Digital Commons Network^™

Reducing Stress Related To Injection Therapy: A Zen Bundle Approach, Valoree Bowen

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Needle fear and stress are common barriers preventing adults from seeking necessary medical treatments, including intramuscular (IM) injection therapy. Research highlights the need for evidence-based interventions to mitigate this fear and improve patient experience.

Objective: This evidence-based pilot project included a Zen Bundle—an intervention incorporating shared decision-making, aromatherapy, and distraction—to evaluate the impact on stress reduction and patient satisfaction in a retail vitamin shop in North Texas.

Methods: The project utilized a pre-and post-intervention design over eight weeks. Participants completed pre-surveys assessing stress levels using a Visual Analog Scale before choosing an intervention (aromatherapy, distraction, or both) during IM …

Management Of Obesity In Adults 18 And Older, Donna Callicoat

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Obesity is a significant public health concern in the United States, with increasing prevalence and substantial healthcare costs. Despite evidence-based guidelines for obesity management, primary care clinics often fail to implement them effectively, leading to missed opportunities in preventing obesity-related comorbidities such as cardiovascular disease, type 2 diabetes, and certain cancers.

Purpose: This evidence-based project aimed to implement the American Heart Association/American College of Cardiology/Obesity Society (AHA/ACC/TOS) obesity guidelines in a rural Texas primary care clinic. The goal was to assess the effectiveness of these guidelines in reducing weight, body mass index (BMI), and waist circumference among adults with …

Reducing Caregiver Burden For The Caregivers Of Heart Failure Patients, Joyce W. Kimani

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Family members and friends of heart failure patients serve as informal caregivers for many heart failure patients, helping with the management of day-to-day heart failure care. Many caregivers of heart failure patients experience stressors associated with caregiving, including social, psychological, financial, emotional, and physical stress. Reducing caregiver burden is important in improving both patient and caregiver well-being. Healthcare systems can improve caregiver outcomes and encourage the long-term sustainability of informal caregivers by addressing caregiver needs through focused support strategies. The Agency for Healthcare Research and Quality framework was used to develop an evidence-based guideline that healthcare professionals can follow in …

Efficient Treatment Of Postoperative Nausea And Vomiting In Adults Recovering From General Anesthesia, Peter A. Palko

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

This manuscript explores strategies to address postoperative nausea and vomiting (PONV), a significant complication affecting up to 30% of surgical patients and 80% of those at high risk. Despite its prevalence, appropriate prophylactic administration of antiemetic medications remains suboptimal, with national rates at 67% and certain academic facilities reporting only 32%, far below the 90% recommended threshold. These deficiencies underscore the urgent need for evidence-based interventions to enhance clinical adherence and improve patient care outcomes.

A quality improvement (QI) initiative was implemented to enhance prophylactic treatment and reduce inefficiencies in PONV management. Following a comprehensive literature review, the project employed …

Guideline For The Management Of Immunotherapy-Related Adrenal Insufficiency At A Cancer Center, Rachna R. Patel

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Immunotherapy has become an important treatment option for cancer care and is being utilized more often. Immunotherapy-related adrenal insufficiency (irAI) is a potential adverse effect of immunotherapy that requires endocrine expertise for management. The goal of this project was to create a guideline with an algorithm for the safe and comprehensive management of irAI in an advanced-practice provider-led clinic.

Methods: A guideline project utilizing the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC) Measure Domain Framework was conducted at this cancer care facility. A literature search was conducted to gather the best available evidence and …

Evidence-Based Discharge Bundle To Reduce Heart Failure Readmissions, Chelsea Zepeda

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Heart failure (HF) affects over 6.7 million adults in the United States, resulting in frequent hospitalizations and readmissions, increased mortality, and billions of dollars spent annually on healthcare costs. Reducing readmission rates is a priority for the healthcare industry.

Objective: This evidence-based practice project aimed to reduce HF readmission rates through a bundled approach to address socioeconomic factors that place patients at higher risk for readmission, provide patient-centered education for HF management at home, and provide follow-up phone calls after discharge to assess patient symptoms.

Methods: English-speaking patients, aged 65 or older, with any active diagnosis of HF were …

Implementing The Tips Toolkit To Prevent Falls In Hospitalized Older Adults: A Rural Hospital Approach, Viridiana G. Gonzalez Msn, Rn

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Falls remain the leading cause of injury-related deaths among hospitalized older adults, contributing to significant morbidity, extended hospital stays, and increased healthcare costs. Implementing effective fall prevention strategies is especially challenging in rural hospitals due to staffing shortages, limited funding, and variability in clinical practice.

Local Problem: A 30-bed Medical-Surgical Unit in a rural Southwest Texas hospital experienced a rise in patient falls among older adults aged 65 and older, including several incidents requiring advanced medical treatment and one resulting in serious injury. A gap analysis revealed inconsistent implementation of tailored fall prevention strategies.

Methods: A quality improvement (QI) …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

Implementing The Gad-7 Screening Tool In An Adult Outpatient Psychiatric Clinic, Elizabath George

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Anxiety disorders are among the leading causes of disability worldwide and the most prevalent mental illness in the United States. Despite affecting 6.8 million adults annually, fewer than half with Generalized Anxiety Disorder (GAD) receive treatment. Many patients present with somatic complaints, leading to underdetection. Standardized screening tools such as the Generalized Anxiety Disorder-7 item (GAD-7) can improve identification and outcomes.

Purpose: This quality improvement (QI) project implemented the GAD-7 screening tool in an adult outpatient psychiatric clinic in North Texas and evaluated its impact on identifying patients with GAD, compared to the prior year without structured screening. …

Nonlinear Wave Dynamics In Asteroseismology With Application To Delta Scuti Stars, Mohammed Mourabit

Physics Dissertations - Archive

This thesis compiles the collection of works in nonlinear astroseismology and its implication to the δ Sct variable that we carried over the course of five years. With the advent of high-resolution space missions such as the Kepler and TESS telescopes, we were able to see significant progress in the field in recent years. Nonetheless the new technologies also brought an increasing number of observation that are seemingly contradictory to the linear theory of asteroseismology. In particular, we find the δ Sct variable, which eludes our models in terms of how varied we find they spectra for stars with very …

Algebra Structures For The Koszul Homology Of Minimal Intersections, Kathryn A. Grebel

Mathematics Dissertations - Archive

The Koszul homology of a local ring is a powerful tool in commutative algebra as it provides information on the structure and properties of the ring. In this research, we explore the relationship between quotients of regular local rings and their Koszul homology algebra. One such relationship is detailed by the Tate-Assmus theorem, which asserts, in part, that a ring is a complete intersection if and only if the Koszul homology is generated by its degree 1 homology elements. An objective of this research is to examine and identify the properties of a minimal intersection and its Koszul homology algebra. …

Soft Prompt Tuning For Augmenting Dense Retrieval With Large Language Models, Zhiyuan Peng, Xuyang Wu, Qifan Wang, Yi Fang

Computer Science and Engineering

Dense retrieval (DR) converts queries and documents into dense embeddings and measures the similarity between queries and documents in vector space. One of the major challenges in DR is the lack of domain-specific training data. While DR models can learn from large-scale public datasets like MS MARCO through transfer learning, evidence shows that not all DR models and domains can benefit from transfer learning. Recently, researchers have resorted to large language models (LLMs) to improve the zero-shot and few-shot DR models. However, the hard prompts or human-written prompts utilized in these works are suboptimal and the generated weak …

Advancing Wind Turbine Blade Longevity Through Innovative Trailing Edge Reinforcement Using Auxetic Tpu Structures, Gianluca Provvisiero

Open Access Master's Theses

The trailing edge of wind turbine blades represents one of the most failure prone regions due to local buckling phenomena and repeated mechanical stresses. This thesis explores a specific reinforcement strategy aimed at extending blade longevity by integrating Re-entrant honeycomb structures made of thermoplastic polyurethane (TPU) within the trailing edge. By numerically identifying and targeting high stress zones, the insertion of lightweight auxetic TPU foam enhances local stiffness and mitigates premature failure without compromising aerodynamic performance. Finite Element Analysis (FEA) simulations demonstrate the effectiveness of this approach when compared to blades models without any internal reinforcement. The methodology of this …

Fire District Impacts On Coastal Access In Rhode Island, Annie Longo

Open Access Master's Theses

There are forty-two fire districts in the coastal state of Rhode Island, nine of which are now archaically named, as they no longer provide firefighting services nor have any firefighting responsibilities. Weekapaug, Watch Hill, and Bonnet Shores fire districts are three coastal fire districts that are uninvolved with fire suppression generally, aside from the occasional bonfire permit or fireworks show. Fire districts are quasi-public entities with taxing authorities and land ownership capabilities that act as the “keepers” of many miles of pristine coastline, instead of strictly as fire departments. The actions of these fire districts often conflict with coastal access …

A Systematic Review Of The Role Of Emotion Regulation In Predicting Behavioral Inhibition Symptoms Among School-Aged Youth, Anne C. Nields

Open Access Master's Theses

Mental health challenges represent a key construct to focus on in support of childhood and adolescent well-being. Mental health challenges represent the leading cause of disability among children and adolescents. Recent research on critical periods in brain development shows that early childhood and adolescence mark times in which behavioral, neurodevelopmental, and mental health features arise. Anxiety disorders, which involve the excessive presence of fear and anxiety, are among the most common psychiatric disorders affecting youth and adults today. Emotion regulation (ER) and behavioral inhibition are important constructs correlated to anxiety which may be leveraged to predict and intervene on the …

Association Between Vitamin D Status And Cortisol Concentration Among Pregnant Women, Kenneth Addae

Open Access Master's Theses

Objective: Vitamin D deficiency (VDD) and high circulating cortisol during pregnancy have each been linked to adverse maternal and child outcomes such as preterm birth. However, limited research has explored the association between vitamin D status and cortisol concentration during pregnancy. Our objective for this study was to determine the association between vitamin D status and cortisol concentration among pregnant women.

Methods: The Prenatal Health and Nutrition (PHAN) study was a pilot cross-sectional study of 30 healthy pregnant women conducted in targeted areas in Rhode Island. Data was collected on sociodemographic characteristics, substance use, perceived stress scale, household food security, …

Guide To The Board Of Trustees Records (University Of San Diego), University Of San Diego, San Diego College For Women, San Diego College For Men

University Records

The Board of Trustees acts as the governing body of the University of San Diego. The board holds regular quarterly meetings and special meetings as necessitated by important issues or events. This collection contains the Board of Trustees minutes and related materials reflecting the merger of the San Diego College for Women with the San Diego College for Men and the School of Law in 1972 as well as combined University of San Diego activities through 2016.

Finding Aids are tools used to aid research by describing the materials in a collection. Special Collections Finding Aids include historical and/or biographical …

Diet Quality And Quality Of Life Among People With Parkinson’S Disease, Elizabeth Tierney

Open Access Master's Theses

Poor diet quality (DQ) and reduced quality of life (QoL) are concerns for people with Parkinson’s disease (PwPD). Non-motor (NMS) and motor symptoms (MS) significantly impact the DQ and QoL of PwPD which can be alleviated through diet intervention. This study examined the relationship between DQ and QoL in PwPD and investigated participant perspectives to identify themes related to nutrition care. This was a secondary data analysis of EMPOWER PD. Diet intake was assessed via the Dietary Screening Tool (DST). Quality of life was assessed by the Parkinson’s Disease Questionnaire-39-item (PDQ-39). Participant perspectives were collected through 1:1 interviews. Nineteen participants …

The Intersection Between Adverse Childhood Experiences And Alcohol Use In Rhode Island High Schoolers From Marginalized Backgrounds, Sydney Iacoi

Open Access Master's Theses

Objective: Adverse childhood events (ACEs) are pervasive, affecting more than half the United States’ population. A large body of research has described an association between an increased number of ACEs and negative outcomes, including the development of a substance use disorder later in life. Further, ACEs are disproportionately experienced by individuals from historically marginalized groups. Thus, the interaction between ACEs and substance use may disproportionately impact individuals from historically marginalized groups (i.e., based on ethnicity and sex). The present study’s main aim was to examine the interaction of group differences, specifically based on sex and ethnicity, on the associations …

Financial Factors And Relationship Satisfaction: A Systematic Review Using The Tccm Framework, David Gardner

Open Access Master's Theses

Relationship satisfaction is critically important for the overall health of the relationship and is therefore inherently desirable for anyone who wants to maintain a long-term romantic relationship. Financial factors have been associated with relationship satisfaction in past research, demonstrating a need for systematic exploration. The purpose of the study is to systematically explore how financial behaviors, values, and macroeconomic systems are connected to relationship satisfaction. The current systematic review follows the PRISMA framework for exclusion and identifies 30 articles studying financial factors and relationship satisfaction from Scopus, PsychInfo, and Web of Science. The analysis followed the Theory, Context, Characteristic, and …

Using A Self-Report Survey To Determine Students’ Self-Concept, Math Attitudes, And Achievement In Ability-Grouped Math Classrooms, Jessica T. Blake

Theses and Dissertations--Educational, School, and Counseling Psychology

Ability grouping is a common practice in the United States that aims to acknowledge differences in student ability by dividing students into more homogeneous groups. Numerous studies have examined factors associated with ability grouping such as self-concept, math achievement, and attitudes toward math, but there is little empirical research exploring these three factors simultaneously. The current study examines the differences in achievement level, achievement gains, math self-concept, and attitudes toward math in middle school students enrolled in math classes based on student ability. Participants included 407 middle school students across two schools that use between-class ability grouping for math. Students …

Earthquake Wrangler: Leveraging Ios Technology For Earthquake Detection And Early Warning Application To Enhance Public Safety., Luis F. Salome

Theses and Dissertations--Civil Engineering

Earthquakes are devastating natural phenomena and generate secondary hazards such as tsunamis, landslides and fires. Their catastrophic impacts span both developed nations including the United States, Japan, Turkey, and Italy and developing countries such as El Salvador, Haiti, Nepal and the Philippines, where disparities in early warning infrastructure remain important. Seismic events start with stress waves generated by tectonic plate motion, with body waves (P- waves and S-waves) and surface Rayleigh and love waves that carry energy through the earth. While some regions have adopted advanced early warning systems based on seismic hazard models and strong ground motion analysis, others …

The Disappearance Of Shannon White, Kathryn J. Limberg

Theses and Dissertations--English

The Disappearance of Shannon White is a Mystery-Thriller novel. The aim of the piece is to explore thematic components including perseverance, socio-economic inequities, the stigmas and medical malpractice of the American mental health system in the late twentieth century, and, ultimately, to entertain. My earliest love in the literary world was science fiction and fantasy. Writers like Robert Jordan, and more recently, Simone St. James, create worlds that test the bounds of reality in a way that I find liberating, and I seek to implement this in my own work. Such authors have taught me that fiction offers freedom to …

No Hope?: Queer Negativity, Afropessimism, And The Limits Of Futurity, Colton Barton

Theses and Dissertations--English

Since their inceptions, black and queer studies have sought to articulate the positions of “black” and “queer” within American social life—often converging on the goal of liberation. This thesis examines the intersection of two “negative” theoretical frameworks—Afropessimism and anti-social queer theory (or “queer negativity”)—to interrogate both the limits and generative potential of radical negativity. Though emerging from distinct intellectual traditions, these frameworks conceptualize blackness and queerness as constitutive negations—gaps within the dominant social order that render those so marked inassimilable to normative notions of humanity. While the convergences of these theories can be illuminating, their shared pessimism risks obscuring alternative …

Preserving Nature: Mapping Patriarchal And Imperial Control In Victorian Fiction, Hannah Schultz

Theses and Dissertations--English

In Thomas Hardy’s Tess of the D’Urbervilles, a group of fallen women see “themselves and surrounding nature forming an organism of which all the parts harmoniously and joyously interpenetrated each other” (65). As relational, boundary-dissolving, ecological subjects, these women are empowered above society’s judgment, made “sublime as the moon and stars” (65). By analyzing such representations of ecological relationality in Victorian fiction, my dissertation reveals new forms of agency for women and racialized others. While many ecofeminists have historically disavowed the nature-gender link as reinforcing the shared oppression of nature and marginalized groups, I depart from this standpoint, as …

Feeling And Experience In American Women's Writing From The First World War, Anika Jensen

Theses and Dissertations--English

This dissertation analyzes the political capacity of feeling in American women’s autobiographical and semi-autobiographical writing from and about their work during the First World War. Women produced emotionally complex accounts that resist easy categorization, and I argue that attending to feeling clarifies not only their emotional experiences with war work but their social and political projects. This dissertation closely examines portrayals and rhetorics of feeling, considering the intersections of gender, class, race, and labor in impacting how feelings are depicted, negotiated, and conveyed. While British women were more compelled to perform and convey feeling according to a rigid class system, …

"These Are The Concepts Of The Father": Proclus' Solution To Parmenides' Dilemma, Daniel J. Grifferty

Theses and Dissertations--Modern and Classical Languages, Literature and Cultures

This master’s thesis will attempt to solve a dilemma presented by Parmenides in Plato’s dialogue of the same name. This dilemma arises because the young Socrates suggests that the forms may be thoughts that come to be in the soul. Parmenides responds to this statement by attempting to force Socrates to admit that this can only lead to one of two outcomes: (1) each thing thinks because it is composed of thoughts or (2) each thing does not think, even though it is composed of thoughts. Both of these outcomes are unsatisfactory and do not provide a solid grounding for …

The Houston Climate Justice Museum As A Catalyst For Environmental Justice: Exploring The Intersection Of Art, Activism, And Creative Placemaking In Houston, Texas, Aylin Castro

Theses and Dissertations--Geography

This thesis explores how the Houston Climate Justice Museum (HCJM) functions as a site for environmental/climate justice education through art and community engagement. Drawing on interviews, participant observation, and document analysis, this research examines how the museum’s curating practices generate new understandings of environmental in/justices, fosters local partnerships, and creates a welcoming space for community dialogue. Findings show that the HCJM does more than exhibit art, it demonstrates how art can be leveraged to advance both activist and educational projects. This study positions the HCJM as a model for how local and justice orientated museums and cultural spaces can contribute …

Making Slums Legible, Visible And Calculable: Geospatial Technologies And The Governance Of Urban Land In Mumbai, Sanjana Krishnan

Theses and Dissertations--Geography

This dissertation examines how geospatial technologies are used to make slums in Mumbai legible, calculable, and hypervisible, and how these practices reshape urban land governance. It situates mapping, remote sensing, and algorithmic systems within their political-economic contexts, showing how technologies intending to see the city often function as instruments of dispossession. The research has three interconnected empirical chapters. The first empirical chapter traces the history of slum mapping in Mumbai, from their absences in early development plans to their selective hypervisibility under the contemporary governance regimes. Using critical cartographic methods, it highlights how novel technologies such as remote sensing, biometric …

Analyzing Agency In Online News Reporting Of The Events Of January 6th, 2021: A Corpus-Based Investigation, Matthew W. Abernethy

Theses and Dissertations--Linguistics

Over the last decade or so, politics in the United States has become increasingly polarized. A central focus of this polarization has been the news media, including both traditional print news, online news, and television news. Results of this have been a rapid rise in misinformation, disinformation, the demonization of news (especially political) providers as purveyors of ‘Fake News’, and distrust in mainstream news outlets. The central focus of this thesis is bias in news reporting, leading naturally to the question of how widespread this bias really is. This thesis uses corpus linguistic and discourse analytic methods to pursue this …