HPU Digital is Hawai‘i Pacific University’s institutional repository, led by the Library as a center of scholarship and innovation. It preserves and shares the academic work of HPU’s faculty, students, staff, and affiliates, reflecting the university’s diverse, global, and inclusive learning community. This initiative supports access, visibility, and long-term preservation of HPU scholarship and aims to connect the HPU community to academic and professional success.
Recent Submissions
Item An Assessment of Environmental Conditions That Define Suitable Habitat for the Upside-down Jellyfish (Cassiopea spp.) on Oʻahu(Hawai‘i Pacific University, 2025)The upside-down jellyfish, Cassiopea, is a genus of scyphozoans that in the past few decades, has become widely invasive across the subtropics and tropics, including the island of Oʻahu. Their biology, including a mechanism that allows them to pump out nutrient-rich porewater as well as a symbiosis with photosynthetic zooxanthellae, give Cassiopea spp. high tolerance to stressors and may increase their invasibility as the effects of climate change intensify. This study investigated what factors influence seasonal presence of the jellyfish, what constitutes suitable habitat, and how the jellyfish potentially impact nutrient cycling in their nonnative environments. The first part of this study focused on a temporal survey over ten months at the interior end of the Ala Wai Canal in Waikīkī, during which water and sediment nutrients were analyzed and used alongside water quality measurements to construct a logistic regression to determine which were most important for jellyfish presence. Only a few jellyfish were found at two of 18 sampling intervals. In the second part of the study, I conducted a spatial survey of ten sites across Oʻahu that currently or previously hosted invasive populations of Cassiopea spp. Water quality measurements and nutrient concentrations in porewater and the water column were used to construct several generalized linear models in order to determine the most influential factors for jellyfish presence, density, and size. Water column turbidity and nitrate concentration both had negative relationships with jellyfish presence and density, reinforcing the importance of the symbionts as well as posing new questions about nitrate tolerance and whether elevated nitrate could disrupt physiological processes. Salinity and sediment organic matter were also found to be positively related to jellyfish presence, which reinforces current understanding of preferred habitat conditions for the genus, sources of nutrition, and how they may benefit from anthropogenic impacts. Jellyfish tended to be larger at sites with higher pH, suggesting that the health of these populations may begin to suffer in the future as ocean acidification intensifies. These findings suggest that several environmental factors may be key in crafting a multifaceted management solution for preventing and eliminating invasions of Cassiopea spp.Item Patient Education: A Strategy to Patient Empowerment(Hawaii Pacific University, 1998)The health care industry is rapidly changing. Changes include the shift from brand name pharmaceutical products to generic versions, consolidation of health care providers, provision of health care through managed care, and disease management initiatives. One important change has been the growing influence of the patient in the health care arena. Patients play a larger role in the emerging health care environment because they are now being asked to share increasing responsibility for the state and care of their health. Preventing illness and controlling its effects when it does occur requires patient participation. Women's health and its determinants, the role of gender, the social context in which women experience life, all play a role in identifying important issues in women's health. The future of women's health can be positively affected by empowering female voices. Because women are major health consumers, it is important that they have participation in both research and policy decisions. There is increased need and a duty for health professionals to communicate with patients efficiently and effectively. For patients to become educated and empowered, health professionals have a duty to keep the patients current in the fields of medical science and health care delivery.Item Using Generative AI to Design Differentiated Learning in a General Education Course(Educational Designer, 2025-09)This design case explores an instructor's experience redesigning her course using generative artificial intelligence (GenAI) tools to facilitate differentiated learning. The course is part of a general education program that draws students from various disciplines, aiming to create unique, interdisciplinary learning experiences that allow each student to engage meaningfully with the content. The redesign process followed the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) model, incorporating differentiated instructional strategies that leverage GenAI for tasks such as researching current leadership trends, crafting learning outcomes, outlining content, and creating assessments tailored to students' diverse mastery levels. This design case reflects on the decisions made during the course redesign process, presents some impact assessments, and discusses critical factors affecting implementation.Item Implementing a Workplace Mindfulness Campaign to Decrease Burnout Levels in Primary Care(2025)Burnout is a leading cause of employees’ poor job satisfaction and performance; while being a source of poor quality of care, influencing turnover, absenteeism, and low morale. An urban primary care clinic in California was experiencing high burnout levels and lacked an evidencebased strategy to support staff members. The purpose of this quality improvement project was to determine if the Palouse mindfulness-based stress reduction (MBSR) program would decrease burnout levels compared to standard practice among staff members of a primary care clinic located in urban California over eight weeks. Kurt Lewin’s Change Model framework served as the project's foundation, encouraging employees to change their behavior. The project determined that the Palouse mindfulness campaign decreased the burnout level of primary care employees. The median scores in each Maslach Burnout Index (MBI) tool subscale improved between the pre- and post-test. Hence, the implementation of Palouse Mindfulness Strategies may decrease the burnout level of employees, which will positively impact their job performance, increase job engagement, and drive high morale. The primary care will have efficient daily clinic operations with tenured and happy employees. By attaining and sustaining a healthcare system fiscal budget, the population needs access to care, and quality patient care is met.Item Implementing the Stop-Bang Assessment Tool to Impact Perceived Stress Among Clinical Staff(2025)Anesthesia-related airway emergencies, particularly those involving failed intubation or ventilation, are a significant concern and contribute to poor patient outcomes. Obstructive sleep apnea (OSA) increases the risk of difficult airway events, further compromising patient safety. Despite its predictive value, the STOP-BANG questionnaire is not currently used to screen for OSA risk in the endoscopy lab of an urban outpatient gastrointestinal clinic in Chicago, Illinois. This gap in practice can lead to procedural delays and safety concerns due to unanticipated equipment needs, insufficient staff readiness, and lack of postoperative awareness. This quality improvement project aimed to determine the impact of implementing the STOP-BANG questionnaire compared to the current practice on stress perception among outpatient gastrointestinal (GI) clinic staff over 8 weeks. The Knowledge to Action (KTA) framework was used as a guide to facilitate this project. A pre- and post-implementation Perceived Stress Survey-10 (PSS-10) was administered to clinical staff (n =10). Also, the STOP-BANG questionnaire was used to evaluate patients for possible undiagnosed OSA prior to anesthesia (n =103). Results showed that the mean pre-intervention score for PSS-10 was lower (M = 13.9, SD = 5.72) than the post-PSS-10 survey mean score (M = 16.8, SD = 4.32). However, implementing the STOP-BANG questionnaire categorically changed perceived stress levels from low to moderate among clinical staff at a low rate (n = 2; 20%). Nevertheless, perceived stress levels did not improve. STOP-BANG scores for colonoscopy patients were at an average of 3.66, whereas the average STOP-BANG scores for patients undergoing an esophagogastroduodenoscopy (EGD) were 3.06. Airway maneuvers were needed for 40.98% of patients who had a colonoscopy and 37.93% of patients who had an EGD.
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