Digital Commons Network^™

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Women Representation In Higher Education Leadership In Egypt: A Qualitative Study, Eman Fouda

Theses and Dissertations

The purpose of this research is to investigate women representation in higher education leadership in Egypt. Currently, the representation of women in leadership roles in higher education is not proportionate to the percentage of women in Egypt, or even to the percentage of women employed in education. The importance of this topic arises from the implications of gender inequality. This research explores the perceptions of women in higher education regarding the social and cultural barriers that hinder their advancement to leadership positions. The discussion is in light of the social dominance theory and the cultural and social issues that stand …

Sex Differences In Allergic Asthma Responses Of Mice Prenatally Exposed To Wood Smoke, Adelynne Walley

Undergraduate Theses, Professional Papers, and Capstone Artifacts

No abstract provided.

Women's Work And Wealth: Measuring The Impact Of Incremental Liberations, 1850-1870, Hannah Kelly

Williams Honors College, Honors Research Projects

Using a two-way fixed effects difference-in-difference model, this project analyzes data from the IPUMS Full Count census for 1850, 1860, and 1870 at a state level for 48 states. Four models assess the impact of property laws on women's real property holdings, labor force participation, household types, and real property values.

By quantifying the impact of various legal reforms on women's economic empowerment, this project fills a gap in the understanding of the intersection between law, society, and women's economic agency during a transformative period in pre-industrial American history. These impacts can implicate the effectiveness of legislative measures in advancing …

Learning To Be Trauma-Informed: An Examination Of Individual-Level Factors Predicting Perceptions Of And Response To Trauma-Informed Practice Trainings, Kelly Daniel

Electronic Theses and Dissertations

Trauma is a substantial threat to public health. As such, significant effort has been exerted into developing interventions which mitigate the consequences of trauma. Trauma-informed practice (TIP) aims to alleviate the effects of trauma by building policies and practices focused on safety, trust, transparency, support, collaboration, and empowerment. This study investigated how individual-level factors, including readiness for organizational change, perceived benefit of TIP training, and personal trauma history affect one’s ability to apply a TIP lens in a sample (n =100) of members of a graduate-level college. Further, it explored if one’s perceptions of and response to trauma-informed practice training …

How Art Therapy And Emdr Help Asylum Seekers And Refugees Move Towards Healing Trauma: A Literature Review, Anna Mogilevsky

Expressive Therapies Capstone Theses

In the past ten years, there has been a significant rise in the number of asylum seekers and refugee populations worldwide (UNHCR, 2022). Displaced individuals are extremely vulnerable to mental illness because of the compounded trauma experienced in their countries of origin with the stress of immigration, asylum seeking, culture shock, and language barriers. PTSD is affecting 500 million individuals globally, and refugees are especially susceptible to having these symptoms (Farrell, 2020). Art therapy and EMDR are identified as the most promising modalities for treating such trauma.

This literature review examines the various ways EMDR and art therapy have been …

Dance/Movement Therapy And Attachment In The Neonatal Intensive Care Unit- Critical Literature Review, Weronika Rozwadowska

Expressive Therapies Capstone Theses

Dance/movement therapy, out of all of the expressive arts therapy modalities, is most often used in relation to attachment because of its embodiment. While dance/movement therapy has been researched in relation to attachment, is it hard to find literature about dance/movement therapy supporting attachment in the Neonatal Intensive Care Unit (NICU). This critical literature review explored and examined the question of how dance/movement therapy can support parents’ wellbeing and its influence on the attachment with their infants in the NICU. A search for literature on the topic happened mostly online on several bibliographic databases. The majority of the sources were …

Reconfiguration-Driven Assembly Of Inorganic Nanomembranes, Divya Jyoti Prakash

Chemical and Biological Engineering ETDs

This thesis focuses on the guided self-assembly of metastable nanomembranes (NMs) that are either amorphous or polycrystalline. Guided self-assembly of NMs is a robust and scalable method to obtain a variety of three-dimensional structures such as helices, rolled-up tubes, and networks of interconnected channels. These 3D structures have important applications as on-chip actuators, sensors, inductors, transformers, waveguides, and antennas. Furthermore, a large amount of strain and strain gradient can be imparted in NMs by bending them to a nanoscale and microscale radius of curvature, making guided self-assembly on NMs a viable route to extreme strain engineering of amorphous and polycrystalline …

Final Scholarly Project: Enhanced Recovery After Surgery (Eras) Guidelines For Pancreaticoduodenectomies, Rebecca Wheeler

Doctor of Nursing Practice Scholarly Projects

A pancreaticoduodenectomy, or Whipple procedure, is the only curative option for pancreatic cancer. For those eligible for tumor resection, the Whipple procedure is a difficult surgery for both the patient and provider. Complications following pancreaticoduodenectomy are numerous and include infection, delayed gastric emptying, high hospital costs, and pancreatic fistulas. Enhanced Recovery After Surgery (ERAS) protocols exist to provide evidence supporting standardization of practices that lead to the improvement of these patient outcomes. An ERAS protocol for the pancreaticoduodenectomy, first established in 2012, is inconsistently implemented in healthcare facilities. Researchers collected data involving the use of the Whipple procedure ERAS guidelines …

Implementation Of Guidelines For Preprocedural Ultrasound In Neuraxial Placement For Obstetric Patients With Scoliosis, Luther Nyirenda

Doctor of Nursing Practice Scholarly Projects

Neuraxial anesthesia including epidural, spinal, and combined spinal-epidural, is used with 65% of parturients in the United States for the management of pain and discomfort. Conventional landmark palpation has been the mainstay technique for neuraxial anesthesia, but unfamiliar spinal anatomy can lead to incomplete blockade or an increased incidence of complications. Scoliosis causes lateral curvature and rotation of the spine leading to arthritis and soft tissue changes that can present obscure anatomical landmarks, cause difficulty in needle passage, and result in inadequacy of local anesthetic efficacy. The literature illustrates that preprocedural ultrasound is recommended for needle placement in parturients with …

Final Scholarly Project: Evidence-Based Practice Guidelines For The Perioperative Management Of Blood Glucose Levels In The Cardiac Surgery Patient, Chelsey Benner

Doctor of Nursing Practice Scholarly Projects

Cardiovascular disease is the leading cause of mortality worldwide, necessitating a high demand for cardiac surgery. A unique stressor for cardiac surgery is an increased surgical stress response involving hyperglycemia. Perioperative hyperglycemia contributes to adverse postoperative outcomes following cardiac surgery. Current evidence examines blood glucose control and its effect on adverse postoperative outcomes, including sternal wound infections, acute kidney injury, prolonged mechanical ventilation, and an increased length of stay in the intensive care unit. Despite the link between hyperglycemia and poor postoperative outcomes, most facilities lack standardized guidelines for the perioperative management of blood glucose levels in cardiac surgery patients. …

Development Of Clinical Practice Guidelines For Incorporating Paravertebral Blockade For Thoracic Surgery Adult Patients, India Hutchison

Doctor of Nursing Practice Scholarly Projects

Thoracic surgery is considered one of the most painful surgical procedures due to its severity and the duration of the procedure. Pain is detrimental to the patient experience, and poor patient satisfaction results in revenue loss for hospitals. Maintaining adequate pain control after surgery is crucial in preventing pulmonary complications such as atelectasis and respiratory failure that prolong patient recovery. It is the responsibility of the anesthesia provider to ensure adequate pain control throughout the perioperative experience. Although current evidence-based data shows that regional anesthesia provides superior thoracic postoperative pain control, the current practice continues to be the utilization of …

Final Scholarly Project: The Administration Of Transversus Abdominis Plane Blocks In Patients Undergoing Anesthesia For Open Ventral Hernia Repairs, Brennon Pinion

Doctor of Nursing Practice Scholarly Projects

Ventral hernia repairs are the only definitive treatment for umbilical or abdominal hernias. These procedures are prevalent and often lifesaving but also carry high risks of adverse effects. Some of the problems that follow include postoperative ileus, increased opioid use, and prolonged length of stay. Due to the rate of complications, there was a need to improve these outcomes. One way to improve outcomes is to implement superior anesthetic techniques. This Final Scholarly Project (FSP) followed the Plan-Do-Study-Act (PDSA) model to conduct evidence-based practice (EBP) and quality improvement (QI) sections. The plan phase included a thorough literature search and analysis …

Development Of Evidence-Based Practice Guidelines For Utilizing Erector Spinae Plane Blockade For Patients Undergoing Cardiac Surgery, Gabrielle Metoyer

Doctor of Nursing Practice Scholarly Projects

In the United States, the aging population and high rates of cardiovascular disease leads to increased cardiothoracic surgeries. Analgesia for cardiac surgeries often involves high-dose opioids. However, with an ever-increasing opioid epidemic and adverse effects on the postoperative healing process, recent literature seeks to decrease opioid consumption by utilizing alternative methods of analgesia. The American Association of Nurse Anesthetists recommends the use of regional anesthesia techniques to reduce the incidence of undertreated postoperative pain that can occur from opioid-sparing methods of analgesia. This project aims to create an evidence-based analgesia guideline for adult patients undergoing cardiac surgery. Interventions will include …

Evidence-Based Practice Guidelines For Perioperative Use Of Dexmedetomidine In Pediatric Congenital Cardiac Surgery, Kayla Thomsen

Doctor of Nursing Practice Scholarly Projects

Tachyarrhythmias are common postoperatively in the congenital cardiac surgery population. About 1% of the population is born with congenital heart disease (CHD), with 50% of patients undergoing surgery for CHD experiencing arrhythmias. Complications can arise from postoperative arrhythmias, including hemodynamic instability and myocardial depression, having catastrophic health repercussions. Despite the high prevalence and complications, there is no standard practice for postoperative tachyarrhythmia prevention in the chosen population, and prevention is at the provider's discretion. However, literature exploring the effects of dexmedetomidine notes promising results for using the drug for postoperative tachyarrhythmia prevention. The project aims to address the lack of …

Analysis Of Clinical Outcomes And Cost Effectiveness Of Neuromuscular Blocking Drug Reversal In Patients Classified As Obese, Trevor Mack

Doctor of Nursing Practice Scholarly Projects

Obesity predisposes patients to heightened risks of adverse outcomes following surgery, including residual neuromuscular blockade and postoperative complications. The administration of non-depolarizing neuromuscular agents (NMBAs) is fundamental for muscle relaxation and optimal surgical conditions. However, the subsequent reversal of these blockers with agents like sugammadex or neostigmine is crucial to mitigate these risks. While sugammadex is recognized as a clinically superior choice due to its rapid and more complete reversal, its extensive use is often limited by cost, presenting challenges in obese patients who already face increased susceptibility to complications. This project evaluates the cost-effectiveness of sugammadex versus neostigmine in …

Development Of Evidence-Based Clinical Practice Guidelines For Pediatric Preoperative Anxiety, Whitney R. Stant

Doctor of Nursing Practice Scholarly Projects

Preoperative anxiety is a problem that occurs frequently in pediatric patients. Preoperative anxiety creates physical and psychological changes that impact a child’s surgical experience. Pediatric patients who experience preoperative anxiety may also experience prolonged postoperative care, long-term psychological complications, and increased postoperative pain. Sedating medications are often administered to prevent and treat preoperative anxiety. Commonly, midazolam is administered intranasally to prevent preoperative anxiety. Midazolam increases the risk of cognitive impairment and respiratory depression. Dexmedetomidine is an effective alternative to midazolam. Dexmedetomidine is a highly selective alpha-2 agonist and provides arousable sedation without respiratory depression. Dexmedetomidine is safe and effective at …

Guidelines For Intraoperative Use Of Quantitative Neuromuscular Monitoring, Alex Thompson

Doctor of Nursing Practice Scholarly Projects

Chemical paralysis with neuromuscular blocking agents is common practice in anesthesia. Adequate reversal of these medications is essential for postoperative recovery and return to physiologic baseline. Inadequate reversal may lead to residual paralysis and respiratory complications such as hypoxemia, upper airway obstruction, atelectasis, and pneumonia. Quantitative neuromuscular monitoring was introduced as an objective measure of adequate recovery from neuromuscular blockade. The American Society of Anesthesiologists recommends utilizing quantitative neuromuscular monitoring before tracheal extubation in their 2023 practice guidelines, as the research involving quantitative neuromuscular monitoring shows a reduction in postoperative residual paralysis rates and adverse respiratory complications postoperatively. In this …

Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, Bridget Hayes

Doctor of Nursing Practice Scholarly Projects

Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence …

Clinical Guidelines For The Perioperative Management Of Patients With Aortic Stenosis Undergoing Noncardiac Surgery, Owen Diehl

Doctor of Nursing Practice Scholarly Projects

Aortic stenosis (AS) is a common valvular disorder that causes left ventricular (LV) outflow obstruction. The prevalence of AS may increase with the aging population and the widespread availability of diagnostic capabilities like echocardiography. With the increasing patient population diagnosed with AS, the chance of encountering these patients during noncardiac surgery (NCS) increases. Performance of anesthesia is challenging in patients with AS due to the pathophysiological consequences of AS and the hemodynamic changes associated with anesthesia. The patient with AS presenting for NCS is at an increased risk of perioperative major adverse cardiac events (MACEs). This project aimed to determine …

Use Cases For Art Therapy Intervention In Clinical Psychedelic Praxis, Kaitlin Maud

Expressive Therapies Capstone Theses

Psychedelic medicine has existed for thousands of years as a traditional, sacred practice and is now in varying stages of legalization for clinical application in the United States. Psychedelic-Assisted Therapy uses specific psychoactive substances to facilitate altered states of consciousness in which clients have access to unconscious material and there is a greater cognitive openness to new perspectives and possibilities. Art Therapy is a modality of psychotherapy with decades of data to support its clinical efficacy in treating mental illness and other chronic conditions. A review of the literature shows a range of use cases for art in the context …

How Music Is Used To Facilitate Communication In Speech-Language And Music Therapy For Children With A Diagnosis Of Autism Spectrum Disorder, Anna Mcgreevy

Honors College Theses

The goal of this research was to determine how music is being used in speech and music therapy sessions for children with a diagnosis of autism spectrum disorder, to discover the most common targets of these therapy sessions, and to examine the anatomical and physiological constructs that support the inclusion of music. This study was a review of literature, and included research from a variety of articles, several written in the past 25 years. Overall, results showed that music-based speech interventions such as Melodic Based Communication Therapy and Developmental Speech and Language Training, as well as music therapy interventions, are …

Parental Perceptions Of Child Life Specialists, Anna Muccio

Human Development and Family Sciences Undergraduate Honors Theses

Most children spend time in the hospital at some point during their childhood whether it is for a short visit or a long-term stay. Hospitalization can be a very stressful experience for children and their families. Child life specialists work in hospitals to help families navigate hospitalizations and cope with stress. This study aimed to investigate parental perceptions of child life specialists, including parents’ familiarity with their role, recognition of its importance, appreciation for help provided, and the formation of meaningful relationships with child life specialists. A survey was conducted among child life specialists who had worked with children and …

Implementation Guidelines For Total Hip And Total Knee Arthroplasty To Reduce The Incidence Of Deep Vein Thrombosis And Subsequent Pulmonary Embolism, Mitchell Mccorkle

Doctor of Nursing Practice Scholarly Projects

With patients living longer, the orthopedic sector has given rise to joint prostheses as a treatment for those experiencing osteoarthritis (OA). With the increase of these procedures, there is also an increased risk of deep vein thrombosis (DVT) and subsequent pulmonary embolus (PE) following these surgical procedures. The orthopedic medical community and anesthesia providers aim to decrease DVT and PE risk through multiple modalities. The anesthesia focuses on reducing DVT, and PE involves a multimodal approach to each anesthetic. Modalities used for the multimodal approach involve peripheral nerve blocks (PNB), neuraxial spinal anesthesia, early mobilization, postoperative nausea and vomiting (PONV) …

"Integrative" Vs "Integration": Stem Skills And Concept Development In 6th Grade Students, Kathryn Chain

Theses/Capstones/Creative Projects

As a whole, interest in Science, Technology, Engineering, and Mathematics (STEM) education in schools is on the rise at a national level, and it is widely recognized that the development of skills and concepts in science, technology, engineering, and math are not only beneficial to students, but are in fact necessities for future citizens of an increasingly global world (Kelley & Knowles, 2016.) Despite this increasing acceptance and awareness of the need for STEM literacy, there is a critical lack of guidelines on what STEM education actually entails and how to effectively integrate these concepts and skills into the educational …

Phoneme Recognition For Pronunciation Improvement, Matthew Heywood

Theses/Capstones/Creative Projects

This project aims to improve English pronunciation by investigating speech errors and developing a tool to provide precise feedback. The study focuses on creating a new pronunciation tool that offers localized feedback, identifies specific errors, and suggests corrective measures. By addressing the shortcomings of current methods, this research seeks to enhance pronunciation refinement.

Utilizing cutting-edge technology, the tool leverages speech-to-phoneme AI models and modified lazy string matching algorithms to compare the user's spoken input with the intended pronunciation. This allows for a detailed analysis of discrepancies, providing users actionable insights into their phonetic errors. The speech-to-phoneme AI models mark a …

Esg Significance In Relation To Corporate Bankruptcy Prediction, Sama Elkady

Theses and Dissertations

This thesis aims to enhance corporate risk assessment through studying ESG (Environmental, Social, and Governance) significance in modeling bankruptcy. Through using artificial intelligence’ natural language processing (NLP), we develop a proxy for ESG scoring based on companies annual reporting retrieved through EDGAR. We integrate the derived ESG score with traditional financial ratios used to calculate Altman’s Z-score (1968) in predicting bankruptcy. Through S&P’s Compustat, we obtain a sample of 108 healthy & bankrupt firms -spanning 14 years of fiscal observations- and match them through time and industry. We use stepwise GLM regression to estimate bankruptcy probability observing that ESG and …

The Grammar Of Approximating Number Pairs (Anps) In Mandarin Chinese, Xuehuai He

Pomona Senior Theses

"There are twenty or thirty people." What exactly does this mean? Is it exactly twenty or thirty, or is it an approximate range? What about "twenty or twenty-six people"?

Approximating number pairs (ANPs) are a kind of approximative expression that takes a number pair and expresses a quantity close to it. There are constraints on the structure and choice of numerals: many combinations would be ungrammatical or denote a precise disjunction rather than being approximative. Studies like Eriksson et al. (2010) statistically generalized the grammar of ANPs through corpus studies on select European languages. However, these surface-level generalizations fail to …

Community College Leadership At The Intersection Of Strategic Planning And Resource Management, Roxy Traxler

School of Business Student Theses and Dissertations

This study seeks to determine the competencies that college leaders need to possess in the intersection of finance and strategic planning. For this purpose, I am using resource management as a construct to define the competencies. This is important because one area rarely mentioned in the research is how the budgeting process, policies and practices that guide financial decisions are used to support student success and the strategic plan. There is literature related to the need for financial or fiscal leadership skills but not about what those skills are and how they are used to accomplish strategic goals to improve …

Restorative Justice Initiatives In Marin County: Mitigating The Impacts Of The School-To-Prison Pipeline On Youth, Gina Dudley

Social Justice | Senior Theses

My senior thesis project delves into Restorative Justice's role in addressing the school-to-prison pipeline in Marin County. Restorative Justice prioritizes repairing the harm caused by crime to individuals, relationships, and communities, advocating for offenders to take responsibility and make amends rather than solely facing punishment (Restorative Justice Exchange, 2022). My capstone aims to pinpoint factors driving student exclusion from schools and subsequent entanglement in the legal system while highlighting how restorative approaches can prevent such outcomes. Additionally, it discusses the benefits of removing police officers from schools and reducing reliance on law enforcement within educational settings. My research will use …