Digital Commons Network^™

Staff Education In An Outpatient Psychiatric Setting Using The Teach-Back Method To Improve Staff Knowledge Toward The Ultimate Goal Of Improving Medication Adherence, Laura Assanga Eyong

Walden Dissertations and Doctoral Studies

For this doctoral project, I implemented a structured staff education intervention at an outpatient psychiatric clinic that required a practice change to address medication nonadherence among patients diagnosed with schizophrenia. The practice-focused question was: For staff in an outpatient psychiatric setting, will structured education on the use of the teach-back method improve staff knowledge toward the ultimate goal of improving medication adherence? The goal of this project was to conduct a rigorous education program using the analysis, design, development, implementation, and evaluation model to bridge the communication gap between staff and patients. Staff knowledge was evaluated via a pre-/posttest design …

Effectiveness Of A Multifaceted Educational Program For Patients Receiving Oral Anticoagulants, Yu-Hsia Tsai, Meei-Fang Lou, Chi-Tai Kuo, Her-Kun Chang, Kuo-Liong Chien, Bih-Shya Gau, Lai-Chu See

International Nursing Research Congress (INRC)

Background: Atrial fibrillation (AFib) is a common arrhythmia associated with elevated risks of stroke and mortality. Oral anticoagulants (OACs) are prescribed to reduce stroke risk, yet many patients lack sufficient understanding of their use. Effective educational strategies are crucial for enhancing medication safety and minimizing complications.

Purpose: This study evaluated the effectiveness of a multifaceted, interactive education program for patients with AFib taking OACs. Grounded in the Health Belief Model, the intervention was delivered via a mobile application (App). Its effectiveness was compared to a control group receiving a printed brochure. Outcomes included patient knowledge, health beliefs, and medication satisfaction. …

Collaborative Community Partnership To Support Foster Families Caring For Medically Complex Children, Christine Rae Platt, Sally Ann Martens, Nyah Haltom, Michael Thomas, Brandon Thatcher

International Nursing Research Congress (INRC)

Background: Children in foster care experience disproportionate health challenges, particularly those with medical complexity or disabilities. Foster families often report unmet needs related to health literacy, access to care, and caregiver support. Recognizing these challenges, a university-community partnership was established with a state foster care foundation to assess current gaps and identify opportunities to strengthen health and resource support for foster families.

Purpose: To assess the needs of foster families caring for medically complex or disabled children and to collaboratively develop feasible, culturally competent strategies to address identified gaps in care and resources.

Methods: A community-based participatory approach was used …

Stop Blaming My Users: Illumination Of The Technocentric Mythos Bias, Ervin H. Frenzel, Richard Lightcap

Journal of Cybersecurity Education, Research and Practice

 Abstract -This conceptual essay addresses the need for systemic and systematic transdisciplinary analytical techniques within cybersecurity and technical security. This conceptual essay is contingent upon recognition that cybersecurity is not simply technical in nature, it does not need an adversary, and more importantly it is based upon systems engineering and systems thinking.  The essay contributes a socio-technical attribution chain and field-specific ontology/taxonomy which distinguish user-triggered events from root causes, latent conditions, technical debt, validation failures, governance failures, and attribution bias before assigning responsibility to end users. It systematically defines an ontology inclusive of developer technical debt, organizational debt arising from …

Looking Inwards, Turning Away: A Review Of Rehan Abeyratne’S ‘Courts And Lgbtq+ Rights In An Age Of Judicial Retrenchment’, Jwalika Balaji

Socio-Legal Review

This review engages with Rehan Abeyratne's book Courts and LGBTQ+ Rights in an Age of Judicial Retrenchment, which examines judicial responses to LGBTQ+ claims over the past two decades across three jurisdictions — the United States, India, and Hong Kong. Abeyratne argues that the apex courts in these countries have grown more inward-looking and have enabled the rise of illiberal and authoritarian forces; however, LGBTQ+ rights have emerged as an exceptional site where these courts continue to extend minimal remedies and adopt a tone of empathy, positioning themselves as the last bastion of liberal constitutionalism. Focusing on recent developments …

Genetic Associations With Pulmonary Embolism Among Those With A Deep Vein Thrombosis: The International Network Against Venous Thrombosis Consortium, Susana Lozano-Esparza, Gabrielle E Shakt, Jennifer A Brody, Angel Martinez-Perez, Matthew P Conomos, Marine Germain, Katharine R Clapham, Maris Teder-Laving, Astrid Van Hylckama Vlieg, Anni Kauko, Florian Thibord, Ohanna C L Bezerra, Girish N Nadkarni, Gaëlle Munsch, Therese Haugdahl Nøst, Ellen L Goode, Yuekai Ji, Daniel I Chasman, Alexander P Reiner, Constance Turman, Kerri L Wiggins, Colleen M Sitlani, Juan Carlos Souto, Pamela L Lutsey, Tiffany Bellomo, Estonian Biobank, Million Veteran Program, Ruifang Li-Gao, Aleksi Kristian Winstén, Ming-Huei Chen, Ron Do, Lénaick Gourhant, Kristian Hveem, Sebastian M Armasu, Noémie Saut, Nathan Pankratz, Franco Giulianini, Jeffrey Haessler, Mingyang Song, Robert Olaso, Eric Boerwinkle, Daniel Dochtermann, Jose Manuel Soria, Stephen S Rich, David Smadja, Satoshi Koyama, Frits R Rosendaal, Teemu Niiranen, France Gagnon, Ha My T Vy, Neil Zakai, Catherine Lemarie, Anne Heidi Skogholt, Jean-François Deleuze, James S Pankow, Paul M Ridker, Yuxi Liu, Kenneth M Rice, Saiju Pyarajan, Mary Cushman, Jospeh Emmerich, Bruce M Psaty, Pradeep Natarajan, Andrew D Johnson, Marc A Rodger, Pierre Suchon, Francis Couturaud, Pierre-Emmanuel Morange, Weihong Tang, Charles Kooperberg, Christopher Kabrhel, Maria Sabater-Lleal, David-Alexandre Trégouët, Alisa S Wolberg, Scott M Damrauer, Nicholas L Smith

Children’s Nutrition Research Center Staff Publications

Background: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE), the latter of which often originates from DVT and can be fatal.

Objectives: The aim of this study was to identify causal genetic factors that alter risk of PE among those with a presumed DVT.

Methods: Using a case-only design of VTE, we conducted meta-analyses of genome-wide association studies (GWASs) in the International Network Against Venous Thrombosis Consortium. Among participants diagnosed with VTE, each study identified those who had a clinically reported PE, with or without a clinically reported DVT; those remaining had isolated DVT. Logistic regression …

Hill, Patricia Evridge, San Jose State University

Emeritus and Retired Faculty Biographies

University of Texas at Dallas, Humanities, Emphasis in History, Ph.D. 1990

University of Texas at Dallas, Humanities, Emphasis in History, M.A. 1984

Southern Methodist University, History Major; Spanish Minor, B.A. 1979

Lifetime Texas Teaching Credential Grades 6 through 12, History and Spanish, 1980

Artificial Intelligence Mechanisms In The Limit Of Crimes And Law Enforcement, Saad Mefleh Alsuwaileh

Journal of Police and Legal Sciences

This study explores the potential of employing technological mechanisms and modern innovations brought about by the Fourth Industrial Revolution, particularly advancements in the field of information technology, in the domains of criminal investigation, crime prevention, and law enforcement. It aims to analyze the impact of these technologies on crime control efforts and the promotion of justice.

The significance of the study lies in highlighting the power of technology in processing and analyzing massive volumes of data with greater speed and accuracy, thereby enhancing the efficiency of criminal investigations and the ability to predict and prevent crimes. The core research question …

Legal And Functional Status Of The Public Prosecution Office In The Moroccan Judicial System - A Comparative Analytical Study, Hatim Anouar

Journal of Police and Legal Sciences

Over the past decade, Morocco has chosen to embark on an experiment aimed at making the Public Prosecutor’s Office independent of the executive branch, by severing any links that might bind it to the Minister of Justice, and by enshrining this independence not at the constitutional level, but at the legislative level. Although this initiative continues to face numerous challenges and issues, it has not been accompanied by a review of the legal and operational status of the Public Prosecutor’s Office, which gives rise to many problems and contradictions.

In this article, the author seeks to shed light on the …

Criminal Investigation Of Crimes Committed In A Metaverse Environment: A Comparative Analytical Study, Hussein Abdelmoaty Abdelnaby

Journal of Police and Legal Sciences

The world is undergoing a radical transformation in the nature of social spaces and human interactions, driven by the emergence of advanced virtual environments such as the "metaverse," which represents a multi-dimensional digital extension of the real world. This transformation has led to the emergence of new forms of criminal activity occurring within this immaterial space, raising fundamental questions about the adequacy of traditional legal and procedural frameworks—particularly criminal investigation mechanisms—in keeping pace with these developments.

This study aims to analyze the key legal and procedural challenges associated with crimes committed in the metaverse and assess the adequacy of the …

Investigating Learning In Immersive Virtual Reality, Andrew Negrette

Master's Theses

Students often struggle with learning challenging subjects throughout their education. This also tends to lead to lower enjoyment and science self-efficacy for learning. Some subjects may be better represented in 3-dimensional spaces utilizing immersive virtual reality (IVR). Recently, IVR headsets have become more accessible and affordable and therefore are in wider use. The purpose of this study was to investigate whether differences in science selfefficacy, enjoyment, presence and knowledge retention exist between IVR and controls on an ocean acidification lesson. I predicted that participants taking the lesson in IVR would score higher compared to a laptop on all measures, due …

Match Made In Ml: Developing Compatibility Relationships In Evidential Reasoning Approaches With Machine Learning, Ella Jolie Thomas

Master's Theses

The presented expectation maximization informed evidential reasoning model extends the ability of the evidential reasoning calculus to support decision making by integrating an adaptive model learning capability. Compatibility relationships in Evidential Reasoning models are traditionally built by human domain experts. This process is labor-intensive, especially for large and complex models. Additionally, when new data becomes available, compatibility relationships must be reconstructed. Using machine learning and the expectation maximization algorithm, it is demonstrated that compatibility relationships can be constructed that learn relationships between domain knowledge that is used to make decisions. Using drug development as a domain of application, a traditional …

Effects Of Variable Light On Sexual Competition In Kelp Species, Jaycee Lanza

Master's Theses

As foundation species, kelps significantly influence the structure and composition of their surrounding habitat by modifying environmental conditions, including light levels, currents, nutrient availability, sedimentation, and seawater chemistry. Light, in particular, is a critical resource that varies greatly within kelp forests, affecting kelp reproductive processes such as gametogenesis, fertilization, and recruitment, which are vital to population persistence. Biological factors, such as density-dependent competition for resources and sexual competition with other kelps, can also affect such processes. To understand how environmental variables influence kelp populations, it is crucial to recognize their combined effects. This study investigated the impacts of light levels …

Hydrus Modeling Of A Sahelian Agroforestry System: An Investigation Of Local Water Balance, Nicole A. Butler

Master's Theses

Effects of drought can devastate agricultural productivity in the West African Sahel. Climate complexities, such as lower-than-average rainfall and high winds, can lead to crop failure and low yields, thereby creating food security issues. Agriculture in the Sahel is primarily rainfed, and the rain is becoming increasingly unpredictable due to the changing climate. The method of intercropping groundnut (Arachis hypogea) and pearl millet (Pennisetum glaucum) with the shrub species Piliostigma reticulatum can combat the effects of climate change and restore degraded soil. Intercropping can increase water availability and crop yield when compared to crops grown in the absence of shrubs. …

Health Literacy, Health Information Seeking Behavior, And Vocal Hygiene Amongst Video Game Voice Actors In The United States, Wendy Lau

Master's Theses

Video game voice actors (VGVAs) perform vocally demanding tasks to bring video game characters to life, and are at high risk for voice disorders. This exploratory study aims to characterize vocal health in VGVAs by investigating the relationships between health literacy, health information seeking behavior, and vocal hygiene practices. Thirty-one VGVAs completed an anonymous online survey. Data were analyzed using a mixed-methods approach: quantitative health literacy scores were calculated, and qualitative data underwent inductive thematic analysis in NVivo. Results show that VGVAs are highly proactive with their vocal health due to their desire for career longevity and their professional vocal …

Hybrid Microbial-Enzymatic Electrosynthesis For De Novo Decanoic Acid Production From Co2, Yongze Wang, Wenjin Dong, Meijing Wei, Su Song, Zhiqing Huang, Yaojie Liu, Shelley D. Minteer, Hui Chen

Chemistry Faculty Research & Creative Works

The steady increase in atmospheric CO₂ levels is a key driver of anthropogenic climate change, prompting widespread global concern. In this context, the sustainable conversion of CO₂ into value-added chemicals represents an attractive route toward carbon-neutral manufacturing and green chemistry. Here, we developed a proof-of-concept hybrid microbial-enzymatic electrosynthesis system that combines microbial electrosynthesis (MES) and enzymatic electrosynthesis (EES) to convert CO₂ into decanoic acid under ambient conditions, using electrical energy. In the MES module, CO₂ was converted to acetate via the Wood–Ljungdahl pathway of Clostridium ljungdahlii, using H2 produced by electrochemical water splitting as the electron …

Bureaucratic Politics Of Reforestation In Indonesia's Conservation Areas: Turf Protection, Competing Mandates, And Implementation Deadlocks, Arief Setiyo Utomo, Pande Made Kutanegara, Ahmad Maryudi

Forest and Society

In response to extensive deforestation and land degradation, the Indonesian government has made reforestation one of its top policy priorities. Although several reforestation programs have been implemented, their outcomes have often been constrained by governance-related challenges. This study examines the political dynamics of reforestation in conservation areas by analyzing interactions between two key bureaucracies within the Ministry of Forestry: the Directorate General of Watershed Management and Forest Rehabilitation (DG-WMFR) and the Directorate General of Natural Resources and Ecosystem Conservation (DG-NREC). Drawing on the bureaucratic politics perspective, we show how competing mandates, organizational interests, and bureaucratic turf protection motives shape the …

Establishing E-Prodeskel, An Integrated Village Information System For The Empowerment Of The Local Community In Kediri, Ani Budi Astuti, Eni Sumarminingsih, Wayan Firdaus Mahmudy, Maulina Pia Wulandari, Wigbertus Ngabu, Nur Kamilah Sa'diyah, Gusti Ayu Putu Rawi Rotchildi, Izza Lailatul Kasanah, Yusuf Gladiensyah Bihanda, Akbar Satya Nugraha

ASEAN Journal of Community Engagement

Digital transformation has become an important strategy for strengthening community empowerment by improving access to public information, governance transparency, and village services. However, many rural communities in Indonesia still face challenges in managing accurate village profile data and utilizing digital technologies to support good governance and sustainable development. This study examines a community engagement program in Purwokerto Village, Kediri Regency, Indonesia. The program intended to develop and implement E-ProDesKel (Elektronik Profil Desa Kelurahan or Electronic Village and Wards Profile), a web-based portal for an integrated village profile information system. The program adopted a participatory approach starting from an assessment …

Deep Neural Networks: A Formulation Via Non-Archimedean Analysis, Wilson A. Zuniga-Galindo

School of Mathematical & Statistical Sciences Faculty Publications

We introduce a new class of deep neural networks (DNNs) with multilayered tree-like architectures. The architectures are codified by using numbers in the ring of integers of non-Archimedean local fields. These rings have a natural hierarchical organization as infinite rooted trees. Natural morphisms on these rings allow us to construct finite multilayered architectures. The new DNNs are robust universal approximators of real-valued functions defined on the mentioned rings. We also show that the DNNs are robust universal approximators of real-valued square-integrable functions defined in the unit interval.

Impact Of Organizational Climate And Leadership Style On Nurse Practitioners' Job Satisfaction, Sung Chien Mei

International Nursing Research Congress (INRC)

Background: Job satisfaction in nurse practitioners is influenced by the level of autonomy and empowerment they perceive within their practice environment. Little in-depth research has been done to explore the relationship among organizational climate, leadership style, and job satisfaction in the context of nurse practitioners.

Purpose: This study was developed to explore the relationship among organizational climate, leadership style,and job satisfaction in nurse practitioners with the goal of enhancing their job satisfaction.

Methods: A cross-sectional correlational approach and snowball sampling method were employed to recruit400 qualified nurse practitioners to complete an online survey. This survey was a structured questionnaire consisting …

Supports And Challenges For Esns In Higher Education: A State University Qualitative Study, Dilkash Ahmed

Dissertations

Although extensive support needs students (ESNS) benefit from access to inclusive higher education opportunities, research shows that navigating college settings has been challenging for these students. This study examined the supports available to ESNS enrolled in college classes and the challenges they encounter within a university setting. Using a State University as the research site, this qualitative study collected data through semi-structured interviews, observations, and reflection responses to capture the experiences of ESNS, faculty, and peer mentors in higher education. The study examined ESNS experiences in classes through the perspectives of faculty on teaching ESNS, peer mentors’ (who support students …

"A Door To The Future." A Case Study In Exploratory And Culturally Sustaining Theater Curriculum, Verónica Meza

Dissertations

This study addresses the persistent inequities in access to quality arts education for Latino immigrant and linguistically diverse communities in California. Despite progressive initiatives such as Proposition 28 (The Arts and Music in Schools Act) and the California Arts Council's Racial Equity Statement, systemic barriers prevent Latino and immigrant students from benefiting equitably from the arts. The central objective of this project is to understand how an exploratory, culturally sustaining theater curriculum can serve as a transformative and healing vehicle for adult immigrant Latino students, providing emotional protection, cultural affirmation, and language preservation within a U.S. educational context. This qualitative …

Rewriting The Plan: Environmental Justice, Community Resistance, And Governance Power In Hollister, California, Rolan Resendiz

Dissertations

This dissertation examines how community-led resistance in Hollister, California, challenged environmental injustice and infrastructure governance through grassroots civic action. Focusing on the Hollister Guardians, a coalition of primarily Latinx residents who organized in response to concerns about the city’s sewer system, this qualitative case study introduces the Critical Just Sustainability Policy Praxis (CJSPP) framework, developed by integrating Critical Policy Analysis and the Just Sustainability Paradigm with a praxis-oriented focus on community action. Using critical document analysis of city council meeting minutes, local media coverage, and community-authored texts mainly from 2023 to 2025, the study explores how policy discourse, institutional decision-making, …

Inferring Host Environment Properties And Gravitational-Wave Decay Time From The Eccentricity Measurement Of Dynamically Captured Binaries, A. Vincent Paul, Parthapratim Mahapatra, Marc Favata, K. G. Arun

Department of Physics and Astronomy Faculty Scholarship and Creative Works

Dynamical capture in dense stellar environments is a promising channel for producing eccentric compact binary mergers. Although there have been no confident detections of eccentric mergers to date, a few candidates show indications of nonnegligible in-band eccentricity upon reanalysis of the data. By assuming an observed eccentric event originates from a dynamical gravitational-wave (GW) capture, we show that it is possible to identify the host environment using the eccentricity and mass posteriors. In particular, the eccentricity posterior can be mapped to posteriors on key capture parameters, such as the relative velocity at infinity and the impact parameter. By comparing these …

Reducing Psychotropic Polypharmacy In Outpatient Mental Health Settings, Roseline Onyebuchi Okafor

Walden Dissertations and Doctoral Studies

Psychotropic polypharmacy in outpatient mental health settings is associated with increased adverse drug events, reduced adherence, and higher healthcare utilization. This Doctor of Nursing Practice project developed and evaluated an evidence-based clinical practice guideline (CPG) to reduce inappropriate psychotropic polypharmacy among adults receiving outpatient psychiatric care. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, a systematic literature review informed recommendations including structured medication reviews, standardized prescribing practices, interdisciplinary collaboration, and shared decision-making. The guideline was evaluated by a multidisciplinary expert panel using the AGREE II instrument. Mean domain scores ranged from 6.3 to 6.8 on a 7-point scale, indicating …

Effective Strategies For Hospital Leaders To Increase Employee Retention, Lionso Gomez

Walden Dissertations and Doctoral Studies

Employee retention remains a critical challenge for hospital leaders because high turnover can contribute to workforce instability, increased organizational costs, and poor patient care quality. The purpose of this qualitative pragmatic inquiry research project was to identify and explore effective strategies that hospital leaders in Texas use to increase employee retention. The participants were six former hospital leaders in Texas's eastern and southern regions who had successfully implemented employee retention strategies. This research project was grounded in Herzberg’s two-factor theory. Data were collected through semistructured interviews and publicly available documents. The data were analyzed utilizing Braun and Clarke’s six-step thematic …

Multiple Perspectives On Inclusion In Science For Students Receiving Support From The Learning Center (Tlc) Program, Jeremy C. Adams

Dissertations

Almaden Country Day School (ACDS) is a small, independent private school located in the Almaden Valley neighborhood of south San Jose, California. Currently serving over 400 students, the school has been in operation for over 43 years. Nan Hunter, its founder, set out to build a school community that could “discover the gifts in every child.” As part of this mission, the school sought to support neurodiverse students with accommodations as part of its general education program. In September of 2017, the school’s leaders committed more deeply to this aspect of the school’s mission when they opened The Learning Center …

Out Of The Briar Patch: Storying Resistance Among Black Male Survivors Of Childhood Sexual Abuse And Its Impact On Their Educational Experiences, Anthony Animuntu

Dissertations

This study examines the lack of support within educational settings for Black boys who are survivors of childhood sexual abuse (CSA). Despite growing attention to trauma-informed practices, the experiences of Black male survivors remain largely absent from educational research. Using a qualitative, phenomenological approach informed by critical autoethnography, semi-structured interviews were conducted with five African American men reflecting on their schooling experiences as CSA survivors. Axial analysis revealed four central themes: silence as survival and strategic invisibility, shame and internalized distress, institutional misrecognition, and the transformative role of relational care and educational kinship. Findings indicate that participants’ trauma was often …

Can Curriculum Improve Confidence? Examining The Impact Of The Implementation Of The California Math Framework On Math Anxiety Levels Of Preservice Teachers In California, Amanda Lubbs

Dissertations

In 2010, the state of California adopted the Common Core State Standards (CCSS) as an effort to ensure students were graduating high school as college and career ready. Shortly after, in 2013, the California Board of Education adopted the California Math Framework (CMF) as a tool for schools to implement the CCSS for Mathematics (CCSSM). Its recommendations incorporated research-based techniques to alleviate math anxiety through the use of explorative learning experiences that help students understand math skills in applied contexts, and by de-emphasizing rote practice and memorization. This study inquires about the framework’s effectiveness in mitigating math anxiety among pre-service …

Rethinking Learning From Incidents In Healthcare: A Safety-Ii Model Integrating Work-As-Imagined, Work-As-Done, And Work-As-Experienced, Nawal Khattabi, Axel Ros, Matt Carey, Aled Jones

School of Nursing and Midwifery

Healthcare organizations increasingly investigate patient safety incidents using systems thinking. However, even investigations that claim to adopt a systems approach frequently revert to linear, event-focused reasoning concluding on deviations and recommending further training. A foundational question remains unresolved: when an incident review identifies a "deviation", does this represent exceptional behavior or the system's typical mode of operation that generally succeeds under varying conditions but occasionally fails? Without this distinction, explanations for incidents tend to focus on individual non-compliance rather than understanding the everyday adaptations that enable care delivery in a complex adaptive system. Consequently, incident reviews that promote system learning …