Digital Commons Network^™

Quality Improvement Project: Increasing Breast Cancer Screening Rates Among Women Ages 40-74 At A Federally Qualified Health Center By Implementing A Provider Alert Tool, Tiny Stephens

Doctor of Nursing Practice Projects

Breast cancer maintains its position as the leading cause of cancer-related death for women worldwide and remains the second deadliest cancer among female patients in the United States (Centers for Disease Control, 2024). The screening rates at Federally Qualified Health Centers (FQHCs), which serve medically underserved communities, remain lower than national benchmarks, thus putting their patients at risk for receiving late-stage cancer diagnoses. This quality improvement project implemented an evidence-based electronic medical record (EMR) provider alert tool at a Northeast Georgia FQHC to address a baseline mammogram order compliance rate falling below national standards at 45%. The project aimed to …

Quality Improvement Project Nursing Student Retention Strategies: A Focus On Peer Mentoring, Anh Vittoria

Doctor of Nursing Practice Projects

The nursing shortage remains a concern in healthcare. Increasing the number of students who complete nursing programs and enter the profession can help with the demand for nurses in the workforce. Nursing programs face challenges with student retention, which limits the number of nurses entering the profession. The quality improvement project aimed to examine the effects of a peer mentorship program on first-year associate degree nursing students’ perception of support and course completion rates. The purpose is to impact student retention and sense of support in an Associate Degree Nursing Program (ADN) through peer mentorship. The project was guided by …

Quality Improvement Project Enhancing Documentation Practices In Community Mental Health Clinics, Carol Parker

Doctor of Nursing Practice Projects

Accurate and timely documentation are essential for safe, high-quality care in community mental health settings. This quality improvement (QI) project addressed inconsistent documentation practices among licensed, unlicensed, and Qualified Mental Health Specialist (QMHS) staff at an outpatient clinic. The purpose of the QI project was to implement and assess a structured in-service training program using the Accountable Health Communities–Health-Related Social Needs (AHC-HRSN) screening and documentation tool to improve staff knowledge, enhance documentation accuracy, and facilitate care coordination. Guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change Management Model, a pre- and post-intervention design was used. Fifteen staff members …

Enhancing Mental Health Providers' Approach To Medication Adherence In Schizophrenia Patients Using Motivational Interviewing Techniques., Jacinta Madu

Doctor of Nursing Practice Projects

Medication non-adherence among individuals with schizophrenia remains a persistent challenge that undermines symptom management and increases relapse and hospitalization rates. This quality improvement (QI) project aimed to evaluate the effect of Motivational Interviewing (MI) training on provider knowledge and confidence in promoting medication adherence within an outpatient mental health clinic. Guided by Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) framework, a quasi-experimental pre–post design was used. Six providers, including psychiatric nurse practitioners, therapists, a psychiatrist, and a registered nurse, participated in a structured MI training session incorporating didactic instruction and role-play exercises. Data were collected using pre- and post-intervention surveys …

Quality Improvement Project: Impact Of A Brief Mindfulness-Based Stress Reduction Program For Healthcare Providers Who Evaluate Veterans, Peng Anderson

Doctor of Nursing Practice Projects

Long-term stress can lead to healthcare provider burnout. Mindfulness-based interventions, even when shortened, may provide a promising and innovative method to reduce stress and prevent burnout. Research on mindfulness programs has demonstrated significant benefits for both providers and patients. This quality improvement project aims to evaluate the effect of a brief mindfulness-based stress reduction program (MBSR) for providers who evaluate veterans on the variable of mindfulness awareness compared to current site practice. Lewin’s change management model and Peplau’s Interpersonal Relations Theory were used. Plan-Do-Study-Act was the implementation framework applied. The design was pretest-posttest using the Mindful Attention Awareness Scale (MAAS). …

Current Knowledge And Perspectives Of Relative Energy Deficiency In Sport In An Athletic Environment, Meredith Rebecca Morgan

Electronic Theses and Dissertations

Sport performance personnel are in a unique position to directly impact athletes. While the primary individuals who manage athlete health are physicians, sport dietitians, and certified athletic trainers, sport coaches and strength and conditioning coaches also play an impactful role in an athlete’s performance and well-being. Using an original survey, this study investigated REDs knowledge by certified athletic trainers, strength and conditioning coaches and sport coaches. The survey was employed to assess sport performance professionals’ general knowledge of Relative Energy Deficiency in Sport (REDs) and low energy availability (LEA) and opinions on the role of health professionals in REDs identification, …

Mindreading And Embodiment: Beyond Mirror Neurons., Sanad Al Khatib

College of Arts & Sciences Senior Theses

This paper examines the question: how do we figure out what other people are thinking and why they act as they do, or put differently, how is it that we can read minds in daily life? For decades, the dominant view held that we explain and predict other people’s behavior by attributing to them mental states such as beliefs, desires, and intentions, represented symbolically in the brain. The embodied simulation model challenges this view, proposing that understanding others primarily relies on mirror neurons that activate both when we perform an action and when we observe someone else performing it. This …

Parental Experiences With Financial Toxicity In The Pediatric Intensive Care Unit: A Phenomenological Research, Sohrab Alexander Sardual

Dissertations and Theses (Open Access)

Background: Parents of children admitted to the pediatric intensive care unit (PICU) encounter multiple stressors; however, there is a need to further understand their experiences with financial toxicity. Understanding parents’ experiences and perspectives on how they can be assisted is a critical first step to formulating interventions to help parents deal with financial toxicity.

Aims: The aims of this study are (a) to describe the experiences with financial toxicity of parents with critically ill children admitted to the PICU and (b) to explore parents’ perspectives on how they can be assisted in dealing with financial toxicity.

Methods: A phenomenological qualitative …

University Of Nebraska At Omaha Commencement: December 2025, University Of Nebraska At Omaha

Commencement Programs

No abstract provided.

Developing An Intergroup Dialogue Training Program For Organizational Leadership: A Pilot Partnership With The Greater Omaha Chamber, Manasi Kate

Communications Theses, Dissertations, and Student Creative Activity

This graduate project proposes the development and pilot implementation of a structured Intergroup Dialogue (IGD) training program designed to enhance communication and leadership capabilities within complex organizational environments. In response to the escalating challenge of social polarization, which systematically impedes collaboration and innovation, this initiative created an adaptable curriculum for leaders in all organizational sectors and settings.

The program was divided into six sessions, each of which led participants through themes such as identity, power, storytelling, systems, and authentic social leadership, with the goal of increasing self-awareness and collective understanding. The program development plan includes a rigorous phase of curriculum …

Political Discoveries In A Žižek Substack Project Critical Digital Studies, Edward Sankowski, Betty J. Harris

International Dialogue

This review essay analyzes Slavoj Žižek’s recent turn to Substack as a publishing platform, examining both his motivations and the philosophical and political implications of this medium for contemporary critical theory. Sankowski and Harris argue that Žižek’s Substack writings continue long-standing themes in his work—anti-capitalism, ecological crisis, updated Communism, and the cultural dimensions of ideology—while also revealing notable shifts, including heightened pessimism about historical progress and new reflections on environmental catastrophe. The authors assess the advantages and pitfalls of Substack for intellectual discourse, including its circumvention of traditional editorial “censorship,” its contribution to information glut, and its role in fostering …

Factors Associated With Preterm Premature Rupture Of Membranes: A Case-Control Study In A Tertiary Hospital In Kabul, Afghanistan, Atia Sharif Nadi, Freshta Sharif Tawakkuli, Zainab Sharif Ezadi, Sayed Murtaza Sadat Hofiani, Shoaib Murtaza Sadat Naeemi, Ahmad Komail Frogh

Journal of Asian Midwives (JAM)

Background: It is essential to identify preterm premature rupture of membranes (PPROM) and its associated risk factors to reduce its impact. This study aims to find the demographic, reproductive, and obstetric factors associated with PPROM among women in Kabul, Afghanistan.
Methods: This case-control study was conducted over six months in 2023 at a tertiary hospital in Kabul, Afghanistan. We included 40 cases of PPROM and 80 controls without PPROM in this study. We used structured questionnaires to collect demographic, reproductive, and obstetric characteristics of the participants. To find the factors associated with PPROM, Logistic regression was performed using IBM SPSS …

Characterizing The Relationship Between Parturition In Beef Cattle And The Lunar Phase And Meteorological Factors., Caroline E. Chambers

Honors College Theses

For beef cattle, parturition is one of the most critical stages in the reproductive process. It is crucial that farmers understand the factors that may influence the timing of parturition. There is a persistent preconception that the onset of parturition is influenced by the lunar phase and weather factors. The objective of this study is to characterize the association between parturition in beef cattle, the lunar phase, and/or different weather factors such as barometric pressure and temperature. Cattle records were obtained from Chambers Family Farm in Cumberland Furnace, TN. Data was collected from 142 calvings from January 2017 to October …

What Does Genius Look Like? Investigating Brilliance Bias In Ai-Generated Images, Juliana Shihadeh, Margareta Ackerman, David Loker

Computer Science and Engineering

Text-to-image models, like Midjourney, DALL-E, and Stable Diffusion, have been shown to reinforce harmful biases, often perpetuating outdated and discriminatory stereotypes. In this study, we delve into a particular bias largely overlooked in generative image research: Brilliance Bias. By age 6, many children begin to internalize the damaging notion that intellectual brilliance is a male trait—a belief that persists into adulthood. Our findings demonstrate that popular image AI models possess this bias, further entrenching the misguided notion that exceptional intelligence is inherently male. This study calls for addressing brilliance bias in AI to ensure a more realistic representation of intellectual …

Prevalence And Characterization Of Post-Acute Sequelae Of Sars-Cov-2 Infection (Pasc) In Rwanda, Fernand Rwamwejo, Vivianne Umuhire Niyonkuru, Gilbert Rukundo, Eric Remera, Edson Rwagasore, Les Sztandera, Ruranga Charles, Elizabeth Krebs

School of Business Faculty Papers

Objectives

Reliable, population-level estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) remain scarce for sub-Saharan Africa. We aimed to quantify PASC prevalence and identify associated factors among adult COVID-19 survivors in Rwanda.

Methods

A nationally representative cross-sectional telephone survey (August-October 2024) sampled 3143 adults from the national COVID-19 registry. PASC was defined as new or persisting symptoms ≥3 months after acute illness and lasting ≥2 months. The prevalence was calculated, and multivariable logistic regression identified factors independently associated with PASC.

Results

Overall, PASC prevalence was 34%. Leading symptoms were back pain, headache, dizziness, fatigue, and reduced sexual desire. Higher odds …

Do Need For Cognition And Need For Affect Moderate The Relationship Between Lecture Style, Learning Strategies, And Retention?, Mary Chapman

Dissertations

Boredom is detrimental to academic achievement. Using shallow learning strategies such as rote memorization is similarly unfavorable for success in academic settings compared to using deep learning strategies such as generating examples. Such is the consensus among scholars, but research conducted in both constructs reveals inconsistencies. The purpose of this study was to experimentally manipulate boredom and learning strategies to determine how boredom and learning strategies impact achievement, as well as to investigate whether certain individual differences, need for cognition and need for affect, change the relationships between boredom, learning strategies, and retention. In an online study, I recruited 131 …

Stayin’ Alive: Examining The Moderating Effect Of Suicide Resilience On The Relationship Between Sexual Minority Stress And Subjective Well-Being, Natalie A. Sachs

Dissertations

Suicidality among sexual minorities is concerning and results from increased social stress, societal stigma, and experiences of discrimination. The effects of sexual minority stress (SMS) lead to negative outcomes for sexual minority college students. The purpose of the current study was to better understand the role of suicide resilience in moderating the adverse effects of SMS among sexual minority college students. The following research questions and hypotheses guided this study: Q1 Does SMS have any effect on subjective well-being among college-student sexual minority individuals (SMIs)? Q2 Does SMS have any effect on suicide resilience among college student SMIs? Q3 To …

Social Well-Being Moderates Behavioral Therapy Response For Generalized Anxiety Disorder., Jacob D. Armstrong, Nicole R. Baughman, Ricardo A. Wilhelm, Dalia El-Shafie, Hannah Berg, Hung-Wen Yeh, Elisabeth Akeman, Christopher Martell, Kate B. Wolitzky-Taylor, Michelle G. Craske, Martin P. Paulus, Robin Aupperle

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Identifying moderators of treatment outcome for depression and anxiety offers promise for personalizing treatment or providing novel intervention targets. Indices of social well-being have emerged as candidate moderators due to their robust impact on mental health and quality of life. Here, we examine whether measures of social support, isolation, and loneliness moderate outcomes to behavioral activation (BA) and exposure-based therapy (EXP) for individuals with GAD.

METHODS: This secondary analysis of a randomized clinical trial included 69 participants (31 EXP, 38 BA). Participants completed the GAD-7, along with NIH PROMIS (Depression; Social Isolation; and Emotional, Instrumental, and Informational Support) and …

The Effect Of Shared Decisions On Intertemporal Choice, Rosemarie M. Davidson

Masters Theses

Substance use disorders are a significant public health concern, and improving treatment outcomes requires a better understanding of the behavioral processes that influence drug consumption. Delay discounting, or the tendency to overvalue immediate reinforcers, is reliably more severe among individuals with substance use disorders. Recent work suggests that shared decision-making may increase tolerance for delayed rewards; however, prior studies used procedures that confounded delay to token delivery with delay to token exchange, limiting conclusions. The present study evaluates delay discounting across individual and social decision-making contexts using a traditional delay discounting paradigm.

Ten undergraduate participants completed sessions involving choices between …

Halo Gravity Traction And Temporary Internal Distraction, Nicholas D. Fletcher, Anson G. Bautista, Joshua S. Murphy, K Aaron Shaw

Manuscripts, Articles, Book Chapters and Other Papers

Severe pediatric spinal deformities may require staged correction strategies to mitigate neurologic risk and optimize cardiopulmonary outcomes. This paper reviews two adjunctive techniques—halo gravity traction (HGT) and temporary internal distraction (TID)—used in the management of rigid scoliosis. HGT enables gradual preoperative spinal elongation and coronal/sagittal realignment, improving pulmonary function and nutritional status while reducing the need for three-column osteotomies. TID offers an internal, staged distraction approach for patients contraindicated for external traction, allowing incremental correction via posterior instrumentation followed by definitive fusion. Clinical studies report Cobb angle reductions of 30–80 %, with low rates of neurologic complications when neuromonitoring and …

Overview Of Huntington's Disease And Emerging Treatment Strategies: A Narrative Review, Alexis J. Vega, Gabriel V. Hernandez, Pearse A. O'Malley, Connor J. Robin, Amanda N. Parra, Giustino Varrassi, Sahar Shekoohi, Alan D. Kaye

School of Medicine Faculty Publications

Huntington's disease (HD) is an autosomal dominant, progressive neurodegenerative disorder caused by a cytosine-adenine-guanine trinucleotide repeat expansion in the huntingtin (HTT) gene. The symptoms of HD include severe motor dysfunction, cognitive issues, and emotional dysregulation. These combined issues are not only debilitating but also lead to depression/anxiety, increased suicide rates, and caregiver burnout. Our narrative review summarizes several recent studies examining the efficacy and differences among emerging treatment strategies for HD. A systematic search of peer-reviewed literature was conducted, focusing on recent studies that describe molecular genetic manipulation of the HTT gene/huntingtin protein. The results of our narrative review reveal …

Moon Moth, Britain Noelle Powers

Open Access Theses & Dissertations

No abstract provided.

Evaluation And Identification Of Risk Factors For Stress Among Maquiladora Workers Based On The Mexican Official Standard 035 Survey Tool, Andrea Baca Melendez

Open Access Theses & Dissertations

Background and significance: Occupational psychosocial risk factors are workplace conditions that can trigger physiological, emotional, cognitive, and behavioral changes. They are strongly associated with mental health issues such as anxiety and depression, as well as non-mental health conditions like myocardial infarction, stroke, and occupational injuries. Analyzing these risks from a sociodemographic perspective provides valuable insights for improving work environments and workers’ well-being. Purpose: This study aimed to identify and determine the levels of occupational psychosocial risk factors among workers in a manufacturing company in Cd. Juárez, Chihuahua, and to examine their relationship with sociodemographic variables to inform future interventions in …

The Persistence Of Homophobia In Men’S Friendship Norms, Sherrie Y. Xue, Stephanie C. Lin, Christilene Du Plessis

Research Collection Lee Kong Chian School Of Business

Across five studies and one supplementary study (five preregistered; N = 3,215 adults), we found that men, more than women, avoided shared experiences (e.g., going to the movies, sharing food) with individuals of the same gender. Furthermore, persistent societal expectations that men should be unambiguously heterosexual underpinned this pattern: Men felt more apprehensive about signaling same-gender romance in platonic relationships than women did. In turn, romantic prototypicality drove the pattern of men (more than women) avoiding shared activities, above and beyond differences in how hedonic, enjoyable, and feminine the activities were; our findings further suggested that men’s reluctance to share …

Aku Research 2025, Office Of Research And Graduate Studies

Office of Research and Graduate Studies

• With dementia surging, BMI seeks tools for prevention
• The past, present and future of teaching in Pakistan
• Transforming educations with evidence
• Research influences national teacher development programme
• Redefining the migrant experience
• Study finds women are underrepresented in East Africa’s media
• Study identifies targets for treating drug-resistant tuberculosis
• Addressing extreme heat’s impacts on the vulnerable
• Colorectal cancer detection gets an AI boost
• Addressing the quiet crisis of women’s mental health
• The pandemic was especially hard for female health workers
• Advancing reproductive health in Pakistan
• A push for advanced practice nursing and midwifery
• Major study yields essential data on maternal health
• Saving …

Relationships Between Social Determinants Of Health And Pain Outcome Changes After Exercise In Adults With Knee Osteoarthritis, Klarissa Siebert

Open Access Theses & Dissertations

Background: Knee osteoarthritis (KOA) is a common musculoskeletal disease with pain as the primary symptom. KOA pain is a major contributor to disability and reduced quality of life and has been associated with social determinants of health (SDOH) variables. As for treatments of KOA pain, exercise such as stationary cycling is a first-line and recommended treatment. However, limited research has examined how SDOH influence pain outcomes following such interventions. Objective: This study investigated whether income level, education level, employment status, acculturative stress, and perceived ethnic discrimination are associated with changes in pain following a standardized cycling ergometer exercise in adults …

A Comparison Of Cultural Aspects Of Breastfeeding In The United States Vs Italy, Madison P. Wallace

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Healthcare systems internationally differ from policies, funding and resources available, and it is evident when comparing the United States and Italy. Participation in the Nursing Across the Lifespan study abroad program at the University of Arkansas Rome Center and Tiny Tusk Breastfeeding and Infant Support internship inspired a comparative exploration of breastfeeding practices in the United States versus. Italy. The United States has a mixed public- private insurance system, workplace policies and government assistance, while Italy has a universal healthcare system with a mandated maternal work paid leave to support breastfeeding mothers. Italy's program supports education and physical care needed …

Exploring Differences In Outcomes For Boys Vs. Girls In Parent-Child Interaction Therapy With Toddlers: Results From A Community Sample, Reese Norbie

Psychological Science Undergraduate Honors Theses

Parent-Child Interaction Therapy with Toddlers (PCIT-T) is an early intervention designed to address behavioral and emotional dysregulation in very young children by strengthening caregiver-child relationships and improving parenting strategies. Although previous research has identified sex differences in childhood behavioral and emotional presentations, little research has examined whether boys and girls differ in outcomes following PCIT-T treatment, especially with it being relatively new. The current study explored demographic differences, protective factors, and treatment outcomes among boys and girls receiving PCIT-T in a United States community sample. Participants included toddlers and caregivers receiving services from trained PCIT-T clinicians across the United States. …

Enabling Injustice: Slapps, Democratic Values, And The Price Of Truth, Costantino Grasso

Buffalo Law Review

Conventional analysis of Strategic Lawsuits Against Public Participation (SLAPPs) often focuses on the promise of recent procedural reforms, including recent U.S. state-level reforms, the 2024 E.U. Anti-SLAPP Directive, the U.K. government’s 2025 SLAPP Bill, and related measures in the Economic Crime and Corporate Transparency Act. This Article argues that these legislative responses, introduced amid growing international concern, still leave structural vulnerabilities, have limited focus, and do not address the deep-seated inadequacies of substantive law that allow powerful actors to chill public-interest speech through abusive lawfare.

Adopting an interdisciplinary “new legal realist” approach, this Article decodes the anatomy of this modern …

Suspending The Truancy Paradigm, Barbara Fedders, Lucy Carlson, Max Parker

Buffalo Law Review

In the aftermath of the COVID-19 pandemic, school absences have skyrocketed. While racially minoritized, disabled, and low-income students have historically been, and remain, most likely to experience absence, white and affluent students’ rates of attendance have also declined. To respond to this new universality of student absenteeism, some policymakers have begun to seek alternatives to what we term “the truancy paradigm.”

We define the truancy paradigm as the range of coercive and often punitive interventions deployed by states and school districts to enforce compulsory attendance statutes. This paradigm, we argue, wrongly assumes (a) that strict enforcement of compulsory attendance laws …