Digital Commons Network^™

Public Perceptions Regarding Surveillance Of Lyme Disease In Tennessee, Shaheena Yasmin Asad

Walden Dissertations and Doctoral Studies

Lyme disease (LD), a tick-borne illness, has been a growing concern in the state of Tennessee. Studies have established environmental concerns regarding a growing tick population and identified a gap between reported cases and disease burden in Tennessee. Despite this information, it remains classified as a low-incidence reporting state, raising concerns about underreporting that indicate an ineffective current surveillance system. Because the public perception regarding surveillance of LD is unknown, the purpose of this qualitative study was to explore how adults in Tennessee perceived LD as a credible public health threat within the context of the current surveillance system. Guided …

Improved Depression Screening In An Outpatient Mental Health Clinic Using The Phq-9, Meghan Rey Young

Walden Dissertations and Doctoral Studies

Depression is a common mental health disorder in the United States that places significant burden on the individual, the community, and the country. It is estimated that 7.8% of adults in the U.S. experienced major depression in 2019. Having a depression diagnosis places the individual at increased risk for suicide by 31%. Therefore, it is important to screen for depression. In a small outpatient mental health clinic, a gap in practice was identified as a lack of depression screening at patient encounters. The question was asked: In the outpatient clinical setting, what is the impact of improved use of the …

Early Childhood Teachers’ Perceptions Of Early Childhood Teacher Leadership, Their Leadership Experiences, And Teacher Leadership Skill Development, Danyle Watkins

Walden Dissertations and Doctoral Studies

The problem that was addressed in this study is that research into early childhood leadership has focused on early childhood directors and programs for leadership, but little research has been conducted on early childhood teachers’ (ECTs’) perceptions of the ECT leadership. Guided by the McCormick Center Whole Leadership Framework, the purpose of this basic qualitative study was to explore ECTs’ perceptions on characteristics of teachers as leaders, their leadership experiences, and their leadership skill development in a Midwestern U.S. state. Data were collected through semistructured interviews with 10 ECTs employed in licensed early childhood centers serving children from birth through …

Consistent Phq-9 Administration At Mental Health Watch Initiation And Discharge In A Correctional Setting, Gouni Aicha Bouraima

Walden Dissertations and Doctoral Studies

This staff education project addressed inconsistent Patient Health Questionnaire-9 (PHQ-9) administration and documentation at mental health watch initiation and discharge in a correctional setting. A baseline audit showed 42.1% PHQ-9 documentation compliance (8 of 19 charts), below the 90% organizational benchmark, limiting objective depression severity data needed for clinical decision-making and safe transitions. The practice-focused question was: Among nurses working with incarcerated individuals at mental health watch initiation and discharge, what is the impact of staff education on nurses’ knowledge of PHQ-9 screening protocols? The purpose was to implement structured staff education to improve nurses’ knowledge of PHQ-9 trigger points, …

Improving Suicide Risk Identification Through Standardized Implementation Of The Columbia–Suicide Severity Rating Scale (C-Ssrs) In An Adult Outpatient Behavioral Health Setting, Mirabel Ngwe Boma

Walden Dissertations and Doctoral Studies

Suicide risk may fluctuate throughout treatment, making ongoing assessment essential for timely identification and intervention. At the project site, an adult outpatient behavioral health practice, the Columbia–Suicide Severity Rating Scale (C-SSRS) was administered consistently at intake but inconsistently at follow-up visits, creating gaps in suicide risk reassessment and documentation. The purpose of this quality improvement project was to evaluate the effect of standardized implementation of the C-SSRS during intake and follow-up visits on suicide risk screening compliance over a 9-week period. The practice-focused question asked how standardized implementation of the C-SSRS, compared with current practice, affected suicide risk screening compliance …

Reducing Primary Cesarean Births Among Nulliparous, Term, Singleton, Vertex (Ntsv) Patients Through Structured Multidisciplinary Communication, Toyin Ajani

Master's Projects and Capstones

Background: Primary cesarean birth among nulliparous, term, singleton, vertex (NTSV) patients remained a persistent quality and safety concern in obstetric care. Unnecessary cesarean birth was associated with increased maternal morbidity, neonatal complications, prolonged recovery, higher healthcare costs, and adverse outcomes in subsequent pregnancies. Problem: A Northern California labor and delivery unit identified an elevated NTSV cesarean birth rate of 26.8%, exceeding the national benchmark of approximately 23%. Variability in provider communication, inconsistent labor management practices, and lack of standardized interdisciplinary collaboration contributed to this quality gap. Context: The project was conducted in a high-volume labor and delivery microsystem serving a …

Improving Peer Feedback Participation Through Psychological Safety Interventions In Labor & Delivery Nurses, Lindsey C. Hora

Master's Projects and Capstones

Abstract 

Background: Labor and Delivery (L&D) units require effective communication, speaking up, and team learning to support safe care. Psychological safety informed this quality improvement project as a contextual strategy to strengthen peer feedback engagement.  

Problem: Peer feedback participation among eligible L&D registered nurses at a large acute care hospital in Santa Clara, California, was 14.29% (N = 112) below the 30% project target and 80% organizational target. Low participation limited routine feedback for professional development, recognition, and team learning.

Interventions: Interventions included psychological safety education, peer feedback reinforcement, workflow integration, platform navigation support, dedicated completion time, and unit champions. …

Implementation Of Visual Bed Indicator Lights To Improve Fall Prevention Processes, Andrea Leffew

Master's Projects and Capstones

Problem: Inpatient falls remain a significant patient safety concern associated with preventable patient harm, prolonged hospitalization, and increased healthcare costs. Routine fall bundle validations identified inconsistent adherence to safe bed configuration practices, such as beds left raised and bed alarms turned off.

Context: A 3-month quality improvement project was implemented on a 20-bed medical-surgical telemetry unit within an integrated healthcare delivery system at a 130-bed community hospital in Northern California, which was experiencing an increase in inpatient falls and fall-related sentinel events.

Interventions: Implementation of bed-monitoring technology with visual indicator lights that provided real-time feedback on bed configuration.

Measures: The …

Experimental Material Analysis And Load Monitoring Of Polyurethane–Steel Belts Subjected To Static And Cyclic Dynamic Loading: Implications For Continuous Mooring Line Systems In Wave Energy Converters, Youssef Mohamed

Electronic Theses and Dissertations

This study experimentally investigates the mechanical and viscoelastic behavior of a steel-cord-reinforced polyurethane synchronous belt capable of withstanding continuous cyclic loading as a potential compliant mooring element for WEC applications. Quasi-static and cyclic tensile tests were conducted to characterize the belt's mechanical response. The quasi-static determined that the belt behaved as a stiff, low-strain tensile member. Under approximately 100 kgf, the belt extended by about 0.107mm over a 250mm gauge length, apparent tensile modulus of 5.41GPa, an axial rigidity of 2.44MN, and an equivalent line stiffness of 9.75MN/m. Cyclic tensile testing showed high dynamic stiffness with stiffness-transfer ratio of 0.924. …

Developing Confidence And Motivation In Writing Through Authentic And Collaborative Writing Approaches, Sara J. Weeks

Masters Projects

Writing is an expressive and complex process that takes time to develop, yet writing in middle school classrooms is primarily used as a way to demonstrate mastery of content rather than develop writers. Writing instruction is limited or used inefficiently in today’s classrooms, which gives students fewer opportunities to engage in authentic writing experiences. As a consequence, middle school students report a lack of confidence and motivation to write. These conditions contribute to stagnant writing achievement for middle school students. Research suggests that improving student writing outcomes requires writing environments that provide authentic, collaborative, and process-oriented writing experiences. However, these …

Supporting Students’ Self-Efficacy And Motivation In The Mathematics Classroom, Audrie H. Cox

Masters Projects

This project examines the role of mathematics self-efficacy in supporting student motivation, engagement, and achievement in secondary mathematics classrooms. Through a review of current research, the project identifies instructional practices that strengthen students' confidence in their mathematical abilities, including formative assessments, meaningful feedback, supportive teacher-student relationships, and opportunities for productive struggle. Drawing on these findings, a professional development workshop session was developed to equip secondary mathematics teachers with practical, research-based strategies that promote positive mathematics self-efficacy and improve overall classroom instruction. By translating research into actionable teaching practices, this project aims to support more confident, motivated, and successful mathematics learners.

Evaluating Diagnostic Information Preservation In Weakly Supervised Medical Imaging, Vinceline Bertrand

Electronic Theses and Dissertations

Weakly supervised medical imaging models trained with coarse image-level labels often report strong performance on metrics such as accuracy and AUC. This thesis argues that these metrics can be misleading: a model may succeed on a coarse diagnostic task while failing to preserve the fine-grained information needed for consequential clinical decisions. It makes this failure measurable through the diagnostic gap, defined as the divergence between coarse and fine-grained diagnostic preservation, across three connected studies. The first shows that near-perfect ovarian ultrasound accuracy reflects visual separability rather than pathological understanding. The second measures the diagnostic gap in a mammographic pipeline, where …

Decreasing Icu Clabsi Through Improved Central Line Dressing Integrity, Sharmila Reyes Moreno

Master's Projects and Capstones

Problem: Central line-associated bloodstream infections (CLABSIs) are a significant source of preventable patient harm, increased healthcare costs, and prolonged hospital stays. In a 20-bed medical-surgical ICU, CLABSI events increased from one case in 2024 to four cases in 2025, resulting in a standardized infection ratio (SIR) of 1.21, exceeding the organizational target of ≤ 0.87.

Context: Audits of central line dressings identified frequent edge lifting and dressing disruption despite staff awareness of CLABSI prevention practices. These findings suggested a gap between evidence-based recommendations and consistent clinical practice. The project was conducted in a 20-bed adult medical-surgical ICU serving a diverse …

Tackling Oversmoothing, Heterogeneity, And Label Distributions For Robust Graph Learning, Yufei Jin

Electronic Theses and Dissertations

With the tremendous development of graph neural networks, graph learning has become a dominant solution applied to various applications naturally integrated with graph structures, including traffic networks [82], molecule networks [40, 22, 1, 30, 32], social networks [4], etc. While most existing graph learning solutions can handle homogeneous graphs (graphs with a single node type and a single edge type) and homophily graphs (graphs where node labels tend to be the same as their neighbors) for multi-class node classification downstream tasks well, in real world applications, graph structures can be more complex with heterogeneous graphs (graphs with multiple node types …

Algebraic And Topological Methods In Computational Neuroscience, Trong-Thuc Trang

Electronic Theses and Dissertations

Neural data is incredibly rich in combinatorial, topological, and geometrical information, reflecting the intricate shape and connectivity of neural firing patterns. To decipher these structures, neuroscience increasingly relies on advanced mathematical tools to analyze neural activity. Here we study (1) neural codes within the poset P_Code of neural codes and (2) the connectivity of neural population activity within the insular cortex when responding to interoceptive information. In (1), we establish combinatorial constructions for all upward covering relations based on what we call “isolated subsets” with supporting theorems and give a slight modification of the existing downward covering relations. We …

Properties Of Enjoyable Mathematical Contexts From The Student Perspective, Emilie Nadine Hendrickson

Theses and Dissertations

Researchers continue to grapple with how to meaningfully engage students in mathematical content. Many students report disengagement due to perceptions that mathematics is difficult, irrelevant, boring, or anxiety-inducing. This study sought to understand how students interpret and respond to different mathematical problem contexts, with particular attention to the reasons students describe certain problems as enjoyable or unenjoyable. Using semi-structured interviews, this research examined student responses to a variety of mathematical problem types primarily across affective engagement. Students reflected on specific problem contexts and explained which features supported or hindered their enjoyment and engagement. Students described that contexts were enjoyable have …

Comparing Principal Component Analysis And Sequential Fusion Deeponet With Varying Dataset Size For Design Space Exploration Of Hypersonic Flow, J. Dallan Trentman

Theses and Dissertations

Design space exploration and optimization of hypersonic vehicles is costly due to the difficulty of producing high fidelity CFD simulations in the hypersonic domain. Reduced order modeling can allow for design optimization at a fraction of the computational cost. This paper investigates the amount of training data required to produce an accurate Reduced Order Model. A PCA based ROM is developed and compared to a Sequential Fusion DeepONet by comparing model prediction accuracy, training time, and prediction time, across dataset sizes from 25 samples to 1024 samples. These models are applied to 2D hypersonic CFD simulations of the Orion reentry …

Resonant Shock Plate Simulation And Prediction Using Modal Substructuring, Harrison C. Denning

Theses and Dissertations

Aerospace structures such as rockets can experience various shock events during flight, such as stage separation or impacts. These shock events can expose components inside the rocket to large accelerations and stresses which in turn can damage the parts. Shocks are often simulated in the lab using a resonant shock plate test. Resonant shock plate testing is often used to qualify aerospace parts, as it can mimic the shocks experienced during launch and stage separations. However, during the course of development, both the definition of the shock environment and the design of the subcomponent tend to change, so that multiple …

Rfsoc Based Ground Penetrating Radar For Detection And Avoidance Of Underground Utilities, Brady Bowerbank

Theses and Dissertations

Preexisting underground utilities present a considerable danger to underground boring projects. Gas and electrical lines can be damaged, leading to major economic impact and even loss of life. While maps of underground utilities exist, they are not always accurate and gas and electrical lines can shift over time, necessitating tools to accurately detect utilities so that crews can steer the machines away from any possible danger. In this thesis, the design of a new frequency-modulated continuous-wave (FMCW) ground penetrating radar (GPR) is outlined. The design of a lightweight, flexible radar is demonstrated using the CASPER FPGA framework with an operating …

Isoperimetric Soft Robots, Mihai Stanciu

Theses and Dissertations

This thesis presents two advances in isoperimetric soft robotic trusses that improve their performance, modularity, and configurability. The first contribution introduces a large-scale modular robotic truss designed as a lightweight, reconfigurable structure for lunar applications. The system consists of inflatable fabric tubes routed through motorized roller units and interconnected by a newly developed spherical joint that enables multiple robotic triangles to connect at a common vertex. The resulting truss can be assembled into structures beyond a single octahedron while retaining compact stowage when deflated and untethered operation after initial inflation. Experimental validation demonstrates modular assembly, long-term pressure retention, load-bearing capabilities …

Quality Improvement Project: Advancing Personalized Depression Care In Outpatient Psychiatry, Jillian K. Benoit

Doctor of Nursing Practice Projects

Depression is a leading cause of disability worldwide, yet inconsistent use of evidence-based assessment and treatment strategies contributes to gaps in the quality of psychiatric care. A needs assessment at a community outpatient psychiatric clinic identified inconsistent documentation of measurement-based care (MBC), shared decision-making (SDM), and patient education during depression treatment. The purpose of this quality improvement project was to evaluate whether implementation of MBC and SDM improved depression treatment documentation among psychiatric providers over a 4-week period. Guided by Lewin’s Change Theory and implemented using the Iowa Model of Evidence-Based Practice as the implementation framework, this quantitative one-group pretest-posttest …

Quality Improvement Project Simulating Ethics: Improving Ethical Decision-Making In Nursing Undergraduates Through Simulation And Faculty Training, Shannon Brown

Doctor of Nursing Practice Projects

Nursing faculty often report limited confidence in teaching ethical principles, despite the essential role ethics plays in preparing students for complex clinical decision-making. This quantitative, quasi-experimental pre/post quality improvement project evaluated whether a structured ethics education module incorporating simulation could impact faculty confidence in teaching ethical principles. Guided by Lewin’s Change Theory and the Jeffries Simulation Framework, the project examined how organizational readiness for change and structured simulation design influence faculty development outcomes. Nursing faculty in a baccalaureate program participated in a single simulation-enhanced ethics session. Data were collected through anonymous pre/post Qualtrics surveys, and faculty confidence was measured using …

Improving Exam Scores: Alternative Next Generation Questions In Curriculum, April Morgan

Doctor of Nursing Practice Projects

Evidence identifies clinical judgment deficits among newly licensed nurses, supporting the integration of the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (NCJMM) and Next Generation NCLEX (NGN) strategies. Inconsistent NGN implementation and Assessment Technologies Institute (ATI) Comprehensive Predictor performance established the local problem. This quality improvement project evaluated the impact of implementing NCJMM-aligned NGN instructional strategies, including unfolding case studies and bow-tie questions, on students’ first-attempt achievement of the ATI Comprehensive Predictor benchmark and faculty outcomes. The primary aim was to increase the percentage of students achieving the ATI Comprehensive Predictor benchmark of 76.2% on …

Hypothermia Management In Adult Trauma Patients: Enhancing Nursing Knowledge And Self-Efficacy In The Emergency Department, Shannon M. Rapert

Doctor of Nursing Practice Projects

Trauma-induced hypothermia is a significant, preventable condition that contributes to increased mortality. Evidence suggests that inconsistent recognition and management of hypothermia persist in the emergency department (ED), highlighting the need to strengthen ED nurses’ knowledge and self-efficacy in evidence-based warming strategies. The purpose of this quality improvement project was to evaluate the impact of an educational intervention on ED nurses’ knowledge and self-efficacy in managing trauma-induced hypothermia. Guided by the Iowa Model of Evidence-Based Practice, the ADKAR Change Model, and the Plan-Do-Study-Act framework, this quantitative, quasi-experimental, pretest–posttest project evaluated the effect of an instructor-led educational intervention in ED nurses at …

Towards The Synthesis Of Dragonamide E And Analogs Thereof, Dante Glover

Chemistry Theses

Leishmaniasis is a disease caused by a parasite spread through the female sand fly. It is categorized as a Neglected Tropical Disease and can cause very severe symptoms, even death, if left untreated. Symptoms include skin lesions that can cause permanent scarring, and mucosal membrane infections that can cause facial deformities. More aggressive forms of leishmaniasis can lead to infections of internal organs like the liver and/or spleen and can lead to death. Drug resistance of these parasites has rendered treatment limited and the side effects of which can be harmful as well.

Scientists looking towards new treatments for tropical …

Thermophysical Property Studies: 1. Thermodynamic Consistency For Associating Compounds 2. Autoignition Temperature, Cassandra Jane Guffey

Theses and Dissertations

Accurate thermophysical property data are essential for the design, optimization, and safe operation of chemical processes. Properties such as vapor pressure, enthalpy of vaporization, heat capacity, density, and autoignition temperature--which are among the properties studied in this work--are required for equipment sizing, process simulation, hazard assessment, and economic evaluation. A major focus of this dissertation is the application of multi-property thermodynamic consistency techniques to compounds that exhibit strong vapor-phase association. These methods improve confidence in recommended property values by enforcing rigorous thermodynamic relationships among ideal-gas heat capacity, liquid heat capacity, vapor and liquid densities, vapor pressure, and enthalpy of vaporization. …

Standardizing Hypertension Care In An Occupational Medicine Clinic: A Quality Improvement Project, Carolyn Duncan

Doctor of Nursing Practice Projects

Hypertension remains a leading modifiable risk factor for cardiovascular disease, and inconsistent implementation of evidence-based hypertension management may contribute to variability in patient education, documentation, and follow-up care. This quality improvement project evaluated an evidence-based educational program and a standardized hypertension management workflow, based on the 2025 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines, in an occupational medicine clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's 8-Step Change Model, and the Plan-Do-Study-Act framework, the intervention aimed to impact staff self-efficacy, documentation of lifestyle education, and follow-up appointment scheduling. A quantitative quasi-experimental pre-post design was used with …

Recognition Of Autism Characteristics In Females: An Examination Of Stakeholders, Laurel Lyn Bishop

Theses and Dissertations

Autism is a neurodevelopmental communication disorder, characterized by differences in social communication, attention, interests, and sensory perception. Diagnostic criteria have historically applied to males, but clinical diagnostic criteria beginning in 2022 now include slight differences in traits comprising the female phenotype. Until recently, autistic females may be missed by the professional and education community or diagnosed later than males. Like their autistic male counterparts, they face an increased risk of suicidal ideation, but they also face more difficulties in peer relationships, academic problems, and increased anxiety and depressive symptoms, but may not get supports. School-age girls spend their days with …

Stochastic Inverse Problems In Stochastic Elliptic And Parabolic Pdes, Zi-Jia Gong

Theses

This dissertation presents a computational framework for solving stochastic inverse problems in partial differential equations (PDEs) with random data. The objective is to recover unknown random coefficients in parabolic and elliptic diffusion equations, as well as nearly incompressible linear elasticity models. To achieve this, optimization-based approaches are used to minimize regularized Energy Least Squares (ELS) and Output Least Squares (OLS) objective functionals. Both direct and adjoint methods are used to estimate the gradient and Hessian of the objective functionals with respect to the coefficients. To avoid the expensive computation of the full Hessian matrix, the Newton-CG-like method is also adopted, …

Retroverse: Enhancing Fashion Shopping Experience Through Augmented Reality, Fanghao Wang

Theses

RetroVerse is a conceptual augmented reality (AR) application that reimagines the vintage fashion shopping experience by addressing the information gaps that often make secondhand purchasing uncertain and inefficient. As the resale market continues to grow, consumers frequently struggle to identify garments, verify authenticity, evaluate condition, compare prices, and determine fit, requiring them to rely on multiple platforms and personal knowledge before making a purchase. To address these challenges, RetroVerse integrates augmented reality, image recognition, and contextual product information into a unified shopping experience. Through video and live garment scanning, users can access brand history, manufacturing information, condition assessments, marketplace price …