Digital Commons Network^™

Economic Development Corporations In Small Communities, Mary L. Bullock

Certified Public Manager® Applied Research

This study evaluates the effectiveness of Type A and Type B Economic Development Corporations (EDCs) in supporting economic growth in small Texas communities. Using key indicators such as population trends, employment, infrastructure, housing, and legal frameworks, this paper compares how each EDC structure addresses these issues. While both Type A and Type B Economic Development Corporations contribute to economic growth, Type B EDCs are generally more effective in small Texas communities due to their broad ability to fund housing projects, create critical infrastructure, and shape quality-of-life community development projects that have a more immediate and measurable impact on unemployment, population …

Interpreting Continuous Glucose Monitoring Through Metabolic Physiology: A Framework For Precision Nutrition In Type 2 Diabetes, Jitendra D. Belani

College of Pharmacy Faculty Papers

Background: Type 2 diabetes is characterized by substantial interindividual variability in postprandial glucose responses, yet continuous glucose monitoring (CGM)-derived glucose patterns are commonly described using quantitative metrics without sufficient consideration of the physiological mechanisms that generate them. Objective: To develop a physiology-based framework for interpreting CGM-derived glycemic phenotypes in relation to dietary exposures and individual metabolic characteristics, thereby supporting precision nutrition in adults with type 2 diabetes. Methods: A structured narrative review of the literature was conducted using PubMed to identify studies examining CGM, postprandial glucose regulation, dietary exposures, metabolic physiology, and precision nutrition. Evidence was synthesized within a predefined …

Healthcare Professionals' Experiences Of Mental Health Crises Among People Experiencing Homelessness, John P. Gilmore

International Nursing Research Congress (INRC)

Background: People experiencing homelessness face significant barriers to accessing mental health care, often resulting in untreated psychological distress and crisis presentations. In Ireland, the absence of dedicated mental health services for this population means that frontline clinicians frequently manage acute mental health deterioration within generalist settings not designed or resourced for such care.

Aim: To explore the experiences of healthcare professionals responding to mental health crises among individuals experiencing homelessness and to identify systemic, relational, and organisational factors influencing care delivery.

Methods: A descriptive qualitative study informed by critical realism was conducted using semi-structured interviews with 14 healthcare professionals, including …

Clarifying The Concept Of Virtual Nurse: A Concept Analysis For Aging And Chronic Care, Chia-Hui Chou, Heng-Hsin Tung

International Nursing Research Congress (INRC)

As the global healthcare landscape grapples with aging populations and the growing burden of chronic diseases, digital innovations like the Virtual Nurse (VN)—AI-powered embodied conversational agents—are gaining recognition for their potential to support patient self-management and improve care delivery. This study applies Walker and Avant's 8-step concept analysis to clarify the definition, boundaries, and essential characteristics of the Virtual Nurse. Thirteen peer-reviewed articles published from 2010 to 2021 were reviewed, focusing on their applicability to older adults and chronic disease management. Four defining attributes emerged: (1) clinical interactivity, (2) human-like empathy, (3) accessibility and understandability, and (4) scalability with feedback …

Adults’ Lived Experiences With Placement In Child Protective Services During Adolescence, Michaela First Haynes

Walden Dissertations and Doctoral Studies

Perceptions of safety and emotional support during involvement with child protective services (CPS) during adolescence may play a significant role in shaping attachment experiences and relationships in adulthood. Although researchers have examined the effects of child maltreatment and foster care involvement, limited research has explored how adolescents perceive emotional support and safety during CPS involvement and how those experiences influence attachment in adulthood. The purpose of this qualitative study was to explore the lived experiences of adults who experienced CPS involvement during adolescence and to understand how perceptions of safety and emotional support are reflected in their adult attachment relationships. …

Exploring The Experiences Of Nigerian Army Personnel With Toxic Leadership, Shamsideen Toyin Shafaru

Walden Dissertations and Doctoral Studies

Toxic leadership has been shown to be present in Nigeria, promoting negative consequences for organizations and adverse effects on employee performance. However, how toxic leadership behaviors impact Nigerian Army operations and the performance of personnel have not been studied. Exploring toxic leadership in the Nigerian Army is important because the way in which leaders exercise influence determines the effects it has on followers. The purpose of this general qualitative study was to examine the lived experiences of Nigerian Army personnel who had worked as subordinates of individuals who exhibited toxic leadership traits and its impact on their performance. The theoretical …

The Lived Experiences Of Midlife Black Women In Atlanta Managing Hypertension Through Nonpharmacological Interventions, Beth Feagins

Walden Dissertations and Doctoral Studies

In this qualitative phenomenological study, the beliefs and lived experiences of midlife, low-income Black women with hypertension were explored, concentrating on understanding how social determinants of health influence effects adherence to diet, physical activity and stress management. Social determinants of health and how health beliefs shape adherence to behaviors were examined. The study was guided by a dual theory approach of the social cognitive theory and theory of planned behavior. Six women, identified as Black, between the ages 40-60, diagnosed with hypertension and living in Atlanta, Georgia, participated in the study. Data was analyzed using Moustakas’ phenomenological analysis and revealed …

Effects Of Exercise On The Quality Of Life And Functional Capabilities For Individuals With Spinal Cord Injury, Luis Ellerbe

Doctorate in Kinesiology

Spinal cord injury (SCI) can significantly impact physical functioning, mental health, social support, and overall quality of life. The purpose of this study was to examine the effects of a 12-week standardized exercise program on quality of life and functional capabilities in adults with SCI. Participants completed a self-guided exercise program consisting of aerobic and strengthening activities performed twice weekly for 12 weeks. Outcome measures included the Spinal Cord Independence Measure (SCIM), 6-Minute Walk Test (6MWT), Hospital Anxiety and Depression Scale (HADS), and Multidimensional Scale of Perceived Social Support (MSPSS). Assessments were completed at baseline, post-intervention, and at a 6-month …

Postmodern Fantasy & Its Twin Traditions, Skyler J. Alexander

Honors Thesis

Fantasy literature is diverse and difficult to categorize; nevertheless, throughout the twentieth century two main subgenres emerged: sword-and-sorcery and high fantasy. This thesis examines the differences and similarities between these two traditions, how contemporary examples of the genre fit into or diverge away from the traditions that influenced them, and proves in the negative what and how much of contemporary fantasy fiction is original to itself, with no prominent antecedent. The analysis was performed by comparatively reading two contemporary fantasy novels, The Eye of the World by Robert Jordan and A Game of Thrones by George R. R. Martin, with …

Influence Of Lumpectomy Cavity Depth On Plan Quality In 3d Arc-Based Simultaneous Integrated Boost For Whole-Breast Radiotherapy, Emmett Dwyer

Masters Projects

Abstract

Purpose: Dynamic conformal arc (DCA) is a three-dimensional (3D) radiation therapy technique that can be used to deliver a simultaneous integrated boost (SIB) during whole-breast irradiation (WBI). This study investigated whether the depth of the lumpectomy cavity affects the feasibility of creating a successful DCA SIB treatment plan for breast radiotherapy.

Methods and Materials: 30 patients who previously received WBI followed by a 3D sequential boost (SeqB) were selected for this retrospective study. A DCA plan was created for each patient and combined with the original whole-breast tangent fields to create a SIB plan. Each plan was required to …

Multimodal Digital Libraries: A Response To Culturally And Linguistically Sustaining Classrooms, Abigail Lopez

Masters Projects

Poorly represented minority groups fail to connect reader identity backgrounds

with the characters in texts due to curriculum traditionally relying on English dominant

translations. This system challenge deficit fails students by placing limitations on the

exposure of rich vocabulary, cultural awareness and sets up lack of engagement. This

project is grounded in Culturally and Linguistically Sustaining Pedagogy, Sociocultural

Theory, Constructing Reader Identities and Engagement theories that transforms

student diversity into an instructional practice that empowers multilingual learners.

To empower students, this digital culturally relevant library optimizes educator

planning time. This digital library provides immediate access to multicultural books

alongside a …

Development And Evaluation Of Personalised Post-Diagnostic Dementia Support Based In Primary Care: The D-Pact Research Programme, Tomasina M. Oh, Hannah Wheat, Richard Byng, Sarah Morgan-Trimmer, Michael Clark, Sarah Griffiths, Paul Clarkson, Victoria Allgar, Angela Bate, Saqba Batool, Rebecca Beresford, Noor Butt, Joseph Coombes, Siobhan Creanor, Sonia Dalkin, Zoe Doran, Nicolas Farina, Leanne Greene, Alex Gude, Margaret Hart, Jane Horrell, Basharat Hussain, Wendy Ingram, Hannah Jones, Reena Lasrado, Tanya Lee, Baber Malik, Rosemarie Mccabe, Antonieta Medina-Lara, Nia Morrish

Peninsula Medical School

Background: Dementia affects nearly 1 million people in the United Kingdom and their unpaid carers physically, psychologically, socially and economically, highlighting that both need support. Post-diagnostic support is recognised as inadequate globally. In England, it is fragmented or absent apart from primary care – leaving many feeling unsupported as the condition progresses. The Dementia PersonAlised Care Team research programme began in 2018 to address evidence gaps on the effectiveness of dementia support roles and what constitutes ‘good’ support. Objective: Dementia PersonAlised Care Team aimed to develop and evaluate an intervention comprising dementia support workers based in primary care, supporting people …

Experiences Of Novice Assistant Principals: Perceptual Evidence From Texas, Gregory Vidal

Electronic Theses and Dissertations

Assistant principals play essential roles in supporting instructional leadership and campus operations. However, limited research has examined how novice assistant principals experience their transition into administration and interpret their preparation and support. This study addressed the gap in understanding how novice assistant principals in a suburban Texas public school district made sense of their preservice preparation and early leadership practice, and how these experiences shaped their perceptions of training and organizational supports. The purpose of this qualitative, experiential, phenomenological study was to explore the lived experiences of novice assistant principals during their first three years in the role. The study …

Spatiotemporal Analyses Of The Biological Condition Gradient (Bcg) For Florida’S Coral Reef, Maya Becker

All HCAS Student Capstones, Theses, and Dissertations

A conceptual model known as the Biological Condition Gradient (BCG) was originally constructed for biological assessments and has recently been adopted for use on Florida’s coral reef after repeated anthropogenic stressors have been linked to declines within the state of the reef. Anthropogenic pressures have reduced water quality, exacerbating coral disease and associated mortality disrupting ecosystem services and biological function throughout Florida’s coral reefs (FCR). The intention of the BCG model is to assess biological condition against increasing levels of anthropogenic stress and to identify biological attributes and measurable increments of change from long term monitoring data. Differences in spatial …

The Effectiveness Of "Little Doctor" Training On Health Knowledge And Behavior Of Karawang Primary Students (2025), Aurelia A. Erawan, Shahnaz F. Azzahra, Rubee P. Risdiyanto, Patricia Andini, Muhammad K. Ramadhan, Ailsa T. Kirana, Istingadah Desiana Md, Raden M. Rifada Md

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Acute respiratory infection (ARI) remains a major public health problem in Indonesia, with West Java reporting the highest incidence. Poor Health-Related Behavior (HRB) practices are associated with increased ARI risk. The "Little Doctor" program is a government initiative that focuses on school health and aims to promote HRB among students. Along with this goal, this study aimed to determine the effectiveness of the program in improving knowledge of HRB and ARI among elementary school students in Pancawati Village, Karawang Regency.

Methods. This study employs a quasi-experimental one-group pretest-posttest design. Participants were selected based on inclusion criteria referring to the …

Dameon Allen V. Attorney General United States Of America

2026 Decisions

Agency

Ildar Niyazov V. Attorney General United States Of America

2026 Decisions

Agency

Parents' Perspectives Of Factors Contributing To Speech Delays In Children Born During The Covid-19 Pandemic, Alva Jessica Daniels

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic significantly disrupted children’s developmental environments by limiting access to childcare, healthcare, and opportunities for social interaction, raising concerns about speech and language outcomes in children born during this period. Grounded in Bronfenbrenner’s ecological systems theory, this qualitative study was an exploration of factors associated with speech and language delays and examined parents’ perceptions and experiences in Philadelphia. The qualitative study included a sample of nine parents who cared for children during the COVID-19 pandemic quarantine period. Analysis of the interview data revealed five emergent themes: (a) limited social interaction during the pandemic, (b) delayed identification and diagnosis …

Probation Officers’ Experiences Supervising Domestic And Intimate Partner Violent Probationers, Megan Davis

Walden Dissertations and Doctoral Studies

This study includes insights regarding potential supervision challenges that are faced by probation officers overseeing domestic and intimate partner violence (IPV) probationers, emphasizing the importance of effective management to enhance offender accountability and victim safety. The relationship dynamic between probation officers and domestic and IPV probationers influences recidivism rates, highlighting the importance of effective and empathetic supervision. The purpose of this study was to identify gaps in training, supervision strategies, and resources, with a focus on integrating attachment-based practices to improve outcomes. Guided by the attachment theory, the research included key questions about supervision effectiveness and relational dynamics. Employing a …

Effective Strategies Small Business Owners Use To Sustain Their Businesses During Periods Of Disruption, Tracey Starr Moon

Walden Dissertations and Doctoral Studies

Small businesses experience significant challenges sustaining operations during periods of disruption, including economic uncertainty, natural disasters, supply chain interruptions, and other environmental changes. This is a concern for small business owners because disruptions can reduce revenue and strain limited financial and operational resources, putting their continued survival at risk. Grounded in the resilience theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies small business owners use to sustain their businesses during times of disruption. The participants were six small business owners in the southern United States. Data were collected through semistructured interviews and …

Strategies To Improve Communication Among Culturally Diverse International Manufacturing Teams, Bessem Enow Nchenge

Walden Dissertations and Doctoral Studies

Inefficient communication and insufficient collaboration in multicultural organizations can result in suboptimal team performance and stifle employee creativity. Manufacturing firm leaders who struggle with communication issues are concerned about deterioration in team cohesion, worker productivity, and information flow. Grounded in the theory of planned behavior, this qualitative, pragmatic inquiry research project explored strategies that leaders of international manufacturing firms use to bridge cultural differences and improve communication among international team members to enhance team performance. The participants were six leaders from manufacturing firms in the southwestern United States with international manufacturing agreements who demonstrated measurable success in improving communication among …

Immigration Status And Lung Cancer Diagnosis In U.S. First-Generation Immigrants, Valeriya Lockwood

Walden Dissertations and Doctoral Studies

The healthy immigrant effect (HIE) is an observed phenomenon in which immigrants exhibit better health outcomes than native-born residents, though relatively few studies have examined its role in chronic diseases in the United States. The purpose of this quantitative cross-sectional study was to assess the associations between immigration status, age, sex, race/ethnicity, median household income, and geographic location and lung cancer diagnosis in first-generation immigrant adults aged 18 or older. The subsequent health trajectory model provided the theoretical framework for the study. Data were obtained from the SEER*Stat Database 1975-2022 (N = 1,993). Binomial regression analysis showed that immigrants were …

Using Environmental Dna (Edna) As A Tool To Detect Sharks And Rays Along The Coast Of Quintana Roo, Mexico, Sara T. Norment

All HCAS Student Capstones, Theses, and Dissertations

Elasmobranchs play a critical ecological role in marine environments, yet many populations worldwide remain poorly known and monitored. This is particularly true in Mexico despite its high biodiversity and ongoing fishing pressures. Traditional monitoring methods, such as commercial fisheries and fishery-independent surveys using longlines or nets, are often limited, leaving important knowledge gaps. Previous studies have shown that environmental DNA (eDNA), small traces of DNA left behind in the water column from feces, skin, or mucus, is a transformative, non-invasive tool for detecting elasmobranch presence and diversity across marine ecosystems.

This project used eDNA metabarcoding to detect and identify elasmobranch …

Terahertz Electromagnetic Effects And Chirality-Induced Spin Selectivity In Dna, F. Matthew Mihelic Md

Faculty Publications

The effects of terahertz electromagnetic stimulation of the DNA molecule can be understood through modeling of the quantum logical mechanics of the DNA molecule.  Coherent conduction of electron spin states along the aromatic nucleotide base pairs and chirality-induced spin selectivity are two characteristics of the DNA molecule that are involved in the precise separation of the double-stranded DNA molecule at a specific location.  Such modeling can inform predictions of DNA strand separation and has significant implications for understanding DNA transcription bubble formation.

Chitinase Variants Establish Environmental Inflammatory Lung Conditioning, Yilin Wang

Arts & Sciences Graduate Student Theses and Dissertations

Environmental particulate exposure contributes to the severity and persistence of numerous acute and chronic lung diseases, including asthma, viral pneumonia, acute respiratory distress syndrome, and pulmonary fibrosis. Chitin, a highly abundant environmental polysaccharide present in fungi, insects, and mites, is continuously encountered at mucosal barrier surfaces and functions as an immunostimulatory particulate substrate within the respiratory tract. Acidic mammalian chitinase (AMCase; CHIA) is an evolutionarily conserved mammalian enzyme that degrades chitin-containing particles and regulates inflammatory responses at barrier tissues. Common human CHIA polymorphisms reduce AMCase enzymatic activity and are associated with asthma susceptibility; however, the physiologic consequences of these variants …

Process From Noise: Erosion Threshold Variability And The Morphology Of Gravel-Bed Rivers, Robert Paul Kostynick

Arts & Sciences Graduate Student Theses and Dissertations

Rivers are remarkably consistent as their geometry, width, depth, and slope change systematically downstream in response to differences in fluid discharge and sediment transport throughout a channel. Rivers move both water and sediment through terrains that depend on these downstream geometric adjustments influencing water quality, ecology, infrastructure, channel morphology, and landscape evolution at increasing timescales respectively. Rivers thus influence all aspects of life and define our spatial landscapes that shape boundaries, whether physical, politically, or socially. Nevertheless, a river is dynamic and does not adhere to human-defined boundaries, making it vital that we understand how these features change over time …

Hematopoietic Stem And Progenitor Cell Reprogramming During Breast Cancer Progression Promotes Myeloid-Biased Hematopoiesis, Emily Maria Eul

Arts & Sciences Graduate Student Theses and Dissertations

Breast cancer progression is associated with systemic immune dysregulation characterized by the expansion of immunosuppressive myeloid populations that promote tumor progression, metastasis, and resistance to therapy. However, the mechanisms that sustain pathological myeloid expansion remain incompletely understood. In particular, it remains unknown whether solid tumors functionally reprogram hematopoietic stem and progenitor cells (HSPCs) to drive enhanced myeloid output and if bone-derived signals can regulate tumor-associated hematopoietic remodeling. In murine models of primary and metastatic breast cancer, tumor progression induced the remodeling of the hematopoietic compartment, characterized by the expansion of HSPCs, enhanced myeloid differentiation, and systemic accumulation of myeloid populations. …

``But What About Me?'': A Structural Redesign For Cascading Trust Into An Integrated Culture Of Care, Hazelin Hei Laam Ngan

Patient Experience Journal

In healthcare, patient experience (PX) and employee experience (EX) are often managed as separate priorities despite their interdependence. This article presents a case study from NYC Health + Hospitals/Community Care, a 250-person safety-net division providing home-based services across New York City. In response to frontline staff repeatedly asking, ``But what about me?'' when offered PX best practice suggestions, the organization integrated patient experience, staff engagement, and wellness into a unified Care Experience portfolio led by the Chief Experience Officer. From this structural redesign emerged a practical framework for trust-building organized around three pillars: Purpose, Presence, and Partnership. Purpose aligns staff …

Plan Of Day | Plan Of Stay: How Inter-Disciplinary Communication Improved Patient Experience And Hospital Throughput, Theresa Jean Dionne, Felicia Hurst, Danna Qunibi, Lauren Lazar, Sydney Mccurdy, Ashlyn Coenraad, Brittney Ward, Whitney Black, Ashley Nelson, Judd Salem, Luisa Restrepo

Patient Experience Journal

Background: Effective communication among healthcare team members is critical for delivering high-quality, patient- and family-centered care while optimizing hospital operations. This case study examines the implementation of a structured ``Plan of Day | Plan of Stay'' model, leveraging bedside whiteboards to enhance inter-disciplinary communication in a pediatric hospital setting. By providing a clear, visual summary of daily care plans, care team members, and discharge goals, whiteboards foster transparency, empower patients and families, and facilitate coordinated clinical decision-making. Purpose: This quality improvement initiative evaluated the implementation of a standardized Plan of Day | Plan of Stay communication model on a pediatric …

Patient Psychological Safety: A Qualitative Study Of Patient Experiences, Derick R. Simmons, Cheryl Rathert, Ryan Valayil, Maria Joseph, Ibraheem Jawadi

Patient Experience Journal

There is growing interest in understanding patients' experiences with psychological safety during healthcare encounters. Recent studies reveal that patients describe needing patient psychological safety (PPS) to form connections with their care providers, which are associated with better health outcomes. Therefore, it is critical to examine indicators of PPS. Using a phenomenological interpretive approach, this study utilized a patient narrative survey methodology to qualitatively explore how and why patients experience a lack of PPS during their healthcare encounters. We surveyed patients from across the U.S. and analyzed responses among a sub-sample of respondents to an open-ended question whose responses indicated they …