Digital Commons Network^™

The Evolution Of Social Protection Norms Within The International Monetary Fund, Cindy W. Ziem

Theses and Dissertations

This research explores the evolution of social protection norms within the International Monetary Fund (IMF) and identifies the key norm entrepreneurs. Social protection, which encompasses policies and programs designed to help individuals and communities manage risks, combat poverty and inequality, and access economic opportunities, has undergone significant transformation on a global scale. Traditionally, social policies were not included in the IMF’s agenda, which primarily focused on fiscal matters. However, the Fund has increasingly recognized social protection as vital for macroeconomic stability. This shift reflects a broader transformation in international norms and the progressive inclusion of social policies within global economic …

2025 Annual Report, Children's Advocacy Institute, University Of San Diego School Of Law

CAI Annual Reports

No abstract provided.

Quantification Of Auxin-Cytokinin Response During Primary Root And Lateral Root Development In Common Bean, Gurdeep Singh

Electronic Theses and Dissertations

Roots support water and nutrient uptake, anchorage, and soil interactions through continuous growth at the primary root tip (PRT). In common bean (Phaseolus vulgaris), new cells are produced in an open root apical meristem and subsequently elongate in the elongation zone, and together these processes drive root tip progression through the soil. Lateral roots (LRs) arise in the differentiation zone, where pairs of pericycle founder cells dedifferentiate, divide asymmetrically, and form lateral root primordia (LRP) that pass through defined developmental stages before emergence. Auxin and cytokinin (CK) are central regulators of both primary root growth and LR development, yet their …

Programming Carcass Composition Through Gestational Nutrition, Sydni Elise Borders

Electronic Theses and Dissertations

The objective of this study was to evaluate the influence of maternal nutrient restriction during mid-gestation on the performance of the dam, feeding performance, carcass composition, and genetic expression in the offspring. Cows (n = 46) were randomly assigned to one of two treatments based on global nutrient intake: 1) fed to achieve and/or maintain a BCS of 5 or 6 (Positive Energy Status [PES]; n = 24) or 2) fed to lose one BCS during 99 days of mid-gestation (Negative Energy Status [NES]; n = 22). Cows in NES had greater decreases (P < 0.05) in body fat stores and muscle mass, elevated NEFA concentrations, and displayed decreased (P < 0.05) DMI, HP, and GHG emissions. There were no differences in milk components or volume produced between treatments (P > 0.05). There were no differences in …

Optimizing Compression In Venous Leg Ulcers To Improve Wound Healing Rates Through Wound Care Nurse Support: A Quality Improvement Project, Temilola Obisesan

DNP Scholarly Projects

BACKGROUND: Venous leg ulcers (VLUs) are the most common lower extremity ulcers, accounting for 75% of chronic leg wounds and affect up to 2% of the population in developing countries. Generally, it has a 1-year recurrence rate of 40-70%. VLUs costs about $11B in the USA and other developed countries annually. Patients with VLUs spend about $7,000 more annually. Compression therapy along with local wound care is the best approach for VLU management, with compression therapy as the gold standard. Currently, compression therapy is underutilized in VLU care. The goal of this QI project is to provide wound nurses who …

Developing A Rural Family Health Curriculum To Promote Retention Of New Graduate Nurse Practitioners, Molly G. Boudreau

DNP Scholarly Projects

Background: There is a critical shortage of primary care providers (PCPs) in rural areas of the United States. Nurse Practitioners (NPs) are essential for addressing the primary care shortage especially in rural communities. However, significant barriers exist to the retention of NPs in rural communities, especially new graduate NPs in the first year of practice. Evidence in the literature suggests bolstering the focus on transition-to-practice for new graduate NPs to improve retention and turnover rates.

Purpose: The aim of this quality improvement project was to develop a structured, postgraduate, on-boarding curriculum at a rural outpatient family medicine clinic with the …

Feeding With Competence: Empowering Parents In Ng Feeding For Nicu Graduates: A Quality Improvement Project, Karen Marsh

DNP Scholarly Projects

Abstract

Background: Infants who are born prematurely stay in a neonatal intensive care unit (NICU) until they are able to take full enteral nutrition by mouth. While in the NICU a nasogastric tube (NG tube) would be used to supplement the volume needed to be ingested for optimal nutrition. Infants typically feed better with a consistent caregiver and at home in an environment with less stimulation. Allowing infants to be discharged with an NG tube allows the parents to be more involved in their infant's care with a shorter hospital stay. An increased number of infants being discharged home with …

Increasing Self-Efficacy Through A Wellness Program For People With Parkinson’S Disease And Their Care Partners, Abby Clark Ot/S, Sheridan Ferland Otd, Otr/L, Carolyn Kosiba-Quiterio Cpt, Crs, Cgx, Sf

Occupational Therapy Doctorate Capstones

Site Description:

Rock Steady Boxing is a nonprofit organization that gives people with Parkinson’s disease the opportunity to improve their quality of life through non-contact boxing, stretching and various exercises (Rock Steady Boxing, 2024). Locally, Rock Steady Boxing East Greenwich (RSBEG) has approximately eighty athletes enrolled.

Aim & Purpose:

Aim: To provide a comprehensive wellness education program on various PD related topics for people who participate in RSB class.

Purpose: To explore the impact of wellness education on self-efficacy to improve physical and mental outcomes for those with PD, thereby addressing a gap in current literature. Question: Does wellness education …

A Quality Improvement Project To Enhance Chronic-Condition And Self-Care Knowledge In Adolescents With Spina Bifida, Ann Paris

DNP Scholarly Projects

Background: Spina Bifida is the most common central nervous system disorder in the United States (CDC, 2024). Even with early surgical repair, patients may have chronic, disabling, multisystem needs (Phillips et al., 2017). Adequate care of Spina Bifida requires a multidisciplinary approach. As such, patients with spina bifida require multiple specialty providers, clinic appointments, care-tasks, and interventions (CDC, 2024, Phillips, et al., 2017). Synthesizing information from multiple care providers can be daunting, especially for adolescents as they grow more autonomous in their care, and especially as they enter the age of pediatric-to-adult transition (Psihogios et al., 2015).

Purpose: …

A Systematic Review And Taxonomy For Privacy Breach Classification: Trends, Gaps, And Future Directions, Clint Fuchs, John Hastings

Research & Publications

In response to the rising frequency and complexity of data breaches and evolving global privacy regulations, this study presents a comprehensive examination of academic literature on the classification of privacy breaches and violations between 2010-2024. Through a systematic literature review, a corpus of screened studies was assembled and analyzed to identify primary research themes, emerging trends, and gaps in the field. A novel taxonomy is introduced to guide efforts by categorizing research efforts into seven domains: breach classification, report classification, breach detection, threat detection, breach prediction, risk analysis, and threat classification. An analysis reveals that breach classification and detection dominate …

How Workplace Equity Laws Perpetuate Inequity, Margaret H. Zhang

Mitchell Hamline Law Review

No abstract provided.

Featured Faculty Mentor/Student Team, Kelly Loftin, Eva Berryhill

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

No abstract provided.

Exploring The Role Of Bingocize® Workshops In Enhancing Health And Well-Being In Older Adults, Kaitlyn Gray

Mahurin Honors College Capstone Experience/Thesis Projects

As the population of older adults grows, the need for better health and well-being also grows, making it necessary to implement effective strategies for healthy aging to improve the length and quality of life of older adults (CDC, 2024). This study evaluates the effectiveness of a Bingocize^® Workshop in improving the physical health of older adults. Bingocize^®, a unique program combining bingo with exercise, is designed to increase physical activity. Eleven (11) participants aged 68.55 ± 6.235 attended a ten-week workshop, two times per week focusing on physical exercises tailored to their abilities. The primary objective was …

Exploring The Challenges And Interventions For Type 1 Diabetes In Young Children, Patra Chisom Ezeamii, Nenrot Gopep, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Quantitative Assessment Of Facial Ptosis In Face Transplantation, Sam Boroumand

Yale Medicine Thesis Digital Library

As a transformative surgical procedure, face transplantation restores form and function to patients with severe facial disfigurements, yet the long-term aging dynamics of transplanted tissues remain poorly characterized. This study aimed to investigate the progression of facial ptosis in transplanted facial allografts over time, addressing a critical gap in the understanding of long-term outcomes following face transplantation. Specific aims include quantifying ptosis progression using cephalometric measurements, identifying regional variations in the degree of ptosis across the face, and comparing changes between face transplant recipients and a non-face transplanted control cohort to contextualize findings.

To assess these aims, standardized frontal headshots …

Exploring Health Professional Student-Led Interventions To Address Gaps In Common Non-Communicable Disease (Ncd) Screening, Management, And Self-Care Education In Ghana., Brian Amu Fleischer

Yale Medicine Thesis Digital Library

BackgroundNon-communicable diseases (NCDs) are expected to become Africa's leading cause of death by 2030. In Ghana, with its limited healthcare resources, hypertension is already the leading cause of death, contributing to 15.3% of total deaths. Student-run free clinics (SRFCs) have become essential components of healthcare systems worldwide, offering primary medical care to underserved populations. This study explores the feasibility of health professional student-led interventions in addressing gaps in NCD screening, early management, and self-care education in Ghana.

MethodsThis research employed an exploratory sequential design, combining qualitative and quantitative phases. Six focus group discussions (FGDs) with 48 health professional students at …

Trends In Missing Race And Ethnicity Data In A National Surgical Database, Kevin Gao Hu

Yale Medicine Thesis Digital Library

Accurate data collection on race and ethnicity is critical to detecting and characterizing disparities in surgical care. This study explores the prevalence and impact of missing race and ethnicity data in the National Surgical Quality Improvement Project Pediatric (NSQIP Pediatric) database. NSQIP Pediatric from 2016-2020 was assessed for patients who were missing data for race (RM), ethnicity (EM), or both (BM). Changes in proportion of RM, EM, and BM patients were assessed with Cochran-Armitage tests. Surgical outcomes were modeled using linear mixed-effects models, treating CPT codes as random effects. Models were bootstrapped with 1000 iterations for each outcome. Of 596,571 …

Maternal Prenatal Anxiety And Child Epigenetic Aging: A Longitudinal Analysis From Childhood To Mid-Adolescence, Shashwat Kala

Yale Medicine Thesis Digital Library

The developmental origins of health and disease posits that in utero exposures and early life experiences increases susceptibility to a host of pathologies. Maternal psychopathology, specifically maternal prenatal anxiety, has been studied as an in utero stressor that can affect childhood development and epigenetic aging. In the current study, we analyzed the longitudinal effects of maternal prenatal anxiety on epigenetic aging, assessed sex-specific effects, and tested the contribution of cellular heterogeneity to these findings. Using the longitudinal Basal Influences on Baby Development (BIBO) cohort, we performed a mixed model for repeated measures to determine how prenatal and postnatal anxiety (State-Trait …

Neighborhood-Level Variation In The Effectiveness Of And Participation In An Intensive Health Behavior And Lifestyle Treatment Program For Pediatric Obesity, Grace Wang

Yale Medicine Thesis Digital Library

Bright Bodies (BB) is a family-based intensive health behavior and lifestyle treatment (IHBLT) for pediatric obesity, with demonstrated efficacy and real-world effectiveness. Our study involved two aims: 1) to assess the extent to which real-world effectiveness varied by participants’ neighborhood characteristics, and 2) to evaluate the impact of the COVID-19-associated transition of BB to virtual delivery on participant engagement, particularly for those disadvantaged by inequities in social determinants of health. To achieve Aim 1, we included first-time BB participants 2008-2018 who had an initial BMI ≥85th percentile and available addresses. Addresses were geocoded using ArcGIS Pro and assigned a Child …

Bipolar Disorder Among Individuals With Atopic Dermatitis: A Case-Control Study In The All Of Us Research Program, Mitchel Wride

Yale Medicine Thesis Digital Library

Background: Atopic dermatitis has been associated with psychiatric comorbidities.Objectives: To characterize the association between atopic dermatitis and bipolar disorder with a case-control study of the NIH All of Us Research Program. Methods: Utilizing Systemized Nomenclature of Medicine diagnostic codes, we identified cases of atopic dermatitis. Four age, sex, and race/ethnicity matched controls were found for each case using propensity score matching. After controlling for age, sex, race/ethnicity, income, smoking status, and depression, the relationship between atopic dermatitis and bipolar disorder was evaluated using logistic regression. Results: We identified 13,431 atopic dermatitis cases with 53,724 matched controls. Participants with atopic dermatitis …

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

Improvement Of Hpv Vaccination Rate In Pediatric Patients In A Clinic Through Implementation Of A Bundle, Macalah Jenschke

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Human papillomavirus (HPV) is a major cause of several cancers, and vaccination is a highly effective preventive measure. However, HPV vaccination rates remain suboptimal, particularly in rural pediatric populations. This quality improvement (QI) project aims to enhance HPV vaccination rates through the implementation of a comprehensive vaccination bundle targeting provider education, patient and parent education, appointment reminders, and the use of a vaccine waiver when needed.

Method: This QI project was conducted over twelve weeks in a rural pediatric clinic with approximately 130 patients seen daily. The intervention bundle included provider education on effective communication regarding HPV vaccination, educational …

Improving Glucose Levels In Adults With Type 2 Diabetes, Kaitlin Castillo

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Type 2 diabetes is a growing health crisis, posing significant challenges not only to individual well-being but also to healthcare systems' financial sustainability. The prevalence of type 2 diabetes continues to rise annually, contributing to increased medical costs, hospitalizations, and long-term complications. Houston, Texas, has a diabetes prevalence of 13.5%, exceeding the national average of 10%. A clinical gap exists in providers’ ability to prevent and manage type 2 diabetes. Prioritizing prevention, early intervention, and improved patient monitoring can reduce incidence rates, lower healthcare costs, and enhance overall population health. A Plan Do Study Act model was utilized for the …

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 …

Multidisciplinary Approach To Reduce The Heart Failure Readmission Rate, Nisha Thekkedam

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States, 6.7 million adults have been diagnosed with heart failure (HF), a number projected to rise to 8.5 million by 2030. National data indicate a 30-day readmission rate of 18.2% among HF patients from 2010 to 2017. In Texas, around 12% of the Medicare population in Texas, and specifically 11% of the Medicare population in North Texas County, have been treated for HF. A North Texas hospital reports an 18-20% HF readmission rate over the past several years. Purpose: This EBP project included the implementation of a care bundle using the Dutch Heart Failure …

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 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. …

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, …

The Role Of Socioeconomic Indicators On Child Behavior And Academic Outcomes During Elementary School, Ashlee Mineau

Open Access Master's Theses

The impact of a child's socioeconomic status (SES) impacts all aspects of development. Children’s SES will be examined to determine the potential impact they may have on children's academics and behavior. The SES variables that will be examined are parent education, parent occupation, and household income. Parent education is one of the strongest predictors of child school achievement (Martinez et al., 2022). Children who come from a lower SES household are more likely to display externalizing behaviors (Barry et al., 2022). This study in particular looks at its impact for academic achievement in reading, math, and science and external problem …