Digital Commons Network^™

Improving Sleep Assessment Compliance On A Medical-Surgical Unit, Cassandra Nguyen

Master's Projects and Capstones

Poor sleep in the hospital is linked to more pain, more opioid use, delirium, slower healing, and longer hospital stays. A required Enhanced Recovery Medicine (ERM) sleep assessment is meant to help, but it is not always documented. On a 25-bed medical-surgical unit in a large integrated health system in northern California, only 75.8% of eligible days had this assessment documented before noon at baseline (March 30 to April 28, 2026). The plan has three parts: bedside sleep champions on the day and night shift, staff education during shift huddles supported by an education flyer, and weekly audits through the …

Fireready Oc: Developing A Public Health Protocol For Wildland-Urban Interface (Wui) Fire Events In Orange County, Christian Andre O. Gequillo, Allyson Hayakawa, Selin Erdogan, Natalie Albarran

Master's Projects and Capstones

Objective/Problem: Wildland-Urban Interface (WUI) fires expose communities to a greater number of hazardous pollutants than traditional wildfires and can pose significant health risks; however, Orange County does not have a standardized public health protocol to address WUI fires. A review of the literature identified the need for standardized WUI fire guidance that is focused on improved preparedness and response. Aim: The FireReady OC quality improvement project aimed to develop an evidence-based public health protocol to improve Orange County’s public health preparedness and response for WUI fire events from 0% to 10% during the 12-week period from May 27, 2026, to …

Food For Thought: Building Confidence In Healthy Food Choices Among Seniors In A Residential Facility Through Nutrition Education, Amy Rodríguez

Master's Projects and Capstones

This quality improvement project evaluated the effectiveness of a 10-week nutrition education program designed to improve nutrition knowledge and confidence among independently living older adults residing in a low-income senior housing community. Aim By August 10, 2026, this project aimed to increase average nutrition knowledge and confidence scores related to selecting nutritious foods and preparing healthy meals by 20% among senior housing facility residents. Methods A microsystem assessment, literature review, SWOT analysis, fishbone diagram, and GANTT chart were completed to guide project development and implementation. Weekly nutrition education workshops were conducted over a 10-week period and included presentations, group discussions, …

The Efficacy Of Transversus Abdominis Plane Block As An Adjunct To Spinal Anesthesia For Cesarean Delivery: An Evidence Synthesis And Implementation Toolkit, Alyssa Hebert, Alex Potts, Gabriela Robertson

Graduate Theses, Dissertations, and Capstones

Postoperative pain hinders cesarean delivery recovery and overall patient experience. Although spinal anesthesia with intrathecal opioids remains the standard of practice, associated side effects and concerns regarding opioid exposure highlight the need for effective opioid-sparing strategies. Anesthesia providers play a critical role in advancing postoperative pain management through evidence-based protocol development, provider education, and interdisciplinary collaboration to optimize maternal outcomes. The transversus abdominis plane (TAP) block provides somatic analgesia to the anterior abdominal wall by targeting the thoracolumbar nerves (T6–L1) and has increasingly been incorporated into multimodal postoperative pain management strategies for abdominal surgery. Nevertheless, a gap remains in obstetric …

Standardizing Gestational Diabetes Group Education In An Outpatient Maternal-Fetal Medicine Clinic: A Quality Improvement Project, Nina Prieto

Master's Projects and Capstones

Gestational diabetes mellitus (GDM) requires timely and consistent education to support effective self-management and reduce maternal and fetal complications. Baseline assessment of an outpatient maternal-fetal medicine clinic identified variation in educational materials, teaching approaches, referral processes, scheduling, and workflows across English- and Spanish-language GDM group visits. This quality improvement project aimed to standardize the group visit process and increase staff compliance with standardized materials and workflows from 0% to 50% over a 12-week period. Data were collected through direct observation of group and individual education sessions, stakeholder feedback, review of existing materials, referral and attendance patterns, and workflow analysis. These …

Improving Nursing Adherence To Chg Bathing And Pivc Maintenance Practices To Reduce Hospital-Onset Bacteremia In An Adult Medical-Surgical Unit, Mohabat Barikzai, Dinazar Altamirano, Edward Rivas, Sarah Trilles

Master's Projects and Capstones

Preventing hospital-onset bacteremia (HOB) is a healthcare priority given its association with increased morbidity, mortality, prolonged hospitalization, and healthcare costs. Literature identifies inconsistent adherence to evidence-based practices for chlorhexidine gluconate (CHG) bathing and peripheral intravenous catheter (PIVC) maintenance as a modifiable risk factor for HOB. This quality improvement (QI) project evaluated whether implementing standardized nurse education, routine compliance audits, and performance feedback would improve adherence to evidence-based CHG bathing and PIVC maintenance practices. The project aimed to achieve at least 90% nursing compliance with HOB prevention practices over an intended 8-week implementation period. A pre-post quality improvement design was implemented …

Improving Pressure Injury Prevention Through Braden Scale Compliance And Education In The Emergency Department, Joycelyn Lee, Kira Simone Faerstain, Alyssa Kristine Ortiz, Ashley Briseida Cruz

Master's Projects and Capstones

Pressure injuries are a major burden in healthcare, particularly in the Emergency Department (ED). Patients can be sedentary for prolonged periods of time and don't always get their skin checked promptly. Patients visiting the ED often have comorbidities and patient-specific medical needs, such as seniors with fragile skin, malnourishment, immobility, etc. At a Southern Los Angeles Hospital, leadership found that there was a need for improvement in this area. Implementing standardized risk assessment methods can help to improve the consistent use of the Braden Scale as a predictive and preventive tool for identifying patients' risk for pressure injuries and promoting …

Nourishing Confidence: Empowering Seniors To Make Healthy Food Choices, Ina Patricia Bangawan

Master's Projects and Capstones

Objective This quality improvement (QI) project evaluated the effectiveness of a 10-week nutrition education program designed to improve nutrition knowledge and confidence in making healthy nutritional choices among independent older adults living in a low-income senior housing community. Aim By August 10, 2026 the goal of this project was to increase average nutrition knowledge and confidence scores related to selecting nutritious foods and preparing healthier meals by 20% among senior housing facility residents. Methods A microsystem assessment and gap analysis, literature review, SWOT analysis, fishbone diagram, and GANTT chart were completed to guide the project development and implementation. Weekly nutrition …

A Dosimetric Comparison Of Halcyon 6x-Fff And Truebeam 6x In Prone Left Whole Breast Radiation Therapy, Maritza Soto, Kelly Labant, M.S., Cmd, Rt(T), Kristen Vu, M.S., Cmd, Rt(T)

Masters Projects

Purpose:

This retrospective study compared dosimetric differences between prone left whole breast radiation (WBRT) treatment plans originally generated for Halcyon using 6X flattening- filter-free (FFF) beams and replanned for a conventional TrueBeam using 6X beams.

Methods:

Ten prone whole left breast treatment plans were paired and retrospectively analyzed. Clinically treated Halcyon 6X flattening filter free plans were replanned on TrueBeam using flattened 6X beams in Eclipse v16.1. Contours for all plans were generated using artificial intelligence-based autosegmentation, reviewed by a medical dosimetrist and radiation oncologist, and forward planned with a tangent technique in EZFluence to achieve identical planning objectives. Dose …

A Middle School Reading Intervention Framework, Ryan Patrick Eder

Masters Projects

Middle school students face increasing literacy demands as they transition from learning to read toward reading to learn content knowledge in science, social studies, and other subjects. However, reading intervention frameworks found in most elementary and middle schools may not fully meet the growing cognitive, academic, and affective needs of middle school students. The purpose of this project is to present a schoolwide reading intervention framework designed for middle school students. Drawing from current research, the proposed framework integrates daily, teacher-assisted intervention and enrichment with data-driven identification of students’ specific literacy growth points using rigorous, grade-level informational texts to provide …

Self-State Shifts During Nonsuicidal Self-Injury: Associations With Trauma History And The Functions Of Self-Harm, Katie E. Callahan

Dissertations, 2020-current

Nonsuicidal self-injury (NSSI) is a clinically significant behavior associated with substantial psychological distress and elevated suicide risk. Despite considerable research on the emotional triggers and functional implications of NSSI, the internal relational states activated during self-harm remain poorly understood. This study examined shifts in self-directed relational patterns during NSSI episodes using the Structural Analysis of Social Behavior (SASB) model and Interpersonal Reconstructive Therapy (IRT) theory. A cross-sectional secondary data analysis was conducted with 125 participants who reported current or past NSSI. Residualized change scores were computed to index shifts in self-state between general and NSSI conditions. Measures included the SASB-based …

Fall Risk In Community-Dwelling Adults: A Comparison Of English And Spanish-Speaking Individuals, Jesus D. Gomez

Dissertations, 2020-current

Falls are a leading cause of injury-related mortality among middle-aged and older adults. Although vestibular dysfunction, hearing loss, behavioral factors, and social determinants of health have been associated with increased fall risk, few studies have examined these relationships. Furthermore, limited research in audiology and vestibular science has investigated fall-risk vulnerability among Spanish-speaking individuals.

This study aimed to: (1) estimate the prevalence of fall risk among community-dwelling adults and compare prevalence between English-speaking and Spanish-speaking participants; (2) assess the prevalence of previously undiagnosed benign paroxysmal positional vertigo (BPPV) and compare prevalence between language groups; and (3) develop predictive models of fall …

Performing Methods Of Beethoven’S Violin Concerto In D Major, Op. 61, Third Movement: “Rondo: Allegro”, Zike Qi

Dissertations, 2020-current

This document examines the third movement “Rondo: Allegro” of Violin Concerto in D major, Op. 61 by Ludwig van Beethoven, focusing on how structural relationships in the score are transformed into auditory experience through performance methods. Rather than treating performance as a direct reproduction of the text, this research understands it as a process in which structure becomes perceptible in time.

Combining structural analysis, recording comparison, and self-recording practice, the study interprets the movement within a rondo–sonata framework (A–B–A–C–A–B–A). It demonstrates that the rondo theme assumes different functions—presentation, transition, and development—depending on its structural position.

Through comparison of recordings by …

In The Loop: Delivering Consistent, Compassionate Communication At Every Step Of The Ed Journey, Karina Basilio

Master's Projects and Capstones

Objective: Nearly 70% of patients in the emergency department (ED) at Hospital X are never roomed and instead wait in the main waiting area for evaluation, results, or disposition. Frequently, without structured updates on their plan of care, expected wait time, or next steps. This communication gap leaves patients feeling forgotten and disengaged from their own care. It is associated nationally with lower satisfaction, increased anxiety, and higher rates of patients leaving without being seen. Context: Hospital X is a mid-sized, community-based acute-care hospital in the Bay Area, California, serving a diverse patient population, with an ED that …

Cultural Tailoring Of Digital Nutrition Interventions: A Scoping Review Of Adaptation Strategies, Evaluation Methods, And Evidence Gaps, Wendy Liang

Master's Projects and Capstones

Background: Nutrition-related chronic diseases disproportionately affect culturally diverse populations, highlighting the need for effective and equitable interventions. Digital nutrition interventions have expanded rapidly due to their accessibility; however, the extent to which they incorporate and evaluate cultural tailoring remains unclear.

Research aim: This scoping review maps the existing evidence on culturally tailored digital nutrition interventions, describes cultural adaptation strategies used, examines methods used to evaluate cultural appropriateness, and identifies gaps for future research and public health practice.

Methods: A scoping review was conducted following the PRISMA-ScR guidelines.

Findings: Culturally tailored digital nutrition interventions generally improved participant engagement, acceptability, and dietary …

Behavior Of Magnetic Reconnection In The Relativistic Regime Under The Presence Of Shear Flows And Guide Field, Sarah Peery

Dartmouth College Ph.D Dissertations

Magnetic Reconnection is a ubiquitous phenomenon in plasma, where magnetic energy is released into plasma thermal and kinetic energy through the rearrangement of magnetic topology. In this study we derive fluid scaling models to predict the steady state and onset behavior of magnetic reconnection in the highly magnetized (relativistic) regime, in the presence of plasma shear flows and a (out-of-plane) guide field. We use 2.5D kinetic particle-in-cell simulations to motivate and validate these models. We find that, similar to the non-relativistic regime, shear flows parallel to the reconnecting magnetic field will delay reconnection onset and slow outflow jets. They can …

Building Fluent Readers: Developing Comprehensive Reading Fluency In K-2 Classrooms, Erika Yersak

Masters Projects

Despite extensive research establishing reading fluency as essential to literacy development, many early elementary students fail to achieve grade-level fluency, compromising their reading comprehension and academic success.  Fluency instruction has been narrowed to measuring reading speed, dismissed beyond third grade, and taught as an isolated skill disconnected from authentic reading across content areas.  While research demonstrates that fluency encompasses accuracy, automaticity, and prosody and should be integrated meaningfully across disciplines, many K-2 teachers lack practical resources and guidance for implementing comprehensive fluency instruction in their classrooms.

To address this gap, this project presents a research-based fluency integration guidebook for K-2 …

Establishing Partnerships Between Families, Schools, And Communities To Support Family Involvement In Literacy Education, Matraca Bourdo

Masters Projects

As the percentage of fourth grade students reading at a proficient level continues to decline, schools are seeking effective ways to improve literacy education and student achievement. Research emphasizes the importance of early literacy development in supporting academic success and lifelong learning. However, not all families have the same background knowledge of literacy skills and how to develop them with their children. Partnerships between schools, families, and communities can provide the support and resources needed while working toward the goal of improving student achievement.

The purpose of this project is to implement a team that partners with families to educate …

Teaching Phonics And Phonemic Awareness To Grow Reading, Brianna N. Wildey

Masters Projects

Research has revealed important information about students reading proficiently, yet most students in public schools throughout the country are reading below their grade level. As proficient readers, early elementary students need to know how to read the words on the page and understand what they mean. Students cannot read for knowledge or fun if they don’t know what the words are on the page. Two theoretical frameworks have informed this project to improve student reading. One is Orthographic Mapping Theory and the other is Alphabetic Phase Theory. This project explores the background of teaching reading, both past and present. Students …

Building Culturally Informed Classrooms Through Professional Learning, Samantha Grimm

Masters Projects

Black Americans remain disadvantaged within today’s current education system. Teachers are not always equipped with equitable resources and teaching practices to effectively teach literacy to historically marginalized groups, where cultural differences are complex. When teachers utilize a culturally informed pedagogy that values students’ cultural identities, personal and academic achievement are enhanced. Culturally informed instruction builds upon previous research by Gloria Ladson-Billings, Geneva Gay, and Gholdy Muhammad. This project is designed to support teachers when working alongside culturally diverse students. The resources created in this project are intended to create positive and equitable learning experiences for Black students. These students deserve …

Cultivating Civility: A Multicomponent Approach To Reducing Workplace Incivility In An Assisted Living Facility, Sanam Bral, Kaylyn Chang, Catherine Dinh, Sanjil Kumar, Truc Mai Moon

Master's Projects and Capstones

Workplace incivility remains a common challenge in healthcare, negatively affecting communication, staff well-being, and the quality and safety of resident care. Baseline survey findings from a faith-based assisted living facility in Southern California identified concerns related to workplace incivility, psychological safety, and gaps in staff knowledge of available reporting resources. This project aimed to reduce workplace incivility by improving staff knowledge and recognition of uncivil behaviors, with a target of at least 90% staff training attendance among nursing, assistive nursing, and medical technicians, and 80% attendee-reported high confidence level (agree or strongly agree) in recognizing incivility and understanding reporting options. …

Breaking The Silence: Standardizing Routine Intimate Partner Violence Screening At A Community Clinic Serving The Latinx Community, Victoria M. Hall

Master's Projects and Capstones

Intimate partner violence (IPV) affects the Latinx population disproportionately due to socioeconomic status, cultural stigma, and language barriers. However, routine screening remains inconsistent and unstandardized at a local community clinic in San Francisco’s Mission District, despite evidence-based practices recommending it. The gap in IPV screenings across the Adult, Teens, and Women’s clinics resulted in only 1.6% of patients being screened in July 2025 and 4.1% in June 2026. This quality improvement project aimed to address low screening rates by standardizing IPV screening through a printed bilingual screener, a 60-minute staff in-service on IPV and the new screening protocol, and by …

The Parkinson's Pathway: Enhancing Knowledge And Care Management In Skilled Nursing, Kaitlyn Chau

Master's Projects and Capstones

Parkinson’s disease (PD) is commonly diagnosed among the older population, contributing to high utilization of skilled nursing facility (SNF) services. Objective: SNF A’s current onboarding and training program for staff discussed general geriatric topics but failed to include structured PD-specific education. This may lead to gaps in competence, confidence, and workflow related to PD care and management, resulting in low quality of patient care, poor health outcomes, and decreased safety and satisfaction. Aim: The project aimed to establish and incorporate a structured PD-specialized education program within a SNF located in Northern California, to increase employees’ self-reported confidence, competence, …

Beyond The Tremor: Building Interdisciplinary Confidence In Parkinson's Disease Management Through Structured Education, Roya Oreo

Master's Projects and Capstones

Abstract

Objective: Parkinson’s Disease (PD) is a neurodegenerative disease that is commonly seen in skilled nursing facilities (SNF). Gaps in knowledge among clinical staff regarding PD-specific care have resulted in negative outcomes such as delayed medication administration, unmet activities of daily living (ADL) needs, restricted mobility, and dissatisfaction with care from residents and family members. At a 55-bed SNF in Northern California, clinical staff self-reported 60% confidence in their ability to care for and manage residents with PD. This reflects a need for structured, evidence-based education, specific to Parkinson’s Disease. Aim: This quality improvement (QI) project aimed to increase the …

Steady Steps: Building Confidence In Parkinson’S Disease Care, Jerlyn T. Nicdao

Master's Projects and Capstones

Parkinson’s disease is a movement disorder that greatly impacts one’s quality of life due to its worsening progression and impact on cognitive and physical functions. Objective: The purpose of this quality improvement project is to strengthen staff confidence and competence in caring for residents with Parkinson’s disease (PD) living in a skilled nursing facility. Aim: Clinical nurse leader (CNL) students aim to increase staff confidence and competence in PD care from 60% to 75% over a six-week period, from June 18, 2026, to July 30, 2026. Method: A total of thirteen interdisciplinary staff members (e.g. registered nurses, licensed vocational nurses, …

Synthesis, Utilization And Biological Evaluation Of Β-Hairpin Peptides As Inhibitors Of Immune Checkpoints, Sarah Naylon

Electronic Theses and Dissertations

Peptide therapeutics have emerged as promising alternatives to monoclonal antibodies because of their smaller size, improved tissue penetration, and synthetic versatility. Yet their broader application is often limited by poor structural stability, rapid clearance, and reduced target residence times. This dissertation describes the design, synthesis, structural characterization, and biological evaluation of β-hairpin peptides as inhibitors of immune checkpoints and as peptide vaccine scaffolds while developing strategies to overcome these limitations. At first a series of antibody-derived β-hairpin peptides (mimics of complementary determining region heavy-chain 3: CDR-H3s) as covalent inhibitors of the PD-1/PD-L1 immune checkpoint were investigated. Electrophilic warheads were incorporated …

African American Gold Star Mothers: Race, Black Motherhood, Loyalism And European Superiority In The First World War, Giovanni Nickolette Gibbs

Masters Theses, 2020-current

This thesis examines the US government’s pilgrimages for Gold Star Mothers of the First World War. It focuses on the Jim-Crowing of black Gold Star Mothers. Through the analysis of archival records, letters, telegrams, newspaper articles, poems, and secondary literature, the thesis explores how two domineering forces, the National Association for the Advancement of Colored People and the federal government of the United States of America, captured dissension when seeking to send black Gold Star Mothers on segregated pilgrimages to Europe. The War Department’s announcement that the widows’ pilgrimages to Europe in the 1930s would be segregated caused a great …

Antigen Discovery In Multiple Myeloma Using Integrated Long-Read Transcriptomics And Immunopeptidomics, Aya Albittar

Dissertations and Theses (Open Access)

Multiple myeloma (MM) remains an incurable plasma cell malignancy, with relapse driven by persistent chemotherapy-resistant cells and residual disease following treatment. Although immunotherapies have transformed MM care, their success depends on identifying tumor-specific antigens that can be safely targeted. While aberrant genomic structural variation and transcriptional dysregulation are increasingly recognized as sources of novel antigens in MM, the HLA-presented antigenic landscape of MM remains incompletely characterized, particularly for non-canonical, structurally-derived peptides, and long-read transcriptome-informed immunopeptidomic data specific to MM remain scarce.

We established an integrated antigen discovery platform combining long-read RNA sequencing (Iso-Seq) with mass spectrometry-based HLA immunoprecipitation and immunopeptidomics …

Dual-Polymer Concrete With Recycled Pet And Hdpe Aggregates: Mechanical And Durability Performance Assessment, Omar Abd El Mageed Hammouda

Theses and Dissertations

This study investigates the fresh, mechanical, durability, thermal, performance as well as preliminary financial aspects of dual-polymer concrete incorporating recycled polyethylene terephthalate (PET) as a partial replacement for fine aggregate and recycled high-density polyethylene (HDPE) as a partial replacement for coarse aggregate, with silica fume as a supplementary cementitious material held constant at 10% by weight of cement. The study responds to the convergence of two pressing challenges in the Egyptian context: the scale of plastic waste mismanagement, which results in widespread informal open burning and environmental contamination, and the high operational energy demand of residential buildings in Egypt's hot …

Long-Term Effects Of Harvesting Disturbance And Site Preparation On Soil Properties And Tree Growth In A Loblolly Pine (Pinus Taeda) Forest, Kyle M. Caccamesi

LSU Master's Theses

Productivity decline between rotations has long been a concern in intensively managed forest plantations. Research done over the last century has provided greater clarity on why this phenomenon occurs. The objective of this research was to observe long-term soil and tree growth characteristics that are likely to be influenced by operational harvesting activities. The experiment was conducted in Washington Parish, Louisiana on a site dominated by Ruston soil series, a well-drained, fine loamy, siliceous and thermic typic Paleudult. A randomized complete block design with 2 x 2 x 2 factorial treatments was used. The treatment factors were harvesting method, fertilization, …