1697 research outputs found
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Unseen Triggers: Exploiting Wireless Channels to Activate Dormant Malware in Air-gapped Critical Infrastructure
No full textCritical infrastructure systems, including power grids, maritime navigation, and industrial networks, face growing threats from cyber attacks that do not rely on conventional Internet-based connectivity. While air-gapping and IT/OT segmentation are widely adopted as security measures, adversaries have developed alternative methods for remote malware activation, exploiting vulnerabilities in wireless communication and system firmware. This paper investigates non-internet-based remote activation techniques that leverage wireless technologies such as GPS, AIS, pager, and others to execute pre-installed malware within air-gapped environments. Through an in-depth analysis of these methods, we highlight how attackers manipulate signals to activate dormant threats in critical systems. We present two case studies demonstrating real-world attack scenarios: one targeting maritime vessels via AIS signal spoofing and another exploiting GPS-based time synchronization vulnerabilities in power grid infrastructure. Finally, we propose mitigation strategies, including secure firmware development, signal authentication, and anomaly detection, to enhance the resilience of critical infrastructure against emerging remote activation threats. Our findings emphasize the urgent need for a holistic cybersecurity approach that accounts for evolving attack vectors beyond traditional internet-based threats
An Examination of the Effectiveness of the United States Coast Guard Training Programs Effective in Preparing Leaders for e-Leadership During COVID-19
No full textThe study examines the effectiveness of United States Coast Guard leadership training in mid-level leaders for e-leadership during crises, using the COVID-19 pandemic as a catalyst. The pandemic-induced shift to remote work highlighted potential gaps in how USCG training equips leaders to navigate e-leadership challenges, particularly in supporting essential constructs like communication, emotional intelligence, trust, and decision-making in digitally mediated environments. This qualitative exploratory research aimed to understand the influence of USCG training on leaders’ abilities to address these challenges. Data were collected through semi-structured interviews with 28 USCG mid-level leaders and analyzed using thematic analysis. Key findings reveal that formal USCG training had a limited direct impact on e-leadership preparedness. Leaders predominantly relied on on-the-job training, mentorship, and personal initiative, with human-centric leadership emerging as critical. Deficiencies in specific e-leadership modules, digital literacy, and infrastructure were also identified. The study offers theoretical insights for e-leadership in military contexts. It provides practical recommendations for the USCG, including curriculum reform and infrastructure improvements, to enhance leadership development for future high-stakes scenarios
Nursing School Progression Of Students Who Speak English As An Additional Language: Faculty Actions and Interventions
Full text linkIt is estimated that approximately 20-25% of nursing students in the United States speak English as an additional language. The failure rate, specifically for nursing students who speak English as an additional language, is approximately 1.5 to 2 times higher than native English-speaking students.
Nurse educators must be aware of the unique challenges faced by students who speak English as an additional language. In addition to fostering success in nursing school, strategic interventions will ensure the students success in their nursing careers
Protect Your Loved Ones (PYLO): A Framework for Etiquette Based Advocacy Communication
Full text linkA problem exists in healthcare communication; a recent study found that one in 10 patients is harmed in healthcare, and patient safety incidents are the cause of over three million deaths annually worldwide. Senior citizens are negatively affected by miscommunication in healthcare settings due to cognitive deficits, limited patient health literacy, hearing loss, and technology challenges. Nearly 80 percent of deaths were due to ineffective communication between the clinician and caregiver.
The growing need for advocacy for senior citizens and better communication between healthcare practitioners, patients, and advocates is a life-and-death situation. Etiquette-based advocacy communication using the framework of social intelligence theory will create a pathway between the advocate for a senior citizen and healthcare providers
Portrait, undated
No full textThis photo is a portrait of Franklin University staff member.https://fuse.franklin.edu/ymca/1021/thumbnail.jp
Future-Proofing Leadership: Leveraging Blended Learning, AI, and Generational Strategies for Workforce Development
Full text linkEnhancing Diabetes Care in Adult Patients with Type 2 Diabetes in an Outpatient Setting
Full text linkType 2 diabetes mellitus (T2DM) is a prevalent chronic condition associated with significant morbidity, particularly among underserved populations. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to improve diabetes care among adult patients with poorly controlled T2DM (A1C \u3e 9%) in an outpatient primary care clinic by increasing referrals to the Diabetes Self-Management Education (DSME) program. Guided by the Plan-Do-Study-Act (PDSA) cycle and the OhioHealth Change Management (OHCM) model, the project implemented structured interventions including standardized DSME referral workflows, electronic health record (EHR) prompts, provider education, and culturally tailored communication strategies.
The 12-week initiative targeted 68 eligible patients. By project end, 53% showed A1C reduction and 22% achieved A1C levels below 9%, resulting in a 10% absolute reduction in poorly controlled diabetes. DSME referral rates increased from 9% to 38% (a 322% relative improvement), and 61% of referred patients attended at least one DSME session. Staff confidence in the referral process rose from 54% to 81%, and workflow efficiency improved due to EHR automation. Although financial outcomes were inferred through literature, the intervention demonstrated alignment with value-based care goals and HEDIS performance measures. This project highlights the critical role of nurse-led QI initiatives in closing care gaps, supporting chronic disease management, and advancing health equity through evidence-based practice
Understanding Barriers to Addressing Social Determinants of Health in Diabetes: Perspectives of Managed Care Administrators
No full textManaged care organizations (MCOs) play a vital role in controlling healthcare costs and improving care quality, yet expenditures in the United States continue to rise. At the same time, chronic conditions like diabetes remain a growing concern, now affecting 11.6% of the U.S. population. Social determinants of health (SDoH), which account for a sizable portion of health outcomes, further complicate efforts to improve care, particularly in marginalized populations. This qualitative study explored how MCO administrators view and respond to the barriers SDoH present in diabetes management. Guided by the Healthy People 2030 SDoH Framework, semi-structured interviews were conducted with seventeen administrators working in MCO across the U.S. The interviews were transcribed and analyzed using NVivo® 14, with reflexive thematic analysis used to identify key themes. Eight major themes emerged, reflecting systemic challenges, gaps in measurement, trust and literacy issues, and limitations in benefit design. At the same time, participants emphasized the importance of cross-sector collaboration, culturally responsive strategies, and policy advocacy. These findings offer insight into the practical realities MCO administrators face and suggest ways that policy and system-level changes could support more effective and equitable diabetes care
Integrated Care and Perceived Quality of Life Outcome Measures
No full textThe rapidly aging population in the United States, combined with increased healthcare costs, has led to an increased use of integrated models of care. Despite the patient lying at the theoretical center of integrated care, existing research has focused on clinical outcomes and cost efficacy rather than whether or not the model is meeting the participant\u27s unique needs. This quantitative, exploratory study intended to identify the relationship between perceived quality of life outcome measures and integrated care participation among a cluster of senior living communities in Michigan. This study was guided by Donabedian’s model, which described patient-centeredness as a core construct in pursuing innovative models of care (Berwick & Fox, 2016). Participants were split into integrated and non-integrated care subgroups, each with 88 participants. The study found a significant relationship between perceived quality of life outcome measures and integrated care participation (p\u3c 0.001). However, the Mann-Whitney U test found no significant relationship between the two groups with a p-value of 0.058. Additionally, findings indicated that socioeconomic status does have a significant moderating effect on the relationship between integrated care participation and perceived quality of life, with a p-value of \u3c 0.001. These findings will encourage future integrated care researchers to focus on patient centered outcome measures to improve comprehension, allowing patients to participate in the informed consent process when enrolling in an integrated model of care
Impact of Electronic Prescription, Access, and Messaging on Health Information Exchange Utilization During Care Transition
No full textThis study examined the impact of electronic prescription generation and transmission, patient access, and secure electronic messaging on health information exchange (HIE) utilization during healthcare transitions. Leveraging longitudinal data from the 2018 CMS EHR Incentive Program, this research tested hypotheses concerning the influence of these variables on HIE utilization using a quantitative method. Findings from logistic regression analyses indicated that electronic prescription practices (B = 2.265, OR = 9.628, p \u3c .001) and patient electronic access capabilities (B = 1.108, OR = 3.027, p \u3c .001) significantly increased HIE usage, aligning with previous studies that underscored the importance of digital prescription systems and patient empowerment in HIE enhancement. Additionally, secure electronic messaging showed a significant association with HIE utilization (¿²(1) = 126.982, p \u3c .001), further reinforcing the role of secure communication in effective healthcare information exchange. A combined predictive model revealed that electronic prescriptions and patient electronic access drastically improved the likelihood of HIE adoption (B = 4.546, OR = 94.284, p \u3c .001), highlighting a synergistic effect. These findings underscored the need for integrated technological frameworks within healthcare systems to optimize communication and care coordination, ultimately improving patient outcomes. The study advocated continued investment in digital health tools to strengthen HIE systems and enhance healthcare delivery