Digital Commons Network^™

A Quality Improvement Project Cultural Competency: A Project For Improving Culturally Competent Care Among Mental Health Providers, Lanre Olanrewaju

Doctor of Nursing Practice Projects

Cultural competence, knowledge, and awareness are essential for improving mental healthcare outcomes in diverse populations. Despite the need, the absence of structured cultural competence training contributes to reduced quality of care and health disparities. The purpose of this quality improvement project is to improve cultural awareness and knowledge among mental health providers at an outpatient clinic by implementing structured staff training. A needs assessment identified gaps in cultural competence knowledge, inconsistent practices, and limited provider confidence in addressing diverse patient needs. In the methodology, the model used to answer the PICOT question is Purnell’s Model, guided by a structured process …

The Place Speaks: Sacred & Artistic Genealogies Of Appalachia, The Reece Museum, East Tennessee State University

The Reece Museum Exhibition Publications

Jimmy Morrow was born March 6, 1955 in Raven Branch, a population area in rural Del Rio, Tennessee. His father, Albert Morrow, is remembered as a very devout man who raised his seven children in the church, and young Jimmy Morrow began preaching there when he was just six years old, soon after he received his first vision. Throughout his career, in which the Rev. Morrow was the founder and pastor of the Edwina Church of God in Jesus Christ’s Name, Morrow also preached at churches in Tennessee, Alabama, Georgia, South Carolina, and Kentucky. Alongside his work as a spiritual …

Feasibility Of A Novel Combined Treatment For Apraxia Of Speech, Claire Evans Jensen

Theses and Dissertations

Apraxia of speech (AOS) is a disorder of articulation and prosody interrupting the spatial and temporal planning and/or programming of speech movements and commonly co-occurs with aphasia. Most AOS treatment research has used single case experimental designs (SCEDS) to document the effects of treatment. The strength of SCEDs is that they can demonstrate clear causal relations between intervention and behavior change. The most studied AOS treatment is an articulatory-kinematic treatment called Sound Production Treatment (SPT). This study was designed to examine the effects of a novel treatment, Sound Production Treatment in a Metrical- Paced Frame (SPTMF), on the speech production …

Predicting The Yield Strength Of Aluminum Alloys Based On Composition, Clinton K. Waite

Theses and Dissertations

This work describes a model to predict the yield strength of aluminum alloys, in either an annealed or T6 (peak aged) state, based solely on its composition. This is accomplished through the analyses of strengthening mechanisms common to aluminum, of which a novel semi-empirical model to predict precipitation strengthening is discussed. Solid solution strengthening and grain boundary strengthening are more simplistically considered but with significant accuracy. It is shown that by combining the strength contributions of each strengthening mechanism, the overall yield strength can be predicted by its composition in any of the 1xxx-7xxx series alloys. This allows the model …

Upregulating Ankhd1 In Ps19 Mice Reduces Tau Phosphorylation And Mitigates Tau Toxicity-Induced Cognitive Deficits, Xiaolin Tian, Nathan Le, Yuhai Zhao, Dina Alawamleh, Andrew Schwartz, Lauren Meyer, Elizabeth Helm, Chunlai Wu

School of Graduate Studies Faculty Publications

Using the fly eye as a model system, we previously demonstrated that upregulation of the fly gene mask protects against FUS- and Tau-induced photoreceptor degeneration. Building upon this finding, we investigated whether the protective role of mask is conserved in mammals. To this end, we generated a transgenic mouse line carrying Cre-inducible ANKHD1, the human homolog of mask. Utilizing the TauP301S-PS19 mouse model for Tau-related dementia, we found that expressing ANKHD1 driven by CamK2a-Cre reduced hyperphosphorylated human Tau in 6-month-old mice. Additionally, ANKHD1 expression was associated with a trend toward reduced gliosis and preservation of the presynaptic marker Synaptophysin, suggesting …

Transforming Business Management Placement Students Into Teachers, Carl Evans, Paul Harrington

Plymouth Business School

A period of work placement is widely recognised to be one of the most effective ways to enhance an undergraduate’s employability and work-readiness. However, at present, the value of all the learning gained on the work placement remains with the placement student. The authors of this viewpoint paper propose an approach to widen the benefits of a work placement, by sharing an element of industrial or commercial knowledge gained with fellow undergraduates and with teaching staff, via a delivered teaching presentation. In doing so, brings work experience to a wider group of undergraduates and strengthens the link between education and …

Next-Gen Leaders: Cultivating Board Room Readiness For Emerging Nurse Professionals, Cheryl Nikol Hamilton

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) project addressed the critical underrepresentation of nurses on healthcare boards by implementing an evidence-based intervention to improve board readiness among emerging nurse leaders in Arkansas. The purpose of the project was to assess and enhance nurses’ self-perceived competencies in governance through a structured educational program and the SHIP-BC© readiness assessment tool. A quasi-experimental pre-post design was utilized with honorees from two leadership programs within a statewide nursing organization. Participants first completed the SHIP-BC© survey to establish baseline perceptions of board readiness across domains of analytical, interpersonal, and organizational skills. Following a four-week microlearning board …

Twelve Tips To Help Junior Faculty Review Medical Education Literature With Confidence, Abagayle Bierowski, Casey Morrone, Ridhima Ghei, Michael Pasirstein, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

Peer reviews play a critical role in maintaining the quality, credibility, and advancement of medical education scholarships. While many early career faculty members are eager to contribute to the peer review process, there are few formal resources available to guide them in how to approach this work effectively. This article offers 12 practical tips tailored specifically for junior faculty who are new to reviewing medical education manuscripts. These tips cover key aspects of the review process, including how to structure feedback, evaluate methodological rigor, assess alignment with journal aims, and communicate constructively with authors and editors. The guide also emphasizes …

Effective Strategies For Mitigating Skills Gaps Postpandemic In The Automotive Industry, Neil Shah

Walden Dissertations and Doctoral Studies

Inadequate approaches to filling employee skill gaps can seriously weaken workforce stability and organizational performance. Canadian automotive sector leaders are concerned about the risk of persistent employment shortages, high employee turnover, and decreased productivity. Grounded in Alderfer's existence, relatedness, and growth theory, the purpose of this qualitative pragmatic inquiry was to identify and explore the strategies employed by Canadian auto manufacturers to address skill shortages in their workforce in the wake of the pandemic and subsequent digitalization. Six senior executives from Canadian auto manufacturers who led successful skill-development and retention initiatives participated in semistructured interviews, complemented by a review of …

Comparative Outcomes Of Coil Embolization And Surgical Clipping In Elderly Patients With Subarachnoid Hemorrhage: A Systematic Review And Meta-Analysis, Yohanna Idsabella Rossi, Gabriel Bolner, Jonathan Costa Dall'acqua, Fabiana Dolovitsch De Oliveira, Lucas V. Zacaria, Taís L. Denicol, Michel Frudit, Natália Vasconcellos De Oliveira Souza

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES: Elderly patients with subarachnoid hemorrhage (SAH) face a disproportionately high burden of morbidity and mortality. While endovascular coiling is often favored in this population, direct comparisons with surgical clipping are limited. We conducted a meta-analysis to compare outcomes of clipping versus coiling in SAH patients aged ≥ 60 years.

METHODS: A systematic search of PubMed, Embase, and Cochrane databases identified studies comparing the two treatments in this age group. The primary outcome was a composite of unfavorable outcomes (modified Rankin Scale [mRS] > 2 and mortality). Secondary outcomes included mortality, favorable outcome (mRS 0-2), rebleeding, and hospital length …

The Effect Of Hcv On Methadone Dose During Pregnancy, Sarah Boudova, Neel S. Iyer, Danielle M. Tholey, Jonathan M. Fenkel, Rupsa C. Boelig

Department of Obstetrics and Gynecology Faculty Papers

Pregnancy is a time of high patient motivation to initiate treatment for opioid use disorder (OUD). Hepatic drug metabolism can be altered by pregnancy and hepatitis C virus (HCV) infection. We aimed to examine the impact of HCV during pregnancy on methadone dosing. Retrospective chart review of all pregnant patients with OUD admitted for initiation of methadone from 1/2020-6/2022. Associations were examined using Student's T-tests, chi-squared tests, Fisher's exact tests and univariate and multivariate linear regression. We identified 191 pregnancies initiated on methadone, of which 188 were screened for HCV. 111 (59.0%) were HCV Antibody (Ab)+, of whom 108 were …

Hemispherotomy For Drug-Resistant Epilepsy In Bilateral Sturge-Weber Syndrome: Illustrative Cases, Eveline Teresa Hidalgo, Eric A Grin, Yosef Dastagirzada, Nealen Laxpati, Judith Bluvstein, Julia R Schneider, Daniel Miles, Michal Tzadok, James Riviello, Howard L Weiner

Faculty, Staff and Students Publications

Background: Sturge-Weber syndrome (SWS) is a congenital neurocutaneous disorder characterized by angiomas of the face, choroid, and leptomeninges. Seizures in these children often present within the first 2 years of life. SWS is typically unilateral, but bilateral SWS occurs in approximately 15% of cases. Bilateral SWS is associated with earlier seizure onset and poorer cognitive, developmental, and functional outcomes. More than half of children with SWS develop drug-resistant epilepsy requiring surgical intervention. Hemispherotomy has been established as a successful treatment for unilateral SWS, but resective surgery has traditionally not been considered a treatment option for patients with bilateral disease.

Observations: …

Combined Passive And Active Ultrasonic Stress Wave Monitoring Of A Full-Scale Laboratory Reinforced Concrete Bridge Column Subject To Reverse-Cyclic Lateral Loading, Niklas Epple, Thomas Schumacher, A. K. M. Golam Murtuz, Ernst Niederleithinger, Peter Dusicka

Civil and Environmental Engineering Faculty Publications and Presentations

Effective monitoring of reinforced concrete structures requires techniques that detect early-stage material change and active, localized cracking. This study investigates a combined structural health monitoring approach using passive acoustic emission and active ultrasonic methods on a full-scale reinforced concrete bridge column subjected to reverse-cyclic lateral loading. Active monitoring, based on coda wave interferometry, was used to track changes in wave velocity and waveforms, while passive acoustic emission monitoring was used to detect crack activity. The instrumentation consisted of three embedded ultrasonic transducers and three surface-mounted acoustic emission sensors. The results show that active ultrasonic monitoring is most effective prior to …

Case Report: Sarcina Ventriculi, A Masquerade Of Motility, Katherine Westbrook Cates, Catherine Hudson

School of Medicine Faculty Publications

Sarcina ventriculi is a rare bacterium that has the potential to cause severe disease in the gastric mucosa. According to our search, there are less than 100 prior published case reports. This case discusses a 69-year-old man who presented to the hospital with severe gastric distention noted on CT of the abdomen with intractable nausea and emesis, for which endoscopy was performed and ruled out gastric outlet obstruction, with biopsies resulting as S. ventriculi. This bacterium has previously been reported to cause gastric dysmotility, as well as severe side effects including gastric perforation.

Exploring Hepatic Stellate Cell-Driven Fibrosis: Therapeutic Advances And Future Perspectives, Alka Singh, Ansab Akhtar, Prashant Shukla

School of Medicine Faculty Publications

BACKGROUND AND PURPOSE: Liver fibrosis, a progressive liver disease arising from viral or metabolic causes, poses a major global health challenge due to its potential progression to cirrhosis and hepatocellular carcinoma. Due to the complex aetiology and epidemiology of liver fibrosis, most therapies fail in the clinic, and very few drugs have been approved by the US FDA. APPROACH: This review highlights the pathophysiological features of liver fibrosis, with a focus on novel targets in hepatic stellate cells (HSCs), key players in the fibrogenesis process, to develop successful therapeutic approaches using both pharmacological agents and active targeting strategies. The review …

Staff Education For Improved Diabetes Management: Enhancing Knowledge And Patient Outcomes, Carissa Martine Bolden

Walden Dissertations and Doctoral Studies

An increase in patients’ hemoglobin A1c levels in a South Mississippi organization suggests that inadequate type 2 diabetes (T2DM) knowledge among the staff hindered them from delivering competent care. The gap in practice at the site revealed a deficiency in knowledge in nutrition education for healthcare providers and staff, which led to the practice question: Does educating providers and staff on nutrition for adults with type 2 diabetes improve knowledge, as evidenced by pre- and post-surveys? This educational initiative employed the analysis, design, development, implementation, and evaluation (ADDIE) model, the John Hopkins evidence-based practice (JHEBP) model, the Walden University Doctor …

Non-Pharmacological Interventions For Attention Deficit Hyperactive Disorders And Anxiety, Alichia Lashawn Pecks

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project used a quality improvement approach to address the co-prescription of stimulants and benzodiazepines in patients with attention deficit hyperactivity disorder (ADHD) and anxiety in outpatient mental health settings. The project explored whether implementing a structured non-pharmacological staff education program for mental health staff could improve knowledge of safe, evidence-based treatment alternatives. The purpose of this staff education project was to improve provider knowledge of evidence-based, non-pharmacological treatment alternatives. To address this issue, a structured non-pharmacological staff education program was implemented to improve provider knowledge of safer, evidence-based treatment alternatives. Four participants completed pre- …

Staff Education To Enhance Nonmedical Staff Competency In Withdrawal Management, Katherine Hedrick

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a significant gap in staff training at a behavioral health residential treatment facility. Nonmedical staff, including substance abuse counselors, lacked formal education in recognizing, assessing, and escalating symptoms of substance withdrawal. This lack of competency posed a risk to patient safety, regulatory compliance, and quality of care. The goal of the project was to evaluate the impact of a structured, simulation-based training program on nonmedical staff’s knowledge and confidence in using validated withdrawal assessment tools and monitoring vital signs. Six nonmedical staff participated in the training, which incorporated lecture, hands-on simulation, and …

Patient Engagement Strategies In Weight-Loss Programs, Olufunmilayo M. Bishop

Walden Dissertations and Doctoral Studies

Weight regain after pharmacological weight-loss interventions remains a pervasive challenge in primary care, with over 70% of patients reverting to baseline weight within six months. This quality improvement project aimed to enhance healthcare providers’ patient engagement skills to improve retention and long-term outcomes in weight-loss programs. A structured staff training program focusing on motivational interviewing, goal-setting, and barrier recognition was implemented among a multidisciplinary team. The program’s effectiveness was evaluated through a mixed-methods approach, incorporating quantitative pre- and post-assessment scores and qualitative staff satisfaction surveys. Results demonstrated a significant increase in staff knowledge, with average scores rising from 68% to …

African American Men's Perceptions Of Law Enforcement, Dr. Dedrie Reshell Leonard-Francis

Walden Dissertations and Doctoral Studies

African American Black men are more likely to report unreasonable, unnecessary, and unwarranted experiences with U.S. law enforcement than men of other racial groups, and they higher mistrust toward law enforcement than any other racial group. These experiences have been described as unjustifiable due to the level of force used by police. In some cases, excessive force by law enforcement has resulted in the death of Black men. The purpose of this phenomenological study was to explore Black men’s perceptions of law enforcement and to understand their distrust. The study centered on the facilitators and barriers to Black men trusting …

Exploring Parenting Students’ Experiences With Institutional Support Using The Loss/Momentum Framework, Paula Kwok Jung

LMU Theses and Dissertations

The California Community College system serves as the primary entry point for our marginalized student populations. According to Cruse et al. (2019), approximately 22% of nontraditional students in colleges and community colleges identify as student parents. Student parents are highly motivated to succeed in their academic journey. However, due to various factors including institutional barriers and the lack of support, it was found that only 37% of all parenting students complete a degree or certificate within six years, compared to 60% of non-parenting college students (Reed et al., 2021). Research has shown that institutional actions and support play a crucial …

Nemvaleukin Alfa Monotherapy In Patients With Advanced Melanoma And Renal Cell Carcinoma: Results From The Phase 1/2 Non-Randomized Artistry-1 Trial, Emiliano Calvo, Valentina Boni, Olivier Dumas, Sang Joon Shin, Seth D Rosen, Arvind Chaudhry, Philip R Debruyne, Xiaomin He, Ulka N Vaishampayan, David F Mcdermott

School of Nursing and Midwifery

BACKGROUND: Despite improved outcomes with immune checkpoint inhibitors (ICIs) and their combinations in advanced solid tumors, a subset of patients remains unresponsive or progresses, highlighting an unmet need for novel treatments with durable benefit. Nemvaleukin alfa (nemvaleukin, ALKS 4230) demonstrated manageable safety and antitumor activity, alone and in combination with pembrolizumab, across heavily pretreated advanced solid tumors in the ARTISTRY-1 study. We report in-depth antitumor activity, safety, pharmacokinetics, and pharmacodynamics of nemvaleukin monotherapy at the recommended phase 2 dose (RP2D) in advanced melanoma and renal cell carcinoma (RCC) cohorts from ARTISTRY-1.

METHODS: ARTISTRY-1 was a three-part (A, B, and C), …

[Abstract And Associated Files For] Multi-Variable Monte Carlo Simulation For Portfolio Analysis In Excel, Tom Arnold, C. Mitchell Conover, Joseph Farizo, Nancy Tran

Finance Faculty Publications

Monte Carlo (MC) simulation has several applications in finance, including risk management, valuation, and portfolio management. In this paper, we use multiple correlated Geometric Brownian motion (GBM) processes that allow for very robust portfolio analysis. In this treatment, five correlated funds make up a portfolio. MC is used to not only forecast possible future portfolio and fund outcomes, but to also evaluate the benefits and costs of a hedging strategy and to consider the effects of different correlation structures between the funds on portfolio performance. Because the programming is in Excel, the analysis is very accessible and available to analysts …

An Unusual Chest Lesion With Dual Pathologies, Jessica Colon, Jay Nguyen, Samuel Stahly, Gulsun Erdag, Rajiv Nathoo

GME Publications

Granuloma faciale (GF) is a rare, benign, chronic inflammatory condition characterized by well-defined reddish-brown papules, nodules, or plaques, often demonstrating follicular accentuation and telangiectasia, which may be termed "peau d'orange." Typically, GF is localized to the facial area, but extrafacial variants have been reported, particularly on the trunk, scalp, and extremities. We report a 66-year-old male with a history of GF and multiple basal cell carcinomas (BCCs) who presented with a pearly plaque on the chest. Biopsy revealed extrafacial GF with a coincidental BCC, representing a rare case of a collision tumor. GF, typically a facial condition, can present in …

Data Registration Techniques For Optical Functional Brain Mapping, Abigail Magee

McKelvey School of Engineering Graduate Student Theses & Dissertations

Optical functional brain mapping presents a versatile, portable, and cost-effective alternative to conventional functional imaging techniques such as functional magnetic resonance imaging (fMRI). However, optical imaging does not inherently capture anatomical details and relies on existing structural imaging to generate accurate brain maps. By employing head models that incorporate participant-specific anatomy, imaging array placement, and the optical properties of underlying tissues, optical functional brain mapping can achieve results comparable to those of fMRI. Despite advances in registration techniques, the creation of atlas-derived yet participant-specific head models remains a significant challenge. My research endeavors to develop innovative registration and analysis pipelines …

Rethinking Empowerment: Financial Self-Efficacy In First-Generation College Students, David Steadman

Masters Projects

Financial wellness difficulties have increasingly been found as a trend found amongst college students in research, as loans increase and student aid decreases, research is needed to understand new approaches to financial wellness and improving this problem within higher education. This project explores financial wellness and the need for wellness support amongst first-generation college students, as they continue to face unique wellness challenges in education at disparate rates. Specifically, it focuses on Financial Self-Efficacy (FSE) as a mediating factor of financial wellness, instead of a traditional focus on purely financial literacy. Grounded in Albert Bandura’s self-efficacy theory, the First-Generation Financial …

Explicit Instruction’S Role In Phonemic Awareness And Phonics In Early Childhood Education, Sydney J. Fisher

Masters Projects

Research consistently demonstrated the impact that explicit instruction has on young children’s acquisition of phonemic awareness and phonics skills, critical foundations for later reading success. These skills are linked to achievement in reading in the upper elementary grades and beyond. Children reading below often face challenges across subject areas, and low literacy levels can limit meaningful participation in the community. This project examines research on developing phonemic awareness and phonics skills. With proper training and knowledge, teachers can improve student outcomes in these areas. However, teacher preparation programs and professional development does not adequately address these skills and how to …

Evaluating Parotid Gland Dose Between Electronic Tissue Compensation And Field In Field Treatment Techniques For Parotid Sparing In Whole-Brain Radiotherapy, Joesph E. Bodgonas

Masters Projects

Purpose:

The parotid glands are essential to salivary function and patient quality of life, yet they are not routinely prioritized as organs at risk (OARs) during whole-brain radiotherapy (WBRT). With growing recognition of long-term side effects like xerostomia in patients with prolonged survival after WBRT, parotid-sparing techniques warrant investigation. This study compares radiation dose to the parotid glands using three different 3D conformal WBRT planning approaches: field-in-field (FiF) with blocking, electronic tissue compensation (eCOMP) without blocking, and eCOMP with blocking.

Methods and Materials:

A retrospective study was conducted on 20 patients previously treated with 3D conformal WBRT. Original eCOMP plans …

Like A Scientist: A Method For Introducing Disciplinary Literacy In The Science Classroom, Elizabeth L. Kuperus

Masters Projects

To be literate within a particular area of study requires an understanding of the literary disciplinary norms practiced in that field. Within the science classroom, students are often expected to engage with scientific literature, yet are unable to fully grasp the material since they have not been taught the disciplinary literacies associated with science. This project evaluates research surrounding the area of scientific disciplinary literacy and suggests how it could be used to inform classroom instruction. Disciplinary literacy skills need to be explicitly taught and modeled to demonstrate how students can approach texts and other literacy practices as a scientist. …

The Need For Updated Curriculum, Krahseeva N. Hugmeyer-Walsh

Masters Projects

The modern world requires a workforce equipped with diverse, adaptable skills, yet many students remain unprepared due to outdated curriculum models that no longer align with current societal and professional demands. This project explores the growing disconnect between traditional educational systems and the skills needed in today’s fast-paced, technology-driven world. Current curricula often emphasize theoretical knowledge over practical application, leaving students ill-equipped to navigate real-world challenges. This project also proposes the development of a modernized secondary-level curriculum unit that prioritizes critical thinking, creativity, collaboration, ethics, and technological literacy. The proposed unit is designed to reflect student interests, promote engagement, and …