Digital Commons Network^™

Changing Patterns Of Psychotropics Use Among Older Adults With Intellectual Disability Over A Decade, With A Focus On Designated Mental Health Conditions, Rohit Shankar

Peninsula Medical School

ABSTRACTBackground: Psychotropics (sometimes off-label), mental health diagnoses and behaviours of concern are common in olderadults with intellectual disability. Guidelines recommend non-pharmacological interventions and regular medication review.This study examined changes in psychotropics among older adults (≥40) with intellectual disability.Methods: Longitudinal data were obtained from the Intellectual Disability Supplement to the Irish Longitudinal Study onAgeing (IDS-TILDA) at two timepoints [Wave 1(2009/10); Wave 4(2019/20)]. Post hoc analysis, Chi-squared tests and univariatebinary logistic regression were conducted.Results: Overall, psychotropics decreased (59.2% to 56.5%). Significant decreases in antipsychotics (43.1%–40.1%) and sedatives/hypnotics (13.6%–8.1%) and significant increase in antidepressants (26.2%–31.8%) were found. Nearly half of antidepressant usersreported depression …

Strategies For Retaining Employees In The Global Healthcare Industry, Tanisha L. Smith

Walden Dissertations and Doctoral Studies

High healthcare employee turnover rates pose a significant threat to organizational productivity, workforce stability, and patient outcomes. Healthcare leaders are concerned with high employee turnover because it contributes to rising operational costs, employee burnout, and a decline in the quality of patient care. Grounded in Herzberg’s two-factor theory of motivation, this qualitative, pragmatic inquiry identified and explored effective strategies that healthcare leaders use to retain employees to maintain organizational productivity and enhance patient outcomes. Data were collected from nine healthcare leaders in the United States using semistructured interviews and publicly available documents. Through thematic analysis with triangulation and member checking …

Enhancing Rn Confidence In Early Recognition And Treatment Of Sepsis, Tiffany Lee Gossai

Walden Dissertations and Doctoral Studies

Background: Sepsis is a leading cause of mortality in U.S. hospitals, with delays in recognition and treatment significantly contributing to poor patient outcomes. Nurses are essential to early identification and timely intervention; however, gaps in confidence and preparedness persist, particularly among newly hired staff. Traditional educational approaches may be insufficient to support rapid clinical recognition and evidence-based management. Purpose: This staff education project evaluated whether participation in a virtual sepsis escape room during general nursing orientation improved newly hired nurses’ confidence in early identification and treatment of sepsis. Methods: A virtual escape room was integrated into an existing general nursing …

Better It Disaster Recovery And Procedures To Improve Response After Computer Crime, Allan Eduardo Arroyo-Melendez

Walden Dissertations and Doctoral Studies

A lack of an effective disaster recovery plan (DRP) can negatively impact business outcomes following a cyberattack. Information technology (IT) managers are concerned that the lack of DRP may increase the risk of ransomware, fines, and public distrust. Grounded in the unified theory of acceptance and use of technology, the purpose of this qualitative pragmatic inquiry study is to explore strategies that some IT managers use to implement a DRP. The participants are four IT managers in the southeast United States. Data were collected through semistructured interviews and a review of publicly available documents. Through thematic analysis, three themes were …

Clinical Practice Guidelines For Suicide Risk Assessment, Jelitta Cleatus

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed a clinical practice guideline (CPG) to address the lack of a standardized suicide risk assessment protocol at a Texas mental health clinic. At project initiation, suicide risk assessment at the facility was inconsistent due to the absence of a CPG. The guideline incorporated the Columbia-Suicide Severity Rating Scale (C-SSRS), a validated instrument that improved early detection of suicidal ideation and behaviors, which were often under recognized in older adults. This inconsistency led to the following clinical question, Does the evidence support the development of a CPG for assessing suicide risk among high-risk patients using …

Investigating Sex Offenders’ Experience Of Being Registered As A Sex Offender, Stacey Mitchell-Swingle

Walden Dissertations and Doctoral Studies

In society, sex offenders are subject to unforeseen consequences of the sex offender registry. The purpose of this qualitative study was to investigate how the sex offender registry contributes to the mental distress of registered sex offenders and their concerns about recidivism. This study addressed a gap in understanding the sex offender registry experiences from the offender’s perspective. The research question addressed how adult male registrants describe their experiences of mental distress associated with registration and how they perceive registration as shaping their risk of reoffending. The theoretical framework was John Braithwaite’s reintegrative shaming theory, with a specific focus on …

Lived Experiences Of Law Enforcement Officers Assigned To Co-Response Teams Responding To Mental Health Crises, Roxanne Miller

Walden Dissertations and Doctoral Studies

Law enforcement officers are increasingly called upon to respond to mental health crises, yet their experiences as members of co-response teams (CRTs) remain underexplored. This study was conducted to address that gap by examining the lived experiences of officers assigned to CRTs that pair specially trained officers with mental health clinicians to respond jointly to calls involving individuals in crisis. The purpose of this qualitative phenomenological study was to describe how officers experience CRT work and how it shapes their perceptions, practices, and professional identity. The study was guided by Lazarus and Folkman’s transactional theory of stress, appraisal, and coping, …

Impact Of Burnout And Empathy On Correctional Officers’ Aggression, Sagan Ladd

Walden Dissertations and Doctoral Studies

Correctional officers experience persistent occupational stress that places them at elevated risk for burnout, which may negatively affect emotional functioning and increase aggression. Guided by general strain theory, this quantitative nonexperimental correlational study examined the relationships between burnout, empathy, and aggression among uniformed correctional officers working in U.S. jails and prisons. Participants (N = 58) completed the Maslach Burnout Inventory, the Interpersonal Reactivity Index, and the Buss–Perry Aggression Questionnaire–Short Form through an anonymous online survey. Simple and multiple linear regression analyses were conducted to answer three research questions. Results indicated that burnout significantly predicted aggression, F(1, 56) = 12.38, p < .001, R² = .18, such that higher burnout was associated with higher aggression scores. Empathy did not significantly predict aggression, F(1, 56) = 2.32, p = .133, R² = .04, though the relationship trended negatively. A multiple regression analysis revealed that burnout and empathy together significantly predicted aggression, F(2, 55) = 7.74, p = .001, R² = .19; however, burnout remained the only significant predictor when controlling for empathy. Additional analyses indicated that burnout significantly predicted all four facets of aggression: verbal aggression, physical aggression, anger, and hostility. These findings suggest that burnout plays a central role in aggression among correctional officers and highlight the importance of organizational and mental health interventions aimed at reducing burnout to promote staff well-being and institutional safety.

Graduates’ Perceptions Of Their High School Career Technical Education Work-Based Learning Experiences, Cheryline M. Hewitt

Walden Dissertations and Doctoral Studies

Little is known about how career and technical education (CTE) work-based learning (WBL) programs support student academic achievement and workforce outcomes. Guided by Kolb’s experiential learning theory, the purpose of this basic qualitative study was to explore high school graduates’ perceptions of their CTE WBL experiences and to identify how completing a CTE WBL program supported and hindered their academic and workforce achievement. Ten graduates of CTE WBL programs were recruited via postsecondary CTE school outreach, Facebook, and LinkedIn groups and participated in a semistructured interview. Thematic analysis using open coding was conducted. The data analysis resulted in three identified …

How Case Management Can Improve Access To Outpatient Mental Health Clinics For Low-Income African American Women, Marie Daphney Vilseant

Walden Dissertations and Doctoral Studies

Abstract: African American women face deeply rooted systemic challenges that affect their access to mental health care treatment. There are no case management techniques that are strategic and equity driven and offer individualized support tailored to the needs of African American women, especially those from low-income backgrounds. The purpose of this study was to explore the role of case management as a potential solution to improve access to outpatient mental health services for this under-served group. The Anderson behavioral model for health care was utilized to understand access and utilization of health care services. The review question focused on case …

The Environmental Mental Health Services Needed For Youth Ages 18-25 Aging Out Of The Foster Care System, Keelin Leger

Walden Dissertations and Doctoral Studies

Youth transitioning out of foster care experience increased mental health challenges that affect their ability to age out successfully to independence. In this qualitative modified action study, the environmental mental health services needed for adolescents, aged 18 to 25, aging out of the foster care system in Lafayette Parish, Louisiana were explored. This study was guided by the Families Rising framework. Purposeful sampling was used to recruit 20 participants who provided insights to this study. Participants were reached by posting flyers on social media and the online platform forums, and they signed the consent form to participate. The data were …

Psychologists’ Attitudes On Capital Punishment And Interpretation Of The American Psychological Association’S Ethics Code, Darya Baugh-Ruschman

Walden Dissertations and Doctoral Studies

When defendants are sentenced to death due to the nature of the crime, psychologists may be asked to participate in these cases, performing tasks such as conducting competency evaluations. Because the American Psychological Association (APA) Ethics Code states that psychologists cannot participate in activities that violate human rights, an ethical debate has emerged regarding whether they should participate in capital cases. The present study examined psychologists’ opinions on capital punishment and their interpretation of the APA Ethics Code, which does not specifically define what constitutes a violation of human rights. The theoretical framework for the study is the ethical decision-making …

Teacher Perspectives Of Their Challenges In Supporting K-3 Students In Mathematics Proficiency, Jasmine Chanel Mills

Walden Dissertations and Doctoral Studies

The problem for this study was that mathematics preparation for students in K–3 classrooms often does not lead to mathematics proficiency for third grade students. Guided by Wigfield’s expectancy value theory, the purpose of this qualitative study was to explore teachers’ perspectives of children’s expectations and values related to mathematics and challenges teachers describe in supporting children’s mathematics achievement. Data were collected through 12 semistructured interviews with K–3 teachers in in a public school district in the eastern United States. Thematic analysis using open coding resulted in six themes which indicated that teacher beliefs and expectations are associated with mathematics …

Staff Education To Improve Nurse Use Of Teach-Back In Outpatient Diabetes Care, Latoya Hodge-Curtis

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is a prevalent chronic condition in the United States, with ineffective patient education and low health literacy linked to poor glycemic control, preventable complications, and increased health care utilization. At the project site, a practice gap was identified related to a lack of knowledge among nurses regarding the use of teach-back strategy for use with Type 2 diabetes education. The practice-focused question was: Does educating nurses on the teach back strategy for Type 2 diabetes improve knowledge as evidenced by pre- to post-survey? This project was implemented using the ADDIE (analysis, design, development, implementation, and evaluation) …

Enhancing Medication Adherence In Home-Based Hypertension Care Through Targeted Staff Education, Marie Lunie Bazile

Walden Dissertations and Doctoral Studies

Summary In this practice-based, quality improvement project, I incorporated a one-group, pre-/posttest design with the aim to evaluate a staff education intervention, reflecting on key principles in improving practice, including continuous evaluation and informing locally based change. This Doctor of Nursing Practice (DNP) project addressed the issue of inconsistent adherence to medication and the lack of staff skills in home-based hypertension management. Notably, the nurse plays an important role in medication adherence to care and in the consistent, evidence-based care with chronic diseases. The practice-focused question was: For home health staff, how does participation in an evidence-based medication adherence education …

Relationships Between The Dark Triad And Justification Of Morally Debatable Behaviors In College Students, Emma P. Paulson, Terry F. Pettijohn Ii

Psychology

The present study examined the relationship between Dark Triad personality traits and moral judgments in a sample of 68 undergraduate students recruited from psychology courses at a southeastern university. All participants volunteered through an online system and received course research credit for participation. Participants completed the Short Dark Triad Measure to assess levels of psychopathy, Machiavellianism, and narcissism, as well as the Revised Morally Debatable Behaviors Scale (MDBS-R), in a controlled laboratory setting. Individuals with strong psychopathic traits were predicted to report greater endorsement of morally debatable behaviors. Pearson correlation analyses were conducted to examine associations between Dark Triad traits …

Black Hole Spectroscopy And Tests Of General Relativity With Gw250114, The Ligo Scientific Collaboration, The Virgo Collaboration, The Kagra Collaboration

Department of Physics and Astronomy Faculty Scholarship and Creative Works

The binary black hole signal GW250114, the loudest gravitational wave detected to date, offers a unique opportunity to test Einstein’s general relativity (GR) in the high-velocity, strong-gravity regime and probe whether the remnant conforms to the Kerr metric. Upon perturbation, black holes emit a spectrum of damped sinusoids with specific, complex frequencies. Our analysis of the postmerger signal shows that at least two quasinormal modes are required to explain the data, with the most damped remaining statistically significant for about one cycle. We probe the remnant’s Kerr nature by constraining the spectroscopic pattern of the dominant quadrupolar (ℓ =𝑚 =2) …

Retrospective Comparison Of Outcomes Of Osteochondral Allograft Transplantation Of The Knee Using Extended Storage Modality Missouri Osteochondral Preservation System Versus Standard Preservation, Henson Destine, Gaston Davis, Harrison S. Fellheimer, Azra Dees, Nathaniel Kern, Bradford Tucker, Kevin Freedman

Rothman Institute Papers

BACKGROUND: Osteochondral allograft (OCA) transplantation is an established surgical intervention for full-thickness chondral defects. Standard preservation (SP) protocols currently allow for OCAs to be stored for a maximum of 28 days after procurement before significant chondrocyte death. An alternative protocol, the Missouri Osteochondral Allograft Preservation System (MOPS), has been shown to allow for grafts to be stored for twice the maximum time allotment as SP.

PURPOSE: To compare clinical outcomes in patients who have undergone OCA transplantation utilizing the extended storage capabilities of the MOPS versus SP protocols.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent …

Partial Versus Full Revision In Cementless Single-Stage Exchange For Hip Periprosthetic Joint Infection: A Multicenter Comparative Study With 10-Year Survivorship Analysis, Wenbo Mu, Atthakorn Jarusriwanna, Boyong Xu, Scot A. Brown, Xiaogang Zhang, Alexander Dawes, Javad Parvizi Md, Li Cao

Rothman Institute Papers

BACKGROUND: Periprosthetic joint infection (PJI) is one of the most challenging complications following total hip arthroplasty (THA). Traditional management typically involves full revision to ensure comprehensive infection eradication. However, for patients with well-fixed implants, partial revision in a single-stage cementless approach may provide a viable alternative, potentially preserving bone stock and reducing operative time. The relative efficacy of this approach compared with full revision remains to be fully explored. This multicenter study aims to determine whether partial revision in cementless single-stage exchange surgery offers comparable infection control outcomes to full revision for select patients with well-fixed implants.

METHODS: We conducted …

Hormetic Doses Of Lead Metal Ion Stimulated Photosynthetic Attributes In Brassica Juncea  During Various Stages Of Growth, Shalini Dhiman, Arun Dev Singh, Nitika Kapoor, Renu Bhardwaj

Turkish Journal of Botany

Low doses of lead (Pb) ions were used in the present study to investigate their effects on photosynthetic efficiency in Brassica juncea. Plants of B. juncea grown for 30, 45, and 60 days were analysed for root and shoot length, pigment content, gas exchange, chlorophyll fluorescence, primary and secondary metabolites, and nonenzymatic antioxidant responses under exposure to hormetic doses of Pb2+. The findings show that low levels of Pb2+ (especially 18- and 36-µM Pb treatments) improve gas exchange metrics, chlorophyll fluorescence parameters, root and shoot growth, and increased amounts of chlorophyll, carotenoid, xanthophyll and low amounts of pheophytin as compared …

Updating Misev: When, What, How, And Why?, Naveed Akbar, Dylan Burger, Benedetta Bussolati, Edit Buzás, Randy Carney, Young-Eun Cho, Tom Driedonks, Juan Manuel Falcon-Perez, Yu Fujita, Deborah Goberdhan, An Hendrix, Yiyao Huang, Suresh Mathivanan, Mỹ Mahoney, Sujata Mohanty, Andreas Möller, Nicole Noren Hooten, Stefano Pluchino, Carlos Salomon, Ana Claudia Torrecilhas, Sara Veiga, Kenneth Witwer

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

No abstract provided.

Mycorrhiza-Mediated Physiological Responses Of Shallot Against Twisted Disease And Drought Stress, Krisnanda Surya Dharma, Ani Widiastuti, Suryanti Suryanti

Turkish Journal of Botany

Shallot, a strategic horticultural commodity in Indonesia, is susceptible to biotic stress (e.g., twisted disease) and abiotic stress (e.g., drought). Mycorrhizal fungi offer an environmentally friendly solution to enhance plant resilience. This study evaluated the effects of mycorrhizal application on shallot plants against twisted disease (Fusarium acutatum) and drought stress. Using a randomized complete block design, we assessed growth, disease resistance, and physiological responses. Data were analyzed using analysis of variance followed by Tukey’s honestly significant difference test at a 95% confidence level. Results indicated that mycorrhizal application reduced both the severity and rate of twisted disease development in shallots. …

The Cowl - V. 89 N. 12 - January 29, 2026

The Cowl

The Cowl - student newspaper of Providence College. Vol. 89 No. 12 - January 29, 2026. 16 pages.

Oncofetal Reprogramming: A New Frontier In Cancer Therapy Resistance, Anh Nguyen, Molly Lausten, Bruce M. Boman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Oncofetal reprogramming has recently emerged as a critical concept in translational cancer research, particularly for its role in driving therapeutic resistance across a variety of malignancies. This biological process refers to a pattern of gene expression that is restricted to embryogenesis, but becomes expressed again in a subpopulation of cancer cells. These genes are typically suppressed after embryogenesis, and their aberrant re-expression in tumors endows cancer cells with stem-like properties and enhanced adaptability. The goal of this review is the following: (i) comprehensively examine the multifaceted nature of oncofetal reprogramming; (ii) elucidate its underlying molecular mechanisms, including its regulators and …

Black Hole Spectroscopy And Tests Of General Relativity With Gw250114, A. G. Abac, I. Abouelfettouh, Teviet Creighton, Mario C. Diaz, Raul Alberto Espinosa Perez, J. Lawrence, Francisco Llamas Villarreal, Soma Mukherjee, Volker Quetschke, Miriam Ramos Arevalo, Wenhui Wang

Physics & Astronomy Faculty Publications

The binary black hole signal GW250114, the loudest gravitational wave detected to date, offers a unique opportunity to test Einstein’s general relativity (GR) in the high-velocity, strong-gravity regime and probe whether the remnant conforms to the Kerr metric. Upon perturbation, black holes emit a spectrum of damped sinusoids with specific, complex frequencies. Our analysis of the postmerger signal shows that at least two quasinormal modes are required to explain the data, with the most damped remaining statistically significant for about one cycle. We probe the remnant’s Kerr nature by constraining the spectroscopic pattern of the dominant quadrupolar (ℓ =𝑚 =2) …

Making Waves Podcast: Individual Science Communication With A Common Thread, C. Rose, H. Harrison, K. Coffie, E. Burke, A. Gielazyn, J. Kiplinger, L. Nofsinger, J. Cardin, E. Graves, S. Campbell, A. R. Arellano

Making Waves REU

• Give students tangible experience learning, working, and educating in the discipline of oceanographic research
• Provide an immersive ocean science experience for undergraduates
• Communicate research and findings to a general audience

Risk Awareness Of Alcohol Related Car Fatalities In Whatcom County, Tayler Wilson

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

My goal to address alcohol-related traffic fatalities in Whatcom County is to reduce the prevalence of these fatalities by 20% over two years through preventative community education and targeted enforcement programs to decrease high-risk drinking behaviors in college-age youth.

Significant Findings

There has been a significant rise in alcohol-related traffic fatalities within Whatcom County, upwards of 50% of fatal car accidents in 2024 involving alcohol; 67.8% higher than the national average (CDC, 2024; Starks et al.,2025). The population most impacted by this public health risk is 21-24 year-olds, especially young men, who are four times more likely to …

A Prevention Model For Delaware: Reducing Opioid Relapse After Release From Incarceration, Jaime Basara

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

The goal of this Social Change Portfolio is to reduce relapse risk among individuals with opioid use disorder who are reentering society after their release from a Delaware correctional facility, by enhancing clinical continuity of care, including counseling, relapse-prevention planning, and linkage to community-based treatment programs.

Significant Findings

This portfolio aims to raise the awareness that justice-involved individuals with opioid use disorder in Delaware face extremely high rates of relapse, overdose, and death during the post-release period, particularly within the first few weeks and months after reentering society. This is often due to abrupt discontinuation of treatment, reduced …

Staff Education On Medication Adherence, Jerome Obiagba

Walden Dissertations and Doctoral Studies

Summary The Doctor of Nursing Practice (DNP) project focuses on improving medication adherence in mental health settings, where many patients do not take medications as prescribed, leading to worsening symptoms, relapse, frequent hospitalizations, higher healthcare costs, and reduced quality of life. This problem mainly affects individuals with anxiety, bipolar disorder, major depressive disorder, and schizophrenia, and is often related to poor understanding of treatment, cultural beliefs, or limited access to care. Because nurses play a key role in medication monitoring, education, and patient support, the project examined whether staff education improves nurses’ knowledge, confidence, and effectiveness compared to standard practice …

Staff Education To Streamline Congestive Heart Failure Education, Shannon Hunter

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive disease that affects a diverse population. Patient-centered education is key to lowering rehospitalizations and mortality rates. Although nurses are essential providers of patient-centered education, those in acute care settings often have unclear directions for implementing and documenting CHF education. Multiple educational materials within electronic health record (EHR) systems further complicate the process and highlight the practice gap. The aim of this Doctor of Nursing Practice (DNP) project was to streamline CHF education by clarifying the role of nurses in education delivery and documentation, potentially enhancing nurse confidence and improving patient health outcomes, with …