Digital Commons Network^™

Reducing Nulliparous, Term, Singleton, Vertex Cesarean Birth Rate, Roseanna Juarez

Master's Projects and Capstones

Abstract

Problem: Cesarean birth rates for nulliparous, term, singleton, vertex (NTSV) pregnancies in the United States continue to exceed the Healthy People 2030 goal of 23.6%, resulting in preventable maternal and neonatal complications and higher healthcare costs.

Context: This quality improvement (QI) initiative was conducted in a high-acuity labor and delivery unit in California’s Central Valley, an area characterized by maternal health disparities, high rates of comorbidities, and limited access to prenatal care. The goal was to reduce the NTSV cesarean rate to 18.0% by July 31, 2025.

Interventions: Guided by Kotter’s 8-Step Change Theory and the Plan-Do-Study-Act (PDSA) framework, …

Mental Health And Substance Use Interventions Within Muslim Community Spaces: A Community Based-Participatory Research Proposal, Halah Mansour Alayleh

Master's Projects and Capstones

Background. Muslim Americans face significant mental health and substance use challenges compounded by Islamophobic discrimination, cultural stigma, and barriers to accessing culturally competent services. They also significantly underuse professional mental health services. Purpose. This study aims to collaborate with Muslim communities within the San Francisco Bay Area to develop a replicable intervention framework for addressing mental health and substance use stigma within mosques and other Muslim community spaces. Methods. The proposal uses a community-based participatory research (CBPR) methodology while integrating the theory of planned behavior (TPB) and stigma theory in the framework. This proposal outlines the four phases of intervention …

Promoting Inclusion Through Evidence-Based Behavior Management: Effective Interventions For Students With Asd In General Education, Emma Kaiser

Masters Projects

As diagnoses of autism spectrum disorder (ASD) continue to rise, general education classrooms are increasingly responsible for meeting the needs of students with ASD. However, many teachers lack the training and resources necessary to manage challenging behaviors effectively. This knowledge gap often results in exclusionary practices such as restraint, seclusion, and suspension, which act as barriers to inclusion. The purpose of this project is to equip educators with evidence-based behavior management strategies that support inclusive practices. Drawing from current research, the project organizes effective interventions into three key categories: preventing challenging behaviors, teaching alternative skills, and reinforcing positive behaviors. Each …

Development Of Numerical Tools And Performance Metrics For Analysis Of Optical Particle Counters, Doug Webb

Theses and Dissertations

Monitoring air quality is essential for understanding and mitigating the health impacts of airborne particulate matter (PM), which is linked to respiratory and cardiovascular disease. Optical particle counters (OPCs) are widely used for air quality monitoring, yet their precision and accuracy remain uncertain due to inconsistent performance evaluations. In this thesis, performance metrics are developed that can be used to assess the accuracy of OPCs in measuring PM concentrations and size distributions. Computational fluid dynamics (CFD) simulations are employed to analyze the behavior of particle-laden air streams through representative OPC models. The impact of design parameters is quantified using newly …

Effects Of Mode And Transitioning To A Mixed-Mode (Web/Phone) Design On Categorical Survey Estimates: Do Question Characteristics Matter?, Mengyao Hu, Vicki A Freedman, Justin Kamens

Faculty, Staff and Student Publications

An increasing number of telephone surveys are introducing a web option. Limited experimental research has explored the implications of such design changes and how they vary by question characteristics. Using an experimental design and propensity score matching techniques, this study examines the effects of mode (web vs. telephone) and transitioning to a mixed-mode design (from telephone-only to the choice of web or telephone) on survey estimates and how effects differ by question characteristics. We draw upon an experiment embedded in the National Study of Caregiving (NSOC), in which half of NSOC-eligible caregivers were randomized to a telephone-only design and the …

The Influence Of Emotional Intelligence On Project Leadership Effectiveness, Puteri Sara Lily Mohd Fauzi

Harrisburg University Dissertations and Theses

Effective leadership was necessary to enable the completion of modern projects due to their increasing complexity. An important component of leadership success was emotional intelligence (EI), which was defined by self-awareness, self-regulation, motivation, empathy, and social skills. This study examined how emotional intelligence affected project leadership effectiveness and how it might have improved project delivery results. The study adopted a qualitative approach and concentrated on detailed information obtained from project managers across a range of industries. Stakeholder communication, team motivation, conflict resolution, and project success rates were examples of leadership performance indicators that were examined in this study in connection …

From Bed To Table: Improving Outcomes By Encouraging Patient Mobility During Meals, Quyen Ho

Master's Projects and Capstones

Abstract

Background: Hospital-acquired pneumonia (HAP) is a preventable complication associated with increased morbidity, prolonged hospital stays, and elevated healthcare costs. Early mobility, particularly positioning patients out of bed for meals, is a key strategy to mitigate this risk. Problem: On a 42-bed telemetry unit, only 24% of eligible patients were positioned out of bed for meals. This low rate of mobility presented an opportunity to reduce the risk of HAP and improve patient outcomes. Interventions: This quality improvement initiative, guided by the Donabedian Model, employed a nurse-led intervention that included daily mobility assessments, visual bedside cues, and targeted staff education. …

Implementing Strategies To Reduce Hospital Readmission Reduction Program Readmissions By Improving Discharge Planning In Nonprofit Hospitals, Joy Nwagboliwe Chukwu

Walden Dissertations and Doctoral Studies

Non-profit healthcare administrators in United States hospitals face the challenge of hospital readmissions, especially due to the CMS Hospital Readmission Reduction Program (HRRP), which affects reimbursement. The purpose and review question for this integrative review was to research evidence-based strategies that could be implemented to improve the discharge planning process in non-profit hospitals and reduce readmissions for patients with HRRP diagnoses. A review of literature identified 126 articles for analysis, with 25 studies selected for quality assessment using the Johns Hopkins Nursing Evidence-Based Practice Model and the Research Evidence Appraisal form. The Donabedian framework provided a structured approach for evaluating …

Teacher Challenges In Ela Instruction For Low-Achieving Elementary Students In Urban Title I Schools, Keshiea Tamika Chandler

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study is that approximately 80% of upper elementary students do not reach proficiency in English Language Arts (ELA) at an urban Title I school district in Georgia, despite implementing intervention and literacy programs. Guided by Senge’s organizational learning theory and Vygotsky’s sociocultural theory, the purpose of this qualitative study was to investigate the challenges that elementary teachers face when providing ELA instruction to low-achieving students in a local Title I school district in Georgia. For this basic qualitative design, semistructured interviews were conducted with 12 ELA teachers across Grades 3-5. Data were analyzed …

Non-Traditional Student Experiences With Using An Asynchronous Video Writing Tutorial, Michele Sweeting-Decaro

Walden Dissertations and Doctoral Studies

The problem investigated in this study was that low-level writing skills among postsecondary, non-traditional students contributed to poor essay grades, a lack of persistence, and low test scores, resulting in increased drop-out rates. A college writing center in a large city in the Northeastern United States developed an innovative, asynchronous tutorial to improve students' writing skills. The purpose of this basic qualitative study was to explore the experiences of non-traditional students at a four-year college regarding an on-demand asynchronous writing tutorial offered by the college writing center. The technology acceptance model was used to frame the study because it has …

Application Of Hybrid Agile-Waterfall In Digitization Of The Fashion Industry, Aashni Tulsian

Harrisburg University Dissertations and Theses

This qualitative study explored employee perceptions of hybrid agile–waterfall methodologies during a digital transformation at a luxury fashion company. Using the Technology Acceptance Model (TAM) as a framework, the research examined how employees with limited exposure to agile frameworks understood, accepted, and anticipated their impact across creative, operational, and technical departments, focusing on perceived usefulness, ease of use, training, leadership support, and cultural fit. Twelve semi-structured interviews were conducted with professionals from merchandising, design, IT, logistics, and digital operations. Thematic analysis revealed limited familiarity with agile principles, moderate perceived usefulness, low ease of use, and widespread demand for contextualized training …

A Comprehensive Evidence-Based Educational Initiative For Improving Hand Hygiene, Lyanna L. Chan

Master's Projects and Capstones

Abstract

Problem: Healthcare-associated infections (HAIs) are a persistent concern in assisted living facilities, often resulting from inconsistent hand hygiene practices. Although national guidelines exist, adherence remains suboptimal, especially where staff training and compliance monitoring are limited.

Context: This project took place in a 53-bed assisted living facility without a formal system to track or reinforce hand hygiene. The aim was to improve staff knowledge and promote infection prevention through education.

Interventions: A Clinical Nurse Leader (CNL) led an evidence-based hand hygiene education program. The intervention included interactive training, visual reminders, personal sanitizers, and leadership support during clinical huddles.

Measures: Pre- …

Wavelet Representation Of Singular Integral Operators, Jeremy Cummings

Arts & Sciences Graduate Student Theses and Dissertations

The idea of representing singular integral operators as averages dyadic shifts has proven fruitful since Petermichl's representation of the Hilbert transform, and its generalization by Hyt\"onen to prove the $A_2$ conjecture. These results employ a random dyadic decomposition of the operator in terms of Haar shifts of all complexities. An alternate approach to wavelet representation was provided by Di Plinio, Wick, and Williams (2022) in which the random dyadic grids are replaced by zero-complexity wavelet projections, providing finer control of smooth operators and a more efficiently computable representation. The goal of this thesis is to provide two main generalizations of …

Shared Kitchens Changing The Housing Development, Agniya Seliuzhytskaya

McNair Summer Research Program

In response to the escalating housing crisis and ongoing economic disruptions, many individuals have turned to home-based food entrepreneurship as a means of financial stability. The Microenterprise Home Kitchen Operation (MEHKO) program enables residents to legally operate small-scale food businesses from their private kitchens, effectively blurring the line between domestic and commercial space. This research investigates how MEHKOs challenge conventional understandings of housing, domesticity, and zoning, and considers how shared or adaptable kitchen models might inform emerging housing typologies.

The study combines spatial and policy analysis by mapping the distribution of approved MEHKO sites in San Diego and overlaying that …

The Consequences Of Workplace Racial Discrimination: A Scoping Review, Yaritza A. Ortiz, Evelyn D. Sarsar

McNair Summer Research Program

Racial discrimination has been consistently associated with negative mental health outcomes among marginalized communities. Racial discrimination within the workplace has shown to be detrimental to mental well-being and behavioral outcomes, however, there is much less work investigating these links. Therefore, this scoping review aimed to understand the association between workplace racial discrimination and mental and behavioral health outcomes.

Empirical articles were identified using Google Scholar and PsycINFO. The extracted data included, design of the study, the number of participants, ethnicity or race, type of discrimination, mental or behavioral outcome, and the results produced by the data. For the final review, …

Empowering Medical-Surgical Nurses To Conquer Burnout: Building Resilience And Wellness, Catherine P. Morante

Master's Projects and Capstones

Problem: In the healthcare industry, nurse burnout is a well-documented issue that affects the well-being of both healthcare professionals and their patients. Burnout manifests as intense exhaustion, depersonalization, and diminished personal accomplishment (Okoniewski & Verni, 2024).

Context: Burnout affects patient outcomes and drives up costs (Dall’Ora et al., 2020). When nurses are overwhelmed, attendance is affected (Unpublished confidential document; 2024). Resilient nurses are essential to a healthy, reliable workforce (Unjai et al., 2024).

Interventions: From May to July 2025, a 12-week initiative was launched to reduce the effects of nurse burnout in the workplace. Evidence-based interventions were implemented, incorporating educational …

Illuminating Leadership Excellence: An Evidence-Based Qi Intervention Reigniting Nurse Leaders From Burnout To Brilliance Using Caring Science And Reflective Practice, Matthew S. Elliott

Master's Projects and Capstones

Abstract

Problem: A 2024 assessment at a 250‑bed Northern California medical center revealed that 76% of 16 inpatient nurse leaders met "high‑burnout" criteria on the Maslach Burnout Inventory, and leader turnover had climbed to 25%, more than triple national benchmarks, threatening patient care quality, financial stability, and alignment with Magnet® and employee engagement goals.

Context: Root causes included pandemic‑era promotions without development support, a task‑oriented leadership culture, and eroding psychological safety (Press Ganey engagement ≈ 30%). An integrative logic model positioned Watson's Caring Science as the theoretical base, Schön's Reflective Model for adaptive learning, and the Prosci ADKAR change framework …

Enhancing Client Intake Efficiency In The Removal Defense Program: A Nursing-Led Quality Improvement Initiative, Johnny Linares, Julia Tran Ngo, Daniel Orea, Atheana Yadira Lopez

Master's Projects and Capstones

This quality improvement project focuses on optimizing the intake process for the Removal Defense Program at a nonprofit immigration legal office serving asylum-seeking clients. The existing intake relied on unstructured, phone-call-based intake interviews that gathered incomplete information, leading to inconsistent documentation, reduced efficiency, and significant client processing delays. A structured, multilingual, and multiplatform new-client admission protocol coupled with the implementation of a client-facing resource guide for waitlist clients were co-developed and implemented using the Lippitt Change Theory framework. Utilizing a mixed methods approach, the study involved staff interviews and observational assessments with staff members from the program. Baseline intake process …

Increasing The Feasibility, Impact, And Equity Of The Medicare Annual Wellness Visit (Awv) With A Practice Tailored Awv Intervention: A Stepped Wedge Clinical Trial Protocol, Chi-Hong Tseng, Neil S. Wenger

Faculty Scholarship

Background Older adults vastly underutilize evidence-based preventive health services and screenings that reduce illness, morbidity and mortality. The free-to-patient Medicare Annual Wellness Visit (AWV) is an opportunity to enhance preventive healthcare use, but also is underused. Objectives To evaluate the effect of a practice-tailored intervention on the sustained use of Medicare AWVs and on guideline-recommended preventive services and racial/ethnic disparities in 3 types of practice settings. Methods This is a stepped wedge cluster randomized controlled trial. The intervention will be implemented at the practice level in 24 primary care practices across the country (8 community-based, 8 academic, and 8 serving …

Beyond A Monoracial Paradigm: Parents Practicing Racial Humility In The Racial Socialization Of Mixed-Race Children, Katherine Johnson

Sociology

Interracial parents face unique challenges in racially socializing their mixed-race children, but this socialization is imperative to their overall well-being and self-esteem. Using critical multiracial theory, the author argues that the interracial parents included in this study overwhelmingly understand the harm of promoting a monoracial paradigm of race when raising their children. They demonstrate this by implementing racial humility in their socialization practices to support and encourage the formation of a positive racial identity in their children. Drawing upon in-depth, semistructured interviews with 19 sets of interracial parents in the United States, the author identifies four themes related to how …

Genetic And Environmental Factors Contributing To The Pathogenesis Of Vertebral Osteomyelitis Caused By Enterococcus Cecorum In Broiler Chicken, Ummu Syauqah Al Musyahadah, Andi Asnayanti, Anh Dang Trieu Do, Adnan Alrubaye

Poultry Science Faculty Publications and Presentations

Enterococcus cecorum (EC) is the primary cause of Vertebral Osteomyelitis (VO) in poultry, characterized by a hock-sitting posture with legs extended forward. The disease begins with intestinal colonization, where pathogenic strains of E. cecorum establish themselves in the gut within the first week of a bird's lifecycle and translocate to the bloodstream later, reaching the organs, which finally infect the birds' Free Thoracic Vertebrae (FTV). Several factors contribute to the initiation and progression of the disease. Environmental factors such as heat stress, high blood sugar levels, prior infections, overcrowding, and rapid growth conditions weaken immunity and stimulate the emergence of …

The Effect Of Feed And Water Provision Strategies On Broiler Breeder Pullet Performance And Welfare, Allison D. Weaver, Lisa R. Bielke, Ramon D. Malheiros, Sara K. Orlowski, Allison N. Pullin

Poultry Science Faculty Publications and Presentations

Feed restriction is common in the broiler breeder industry to optimize health and reproduction. However, this practice has been associated with increased drinking behavior, leading to water spillage, higher litter moisture, and footpad lesions. Consequently, parts of the industry have adopted water restriction protocols. This study aimed to evaluate how different combinations of feed and water restriction affected drinking behavior, welfare, and performance indicators in broiler breeder pullets. At 1 day of age, 960 Cobb 500 FF pullets (Gallus gallus domesticus) were randomly allocated to one of four treatments: skip-a-day feeding with ad libitum water (SAD + ADLIB), every-day feeding …

The Anti-Work Attitude Scale: Conceptualizing And Measuring The Resistance To The Institution Of Work, Alayna Del Rosario

Master's Theses

Recent shifts in labor discourse have drawn attention to rising burnout, declining organizational commitment, and diminishing job satisfaction, which challenge traditional assumptions about the centrality and desirability of work. These tensions have given rise to the concept of anti-work, a growing discourse that questions the moral, economic, and psychological foundations of work itself. Despite its cultural relevance, anti-work remains largely undertheorized and unmeasured in empirical research. Drawing from interdisciplinary scholarship, this study defined anti-work as a negative critique of work as a social construct, questioning its value, purpose, and impact on individuals and society. Anti-work was operationalized through two higher-order …

Stability Of Micrornas In Serum And Plasma Reveal Promise As A Circulating Biomarker, Erryk S. Katayama, Jonathan J. Hue, Alexander W. Loftus, Semmer A. Ali, Hallie J. Graor, Luke D. Rothermel, Eric R. Londin, Mehrdad Zarei, Jordan M. Winter

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

PURPOSE: To verify the stability and reliability of circulating microRNA (miRNA) profiles in plasma and serum under different processing and storage conditions to inform future applications to circulating biomarker analyses.

BACKGROUND: The development of blood-based methods for early disease detection has become increasingly desirable across various medical fields. RNA profiles have been investigated but have been a challenge due to rapid degradation of the analyte by ubiquitous RNases. miRNAs are short, non-coding regulatory RNAs that are believed to be more stable under certain conditions, large in number, and specific to cell type and disease state. Thus, circulating miRNA profiles hold …

Correction: Development And Extensive Sequencing Of A Broadly-Consented Genome In A Bottle Matched Tumor-Normal Pair, Jennifer H Mcdaniel, Vaidehi Patel, Nathan D Olson, Hua-Jun He, Zhiyong He, Kenneth D Cole, Alexander A Gooden, Anthony Schmitt, Kristin Sikkink, Fritz J Sedlazeck, Harsha Doddapaneni, Shalini N Jhangiani, Donna M Muzny, Marie-Claude Gingras, Heer Mehta, Sairam Behera, Luis F Paulin, Alex R Hastie, Hung-Chun Yu, Victor Weigman, Alison Rojas, Katie Kennedy, Jamie Remington, Isai Salas-González, Mitch Sudkamp, Kelly Wiseman, Bryan R Lajoie, Shawn Levy, Miten Jain, Stuart Akeson, Giuseppe Narzisi, Zoe Steinsnyder, Catherine Reeves, Jennifer Shelton, Sarah B Kingan, Christine Lambert, Primo Baybayan, Aaron M Wenger, Ian J Mclaughlin, Aaron Adamson, Christopher Kingsley, Melanie Wescott, Young Kim, Benedict Paten, Jimin Park, Ivo Violich, Karen H Miga, Joshua Gardner, Brandy Mcnulty, Gail L Rosen, Rajiv Mccoy, Francesco Brundu, Erfan Sayyari, Konrad Scheffler, Sean Truong, Severine Catreux, Lesley Chapman Hannah, Doron Lipson, Hila Benjamin, Nika Iremadze, Ilya Soifer, Gat Krieger, Stephen Eacker, Mary Wood, Erin Cross, Greg Husar, Stephen Gross, Michael Vernich, Mikhail Kolmogorov, Tanveer Ahmad, Ayse G Keskus, Asher Bryant, Francoise Thibaud-Nissen, Jonathan Trow, Jacqueline Proszynski, Jeremy Wain Hirschberg, Krista Ryon, Christopher E Mason, Mital S Bhakta, J Zachary Sanborn, Elizabeth M Munding, Justin Wagner, Chunlin Xiao, Andrew S Liss, Justin M Zook

Faculty, Staff and Students Publications

No abstract provided.

Micbg406a Polymorphism Reduces Risk Of Mechanical Ventilation And Death During Viral Acute Lung Injury, Harry Pickering, Narges Alipanah-Lechner, Ernie Chen, Dylan Duchen, Holden T Maecker, Seunghee Kim-Schulze, Ruth R Montgomery, Chris Cotsapas, Hanno Steen, Florian Krammer, Charles R Langelier, Ofer Levy, Lindsey R Baden, Esther Melamed, Lauren Ir Ehrlich, Grace A Mccomsey, Rafick P Sekaly, Charles B Cairns, Elias K Haddad, Albert C Shaw, David A Hafler, David B Corry, Farrah Kheradmand, Mark A Atkinson, Scott C Brakenridge, Nelson I Agudelo Higuita, Jordan P Metcalf, Catherine L Hough, William B Messer, Bali Pulendran, Kari C Nadeau, Mark M Davis, Ana Fernandez Sesma, Viviana Simon, Monica Kraft, Chris Bime, David J Erle, Joanna Schaenmann, Al Ozonoff, Bjoern Peters, Steven H Kleinstein, Alison D Augustine, Joann Diray-Arce, Patrice M Becker, Nadine Rouphael, Matthew C Altman, Steve Bosinger, Walter Eckalbar, Carolyn S Calfee, Oscar A Aguilar, Elaine F Reed, John R Greenland, Daniel R Calabrese

Faculty, Staff and Students Publications

MHC class I polypeptide-related sequence B (MICB) is a ligand for NKG2D. We have shown NK cells are central to lung transplant acute lung injury (ALI) via NKG2D activation, and increased MICB in bronchoalveolar lavage predicts ALI severity. Separately, we found a MICB polymorphism (MICBG406A) is associated with decreased ALI risk. We hypothesized this polymorphism would protect against severe SARS-CoV-2 respiratory disease. We analyzed 1,036 patients hospitalized with SARS-CoV-2 infection from IMPACC. Associations between MICBG406A and outcomes were determined by linear regression or Cox proportional hazards models. We also measured immune profiles of peripheral blood and the upper and lower …

Dual-Function Polyester Nanoparticles For Amplified Anti-Inflammatory Effects, Ingrid M Heyns, Abiodun T Wahab, Raghu Ganugula, David Sheikh-Hamad, M N V Ravi Kumar, Meenakshi Arora

Faculty, Staff and Students Publications

This study investigates a dual-acting drug delivery system using naringenin (NAR) as a folate receptor ligand to enhance intestinal uptake and encapsulated NAR for combating inflammation. The dual-acting systems were tested in vitro on cisplatin-induced human kidney-2 cells and in vivo in a mouse model of cisplatin-induced acute kidney injury (AKI). NAR-loaded passive nanoparticles [P2Ns(NAR)] and dual-acting systems [P2Ns-NAR(NAR)] showed notable advantages over unformulated NAR, reducing the required dose by up to 57 and 79%, respectively. These nanoparticles modulated immune responses, restored T cell function, and shifted macrophage polarization from proinflammatory M1 to tissue-repairing M2. In addition, P2Ns-NAR(NAR) alleviated AKI …

Urban Wildlife In Your Backyard: Community Experiences With Coyotes And Outdoor Cats, Clarissa Emma Cressotti

Dissertations and Theses

Urbanization reshapes ecological processes by fragmenting habitat and altering patterns of human-wildlife interaction, often reducing biodiversity. However, at the household scale, residential yards can either enhance or inhibit ecological connectivity - functioning as informal habitat stepping stones or barriers to wildlife. This thesis examines how residents' environmental attitudes, wildlife experiences, and socio-demographic characteristics influence yard-level behaviors and shape the presence of urban-adapted wildlife species, particularly coyotes and domestic cats, across the Portland, Oregon metropolitan region. A mixed-methods, social-ecological framework guided the analysis, integrating survey data from 244 households with wildlife detections from motion-triggered cameras (Urban Wildlife Information Network, UWIN), citizen …

Celebrating 20 Years Of Abriendo Oportunidades: Transforming The Lives Of Indigenous Girls In Guatemala, María Isabel Mayorga

Adolescents and Young People

This blog post originally appeared on the Population Council’s website in August 2025.

Tenth Anniversary Celebrations Of Aga Khan University Karachi

University anniversary celebration materials

No abstract provided.