Digital Commons Network^™

Implementation Of A Standardized Antibiotic Order Set To Improve Evidence-Based Antibiotic Prescribing In Oral Surgery, Lashundra Miles

Walden Dissertations and Doctoral Studies

Inconsistent antibiotic prescribing practices in an oral surgery clinic contributed to variation in antibiotic selection, timing, dosing, redosing when indicated, and duration. This variation limited adherence to evidence-based prescribing recommendations and highlighted the need for a workflow-based strategy to support antibiotic stewardship. The purpose of this quality improvement project was to increase use of a standardized antibiotic order set through reminder-based reinforcement and to improve evidence-based prescribing practices. The practice-focused question examined whether implementing the standardized antibiotic order set, supported by workflow-integrated reminders and ongoing performance feedback, would improve order-set utilization during a 6-week implementation period. The project was guided …

Telomere-To-Telomere Genome Assembly And A Pangenome For The Rat, Kai Li, Julia L Ciosek, Sergey Koren, Adam M Phillippy, Yaming Zhu, William A Lauer, Shelise Y Brooks, Gerard G Bouffard, Brandon D Pickett, Beth L Dumont, Melissa L Smith, Theodore S Kalbfleisch, Peter A Doris

The Brown Foundation: Institute of Molecular Medicine

We report a complete rodent telomere-to-telomere genome assembly from the brown rat, Rattus norvegicus. Annotation was enriched with multi-tissue long-read RNA sequencing and uncovered numerous novel genes. Assembly of both sex chromosomes reveals the absence of gene coding in the presumed pseudo-autosomal regions and the presence of centromeric satellite repeats on distal chromosome Y (chrY). We provide evidence of meiotic conjunction between Xp and Yq. The genome assembly reveals several expanded autosomal regions enriched for testis-expressed genes. Finally, we have generated a pangenome from recent high-quality assemblies of 8 distinct inbred rat strain genomes. This allows the strain-specific distribution of …

Clinical Practice Guideline For Fall Prevention And Reduction, Wendy Zitzloff

Walden Dissertations and Doctoral Studies

Falls are a significant concern for residents in long-term care facilities who are 65 years old or older, which places them at a higher risk of injury. The risk of falling is unique to each patient and cumulative with advanced age and complex comorbidities. A Long-Term Care (LTC) Facility in Minnesota had 6.6% of long-stay residents experience a fall resulting in a major injury, higher than the Minnesota average of 4.1%. This Clinical Practice Guideline (CPG) outlines foundational components for preventing and reducing falls among geriatric patients in long-term care facilities. The purpose of the CPG is to outline the …

Underrepresented Students’ Perceptions Of Precollege Programs And Challenges Of Transitioning To Postsecondary Education, Dana Truesdale

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study is that underrepresented students (low-income and first generation college students) face challenges associated with the transition from secondary education to postsecondary education. Grounded in Schlossberg’s transition theory, the purpose of this study was to explore underrepresented students’ perceptions of support provided by precollege programs and remaining challenges when transitioning to higher education. For this basic qualitative design, semistructured interviews with 11 underrepresented students who participated in a precollege program were conducted. Braun and Clarke’s six-phase data analysis was used. After deductive and inductive analysis, the following themes emerged: Students indicated that the …

Exploring The Definition Of Democracy And Rule Of Law From Afghan Women’S Perspective, Lynda Boswell

Walden Dissertations and Doctoral Studies

Although the United States funded programs from 2001 to 2021 to promote democracy, the rule of law, and opportunities for Afghan women, existing reports and evaluations focused primarily on expenditures, implementation, outputs, and accountability rather than Afghan women’s perspectives, particularly after the Taliban’s return to power in August 2021. This study addressed that gap by exploring how Afghan women experienced and understood democracy and the rule of law before and after the U.S. withdrawal and how U.S.-supported programs influenced their perceptions and experiences. Guided by theoretical frameworks of democracy and the rule of law as applied in Afghanistan and other …

Patient-Reported Outcomes Of Effectiveness Of Esketamine For Treatment-Resistant Depression, Erica L. Marino

Walden Dissertations and Doctoral Studies

Treatment-resistant depression (TRD) affects approximately 30% of individuals with major depressive disorder who do not respond to conventional antidepressant therapies. TRD symptoms severely impact a patient’s quality of life (QoL) and impose a considerable burden on healthcare systems. The purpose of this quantitative study was to evaluate the impact of esketamine in decreasing depressive symptoms and improving QoL factors in patients diagnosed with TRD. The research aimed to determine whether there were statistically significant improvements in depressive symptoms, as measured by the Patient Health Questionnaire-9, and changes in QoL, as measured by the Quality of Life in Depression Scale, over …

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 …

Strategies To Reduce Staff Shortages In A Freestanding Dialysis Clinic In Rural Georgia, Shayla Daniell Sanders

Walden Dissertations and Doctoral Studies

Vacancy rates are a current problem in a freestanding outpatient dialysis clinic in rural communities. From an administrative perspective, vacancy rates increase costs associated with recruitment, onboarding, training, overtime and compromise the quality and safety of patient care. The purpose of this integrative review was to identify evidence-based strategies to decrease vacancy rates in rural Georgia dialysis clinics. Donabedian’s framework of structure, process, and outcome was used for this integrative review. The integrative review question explored evidence-based strategies that can decrease vacancy rates in dialysis clinics in rural Georgia. Out of 50 articles reviewed using the John Hopkins Evidence-Based Practice …

Psychotropic Medication Prescribing To Children And Young People Mental Health Inpatient Services: An English National Study, David Branford, Anne Webster, Marinos Kyriakopoulos, Shermin Imran, Prathiba Chitsabesan, Tina Irani, Teresa Randon, Kirsten Peebles, Rohit Shankar

Peninsula Medical School

Background:Mental disorders frequently begin in childhood or adolescence. Worldwide, psychotropics are commonly prescribed for under-18s to stabilise behaviour, mood or thoughts. Psychotropics could cause long-term effects on children and young people (CYP) health, growth and development. There is a knowledge gap about psychotropic prescribing in CYP mental health inpatient units.Aims:To understand and compare psychotropic prescribing patterns in England mental health inpatient units for CYPs and to solicit CYP and their parents’ and carers’ views of it.Method:A national Quality Improvement programme authorised by National Health Service (NHS) England invited all English CYP mental health inpatient units to participate. The programme included …

Development Of A Clinical Practice Guideline For Hpv Vaccination In Low-Income Adolescents Using The Agree Ii Framework, Jariatu Fatu Bundu

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) vaccination is an effective strategy for preventing HPV-related cancers; however, vaccination initiation and series completion remain suboptimal among adolescents, particularly those from low-income and underserved populations. This Doctor of Nursing Practice project addressed an evidence-to-practice gap involving the absence of a standardized clinical practice guideline (CPG) for HPV vaccination in a family practice setting serving predominantly low-income adolescents. The purpose of the project was to develop and validate an evidence-based CPG to standardize provider recommendations and support improvement in HPV vaccination initiation and series completion. Evidence was appraised and synthesized using the Johns Hopkins Evidence-Based Practice Model, …

The Byu Advocate, J. Reuben Clark Law School

The BYU Advocate (& Annual Reports)

"Experiential learning opportunities in law school have expanded dramatically, but pressure remains for students to graduate ready to practice. Artificial intelligence (AI) is transforming education and legal practice, generating questions about how and what to teach and raising uncertainties about future employment. At the same time, big firms are interviewing students in their first semester and extending offers before or shortly after first-semester grades are out."

– David H. Moore

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 ( …

Documents From The August 12, 2026 Meeting Of The University Of Montana Staff Senate, University Of Montana--Missoula. Staff Senate

University of Montana Staff Senate Meeting Minutes

Agenda and minutes from the University of Montana Staff Senate August 12, 2026 Meeting. Highlights include a guest presentation from Internal Communications and Employee Engagement as well as senator reconfirmations.

System Leadership For Sdg-Aligned Research Security In Ireland, Seán Lacey

Publications

What is new?

Research security has rapidly emerged as a priority in research governance across Europe and internationally. However, discussions frequently frame research security primarily in terms of national security or geopolitical risk, with limited attention to how security measures intersect with sustainable development objectives. This paper addresses this gap by exploring the relationship between research security and the Sustainable Development Goals (SDGs), using the emerging Irish research security framework as an illustrative context. It argues that research security and sustainable development are not inherently in conflict; however, aligning them requires coordinated system leadership to ensure that security measures protect …

Syllabus: Political Philosophy (Philo 24600 / Polsc 20401), Georgie Malone

Open Educational Resources

This syllabus was created for Political Philosophy (PHILO 24600) (POLSC 20401) at Hunter College. It is an intermediate/advanced introduction to key texts in the history of political philosophy. Course description: In this course, we will journey through the major contributions of those thinkers that have shaped the field we call political philosophy. We will begin with Plato and Aristotle, followed by the social contract theorists of the early modern period—Hobbes, Locke, and Rousseau—before turning to the critical perspectives of Fanon and Marx. We will then turn to the vastly influential work of 20th century liberal philosopher John Rawls and …

Midweek Memo, Georgia Southern University

Midweek Memo

• Applaud 
• Remember 
• Share 
• Experience 
• Around the Nest

Role Of Central And Peripheral Nlrp3 In Parkinson's Disease Models, Elisa Carloni

Dartmouth College Ph.D Dissertations

Neuroinflammation, particularly NLRP3 inflammasome activation, has been implicated in Parkinson's disease (PD) neurodegeneration, but the cell-type-specific contributions of NLRP3 activity remain poorly understood. This dissertation tested whether NLRP3 activation in microglia versus peripherally derived myeloid cells differentially drives Parkinsonian pathology. Microglial NLRP3 gain-of-function was achieved using Nlrp3^L351P crossed with Tmem119-CreER, both on an Nlrp3^⁻/⁻background. For peripheral myeloid cells, an analogous Ms4a3-Cre-driven strategy resulted in perinatal lethality of animals with Nlrp3^L351P restricted to granulocyte-monocyte progenitors (GMPs). Instead, we used Ms4a3-Cre tdTomato reporter mice generated on wild-type and Nlrp3^⁻/⁻backgrounds to fate-map GMP-derived …

Dibh Liver Sbrt: Comparative Analysis Of Vmat 6fff And 10fff For Safety And Efficiency, Justen Hudson

Masters Projects

Purpose:

To evaluate the dosimetric performance and delivery efficiency of 6MV flattening filter free (6FFF) and 10MV flattening filter free (10FFF) VMAT beam energies for deep inspiration breath- hold (DIBH) liver stereotactic body radiation therapy (SBRT), with emphasis on treatment time, breath-hold demands, and organ at risk (OAR) sparing.

Methods:

Ten previously treated DIBH liver SBRT patients were retrospectively replanned using standardized VMAT geometry, identical optimization objectives, and consistent contouring. Each patient received paired 6FFF and 10FFF plans generated in Eclipse using AcurosXB. Dosimetric endpoints included target coverage, conformity index (CI), gradient index (GI), and OAR dose metrics based on …

Dosimetric Comparison Between Geometric Centroid And Minimax Isocenter Placement In Single Isocenter Multitarget Stereotactic Radiosurgery Plans In Hyperarc, Matthew Gloudeman

Masters Projects

Single-isocenter multi-target (SIMT) stereotactic radiosurgery (SRS) utilizing Varian HyperArc streamlines clinical workflows but introduces geometric sensitivity for distant outlier lesions when rotational and setup uncertainties are taken into account. The default isocenter location in the HyperArc workspace is the geometric centroid, which is inherently biased toward clusters of lesions. This study evaluates the dosimetric plan quality of an alternative minimax isocenter strategy, which minimizes the maximum lesion-to-isocenter distance, shortening the rotational lever arm to enhance mechanical robustness. Two fractionated SRS (fSRS) plans were generated for ten patients with 3-5 brain metastases using identical beam configurations: one using HyperArc’s default geometric …

Improving Rsv Vaccination Uptake Through Nurse-Led Educational Intervention, Lawrence Onuorah

Walden Dissertations and Doctoral Studies

In this quality improvement project, the DNP scholar explored the impact of a nurse-led staff education approach on improving respiratory syncytial virus (RSV) vaccine uptake. RSV disease results in negative health outcomes and even death among vulnerable individuals. Despite the availability of U.S. Food and Drug Administration (FDA)-approved vaccines, uptake remains low due to limited provider knowledge and inconsistent vaccine recommendations. Therefore, the project question addressed whether a staff education program would increase providers’ perceived knowledge of RSV vaccine recommendation and confidence to engage in patient education. The purpose of this quality improvement project was to implement a nurse-led staff …

Multidimensional Impacts Of Insecure Password Workaround Techniques On Modern Organizations, Emmanuel Paintsil

Walden Dissertations and Doctoral Studies

Password workaround (PWWA) behaviors, such as password sharing, credential reuse, and other informal security practices, continue to expose organizations to significant cybersecurity risks. Small and medium-sized enterprise (SME) leaders are particularly vulnerable because they often operate with limited resources while balancing security requirements, regulatory obligations, and operational demands. Guided by Herzberg’s two-factor theory and activity theory. The purpose of this qualitative pragmatic inquiry was to explore [CS3.1]strategies SME leaders use to identify, manage, and mitigate the financial, reputational, and regulatory risks associated with PWWA behaviors. Data were collected through semistructured interviews with 10 cybersecurity professionals and organizational leaders who had …

Staff Education To Improve Obesity Risk Assessment And Referral Practices, Omolara Aminat Oshokoya

Walden Dissertations and Doctoral Studies

Summary This staff education project addressed inconsistent obesity risk assessment practices in an adult primary care setting. Obesity is associated with increased rates of cardiovascular disease, diabetes, hypertension, and other chronic conditions. At the project site, obesity assessment practices relied largely on body mass index (BMI), resulting in inconsistent identification of obesity-related risks and referral needs. The purpose of this project was to educate providers on the Edmonton Obesity Staging System (EOSS) to improve obesity risk identification and referral practices. The project evaluated whether the staff education intervention improved providers' knowledge and use of the Edmonton Obesity Staging System (EOSS) …

Reducing Live Discharges Using A Tiered Protocol In A Rural Hospice: A Quality Improvement Project, Jemma Lowak

Doctor of Nursing Practice Final Project Abstract

Purpose: To reduce 30-day caregiver-driven hospice revocations by implementing a tiered post-admission nursing visit protocol based on caregiver preparedness. Background: Caregiver distress and inadequate support contribute to hospice revocations and interruptions in care. Increased nursing contact during the first week of enrollment may improve caregiver preparedness and reduce crisis-driven hospitalizations. Methodology: An eight-week quality improvement project using the Plan-Do-Study-Act framework was implemented at a rural hospice agency. Caregivers completed a Caregiver Preparedness Survey to assign preparedness tiers and guide additional nursing visits during the first week. Process measures included survey completion and protocol adherence. Outcome measures included caregiver preparedness and …

Interview With Cecilia 'Sue' Sill, Cecilia 'Sue' Sill, Logan Dovalina

Rio Grande Valley Oral Histories

Cecilia 'Sue' Sill (b. 1939, Woodward, Oklahoma) recounts a life shaped by mobility, scientific curiosity, and engagement with the natural world of South Texas and Mexico. The daughter of a pipeline welder, she moved frequently as a child before settling for a time in Pharr, Texas, in 1950. She later spent roughly forty years in Corpus Christi, where she raised two sons, pursued higher education later in life, and earned a Ph.D. focused on the systematics of Tillandsia (air plants), describing several new species centered in Mexico.

After her divorce in 1990, Sill lived for eight years on a mountainside …

Bcg Overexpressing Ag85b Reprograms Host Immune Response Through Coordinated Transcriptional Networks, Vivek Chauhan, Rakesh Kumar, Raja Veerapandian, Enrique I. Ramos, Chinnaswamy Jagannath, Shrikanth Gadad, Subramanian Dhandayuthapani

School of Medicine Publications

Antigen 85B (Ag85B), an immunodominant protein secreted by Mycobacterium tuberculosis (Mtb), induces robust T-cell-mediated immunity in host cells. Previous studies have demonstrated that recombinant BCG strains overexpressing Ag85B (BCG85B) confer significant protection against tuberculosis in mouse models. This study hypothesized that enhanced protection by recombinant BCG85B results from modulation of host immune gene expression by the Ag85B antigen. To test this, RNA-seq analysis was performed on splenocytes from mice immunized with the wild-type BCG (BCG-WT) and BCG85B strains. Differentially expressed genes (DEGs) in the splenocytes of BCG85B-immunized mice indicated upregulation of immune-related KEGG pathways, including Th1/Th2 and Th17 differentiation, NF-kappa …

The Gut-Bladder Axis: How Symbiont Microbes Alter Urinary Tract Infections, Benjamin S. Olson

Arts & Sciences Graduate Student Theses and Dissertations

Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. Consequently, they are one of the leading indications for antibiotic prescription. Despite the typically successful treatment of an acute UTI, recurrent infections are exceedingly common, particularly among women. Nearly a quarter of otherwise healthy women will suffer recurrent UTIs (rUTI) after a primary UTI; why these select individuals are continually afflicted is unkown. There are no successful therapeutics to treat rUTI representing a gap not just in the medical toolkit but in our understanding of why rUTI is so prevalent. There are many hypotheses for the risk factors …

Public Defenders’ Challenges Representing Erroneous Prosecution Cases In The Black Community, Kayla Kristine Stephens

Walden Dissertations and Doctoral Studies

Public defenders in a southern state continue to face significant challenges when representing Black individuals in the criminal justice system, particularly in cases involving erroneous prosecution. These challenges are intensified by high caseloads, limited funding, and systemic inequities, which can be stressors affecting the prosecutors wellbeing and hinder the provision of adequate legal representation. Public defenders, appointed to represent indigent defendants, frequently navigate complex legal and social circumstances that intersect with racial disparities in the justice system. For this qualitative study the research question was, how do public defenders perceive and manage any stresses representing erroneous prosecution cases in the …

Improving Nurses’ Knowledge Of Barcode Medication Administration Using Structured Education In Group Homes, Bernadette Beleho Woueko

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) educational project evaluated the effectiveness of a structured Barcode Medication Administration (BCMA) education program in enhancing nurses’ knowledge of BCMA and promoting medication safety. Because local BCMA compliance rates were 15 percentage points below the organizational benchmark, an educational intervention was implemented using the Johns Hopkins Evidence-Based Practice Model and the Plan-Do-Study-Act framework. Fifteen staff members, including Registered Nurses, Leaders, and Managers, participated in two educational sessions focused on BCMA use, medication safety, case studies, and role-play activities. Findings demonstrated a significant increase in BCMA knowledge, with scores improving from 68.4% to 86.7% (p < .001). These results support the continuation of BCMA education, competency validation, and training programs to reduce medication errors and enhance patient safety. Keywords: Barcode Medication Administration, BCMA, medication administration errors, nursing education, patient safety, evidence-based practice, educational project.

Targeted Staff Education To Improve Bipolar Disorder Screening Through Implementation Of The Rapid Mood Screener, Emmanuel Alfred

Walden Dissertations and Doctoral Studies

This project addressed the persistent challenge of bipolar disorder misdiagnosis in an outpatient mental health clinic. Misdiagnosis mostly occurs when bipolar disorder is mistaken for major depressive disorder, resulting in delays in treatment, inappropriate medication administration, worsening symptoms, and poorer patient outcomes. The Rapid Mood Screener (RMS) is a validated six-item screening tool that was developed to improve the identification of bipolar disorder and support diagnostic accuracy. The practice-focused question was, Among outpatient mental health clinicians and nursing staff, will an educational intervention on the use of the RMS improve their knowledge and self-efficacy compared to pre-education levels over a …