Digital Commons Network^™

Creating Consistency: Standardizing Gestational Diabetes Group Visit Framework In High-Risk Obstetric Care, Danielle Pack

Master's Projects and Capstones

Objective: Gestational diabetes mellitus (GDM) requires timely and consistent education to promote effective self-management and improve maternal and fetal outcomes. Baseline observations at a Santa Clara County high-risk obstetric clinic identified variation in educational materials, educator delivery, referral processes, and workflows between English- and Spanish-language GDM group visits. A review of the literature supported standardized diabetes education and group prenatal care as strategies to improve consistency, efficiency, and patient access. Aim: This quality improvement project aimed to develop and implement a standardized GDM group visit framework for nurse practitioners, registered dietitians, and scheduling staff, with the goal of increasing compliance …

You Haven’T Been Forgotten: Driving Improvements In Trust, Transparency, And Accountability Through A Patient-Centered Communication Initiative In The Emergency Department, Ellie Mead

Master's Projects and Capstones

Objective: In Spring 2026, the Emergency Department (ED) at Hospital X identified difficulties securing high levels of patient satisfaction. Over one third of patients did not feel adequately “informed about delays,” and observation of nurse-patient interactions in front-end care areas confirmed these communication gaps: in 87% of interactions, nurses did not explain next steps to the patient, and in none of the 51 interactions observed did nurses proactively inform patients about possible delays. Aim: This quality improvement initiative sought to improve the patient experience in the ED and drive a 10% increase in Press Ganey patient satisfaction survey results relating …

Trace Elements In Complete Feeds Used In Intensive Rearing Of Cattle, Poultry, And Pigs: Occurrence And Predicted Transferred Concentrations In Animal-Derived Food, Elizabeta Dimitrieska Stojkovikj, Vangelica Enimiteva, Aleksandra Angjeleska, Risto Uzunov

Turkish Journal of Veterinary & Animal Sciences

This study investigated the concentrations of essential (Zn, Cu, Mn, Co, and Mo) and toxic (Pb, Cd, As, and Hg) trace elements in complete feeds used for the intensive rearing of cattle, poultry, and pigs in North Macedonia and predicted their transfer into animal-derived foods. A total of 107 feed samples were collected from 40 farms between May 2023 and April 2024 and analyzed using inductively coupled plasma mass spectrometry. The results revealed that while most essential elements were within the regulatory limits, Co exceeded the maximum level in two cattle feed samples. Zn, Cu, and Mn levels were generally …

Molecular Characterization Of Pasteurella Multocida Capsular Type A Strains Isolated From Different Regions Of Anatolia, Türkiye​, Adam Bashir Tawor, Osman Ergani̇ş, Asli Balevi̇, Suliman Mohamed Yousof Sadam

Turkish Journal of Veterinary & Animal Sciences

Pasteurella multocida serotype A is an important pathogen that causes respiratory illness in both farm animals and poultry, leading to severe economic losses worldwide. This study aimed to isolate P. multocida capsular type A (capA) as well as investigate the virulence-associated genes (VAGs) within the isolates. Samples (n = 250) were collected in the Anatolia region from cattle (n = 130), sheep (n = 70), goats (n = 45), and pet birds (n = 5) with clinical respiratory signs. Polymerase chain reaction (PCR) assays were conducted using kmt1 and capA primers for P. multocida species identification and capsular serogroup A …

Effect Of Rangeland Quality On Rumen Development Of Angora (Mohair) Goat Kids And Bucks, Betül Zehra Sariçi̇çek

Turkish Journal of Veterinary & Animal Sciences

This study was conducted to determine the effect of rangeland quality on the rumen development of Angora goat kids and bucks. Twenty male singleton Angora goat kids with similar birth dates and birth weights were selected from each farm in an area with three different rangeland quality levels (good, medium, or poor) in Ankara Province. The kids were weaned at 60 days of age and then grazed completely on rangeland until slaughter. Rumen volumetric and papillary development of animals slaughtered at 4 and 7 months of age were determined. Empty rumen length, width, and weight were affected by rangeland quality …

Hard Palate Morphology In The Anatolian Water Buffalo (Bubalus Bubalis), Mehmet Can, Şükrü Hakan Atalgin, Mehmet Faruk Aydin, Soner Bekmezci̇

Turkish Journal of Veterinary & Animal Sciences

This study aimed to examine the morphological and histological features of the hard palate in the Anatolian water buffalo through light and scanning electron microscopy, complemented by gross and morphometric evaluations. Eight hard palates were used in the study. A total of eight Anatolian water buffalo heads from healthy adult female water buffaloes were collected immediately after slaughter from various slaughterhouses in Balıkesir, Türkiye. After analyzing and identifying the obtained hard palate samples, measurements were taken and documented through photography. The papilla incisiva, located in the middle of the caudal concave edge on the ventral surface of the pulvinus dentalis, …

Arterial Architecture Of The Goat Spleen (Capra Hircus) Revealed By Corrosion Casting And Scanning Electron Microscopy, Baran Erdem, Sevi̇nç Ateş, Meryem Karan

Turkish Journal of Veterinary & Animal Sciences

The spleen is an essential organ involved in hematopoietic and immune functions. A comprehensive understanding of its anatomy, including vascular topography and segmentation, is essential for the accurate diagnosis and treatment of splenic diseases, and the minimization of complications during surgical procedures. Detailed knowledge of the vascular architecture also supports the accurate prediction and management of hemorrhage severity in cases of splenic rupture. The spleen’s microvascular system has a unique and complex organization that is distinct from other organs, and its elucidation is critical for understanding splenic function. In the present study, the spleens of 20 hair goats were examined. …

Motherhood-Defining Memories And Narrative Identity Awareness In Relation To Psychological Wellbeing And Maternal Functioning Following A Parenting Program, Christin Camia, Antje Von Suchodoletz, Michelle P. Kelly

All Works

Introduction – Drawing on previous research showing that self- and relationship-defining memories relate to psychological and relational functioning, this study began to explore motherhood-defining memories and their relation to psychological wellbeing and maternal functioning within a parenting program context. The study aimed to examine whether participation contributes to the narrative coherence of motherhood-defining memories. Methods – Participants were 155 mothers from diverse cultural backgrounds (M age = 32.85 years, SD age = 5.20) residing in the United Arab Emirates (UAE). Seventy-five mothers participated in an eight-session parenting program, and 80 mothers served as controls in a comparison group. Motherhood-defining memories …

Definitive Radiation Therapy For Schneiderian Inverted Papilloma Of The Soft Palate And Uvula., Rahul Sinha, Arianne J Abreu, Christopher E Fundakowski, Robert T Sataloff

Otolaryngology (ENT) Resident Research

Schneiderian inverted papilloma is a benign, locally aggressive tumor that typically arises in the respiratory mucosa of the nasal cavity and paranasal sinuses. These tumors are often asymptomatic but can cause unilateral nasal obstruction, discharge, hyposmia and epistaxis. They warrant attention particularly due to the potential for malignant transformation. They are treated most often with surgical excision. This case report describes a patient with Schneiderian inverted papilloma arising outside its usual location and managed with definitive radiation therapy instead of surgical excision due to concerns for functional impairment. Remission was obtained with radiation therapy, although the patient experienced treatment-related side …

Urine Good Care: Catheter-Associated Urinary Tract Infection Prevention At The Bedside, Ruby Yost

Master's Projects and Capstones

Catheter-Associated Urinary Tract Infections (CAUTIs) have been associated with increased morbidity, mortality, healthcare costs, and length of stay and is one of the most common healthcare-acquired illnesses accounting for up to 40% of hospital-acquired infections (Rubi et al., 2022). Because 65-70% of CAUTIs are preventable, reducing the incidence has become a focus area for infection control and nursing quality management among hospital organizations (Tang et al. 2025). CAUTIs are urinary tract infections that occur in patients with indwelling urinary catheters and are typically associated with bacterial colonization of the urinary tract. The aim of this QI Project is to increase …

Reducing Variation, Improving Outcomes: Standardizing Gestational Diabetes Mellitus Education In A Clinical Microsystem, Thanh Le

Master's Projects and Capstones

Objective: Variations in referral, scheduling, delivery of educational information, patient materials, and documentation hampered the quality of gestational diabetes mellitus (GDM) education in the outpatient maternal-fetal medicine clinic. Purpose: The aim of the quality improvement project was to boost adherence to a standardized GDM group education framework from 0 to 50% in the course of 12 weeks and assess attendance at group visits. Methods: The microsystem analysis was conducted based on observations of group visits conducted in Spanish and English, examination of current processes and resources in use, educator pre-survey, SWOT analysis, and cause and effect analysis. The implementation of …

Standardizing Group Visits For Gestational Diabetes Education: A Quality Improvement Initiative In An Outpatient Maternal-Fetal Medicine Clinic, Nha Nguyen

Master's Projects and Capstones

Objective: At an outpatient maternal-fetal medicine clinic in Northern California, gestational diabetes mellitus (GDM) education is delivered inconsistently across nurse practitioners (NPs) and registered dietitians (RDs), with no standardized curriculum, referral criteria, or educational materials. Aim: By August 12, 2026, this project aimed to develop and implement a standardized GDM group visit framework for NPs, RDs, and scheduling staff in maternal-fetal medicine clinic, increasing compliance with standardized referral, enrollment, and educational processes from a baseline of 0% to 50%. Methods: Using baseline observations, workflow assessment, stakeholder input, and a literature review, the QI team developed standardized bilingual slide …

Digital Markers For Passive Remote Monitoring Of Bipolar Disorder: Systematic Review, Thomas P Kutcher, Isha Chakraborty, Kristin Kostick-Quenet, Akane Sano, Nidal Moukaddam, Jeffrey A Herron, Wayne K Goodman, Sameer A Sheth, Ashutosh Sabharwal, Nicole R Provenza

Duncan NRI Faculty and Staff Publications

Background: Bipolar disorder (BD) features episodic shifts among mania, hypomania, depression, mixed states, and euthymia. Timely detection of mood transitions is difficult due to infrequent clinical touchpoints. Digital health technologies, including wearables and smartphones, offer a unique opportunity to passively and continuously monitor behavior and physiology that could reflect underlying mood dynamics in real-world settings.

Objective: This study aimed to systematically review passively collected digital markers for BD mood states, characterize devices/modalities and analytic approaches, appraise risk of bias, and identify design gaps and priorities for clinical translation.

Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) …

Full Issue, Volume 14, Number 1., Donna J. Peterson Dr., Scott Cummings, Elizabeth Gregory North

Journal of Human Sciences and Extension

No abstract provided.

Impact Of Acute Flight Training Stress On Cardiovascular Health: A Pilot Study, Toni Butler

Discovery Day - Daytona Beach

Impact of acute flight training stress on cardiovascular health: A pilot study  Toni C. Butler, Carolina R. P. Ferreira, Bryan W. Hinton, Noah J. Robbins, Sophia R. Vaden, Andrew H. Schneider, Scott K. Ferguson, Ph.D.   Cardiovascular conditions are among the most common medical issues in certificated pilots and a major source of certification scrutiny. Student pilots experience unique acute stressors during flight training that may influence both physiological and psychological health. Acute stress is known to affect cardiovascular function, including vascular endothelial health; however, the impact of flight training–related stress on cardiovascular function remains poorly characterized. This pilot study tested …

The Effects Of Hypoxia On Balance Systems, Samuel Drescher Drescher, Heather Bond, Allysa Hayden, Victoria Cornaro, Brandon Ibarra, Noah Clark, Frank Cunningham Iv, Carolina Ferreira, Sierra Martinez, Katie Stubits

Discovery Day - Daytona Beach

Hypoxia, a condition characterized by insufficient oxygen availability to body tissues, is known to impair physiological and cognitive function, particularly at high altitudes above 15,000 ft. However, the effects of mild hypoxia (10,000–15,000 ft) remain less well understood. This study, conducted by the department of Human Factors and Behavioral Neurobiology at Embry-Riddle Aeronautical University, investigates the impact of mild hypoxia at 12,000 ft on human balance systems. Specifically, it examines the three primary components of balance: visual, proprioceptive, and vestibular systems. Participants complete nine balance tasks under both normoxic and hypoxic conditions. Tasks are structured to progressively limit sensory input: …

The Effects Of Acute Dietary Nitrate Supplementation On The Inspiratory Muscle Metaboreflex In Young Healthy Adults, Sabrina Ehrenfort, Riley Dienna, Ben Kerns, Hannah Lyons, Rachel Phillips

Discovery Day - Daytona Beach

Increased work of breathing (Wb) triggers the inspiratory muscle metaboreflex, which elevates systemic blood pressure in response to diaphragmatic fatigue. To counteract this, dietary nitrate could act as a source of nitric oxide, which is known to improve muscle power and efficiency (Jones et al., 2018). This study examines the hypothesis that acute nitrate supplementation would attenuate this response. Utilizing the KH2 device from PowerBreathe, 20 healthy participants (mean age: 21.1 ± 2.5 years; range: 18–30 years) underwent a resistive breathing task (RBT) for a total of three minutes at 60% of their maximal inspiratory pressure (MIP). All 20 participants …

Impact Of Stress & Fatigue On Cardiovascular Function In Young Pilots: A Thematic Review, Swarna Manoj

Discovery Day - Daytona Beach

Impact of Stress & Fatigue on Cardiovascular Function in Young Pilots: A Thematic Review   Authors: Swarna Manoj, Scott Ferguson   Keywords: pilot, stress, fatigue, heart rate variability (HRV), cardiovascular disease (CVD) Aviation is expanding globally and young pilots are the major workforce, yet FAA protocols require mandatory ECG only from age 35, with annual cardiac screening after age 40. Over the past five years, a pattern of sudden cardiac arrests in pilots particularly aged 30-40 has urged safety concerns. Despite the existing literature examining fatigue, burnout, stress, sleep hygiene and circadian disruption, only few studies systematically examine how these factors impact …

Analyzing Fungal Growth Dynamics Under Different Environmental Conditions Using A Lotka–Volterra Competition System, Maria Ordonez, Fabrio Araujo

Discovery Day - Daytona Beach

Fungi play a critical role in ecosystems as decomposers that recycle nutrients and maintain environmental balance. Their populations are influenced by multiple environmental factors such as temperature, humidity, nutrient availability, and interactions with other organisms. In this project, the Lotka–Volterra model is used to analyze how competing fungal species interact and how these interactions influence population dynamics over time. By modeling two fungal populations competing for the same limited resources, the equations illustrate how environmental conditions and competition coefficients determine whether one species dominates; both species coexist, or one species becomes extinct. The model provides insight into how changes in …

Ai-Based Pilot Fatigue Monitoring For Enhanced Aviation Safety, Joshua Henderson, Alexander Landau, Braxton Moor, Jacky Yang, Caleb Difabio

Discovery Day - Daytona Beach

Pilot fatigue remains a persistent systemic operational hazard in commercial aviation because it can degrade attention, reaction time, decision-making, and crew coordination during safety-critical phases of flight. Although regulatory duty-time limits and Fatigue Risk Management Systems provide baseline protections, these controls rely heavily on voluntary reporting and post-event analysis, which may fail to detect fatigue in real time. The purpose of this project was to design and evaluate an artificial intelligence-enabled fatigue monitoring concept intended to reduce undetected pilot fatigue risk within the airline Safety Management System framework. The study applied a structured research approach including a literature review to …

Assessing The Impact Of Various Factors On Hypoxic Response, Reese Kim, Allysa Hayden

Discovery Day - Daytona Beach

Hypoxia is a condition in which the body’s tissues are deprived of oxygen and has deleterious effects on cognition, perception, and performance. Hypoxia has a myriad of symptoms such as euphoria, difficulty concentrating, headache, fatigue, nausea, dizziness, tunnel vision, and more. Outward signs of hypoxia include cyanosis (blueing of the fingertips and lips), tremors, loss of coordination, pallor, and complexion change, and can be used to notice the onset of hypoxia in others. Many factors are known to contribute to the manifestation of hypoxia, namely altitude, exposure duration, and certain physiological conditions such as heart problems and low blood flow …

Radiographic Evaluation Of Kidney Size In Cats: Effects Of Sex And Gonadal Status, Somchin Sutthigran, Auraiwan Klaengkaew, Chutimon Thanaboonnipat, Suppawiwat Ponglowhapan, Nan Choisunirachon

The Thai Journal of Veterinary Medicine

Radiographic evaluation of kidney size using the kidney-to-second lumbar vertebral body length (K/L2) ratio is a standard method for assessing kidney size in cats. However, current reference values underdetermine biological factors such as sex and gonadal status, which may influence kidney and lumbar length. Reproductive hormones are known to influence kidney and vertebral development, but their specific effects on radiographic kidney and vertebral measurements in cats are unclear. This retrospective study aimed to assess the effects of gonadal status on kidney length, L2 vertebral length, and the K/L2 ratio in clinically healthy cats. A total of 285 cats were included …

From Crisis To Reform: How The 1918 Influenza And Covid-19 Pandemics Redefined The Relationship Between Nurses And The American Healthcare System., Anh N V Le

Undergraduate Research and Scholarship Symposium

The 1918 Influenza and COVID- 19 pandemic have become two major public health crises that reshaped the role of nurses in the America healthcare system. Although a hundred years apart, both pandemics revealed how deeply the country depends on nurses during emergencies without proper and efficient strategies. This paper argues that these pandemics acted as turning points that redefined the social contract between nurses and the U.S. healthcare system. By examining historical context, nurses’ responsibilities, public perception, and long-term effects, this research show how pandemics expanded nurses’ authority while also exposing long-term weakness of the systems. In 1918, nurses were …

The Chameleon Experience: Queer Identity, Mental Health, And Transformation, Cameron Penny

Communication and Theater Association of Minnesota Journal

In this autoethnographic piece, I examine the correlation between queer identity and mental health through reflective analysis of my own experiences within a Western socio-cultural setting. I expand external perspectives on the queer experience by highlighting the normalization of queer prejudice and its adverse impact on self-image. I share how the religious praxis of Catholicism enforces binary conformity by promoting dichotomous thinking that simultaneously constricts queer expression and subjugates implicit biases. In tandem, I utilize autoethnography as my medium because it provides a unique outlet to raise awareness for chronically stigmatized identities by centering marginalized voices (Atay, 2011; Chavez, 2013). …

Standardizing Gestational Diabetes Mellitus Education To Improve Patient Knowledge And Care Consistency In A Prenatal Clinic Setting, Wynn Zara

Master's Projects and Capstones

The gestational diabetes mellitus (GDM) group visit framework aims to improve consistency of GDM education by standardizing referral processes, educational materials, staff workflows, and patient communication. Although evidence-based GDM education supports patient self-management and improved maternal-fetal outcomes, variability in education delivery contributed to inconsistent care within the outpatient maternal-fetal medicine setting. This quality improvement project was conducted in an outpatient maternal-fetal medicine clinic in Santa Clara County serving pregnant patients diagnosed with GDM. To address this gap, a standardized GDM group visit framework was developed and implemented using structured educational resources, referral criteria, and communication workflows. The intervention was evaluated …

Dibh Liver Sbrt: Comparative Analysis Of Vmat 6fff And 10fff For Safety And Efficiency, Justen Hudson

Masters Projects

Purpose:

To evaluate the dosimetric performance and delivery efficiency of 6MV flattening filter free (6FFF) and 10MV flattening filter free (10FFF) VMAT beam energies for deep inspiration breath- hold (DIBH) liver stereotactic body radiation therapy (SBRT), with emphasis on treatment time, breath-hold demands, and organ at risk (OAR) sparing.

Methods:

Ten previously treated DIBH liver SBRT patients were retrospectively replanned using standardized VMAT geometry, identical optimization objectives, and consistent contouring. Each patient received paired 6FFF and 10FFF plans generated in Eclipse using AcurosXB. Dosimetric endpoints included target coverage, conformity index (CI), gradient index (GI), and OAR dose metrics based on …

Staff Education To Integrate The Cdc Prediabetes Risk Test Into Primary Care Intake, Helen Ndangam

Walden Dissertations and Doctoral Studies

This staff education project involves addressing the gap in using a standardized prediabetes screening protocol at an outpatient primary care clinic in Maryland, which leads to missed early interventions. Standardizing this process is vital for nursing practice to promote preventive care and optimize workflows. The practice-focused question was for medical support assistants (MSAs) at an outpatient primary care clinic: How does implementing a competency-based education program on the Centers for Disease Control and Prevention (CDC) Prediabetes Risk Test (Centers for Disease Control and Prevention [CDC], n.d.) affect staff knowledge, workflow confidence, and screening compliance over a 7-week period? The purpose …

Staff Education To Reduce Burnout Among Psychiatric Nurses Caring For Patients With Schizophrenia, Gloria Laizer

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project addressed occupational burnout among psychiatric registered nurses caring for patients with schizophrenia. Workplace violence, compassion fatigue, emotional exhaustion, and staffing shortages place psychiatric nurses at high risk for burnout, threatening nurse well-being, workforce retention, and patient safety. The practice site lacked a standardized resilience education program. The practice-focused question was, In psychiatric nurses caring for patients with schizophrenia, does implementation of an evidence-based resilience education program, compared with current practice, reduce occupational burnout? The purpose was to implement and evaluate such a program, informed by the Johns Hopkins evidence-based practice (JHEBP) Model …

Improving Nurses’ Knowledge Of Barcode Medication Administration Using Structured Education In Group Homes, Bernadette Beleho Woueko

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) educational project evaluated the effectiveness of a structured Barcode Medication Administration (BCMA) education program in enhancing nurses’ knowledge of BCMA and promoting medication safety. Because local BCMA compliance rates were 15 percentage points below the organizational benchmark, an educational intervention was implemented using the Johns Hopkins Evidence-Based Practice Model and the Plan-Do-Study-Act framework. Fifteen staff members, including Registered Nurses, Leaders, and Managers, participated in two educational sessions focused on BCMA use, medication safety, case studies, and role-play activities. Findings demonstrated a significant increase in BCMA knowledge, with scores improving from 68.4% to 86.7% (p < .001). These results support the continuation of BCMA education, competency validation, and training programs to reduce medication errors and enhance patient safety. Keywords: Barcode Medication Administration, BCMA, medication administration errors, nursing education, patient safety, evidence-based practice, educational project.

Staff Education To Improve Hypertension Management Knowledge, Angelor Eliscard

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project, I addressed inconsistent staff knowledge of evidence-based strategies for preventing and controlling hypertension among African American women in an outpatient primary care setting. The practice-focused question was: In an outpatient clinical setting, what was the impact of an evidence-based staff education program on healthcare providers' knowledge of hypertension prevention and control strategies for African American women, as measured by pretest and posttest scores? The purpose of this project was to implement and evaluate a structured staff education program to improve providers' knowledge of evidence-based strategies for preventing and controlling hypertension …