Digital Commons Network^™

Definitive Radiation Therapy For Schneiderian Inverted Papilloma Of The Soft Palate And Uvula., Rahul Sinha, Arianne J Abreu, Christopher E Fundakowski, Robert T Sataloff

Otolaryngology (ENT) Resident Research

Schneiderian inverted papilloma is a benign, locally aggressive tumor that typically arises in the respiratory mucosa of the nasal cavity and paranasal sinuses. These tumors are often asymptomatic but can cause unilateral nasal obstruction, discharge, hyposmia and epistaxis. They warrant attention particularly due to the potential for malignant transformation. They are treated most often with surgical excision. This case report describes a patient with Schneiderian inverted papilloma arising outside its usual location and managed with definitive radiation therapy instead of surgical excision due to concerns for functional impairment. Remission was obtained with radiation therapy, although the patient experienced treatment-related side …

A Dosimetric Comparison Of 6-Mv Flattening Filter And Flattening Filter-Free Photon Beams For Stereotactic Body Radiation Therapy Of Adrenal Tumors, Sarah Mcintosh

Masters Projects

Purpose: This study aimed to compare dosimetric characteristics and treatment delivery efficiency between 6-MV Flattening Filter (FF) and Flattening Filter-Free (FFF) photon beams for adrenal Stereotactic Body Radiation Therapy (SBRT). While FFF beams have demonstrated dosimetric and efficiency advantages at other SBRT sites, there is limited data about their use in adrenal SBRT.

Methods and Materials: A retrospective dosimetric comparison was performed using 10 patients previously treated with adrenal SBRT. For each patient, two Volumetric Modulated Arc Therapy (VMAT) plans were generated in Eclipse: one using 6-MV FF beams and one using 6-MV FFF beams, resulting in 20 total treatment …

Staff Education On Fall Reduction For Residents Of Long-Term Care Facility, Lauretta Ifeoma Iwuala-Mcwilliams

Walden Dissertations and Doctoral Studies

Falls pose a major safety risk for elderly individuals living in long-term care facilities, leading to injuries, hospitalizations, loss of autonomy, increased healthcare expenses, and higher morbidity and mortality rates. In the facility involved in this project, the incidence of falls was above anticipated benchmarks. Factors such as high staff turnover and reliance on agency staff resulted in inconsistent knowledge among personnel regarding fall prevention measures. Purpose: This Doctor of Nursing Practice quality improvement initiative aimed to implement and assess an evidence-based educational program designed to enhance staff understanding and skills related to fall-risk assessment, the identification of both intrinsic …

Creating Consistency: Standardizing Gestational Diabetes Group Visit Framework In High-Risk Obstetric Care, Danielle Pack

Master's Projects and Capstones

Objective: Gestational diabetes mellitus (GDM) requires timely and consistent education to promote effective self-management and improve maternal and fetal outcomes. Baseline observations at a Santa Clara County high-risk obstetric clinic identified variation in educational materials, educator delivery, referral processes, and workflows between English- and Spanish-language GDM group visits. A review of the literature supported standardized diabetes education and group prenatal care as strategies to improve consistency, efficiency, and patient access. Aim: This quality improvement project aimed to develop and implement a standardized GDM group visit framework for nurse practitioners, registered dietitians, and scheduling staff, with the goal of increasing compliance …

You Haven’T Been Forgotten: Driving Improvements In Trust, Transparency, And Accountability Through A Patient-Centered Communication Initiative In The Emergency Department, Ellie Mead

Master's Projects and Capstones

Objective: In Spring 2026, the Emergency Department (ED) at Hospital X identified difficulties securing high levels of patient satisfaction. Over one third of patients did not feel adequately “informed about delays,” and observation of nurse-patient interactions in front-end care areas confirmed these communication gaps: in 87% of interactions, nurses did not explain next steps to the patient, and in none of the 51 interactions observed did nurses proactively inform patients about possible delays. Aim: This quality improvement initiative sought to improve the patient experience in the ED and drive a 10% increase in Press Ganey patient satisfaction survey results relating …

Staff Re-Entry Plan — Indian Trail, Flett, Woodridge, Travis Schulhauser

Spokane Wildfire Academic Consortium Repository

Following the downgrade of Level 3 Evacuation orders at Flett Middle School and Indian Trail and Woodridge elementary schools on Aug. 9, district staff worked with Fulcrum Environmental Consulting to conduct visual inspections and air-quality testing at these sites. More than 100 interior and exterior locations were tested, with indoor air quality within the Good-to-Moderate range under the EPA Air Quality Index. Inspectors also found no indication of unusual ash, soot or other settled particulates inside or outside the buildings.

Staff Education To Improve Staff Knowledge On Fall Prevention, Nginjoh Presilia Njofang

Walden Dissertations and Doctoral Studies

Patient safety risks associated with falls are a major issue in adult inpatient medical-surgical environments because nursing inconsistencies with regard to fall risk assessments, individualized fall prevention interventions, and documentation could impede adherence to best practices. To overcome this knowledge gap among RNs in the selected environment, a DNP education project aimed at standardized fall-prevention staff education was initiated. The question for the practice was whether standardized staff education would increase knowledge among nurses regarding fall-risk assessments, preventive measures, and documentation requirements, based on pretest and posttest results. In the course of a one-hour educational session conducted face-to-face, twenty RNs …

Staff Education To Improve Early Identification Of Behavioral Escalation And Timely Clinical Intervention In An Adult Group Home Setting, Gayduo Barr

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project addressed a gap in staff knowledge regarding the early identification of behavioral escalation and timely intervention in an adult group home setting. The practice-focused question was: Does staff education about early identification of behavioral escalation and timely clinical intervention improve the knowledge of staff working in an adult group home setting? The purpose was to improve staff knowledge of behavioral escalation, triggers, trauma-informed care, and intervention strategies. I delivered a structured educational intervention to 14 house managers. Educational content included behavioral escalation stages, triggers, de-escalation techniques, trauma-informed care, documentation, and …

Effect Of Rangeland Quality On Rumen Development Of Angora (Mohair) Goat Kids And Bucks, Betül Zehra Sariçi̇çek

Turkish Journal of Veterinary & Animal Sciences

This study was conducted to determine the effect of rangeland quality on the rumen development of Angora goat kids and bucks. Twenty male singleton Angora goat kids with similar birth dates and birth weights were selected from each farm in an area with three different rangeland quality levels (good, medium, or poor) in Ankara Province. The kids were weaned at 60 days of age and then grazed completely on rangeland until slaughter. Rumen volumetric and papillary development of animals slaughtered at 4 and 7 months of age were determined. Empty rumen length, width, and weight were affected by rangeland quality …

Full Issue, Volume 14, Number 1., Donna J. Peterson Dr., Scott Cummings, Elizabeth Gregory North

Journal of Human Sciences and Extension

No abstract provided.

Impact Of Stress & Fatigue On Cardiovascular Function In Young Pilots: A Thematic Review, Swarna Manoj

Discovery Day - Daytona Beach

Impact of Stress & Fatigue on Cardiovascular Function in Young Pilots: A Thematic Review   Authors: Swarna Manoj, Scott Ferguson   Keywords: pilot, stress, fatigue, heart rate variability (HRV), cardiovascular disease (CVD) Aviation is expanding globally and young pilots are the major workforce, yet FAA protocols require mandatory ECG only from age 35, with annual cardiac screening after age 40. Over the past five years, a pattern of sudden cardiac arrests in pilots particularly aged 30-40 has urged safety concerns. Despite the existing literature examining fatigue, burnout, stress, sleep hygiene and circadian disruption, only few studies systematically examine how these factors impact …

Analyzing Fungal Growth Dynamics Under Different Environmental Conditions Using A Lotka–Volterra Competition System, Maria Ordonez, Fabrio Araujo

Discovery Day - Daytona Beach

Fungi play a critical role in ecosystems as decomposers that recycle nutrients and maintain environmental balance. Their populations are influenced by multiple environmental factors such as temperature, humidity, nutrient availability, and interactions with other organisms. In this project, the Lotka–Volterra model is used to analyze how competing fungal species interact and how these interactions influence population dynamics over time. By modeling two fungal populations competing for the same limited resources, the equations illustrate how environmental conditions and competition coefficients determine whether one species dominates; both species coexist, or one species becomes extinct. The model provides insight into how changes in …

Assessing The Impact Of Various Factors On Hypoxic Response, Reese Kim, Allysa Hayden

Discovery Day - Daytona Beach

Hypoxia is a condition in which the body’s tissues are deprived of oxygen and has deleterious effects on cognition, perception, and performance. Hypoxia has a myriad of symptoms such as euphoria, difficulty concentrating, headache, fatigue, nausea, dizziness, tunnel vision, and more. Outward signs of hypoxia include cyanosis (blueing of the fingertips and lips), tremors, loss of coordination, pallor, and complexion change, and can be used to notice the onset of hypoxia in others. Many factors are known to contribute to the manifestation of hypoxia, namely altitude, exposure duration, and certain physiological conditions such as heart problems and low blood flow …

From Crisis To Reform: How The 1918 Influenza And Covid-19 Pandemics Redefined The Relationship Between Nurses And The American Healthcare System., Anh N V Le

Undergraduate Research and Scholarship Symposium

The 1918 Influenza and COVID- 19 pandemic have become two major public health crises that reshaped the role of nurses in the America healthcare system. Although a hundred years apart, both pandemics revealed how deeply the country depends on nurses during emergencies without proper and efficient strategies. This paper argues that these pandemics acted as turning points that redefined the social contract between nurses and the U.S. healthcare system. By examining historical context, nurses’ responsibilities, public perception, and long-term effects, this research show how pandemics expanded nurses’ authority while also exposing long-term weakness of the systems. In 1918, nurses were …

The Chameleon Experience: Queer Identity, Mental Health, And Transformation, Cameron Penny

Communication and Theater Association of Minnesota Journal

In this autoethnographic piece, I examine the correlation between queer identity and mental health through reflective analysis of my own experiences within a Western socio-cultural setting. I expand external perspectives on the queer experience by highlighting the normalization of queer prejudice and its adverse impact on self-image. I share how the religious praxis of Catholicism enforces binary conformity by promoting dichotomous thinking that simultaneously constricts queer expression and subjugates implicit biases. In tandem, I utilize autoethnography as my medium because it provides a unique outlet to raise awareness for chronically stigmatized identities by centering marginalized voices (Atay, 2011; Chavez, 2013). …

Confidence Versus Competence: Addressing Nursing Knowledge Gaps In Catheter Care To Reduce Catheter-Associated Urinary Tract Infections, Leslie Anne Villanueva Bautista

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most prevalent and preventable healthcare-associated infections (HAIs), contributing substantially to patient morbidity, mortality, prolonged hospitalization, and healthcare expenditures. Most hospital-acquired UTIs are related to urinary catheters, and this burden costs the United States alone an estimated $340 to $450 million annually (Yang et al., 2022). CAUTIs are UTIs that occur in patients with indwelling urinary catheters. This quality improvement project aimed to increase adherence to existing bladder scanning protocols and strengthen urinary catheter care to prevent CAUTI. Baseline staff nurse knowledge was obtained, and reinterpretation of the facility’s existing protocols and bundles …

Draining The Risk, Holding The Line: A Nurse-Driven Approach To Catheter-Associated Urinary Tract Infection Prevention, Thy Nguyen

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over …

Resource-Conscious Care: Time To Pregnancy And Iui Cycle Outcomes In Female Same-Sex Couples, Lea George, Devika Sachdev, Kassie Bollig

Department of Medicine Faculty Papers

RESEARCH QUESTION: Does the clinical pregnancy rate (CPR) for the first cycle, time to pregnancy, and cumulative CPR up to six consecutive cycles differ between female same-sex couples undergoing intrauterine insemination (IUI) alone and those undergoing IUI with ovarian stimulation?

DESIGN: This retrospective cohort study evaluated 554 female same-sex couples undergoing IUI alone (n = 264) or IUI with ovarian stimulation (n = 290) at a single centre using cryopreserved donor spermatozoa from January 2012 to January 2022.

RESULTS: Overall, CPR for the first cycle was 17.9% (99/554). In adjusted analyses, there was no significant difference in CPR in IUI …

Improving Adherence To Remote Patient Monitoring (Rpm) For Patients With Hypertension, Chioma Udegbune

Student Scholarly Projects

Practice Problem: Hypertension is a leading contributor to cardiovascular disease, and suboptimal adherence to remote patient monitoring (RPM) limits opportunities for timely intervention and effective blood pressure management in outpatient primary care.

PICOT: The PICOT question that guided this project was: Among outpatient clinic nursing staff responsible for remote patient monitoring (RPM) in adults with hypertension (P), how does implementation of a structured nurse-led education and reminder protocol (I), compared to standard RPM practices consisting of routine onboarding and passive reminder processes (C), influence patient adherence to RPM protocols (O) over a 10-week period (T)?

Evidence: Evidence supports nurse-led education, …

Pre-Implementation Factors For Active Music Engagement (Ame): Barriers And Facilitators To Integrating An Evidence-Based Dyadic Intervention Into Pediatric Oncology Care., Kristin M. Story, Elizabeth Harman, Kristin Stegenga, Jelena Golubovic, Sheri L. Robb

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pediatric cancer treatment is a difficult and distressing experience that often results in sustained, interrelated distress in young children and parents, and traumatic stress symptoms for some parents. Few evidence-based interventions address this dyadic distress. Active Music Engagement (AME) is a manualized, evidence-based music play intervention that significantly reduces distress in child/parent dyads and mitigates traumatic stress and improves well-being among highly distressed parents and those experiencing sociodemographic risk. Successfully integrating AME into standard care requires a systematic understanding of implementation factors. This study aimed to identify site-specific barriers and facilitators that influenced successful AME delivery during a recently …

Standardizing Gestational Diabetes Mellitus Education To Improve Patient Knowledge And Care Consistency In A Prenatal Clinic Setting, Wynn Zara

Master's Projects and Capstones

The gestational diabetes mellitus (GDM) group visit framework aims to improve consistency of GDM education by standardizing referral processes, educational materials, staff workflows, and patient communication. Although evidence-based GDM education supports patient self-management and improved maternal-fetal outcomes, variability in education delivery contributed to inconsistent care within the outpatient maternal-fetal medicine setting. This quality improvement project was conducted in an outpatient maternal-fetal medicine clinic in Santa Clara County serving pregnant patients diagnosed with GDM. To address this gap, a standardized GDM group visit framework was developed and implemented using structured educational resources, referral criteria, and communication workflows. The intervention was evaluated …

Staff Education To Improve Hypertension Management Knowledge, Angelor Eliscard

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project, I addressed inconsistent staff knowledge of evidence-based strategies for preventing and controlling hypertension among African American women in an outpatient primary care setting. The practice-focused question was: In an outpatient clinical setting, what was the impact of an evidence-based staff education program on healthcare providers' knowledge of hypertension prevention and control strategies for African American women, as measured by pretest and posttest scores? The purpose of this project was to implement and evaluate a structured staff education program to improve providers' knowledge of evidence-based strategies for preventing and controlling hypertension …

The Impact Of Scar Wires On Dose Distribution Of Electron Fields, Ahmad Nour

Masters Projects

Purpose: This phantom study looked at whether changing the Hounsfield unit (HU) value for radiopaque scar wires in Eclipse changed the calculated electron dose distribution. Methods and Materials: Radiopaque wires were placed in the same abdominal area on an anthropomorphic phantom. The wires were set up in a circle. The CT images were brought into Eclipse, the wires were contoured, and the planning target volume was made 1 cm inside the circle of wire. For every wire size and electron energy, two matching plans were made: one plan with no density override and one plan with a density override applied …

Cone Vs. Volumetric Modulated Arc Therapy (Vmat) Stereotactic Radiosurgery (Srs) Planning For Multiple (7) Brain Targets: Dosimetric Tradeoffs And Clinical Decision Guidance, Juan Garcia

Masters Projects

Purpose: This study compared cone-based stereotactic radiosurgery (SRS) and single-isocenter volumetric modulated arc therapy (VMAT) for multiple (7) intracranial targets to evaluate differences in target coverage, conformality, dose falloff, and normal brain exposure.

Methods: A phantom-based study was performed using progressively increasing configurations of 10-mm spherical targets, from one to seven targets. Cone-based SRS and VMAT plans were evaluated using D99, CI100, CI50, gradient index (GI), maximum dose, V12Gy, and V5Gy.

Results: Both planning techniques achieved similar target coverage. Cone based SRS produced a steeper dose gradient, with a mean GI of 2.99 compared with 4.66 for VMAT ( …

Best-Practice Patient Education On Glp-1, Low-Glycemic Diet, Intermittent Fasting, And Exercise For Weight Loss In Obese Nondiabetics, Clara Green

Walden Dissertations and Doctoral Studies

Executive Summary: Clinical Practice Guideline Best-Practice Patient Education on GLP-1, Low-Glycemic Diet, Intermittent Fasting, and Exercise for Weight Loss in Obese Nondiabetics by Clara Green MS, Walden University, 2020 BS, University of Texas at El Paso, 2014 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2026

A Clinical Accuracy Study Protocol For A Saliva-Based Point-Of-Care Lateral Flow Test To Assess Protective Immunity To Tetanus (Tetanus Study), K Gokani, S E Faustini, C Tanner, H F Kwok, R Agarwal, Y Takwoingi, Semukunzi H, C Umuhoza, A Richter, J Nyombayire, C M Muvunyi, J Heaney, C A Green

Faculty, Staff and Students Publications

Introduction: Despite the availability of a safe and effective vaccine, 2000-3000 neonates die of tetanus yearly, predominantly in low- to middle-income countries (LMICs). Inaccurate coverage estimates and vaccination records, together with variability in vaccine response, make identifying individuals who lack protective immunity and may benefit from vaccination difficult. A more direct measure of protective immunity is widely accepted as anti-tetanus IgG concentration at or above 0.1 IU/mL. This study aims to evaluate the performance of a novel saliva-based point-of-care lateral flow test (CIS-IMMUNE Tet) for the binary classification of tetanus protective immune status (protected/unprotected) against WHO threshold-based classification of IgG …

Myoelectric Transradial Prosthesis Motor Control With Temporal Convolutional Neural Network Signal Processing, Carolyn Ascha Richardson, Katherine Clark, Francis Genco, Hope Lea, Tobiah Rosser

Discovery Day - Daytona Beach

Transradial (below-the-elbow) amputees account for more than half of all upper limb amputations. Myoelectric prosthetic arms, which use electromyography (EMG) sensors on the surface of the forearm to convert electrical signals from residual limb muscles and mimic hand movement, are popular options for these amputees. However, these prostheses are limited in residual muscle detection and movement accuracy. The objective of this project is to affordably manufacture an externally-powered transradial prosthesis prototype through EMG time-versus-voltage readings collected with six Delsys Trigno Avanti and eight Thalmic MYO EMG sensor channels placed along the extensor digitorum, extensor carpi radialis, extensor carpi ulnaris, flexor …

Home-Use Oct For Neovascular Age-Related Macular Degeneration: A Rapid Review, Sneh S. Shah

inSIGHT

Neovascular age-related macular degeneration (nAMD) requires frequent monitoring to identify recurrent exudation and guide treatment with anti-vascular endothelial growth factor (VEGF) therapy.1 Clinic-based optical coherence tomography (OCT) plays a central role in management but provides only intermittent assessments of a disease that changes over time. Home-use OCT technologies have recently been developed as a possible solution, allowing patients to perform self-imaging with remote clinician review and artificial intelligence (AI)-assisted analysis. This rapid review summarizes current evidence on home-use OCT for nAMD, including feasibility, diagnostic performance, clinical usefulness, and challenges related to implementation. Findings from feasibility studies, AI validation analyses, observational …

Enhancing Patient Understanding: Standardizing Cardiac Medication Education Using Teach-Back For Heart Failure, Nicole Valerie Hediger

Master's Projects and Capstones

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding …

Improving Pain Reassessment Within One Hour Of Pain Medication Administration, Geraldine B. Macalma

Master's Projects and Capstones

Abstract

Problem: Timely reassessment of pain is often missed or inconsistently documented, creating a gap between evidence-based standards and actual nursing practice. This inconsistency prevents evaluation of intervention effectiveness and contributes to unmanaged pain, reduced patient satisfaction, and safety concerns.

Context:  Pain reassessment is a critical component of evidence-based pain management, ensuring that nurses evaluate the effectiveness of interventions and adjust care accordingly.  Competing priorities and documentation challenges often lead to inconsistent reassessment, affecting patient comfort, safety, and overall quality of care.

Interventions: Guided by a Plan-Do-Study-Act framework, the intervention included documentation of a safety round, purposeful hourly rounding, …