Digital Commons Network^™

Utilizing The Patient Health Questionnaire In A Family Practice Clinic To Enhance Clinical Benchmarks, Dorothy Akaeze

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: About one-third of the 129 million chronically ill patients in the United States experience persistent depressive symptoms. Approximately 300 of 500 (60%) chronically ill patients treated at the project site each month show signs of depression, indicating a higher prevalence than the national rate of 33.33%. Despite the critical role of family practice in identifying and managing depression, many patients are not adequately screened, leading to missed opportunities for early diagnosis and treatment. The project site does not use the digitized PHQ screening tool to screen patients for depression. An analysis of patient charts revealed that, out of about …

The Impact Of A Nurse Navigator On The Completion Of Medicare Annual Wellness Visits, Nanette L. Snyder

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Despite being a covered service designed to support individualized prevention planning, the Medicare Annual Wellness Visit (MAWV) remains underutilized at a rural Federally Qualified Health Center (FQHC). Barriers include low patient awareness, inconsistent outreach, and a reactive scheduling process that excludes patients without upcoming appointments. These issues limit the FQHC’s ability to meet preventive care goals and sustain performance in value-based reimbursement models.

Aim of the Project: This quality improvement project evaluates the impact of implementing a nurse navigator on MAWV completion. The intervention incorporates proactive scheduling and cohort engagement to address barriers related to awareness, access, and outreach. …

Optimizing Transfer Classification: Enhancing Accuracy And Reducing Readmission Rate Penalties For Cardiovascular Care In Short-Term Rehab, Aeshia Hicks

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: In a short-term rehabilitation (STR) setting, misclassification of planned hospital transfers as unplanned readmissions among elderly cardiovascular patients inflated CMS-reported readmission rates, distorted performance metrics, and led to financial penalties under the Hospital Readmissions Reduction Program (HRRP). A gap analysis revealed a 14% misclassification rate, significantly higher than the CMS benchmark of 8.65%, which was attributed to inconsistent documentation and a lack of standardized classification criteria.

Aim of the Project: To reduce transfer misclassification by 20% through the implementation of a standardized electronic health record (EHR) template and targeted staff education, thereby improving CMS compliance and documentation integrity in …

Effect Of Standardized Phone Call Protocol On The Achievement Of Target Hba1c Levels, Felicia Choyce

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

Type 2 Diabetes Mellitus is a common chronic illness with far-reaching health and financial consequences. At the project’s primary care clinic, the average hemoglobin A1c among adults with Type 2 Diabetes Mellitus was 9.6%, exceeding the recommended clinical goal of less than 7% (American Diabetes Association, 2023). The absence of a standardized follow-up protocol and inconsistent use of health literacy-based communication contributed to persistent hyperglycemia and failure to reach target HbA1c levels. These factors indicated an urgent need for an evidence-based intervention.

Aim of the Project:
The aim of this project was to reduce HbA1c levels among adults with …

Implementing A Fast-Track Pathway For Low Acuity Patients To Reduce Patient Length Of Stay In The Emergency Department, Dawnyel Donaldson

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Overcrowding and prolonged wait times in emergency departments (ED) negatively affect patient safety, outcomes, and satisfaction. Hospital A, a Level 1 trauma center with over 52,000 annual ED visits, consistently exceeded the national ED length of stay (EDLOS) benchmark of 6 hours, averaging 6.7 hours, with left without being seen (LWBS) rates at 2.89%, surpassing the 2% target. Low-acuity Emergency Severity Index (ESI) level 4 and 5 patients contributed to congestion due to inefficient triage processes and lack of alternative care pathways, delaying timely access to care.

Aim of the Project: The project aimed to implement an evidence-based fast-track …

Integrating Kangaroo Care Into Cesarean Delivery Practices: A Pathway To Enhanced Health Outcomes, Julia Swords

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Cesarean deliveries often interrupt early mother-infant bonding, delaying the initiation of breastfeeding and limiting opportunities for skin-to-skin contact. Despite national guidelines promoting immediate postpartum contact, cesarean-born infants receive kangaroo care (KC) at significantly lower rates than those born vaginally. Prior to this project, only 2% of cesarean births at the project site received KC, highlighting a significant gap in care delivery.

Aim of the Project: The aim was to evaluate the feasibility and impact of implementing kangaroo care during cesarean deliveries in a community hospital to improve neonatal outcomes and adherence to evidence-based postpartum practices.

Review of the Evidence: …

The Safe Harbor For Leveraged Buyouts In Bankruptcy, David G. Carlson

Articles

No abstract provided.

Neurodiversity In Action: Understanding The Brain Basis Of Dyslexia, Rebecca Marks

Science of Reading

Dyslexia, a specific learning disability (SLD) characterized by persistent difficulties in accurate and/or fluent word reading, is often misunderstood. This brief resource, written for non-neuroscientists, describes how research in cognitive neuroscience has revealed systematic differences in the reading brain between individuals with and without dyslexia.

3. Academic Policies And Services, Saint Mary's College Of California

Faculty Handbook

No abstract provided.

Corrigendum To 'Scai Expert Consensus Statement On Alternative Access For Transcatheter Aortic Valve Replacement' [Journal Of The Society For Cardiovascular Angiography & Interventions 4 (2025) 102514]., Matthew Sherwood, Keith B Allen, Thom G Dahle, Chandan M Devireddy, Jeffrey Gaca, Santiago Garcia, Kendra J Grubb, Tsuyoshi Kaneko, Chad A Kliger, Robert J Lederman, John C Messenger, Puja B Parikh, Marie-France Poulin, Carlos Sanchez, Anene Ukaigwe, James J Yun, Paul D Mahoney

Heart and Vascular Articles

[This corrects the article DOI: 10.1016/j.jscai.2024.102514.].

Returning To Nature: A Virtue-Based Approach To Urban Sustainability, Liam A. L. Cormack

Cities and the Environment (CATE)

This paper advocates for a pragmatic and virtue-ethics-based approach to urban sustainability initiatives that prioritizes the consideration of moral responsibility. Looking at literature on rewilding, this paper argues that the principle of ecophronesis, and the larger discipline of ecopracticology, offers a compelling framework for integrating diverse opinions on the future of conservation from different disciplines and ecological stakeholders. Ultimately, an ecophronetic approach to urban sustainability initiatives facilitates a sense of conceptual rewilding that disregards the nature-culture dualism paradigm limiting Western environmental thought and may help address the perceived alienation from nature characterized by nature-deficit disorder.

Exploring The Clinical Utility Of Neurofilament Light Chain Assays In Multiple Sclerosis Management., Amit Bar-Or, Jacqueline Nicholas, Jenny Feng, Francesca Sorrell, Mark Cascione

Neuroscience Articles

Multiple sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease that affects nearly 1 million adults in the United States. Owing to its unpredictable disease course, diverse phenotypes, and an array of currently available disease-modifying therapies, a personalized approach to MS management is required. There is an unmet need to identify, validate, and incorporate prognostic, monitoring, and predictive biomarkers into routine clinical practice for MS. A mounting body of evidence supports the use of blood biomarkers, such as neurofilament light chain (NfL), in predicting disease activity and monitoring treatment response. Previous hurdles for the widespread use of NfL in the …

Who Reconstitutes The Chemotherapy? The Educational And Practice Needs Of Oncology Pharmacists In West Africa: A Call For Multidisciplinary Team Approach In Oncology Care., Runcie C.W. Chidebe, Ramatu M. Alabelewe, Krishna Prasad Sapkota, Darlingtina K. Esiaka, Candidus C. Nwakasi, Gloria C. Okwu, Jacinta Emejulu, Adamu A. Umar, Ndifreke Okwuegbunam, Funsho David, Toyosi Adepoju, Agha A. Agha, Ejike S. Ugwu, Simeon C. Aruah, Richard Mshelia, Rob Duncombe, Noel N. Wannang, Peace C. Babalola, R. Donald Harvey, Cindy O'Bryant, Folakemi T. Odedina

Behavioral Science Faculty Publications

PURPOSE: Oncology pharmacists (OPs) play a crucial role in cancer care, treatment, survivorship, and multidisciplinary teams (MDTs). OPs have specialized training in designing, administering, monitoring, and modifying oncology chemotherapy; managing adverse events; and evaluating clinical trials and investigational drugs. Yet, the state of OP has remained largely unknown in the clinical oncology workforce of the West African region. Therefore, this study aimed to understand who reconstitutes chemotherapy and to explain the OP educational and practice needs, challenges, and solutions in Nigeria.

MATERIALS AND METHODS: Using a concurrent embedded mixed method design, 35 OPs completed a questionnaire, and 12 others responded …

When Money Isn't Money: The Second Circuit's Gutting Of The Discharge-For-Value Defense For Erroneous Payments, Jeanne L. Schroeder

Articles

No abstract provided.

Varied Legal Parameters Shape Fiduciaries’ Ability To Act On Climate Risk, Cynthia Hanawalt, Andy Fitch

Sabin Center for Climate Change Law

Commentators who advocate either for or against corporate and asset managers addressing climate risks often refer to “fiduciary duty” as justification for their claims. Yet no field of corporate or asset management actually imposes one standalone fiduciary duty. Nor do any two business-law fields impose the same fiduciary regime. Instead, these fields adopt differing arrays of fiduciary duties to address various types of relationships, comprising a different blend of affirmative obligations and/or prohibitions, assessed with different degrees of strictness by enforcers and courts. As a result, overgeneralizations about fiduciaries’ duty in all business-law contexts tend to further obscure what a …

Property Values: Accounting For Racial Valorization And Stigmatization In Development, Audrey G. Mcfarlane

Articles

No abstract provided.

Longitudinal Surveillance Of Aedes Aegypti (Diptera: Culicidae) In Urban Coastal Kenya: Population Dynamics, Blood Feeding Frequency And Dengue Virus Infection Rates, Josephine Osalla, Louis Clement Gouagna, Gilbert Rotich, Maureen Nzilani, Penina Safari, Kennedy Senagi, Francis Mutuku, Baldwyn Torto, David P. Tchouassi

All Peer-Reviewed Publications

The coastal region of Kenya has emerged as a focal point for urban dengue virus transmission driven by Aedes aegypti as the primary vector. To gain a deeper understanding of the epidemiological situation, we carried out a year-long longitudinal study (December 2021- November 2022) of the population dynamics of A. aegypti through weekly mosquito surveys using ovitrap and CO2-baited Biogents (BG) mosquito traps in Ukunda, an urban township in the coastal region. Aedes eggs laid in ovitraps were exclusively A. aegypti with 80.8% mean hatch rate. A total of 35,109 adult A. aegypti were captured, with twice as many females …

Do Search Costs Explain Persistent Investment In Active Mutual Funds?, Aljoscha Janssen, Jurre Thiel

Research Collection School Of Economics

Active funds, though losing market share since the 1990s, make up nearly half of all mutual funds but charge more without better performance. We analyze fund data and a search model, highlighting the impact of search costs and active fund preferences. From 1993 to 2018, reduced search costs expanded the market and heightened competition, while a preference shift from active to passive funds increased the latter's market share. However, investors who choose active funds, facing higher search costs, and continue to show a strong preference for them, allow these funds to keep charging higher fees.

Query Understanding In Llm-Based Conversational Information Seeking, Yifei Yuan, Zahra Abbasiantaeb, Mohammad Aliannejadi, Yang Deng

Research Collection School Of Computing and Information Systems

Query understanding in CIS involves accurately interpreting user intent through context-aware interactions. This includes resolving ambiguities, refining queries, and adapting to evolving information needs. LLM enhance this process by interpreting nuanced language and adapting dynamically, improving the relevance and precision of search results in real-time. In this tutorial, we explore advanced techniques to enhance query understanding in LLM-based CIS systems. We delve into LLM-driven methods for developing robust evaluation metrics to assess query understanding quality in multi-turn interactions, strategies for building more interactive systems, and applications like proactive query management and query reformulation. We also discuss key challenges in integrating …

High Frequency Factor Analysis With Partially Observable Factors, Dachuan Chen, Wenqi Lu, Siyu Xie

Research Collection School Of Economics

This paper considers a novel factor structure – Partially Observable Factor Model – where both observable factors and latent factors exist in the model simultaneously. Such factor structure can make sure both interpretability and goodness-of-fit at the same time. Necessary estimation methodologies for this partially observable factor model are developed in this paper for the high frequency data. The proposed estimation methodology is robust to jumps, microstructure noise and asynchronous observation times simultaneously.When the observable factors are exogenous, we provide the estimation theory for the integrated eigenvalues of the residual covariance matrix, which including the bias-corrected estimator, central limit theorem …

Grazing On The Early Life History Stages Of Macrocystis Pyrifera By The Purple Sea Urchin Strongylocentrotus Purpuratus, Sloane Lofy

Capstone Projects and Master's Theses

In California, recent large-scale declines in kelp forest cover, the formation of sea urchin barrens, and the subsequent biodiversity loss have heightened the need to further investigate mechanisms of kelp forest recovery and sea urchin barren dynamics. To better understand the kelp recruitment potential of these deforested areas it is important to determine the effect sea urchins have on the microscopic portion of the kelp lifecycle and if a size refuge exists. Laboratory studies were used to examine the effect of the purple sea urchin Strongylocentrotus purpuratus on the density, percent cover and reproductive output for three microscopic stages of …

Building Respect, Responsibility, And Reciprocity: Insights From A Rural Stem Research Practice Design Partnership, Amanda Obery, Martha Cabell, Shelly Hogan, Matt Queen

The Rural Educator

Rural schools often have strong community involvement and thus can offer educational experiences to students that are more closely aligned with local people and places. However, curricula in rural schools rarely offer this same alignment. Partnerships with others, including higher education, can support rural schools in creating STEM curricula that center the resources and careers present in their communities. A research design practice partnership (RPDP) was created as a Third Space to enable the development of locally relevant STEM curricula. The partnership was formed focusing on respect, responsibility, and reciprocity, necessary tenets as the roles and goals of the project …

Distributed Tracking Control Of Multiple High-Order Uncertain Nonlinear Systems With Guaranteed Performance, Eduardo Alvarez, Wenjie Dong

Electrical and Computer Engineering Faculty Publications

This paper addresses the distributed tracking control of multiple uncertain high-order nonlinear systems with prescribed performance requirements. By introducing a performance function and a nonlinear transformation, the prescribed fixed-time performance tracking control problem is reformulated as a distributed tracking control problem for multiple special nonlinear systems. With the aid of the universal approximation theorem for continuous functions and algebraic graph theory, distributed robust adaptive controllers are designed using the backstepping technique. Simulation results are presented to demonstrate the effectiveness of the proposed algorithms.

Psychosocial Supports For The Physical And Mental Health Of Youth With Autism And Other Neurodevelopmental Disabilities., Melissa Campbell, Elizabeth Hastings, Paige Mcardle, Darren Olsen, Kathryn Benton, Cy Nadler

Manuscripts, Articles, Book Chapters and Other Papers

One in six youth has a neurodevelopmental disability (NDD), and autism diagnostic rates continue to rise. Before and after a diagnosis, families need trusted sources of guidance to navigate co-occurring medical and psychological conditions, and to manage unique stressors including transition to adulthood. However, medical professionals from all specialty areas struggle to identify resources to support the complex psychosocial and healthcare needs of these patients and their families. This primer on psychosocial supports for youth with autism will explore the major mental and physical health stressors faced by affected youth and families, and discuss opportunities for primary care and other …

On Data Envelopment Analysis Framework For Optimizing Two-Stage Systems Under Neutrosophic Environment, Basma E. El- Demerdash, A. Almutairi, Sultan S. Alodhaibi, Hamiden Abd El- Wahed Khalifa, Heba Ghareb Goma

Neutrosophic Sets and Systems

No abstract provided.

Neutrosophic Reliability Assessment Of Hydroelectric Power Plant Using Universal Generating Function Technique, Kanak Saini, Monika Saini, Ashish Kumar, $Dinesh Kumar Saini

Neutrosophic Sets and Systems

No abstract provided.

A Dual Treesoft-Hypersoft Set-Based Framework For Assessing Employment Guidance Satisfaction In Vocational Colleges, Wei Liu, Xing Gao, Hongtao Fang

Neutrosophic Sets and Systems

No abstract provided.

Green Supply Chain Management Capability Evaluation Using Neutrosophic Twofold Algebra Decision Model, Hui Wang

Neutrosophic Sets and Systems

No abstract provided.

Systemic Exogenous Progestins With Or Without Estrogens Are Associated With Decreased Rates Of Venous Procedures For Varicose Veins, Paarth Jain, Adam M. Ostrovsky, Paul J Dimuzio, Luis H. Eraso, Michael Nooromid, Dawn Salvatore, Babak Abai

Department of Surgery Faculty Papers

OBJECTIVES: Risk factors for varicose veins (VVs) such as female sex, pregnancy, and obesity are high estrogen states, yet the role of systemic progestins with or without estrogens (SPEs) in VV management is not well characterized. This study investigates how SPE use affects rates of venous procedures for patients with VV.

METHODS: The TriNetX database was queried for subjects with International Classification of Diseases, 10th edition, diagnoses of asymptomatic VV, chronic venous insufficiency, and complicated VV (inflammation or ulceration). Patients were divided into a control cohort with no subsequent SPE use, a progestin-only cohort, and a combined estrogen-progestin (CEP) cohort. …

Covid-19 Vaccine Attitudes And Behaviors Among Pregnant Women In Nairobi, Kenya With Diverse Socio-Economic And Educational Backgrounds, Jessica Schue, Ferdinand Okwaro, Ingrid Gichere, Daizy Cherono, Mandeep Sura, Emily Miller, Berhaun Fesshaye, Prachi Singh, Grace Belayneh Belayneh, Rupali Limaye, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction

Methods