Digital Commons Network^™

Standardized Infection Prevention Protocol To Reduce Surgical Site Infections In Pediatric Neurosurgery, Pisey Kareth

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.

Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.

Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing …

Pressure Injury Prevention Bundle Implementation In An Acute Care Unit, Hannah K. Pobi

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Pressure Injuries are quality indicators that reflect the quality of care delivered to patients. With a hospital-acquired pressure injury rate above 12%, the project site exceeded the national benchmark average of 5-8% for acute inpatient settings. The cost of managing hospital acquired pressure injury ranges from $20,900 to $151,700 per patient, compounded by complications in a patient’s treatment plan.

Aim of the Project: To reduce the prevalence of HAPIs in a step-down unit to below 8% by implementing the Pressure Injury Prevention bundle. The PIP bundle, an evidence-based intervention, primarily aimed to educate the nursing team on its …

Reducing Catheter-Associated Urinary Tract Infections In Progressive Care, Kelli S. Bylsma

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTI) harm patients and increase healthcare costs. In fiscal year 2025, the progressive care unit reported a CAUTI rate 2.5 times the National Healthcare Safety Network benchmark of 1.0 infection per 1,000 catheter days. A gap analysis revealed that the project site lacked a policy mandating chlorhexidine baths for catheterized patients, resulting in suboptimal catheter hygiene and ineffective bactericidal intervention.

Aim of the Project: The aim of the quality improvement project was to reduce CAUTI rates by 50% through daily chlorhexidine baths for catheterized patients in the progressive care unit.

Review of the Evidence: Recent …

The Mental Health Of Athletes: Channeling Frustration, Aggression, Internal/External Behaviors In The Real World To Improve Performance, Jabari Johnson

Dissertations

This qualitative study examined how college athletes, 18 years and older, experience and interpret internalizing behaviors and externalizing behaviors within contact and non-contact sports, and how those experiences are shaped by gender, racial/ethnic background, and socioeconomic status. The study addressed a gap in the literature by centering athletes’ own perspectives on how emotions, coping, identity, and performance intersect within collegiate sport contexts. A purposive sample of 12 athletes completed a demographic questionnaire and participated in semi-structured interviews conducted in person between December 2025 and February 2026. Interview transcripts were deidentified and analyzed using reflexive thematic analysis following Braun and Clarke’s …

Strengthening The Shield: Exploring Post-Traumatic Growth In Law Enforcement, Aaleiyah C. Spaulding

Dissertations

Law enforcement officers are routinely exposed to traumatic incidents that can lead to psychological distress, including posttraumatic stress disorder (PTSD). However, emerging literature highlights the potential for posttraumatic growth (PTG), a positive psychological change following adversity. This study examined the prevalence and predictors of PTG in a sample of 33 police officers from a Midwestern department. Using validated self-report measures, the study assessed the role of trauma exposure, cognitive restructuring of core beliefs, and perceived organizational culture, particularly supervisor support. Results indicated that both internal (core belief reflection) and external (supervisory support) factors significantly predicted PTG. Additionally, involvement in a …

The Effects Of Functional Coaching On Increasing Functional Play Behaviors In Adults, Abby L. Pattengale

Theses and Dissertations

Play is a critical developmental context for children with autism spectrum disorder (ASD), supporting cognitive, social, communication, and adaptive skill development. However, many adults, specifically registered behavior technicians (RBTs), demonstrate limited engagement in developmentally appropriate play behaviors, which can restrict the quality of play-based interventions, which are essential for effective treatment. However, little research has examined interventions designed to improve adult play behaviors. The purpose of this study was to evaluate the effects of functional coaching on increasing adult functional play behaviors during therapy sessions with children diagnosed with ASD. Two RBTs participated in the study, and two children receiving …

From Gap To Growth: Academic Librarian Perspectives On Why Collaboration And Curriculum Matter, Stephanie Hallam

Library Faculty Scholarship

Incoming undergraduate students possess information literacy skillsets impacted by several factors, such as prior development of information literacy skills, librarian-faculty collaboration, and GenAI advancements. Academic librarians’ perspectives on undergraduate students’ library use and information literacy skills were examined via a 2025 survey of 337 undergraduate academic librarians. Using the Pearson bivariate method, the authors identified themes pertaining to the challenges students face as well as librarian-proposed solutions. Open responses from librarians provide additional insights. The results showed that librarians desire faculty partnerships and collaborative library instruction to improve information literacy skills and library use.

Empowering Domestic Violence Survivors Through Community-Based Self-Regulation Suppor, Xen Gabrielle O. Advincula

Occupational Therapy Student Capstones

Purpose: Program development of trauma-informed, occupation-based resources and program and incorporating OT-related principles to support occupational balance and engagement of survivors of DV and IPV

Goal: Enhance and support the staff’s capacity and understanding of OT-scope in community settings and incorporation of OT-focused self-regulation strategies

Outcome: Increase the staff’s confidence levels of knowledge on the scope of OT within community-based settings and OT-related strategies to support self-regulation levels

An Epilepsy Community Collective Towards Occupational Justice And Empowerment, Tyler Debuty

Occupational Therapy Student Capstones

Underutilization of epilepsy-specific resource programs, lack of public awareness about epilepsy, limitations in community belonging, and implications for self-management programs aimed towards improving quality of life and reducing the burden of care during the transition into adulthood and throughout the lifespan for people with epilepsy.

Promoting Mental Health Awareness, Advocacy, And Occupational Justice For First-Generation College Students, Gilberto Duran Garcia

Occupational Therapy Student Capstones

First Generation College Students (FGCS) face a high prevalence of mental health concerns

Stress, anxiety, depression, financial burden, cultural expectations, imposter syndrome, pressure to meet expectations, fear of the unknown, lack of guidance, and lack of preparedness

Enhancing New Mother's Mental Health And Confidence After Discharge, Breana De La Cruz

Occupational Therapy Student Capstones

New mothers lack guidance, education and resources for common postpartum complications resulting in a decreased overall wellbeing in the postpartum period.

Going With The Flow: Psychological Flow & The Mental Health Of Occupational Therapy Students, Sydney Buchanan

Occupational Therapy Student Capstones

Despite a growing interest in psychological flow as a factor associated with positive mental health outcomes, its relationship to OTD student well-being has remained underexplored.

Kickin' It Old School: Connecting The Ages, Elyssia Lambert

Occupational Therapy Student Capstones

Problem Statement

Lack of social participation is associated with negative impacts on QoL in individuals with dementia

Lack of awareness and knowledge of OT as a career option

Supporting The Transition: A Summer Camp Model For Students With Adhd Entering Middle School, Anna G. Schene

Occupational Therapy Student Capstones

Students transitioning from elementary school to middle school experience newfound independence, requiring sufficiency in their executive functioning skills. The school-based OT service delivery does not always include or target this population, leaving students without the support needed to develop these skills.

Learn As You Are: Equipping Key Educational Stakeholders With Neuro-Affirming Knowledge To Support Inclusion Of Autistic Students, Jessalyn Sulamo

Occupational Therapy Student Capstones

Students throughout the autism spectrum often experience challenges relating to social and communication difficulties, sensory challenges, and inflexible approaches that hinder their social, emotional, and academic well-being (Black et al., 2024).

Hope College Magazine, Volume 58, Number 1: Summer 2026, Hope College

Hope College Magazine

No abstract provided.

Relationships Between Shared Group Properties: Theory, Measurement, Estimation, And Adjustment, Mark A. Maltarich, Paul D. Biese, Nichelle C. Carpenter

Faculty Publications

Teams researchers, meta-analysts, and others often study relationships between group-level constructs measured by aggregating individual-level variables, but it is well-known that group-mean correlations are influenced by individual-level relationships. We review multilevel issues and current practices in estimating and adjusting group-mean associations. We give special attention to comparisons across levels of analysis, and to adjustments for estimating population parameters. A Monte Carlo simulation study indicates that the two most commonly used adjustments in meta-analysis are ineffective in estimating population-based effect sizes. They frequently overestimate true relationships, sometimes severely. Indeed, simulations show that common adjustments move estimates away from population values in …

Dnp Final Report: Implementing The 5-2-1-0 Lifestyle Framework To Address Elevated Bmi In Pediatric Primary Care, Mary K. Williams

DNP Final Reports

Pediatric obesity remains a significant public health concern, particularly in rural areas where access to specialty care is limited. Primary care settings provide an important opportunity for early identification and intervention through family-based lifestyle modification. The purpose of this quality improvement project was to evaluate the feasibility and preliminary impact of implementing the 5-2-1-0 healthy habits framework, developed by researchers at Penn State, in a rural pediatric primary care clinic to promote improved lifestyle behaviors among children with elevated body mass index (BMI).

This project included pediatric patients ages 5–16 years presenting for well-child visits with a BMI at or …

Adaptive Sports Program & Wellness Initiatives For Individuals With Intellectual/Developmental Disabilities Beyond The Service Cliff, Jordan Pare, Erin K. Wells

OTD DEx Reports - College of Pharmacy and Health Sciences

Young adults with Intellectual and Developmental Disability over the age twenty-one face significant barriers to accessing support in mental health, physical activity, and social communication opportunities due to the loss of federal educational entitlement at this age. Individuals with a disability who lose their educational funding at age twenty-one may be forced into underfunded and uncoordinated systems for support, also known as the service cliff. This paper evaluates the benefits of implementing an adaptive sports program for this population, which research suggests can foster social and physical needs while influencing executive functioning in mental health. The benefits of providing education …

Toward Intentional Praxis: A Design Thinking Multi-Case Study Of Cognitive-Constructive Toolkit Implementation In An Elementary Professional Learning Community, Azam Nathaniel

Dissertations

Among several learning theories that were dynamic and constantly evolving with time, cognitive and constructive theories were predominant in the field of education. However, these theories often included overlapping and contrasting concepts, contributing to confusion in terminology among teachers and limited explicit use in instructional practice. Within the context of K-12 education, teachers demonstrated conceptual awareness of cognitive and constructive learning theories; however, the theories were not a part of day-to-day conversations and were minimally identified in practice. Instead, the theories were implicitly applied as teachers balanced competing professional responsibilities, including daily routines, syllabus requirements, district standards, new initiatives, differentiated …

Empowering Amputees Through Education And Resources To Improve Independence And Quality Of Life, Brooke A. Hodges, Wendy M. Tremaine

Summer 2026 OTD Capstone Symposium

This doctoral capstone project aimed to develop and implement an evidence-based educational toolkit to increase community resource awareness for individuals with amputations. The project was completed at Baylor Scott & White Institute for Rehabilitation in Dallas, Texas, and involved adult patients with limb loss and rehabilitation healthcare professionals. A needs assessment was conducted using surveys, semi-structured interviews, and informal discussions to identify educational gaps and resource needs. Findings informed the development of educational materials addressing mental health, peer support, financial assistance, transportation, driving rehabilitation, home modifications, adaptive recreation, prosthetic resources, and community organizations. The toolkit was designed to accommodate varying …

Navigating Concussion Recovery: An Educational Module-Based Approach To Strengthening Occupational Therapist Confidence And Effectiveness In Concussion Rehabilitation, Alejandra Abella, Wendy Tremaine

Summer 2026 OTD Capstone Symposium

Background: Mild traumatic brain injury (mTBI), commonly known as concussion, presents with complex physical, cognitive, visual, vestibular, and emotional symptoms that can significantly affect an individual's ability to participate in meaningful daily occupations. Although occupational therapists play an essential role in concussion rehabilitation, many clinicians report that confidence in evaluating and treating this population develops primarily through years of clinical experience rather than structured education. Inconsistent exposure to concussion cases and limited access to current evidence-based resources contribute to variations in clinical confidence and practice.

Purpose: The purpose of this doctoral capstone project was to develop and implement a comprehensive …

Beyond The Athlete: An Autoethnographic Exploration Of Occupational Identity, Sofia Paniagua-Bauer, Karen Park

Summer 2026 OTD Capstone Symposium

Adolescent student-athletes experience unique demands as they navigate the expectations of competitive sport alongside academic, social, and developmental responsibilities. These demands may influence mental health, executive functioning, occupational balance, and the development of occupational identity. The purpose of this Doctor of Occupational Therapy (OTD) capstone project was to explore the development of occupational identity through the lived experience of growing up as a competitive athlete and to examine how participation in sport influenced mental health, self-regulation, executive functioning, and engagement in meaningful occupations. An autoethnographic approach was used to reflect on my personal experiences while completing a capstone experience at …

The Effect Of The Continuous Care Model On Self-Practices And Quality Of Life Among Preeclamptic Women, Amira Ahmed Altweel, Salma Abd-Elatty Moawed, Amr Mahmoud Riad, Shaimaa Hassan Mohamady

Nursing

No abstract provided.

Hybrid Type 1 Randomized Controlled Trial Of Technology-Assisted Stepped Care Behavioral Health Intervention For Caregivers And Children Following Pediatric Traumatic Injury, Leigh E. Ridings, Kari N. Thomsen, Margaret A. Prentice, Ebonie Powell, Gabriela Becerra, Martina Mueller, Rochelle Hanson, Christian J. Streck, Peter Ehrlich, Linda Ewing-Cobbs, Meghan L. Marsac, Ryan Spurrier, Tatiana Davidson, Kenneth J. Ruggiero

Psychiatry Faculty Publications

Pediatric traumatic injury (PTI) has substantial physical and emotional health impacts, sometimes resulting in hospitalization and/or the development of posttraumatic stress disorder (PTSD) and depression in children. Caregivers are a key source of support for children following PTI; however, many caregivers experience their own distress and psychological reactions following injury. The CAARE (Caregivers' Aid to Accelerate Recovery after pediatric Emergencies) model is a technology-assisted, stepped care intervention to support the emotional and behavioral recovery of preadolescent children hospitalized after PTI and their caregivers. The CAARE model seeks to provide a systematic, evidence-based screening and intervention procedure that is feasible to …

Life After Divorce: Effects Of Joint Custody On Parents And Children, Stella Canessa, Gordon B. Dahl, Anna Hasselqvist, Costas Meghir, Susan Niknami, Mårten Palme, Helmut Rainer, Olof Rosenqvist, Pengpeng Xiao

Cowles Foundation Discussion Papers

Divorce reshapes family life, yet little is known about one of its most consequential features: the allocation of child custody. We study the impact of joint versus sole custody on both parents and children using rich administrative data from Sweden linked to over 25 years of newly-collected court custody rulings. To address selection concerns, we exploit random assignment of custody disputes to judges who differ sharply in their propensity to grant joint custody. For fathers, joint custody substantially raises earnings and improves mental health, consistent with sustained paternal involvement enhancing labor market attachment and psychological well-being. In contrast, there are …

Domestic Outsourcing And Young-Worker Entry Into The Formal Sector, Mayara Felix, Michael B. Wong

Cowles Foundation Discussion Papers

We provide evidence that domestic outsourcing increases young-worker entry into the formal sector. Leveraging a pair of 1993–1994 Brazilian reforms that reduced the relative cost of outsourcing security guards, a triple-differences design shows that the reforms increased formal guard employment by 4% and hiring from unemployment or informality by 7%, while reallocating formal employment from older to younger workers and leaving demographic-adjusted wages unchanged. Census data corroborate the rise in formality, driven by the youngest cohorts. The compositional shift mirrors a general pattern in Brazil’s matched employer–employee records: conditional on total firm size, employers with greater occupation-specific scale hire younger …

Lawyers' Manual For Appealing Parole Denials: Administrative Appeals And Article 78 Petitions, Parole Preparation Project

All Categories

No abstract provided.

Black Brilliance By Design: Culturally Affirming Strategies For High School And Postsecondary Success, Kirsten E. Thornton

Education Dissertations

College and career readiness and access programming aims to prepare students for postsecondary enrollment and success. The intentional implementation of college and career readiness programming was introduced to address the achievement gap in educational outcomes, including but not limited to: graduation rates, college enrollment, college retention, and viable career opportunities. However, Black students who graduate high school and are not adequately academically and socially prepared for postsecondary education compared to their white and non-white counterparts. Current college and career readiness frameworks lack a culturally-relevant lens necessary to effectively address the unique needs of the Black communities in achieving college readiness. …

Co-Designing Multimodal, Multilingual Text Sets: Centering Caregiver Choice, Katie M. Crook, Emily Howell, Lindsey W. Rowe, Hazel Vega Quesada, C. C. Bates

Publications

Early literacy instruction in the U.S. often centers monolingual, English-dominant practices that marginalize multilingual learners and their families. This qualitative design-based research study examines a family literacy initiative that engaged caregivers and teachers as co-designers of a multilingual, multimodal literacy resource bag. Using the MultiSemiotic Architecture Framework, we analyzed qualitative data to explore how collaborative text selection can advance linguistic justice in early childhood education. Findings highlight five themes that shaped intentional text selection and supported multilingual home literacy practices: content, language, cultural relevance, curricular alignment, and collaborative modifications. By centering families' cultural and linguistic resources, the project disrupted monolingual …