Digital Commons Network^™

Effect Of Virtual Reality Intervention Of Postoperative Pain In Pediatric Surgical Patients, Tara L. Kempker

Dissertations

Problem: Pediatric surgical procedures are associated with preoperative anxiety. Preoperative anxiety is associated with higher postoperative pain. Multiple studies have found that decreasing preoperative anxiety using Virtual Reality (VR) Intervention also decreases postoperative pain scores and use of rescue analgesics in postoperative care units (PACU). However, there is no standardized protocol for use of VR interventions and in our institution, VR was not utilized at all.

Methods: This quality improvement (QI) initiative utilized a quasi-experimental design and convenience sampling. Quantitative data was collected during visits for scheduled operative visits for pediatric surgical patients ages seven to 18 years …

Sleep Disturbances Affect Sleep Quality Of Hospitalized Adults, Tonjia Hardesty

Dissertations

Abstract

Background: Sleep disturbances affect the quality of sleep hospitalized adults experience, possibly extending patient recovery time. Treatment of insomnia frequently includes pharmacological interventions exposing patients to potential side effects, leading to negative patient outcomes.  The purpose of this project was to determine if a sleep hygiene toolkit including eye masks, earplugs, advocacy cards, and removal of nicotine patches at bedtime would improve patient sleep quality without use of pharmacological interventions.

Methods: A descriptive observational design was used in this quality improvement (QI) project. A convenience sample of 37 (N =37) participants over the age of 18 years and …

Psychotropic Medication Use In Older Adults In A Long-Term Care Facility: Implications For Screening Tool, Callie M. Johnson

Dissertations

Psychotropic medication use in older adults aged 65 years and older residing in the long-term care facility has a complex issue in the high use of psychotropic medications. Older adults residing  in long-term care (LTC) facilities are affected and prescribed at least one psychotropic or antidepressant medication.

Enhancing Well-Being: Implementing Weekly Social Interventions For Older Adults In Independent Living, Rosa Huang

Dissertations

Loneliness and social isolation significantly impact the physical and mental well-being of older adults. This quality improvement project implemented an eight-week social intervention designed to reduce loneliness and enhance well-being through weekly sessions incorporating mindfulness exercises, gratitude journaling, and structured socialization activities. The intervention was delivered by nursing students to a sample of residents in a Midwestern independent living community. While most standardized measures of loneliness and mood did not show statistically significant changes, the project resulted in a statistically significant increase in social network engagement as measured by the Lubben Social Network Scale-6 (LSNS-6). The findings suggest that group-based …

Educating School Nurses On Trauma-Informed Care, Na-Keisha Allene White

Walden Dissertations and Doctoral Studies

Trauma-informed care is a critical component of supporting students' overall wellness, and school nurses are central to this work. They are often the first professionals to recognize when a student is exhibiting a trauma response or experiencing a mental health concern during the school day. Although evidence-based school health organizations have advanced efforts to ensure that academic environments are prepared to support students’ mental health needs, school nurses are too often left out of these strategic planning processes. Their exclusion not only overlooks their clinical expertise but also weakens the school’s ability to respond effectively and holistically to student needs. …

Vocabulary Acquisition Through Developmental Play, Amy Storlie

Graduate Teacher Education

As the population of English learners in the United States grew, there was a greater need for linguistically and developmentally appropriate instructional approaches for young learners. The question that guided this research on appropriate instructional approaches was: How does developmental play support the acquisition of academic vocabulary among early-emergent multilingual students in kindergarten and first grade? The research review examined peer-reviewed research across three interconnected bodies of literature: play-based learning, interactions in developmental play, and vocabulary instruction. The findings indicated that purposeful, guided play strengthened executive function, expressive language, and academic growth. In addition, collaborative practices such as translanguaging supported …

Fecal Fatty Acids And Other Risk Factors Associated With Multiple Sclerosis Score, Progression And Diagnosis Among Hispanic Adults, Juliana Ayala-Viqueira

Walden Dissertations and Doctoral Studies

Multiple sclerosis (MS) is a chronic neurological condition with insufficient research regarding risk factors influencing MS severity score (MSSS), progression and diagnosis among Hispanic adults living in the United States. This cross-sectional study assessed factors associated with MS score, progression and diagnosis using secondary data from the International Multiple Sclerosis Microbiome Study (iMSMS). Guided by the ecological model, the study included N = 576 participants with MS. Manuscript 1 explored the association between body mass index (BMI), sodium consumption, and the MS severity score in a Hispanic adult population. A multiple linear regression was conducted to examine whether age and …

Examining Inmate Labor In Emergency Management: Contributions, Challenges, And Ethical Considerations, Boris Eugene Valiance

Walden Dissertations and Doctoral Studies

Incarcerated individuals remain inconsistently engaged in disaster preparedness, response, and recovery, creating both an operational gap and an ethical challenge regarding labor equity, safety, voluntariness, and human dignity. Guided by RBT and EMT, the purpose of this qualitative case study was to explore how incarcerated individuals are utilized in emergency management and to examine stakeholder perceptions of the operational, ethical, and policy implications of inmate labor programs. The research questions examined current utilization patterns, stakeholder-perceived benefits and drawbacks, and ethical concerns influencing participation decisions. Data were collected through semi structured interviews with purposefully sampled emergency management professionals, policymakers, and correctional …

The Impact Of Social Determinants Of Health On Alcoholism Among African American Communities Aged 65 And Older, Kymberly Williams

Walden Dissertations and Doctoral Studies

Alcohol use disorder among African American older adults (aged ≥65) remains an underrecognized contributor to preventable morbidity and diminished quality of life. Although previous research has identified individual risk factors for alcohol misuse, little is known about how social determinants of health shape alcohol use among this population. The purpose of this descriptive phenomenological study was to explore how family support, experiences of racial discrimination, religious engagement, and economic stability influence late-life alcohol use. Cultural Resilience Theory guided the exploration of how cultural resources and structural stressors influence alcohol use. Five African American adults aged 65 years and older were …

Relationship Between Employee Engagement, Gender, And Intention To Quit In The Retail Industry, Lataya V. Mills

Walden Dissertations and Doctoral Studies

Intention to quit remains a significant challenge for retail organizations, contributing to recruitment and training costs, workforce instability, and operational disruptions. The purpose of this quantitative correlational research project was to examine the relationship between employee engagement, gender, and intention to quit among frontline retail employees in the Mid-Atlantic United States. Grounded in employee engagement theory, participants included 71 frontline retail employees. Data were collected using the Utrecht Work Engagement Scale, an Intention to Quit Scale, and demographic questions. Composite scores were calculated for employee engagement and intention to quit, and the data were analyzed using descriptive statistics, reliability analysis, …

Racial Profiling In Traffic Enforcement: A Qualitative Exploration Of Police Chiefs' Perspectives On Traffic Stop Data Analysis, Peter J. Didomenica

Walden Dissertations and Doctoral Studies

Racial profiling of people of color by police departments as part of traffic enforcement practices is a pervasive practice in the United States. The practice is a form of systemic racism, the conceptual framework for this study, that has resulted in people and communities of color suffering its deleterious effects. Although statistical analysis of traffic stop data is most effective in uncovering racial profiling in traffic enforcement, most police departments fail to conduct such analysis, and for those departments that do so, there is no uniform judicially accepted method. The purpose of this study was to understand the reasons most …

The Stigma Experiences Of The African American Transgender Individual In Mental Health Settings, Linda Shaw Henley

Walden Dissertations and Doctoral Studies

The intersection of race, gender identity, and systemic marginalization has profound implications for mental health outcomes, particularly among African American transgender individuals. Addressing African American transgender individuals’ stigma experiences in mental health settings is important because transgender individuals have dual minority statuses, wherein racism, stigma, transphobia, and institutional neglect converge, significantly impacting their access to affirming and effective mental health treatment. The purpose of this study was to explore the stigma experiences of the African American transgender individual in mental health settings. The phenomenon of interest in this study was stigma experiences in mental health settings with mental health providers. …

Cytoskeletal Protein Expression In Autism Spectrum Disorder: A Psychoneuroimmunological Perspective On Sars-Cov-2, James Birch

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic heightened concerns about health disparities among individuals with autism spectrum disorder (ASD). Limited understanding of the biological factors underlying health variability may hinder efforts to reduce disparities and improve care for neurodivergent populations. Guided by the psychoneuroimmunology framework, this quantitative study investigated whether cytoskeletal gene expression was associated with neuroimmune variability in ASD and SARS-CoV-2 populations. Three genes –Nck-associated protein 1 (NCKAP1), WAS/WASL-interacting protein family member 1 (WIPF1), and actin-related protein 2/3 complex subunit 1B (ARPC1B)—were evaluated using two publicly available Gene Expression Omnibus datasets GSE212645 (ASD vs. sibling-matched controls, N = 40) and GSE152641 (SARS-CoV-2-positive vs. …

First Year College Students’ Perceptions Of Their Engagement Skills And Satisfaction In Online Courses, Ryan Ann Mathews

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study is the gap in literature on first-year college students’ perceptions of engagement and satisfaction in online courses. Grounded in the framework of Astin’s student involvement theory and Cotton et al., happy productive theory, the purpose of this basic qualitative study was to explore first-year college students’ perceptions of their engagement and satisfaction in online courses. Semistructured interviews with eight first-year online college students throughout the U.S. were conducted. Through thematic analysis, the following four themes emerged: First-year online college students noted that their (1) engagement skills and study habits, when used consistently, …

African American Women’S Perceptions And Experiences With Weight Management And Ensuing Health Outcomes, Brenda Louise Gill

Walden Dissertations and Doctoral Studies

African American women (AAW) experience disproportionately high rates of obesity and chronic disease compared to all other demographic groups in the United States. The purpose of this basic qualitative study was to explore the experiences of AAW aged 36–64 residing in Nashville, Tennessee, regarding food, weight management, and chronic disease management. The social-ecological model (SEM) served as the theoretical framework, providing a multilevel lens through which individual, interpersonal, organizational, community, and societal factors are examined. Three research questions guided the inquiry, examining individual-level experiences, parental and caregivers’ influences, and community and societal-level factors shaping participants’ relationship with food, weight management, …

Early Identification Of Skin Breakdown In The Medical-Surgical Setting, Brandi S. Paul, Kathryn Justice, Nic Money

Group: Samford University Moffett & Sanders School of Nursing

Hospital-acquired pressure injuries (HAPIs) remain a significant patient safety concern in acute care settings. The purpose of this Doctor of Nursing Practice (DNP) project was to reduce HAPI rates through a multidisciplinary intervention focused on the early identification of high-risk patients and improved adherence to pressure injury prevention practices.

Guided by the Iowa Model of Evidence-Based Practice, this quality improvement project was implemented over eight weeks on one medical-surgical unit at two southeastern U.S. hospitals. Adult patients with Braden scores ≤14 were identified as high risk. Nurses initiated the Pink Paper Initiative (PPI), which included visual bedside reminders, multidisciplinary checklists, …

Implementation Of A Follow-Up Call To Improve Glp-1 Medication Compliance, Hanna Weitzman-Flanigan

DNP and Student Works

Background: Obesity is a major driver of healthcare spending in the United States. GLP-1 receptor agonists are effective for weight management; however, high rates of early discontinuation reduce both clinical and economic value.

Methods: A pre–post quality improvement project implemented a nurse-led follow-up call at four weeks.

Results: Adherence improved significantly (p=0.009), weight decreased by 10 pounds (p=0.023), and estimated annual savings per patient were $6,472, contingent on sustained long-term adherence. Total estimated project savings were $80,141.

Conclusion: Nurse-led follow-up calls are a high-value intervention supporting economic sustainability.

Bilingualism And Literacy Development: A Systematic Review Of English-Italian Bilingual Children, Francesca Cocilovo

Electronic Theses and Dissertations

This systematic review examines the cross-linguistic effects of English-Italian bilingualism on the early literacy development of children ages 4 to 10. Nine studies published between 1995 and 2021 are included following a systematic search, screening, and quality appraisal process. Evidence supports that cross-linguistic transfer effects influenced grammar, metalinguistic, reading fluency, comprehension, spelling, vocabulary, writing, and memory skills across English and Italian. English-Italian bilingualism generally results in neutral or positive literacy outcomes. However, case-by-case variations appear depending on orthographic depth, bilingual presentation, language exposure, and reading status. Children with reading difficulties are particularly sensitive to orthographic differences during second-language acquisition. Although …

Examining The Moderating Roles Of Religious Coping And Belonging In The Relationship Between Moral Injury, Depression, Anxiety, And Stress Within The Israeli Defense Forces Reservist Soldiers, Rotem Z. Moshe

Electronic Theses and Dissertations

This study examined the moderating roles of religious coping and belonging in the relationship between moral injury and psychological distress, among Israeli Defense Forces (IDF) reservist soldiers. This study investigated whether religious coping predicted moral injury, depression, anxiety, and stress, and examined whether religious coping and belonging moderated the relationship between moral injury and psychological distress. Exposure to potentially morally injurious events during military service is associated with increased risk for adverse mental health effects, particularly in times of prolonged conflict. Research on protective factors that mitigate these outcomes remains limited. Pointed by religious coping and belongingness frameworks, this study …

A Teacher’S Critical Content Analysis Of Children’S Literature In A Read Aloud Book Series, Tanya Renee Gilliam

Theses and Dissertations

Tanya Gilliam A TEACHER’S CRITICAL CONTENT ANALYSIS OF CHILDREN’S LITERATURE IN A READ ALOUD BOOK SERIES2025-2026 James Coaxum, Ph.D. Doctorate of Education This study examined the cultural responsiveness of kindergarten read aloud texts in the Houghton Mifflin Harcourt (HMH) Into Reading curriculum used in District Rynie. Using critical content analysis, seventy read alouds were analyzed to explore representations of culture, identity, and power. The analysis was guided by Botelho and Rudman’s multicultural framework, Bishop’s mirrors, windows, and sliding glass doors model, and Short’s criteria for multicultural literature, across four domains: Authenticity and Representation; Content and Perspective; Challenging Bias and Equity; …

Cooperative Evolution For Discovering Scalable Spiking Neural Network Architectures, Catherine C. Rodriquez

LSU Master's Theses

SNNs are a foundational model in neuromorphic computing, where efficient architectures must be discovered for a wide range of applications. Evolutionary methods, such as EONS, offer a flexible approach to this search but become increasingly difficult to scale as task complexity grows due to the rapidly expanding combined topology–parameter search space and associated memory demands. To address this challenge, we propose a co-evolutionary ensemble framework in which a population of candidate SNNs is evolved with fitness defined by each network’s marginal contribution to group performance. Grounded in cooperative game theory and difference evaluation functions from multiagent systems, this formulation provides …

Policy Analysis Of The Inclusion Of Mitigation Measures In The Re-Design And Construction Of The New Frances Scott Key Bridge, Patrick John O'Connor

Theses and Dissertations

This thesis discusses the tragic event of the container ship MV Dali impacting the Francis Scott Key Bridge on March 26, 2024, leading to the collapse of the structure and killing six people despite having collision mitigation protections in place. This research examines how late twentieth-century structures are inadequate for current shipping demands and emphasizes that updated mitigation design criteria must accommodate larger modern vessels as governments replace or upgrade these structures. This paper will examine four case studies of different collisions that have similar circumstances to the Francis Scott Key Bridge collapse and review National Transportation Safety Board reports …

How Young Mothers’ Interpersonal And Emotional Well-Being Impacts Parental Stress And Dating Violence, Jonathan Jin

Theses and Dissertations

This two-part dissertation investigated two distinct, yet interconnected aspects of young mothers’ wellbeing which span individual and interpersonal factors. Study 1 examined how adverse childhood experiences (ACEs) are related to parental stress, and how symptoms of anxiety and depression might mediate this association. Within a sample 255 young mothers with an average age of 22.2 (SD = 2.3), the pooled results of a parallel mediation model across 10 imputed datasets indicated a significant average direct effect of ACEs on parental stress (0.25, p < .01), suggesting that experiencing a history of ACEs was significantly associated with more parental stress. Study 2 examined the relationship between young mothers’ romantic attachment, emotion regulation, and dating violence (DV) victimization. In a different sample of 256 young mothers with an average age of 19.8 years (SD = 1.1), more avoidant (less secure) romantic attachment styles (β = 0.26, SE = 0.1, p < 0.01) and more anxious romantic attachment styles (linear component β = 3.81, SE = 0.9, p < 0.001 and quadratic component β = -2.86, SE = 0.9, p < 0.01) were significantly associated with greater DV victimization. Future research may extend this work by using longitudinal designs to test bidirectional links between interpersonal and emotional wellbeing factors among young mothers.

Fatigue And Healing Performance Of Asphalt Materials Modified With Nanomaterials And High-Polymer Asphalt Binders, Samuel M. Addai

Theses and Dissertations

Fatigue cracking is one of the primary distress mechanisms affecting asphalt pavement durability under repeated traffic loading and environmental aging. Although asphalt binders possess an inherent ability to heal micro-damage during rest periods, this healing capacity is often insufficient to fully counter progressive fatigue damage under field conditions. This thesis investigates the fatigue and self-healing behavior of asphalt binders and mixtures modified with nanomaterials and advanced polymer-based systems. Nanomodified binders were evaluated using Linear Amplitude Sweep (LAS) and Linear Amplitude Sweep with Healing (LASH) tests within the VECD framework to quantify fatigue resistance and healing behavior under different rest periods …

Integrating Multimodal Composition Practices In A Fifth-Grade Classroom To Enhance Student Engagement And Comprehension, Erin Beal

Theses and Dissertations

This study investigated the impact of integrating multimodal composition practices on fifth-grade students' writing development. Specifically, it examined how multimodal opportunities influenced student engagement, content area understanding, and overall attitudes toward the writing process. Utilizing a mixed-methods approach, the study utilized pre- and post-surveys to assess changes in students' self-awareness and dispositions toward writing. Over the course of the research study, data was gathered through anecdotal teacher notes, direct observations, and student work samples. Working both independently and collaboratively, students synthesized content material to create and present original multimodal projects.

¿Cómo Se Hace Translanguaging En Kindergarten?, Diana Marie Franco

Theses and Dissertations

This qualitative case study explored the use of translanguaging among kindergarteners and examined how students’ use of their full linguistic repertoire served as a pedagogical practice in a two-way dual-language, Spanish-world classroom. The findings indicated that translanguaging functioned as an academic and linguistic resource, supporting student engagement and participation in classroom learning. Students used their complete linguistic repertoires to clarify meaning, negotiate understanding, develop vocabulary, make cross-linguistic connections through cognates, and demonstrate emerging metalinguistic awareness. These findings contribute to the growing body of research supporting translanguaging as a pedagogical approach in dual language classrooms, especially in early childhood education. The …

An Analytical And Performance Guide To Jake Heggie's Of Gods And Cats And Thought Unspoken For Baritone And Piano, Wenxin Sha

LSU Doctoral Dissertations

This dissertation provides a comprehensive performance guide to two song cycles by Jake Heggie: Of Gods and Cats and Thoughts Unspoken for baritone and piano. This study aims to assist singers in preparing these cycles to achieve an expressive performance that is word driven and, just as Mr. Heggie says “Words first, then music.”

Chapter 1 introduces Heggie’s biography and compositional style, emphasizing his text-driven approach, lyrical melodic writing, and close collaboration with poets and performers. Chapter 2 introduces the poets John Hall and Gavin Geoffrey Dillard, and highlights how their texts shape the dramatic and emotional content of the …

Understanding Teacher Retention In A Christian Non-Profit School: A Qualitative Case Study, Faith Solomon

Theses and Dissertations

Faith Solomon UNDERSTANDING TEACHER RETENTION IN A CHRISTIAN NON-PROFIT SCHOOL: A QUALITATIVE CASE STUDY 2025-2026 Stephanie Lezotte, Ph.D. Master of Arts in Higher Education This qualitative case study examines the factors that influence teacher retention in a Christian nonprofit private school located in an urban community in the northeastern part of the United States. The study addresses a gap in existing research by focusing on how educators in faith-based schools understand the motivations and conditions that shape their decisions to remain in the profession. Specifically, the study examines how intrinsic motivation, faith identity, leadership practices, and relational culture contribute to …

Do I Belong Here?: A Narrative Inquiry Into Ableism, Accommodation, And Professional Identity Among Medical Students With Mobiilty Disabilities, Nicole J. Albano Robinson

Theses and Dissertations

Abstract Nicole J. Robinson DO I BELONG HERE?: A NARRATIVE INQUIRY INTO ABLEISM, ACCOMMODATION, AND PROFESSIONAL IDENTITY AMONG MEDICAL STUDENTS WITH MOBILITY DISABILITIES 2025-2026 Ane Turner Johnson, Ph.D. Doctor of Education in Educational Leadership Despite federal and institutional disability policy designed to protect equitable access to education, medical students with mobility disabilities encounter systemic barriers shaped by ableism, inconsistent accommodation practices, cultural bias, and exclusionary learning environments. This qualitative study sought to describe the lived experiences of undergraduate medical students with mobility disabilities within U.S. MD and DO programs. A qualitative narrative inquiry using Kim’s (2016) two-phase life story interview …

Transport Properties And Microstructural Development Of Co₂-Cured, Co₂-Infused, And Cold-Weather Concrete, Arlene Jane Looc

Theses and Dissertations

This research aims to advance the understanding of durability and transport behavior in emerging CO₂-cured and cold-weather concrete technologies. Limited work has examined long-term durability indicators such as permeability, resistivity, and pore connectivity in these types of concrete. To bridge this gap, the study evaluates transport properties alongside microstructural changes that govern the progression of hydration and the evolution of pore structure. This study measures transport properties, determines correlations between resistivity and fluid ingress, and analyzes the evolution of pore structure. To achieve this, the experimental program evaluated three concrete mixtures for external CO₂ exposure, nine for dry ice infusion, …