Digital Commons Network^™

Chew On It: A Pilot Study Of A Multimodal Assessment Of Mastication Protocol, Michelle Catão

Electronic Theses and Dissertations

Despite its subconscious nature, deglutition is an elaborate and multifaceted process, contingent on the activation of specific neural pathways and muscles. The inherent complexity gives rise to a wide array of potential complications and difficulties, known as dysphagia. Screening and assessment for dysphagia aid in determining the presence and etiology of swallowing difficulties, providing information that is critical for maintaining and improving the health status of vulnerable populations from the standpoint of nutrition, hydration, and socialization (Dziewas et al., 2017). Previous studies surrounding dysphagia assessment have prioritized formulating clinical protocols to evaluate the nonvolitional stage, often failing to address the …

Illness Terminable And Interminable: A Lacanian Exploration Of Medical Assistance In Dying, Matthew Devine

Electronic Theses and Dissertations

More and more people worldwide are requesting euthanasia, physician-assisted suicide (PAS), or medical assistance in dying (MAiD). Arguments in favor of expanding access to MAiD tend to prioritize the rational, competent, autonomous subject who has the right to make decisions about their body, including their death. Some have argued that this perspective – common in biomedical and bioethical literature – tends to neglect the fact that requests for assisted dying involve a relational structure: a relationship between the subject who requests an assisted death and the Other to whom this request is addressed. After reviewing relevant psychoanalytic approaches to suicide …

Sex-Related Measurement Bias In Autism Spectrum Disorder Symptoms In The Baby Siblings Research Consortium, Catherine A. Burrows, Sooyeon Sung, Shuting Zheng, Greg S. Young, Tony Charman, Cherly Klaiman, Ami Klin, Natasha Marrus, Sally Ozonoff, Joseph Piven, Diana L. Robins, Rebecca J. Schmidt, A. J. Schwichtenberg, Sara Jane Webb, Lonnie Zwaigenbaum, Leslie J. Carver, Katarzyna Chawarska, Suzanne Curtin, Shafali S. Jeste, Jana M. Iverson, Jane E. Roberts

Faculty Publications

Importance Disparities exist in age of diagnosis and prevalence of autism spectrum disorder (ASD) for female compared with male children. Correcting for sources of bias is critical for improving equitable ASD identification.

Objective To determine whether sex differences exist in measurement of ASD symptoms using the Autism Diagnostic Observation Schedule (ADOS) among young children at high familial likelihood (HFL) and low familial likelihood (LFL) of ASD.

Design, Setting, and Participants This cohort study collected longitudinal, prospective data from the Baby Siblings Research Consortium between January 1, 2003, and December 31, 2021. Participants included 3106 children who had an older sibling …

Sex-Related Measurement Bias In Autism Spectrum Disorder Symptoms In The Baby Siblings Research Consortium, Catherine A. Burrows, Sooyeon Sung, Shuting Zheng, Tony Charman, Cheryl Klaiman, Ami Klin, Natasha Marrus, Sally Ozonof, Joseph Piven, Diana L. Robins, Rebecca J. Schmidt, A. J. Schwichtenberg, Sara Jane Webb, Lonnie Zwaigenbaum, Leslie J. Carver, Katarzyna Chawarska, Suzanne Curtin, Shafali S. Jeste, Jana M. Iverson, Rebecca J. Landa, Daniel S. Messinger, Jane E. Roberts, Wendy L. Stone, Helen Tager-Flusberg, Amy N. Esler, Meghan Miller, Somer L. Bishop, Jed T. Elison

Faculty Publications

IMPORTANCE Disparities exist in age of diagnosis and prevalence of autism spectrum disorder (ASD) for female compared with male children. Correcting for sources of bias is critical for improving equitable ASD identification. OBJECTIVE To determine whether sex differences exist in measurement of ASD symptoms using the Autism Diagnostic Observation Schedule (ADOS) among young children at high familial likelihood (HFL) and low familial likelihood (LFL) of ASD. DESIGN, SETTING, AND PARTICIPANTS This cohort study collected longitudinal, prospective data from the Baby Siblings Research Consortium between January 1, 2003, and December 31, 2021. Participants included 3106 children who had an older sibling …

From Bed To Table: Improving Outcomes By Encouraging Patient Mobility During Meals, Quyen Ho

Master's Projects and Capstones

Abstract

Background: Hospital-acquired pneumonia (HAP) is a preventable complication associated with increased morbidity, prolonged hospital stays, and elevated healthcare costs. Early mobility, particularly positioning patients out of bed for meals, is a key strategy to mitigate this risk. Problem: On a 42-bed telemetry unit, only 24% of eligible patients were positioned out of bed for meals. This low rate of mobility presented an opportunity to reduce the risk of HAP and improve patient outcomes. Interventions: This quality improvement initiative, guided by the Donabedian Model, employed a nurse-led intervention that included daily mobility assessments, visual bedside cues, and targeted staff education. …

Improving Intraoperative Antibiotic Stewardship To Reduce Surgical Site Infections: A Quality Improvement, Allyson Nichelle Heard

Doctor of Nursing Practice (DNP) Manuscripts

Purpose: Surgical site infections (SSIs) have been associated with poor pre-surgical incision antibiotic and intraoperative redosing practices and are the leading cause of postoperative readmissions and healthcare-acquired infections. A Quality Improvement (QI) project was developed to evaluate SSIs rates and pre-surgical incision antibiotic dosing and intraoperative redosing practices of anesthesia providers at a Level 1 trauma center in the Midwest. Methods: A pre- and post-intervention knowledge, attitudes, and practices (KAP) survey addressing intraoperative antibiotic stewardship was administered to 138 anesthesia providers. Interventions included education, a reference sheet, and a clinical pathway. Data analysis for surgical procedures involving anesthesia services, …

Enhancing Care Coordination And Expedited Appointment Scheduling By Structured Workflow Process In Oncology Clinics: A Quality Improvement Initiative, Jasmine Lassiter

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Delays in oncology appointment scheduling can negatively impact timely cancer treatment, care coordination, and patient outcomes. Inefficiencies often stem from inconsistent workflows, communication breakdowns, and limited visibility into provider availability, contributing to scheduling inaccuracies, and treatment delays (Fletcher et al., 2023; Johnson et al., 2020). Purpose: This quality improvement project aimed to implement and evaluate a structured workflow for expedited oncology appointment scheduling in an outpatient setting to improve scheduling accuracy, care coordination, and healthcare team vitality. Intervention and Implementation Plan: Guided by the Institute for Healthcare Improvement (IHI) Model for Improvement and the Johns Hopkins Evidence-Based …

The Implementation Of A Pilot Program On Puberty And Menstruation Education For Adolescent Females And Youth Development Specialists For A Gender-Specific Community Organization: A Quality Improvement Project, Cassandra Tavares

Doctor of Nursing Practice (DNP) Manuscripts

Background & Significance: Adolescent girls in the United States (U.S.) often lack adequate education and support regarding puberty and menstruation, despite the importance of this knowledge for healthy development (Schmitt et al., 2022). Only 21% of school systems serving ages 8–12 provide puberty education, and many educators feel unprepared to teach it (Schmitt et al., 2022). Purpose: This quality improvement project aimed to equip youth development specialists (YDS) at a community organization with a structured curriculum and educational tools to confidently educate adolescent females (ages 8–13) on the physical, emotional, and social aspects of puberty and menstruation. Intervention: A four-day …

Mca 10100 Oer/Ztc Syllabus, Daniel Gilmore

Open Educational Resources

This is a syllabus for the MCA 10100 Introduction to Media Studies course taught at City College in the Media & Communication Arts department. It is an OER & ZTC compliant syllabus.

Exploring Strategies For Mitigating Toxic Behaviors And Improving Employee Retention In Organizations, Roy Lydell Rucker

Walden Dissertations and Doctoral Studies

A lack of mitigation strategies for middle manager toxic leadership can negatively affect organizational retention outcomes. Business leaders are concerned with a lack of effective strategies to counteract these behaviors and improve retention. Grounded in the toxic leadership theory, this study aimed to explore executive leaders’ strategies for mitigating toxic leadership and enhancing retention, guided by the toxic leadership framework. A qualitative, pragmatic inquiry design employed purposive sampling of nine C-suite executives from U.S. technology small and medium-sized enterprises (SMEs). Data were collected via semistructured interviews and organizational documents. Thematic analysis, employing iterative coding and constant comparison, yielded six themes: …

The Protective Role Of Resilience In Indirect Aggression Perpetration And Victimization, Amelia Klass

Electronic Theses and Dissertations

This study examines the relationship between resilience and indirect aggression, specifically relational and social aggression, utilizing a sample of 104 females aged 18–22. Indirect aggression, characterized by behaviors such as social exclusion, gossip, and manipulation, is associated with significant emotional and interpersonal difficulties. Using a theoretical basis that includes gender schema theory, social learning theory, and social information processing theory, this study investigates whether resilience has a significant relationship in both the perpetration of and victimization through the use of indirect aggression. Participants completed self-report measures, including the Adult Resilience Measure – Revised and the Young Adult Social Behavior Scales …

Collecting The Strands: A Psychoanalytic Study Of Hair-Pulling In Women, Jacklyn Corsitto

Electronic Theses and Dissertations

This dissertation investigated compulsive hair-pulling (i.e., trichotillomania) in women from a psychoanalytic perspective. The assumption, from a psychoanalytic viewpoint, is that the symptom of hair-pulling serves meaningful, and multiple, psychical purposes that should be analyzed rather than immediately removed, as would be the case in the current gold standard of treatment—behavioral therapy with habit reversal training. This behavioral modality leaves little to no room for exploring the historical, relational, symbolic, and emotional dimensions of hair-pulling. This dissertation fleshed out these dimensions and investigated what hair-pulling was doing for the individual, what its function or purpose was, and, indeed, what ideational …

Healthy And Successful Aging Outside The Closet: How Outness And Social Support Relate To Health And Aging Concerns, Jessica Segal

Electronic Theses and Dissertations

The ability to disclose an LGBTQ+ identity is a significant part of many queer lives. A person’s outness can often be tied into their social support whether through their network or available resources. This study investigated how outness, social network, and access to resources relate to older LGBTQ+ individuals’ concerns regarding their care and their aging. A secondary data analysis was conducted using survey data from the American Association of Retired Persons (AARP). The results showed that an increase in one’s social network indicated a decrease in aging-related care concerns; an increase in access to resources indicated a decrease in …

Identifying The Experiences And Perceptions Of School Psychologists On Racial Disparities In Autism Spectrum Disorderidentifying The Experiences And Perceptions Of School Psychologists On Racial Disparities In Autism Spectrum Disorder, Anna Marie Paolicelli

Electronic Theses and Dissertations

This paper investigates the experiences and perceptions of school psychologists who identify as experts in autism spectrum disorder (ASD) regarding racial and ethnic disparities in ASD identification. Utilizing a convergent embedded mixed-methods design grounded in Consensual Qualitative Research (CQR), the study explores how school psychology practices may have contributed to recent changes in ASD outreach and assessment, as well as persistent disparities, particularly for Black children with co-occurring intellectual disability (ID). Thirteen credentialed school psychologists with extensive experience in diverse educational and clinical settings participated in semi-structured interviews and binary survey items. Findings reveal perceived progress in ASD awareness and …

Effects Of Treatment Integrity Level And Error Type On Dro Efficacy: A Parametric And Comparative Analysis, Paige O'Neill

Theses & Dissertations

Differential reinforcement of other behavior (DRO) is a strategy commonly used in applied contexts to address challenging behavior but can be difficult to implement with high treatment integrity. Previous research has shown that DRO may be robust despite marginal errors of commission, but the impact of differing degrees of errors and different error types during DRO is still unclear. The purpose of the current study was to conduct a parametric evaluation of treatment integrity level (100%, 80%, 60%, 40%, 20%) in DRO when implemented with combined errors (Experiment 1) and to directly compare error types (commission errors, omission errors, combined …

Optimizing Sourcing Through Agile Project Management: Enhancing Efficiency And Cost Effectiveness In Apparel Production, Gautami Vikrant Moghe

Harrisburg University Dissertations and Theses

Production delays, cost overruns, and inventory mismanagement are a few of the challenges that the garment industry faces in its sourcing process. The main causes of these challenges are fluctuating market demands and evolving customer preferences. This research explored the application of agile project management methodologies to address these challenges by enhancing flexibility and collaboration. This study implemented a qualitative approach, leveraging interviews with industry professionals to gather insights into the practical implementation. The significance of this research lied in its potential to provide actionable insights for companies that were seeking to improve their sourcing efficiency and cost-effectiveness. To contextualize …

Quality Improvement Project Impact Of Impostor Phenomenon On Medical Personnel, Elizabeth L'Heureux

Doctor of Nursing Practice Projects

The DNP project examined medical healthcare personnel who displayed an impostor phenomenon (IP), as reflected in the Perceived Stress Scale (PSS-10) surveys, identifying a lack of structured support for reducing stress. The aim of the quality improvement project (QI) is to evaluate the impact of a four-week structured mentorship and resilience training intervention on perceived stress levels among medical healthcare personnel experiencing symptoms of the impostor phenomenon. The QI project utilized the Cognitive-Affective framework to shape what needed to change, the origins of IP stress, while Lewin’s Change Theory guided how to implement and sustain those changes. A quasi-experimental study …

The Effects Of A Breastfeeding Educational Program On Nurses’ Self-Efficacy And Knowledge, Amanda Quinn

Doctor of Nursing Practice Projects

Breastfeeding, a cornerstone of maternal and infant health, faces barriers due to inadequate healthcare provider education, contributing to low exclusive breastfeeding rates. The purpose of this quality improvement project was to evaluate the impact of a four-week educational program on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. This project evaluated a four-week educational program’s effect on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. Using a quasi-experimental pre-post design, nine licensed/certified staff (medical assistants, licensed practical nurses, registered nurses, advanced practice registered nurses) …

Quality Improvement Project Evaluating The Impact Of A Structured Training Program On Cultural Competency Among Mental Health Providers In A Local Outpatient Clinic, Adedamola Adefioye

Doctor of Nursing Practice Projects

Culturally responsive care is critical in addressing mental health disparities, but many mental health providers express feeling unprepared to engage with culturally diverse patients. Low cultural competence is associated with communication failures, lack of patient trust, and the possibility of poorer treatment outcomes. This quality improvement project evaluated the impact of a structured cultural competency training program at an outpatient behavioral health clinic. A quasi-experimental, one-group pre-test/post-test design was used with the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals - Revised (IAPCC-R). Eight licensed mental health providers participated in four weekly one-hour interactive training sessions using …

Should School Board Elections Be Partisan? Analyzing Elite Discourse In The Debate Over The Structure Of Local Elections, Bre'arra M. Long

McNair Summer Research Program

The goal of this research paper is to identify the most prevalent arguments for and against partisan school board elections while also examining what differences, if any, exist between Republicans and Democrats with respect to the way they talk about the issue. The interdisciplinary fields of political science and linguistics provide helpful context to the effectiveness of political communication in smaller scale, yet salient elections in communities where impacts are most directly felt. My interest lies in how the nationalization of politics influences local government and elections, and how language and the media act as conduits for that relationship. It …

Routine Outcome Monitoring With The Youth Outcome Questionnaire-30.2 Self-Report: Creating And Testing An Empirical Alert System And Exploring Informant Discrepancy Patterns, Tate M. Paxton

Theses and Dissertations

Objective: Youth self-report data using the YOQ-30 has not been specifically examined for use in routine outcome monitoring systems. This study used the YOQ-30 self-report in three endeavors: (1) modeling change trajectories in a large, naturalistic outpatient sample, (2) creating and testing an empirical alert system for deterioration, and (3) exploring the role of informant agreement, both descriptively and in a change trajectory model. Method: The sample consisted of 21,098 adolescents ages 12-17 receiving outpatient mental health care who used the OQ Measures system. Multilevel individual change trajectory models estimated symptom change over time. An alert system was developed on …

Attachment Or Aversion: A Study Of The Effects Of Parental Technoference On Child Emotion Knowledge, Brooklyn Coleman

Theses and Dissertations

Young children's understanding of emotions is heavily socialized by their parents. Through interactions with parents, children learn what emotions look like, when they are expressed, and how they are labeled (Laible, 2004a). Interruptions to interactions between children and parents have the potential to influence the development of children's emotion knowledge. According to the DREAMER framework, how one family member uses media and technology can influence other family members (Barr et al., 2024). Technoference (i.e., digital distraction while with others) is one example of how media might interrupt family life and influence child development as a whole. The current study examined …

Comparing The Effectiveness Of Online Training With Behavioral Consultation: The Impact Of Teacher Buy-In And Efficacy, Allison C. Lindsey

Theses and Dissertations

This study investigated the comparative effectiveness of two different behavioral training methodologies, online training and behavioral consultation, in supporting teacher implementation of evidence-based practices, with a focus on the roles of teacher buy-in and self-efficacy. Challenging behavior is on the rise and teacher's need to know how to apply behavior management strategies to their classroom in order for their students to be most successful. Many teachers do not begin their careers with proper behavior management knowledge, training experience, or do not feel a sense of efficacy in implementing behavior management. Lack of knowledge and training may lead to decreased teacher …

Centering The Medical Student Perspective In A Mixed-Methods Evaluation Of The Holistic Admissions Process At A Mission-Driven Institution, Brenda L. Liszka

Electronic Theses and Dissertations

This mixed-methods research explores the influence of a holistic admissions process on medical student enrollment at a mission-driven institution. The study quantitatively measured the impact of various admissions touchpoints on enrollment decisions and qualitatively investigated the experiences of students underrepresented in medicine based on their race or ethnicity, first-generation status, and medically underserved backgrounds. Individual interviews, guided by Maslow's Hierarchy of Needs, were used to understand participants' sense of belonging and esteem throughout the process. The findings inform an improvement agenda aimed at creating a responsive and inclusive admissions process that supports diverse student bodies and addresses national public health …

The Crucial Role Of Grassroots Social Organizations In Advancing Immigrant Legal Protections And Reshaping Immigration Policy, Isabella Reynolds

McNair Summer Research Program

This research project examines how grassroots social organizations contribute to the advancement of immigrant legal protections and shape immigration policy, with a particular focus on formerly incarcerated migrants in California. I focus on case studies and the personal experiences of organizers from Homies Unidos, Border Angels, and other organizations that operate near the San Diego–Tijuana border region. The study illustrates how these groups provide essential services, mental health support, and community-based initiatives for vulnerable and formerly incarcerated immigrants. By conducting oral histories and ethnography as methods for preserving emotional labor and shared memory, this research challenges prevailing narratives that criminalize …

Infusing Ot Principles Into A Program For Women Survivors Of Domestic Violence, Lark M. Wilkerson, Mary Jan Greer, Kim Broussard, Wendy Tremaine

Summer 2025 OTD Capstone Symposium

This capstone project proposes the development and implementation of a trauma-informed occupational therapy (OT) program designed to support women survivors of domestic violence. Grounded in trauma-informed care principles, the program aims to address the psychosocial, emotional, and functional disruptions commonly experienced by survivors, including trauma-related stress, anxiety, and difficulty engaging in meaningful daily activities. A comprehensive needs assessment informed the development of structured interventions focused on improving emotional regulation, promoting self-care, fostering social participation, and enhancing overall occupational performance. Using both qualitative and quantitative methods, the project evaluates changes in participants’ functional abilities, psychosocial well-being, and perceived quality of life. …

Improving Effective Assistant Nurse Manager Communication In Obstetrics, Julie Marie Glover

Master's Projects and Capstones

Abstract

Problem: This quality improvement project addresses inconsistent leadership communication among Assistant Nurse Managers (ANMs) in the Obstetrics (OB) department of a hospital in Northern California. ANM and staff concerns around shift handoff, huddles, and leadership responsiveness have created confusion and hindered team coordination. The project aims to improve communication effectiveness scores among OB ANMs from 50% to 75% by July 11, 2025.

Context: The project was conducted in the Maternal-Child-Health (MCH) unit of a hospital in Northern California, specifically targeting communication practices among OB ANMs. Concerns around communication practices were voiced by both ANM leadership and frontline staff, signaling …

The Anti-Work Attitude Scale: Conceptualizing And Measuring The Resistance To The Institution Of Work, Alayna Del Rosario

Master's Theses

Recent shifts in labor discourse have drawn attention to rising burnout, declining organizational commitment, and diminishing job satisfaction, which challenge traditional assumptions about the centrality and desirability of work. These tensions have given rise to the concept of anti-work, a growing discourse that questions the moral, economic, and psychological foundations of work itself. Despite its cultural relevance, anti-work remains largely undertheorized and unmeasured in empirical research. Drawing from interdisciplinary scholarship, this study defined anti-work as a negative critique of work as a social construct, questioning its value, purpose, and impact on individuals and society. Anti-work was operationalized through two higher-order …

Wellness Tourism: An Introduction, Karen Thal

All Open Educational Resources

Wellness tourism is a growing segment of the travel industry that focuses on experiences designed to improve physical, psychological, and spiritual well-being. From yoga retreats and spa getaways to outdoor adventures and healthy culinary experiences, this form of tourism reflects a broader cultural shift toward self-care and holistic health. The current textbook introduces wellness tourism in a U.S. context, offering a practical, business oriented overview for undergraduate students. It provides insights into the concept of wellness, defines and examines both the wellness industry and the wellness tourism sub-sector, highlights key trends, explores the motivations of wellness travelers, and explains how …

Summer Commencement: August 8, 2025, University Of North Dakota

UND Commencement Programs

UND Summer Commencement program from August 8, 2025.