Mortality For Patients With Stage Iv Pancreatic Ductal Adenocarcinoma, Ren Bryant, Hannah Darnell, Megan Hall, Kelsey N. Karnik, Kristen J. Mcquerry, Ruben R. Plentz

Biostatistics Faculty Publications

Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of United States (USA) cancer death. Overweight and obesity developing into a growing global medical and socio-economic problem, affecting approximately 42% of adults in the USA population. The aim of our analysis was to evaluate the influence of overweight and obesity on complications and clinical outcome in patients with stage IV PDAC.

Methods: We retrospectively reviewed electronic health records of patients diagnosed with stage IV PDAC (n=162) who followed with the University of Kentucky from January 2017–October 2024. Comparisons were based on the body mass index (BMI): low BMI …

Bridging The Gap In Patient Attendance: A Dnp-Led Quality Improvement Project To Reduce No-Show Rate By Implementing Text Message Reminders, Charles D. Rogers

Master's Theses or Doctor of Nursing Practice

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments …

Effect Of Antipsychotic Medication Use And Type On Mortality And Cardiovascular Risks In Nursing Home Patients With Dementia, Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan

Glennan Center for Geriatrics and Gerontology Faculty Publications

Introduction

Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. This study assessed the association between APM use and mortality, stroke, and myocardial infarction (MI) compared to non-use, as well as differences between first- and second-generation APMs.

Methods

A serial cross-sectional study using Medicare data examined outcomes from 2012 to 2015 in a national sample of 328,138 US NH residents aged 50 and older with dementia. Multivariate logistic regressions were used to analyze risk.

Results

APM use was associated with increased mortality in all years (odds ratio [OR] range: 2.39 to 1.23, all …

Patient-Centered End-Of-Life Care: Balancing Ethics, Communication, And Quality Of Life, Alexis N. Courtney

Integrated Studies

Abstract

End-of-life care is not just a medical treatment, but can be the turning point in someone’s life to end unnecessary suffering and honor their wishes to have quality over quantity in life. This paper will discuss end-of-life care from the perspectives of patient autonomy, communication, ethical decision making, and system influences. It will explore the impact of honoring patient preference. Not to mention how speaking honestly and compassionately may affect enhancing the quality of life of patients experiencing terminal or life-limiting illnesses.

One of the key aspects of this paper is the significance of communication in end-of-life care. Specifically, …

Beyond The Lace Index: Benchmarking Machine Learning Architectures And Explaining 30-Day Hospital Readmission Risk With Shap Analysis, Carl E. Hughes Iii

Williams Honors College, Honors Research Projects

Unplanned 30-day hospital readmission remains a fundamental challenge in US healthcare, associated with increased risk to patient recovery and representing an estimated $52.4 billion in annual expenses (Beauvais et al., 2022). While the rigorously validated LACE index serves as the clinical standard for readmission modeling, its linear structure and four explanatory variables lack the complexity to capture the high-dimensional and interactive nature of patient risk. This study utilizes an admission granularity level cohort of the MIMIC-IV database to develop and compare machine learning architectures against the baseline LACE index. Due to the imbalanced prevalence of readmission, the penalized logistic regression, …

Increasing Nursing Perceptions On Advanced Directives Through Education To Promote Patient Centered Care, Michelle Strong

Master's Theses and Capstones

No abstract provided.