Digital Commons Network^™

Managerial Strategies For Increasing The Engagement And Retention Of Retail Employees, Dorothy Kelly Williams

Walden Dissertations and Doctoral Studies

A lack of employee engagement strategies to increase worker retention is a concern for managers in the retail industry. This problem is important because without such strategies, organizations may experience turnover, which undermines operational stability, customer experience, and profitability. Grounded in employee engagement theory, the purpose of this qualitative pragmatic inquiry was to identify and explore effective employee engagement strategies that retail managers use to increase employee retention. Participants were six retail managers in the southern United States, each with at least 3 years of experience managing employees. Data sources consisted of semistructured interviews, public documents, and related studies. Thematic …

Draining The Risk, Holding The Line: A Nurse-Driven Approach To Catheter-Associated Urinary Tract Infection Prevention, Thy Nguyen

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over …

Set-Valued Conjugate Calculus And Duality In Optimization And Machine Learning Via Generalized Relative Interiors, Gary Lee Sandine

Dissertations and Theses

Convex analysis, optimization, and duality theory are broadly applicable to a multitude of real-world problems. Theoretical frameworks ensuring strong duality and optimality are fundamentally tied to convex separation under qualification conditions frequently involving topological or relative interiors. These can be empty in convex sets that appear naturally in infinite-dimensional models, yet guarantees of optimality and strong duality are often attainable. This dissertation presents frameworks for applying convex separation via generalized relative interiors to develop generalized calculus rules as well as conditions for strong duality and optimality for infinite-dimensional constrained convex optimization problems.

The first major contribution is the introduction of …

Role Of Central And Peripheral Nlrp3 In Parkinson's Disease Models, Elisa Carloni

Dartmouth College Ph.D Dissertations

Neuroinflammation, particularly NLRP3 inflammasome activation, has been implicated in Parkinson's disease (PD) neurodegeneration, but the cell-type-specific contributions of NLRP3 activity remain poorly understood. This dissertation tested whether NLRP3 activation in microglia versus peripherally derived myeloid cells differentially drives Parkinsonian pathology. Microglial NLRP3 gain-of-function was achieved using Nlrp3^L351P crossed with Tmem119-CreER, both on an Nlrp3^⁻/⁻background. For peripheral myeloid cells, an analogous Ms4a3-Cre-driven strategy resulted in perinatal lethality of animals with Nlrp3^L351P restricted to granulocyte-monocyte progenitors (GMPs). Instead, we used Ms4a3-Cre tdTomato reporter mice generated on wild-type and Nlrp3^⁻/⁻backgrounds to fate-map GMP-derived …

Dosimetric Comparison Between Geometric Centroid And Minimax Isocenter Placement In Single Isocenter Multitarget Stereotactic Radiosurgery Plans In Hyperarc, Matthew Gloudeman

Masters Projects

Single-isocenter multi-target (SIMT) stereotactic radiosurgery (SRS) utilizing Varian HyperArc streamlines clinical workflows but introduces geometric sensitivity for distant outlier lesions when rotational and setup uncertainties are taken into account. The default isocenter location in the HyperArc workspace is the geometric centroid, which is inherently biased toward clusters of lesions. This study evaluates the dosimetric plan quality of an alternative minimax isocenter strategy, which minimizes the maximum lesion-to-isocenter distance, shortening the rotational lever arm to enhance mechanical robustness. Two fractionated SRS (fSRS) plans were generated for ten patients with 3-5 brain metastases using identical beam configurations: one using HyperArc’s default geometric …

The Impact Of Scar Wires On Dose Distribution Of Electron Fields, Ahmad Nour

Masters Projects

Purpose: This phantom study looked at whether changing the Hounsfield unit (HU) value for radiopaque scar wires in Eclipse changed the calculated electron dose distribution. Methods and Materials: Radiopaque wires were placed in the same abdominal area on an anthropomorphic phantom. The wires were set up in a circle. The CT images were brought into Eclipse, the wires were contoured, and the planning target volume was made 1 cm inside the circle of wire. For every wire size and electron energy, two matching plans were made: one plan with no density override and one plan with a density override applied …

Cone Vs. Volumetric Modulated Arc Therapy (Vmat) Stereotactic Radiosurgery (Srs) Planning For Multiple (7) Brain Targets: Dosimetric Tradeoffs And Clinical Decision Guidance, Juan Garcia

Masters Projects

Purpose: This study compared cone-based stereotactic radiosurgery (SRS) and single-isocenter volumetric modulated arc therapy (VMAT) for multiple (7) intracranial targets to evaluate differences in target coverage, conformality, dose falloff, and normal brain exposure.

Methods: A phantom-based study was performed using progressively increasing configurations of 10-mm spherical targets, from one to seven targets. Cone-based SRS and VMAT plans were evaluated using D99, CI100, CI50, gradient index (GI), maximum dose, V12Gy, and V5Gy.

Results: Both planning techniques achieved similar target coverage. Cone based SRS produced a steeper dose gradient, with a mean GI of 2.99 compared with 4.66 for VMAT ( …

The Gut-Bladder Axis: How Symbiont Microbes Alter Urinary Tract Infections, Benjamin S. Olson

Arts & Sciences Graduate Student Theses and Dissertations

Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. Consequently, they are one of the leading indications for antibiotic prescription. Despite the typically successful treatment of an acute UTI, recurrent infections are exceedingly common, particularly among women. Nearly a quarter of otherwise healthy women will suffer recurrent UTIs (rUTI) after a primary UTI; why these select individuals are continually afflicted is unkown. There are no successful therapeutics to treat rUTI representing a gap not just in the medical toolkit but in our understanding of why rUTI is so prevalent. There are many hypotheses for the risk factors …

Family Religious Socialization Index: Development And Preliminary Validation, Kaelie Rene Crockett

Theses and Dissertations

A key area of interest for religious scholars is how religious beliefs are passed across generations, or religious socialization. To expand this field of study, a theoretically grounded, validated measure of this construct is needed. This article describes the development and validation of the Family Religious Socialization Index (FRSI), a multi-informant, multidimensional assessment of the processes through which parents socialize religion and faith in their children. Based on Social Cognitive Theory and through a rigorous development and validation process, three subscales were developed to represent the primary processes of religious socialization. The FRSI consists of two parallel scales, a parent …

Hybrid Photonic–Electronic Neuromorphic Integrated Circuits, Lilian Neim

Theses

Photonic neural networks use integrated photonic circuits to perform neural network operations with high bandwidth and the potential for energy-efficient computation. In these systems, optical device responses can represent weights, and wavelength division multiplexing enables multiple wavelength channels to be processed in parallel within the same waveguide. However, scalable photonic neural network hardware needs weights that can be programmed, stored, and read reliably. Many current approaches require continuous electrical or thermal tuning to hold the optical state. This dissertation addresses this challenge by developing a hybrid photonic-electronic approach to non-volatile electro-optic memory. Here, we design and demonstrate a non-volatile electro-optic …

Improving Pain Reassessment Within One Hour Of Pain Medication Administration, Geraldine B. Macalma

Master's Projects and Capstones

Abstract

Problem: Timely reassessment of pain is often missed or inconsistently documented, creating a gap between evidence-based standards and actual nursing practice. This inconsistency prevents evaluation of intervention effectiveness and contributes to unmanaged pain, reduced patient satisfaction, and safety concerns.

Context:  Pain reassessment is a critical component of evidence-based pain management, ensuring that nurses evaluate the effectiveness of interventions and adjust care accordingly.  Competing priorities and documentation challenges often lead to inconsistent reassessment, affecting patient comfort, safety, and overall quality of care.

Interventions: Guided by a Plan-Do-Study-Act framework, the intervention included documentation of a safety round, purposeful hourly rounding, …

Identifying The Brain Circuits Involved In Religious Obsessive-Compulsive Disorder, Kiana Bunnell

Theses and Dissertations

Obsessive-compulsive disorder (OCD) is an often-debilitating psychiatric disorder involving a pattern of obsessive thoughts and compensatory compulsions. Symptoms tend to be chronic, leading to substantial emotional burden and significant impairment across multiple domains of daily functioning. Previous research has identified some consistency in the brain regions implicated in OCD. In particular, cortico-striato-thalamo-cortical (CSTC) circuitry has been linked to behavioral features commonly observed in OCD. Moreover, some studies suggest that distinct patterns of brain activation and functional connectivity may be associated with different OCD symptom dimensions, though findings have not been consistent. One symptom dimension of OCD (scrupulosity) is characterized by …

Modifying Lta Zeolites For Reversible Hydrogen Sulfide Capture And Elucidating The Structure Of The Incorporated Metal And Sulfur Ions, Adeyemi D. Ojaide

Theses and Dissertations

Hydrogen sulfide (H2S) is a highly toxic and corrosive gas that poses significant environmental and industrial challenges, particularly within the wastewater treatment and oil and gas sectors. H2S leakage is among the deadliest industrial hazards, highlighting the urgent need for the development of highly efficient, non-corrosive adsorbents. This dissertation provides an in-depth examination of the use of metal-zeolites for H2S capture. We carefully investigate the impact of multiple divalent and one monovalent transition metals on LTA zeolites to optimize H2S removal. While Linde Type A (LTA) zeolites offer a robust structural framework for gas separation, a comprehensive understanding of how …

Is “No Change” Really No Change?: A Qualitative Analysis Of Clients With “No Change” On Routine Outcome Monitoring Who Report Improving In Therapy, Audrey Louise Stewart Parker

Theses and Dissertations

Routine outcome monitoring (ROM), the practice of tracking client progress in therapy by administering regular questionnaires to assess functioning, has demonstrated a significant positive effect on psychotherapy outcomes, especially for clients are who not improving as expected. However, some researchers argue the symptom-based measures and outcome classification criteria commonly used in ROM may not represent a complete picture of client change. A recent body of mixed-methods research has investigated these ROM-determined outcome categories to gain insight into client experiences and whether the category and client perception of therapy outcome align. In this investigation, researchers have found significant variety within outcome …

Implementing A Standardized Counting Process, Paula M. Mbye

Master's Projects and Capstones

Abstract

Background: In a Northern California medical center with 11 operating rooms, two retained foreign object (RFO) events occurred following surgical procedures in 2025.

Problem: Surgical teams rely on manual counting processes to prevent retained foreign objects. Variability in counting practices among registered nurses and surgical technologists, combined with workflow interruptions and environmental distractions, can increase the risk of counting discrepancies and missed items. Standardizing the counting process may improve count accuracy and reduce the risk of RFOs.

Interventions: This quality improvement project implemented a standardized surgical counting process based on Association of periOperative Registered Nurses (AORN) guidelines within …

Dosimetric Comparison Of Hybrid 3d Conformal Radiation Therapy And Volumetric Modulated Arc Therapy Versus Vmat-Only Planning For Accelerated Partial Breast Irradiation, Erjona Jusufi

Masters Projects

Abstract

Purpose: To compare dosimetric outcomes between volumetric modulated arc therapy (VMAT)-only and hybrid VMAT plus three-dimensional conformal radiotherapy (3D-CRT) techniques for accelerated partial breast irradiation (APBI) in patients with early-stage left-sided breast cancer.

Methods and Materials: Thirty patients treated with APBI at a single institution were retrospectively replanned using both VMAT-only and hybrid (VMAT + 3D-CRT) techniques. All plans were prescribed 26 Gy in 5 fractions. Each patient was planned using the same target volumes, optimization objectives, and evaluation criteria for both techniques. Planning target volume (PTV) coverage, conformity index (CI), homogeneity index (HI), hotspot control, organ-at-risk (OAR) doses, …

Staff Education To Enhance Phq-9 Depression Screening Compliance, Chibugo Chukwu

Walden Dissertations and Doctoral Studies

This staff education quality improvement project at Clinic P targeted the clinical problem of depression under-diagnosis, evidenced by less than 60% of patients completing the patient health questionnaire (PHQ-9) before the initiative. Depression under-diagnosis, significantly caused by provider PHQ-9 screening competency deficits that need to be addressed through staff education, is associated with adverse patient health outcomes, in turn generating negative implications for providers and wider society. The problem compromises the quality of nursing care because it limits nurses' ability to intervene and deliver timely and effective care to patients with depression. Thus, at Clinic P, this initiative asked how …

Staff Education To Address Verbal De-Escalation Skills In Correctional Mental Healthcare, Mary L. Goodman

Walden Dissertations and Doctoral Studies

This staff education project evaluated the effects of a structured verbal de-escalation training program on self-efficacy among staff in a federal correctional mental health unit. Staff at the site often reported uncertainty managing escalating behaviors, leading to frequent use of restrictive interventions like restraints and seclusion—practices that can compromise safety, quality of care, and raise ethical concerns. To address this gap, an evidence-based curriculum was implemented for 41 multidisciplinary staff, including nurses, certified nursing assistants, and correctional officers. The curriculum included a PowerPoint presentation, role play, and group discussion. A pre–post design measured changes in staff confidence using a modified …

A Program Proposal For An Evidence-Based Dietary Program To Support Spanish Speaking Diabetic Patients, Shaquetta Ann Mccloud-Petion

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) executive leadership system improvement project addresses provider-identified gaps in dietary education for Spanish-speaking patients with diabetes, which may contribute to suboptimal glycemic control and diabetes self-management. A comprehensive review of evidence from CINAHL Complete, PubMed/MEDLINE, and Cochrane supports the use of culturally tailored, evidence-based dietary education to improve diabetes knowledge, self-management behaviors, and health outcomes. The project proposes the development and implementation of a standardized dietary education program using culturally appropriate dietary exchange tools within an outpatient clinic. The initiative aims to improve staff confidence, adoption, and consistency in delivering culturally responsive diabetes education …

The Lived Experience Of Running Among Individuals With Anxiety, Emily Rice

Walden Dissertations and Doctoral Studies

Anxiety is among the most prevalent mental health concerns affecting adults, yet many individuals encounter barriers to traditional mindfulness-based interventions. Running is frequently described as promoting presence, mental clarity, emotional grounding, and relief from anxiety-related distress; however, little qualitative research has explored how adults with anxiety make meaning of their lived experiences of running. The purpose of this interpretative phenomenological analysis (IPA) study was to explore how adults with anxiety describe and make meaning of their lived experiences of running. Guided by embodied cognition and informed by mindfulness and flow theories, this study explored participants' lived experiences of running. Participants …

K–3 Teachers’ Perspectives Regarding Learnable Intelligence As A Developmental Target And Their Advocacy For Students’ Cognitive Capabilities, Eleanor Nkechi Maduako

Walden Dissertations and Doctoral Studies

Extensive research shows the brain is malleable and, with experience and knowledge, intelligence can grow. The research problem addressed through this study was that the extent of early childhood educators' knowledge of learnable intelligence and their advocacy for advancement of children’s cognitive capabilities as a developmental goal were unknown. Guided by Perkins’s theory of learnable intelligence, the purpose of this basic qualitative study was to explore K–3 teachers’ perspectives on learnable intelligence as a developmental target and how they advocate for children’s cognitive capabilities in their classrooms. In vivo and axial coding of data from semistructured interviews with 12 participants …

Influence Of National Policies In Addressing Intimate Partner Violence In Sierra Leone, Yatta Matilda Musa

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) has been shown to be a critical public health and human rights crisis in Sierra Leone driven by patriarchal sociocultural norms. However, despite legislative frameworks like the Domestic Violence Act of 2007, IPV incidents continue to rise, revealing a gap in policy implementation and real-world enforcement. Past research has documented IPV prevalence, yet an empirical evaluation assessing how stakeholders viewed the impact of national policies on prevention and response had not been conducted. The purpose of this study was to explore frontline stakeholders' perceptions regarding the operational influence of existing IPV policies. Grounded in the narrative …

The Role Of Political And Media Narratives In Housing Affordability, Craig Anthony Bardo

Walden Dissertations and Doctoral Studies

The problem addressed in this study was that persistent reliance on market-oriented affordability strategies continued despite evidence of declining housing affordability in Nashville. Understanding how policy narratives structured accepted solutions may help explain the persistence of existing policy approaches. Research has shown that housing affordability is a significant policy concern in many U.S. cities. Rising housing costs, displacement pressures, and persistent rent burdens have been indicated in studies as contributing factors. However, less attention has been paid to how political and media narratives shape the boundaries of recognized housing policy solutions within local discourse, specifically in Nashville, Tennessee. The purpose …

Staff Education To Improve Knowledge On Accurate Administration Of Medication, Deepu Pudasaini

Walden Dissertations and Doctoral Studies

Medication errors have been a significant problem, primarily due to a lack of continuous monitoring and inadequate training for personnel involved in managing or administering medications in non-healthcare settings. These errors often go undetected or unreported. This Doctor of Nursing Practice (DNP) project was a staff education project to improve staff knowledge of accurate medication administration of medication in a group home. The practice-focused question was: Will a staff education program on the accurate administration of medication improve certified medication technicians’ (CMTs) knowledge about the association between the medication administration process and medication error? The purpose of this DNP staff …

Staff Education To Reduce Foley Catheter Utilization In Patients With Acute Urinary Retention, Dennis Ulep

Walden Dissertations and Doctoral Studies

Acute urinary retention (AUR) is a common inpatient condition associated with complications such as urinary tract infections, prolonged hospitalization, and impaired mobility when not managed appropriately. Despite evidence supporting intermittent catheterization as a preferred first-line intervention for many patients with AUR, indwelling Foley catheters continue to be overused in acute care settings. Purpose: This Doctor of Nursing Practice (DNP) project evaluated whether staff education on a standardized AUR algorithm would improve evidence-based urinary retention management and reduce unnecessary Foley catheter utilization among nurses caring for adult hospitalized patients on a hematology and oncology unit in a Southern California acute care …

Exploring The Psychosocial Barriers To Kidney Transplant For African Americans In Southern Florida Diagnosed With End-Stage Renal Disease, Erica Lindsey Mitchell

Walden Dissertations and Doctoral Studies

African Americans experience disproportionately high rates of end-stage renal disease (ESRD) yet continue to experience disparities in access to kidney transplantation, the preferred treatment for ESRD. The purpose of this qualitative action research study was to explore the psychosocial barriers to kidney transplantation for African Americans living with ESRD in south Florida. This capstone project was guided by the tenets of intersectionality theory. Data was obtained through semi-structured interviews with four human services professionals and analyzed using thematic analysis. The findings revealed six interconnected themes: a) social support, b) practical barriers, c) psychological and cognitive barriers to transplant navigation, d) …

Effective Strategies To Implement Energy-Efficient Practices In Enterprise Cloud Data Centers: A Qualitative Pragmatic Inquiry, Joshua Tremayne Campbell

Walden Dissertations and Doctoral Studies

Cloud computing has increased electricity use in data centers, leading to higher costs and a larger carbon footprint. Information Technology (IT) leaders need to address this, as such inefficiencies will increase operational costs, undermine sustainability commitments, and leave companies unprepared for future regulatory pressures. Energy-efficient technologies can reduce data center energy consumption by 40-60%, yet few studies examine the qualitative processes behind IT leaders' practices. The specific IT problem is that some IT leaders lack effective strategies to implement energy-efficient practices in enterprise cloud data centers. Grounded in the technology-organization-environment (TOE) framework, the purpose of this qualitative pragmatic inquiry was …

Standardizing Interfacility Transfer In And Out Processes Across The Local Va Setting, Petrice Robinson Brown

Walden Dissertations and Doctoral Studies

The quality improvement project focused on the inconsistent documentation and communication of the transfer of veterans in and out of a Veterans Affairs Medical Center. Lack of transparency in handoff knowledge and ineffective documents posed a risk of delayed care and patient injuries. The staff provided an audit tool with staff education to monitor completion of mandatory transfer steps, such as special mode travel approval, equipment needs, nurse-to-nurse handoff, transfer notes, consent, and physician correspondence. This method was based on the evidence found in literature indicating that structured checklists and handoff tools minimize missed information and facilitate safer care transitions …

Improving Documentation Of Skin Assessment In The Med-Surg Overflow Microsystem, Min Kim, Mikeal A. Swift

Master's Projects and Capstones

Abstract

Problem

Hospital-acquired pressure injuries (HAPIs) remain a costly patient safety concern with increased morbidity and prolonged hospitalization. Inconsistent admission skin assessment documentation in a 24-bed overflow medical–surgical microsystem led to delayed wound identification and misclassification.

Context

A baseline needs assessment (n = 15) identified key barriers, including low nurse confidence utilizing Rover (mobile software application) and linking photos to the LDA (lines-drains-airway) in the electronic health record.

Intervention

A bundle of 6 components was tested over 12 weeks: standardization of the two-RN skin assessments within 8 hours of admission or transfer; optimization of Rover photo capture and LDA linkage; …

Experiences Of Resilience During Divorce For Black Women Who Attend Church, Tracey Ann Grant

Walden Dissertations and Doctoral Studies

Across the globe, divorce is a challenging situation that affects family relationships and disrupts social networks. Divorced women often experience a decline in their health and well-being immediately postdivorce. The problem addressed in this study is that divorcing women tend to experience more negative or undesirable impacts on their mental health (e.g., depression) postdivorce than men and often find involvement in church to be a source of support or added stress. The purpose of this generic qualitative study was to investigate how recently divorced Black women describe how their involvement in church may have supported their mental health and resilience …