Digital Commons Network^™

Optimization Of Social Determinants Of Health Data With Z Code Utilization In Inpatient Care, Felicia Cordia Alleyne

Yale School of Nursing Digital Theses

The U.S. healthcare system is characterized as being costly, wasteful, and fraught with inequity, due to historical disparities and contemporary challenges such as the aftermath of the COVID 19 pandemic and recent international policy changes that raise the costs of materials and imports. There is evidence to support that with the use of social determinants of health screening tools that are associated with a standardized data capture approach can contribute to value-added clinical and financial changes, resulting in improve care, reduce healthcare disparities, and reduce healthcare costs. This DNP project piloted the implementation of a training protocol for a social …

Nursing Primary Care To Better Health, Kristen Dulling

Yale School of Nursing Digital Theses

The national nursing shortage and the rising cost of nursing is threatening sustainability of

the RN role on the care team in ambulatory care settings. There is a critical need to develop a

care model that defines the value of RNs on the primary care team by improving access and

effectively reducing cost by mitigating turnover and role dissatisfaction. This DNP project

developed and implemented a care model across four primary care settings that shifted

workflows for vaccine administration, prior authorizations, and emergency department follow up

calls from RNs to other roles on the care team. Capacity created allowed the …

Addressing Social Determinants Of Health To Reduce Missed Appointments In Primary Care Setting., Omolara Goyea

Yale School of Nursing Digital Theses

Background: Missed appointments impose a significant financial burden on the U.S. healthcaresystem, costing over $150 billion annually, with individual physicians losing an average of $200 per unused time slot (Gier, 2017). Unmet Social Determinants of Health (SDOH), such as transportation barriers, negatively impact primary care services and contribute to missed appointments (Brown et al., 2020; Fiori et al). The missed appointment rate in the United States ranges from 12% to 50% of scheduled appointments (Boone et al., 2023). Objective: This quality improvement project aimed to develop, implement, and evaluate a telehealth protocol specifically tailored for patients who identified transportation as …

The Effect Of Polypharmacy On Nurse’S Workflow And Healthcare Expenditure In Post-Acute Care, Rachel Hudec

Yale School of Nursing Digital Theses

This DNP project modified a deprescribing initiative to engage frontline nursing staff. The intervention included a comprehensive educational curriculum, clinical guidelines, and a system to track nurse workflow and financial metrics. Guided by Donabedian’s conceptual model, the project was piloted in a large municipal PAC facility. Methods included twelve in-person training sessions for 93 nurses, pre- and post-knowledge tests, a program evaluation, medication pass times, and tracked the costs deprescribed medications over six months.Nursing knowledge significantly improved, with mean test scores rising from 41.39 to 90.64 (p < .001). Medication pass decreased by 18%, reducing the time per resident from 7 to 5.7 minutes. Financially, the initiative saved over $21,000 in six months, with a projected annual savings exceeding $42,000. Integrating nurses as leaders in deprescribing enhances clinical competency and operational efficiency. These findings provide a compelling case for standardizing an interdisciplinary deprescribing program to improve financial sustainability, nursing efficiency and resident safety in the PAC setting.

Nurturing Novice Nurse Development Through The Legacy Mentor Model: Building The Infrastructure And Stabilizing The Workforce In A Healthcare System, Maureen Scanlan

Yale School of Nursing Digital Theses

There is a historically high nurse turnover rate with a limited supply of experienced registered nurses across healthcare organizations. The retirement of senior nurses, referred to as Legacy Mentors, leaves inexperienced ones without valuable support and guidance. This project aimed to implement and evaluate a mentorship program to improve intent to stay among novice nurses in their first year of practice in an acute care setting. The novice nurses were paired with Legacy Mentors. A total of 32 nurses participated in 16 mentee/mentor pairs. The program consisted of six one-hour sessions over three months, which focused on wisdom sharing, community …

Implementing Hepatitis C Screening And Treatment In Primary Care, Michele Castellano Wetmore

Yale School of Nursing Digital Theses

AbstractHepatitis C (HCV) is a curable hepatic disease. With direct-acting antivirals, it can be treated in 95% of cases. When left untreated, it can cause severe liver disease, including hepatocellular carcinoma and even death. The World Health Organization’s (WHO) goal is to eliminate HCV by 2030. This Quality Improvement (QI) project, conducted at a Federally Qualified Health Center (FQHC) from 8/4/2025 to 11/4/2025, will address the barriers to elimination and show that providing local services closes gaps. Screening and treating HCV within primary care has become a strategic approach to enhance access to treatment. This involves developing and utilizing a …

The Effect Of Verbal De-Escalation Simulation Training Using Artificial Intelligence On Nurse Leader’S Self-Efficacy, Mary Vitullo

Yale School of Nursing Digital Theses

Per year, rates of verbal workplace violence (V-WPV) are estimated to occur in 38.8 per 100 nurses, which is decreasing leader retention (NIOSH, 2020, Chang, Hsu, & Ouyang, 2022). Increasing the confidence of nurses in handling V-WPV through simulated training programs increases their intent to stay (Ming et al., 2019).

A two-pronged training program allowed nurse leaders to learn de-escalation techniques and then apply that knowledge in a life-like simulated environment. The education included a pre-work module on V-WPV de-escalation and a simulated scenario using an artificial intelligence conversational agent.

The aims of the project were: to develop a model, …

Differences Of Sex Development (Dsd), Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Challenging And Diagnosing Structured Population Models By Testing Predictions From Stochastic Demography, Stephen P. Ellner, Robin E. Snyder, Daniel T. Blumstein, Dylan Z. Childs, Joshua C. Fowler, Christina M. Hernández, Julien G. A. Martin, María Paniw, Yngvild Vindenes

Biological Sciences Faculty Publications

1. Structured population models are parameterized to accurately project expected population sizes, stage/state distributions and population growth rates, but they also predict the variation in outcomes among individuals, such as the variance and skewness of lifetime reproductive output (LRO) and lifespan, the probability of never reproducing, and many other life-history metrics.

2. Testing such predictions about individual outcomes can be very useful model 'stress tests', because they depend on how components of the model (e.g. submodels for survival and fecundity) interact over multiple time steps, not just on the accuracy of the submodels. Because data on among-individual variation is rarely …

Examining The Flow State In College Football, Nicholas R. Reynolds Jr., Selen Razon

West Chester University Graduate Theses, Dissertations, and Final Projects

The flow state, first defined by Csikszentmihalyi (1990) as a state of total absorption in an activity characterized by effortless control, heightened focus, and peak functioning, has been well-documented in sport but has received limited attention in the context of college football. This study examined the flow state experiences of varsity football players at West Chester University, including their awareness of the concept, the frequency and subjective nature of their experiences, the strategies they use to reach this state, and their perceptions of its relationship to team success. A researcher-developed survey was administered to team members during the offseason, yielding …

Looking Beyond Minimalist Pedagogies: Rhetorical Listening As A Framework For Ethical Collaboration And Student Empowerment In The Writing Center, Abby M. Samella

West Chester University Graduate Theses, Dissertations, and Final Projects

Since its establishment, the Writing Center has strived to solidify its institutional presence as a space of student-centered pedagogy, minimalist directive approaches, and collaborative learning. However, students frequently perceive Writing Centers as the polar opposite of collaboration, frequently seeking out this support for a transactional, ‘remedial’ fix to their writing product. As Writing Centers grapple with this tension that threatens their process-driven pedagogies, scholars recognize a gap in Literature regarding collaborative approaches that empower the student through the implementation of rhetorical listening. Using the foundational framework of Rhetorical Listening as a strategy to reassert the collaborative identity of the Center …

Connecting Classroom Physics To Real-World Research: A Citizen Science Approach In Ap Physics 1, Heather M. Landgarten

West Chester University Graduate Theses, Dissertations, and Final Projects

Advanced Placement (AP) Physics 1 emphasizes evidence-based reasoning, quantitative modeling, and scientific inquiry. However, secondary science instruction often remains focused on procedural problem solving and standardized assessment rather than authentic scientific practice. This study examined the integration of citizen science projects into an AP Physics 1 curriculum to provide students with authentic research experiences while reinforcing physics concepts during the post-AP examination instructional period.

Using a classroom-based mixed-methods pre–post design, students participated in citizen science activities through publicly available research platforms, including Zooniverse. Students collected and classified authentic scientific data, analyzed real-world datasets, developed research questions, compared observations with theoretical …

Refining The Fiat: Exploring The Vocations Of Four Women Catholic Educators Through Narrative Inquiry In The Archdiocese Of Philadelphia, Kaitlyn A. Rodgers

West Chester University Graduate Theses, Dissertations, and Final Projects

Catholic education in the Archdiocese of Philadelphia has a long history of integrating faith and education. While research often focuses on school efficacy and Catholic identity, less attention has been given to the educators who sustain these institutions. This qualitative narrative inquiry explored how Catholic faith shapes the professional identities and vocational commitments of four women educators in the Archdiocese of Philadelphia. Guided by Catholic Social Teaching and feminist theology, the study examined how participants understood their vocation, or “fiat,” through personal and professional narratives. Semi-structured interviews were conducted with both vowed religious and lay educators.

Three themes emerged. First, …

The Role Of Growth Mindset As A Mitigating Factor On Teacher Burnout In The Secondary Math Classroom, Grant Butler

West Chester University Graduate Theses, Dissertations, and Final Projects

This mixed methods sequential explanatory study examined how secondary mathematics teachers’ mindsets relate to burnout tendencies, and how schools can support staff mindset to prevent burnout. Using a two-phase design, Phase 1 gathered survey data from 94 secondary math teachers, measuring mindset and burnout with descriptive statistics, correlations, chi-square tests, and regression analysis to quantify associations between mindset orientation and burnout risk. Phase 2 employed semi-structured interviews with a subsample of teachers and open and axial coding to explain and contextualize the quantitative patterns. Quantitative analyses revealed that teachers with more fixed mindset tendencies reported significantly higher burnout scores across …

Beyond The Game: Career Readiness Development At The Nirsa Championship Series, Samantha A. Wary

West Chester University Graduate Theses, Dissertations, and Final Projects

Understanding the students' perceptions of the career readiness skills they develop and how they develop is critical in higher education. This allows campus recreation professionals to better understand and create opportunities for student development related to career readiness. A convergent mixed-methods design was employed to investigate students’ perceptions of the career readiness development of student officials who have participated in the NIRSA Championship Series flag football tournaments. Informal and Incidental Learning Theory and Experiential Learning Theory guided the study. The National Association of Colleges and Employers (NACE) career readiness competencies were used as a standardized tool to define career readiness. …

Updating Order Set Review Policy To Improve Adherence To Evidence-Based Practice In A Multi-Hospital System, Corynne Lurie

West Chester University Graduate Theses, Dissertations, and Final Projects

Ensuring that clinical order sets reflect current evidence-based practice is essential to delivering safe, high-quality, and consistent patient care across health systems. In multi-hospital organizations, maintaining alignment across facilities presents additional challenges, including variability in workflow, stakeholder involvement, and policy adherence. This quality improvement project evaluated the existing order set review process within a three-hospital health system to determine whether current policies effectively support system-wide needs and promote best practices. Guided by Lewin’s Change Theory, a qualitative descriptive design was used to assess current workflows and gather feedback from stakeholders involved in order set development and review. Survey data, with …

Seeing Through Their Lenses: Perspectives Of Kindergarten Teachers On Implementing Purposeful Play For Children’S Academic And Developmental Learning, Subarna Basu

West Chester University Graduate Theses, Dissertations, and Final Projects

The purpose of this study was to examine the kindergarten teachers’ perceptions of using purposeful play for children’s academic and developmental learning, and the benefits and challenges they perceive in implementing purposeful play. The study utilized a qualitative, visual arts-based, participatory action research (PAR) design, in the form of Photovoice methodology. This qualitative study focused on the kindergarten teachers’ lived experiences and voices on the importance of implementing purposeful play and employed Paulo Freire’s Critical Pedagogy and Constructivist theories. Utilizing this methodology, six kindergarten teacher participants collected photographs based on photo prompts, provided narratives to their photographs, and reflected and …

Say Gay: Increasing Preservice Teacher Confidence Using Participatory Theatre, Sarah Maxime Hyson

West Chester University Graduate Theses, Dissertations, and Final Projects

Research Design: Research shows a lack of LGBTQ+ instruction in teacher preparation programs. This social justice mixed methods study evaluates effectiveness of participatory theatre for increasing confidence in preservice teachers. Research Questions: RQ 1: How does student self-rating of confidence change after participatory theatre experiences that examine issues concerning LGBTQ+ individuals and materials? RQ 2: What do preservice teachers’ writing, sketching, and discussion about their participatory theatre experience reveal about their evolving confidence regarding LGBTQ+ individuals and issues? RQ 3: What do the instructor’s experiences and reflections reveal about the effectiveness ofparticipatory theatre pedagogy to increase confidence in preservice teachers …

Examining The Stories Of Early-Career Student Affairs Professionals And Free Speech Issues On College Campuses, Kimberly C. Farrer

West Chester University Graduate Theses, Dissertations, and Final Projects

This qualitative research study explored the stories of early-career student affairs professionals on their experiences responding to free speech issues on college campuses. Additionally, this studied explored how they were prepared for those responses. This study was important because early-career student affairs professionals are managing free speech issues on college campuses but lack the training and preparation to do this (Duran Leftin & Duran, 2021; Harris & Ray, 2014). This study utilized both authentic leadership theory (Avolio & Gardner, 2005; Gardner et al., 2005; Luthans & Avolio, 2003; May et al., 2003; Northouse, 2025) and Kohlberg’s (1976) theory of moral …

Case Report: Suspected Rupture Of A Papillary Thyroid Tumor In A Patient With Graves' Disease Who Experienced Airway Narrowing Without Respiratory Distress., Daniel Goodman, Samuel Bosco, Bradford Davison Smith

Otolaryngology (ENT) Resident Research

This case report describes a 55-year-old woman presenting with acute dysphagia and neck swelling after a "popping" sensation in her neck. CT and MRI revealed a large retropharyngeal cystic mass and a left thyroid lobe mass, causing airway displacement. Despite significant effacement of the oropharyngeal and supraglottic airway on flexible nasopharyngolaryngoscopy, the patient remained asymptomatic regarding respiratory distress. Subsequent ultrasound-guided fine needle aspiration biopsy diagnosed malignant papillary thyroid carcinoma. Concurrently, previously undiagnosed Graves' disease was identified. The clinical presentation was attributed to suspected rupture or hemorrhage of the malignant thyroid tumor, leading to a serosanguineous fluid collection and inflammatory edema. …

Which Forms Of Work Flexibility Retain Working Mothers: A Moderated Mediation Model Of Flexibility Need, Flexibility Use, And Top Management Support, Jeanine K. Andreassi, Angela R. Grotto, Leanna Lawter, Tuvana Rua, Cynthia A. Thompson

WCBT Faculty Publications

This study investigates the relative impact of utilizing various forms of work flexibility on mothers’ retention in full-time jobs. Drawing from a model of work reentry for new mothers and Human Ecology Theory (HET), we theorize that mothers’ flexibility needs influence retention through flexibility use and that top management support strengthens this process. Using a cross-sectional Qualtrics online survey, we recruited a diverse sample of 213 women across the United States who stayed with or left their full-time jobs after childbirth or adoption. Using relative weights and path analysis, we compared six forms of flexibility. Schedule, career, and leave flexibility …

Owning The Afterlife? Reframing Ai “Resurrections” Through A Dignity Lens, Emily Frank

SMU Law Review

Artificial intelligence tools now enable startlingly lifelike recreations of the dead—replicating a person’s face, voice, and mannerisms for entertainment, advertising, and even political messaging. American law largely funnels disputes over these “digital resurrections” into the right of publicity, a property-centered regime that turns identity into an asset to be bought, sold, licensed, and inherited. That framework protects market value but often misses the harm that matters most to families: degradation, distortion, and reputational injury to the decedent’s memory. This Comment argues for a narrow “dignity backstop” that operates when property rules fail or have been waived. The proposal recognizes a …

New Media For New Marijuana: An Initiative Addressing The Challenges Of A Changing Cannabis Landscape And Its Impact On The Driving Safety Of The Vcu Community, Kelsa Bartley, Peter Henry, Donisha Terry, Emily Yeaman, Quingguo Xu, Matthew Winheim

GEHLI - 2026 VCUL Team Project Publications

Cannabis products today are significantly more potent and more widely available than in previous generations, creating new health and safety challenges for college students. This project aims to develop an evidence-based awareness campaign that delivers information about the health risks of emerging cannabinoid products and the consequences of impaired driving due to cannabis use. The campaign aims to increase student awareness, encourage responsible decision-making, and contribute to a safer, healthier VCU community.

J Mich Dent Assoc January 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons. The January 2026 (Volume 108, No. 1) issue of the Journal is published in a print format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

This issue includes feature articles on Pediatric Dentistry and 2025 Life Membership recipients.

Regular monthly contributions include:

• Editorial …

Life Membership Status Awarded To 61 Members, Mda Membership Department Staff

The Journal of the Michigan Dental Association

The Michigan Dental Association (MDA) recently awarded life membership to 61 members for their long-term commitment, requiring either 30 consecutive or 40 total years of membership. This status includes active life members, who still practice, and retired life members, who are exempt from dues. These individuals contribute to the profession through mentoring, teaching, and legislative outreach, as well as volunteering in local clinics. The article lists new life members across various Michigan districts, including Central, Detroit, and West Michigan. This recognition honors their decades of dedication to organized dentistry and their ongoing impact on both the association and their local …

What About Our Teen-Age Patients?, Michelle C. Dziurgot

The Journal of the Michigan Dental Association

This editorial advocates for "mentally treating" teenage patients, specifically those around 14 years of age, as adults. By respecting their concerns and allowing age-appropriate decisions, clinicians can enhance a teen's dental IQ and self-esteem. This approach fosters confidence, communication, and independence, encouraging patients to take accountability for their treatment outcomes. Respectful dialogue leads to better compliance with home care, such as using rotary brushes or wearing retainers. Ultimately, treating teenagers with empathy and valuing their opinions helps them blossom into responsible adults while building lasting professional bonds.

Is Being A Shareholder ‘In Name Only’ A Problem?, Daniel Schulte Jd

The Journal of the Michigan Dental Association

This column addresses the legal risks for Michigan dentists entering "shareholder in name only" agreements with non-dentist entities. Michigan law requires dental practices to be owned by licensed dentists to ensure professional control over public healthcare. Arrangements where management companies or manufacturers can reclaim stock for a nominal fee effectively strip the dentist of true ownership. This lack of control can lead to ethical conflicts, such as pressure to sell specific appliances regardless of professional judgment. Engaging in such schemes may endanger a dentist's license by thwarting state laws intended to protect clinical independence.

Does The Mda Still Offer A Staff Compensation Study?, Rachel Sinacola Dds, Ms, Angie Kanazeh

The Journal of the Michigan Dental Association

This Q&A section clarifies that the MDA no longer distributes staff compensation surveys due to 2023 FTC enforcement policy changes. However, members can access UCR fee analysis reports at a discount through PPO Negotiation Solutions. For dentists nearing retirement, the MDA offers retired and retired life membership categories, which provide dues discounts or exemptions for those no longer earning income from dentistry. The source also recommends Best Card for credit card processing to save an average of $6,496 annually. Finally, practitioners are reminded that licensure renewal must be completed through the MiPLUS platform, which primarily issues electronic licenses.

Letter From The Faculty Editor, Beth Kegley

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

No abstract provided.

Featured Faculty Mentor/Student Team, Lauren Rogers, Danielle Reeves

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

No abstract provided.