Digital Commons Network^™

Improving The Reporting And Tracking Of Hospital-Acquired Pressure Injuries, Melinda Rosado

Yale School of Nursing Digital Theses

Hospital-acquired pressure injuries (HAPIs) affect millions of patients a year, impacting patient safety and creating a significant financial burden for healthcare systems. Inadequate reporting and tracking of HAPIs lead to delays in care, inaccurate data reporting and missed opportunities for quality improvement. This is in large part due to a lack of training and education around HAPIs, poor communication of injuries during hand-off and a lack of system integration. A process improvement program to improve the reporting and tracking accuracy of HAPIs was piloted on two post-surgical units in a large urban cancer center. This initiative combined comprehensive training via …

Cultural Intelligence For Advanced Practice Providers: Moving A Contextually Based Model Forward For Workforce Training, René Padilla

Yale School of Nursing Digital Theses

Cultural Intelligence for Advanced Practice Providers: Moving a Contextually Based Model Forward for Workforce TrainingCultural Intelligence (CQ) among clinicians in primary care for the Hispanic population is inadequate (Da Costa, 2023). Cultural diversity training for patient care has been identified as a need to improve outcomes since the 1960s (Lin et al., 2017). In 2000, the Office of Minority Health (OMH) at the US Department of Health released the National Standards for Culturally and Linguistically Appropriate Services in Healthcare and updated those standards in 2013. Mainous et al. (2020) found that only 35% of primary care providers (PCPs) knew of …

Promoting Mental Health Awareness And Reducing Stigma In Spanish-Speaking Communities Through Educational Interventions, Kelly Medina Prado

Yale School of Nursing Digital Theses

Background: Spanish-speaking Latino populations in the U.S. experience significant disparities in mental health access driven by language barriers, low mental health literacy, and cultural stigma. These factors contribute to the underutilization of services, early treatment dropout, and poor outcomes.

Objective: This quality improvement project aimed to develop, implement, and evaluate a culturally and linguistically tailored mental health education intervention designed to increase mental health literacy and reduce stigma among Spanish-speaking Latino adults in a federally qualified health center.

Methods: A total of four group sessions were conducted over an eight-week period. The sessions were delivered in Spanish and included culturally …

Panel: Program For Advancing Nursing Excellence For Leaders, Christopher D. Tarquinio

Yale School of Nursing Digital Theses

Healthcare organizations strive for nursing excellence, evident through prestigious awards like Magnet® Recognition and the Beacon Award of Excellence®. Nurse leaders play a crucial role in fostering a culture of excellence, but many face challenges due to confidence levels. PANEL educates nurse leaders on the connections between nurse satisfaction, patient satisfaction, and nurse quality measures (NQMs). By applying PANEL principles and transformational leadership, healthcare systems can positively impact nurse satisfaction, patient satisfaction, and NQMs. The aims of this project were: to develop a nursing excellence program for nurse leaders within a community-based healthcare system with the goal of connecting the …

Changing The Vantage Point Of Nurses Toward Evidence-Based Practice: Embedding Storytelling Into A Novel On-Demand Micro-Learning Program, Janet Ruscoe

Yale School of Nursing Digital Theses

CMS withholds billions in payments to fund VBP and incentivize hospitals to improve care. Achievements in TPS, which includes patient satisfaction and safety domains, is an opportunity to earn back incentive payments. Advancing nurses' adoption of EBP helps keep patients safe, improves satisfaction, and supports hospital financial viability (Kemp et al., 2023). However, gaps exist in the competency and application of EBP (Melnyk et al., 2018). A curriculum was developed to improve nurses' perceptions of EBP value. A storytelling, micro-learning approach was utilized to deliver the EBP-relevant knowledge. The digital platform provided on-demand, unlimited re-entry features that optimized flexibility, convenience, …

Provider Mindfulness: Changing Implicit Bias And Improving Perinatal Health Outcomes For Patients With Adverse Social Determinants Of Health, Nina Sarah Simon

Yale School of Nursing Digital Theses

AbstractProvider Mindfulness: Changing Implicit Bias and Improving Perinatal Health Outcomes for Patients with Adverse Social Determinants of Health Purpose: Implicit bias is an unconscious prejudice or preexisting belief developed over time toward another group. It can influence provider judgement, treatment decisions and levels of care. The purpose of this DNP Quality Improvement (QI) project was to improve patient care and provider knowledge on how implicit bias affects perinatal health for those with adverse social determinants of health (SDOH). Methods: A 53-second daily mindfulness intervention was developed and implemented among 8 obstetric providers caring for a population at risk for bias …

Implementing A Patient-Centered Pediatric Obesity Protocol In A Population With Social And Environmental Risk Factors, Carolyn Walsh

Yale School of Nursing Digital Theses

Children and adolescents exposed to adverse childhood experiences (ACEs) and negative social determinants of health (SDoH) have an increased risk of developing pediatric obesity. The American Academy of Pediatrics Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity (2023) recommends assessing these factors in children with obesity. At a School-Based Health Center (SBHC), the standard of care for pediatric obesity did not include ACEs and SDoH screening, highlighting a gap in practice. This Doctor of Nursing Practice project developed, implemented, and evaluated a patient-centered pediatric obesity protocol incorporating ACEs, SDoH screening, and referrals to patient-centered …

A Model For Improving Nursing Homes' Quality Metrics Through Systems' Policy Change In Widespread Antipsychotic Use, Hugo Masangkay Gozos

Yale School of Nursing Digital Theses

In 2019, more than half of nursing home residents were estimated to have had dementia (PRB, 2023). In 2020, about 300,000 of these residents had been prescribed antipsychotics (Jaffe, 2020). Per the Office of the Inspector General (OIG) (2021), nearly one in three nursing home residents were inappropriately diagnosed to justify the use of antipsychotics. Individuals diagnosed with dementia and prescribed with antipsychotics have a 78% higher risk of death (Kheirbek et al., 2019). Educational training can serve as an effective tool for advancing knowledge of antipsychotics in avoidance of inappropriate use, specifically when directed toward nursing home providers and …

Addressing Intergenerational Retention And Workplace Satisfaction Factors With A Workshop For Nurse Leaders, Elizabeth Labish

Yale School of Nursing Digital Theses

Nursing is a multigenerationally diverse workforce, with up to five generations (Traditionalists, Baby Boomers, Generation X, Millennials, and Generation Z) contributing simultaneously (Gerhardt et. al, 2022). Each generation holds varied work preferences and retention drivers, which manifest as unique drivers of preventable turnover. Leaders can reduce turnover and its associated costs by cultivating a multi-generationally preferred work environment (Koehler & Olds, 2022). The purpose of this project was to deliver a workshop for nurse leaders to improve their knowledge about leading multigenerational workforces. Following literature review, A 2.5 hour in-person workshop was created and delivered at a community hospital. The …

Research Methodology Education In Europe: A Multi-Country, Cross-Disciplinary Survey Of Current Practices And Perspectives, Silke Kniffert, Ivan Buljan, Flavio Azevedo, Peter Babinčák, Lucija Batinović, Thomas Rhys Evans, Sara Garofalo, Christopher Graham, Lucianne Groenink, Malika Ihle, Milosav Klugar, Lucia Kočišová, Michal Kohút, Nikolaos Kostomitsopoulos, Seán Lacey, Anita Lunić, Ana Marušić, Thomas Nordström, Charlotte R. Pennington, Daniel Pizzolato, Ulf Toelch, Marta Topor, Miro Vuković, Michiel R. De Boer

Publications

Background

Research methodology education aims to equip students with the foundational knowledge of robust scientific practices, emphasizing deep understanding of scientific inquiry, integrity, and critical thinking in research practice. A literature review reveals that the observed diversity in research methods course design and instruction stems from a lack of consensus about the essential foundations required to critically engage with, design, and execute research in education. This is further compounded by a limited pedagogical innovation. However, no study has yet investigated how research methodology is taught and perceived across European universities. The objective of this study is to examine practices and …

Affective Forecasting With A Chance Of Collective Action: Women’S Anticipated Affect After Acting Against Sexism And Its Relationship To Collective Action Intentions, Adrianna Tassone

Theses and Dissertations (Comprehensive)

Confronting sexism elicits social costs like name-calling (Mendes et al., 2018) and anticipating these costs inhibits confrontation (Good et al., 2012). But taking collective action can also improve women’s wellbeing and reduce negative emotion (Foster, 2015). How women anticipate their own emotions in response to social cost may be a predictor of action. However, it is not yet known how women anticipate taking action will make them feel, and how perceived costs relate to these predictions and action intentions. The present thesis integrates two previously distinct literatures, affective forecasting (Gilbert et al., 1998) and collective action motivation to assess the …

Coupling Remote Sensing And Modelling To Monitor The Spatial Distribution And Trends Of Surface Temperature And Ice Thickness On Sub-Arctic Lakes, Gifty Attiah

Theses and Dissertations (Comprehensive)

Lake surface temperature (LST), lake ice thickness (LIT), and lake ice phenology (LIP) play significant roles in the diverse regional processes of freshwater in cold regions. They offer direct indications of regional weather and climate conditions, and their interactions with the atmosphere impact climate processes. Furthermore, lake ice is valuable to northern communities, such as those in the Northwest Territories (NWT). Ice roads, including the longest ice road in the NWT, spanning over 80 lakes, are constructed during winter to haul goods to and from industrial establishments (e.g., mines) and for travel within and between communities. A significant challenge to …

The Impacts Of Permafrost Thaw Slumps On Arctic Stream Ecology, Maria Dolan

Theses and Dissertations (Comprehensive)

Climate change is intensifying permafrost thaw across terrain of the circumpolar Arctic. Increased temperatures and rainfall at northern latitudes have resulted in the expansion of thermokarst features such as retrogressive thaw slumps, which make previously frozen debris available for transport into nearby river systems. In the Peel Plateau, Northwest Territories, the mobilization of these materials exposes rivers to a large quantity of sediment and solutes that may act as a chronic, press disturbance, potentially altering stream food webs. Here, I examine if: 1) thaw slumps have driven changes to the physical and biological properties of slump impacted streams since an …

Children's Interpretation Of Others' Faces Covered With Medical Masks, Sevval Cinar

Theses and Dissertations (Comprehensive)

How we recognize and regulate emotions is fundamental to overall health and wellbeing. Emotional recognition and understanding are key to proper communication and emotion regulation. Barriers, such as masks, might have an impact on the way children recognize and interpret others' emotions, and therefore the way they learn, communicate, and regulate their own. The COVID-19 pandemic necessitated widespread mask-wearing, raising questions about its impact on children’s emotional development. Using a sample of children with varying levels of exposure to mask wearing adults (N= 13, ages 4 to 6), we investigated how prolonged mask wearing predicts emotion recognition, particularly …

Capital Structure Models And Contingent Convertible Securities, Di Meng

Theses and Dissertations (Comprehensive)

The 2007-09 financial crisis showed financial institutions are vulnerable during distressed times. As an alternative resolution to a government bail-out, contingent convertible securities (contingent capital or CoCos) were proposed by various researchers. CoCo is a hybrid capital security that converts from a bond to common equity when a pre-determined event occurs. The loss absorption mechanism of CoCo is essential to the financial health of a bank during a crisis as it provides an instant capital infusion when public capital is difficult to access.

In this thesis, we first implement a methodology to calibrate capital structure models for large Canadian banks. …

South-South Migration: Examining The Links Between Food Security And Migration From Ghana To Qatar, Bernard Owusu

Theses and Dissertations (Comprehensive)

This dissertation contributes to the migration-development literature by integrating food security into the analysis of South-South migration. While migration and development have been extensively studied, the connection between migration and food security remains underexplored, particularly in South-South migration contexts. The dissertation highlights the role of migration as both a coping strategy for food insecurity and a source of vulnerability for migrants in the specific context of temporary labour migration between Ghana and Qatar. Addressing this gap, the research examines how migration decisions are influenced by food insecurity in Ghana, the food security challenges faced by Ghanaian migrants in Qatar, and …

Structural Insights Into Peptidoglycan O-Acetylation In Gram-Negative Bacteria, Tyler Malloch

Theses and Dissertations (Comprehensive)

The Centres for Disease Control has acknowledged that we are entering a post-antibiotic era, where increasing numbers of bacterial pathogens are becoming resistant to known antibiotics. One of the most successfully targeted features of bacteria is also the main component of the cell wall, peptidoglycan (PG). PG is a heteropolymer of alternating sugar residues, namely N-acetylmuramic acid (MurNAc) and N-acetylglucosamine (GlcNAc) which are joined together by b-(1,4)-glycosidic bonds and crosslinked via stem peptide chains. PG is a target, readily lysed by exogenous and endogenous autolysins, such as lysozyme and lytic transglycosylase, respectively. This event leads to cell death …

Lichen It: Optimizing Post-Fire Caribou Lichen Transplantation And Assessment, Elise Brown-Dussault

Theses and Dissertations (Comprehensive)

Caribou lichen species are common in mid- to late-seral boreal forests, serving as an important winter diet staple for boreal woodland caribou. However, as climate change causes boreal wildfires to increase in size, severity, and frequency, available tracts of mature forest are decreasing, diminishing the extent of mature caribou lichen stands. Caribou lichens reproduce vegetatively, so bigger and more severe fires could exacerbate their dispersal limitations, potentially extending the timeline for caribou lichen stand recovery beyond 80 years. Trials have shown that “transplanting” caribou lichen fragments into disturbed areas can lead to the establishment of caribou lichen mats; as such, …

Fallow Fields Or Fertile Ground: Analysing Food Governance In A Changing World, Johanna L. Wilkes

Theses and Dissertations (Comprehensive)

Our food systems are failing us. In particular, industrial food systems fail to deliver healthy, adequate food to billions of people (FAO et al. 2019; FAO et al. 2024) and have led to increased instances of mental health crises for farmers (Jones-Bitton 2019; Younker & Radunovich 2021). In addition, industrial food systems contribute to the devastating impacts of a warming climate (IPCC 2021), biodiversity loss (WWF 2021), and soil erosion (Wise 2019; Badreldin and Lobb 2023) worldwide. Yet, little structural change has occurred in the way agriculture is governed and the problems created by industrial agriculture are becoming increasingly entrenched. …

To Encounter The Other? How Journalists Make Catholic Faith-Based Organizations In Mexico And Russia (In)Visible, Xochiquetzal Luna Morales

Theses and Dissertations (Comprehensive)

Catholic Faith-Based Organizations (CFBOs) in Mexico and Russia are unique entities of study and comparison to understand the power dynamics between majority/minority institutional religions and their media representation. Although both countries recognize their religious diversity, Catholicism is still the major religion in Mexico, not only because of its large number of adherents but also its significant cultural and political capital. In contrast, in Russia, Catholicism is considered a minority religion and is often viewed as foreign to Russian values and traditions. These conditions influence how CFBOs have been featured in the news media in both countries. However, no single factors …

Multi-Lingual And Cross-Domain Frontiers In Machine-Generated Content Detection, Gurunameh Singh Chhatwal

Theses and Dissertations (Comprehensive)

The rapid advancement of generative artificial intelligence, particularly Large Language Models (LLMs) such as GPT-4 and their multilingual capabilities, has significantly blurred the distinction between human-authored and machine-generated content. This technological evolution introduces critical challenges concerning the detection and attribution of textual authenticity and authorship, exacerbating societal issues like misinformation proliferation and compromising academic and professional integrity. Traditional detection methodologies, predominantly monolingual and heuristic-based, have demonstrated inadequate generalizability and efficacy against the sophisticated, multilingual capabilities of contemporary generative models.

This thesis addresses two major problems arising from these advancements. Firstly, it introduces novel multilingual detection methodologies explicitly designed to differentiate …

What Is Success? How Peer Support Workers In Ontario See Addiction & Recovery, Ngaire Rasmussen

Theses and Dissertations (Comprehensive)

The drug crisis in Canada has high mortality rates, especially in remote and rural communities, but there are significant barriers to accessing healthcare to which peer support may represent a partial solution, (Eddie et al., 2019; Englander et al., 2020; The Government of Canada, 2023; Kourgiantakis et al., 2023; Lavalley et al., 2020; Lennox et al., 202; Russell et al., 2021). Research how peer support workers define success in their work with adults experiencing addiction in Ontario, Canada is lacking, but important to understanding the crisis and implementing peer programs. Grounded in Marxist theory, the following exploratory research investigated the …

Exploring Canadian Social Work Students' Aphobic Attitudes: The Role Of Knowledge About Asexuality And Asexual People, Brianna V. Azzoparde

Theses and Dissertations (Comprehensive)

Aphobic attitudes are negative biases and prejudices against asexual individuals that can contribute to aphobic discrimination. While the Canadian Social Work Code of Ethics states that social workers should not discriminate and should provide culturally responsive services to marginalized populations, individually held aphobic attitudes have the potential to diminish one’s ability to provide culturally responsive services to asexual people. This national study examined aphobic attitudes among 326 Canadian social work students, exploring the relationship between knowledge about asexuality and aphobic attitudes, including controlling for demographic factors, social contact with asexuals, and social attitudes that previous research has identified as being …

Using Landscape Ecology And Spatial Statistics To Examine The Impacts Of Proposed Removals To Natural Heritage System And The Agricultural System Of Ontario’S Greenbelt, Brianna Downey

Theses and Dissertations (Comprehensive)

The 2022 proposed removals from the Greater Toronto Area (GTA), Southern Ontario’s Greenbelt would have resulted in negative impacts including, reductions to the size and functionality of the Agricultural System and Natural Heritage System, which are components of protected Greenbelt area. Several removal sites were located either on or in close proximity to corridor areas of the NHS, reducing connectivity and negatively impacting the surrounding ecological area. The removal of Agricultural land primarily consisted of corn and soybeans, as well as large removals of woodland, wetland, and shrubland class areas. The removal sites on local Agricultural composition and configuration were …

Don’T Stop Believin’: Emotion Beliefs And Daily Affective Experiences Across Adulthood, Jocelyn A. Rutledge

Theses and Dissertations (Comprehensive)

Emotion control beliefs reflect the extent to which people believe emotions “should” and “can” be controlled and have been linked to psychological well-being. Research has yet to examine age-related differences in these beliefs and their daily associations with affective experiences. The present study examines age differences in daily emotion control beliefs and their within-person associations with positive and negative affect. The study used 14-day daily diary data from an adult lifespan community sample (younger adults: 18-36 years old, N = 72; older adults: 66-92 years old, N = 66). The results revealed that older adults reported …

Contrasting Trajectories In Adolescent Pro-Environmentalism: Qualitative Differences Between “Engagers” And “Disengagers”, Jaida Brown

Theses and Dissertations (Comprehensive)

This qualitative study extends Krettenauer and colleagues' (2024) longitudinal research by examining how different developmental contexts shape divergent trajectories in adolescents' environmental engagement. We conducted semi-structured interviews with nineteen adolescents, focusing on two distinct groups: "Engagers" who showed remarkable increases in pro-environmental behavior from ages 13 to 17, and "Disengagers" who exhibited substantial decreases inengagement during the same period. While all participants reported meaningful childhood nature experiences, supportive family sustainability practices and access to environmental information through media, their developmental paths diverged significantly. Disengagers gradually deprioritized environmental concerns as other life goals took precedence, while Engagers actively expanded their environmental …

Unveiling Trauma And Seeking Justice: Exploring Mass Atrocities Against Tamils Through The Lens Of Religion, Culture, And Global Justice, Arrabe Vigneswaran

Theses and Dissertations (Comprehensive)

This paper examines the mass atrocities committed against the Tamil population in Sri Lanka, analyzing them through the interconnected lenses of religion, culture, and global justice. It explores how Sinhalese-Buddhist nationalism, codified through legal and constitutional mechanisms such as the Sinhala Only Act and state-sponsored cultural erasure, facilitated the systemic marginalization, displacement, and dehumanization of Tamils. The study investigates the legal, political, and cultural underpinnings of these acts ranging from war crimes and ethnic cleansing to potential genocide while assessing the reluctance of both domestic and international actors to enforce meaningful accountability. Drawing on hybrid court models, transitional justice theories, …

Examining Gender Differences In Heritage Language Maintenance And Loss Among South Asian First-Generation Canadians, And The Effect On Well-Being, Amreen Sangha

Theses and Dissertations (Comprehensive)

Language is prevalent in various aspects of life. Not only is it often essential for communication, but it also has deep roots within cultural contexts. Specifically, within South Asian culture knowing one’s heritage language is considered to be necessary when it comes to connecting with one's cultural group and identity. Heritage language maintenance can be seen differently within different individuals and have different implications for them. This study was designed to explore gender differences in heritage language loss as well as the role language may play in one’s well-being. Canadian-born South Asian children and young adults aged 10-25 completed an …

Examining The Impact Of Early Literacy Interventions On Teachers’ And Parents’ Learning And Perceptions Of Early Literacy Development, Abigael Mary Hogarth Todd Miss

Theses and Dissertations (Comprehensive)

Parents and teachers play a vital role in fostering early literacy development; however, many require additional training to enhance their understanding of alphabet knowledge and phonological awareness. This study examined the effectiveness of two instructional videos—one on phonological awareness and one on evaluating alphabet books—in increasing teachers’ (n = 35) and parents’ (n = 34) perceptions about these domains and the practical application of information covered in the videos. The 69 participants viewed each video, and results indicated a general decrease in confidence following exposure to these videos, likely reflecting an increased awareness of the complexity of the …

“We’Re Here, We’Re Queer, And We’Re Not Going Away” Student Policies And Lgbtq+ Students’ Experiences On Canadian Christian Campuses, Angela E. Gallo

Theses and Dissertations (Comprehensive)

Research highlights that Christian campuses are often unwelcoming and hostile spaces for lesbian, gay, bisexual, transgender, queer, and other gender and sexually diverse (LGBTQ+) students. Yet, research, including emerging Canadian research, often overlooks how institutional policies shape LGBTQ+ students’ experiences. Further, little attention is given to the affirming experiences LGBTQ+ students encounter on Christian campuses. Through a collective case study of two Canadian Christian universities involving document analysis and interviews, I explored the discourses that school policies constructed concerning gender and sexuality, LGBTQ+ students’ experiences of exclusion and affirmation, and how policy, alongside other factors, shapes their experiences and well-being. …