Digital Commons Network^™

Influence Of Lumpectomy Cavity Depth On Plan Quality In 3d Arc-Based Simultaneous Integrated Boost For Whole-Breast Radiotherapy, Emmett Dwyer

Masters Projects

Abstract

Purpose: Dynamic conformal arc (DCA) is a three-dimensional (3D) radiation therapy technique that can be used to deliver a simultaneous integrated boost (SIB) during whole-breast irradiation (WBI). This study investigated whether the depth of the lumpectomy cavity affects the feasibility of creating a successful DCA SIB treatment plan for breast radiotherapy.

Methods and Materials: 30 patients who previously received WBI followed by a 3D sequential boost (SeqB) were selected for this retrospective study. A DCA plan was created for each patient and combined with the original whole-breast tangent fields to create a SIB plan. Each plan was required to …

Multimodal Digital Libraries: A Response To Culturally And Linguistically Sustaining Classrooms, Abigail Lopez

Masters Projects

Poorly represented minority groups fail to connect reader identity backgrounds

with the characters in texts due to curriculum traditionally relying on English dominant

translations. This system challenge deficit fails students by placing limitations on the

exposure of rich vocabulary, cultural awareness and sets up lack of engagement. This

project is grounded in Culturally and Linguistically Sustaining Pedagogy, Sociocultural

Theory, Constructing Reader Identities and Engagement theories that transforms

student diversity into an instructional practice that empowers multilingual learners.

To empower students, this digital culturally relevant library optimizes educator

planning time. This digital library provides immediate access to multicultural books

alongside a …

Experiences Of Novice Assistant Principals: Perceptual Evidence From Texas, Gregory Vidal

Electronic Theses and Dissertations

Assistant principals play essential roles in supporting instructional leadership and campus operations. However, limited research has examined how novice assistant principals experience their transition into administration and interpret their preparation and support. This study addressed the gap in understanding how novice assistant principals in a suburban Texas public school district made sense of their preservice preparation and early leadership practice, and how these experiences shaped their perceptions of training and organizational supports. The purpose of this qualitative, experiential, phenomenological study was to explore the lived experiences of novice assistant principals during their first three years in the role. The study …

Spatiotemporal Analyses Of The Biological Condition Gradient (Bcg) For Florida’S Coral Reef, Maya Becker

All HCAS Student Capstones, Theses, and Dissertations

A conceptual model known as the Biological Condition Gradient (BCG) was originally constructed for biological assessments and has recently been adopted for use on Florida’s coral reef after repeated anthropogenic stressors have been linked to declines within the state of the reef. Anthropogenic pressures have reduced water quality, exacerbating coral disease and associated mortality disrupting ecosystem services and biological function throughout Florida’s coral reefs (FCR). The intention of the BCG model is to assess biological condition against increasing levels of anthropogenic stress and to identify biological attributes and measurable increments of change from long term monitoring data. Differences in spatial …

Development And Evaluation Of Personalised Post-Diagnostic Dementia Support Based In Primary Care: The D-Pact Research Programme, Tomasina M. Oh, Hannah Wheat, Richard Byng, Sarah Morgan-Trimmer, Michael Clark, Sarah Griffiths, Paul Clarkson, Victoria Allgar, Angela Bate, Saqba Batool, Rebecca Beresford, Noor Butt, Joseph Coombes, Siobhan Creanor, Sonia Dalkin, Zoe Doran, Nicolas Farina, Leanne Greene, Alex Gude, Margaret Hart, Jane Horrell, Basharat Hussain, Wendy Ingram, Hannah Jones, Reena Lasrado, Tanya Lee, Baber Malik, Rosemarie Mccabe, Antonieta Medina-Lara, Nia Morrish

Peninsula Medical School

Background: Dementia affects nearly 1 million people in the United Kingdom and their unpaid carers physically, psychologically, socially and economically, highlighting that both need support. Post-diagnostic support is recognised as inadequate globally. In England, it is fragmented or absent apart from primary care – leaving many feeling unsupported as the condition progresses. The Dementia PersonAlised Care Team research programme began in 2018 to address evidence gaps on the effectiveness of dementia support roles and what constitutes ‘good’ support. Objective: Dementia PersonAlised Care Team aimed to develop and evaluate an intervention comprising dementia support workers based in primary care, supporting people …

Perilaku Merokok Dan Paparan Informasi Bahaya Merokok Di Media Pada Penduduk ≥15 Tahun: Analisis Potong Lintang Gats Indonesia 2021, Hana Aulia Putri, Izza Nayla Paramitha, Nuha Nazeeha, Rahma Amalia

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Smoking remains a significant health problem in Indonesia. Although anti-smoking information is disseminated through various media, exposure levels and effectiveness among adults are not clearly documented.

Objective. To describe the proportion of anti-smoking information exposure among Indonesian adults by media type (television, radio, billboards, newspaper/magazines, internet, and others) and compare exposure between smokers and non-smokers using GATS 2021 data.

Methods. Cross-sectional study using Global Adult Tobacco Survey (GATS) Indonesia 2021 data. A total of 9,156 respondents aged ≥15 years were analyzed descriptively to determine exposure proportions by smoking status across multiple media channels.

Results. Television showed the highest exposure …

Faktor Yang Berhubungan Dengan Perilaku Merokok Pada Pekerja Tambang Batubara Di Pt X Kabupaten Kutai Kartanegara, Alma Feriyanti, Lies Permana, Ida Lestari, Rina Tri Agustini

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Smoking behavior remains a significant public health concern, particularly in high-risk occupational settings such as coal mining. Coal mine workers are exposed to various occupational stressors and psychological challenges that may contribute to smoking behavior.

Objective. This study aimed identify factors associated with smoking behaviour among coal mine workers at PT X in Kutai Kartanegara regency.

Methodes. A quantitative cross-sectional study was conducted involving 113 respondents selected from total population workers using convenience sampling. Data were collected through a structured questionnaire assesing smoking behavior, length of employment, and psychological stress levels. The chi-square test was applied to examine associations …

Pemberdayaan Pik-R Berbasis Permainan Make A Match Untuk Meningkatkan Pengetahuan Dan Sikap Pencegahan Anemia Remaja Putri Di Smpn 5 Kota Bengkulu, Madu Sarah Fadhilah, Reka Lagora Marsofely, Lissa Ervina

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. The prevalence of anemia among adolescent girls at SMPN 5 Bengkulu City increased from 26.8% (2023) to 32.9% (2024). Low knowledge and unfavourable preventive attitudes are key determinants, while the integration of the Youth Information and Counselling Centre (PIK-R) with the cooperative “Make a Match” card method has rarely been evaluated in a structured manner.

Aim. To analyse the difference in knowledge and attitude scores on anemia prevention among adolescent girls before and after PIK-R empowerment using the “Make a Match” game at SMPN 5 Bengkulu City.

Methods. A quantitative, pre-experimental study with a one group pretest-posttest design. The …

The Effectiveness Of "Little Doctor" Training On Health Knowledge And Behavior Of Karawang Primary Students (2025), Aurelia A. Erawan, Shahnaz F. Azzahra, Rubee P. Risdiyanto, Patricia Andini, Muhammad K. Ramadhan, Ailsa T. Kirana, Istingadah Desiana Md, Raden M. Rifada Md

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Acute respiratory infection (ARI) remains a major public health problem in Indonesia, with West Java reporting the highest incidence. Poor Health-Related Behavior (HRB) practices are associated with increased ARI risk. The "Little Doctor" program is a government initiative that focuses on school health and aims to promote HRB among students. Along with this goal, this study aimed to determine the effectiveness of the program in improving knowledge of HRB and ARI among elementary school students in Pancawati Village, Karawang Regency.

Methods. This study employs a quasi-experimental one-group pretest-posttest design. Participants were selected based on inclusion criteria referring to the …

Peran Reinforcing Factor Dalam Kepatuhan Konsumsi Tablet Tambah Darah Pada Remaja Putri, Helma Roswinda Sidebang, Ratih Indraswari, Aditya Kusumawati

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. The government is implementing a program to give blood tablets to female teenagers to prevent anemia. In Semarang City, the coverage of compliance with the consumption of iron supplement tablets in 2024 is still low, which is 34.85%.

Aim. To analyze factors associated with compliance in iron supplementation consumption among female teenagers in the working area of Candilama Primary Health Center, Semarang City.

Method. This study uses a cross-sectional design. The subjects of the study were female teenagers who were selected using the proportional random sampling technique. Data were collected through interviews and analyzed using the …

Hubungan Paparan Informasi Anemia Dan Tablet Tambah Darah (Ttd) Melalui Media Digital Dengan Kebiasaan Konsumsi Makanan Ibu Hamil Berdasarkan Food Frequency Questionnaire (Ffq), Muthiah Salsabilah, Bernadette Oktavia Jelita, Thariq Zafar Surapati, Alya Khairunnissa, Primasti Nuryandari Putri, Ratu Ayu Dewi Sartika

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background: Proper nutrition is important for the mother and baby. The media is an important source of information for every pregnant woman, but the information might be inaccurate.

Aim: This study aims to examine the association between exposure to digital media information on anemia and iron-folic acid (IFA) supplementation and the food consumption habits of pregnant women as measured by the Food Frequency Questionnaire (FFQ) at Puskesmas Kecamatan Beji, Depok City in 2024.

Method: This study utilized a cross-sectional design involving secondary data analysis of the 2024 antenatal care (ANC) survey conducted at Beji Primary Health Center, Depok City. Purposive …

The Consequences Of Using Human Behavior To Train Ai, Lauren Treiman

McKelvey School of Engineering Graduate Student Theses & Dissertations

Artificial intelligence (AI) is now an integral part of everyday decision making. These systems not only help us make choices but also learn from our behavior. Therefore, it is important to understand how our interactions with AI influence these systems. Current approaches often assume that the behavior used to train AI accurately reflects how people would naturally behave. However, people are often informed that their choices will be used for AI training, and as a result, may change how they would normally act. In this dissertation, we combine psychological and computer science perspectives to investigate the consequences of this awareness. …

Workforce Solutions For Primary Care Physician Shortages In Veterans Health Administration Outpatient Clinics, Quintin Warner

Walden Dissertations and Doctoral Studies

The shortage of primary care physicians (PCPs) in the Veterans Health Administration (VHA) hospital system highlights the need for strategies to effectively mitigate this issue. The purpose of this integrative review was to examine the literature on primary care physician shortages in VHA hospital-based outpatient clinics and determine evidence-based solutions. The review question centered on strategies and best practices that can be implemented to address PCP shortages in VHA outpatient clinics. The Donabedian Model provided the framework for analyzing structural factors, processes, and patient outcomes. A comprehensive review of the literature resulted in 40 articles being screened for quality and …

Parents' Perspectives Of Factors Contributing To Speech Delays In Children Born During The Covid-19 Pandemic, Alva Jessica Daniels

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic significantly disrupted children’s developmental environments by limiting access to childcare, healthcare, and opportunities for social interaction, raising concerns about speech and language outcomes in children born during this period. Grounded in Bronfenbrenner’s ecological systems theory, this qualitative study was an exploration of factors associated with speech and language delays and examined parents’ perceptions and experiences in Philadelphia. The qualitative study included a sample of nine parents who cared for children during the COVID-19 pandemic quarantine period. Analysis of the interview data revealed five emergent themes: (a) limited social interaction during the pandemic, (b) delayed identification and diagnosis …

Probation Officers’ Experiences Supervising Domestic And Intimate Partner Violent Probationers, Megan Davis

Walden Dissertations and Doctoral Studies

This study includes insights regarding potential supervision challenges that are faced by probation officers overseeing domestic and intimate partner violence (IPV) probationers, emphasizing the importance of effective management to enhance offender accountability and victim safety. The relationship dynamic between probation officers and domestic and IPV probationers influences recidivism rates, highlighting the importance of effective and empathetic supervision. The purpose of this study was to identify gaps in training, supervision strategies, and resources, with a focus on integrating attachment-based practices to improve outcomes. Guided by the attachment theory, the research included key questions about supervision effectiveness and relational dynamics. Employing a …

Staff Education To Improve Staff Knowledge, Confidence, And Competency In The Use Of The Zung Self-Rating Depression Scale, Theresa Buabeng

Walden Dissertations and Doctoral Studies

Staff Education to Improve Staff Knowledge, Confidence, and Competency in the Use of the Zung Self-Rating Depression Scale

Effective Strategies Small Business Owners Use To Sustain Their Businesses During Periods Of Disruption, Tracey Starr Moon

Walden Dissertations and Doctoral Studies

Small businesses experience significant challenges sustaining operations during periods of disruption, including economic uncertainty, natural disasters, supply chain interruptions, and other environmental changes. This is a concern for small business owners because disruptions can reduce revenue and strain limited financial and operational resources, putting their continued survival at risk. Grounded in the resilience theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies small business owners use to sustain their businesses during times of disruption. The participants were six small business owners in the southern United States. Data were collected through semistructured interviews and …

Strategies To Improve Communication Among Culturally Diverse International Manufacturing Teams, Bessem Enow Nchenge

Walden Dissertations and Doctoral Studies

Inefficient communication and insufficient collaboration in multicultural organizations can result in suboptimal team performance and stifle employee creativity. Manufacturing firm leaders who struggle with communication issues are concerned about deterioration in team cohesion, worker productivity, and information flow. Grounded in the theory of planned behavior, this qualitative, pragmatic inquiry research project explored strategies that leaders of international manufacturing firms use to bridge cultural differences and improve communication among international team members to enhance team performance. The participants were six leaders from manufacturing firms in the southwestern United States with international manufacturing agreements who demonstrated measurable success in improving communication among …

Staff Education To Improve Skills In Detecting And Addressing Medication Nonadherence Among The Psychiatric Nursing Staff, Uchenna Owunna

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education project focused on addressing the knowledge gap of medication nonadherence patterns by the psychiatric nurses in outpatient settings. Nonadherence to psychiatric medications is a major health issue that leads to disruptions of care and symptom relapse, hospitalization, and suboptimal treatment outcomes as well as high healthcare costs. Thus, improving the capacity of the psychiatric nurses to enhance medication adherence through staff education is essential. The purpose of this DNP project was to determine if a comprehensive medication adherence education program would increase psychiatric nurses’ knowledge and skills in assessing …

Improving Chronic Disease Monitoring In Patients With Diabetes And Hypertension Through Guideline-Adherent Care, Olukemi Ogunmakinwa

Walden Dissertations and Doctoral Studies

Evidence-based chronic disease monitoring is essential for improving outcomes among adults with diabetes and hypertension; however, inconsistent application of clinical practice guidelines may result from gaps in healthcare providers' knowledge, confidence, and competency. Staff education is an effective strategy for strengthening evidence-based practice and promoting consistent guideline implementation. Purpose: The purpose of this Doctor of Nursing Practice (DNP) staff education project was to develop, implement, and evaluate a structured educational program to improve healthcare providers' understanding, knowledge, confidence, self-efficacy, and competency in applying evidence-based chronic disease monitoring guidelines in a primary care clinic. Methods: The educational intervention was developed using …

Evaluating Mentorship, Professional Networking Participation, And Leadership Classifications For Women In Health Service Organizations, Marina Nagy Hanna

Walden Dissertations and Doctoral Studies

Despite women comprising a substantial portion of the U.S. health care workforce, they continue to be underrepresented in leadership across health service organizations. Mentorship and professional networking opportunities are commonly used to support women’s professional growth; however, inequities in leadership attainment remain prevalent, particularly among women from racial and ethnic minority backgrounds. The purpose of this quantitative archival comparative study was to examine associations across mentorship participation indicators, professional networking participation indicators, leadership classifications, and racial and ethnic classifications. The study was underpinned by intersectionality theory and social capital theory, which supported examination of how demographic identities and access to …

Immigration Status And Lung Cancer Diagnosis In U.S. First-Generation Immigrants, Valeriya Lockwood

Walden Dissertations and Doctoral Studies

The healthy immigrant effect (HIE) is an observed phenomenon in which immigrants exhibit better health outcomes than native-born residents, though relatively few studies have examined its role in chronic diseases in the United States. The purpose of this quantitative cross-sectional study was to assess the associations between immigration status, age, sex, race/ethnicity, median household income, and geographic location and lung cancer diagnosis in first-generation immigrant adults aged 18 or older. The subsequent health trajectory model provided the theoretical framework for the study. Data were obtained from the SEER*Stat Database 1975-2022 (N = 1,993). Binomial regression analysis showed that immigrants were …

Performative Belonging And Embodied Meaning-Making In Africa–China Encounters, Ignatius Suglo

Rhetoric and Communication Studies Faculty Publications

Since the Mao era, political rhetoric has framed Africa–China relations through a discourse of brotherhood and solidarity, presenting belonging as ontological. I argue instead that belonging in the Africa–China space is achieved through sustained labor across political, cultural, and everyday contexts. Existing scholarship has predominantly examined belonging through spatial frameworks of community-building and place-making. Through case studies of two musicians – Hao Di, a Nigerian performer who achieved prominence in Chinese Mandarin singing competitions, and Akua China, a Chinese musician active in Ghana – I propose the concept of ‘performative belonging.’ Situating discussion on belonging within those of performativity enables …

Intravenous Thrombolysis Beyond The Conventional Time Window For Acute Ischemic Stroke: A Systematic Review And Meta-Analysis, Shaan Patel, Shiva A. Nischal, Kush M. Kale, Michael R. Gooch, Stavropoula I. Tjoumakaris, Pascal Jabbour

Department of Neurosurgery Faculty Papers

IMPORTANCE: Intravenous thrombolysis (IVT) is an established therapy for acute ischemic stroke when administered within 4.5 hours of symptom onset. However, many patients present beyond this window or with unknown onset, and recent randomized clinical trials (RCTs) have evaluated whether imaging-selected patients may benefit from thrombolysis in the extended window.

OBJECTIVE: To evaluate the functional and safety outcomes associated with IVT administered 4.5 hours or more after stroke onset.

DATA SOURCES: PubMed, Embase, and Cochrane Central Register of Controlled Trials were systematically searched from database inception through March 3, 2026.

STUDY SELECTION: RCTs enrolling adults with acute ischemic stroke treated …

Mitigation Of The Seductive Details Effect In Children, Allison S. Dobuler

Electronic Theses and Dissertations 2020 - Present

The present thesis examines if interspersing guiding questions between sections of an expository text can mitigate the seductive details effect, in which the addition of interesting but tangentially related information to the base text may hinder the ability to learn the essential material, for typically developing children. Participants were given two passages to read, one with seductive details and one without. They either had no guiding questions for both passages or guiding questions interspersed between the text of both passages. They were given retention and comprehension assessments for both passages. While the guiding questions did not mitigate the seductive details …

China Maritime Report #57: Sailing Thousands Of Miles Without Losing Course: The Roles And Authorities Of The Plan Party Standing Committee, Jeffrey Becker, Brian Waidelich

CMSI China Maritime Reports

Main Findings:

• The Navy Party Standing Committee (NPSC) is the Chinese Navy’s core leadership body, but it does not operate independently; it functions within the broader Chinese Communist Party (CCP) and PRC military hierarchy.
• Politically, the NPSC ensures that China’s Navy remains loyal to the CCP with Xi Jinping at its core. Administratively, it ultimately directs personnel, training, procurement, logistics, fiscal management, readiness, and modernization.
• Military reforms have preserved the NPSC’s authoritative role within the Navy, and today’s members have gained more diverse operational experience earlier in their careers than their predecessors. 
• At the same time, members’ shorter average tenures …

Terahertz Electromagnetic Effects And Chirality-Induced Spin Selectivity In Dna, F. Matthew Mihelic Md

Faculty Publications

The effects of terahertz electromagnetic stimulation of the DNA molecule can be understood through modeling of the quantum logical mechanics of the DNA molecule.  Coherent conduction of electron spin states along the aromatic nucleotide base pairs and chirality-induced spin selectivity are two characteristics of the DNA molecule that are involved in the precise separation of the double-stranded DNA molecule at a specific location.  Such modeling can inform predictions of DNA strand separation and has significant implications for understanding DNA transcription bubble formation.

Prompt Framing And Evidence Requirement For Ai-Generated Educational Responses In Dental Education: Experimental Study., Man Hung, Corban Ward, Owen Cohen, Jacob Marx, Zachary Smit, Jacob Newman, Martin S. Lipsky

Institute on Aging Publications

Large language models are increasingly used in health professions education; however, the role of prompt design in shaping their outputs remains poorly understood in clinical training contexts. In dentistry, where information presentation, perceived credibility, and procedural reasoning are important, the effects of instructional framing and evidence requirements on AI-generated educational responses are particularly relevant.

Chitinase Variants Establish Environmental Inflammatory Lung Conditioning, Yilin Wang

Arts & Sciences Graduate Student Theses and Dissertations

Environmental particulate exposure contributes to the severity and persistence of numerous acute and chronic lung diseases, including asthma, viral pneumonia, acute respiratory distress syndrome, and pulmonary fibrosis. Chitin, a highly abundant environmental polysaccharide present in fungi, insects, and mites, is continuously encountered at mucosal barrier surfaces and functions as an immunostimulatory particulate substrate within the respiratory tract. Acidic mammalian chitinase (AMCase; CHIA) is an evolutionarily conserved mammalian enzyme that degrades chitin-containing particles and regulates inflammatory responses at barrier tissues. Common human CHIA polymorphisms reduce AMCase enzymatic activity and are associated with asthma susceptibility; however, the physiologic consequences of these variants …

Process From Noise: Erosion Threshold Variability And The Morphology Of Gravel-Bed Rivers, Robert Paul Kostynick

Arts & Sciences Graduate Student Theses and Dissertations

Rivers are remarkably consistent as their geometry, width, depth, and slope change systematically downstream in response to differences in fluid discharge and sediment transport throughout a channel. Rivers move both water and sediment through terrains that depend on these downstream geometric adjustments influencing water quality, ecology, infrastructure, channel morphology, and landscape evolution at increasing timescales respectively. Rivers thus influence all aspects of life and define our spatial landscapes that shape boundaries, whether physical, politically, or socially. Nevertheless, a river is dynamic and does not adhere to human-defined boundaries, making it vital that we understand how these features change over time …