Digital Commons Network^™

"Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project", Amber M. Woodring, Samantha Kalkstein

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Quality Improvement Initiative For Emergency Cesarean Delivery: Implementation Of Rapid Sequence Spinal Anesthesia, Hunter L. Baselj, Joseph A. Gabster

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract

Background: General anesthesia (GA) for emergency cesarean sections (EmCS) poses potential risks Rapid Sequence Spinal Anesthesia (RSSA) offers a promising alternative that preserves benefits of neuraxial anesthesia while accommodating the urgency of EmCS. This quality improvement (QI) project aimed to implement and evaluate the use of RSSA at a teaching hospital, utilizing a decision-tree tool to enhance clinical efficiency and assess provider perceptions regarding its impact on airway complications and post-operative pain outcomes. Methods: A RSSA decision-making chart was developed and introduced to anesthesia providers at a teaching hospital. A total of 16 providers, including CRNAs, SRNAs, and anesthesiologists, …

Utilizing Simulation Training To Understand Maternal Cardiac Arrest Precipitated By Amniotic Fluid Embolism: A Quality Improvement Project, Erica L. Wright, Megan L. Tiernan, Michael W. Neft, Paige Spagiare, Erica Coffin

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Background and Problem: Maternal cardiac arrest precipitated by amniotic fluid embolism is among the leading direct causes of death among laboring women (Enomoto et al., 2022). Because it presents suddenly without any immediate apparent cause and lacks specific diagnostic tests, frontline obstetric caregivers must be vigilant, competent, and prepared to handle this potentially catastrophic emergency. Coordination among multiple disciplines is paramount since two lives, not just one, are at risk. Unfortunately, the rarity of maternal cardiac arrest significantly limits opportunities for staff to learn how to identify and manage these events successfully. Method: This quality improvement project established a simulation-based …

Improved Obstetric Hemorrhage Care Through Toolkit Revision: A Quality Improvement Project, Samantha Kalkstein, Amber Woodring

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric hemorrhage (OBH) remains a leading cause of preventable maternal morbidity and mortality in the United States. Accurate risk identification is critical for initiating timely interventions; however, current risk assessment practices vary significantly. This quality improvement (QI) project aimed to implement the California Maternal Quality Care Collaborative (CMQCC) OBH Risk Assessment Tool on the labor and delivery (L&D) unit of a community-based hospital to standardize risk stratification and improve interdisciplinary communication. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, the project involved a gap analysis, staff education, and the introduction of a paper-based CMQCC tool formatted for visibility and …

Native Spaces: The Struggle For Colleges To Incorporate Native Frameworks Into Curriculums, Eleanor A. Gelb

Honors Scholar Theses

Out of the thousands of universities in America, there are only thirty-seven Native American Serving Nontribal Institutions (NASNTIs), schools with ten percent or more of the total student population being of Native American descent. While many typical American colleges offer courses on Native American history for students with Native American studies majors and minors, the students involved in these programs are often taught through the lens of traditional schooling, which negates the full effectiveness of these classes. Native leaders across the country are pushing for Native frameworks to be adopted by universities so that past and contemporary Native histories may …

Optimizing Processes To Improve Relative Value Units For Healthcare Providers, Amalia Vaca

Master's Projects and Capstones

Problem: An outpatient epilepsy clinic receives reimbursement for services rendered based on three relative value units (RVUs). Nurse practitioners (NPs) in the clinic are not meeting their expected RVUs based on current productivity limitations.

Context: The clinic assessment revealed workflow gaps limiting NPs’ ability to increase productivity. The clinic is high-performing, and the staff worked collaboratively to improve the work RVUs. However, dissatisfaction can occur in other microsystems if collaboration breaks down.

Intervention: A microsystem assessment, NP interviews, and clinic template revisions were discussed with leadership and implemented.

Measures: Monthly productivity reports and pre- and post-intervention visit templates were collected …

Molding Leominster's Plastics Industry: The Impact Of Italian Immigrant Labor, Kimberly M. King

Graduate Masters Theses

This thesis examines the centrality of Italian immigrant labor in launching Leominster, Massachusetts’ transformative plastics industry. The study traces the arc of the immigrants’ stories from their arrival at the turn of the twentieth century, when their unskilled labor helped Leominster transition from artisan comb production to industrial celluloid manufacturing, to their rise as new technical experts and company owners in the 1940s. They endured hazardous work conditions and social marginalization to create better lives for themselves and their families.

Ultimately, their efforts were critical to the expansion and global recognition of Leominster’s plastics industry. Yet the role of immigrant …

Sugar: A Sequence Unfolding Based Transformer Model For Group Activity Recognition, Yash U. Gondkar

Graduate Masters Theses

Large Language Models have improved significantly in the past couple of years due to the adoption of transformers. However, transformers still find it challenging to process videos due to limited context size caused by their quadratic computing cost. Therefore, we studied a booming field in machine learning which powers applications like social scene analysis and video surveillance systems called Group Activity Recognition (GAR). We found that recent models were able to achieve more than 90% accuracy on popular datasets like the Volleyball dataset, however, it turned out that even they relied on transformers.

Therefore, in this work, we developed a …

Choked: How Decades Of Failures To Address Air Pollution And Housing Shortages Exacerbated Mortality In Pittsburgh During The Influenza Pandemic Of 1918, Virginia Montanez

Graduate Masters Theses

Pittsburgh experienced the highest death rate of all major U.S. cities during the 1918 H1N1 influenza pandemic. This record mortality was not due to inadequate, absent, or ignored nonpharmaceutical interventions and mandates. Instead, for decades prior, city officials prioritized industry at the expense of the collective health of the laboring class. They were especially egregious in permitting industrial smoke pollution and overcrowded housing to persist in immigrant-heavy working-class wards, leaving residents susceptible to respiratory disease incidence and mortality. As a result, Pittsburgh’s annual influenza and pneumonia death rates were drastically the worst in the nation to such an extent that …

On Being The Only: Using Black Feminist Thought And Hermeneutic Phenomenology To Deeply Understand Onliness As Experienced By Black Women In Stem, Karen M. Jarvis-Thorne, Karen M. Jarvis-Thorne

Graduate Doctoral Dissertations

When a Black woman persists in a STEM undergraduate academic space as the only Black woman in that space, how is she shaped as a human being? How does she fare? How does the experience influence her decision making as she contemplates graduate school applications? Does the experience guide her decision to stay or leave STEM? In this study, the author used Black Feminist Thought to provide cultural and critical oversight of her engagement with Hermeneutic Phenomenology. Hermeneutic Phenomenology requires this oversight because the methodology’s theoretical foundations are grounded in Heidegger’s Nazism and should be critiqued if and when appropriate …

Global Commons, Local Crises: The Ecological Embeddedness Of Global Production Networks, Christopher R. Whynacht

Graduate Doctoral Dissertations

Notions of Global Production Networks (GPNs) are popular approaches to studying the complex, dispersed, and socially embedded production of goods and services. Yet, these concepts have largely struggled with incorporating environmental resources, risks, and actors. My dissertation leverages insights from Actor-Network Theory (ANT) to contextualize ecological elements of production as coequal participants with social stakeholders. I describe how GPNs are ecologically embedded and nested within the natural environment. I draw from ANT to develop a GPN framework that internalizes ecological dimensions. The second chapter in this dissertation develops these ideas and provides theoretical framing for further empirical chapters. The third …

Pipeline Vs. Choice: The Global Gender Gap In Stem Applications, Isaac Ahimbisibwe, Adam Altjmed, Georgy Artemov, Andres Barrios-Fernandez, Aspasia Bizopoulou, Martti Kaila, Jin-Tan Liu, Rigissa Megalokonomou, José Montalban, Christopher Neilson, Jintao Sun, Sebastian Otero, Xiaoyang Ye

Cowles Foundation Discussion Papers

Women account for only 35% of global STEM graduates, a share unchanged for a decade. We use administrative microdata from centralized university admissions in ten systems to deliver the first crossnational decomposition of the STEM gender gap into a pipeline gap (academic preparedness) and a choice gap (first-choice field conditional on eligibility). In deferred-acceptance platforms where eligibility is score-based, we isolate preferences from access. The pipeline gap varies widely, from -19 to +31 percentage points across education systems. By contrast, the choice gap is remarkably stable: high-scoring women are 25 percentage points less likely than men to rank STEM first.

The Concept Of Maqāṣid Al-Sharī‘Ah And Maṣlaḥah In The Classical And Contemporary Tafsîr, Yusuf Wibisono, Femmy Roeslan

International Journal of Islamic Economics and Business Sustainability

A contemporary mufassir (Qur’anic exegete) employs the principle of al-‘ibrah bi maqāṣid al-sharī‘ah—that interpretation must refer to the objectives of Islamic law—in an effort to uncover the true meaning of the Qur’anic text. A purely literal reading of the Qur’an, without an understanding of its maqāṣid (objectives), faces many limitations. The maqāṣid approach emphasizes not only the wording of the text but also its underlying purposes and goals. The greatest strength of maqāṣid-based tafsīr (interpretation) lies in its ability to render the Qur’an always relevant, adaptable, and universally applicable. As an interpretive approach not strictly tied to …

Subsidiarity In The Shadow Of Sovereignty, Loren King

Political Science Faculty Publications

Subsidiarity frustrates. It admits of clear articulation as an ideal (‘vest authority as close as feasible to those most affected’) but then invites conflicting interpretations and elaborations. As a workable principle, subsidiarity seems to founder exactly when we need it: when we ask what, precisely, that principle regulates. As a regulative moral precept, subsidiarity promises a politics sensitive to diverse needs and responsive to local knowledge, yet in practice any implementation of the ideal pulls us back toward an authoritative center to regulate disputes and coordinate all of this local wisdom. I love subsidiarity for these frustrations and ambiguities. In …

Oral Hygiene Practices, Treatment Needs And Barriers To Dental Care Among Adolescents Attending Special Education Schools In Shah Alam, Selangor, Malaysia, Nur Hafizah Nor Wira, Noraida Mamat, Maryani Mohamed Rohani, Aimi Kamarudin, Sofia Anis

Journal of Dentistry Indonesia

Objective: This study aimed to evaluate the oral health practices, status, and treatment requirements of adolescents with special healthcare needs attending special education schools in Selangor, Malaysia. The adolescents’ parents perceived challenges to oral healthcare were also established. Methods: The current study employed a cross-sectional approach involving 131 adolescents with varying special needs. The participants were between 13 and 18 years old and fulfilled the pre-determined inclusion criteria. The participants’ parents supplied information on sociodemographic, oral health practices, and possible obstacles to dental care through an online survey form. The oral examination on decay, missing, and filled teeth (DMFT), simplified …

Cooling Protocols Impact On Nickel-Titanium Rotary Instruments Cyclic Fatigue Resistance Under Extreme Curvatures And Sodium Hypochlorite, Palak Ravjibhai Ranparia, Chintan Joshi, Mona Somani, Aashray Patel, Urooj Desai, Janki Prajapati

Journal of Dentistry Indonesia

Objective: In this work, Hyflex CM, TruNatomy, and Plex V heat-treated nickel titanium rotary instruments were evaluated at body temperature (36 °C ± 1 °C) with and without a cooling protocol to assess the cyclic fatigue resistance. Methods: A 90° curved stainless-steel block was used for cyclic fatigue tests on 60 randomly selected rotary instruments, divided into two groups of 30: body temperature (n = 10) and body temperature with cooling (n = 10). Instruments were further subdivided into 6 groups of 3 different instruments. Cooling protocol group instruments received 5-second spray cooling every 30 seconds, along with continuous 5% …

Development And Comparative Evaluation Of A Novel Aloe Vera–Vinegar Gel As A Sustainable Histological Slide Coating Agent, Jayagopi Deepasakthi, Palati Sinduja

Journal of Dentistry Indonesia

Objective: Reliable tissue adhesion to glass slides is critical for accurate histological evaluation. Egg albumen, a commonly used coating agent, often results in background staining and inconsistent performance. Aloe vera, known for its biocompatibility and adhesive properties, presents a sustainable alternative. This study aimed to develop a novel aloe vera–vinegar gel formulation and compare its slide-coating performance with that of traditional egg albumen. Methods: Fresh Aloe vera gel was extracted and combined with nonfruit vinegar, filtered, and refrigerated. Thirty paraffin-embedded tissue sections were divided into two groups: one coated with aloe vera–vinegar gel and the other coated …

Positive And Negative Personality Traits In Relation To Oral Health-Related Quality Of Life And Satisfaction After Implant-Supported Prosthetic Treatment, Naimeh Hasheminejad, Maryam Farzadmoghadam, Mohammad Mohammadi, Amir Nekouei, Mohammadreza Rostamizadeh

Journal of Dentistry Indonesia

Objective: This study aimed to determine patients’ positive and negative personality traits in relation to treatment satisfaction and oral health-related quality of life (OHRQOL) in patients who have received dental implant-supported prosthesis. Methods: This study was carried out on 135 adults above the age of 30 who had received reasonable implant treatment and prosthesis in the last 1–24 months in a private and a public dental office. Data collection was carried out using a questionnaire, which was sent to patients via WhatsApp and email. Also, the Persian version of the Oral Health Impact Profile 14 and the Positive Affect Negative …

Self-Medication Behavior Of Dental Students With Oral Ulceration Lesions: A Cross-Sectional Study In Yogyakarta, Indonesia, Fita Fathaya Iriana, Hendri Susanto, Rosa Amalia

Journal of Dentistry Indonesia

Objective: Self-medication refers to medication behavior for self-diagnosed symptoms. Oral ulcers are self-medicated lesions in the oral cavity. Dental students have different knowledge about oral cavity lesions and may self-medicate using drugs. This study aimed to determine the self-medication behavior of dental students for oral ulcers. Methods: This cross-sectional study was conducted on dental students in the Faculty of Dentistry from different batch years. Purposive sampling was used to select students with oral ulcer lesions in the last six months. A validated and reliable questionnaire was used to assess self-medication behavior. Data collection using the online form. Student behavior …

Perception Of Conventional Cigarettes And Vaping Among Smokers And Nonsmokers: A Cross-Sectional Study, Indrayadi Gunardi, Rahmi Amtha, Firstine Kelsi Hartanto, Niko Falatehan, Alyah Heriandi, Angelita Victoria Kurniawan, Najla Nadiah, Wiwiek Poedjiastoeti, Andrijanto Andrijanto, Elizabeth Fitriana Sari

Journal of Dentistry Indonesia

Objectives: The growing popularity of vaping has introduced additional challenges, as potential health risks are still under investigation. Exploring differences in smoking perceptions between smokers and non-smokers could provide valuable insights into smoking behavior and inform effective intervention strategies. This study aimed to evaluate and compare the perceptions of smoking, specifically vaping and conventional cigarette use, among young adult smokers and non-smokers. Methods: An analytical cross-sectional design was employed, with 542 university students included through random sampling, using a questionnaire consisting of 8 items. Data were analyzed using the Kruskal-Wallis test and Rasch model analysis. Results: Of the subjects, 259 …

Neutral Zone Vs. Conventional Denture Fabrication: A Randomized Crossover Study On Denture Performance, Karthik Kannaiyan, Arunima Chauhan, Vijayendranath Nayak, Riyshmaa Devendaran, Dashmita Peterson, Pavittra Kanesan, Vityaa Lakshmi

Journal of Dentistry Indonesia

Objectives: It is challenging to achieve satisfactory outcomes in a complete denture for patients with resorbed residual ridges. Utilization of neutral zone techniques to guide posterior denture tooth arrangement and denture base contouring has been considered for many decades. However, the evidence is still not enough to revise protocols. This study aimed to compare patient satisfaction and stability of neutral zone denture with conventional denture. Methods: A crossover clinical trial was conducted among patients with resorbed mandibular ridges. Each participant received two sets of dentures: one fabricated using the neutral zone technique and one using the conventional method, in a …

Papillon–Lefèvre Syndrome: A Report Of Four Cases In One Family, Muhammed Abdullah Çege, Dilek Aynur Çankal, Ebru Binici, Bilge Turhan Bal

Journal of Dentistry Indonesia

Papillon–Lefèvre syndrome (PLS) is a rare genetic disorder caused by mutations in the cathepsin C gene and inherited in an autosomal recessive pattern. The risk of its occurrence is heightened by consanguineous marriages. PLS affects both genders and presents with hyperkeratotic patches on the hands and feet and precocious aggressive periodontitis. Although teeth initially erupt normally, rapid resorption in periodontal tissues leads to swift tooth loss, and prosthetic rehabilitation is complicated due to aggressive alveolar bone resorption. Case report: In 2021, a brother and sister sought dental treatment at Gazi University’s Faculty of Dentistry. After thorough examinations, the brother underwent …

Comparison Of Pharyngeal Airway And Dentoskeletal Effects Of 2 And 4 Premolar Extraction Treatment In Adult Orthodontic Patients, Esra Genc, Ahmet Karaman

Journal of Dentistry Indonesia

Objective: This study aimed to compare pharyngeal airway and dentoskeletal effects of 2 and 4 premolar extraction treatments in adult patients separately for each gender. Methods: The study was conducted with 60 adults (26 males; 34 females) aged 18-35 years. Individuals were divided into 3 groups as non-extraction, 2-premolar extraction, and 4-premolar extraction. Pre-treatment (T0) and post-treatment (T1) dentoskeletal and pharyngeal airway measurements were performed on cephalometric radiographs. Results: A significant increase in nasopharyngeal airway (PNS-ad2) and anterior hyoid bone movement (CV3ai-H) was observed in the 4-extraction group; whereas in the 2-extraction group, inferior oropharyngeal airway (IAS) narrowing and hyoid …

Effectiveness Of Resin-Infiltration In Masking White Spot Lesions And Enamel Defects, Color Stability And Inhibition Of Caries Progression: A Systematic Review, Amaradri Sravya, Chandrappa Vinay, Kadidal Uloopi, Peddi Ravigna, Penmatsa Chaitanya, Spandana Cheeli

Journal of Dentistry Indonesia

Objective: The study aims to demonstrate the efficacy of resin-infiltration in masking white spot lesions and enamel defects, color stability, and caries progression inhibition in primary and permanent teeth. Methods: PubMed, Cochrane library, Wiley Online Library, and Google Scholar databases were searched from 2018 to 2022 and only randomized controlled clinical trials (RCT’s) were included. The studies were analyzed regarding the clinical efficacy of resin-infiltration in masking white spot lesions and enamel defects, color stability, and inhibition of caries progression. Results: Of the 14 articles identified, 5 RCTs were included. The quality of the studies was assessed …

Access To Information On Toddler Family Development Program And Family Participation In Child Growth And Development, Dita Dhammayanti, Demsa Simbolon, Lissa Ervina, Yusran Fauzi

Kesmas

The comprehension of the Toddler Family Development (TFD) Program among families in Indonesia remains limited, likely due to insufficient access to information and low participation rates. Limited participation can negatively affect a family’s ability to support optimal child growth and development. This study examined the relationship between access to information on the TFD Program and family participation in child growth and development. Using secondary data from the 2019 Program Performance and Accountability Survey in Indonesia, the cross-sectional analysis included 21,497 respondents. The results revealed an association between access to information on the TFD Program and family participation in child growth …

Effect Of Seasonal Variability In Methane Emissions And Iron Redox Chemistry At Terrestrial-Aquatic Interfaces, Hermes C. Ruiz

Master's Theses

Methane (CH₄) emissions at terrestrial–aquatic interfaces (TAIs) are significant contributors to the global carbon budget, yet the mechanisms driving methanogenesis remain poorly understood. Limited data exist on how seasonal variations and redox processes influence CH₄ fluxes in these dynamic ecosystems. This study addressed two questions: (1) How are CH₄ fluxes in riverine floodplains and adjacent hillslopes impacted by seasonal variations? (2) What roles do metal redox processes (e.g., iron (Fe)) play in regulating methanogenesis?

In-situ CH₄ flux and solid-phase Fe speciation were quantified in East River, CO, under flooded and drained conditions. Groundwater chemistry, gas flux, and soil physical properties …

Crisis Convergence, Sarah Medina Camiscoli

Northwestern University Law Review

Progressive jurists and legal scholars have called the Supreme Court’s doctrine of colorblind constitutionalism that dismantled affirmative action in Students for Fair Admissions, Inc. v. President and Fellows of Harvard (SFFA) a crisis for constitutional democracy. However, scholars have not yet tended to students, particularly students mobilized for racial justice, to understand their interpretation of this race-evasive ideology and what insights those mobilized students might offer in this pivotal moment. Given the fact that a small coalition of dissenting conservative jurists, scholars, and mobilized students—the Federalist Society—spent decades crafting the doctrine, scholarship, and resources that drive colorblind constitutionalism …

Transforming Student Coaching To Support Students' Personal, Academic, And Professional Success: Insights From The Student Success Coaching Programme, Abdellatif Atif, Tony Hall, Larissa Lamb, Michelle Millar, Majella Perry

Irish Journal of Academic Practice

The University of Galway introduced Student Success Coaching (SSC), a core commitment of an institution-wide innovation programme, Designing Futures. Designing Futures received significant government funding of €7.57m in 2020 to enhance the student experience through enterprise-engaged education, research-led learning, and cross-faculty teaching. An integral part of Designing Futures, SSC constitutes the holistic development element of the wider university programme, applying design thinking principles to support students’ personal, academic, and professional success. It encourages students to recognize their strengths and natural talents and navigate successful transitions into university life and community. Firstly, this paper outlines how design thinking theories and principles …

Assessing Stages Of Objective Memory Impairment And Neuroimaging As Risk Factors Of Incident Cognitive Impairment, Kellen K Petersen, Ali Ezzati, Bhargav T Nallapu, Richard B Lipton, Reisa A Sperling, Kathryn V Papp, Dorene M Rentz, Keith A Johnson, Ellen Grober

2020-Current year OA Pubs

OBJECTIVE: The Stages of Objective Memory Impairment (SOMI) system, based on the Free and Cued Selective Reminding Test (FCSRT), is a potential marker of subtle cognitive impairment in cognitively normal persons defined by a Clinical Dementia Rating (CDR) = 0. We investigated SOMI's ability to predict incident cognitive impairment (CDR >0) in combination with demographic features and neuroimaging biomarkers.

METHODS: Cognitively unimpaired participants (CDR = 0) from the Harvard Aging Brain Study had baseline FCSRT scores, MRI, FDG-PET, and PiB-PET as well as follow-up CDRs for 5 years. Cox proportional hazards models with correction for multiple testing assessed the predictive …

The Effect Of Maternal Diet On Neonatal Jaundice: A Case-Control Study, Marzieh Mahdipoor, Alireza J. Motlagh, Hamid S. Baghbanan, Mahmood Bakhtiyari, Zohreh Khodaii, Sara E. Saeieh

Sultan Qaboos University Medical Journal

Objectives: This study aims to investigate the influence of dietary heat intensity in maternal diets on the incidence of neonatal jaundice. Specifically, we examine whether maternal consumption of "dietary heat intensity" foods affects neonatal bilirubin levels, while controlling for potential demographic and obstetric confounding factors. Methods: This retrospective case-control study was conducted between October 2023 and September 2024. The study population consisted of mothers and their newborns attending healthcare centers in Alborz Province, Iran. Based on predefined inclusion and exclusion criteria, 152 newborns were enrolled, comprising 75 non-jaundiced and 77 jaundiced infants. Data were collected using an information-gathering form and …