Digital Commons Network^™

Evaluation And Improvement Of Nuclear Security Measures At A Radiological Facility In Morocco, Halima Jemmal, Abdelmajid Choukri, Mohammed Mouhib

International Journal of Nuclear Security

Nuclear security combines both concepts of physical security and security culture within a nuclear facility to protect people, property, society and the environment from harmful effects of ionization radiation. Physical security means prevention, detection, and response to unauthorized removal, sabotage, and/or illegal transfer involving radioactive sources and nuclear material. Nuclear security culture is the human factor within the nuclear field which is considered a principal means to support and enhance nuclear security system. This paper presents a study of nuclear security system already established within a radiological facility considering concepts such as: deter, detect, delay, and response layers. This study …

Mindfulness In Early Childhood Education, Madalyn L. Coss

Honors Projects

The following work identifies the need for mindfulness in early childhood education. It explains what mindfulness is, what the benefits of it are, and how it can be used in early childhood classrooms. A podcast episode is included with the intent of it being used to inform educators on the subject.

Arts And Science Integration On The Kaleidoscope School Nature Trail And Greenhouse, Sara Boersma

Education

The Kaleidoscope KSAS Nature Trail and Greenhouse provide a gateway to pathways of understanding the immediate natural space surrounding our school. In addition, students are provided arts and science education informed by a critical place-based pedagogy. This emphasizes the activist, restoring possibilities of art making and affirming the need for students to become involved in learning outside the physical school building (Graham, 2003). The possibilities ofunderstandings and stewardship are encouraged through arts and science integration and experiences on the nature trail and greenhouse. Through these experiences, students can gain a sense of awareness and understanding oftheir natural environment and this …

Culturally Therapeutic Approaches To Prejudice And Discrimination: Formulations, Interventions, And Structural Change, Jayme J. Jenkins

Electronic Theses and Dissertations

Aims. Though psychologists are generally well-positioned to implement micro- and macro-level interventions from their roles as clinicians, educators, researchers, and consultants, there is a paucity of formal guidance on how to approach client-generated or structural prejudice and discrimination. The current study addresses this literature gap by integrating previous literature and implementation models from a related field toward a novel treatment approach.

Background. A critical literature review supported intervention-focused conceptualizations of “supremacism” and demonstrated that mutually reinforcing micro- and macro-level discrimination generates demographic disparities in safety, liberty, and well-being. This typically emerges in the United States as White supremacist heteropatriarchy while …

Barriers To Completing Degrees For Uaf Ph.D. Students, Hannah L. Whitaker

Counseling

A student faces several challenges when working towards a doctoral degree. Previous research has demonstrated that discrimination, lack of support, poor mentorship, funding issues, mental health concerns, and minority stress are barriers to degree completion. The available research also suggests that these difficulties are especially challenging for underrepresented students. Although universities are currently attempting to mitigate certain of these barriers, more can be done to understand the doctoral experience as a way of supporting students. Focus groups were conducted for this thesis to explore the barriers, strengths, and advice for others that doctoral students have at the University of Alaska …

Age Related Dementias, Shahab Soltani

Chemistry and Biochemistry

During the last few decades, the average life expectancy has dramatically increased in the U.S.A. and globally. As a result, the diseases associated with age, such as dementia, significantly impact families, society, and government. Dementia is a broad term describing memory loss, cognitive dysfunctions, and limited social skills caused by many factors such as aging, stroke, and genetic background. Although the primary etiology remains unclear but inflammatory reactions, neurodegeneration, vascular abnormalities play an important role in the progression of these disorders. Therefore, treatment is mainly supportive to relieve the symptoms of dementia and not to cure dementia or slow down …

Implementation Of An Agitation Scale In Three Emergency Departments In An Urban Area Of Northern California, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Background. Behavioral health patients in the emergency department are customarily treated without an objective assessment of agitation at presentation and throughout their hospital stay.

Local Problem. Behavioral health patients presenting with agitation in three emergency departments in Northern California are customarily treated with activation of a Code Grey emergency alert, use of physical restraints, or emergent sedation medication administration to manage the situation, prevent escalation, and protect the staff.

Context. Agitation in patients that is not recognized can lead to emergent sedation medication administration, physical restraints placed, and Code Greys activated to support the clinical staff.

Interventions. An evidenced-based agitation …

Preparing Nurses In Management Positions For Bedside Care During Times Of Crisis, Trevor Murray

Doctor of Nursing Practice (DNP) Projects

Background

The purpose of this quality improvement project was to increase perceived self-efficacy in performing bedside skills among nurse leaders. As the demand for nurses increased, these leaders anticipated a direct role in providing patient care in the event of a patient surge due to COVID-19.

Problem

Due to the COVID-19 pandemic and Delta variant, hospital nursing leaders were and still are concerned with the challenge of providing enough competent nurses to deliver care. The DNP project prepared nurses who work in leadership roles to take or assist in taking a patient assignment.

Methods

Nurse leaders attended a skills lab …

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

Implementation Of An Acute Care For The Elderly (Ace) Unit In A Community Hospital, Kimberly A. Colonnelli

Doctor of Nursing Practice (DNP) Projects

Background: “Baby boomers” (born between 1946 and 1964) represent 15% of the total population of the United States (Population Reference Bureau, 2019), but 50% of its total healthcare expenses (Mattison, 2021). Growth of this population will have a corresponding rise in demand on healthcare resources. Replication of a geriatric inpatient care model (Palmer et al., 1994) was introduced in a large geographically and ethnically diverse integrated care delivery system.

Problem: The demographic for this small community hospital located in Northern California has a larger percentage of patients over the age of 65 compared to other facilities within this …

Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le

Doctor of Nursing Practice (DNP) Projects

Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.

Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.

Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.

Interventions: The Suicide and …

Targeting Pre-Operative Booking Processes To Decrease Risks Of "Never Events", Rebecca Lynn Poths, Rebecca Lynn Poths

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Wrong patient, wrong procedure, wrong site, and wrong side surgeries are such egregious errors that are known as “never events.” Root cause analyses can pinpoint a failure yet do little to determine if corrective action has reduced the risk of recurrence.

Context: Monitoring surgical cases prospectively to identify weaknesses that could help identify specific risk factors to avert and move toward zero defects. The setting for this quality improvement project is a >300-bed Level III trauma hospital, where the risk of wrong-site surgeries and lack of standardized processes in the surgical pre-operative booking process was of concern to …

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …

Venezolanos En New York, Mariel V. Lozada

Capstones

The process of developing a website with information about the bureaucratic process for the immigrants in the city, especially focusing on the Venezuelans and a five steps guide with the most basic information a newly arrived immigrant may need. The idea behind is to deliver useful content that would live in their inbox so they can revisit it easily anytime they want, even without having an internet connection, and, if the reader wants to deepen their knowledge, can visit the website for more in-depth coverage of these topics.

Young People More Optimistic About Climate Crisis, Syed U. Haq

Capstones

This is story on how the youth today is feeling more ambitious about rectifying the mistakes the previous generation has made regarding climate. It takes the reader through a poll done by Generation Lab, about the optimism in the younger generation to tackle the climate crisis and what factors are in play in making them feel that way. It also provides three brief audio pieces from student activists, Anna Kathawala, from the local Fridays for Future, Mars Vazquez-Plyshevsky, who comes from a family of climate deniers, and Aderinsola Babawale, a local activist with Brownsville Green Justice. And of course, their …

Improving Lymphedema Self-Management And Screening In Newly Diagnosed Breast Cancer Clients Through The Use Of A Self-Management Lymphedema Toolkit, Kescia Gray

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: With breast cancer effecting women at much younger ages and modern treatments prolonging the life span, survivors are at increased risk of developing breast cancer-related lymphedema (BCRL), a chronic, progressive condition that can cause disability.

Purpose: The purpose of the project was to determine the level of knowledge and awareness of BCRL in newly diagnosed breast cancer clients; and to provided education on self-care after treatment, using of a self-management lymphedema toolkit (SMLT), to decrease risks of treatment-related lymphedema, improve self-efficacy, and enhance quality of life (QOL).

Methods: Newly diagnosed breast cancer clients (N=10) from the Breast …

Optimizing Postpartum Care By Ongoing Care Coordination Initiatives (Cci) In Screening And Management Of Postpartum Depression (Ppd) Among Clients In An Obgyn Practice: A Quality Improvement Project., Jennifer Broussard

Doctor of Nursing Practice (DNP) Manuscripts

Background: Postpartum depression (PPD) is defined as physical, emotional, and behavioral changes that occur after the birth of a child. Postpartum depression is complex and a mix of physical, emotional, and behavioral changes (Cleveland Medical Clinic, 2018). Postpartum depression screening is of high importance at a comprehensive postpartum visit. The consequences of a patient suffering postpartum depression can be serious and early recognition and interventions improve outcomes for the patient as well as the infant. Problem: There is a lack of screening for PPD among postpartum clients and this period is critical for the mother and the infant (American College …

Reducing Opioid Related Deaths And Improving Rehabilitation Access Through The Elk Grove Village Cares Program: A Program Evaluation, Rebecca Barron

Doctor of Nursing Practice (DNP) Manuscripts

Abstract The goal of the Elk Grove Village Cares program is to decrease the deaths and overdoses of those who abuse opioids through harm reduction strategies and provide access to treatment. The article is a program evaluation of the Elk Grove Village Cares program. Surveys, interviews and the synthesis of program data is used to evaluate the efficacy of program activities. Results: The rate of death from opioid use has decreased an average of 1.7 deaths since program implementation in 2018. Law enforcement officers (LEO) and the community responded similarly to many survey questions regarding attitudes surrounding addiction. Within the …

Telehealth Appointments To Increase Therapy Compliance In Patients With Mosa, Tracy J. Partington

Doctor of Nursing Practice (DNP) Projects

Background: At the VA Puget Sound Healthcare System, care as usual for patients with a new diagnosis of mild obstructive sleep apnea (MOSA) is a letter directing the patient to call the continuous positive airway pressure (CPAP) clinic to establish ongoing care.

Local Problem: This model has resulted in low therapy compliance and does not afford patients the ability to discuss their diagnosis and treatment options with a licensed healthcare provider. A literature review showed telemedicine interventions increase therapy compliance in patients with MOSA.

Context: The Doctor of Nursing Practice project implemented an evidence-based practice change to improve therapy compliance …

Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Abstract

Introduction: Patient agitation is a phenomenon that presents itself to the emergency department (ED) on a daily basis. Agitation can manifest from an array of physical or psychological complaints. Behavioral health patients presenting with agitation is a growing subset of the total agitation population within EDs. A better understanding of behavioral health patient agitation in the ED setting is needed to guide best practices in treating this fragile population with therapeutic, patient-centered care.

Methods: A review of literature was conducted on agitation and behavioral health in ED settings, using the search terms emergency department, agitation, restraints, sedation, and behavioral …

Winning The Battle, Winning The War, Malka Herman

William & Mary Law Review Online

This Article analyzes Derrick Bell's interest-convergence theory and its utility for lawyers when litigating for the rights of nondominant groups. The first part of this Article studies four different cases in which plaintiffs or amicus curiae chose arguments that highlighted the ways their interests converged with potential allies. The Article uses these cases as examples of four different ways that a lawyer can engage in interest-convergence litigation. The strategies examined in this Article rest on two axes: dominant/nondominant narrative convergence and natural/unnatural ally convergence. An analysis of the effects of each of these techniques makes it clear that dominant narrative …

Philosophical Anthropology And Biblical Interpretation In John Paul Ii’S Theology Of The Body, Shawn Conoboy

Electronic Theses and Dissertations

In the Theology of the Body, through a series of Wednesday Catecheses, John Paul II presents a magisterial understanding of the sacrament of marriage and of marriage and family ethics. At the same time, John Paul II presents a theological anthropology, which forms a basis for the magisterial teaching. His theological anthropology is developed through an exegesis of selected biblical texts, especially Genesis 1-3 and Ephesians 5, and through an application of a philosophical anthropology articulated by Karol Wojtyła. This dissertation draws the connection between the philosophical anthropology of Wojtyła, especially as it is articulated in his major works, …

Piloting A Theoretical Framework For Understanding Teacher Resilience In Hard-To-Staff Schools, Traci Durant

Electronic Theses and Dissertations

The study examined the nature of hard-to-staff schools in relation to teacher resilience. The study proposes a theoretical framework that blends theories of self and collective efficacy, critical race, and resilience theories with Bronfrenbrenner’s ecological systems theory to examine personal and organizational factors that contribute to or weaken the resilience of teachers in challenging urban schools.

Two research questions guided the study: What are the personal factors that strengthen resilience in teachers in hard-to-staff schools? And, What organizational factors impact teacher resilience in hard-to-staff schools?

Participants were recruited using convenience sampling methods. School administrators were asked to identify teachers who …

Relational And Social Aggression: A Scoping Literature Review, Angela Fidazzo

Electronic Theses and Dissertations

School violence is an omnipresent problem within the United States, at worst, resulting in the death of children and teachers across the nation. Over time, numerous strategies and tools have been introduced in order to reduce aggression within schools. However, as both overt and covert forms of aggression contribute to school violence, it is necessary for researchers to investigate covert, indirect forms of aggression as a way to better identify and prevent a salient contribution to this problem. Although much research has investigated bullying in general, further research is needed in better understanding the forms of covert bullying, relational and …

Counselors Dumbfounded: Implications For Counseling Ethics, Ivan Irizarry

Electronic Theses and Dissertations

How counselors should make ethical decisions frequently differs from how counselors actually make ethical decisions, which is often a non-linear process. Social Intuitionist Theory (Haidt, 2003) suggests this process entails a socially influenced intuitive judgment followed by post hoc rationale. The purpose of this study was to examine whether moral dumbfounding, which entails maintaining a moral judgment without supporting reason, occurs with practicing counselors. The results of survey data and open-ended coding showed that 58.5% of counselors were dumbfounded at least once when presented with four moral or ethical vignettes. Additional analyses exploring differences in dilemma-based vs. non-counseling vignettes, moral …

The Effect Of School-Based Mindfulness Intervention On Student Attention And Executive Function: A Meta-Analysis, Sarah E. Rea

Electronic Theses and Dissertations

Schools are facing increasing responsibility to foster the social-emotional development of students. One way in which schools can improve student functioning is through school-based mindfulness interventions. Using mindfulness practices, in particular, can teach students to increase their attention of surroundings and internal experiences, and awareness of their thoughts and behaviors. While the evidence-base for mindfulness interventions in schools continues to grow, there are several studies that show promising outcomes. The purpose of this study was to determine how large the effect sizes for school-based mindfulness studies are in regard to increasing student attention, cognitive flexibility, and working memory. Results indicate …

Cgrp-Driven Lateralization Of Pain Modulation By The Central Amygdala, Heather Allen

Electronic Theses and Dissertations

The central amygdala (CeA) is a bilateral, mid limbic brain region involved in the processing of pain and emotion. Interestingly, the left and right CeA are functionally lateralized in the context of bladder pain, with the left and right CeA having opposing effects on bladder pain-like behavior. However, the specific mechanisms driving these divergent functions are unknown. Nociceptive signals from the bladder are relayed to the CeA via projection neurons in the parabrachial nucleus (PBN) that express high levels of calcitonin gene-related peptide (CGRP). In these studies, we investigated the influence of PBN CGRP signaling in the left and right …

Investigating Relationships Between Diabetes Distress, Diabetes Self-Care Behaviors, Intention To Use And Actual Use Of A Personal Health Record Within 30 Days Of Hospital Discharge In Persons With Type 2 Diabetes, Khaliah Fisher-Grace

Electronic Theses and Dissertations

Background: Diabetes distress (DD) is defined by emotional and behavioral challenges caused from diabetes and its management. Diabetes self-care behaviors can be compromised by DD. Personal Health Record (PHR) use has been associated with improvements in HbA1c, blood pressure, and LDL-C, but the relationship between DD and PHR use is unknown. Aims: 1) to determine differences between sociodemographic variables and intention to use and actual use of PHR in hospitalized persons with Type 2 Diabetes Mellitus (T2DM), 2) to investigate the relationship between DD, intention to use a PHR and actual use of a PHR within 30 days of hospital …

Forced Together, Growing Apart: An Exploration Of Heterosexual African American Males' Disengagement In Romantic Relationships With African American Females, Kenya Johns

Electronic Theses and Dissertations

The decline of intraracial dating has been more pronounced among African Americans in comparison to other racial groups. There is lack of available research tailored towards Black men’s dating experiences. The purpose of this study was to explore the lived experiences of heterosexual African American males related to their disengagement in romantic relationships with African American females.

A phenomenological study explored the lived experiences of 10 African American males and the dynamics that appear to contribute to the decline in intraracial dating in the African American community. Five themes emerged from the study: – self-regard, family matters, proximity, the new …

Patient Placement Matters: The Impact Of Unnecessary Lateral Movement On Patients, Jacqueline Strinden

Doctor of Nursing Practice (DNP) Projects

Patient Placement Matters: The Impact of Unnecessary Lateral Movement on Patients

Abstract

Background: National trends to decrease the number of licensed beds have created inpatient capacity constraints which have resulted in increased unnecessary lateral patient movement events, which contribute to decreased patient safety and quality of care. The incidence of adverse events increases significantly when multiple unnecessary lateral relocations result from secondary efforts to relieve hospital capacity constraints and improve efficiency.

Problem: At a 352 acute care hospital, 12,906 patient movement events were evaluated over a baseline period of three months resulting in an average of 1.48 unnecessary lateral patient …