Digital Commons Network^™

Dental Students’ Preferences In Selecting Artificial Teeth For Older Adults' Dentures, Muhammad Afif Sapie, Nur Hanim Farhana Mohamad Hilmi, Aiemeeza Rajali, Nik Rahayyu Nik Zulkifeli, Nor Wati Nur Atikah Mustafa, Hazem Mofreh Dakhilallah Al Tarawneh

Journal of Dentistry Indonesia

Objective: Selecting and arranging acrylic resin teeth for dentures is essential to achieve a natural appearance; however, limited understanding and older adults’ aesthetic expectations may result in inconsistencies and increased patient visits. This study aimed to explore the methods and factors dental students prefer when selecting artificial teeth for dentures for older adults. Method: A validated questionnaire, including consent, demographics, and six domains of the methods with related factors for selecting acrylic teeth, was distributed to dental students of the Universiti Teknologi MARA (UiTM). The participants responded using a five-point Likert scale and closed-ended questions. Result: 161 dental students participated …

Individualized Oral Care Using Photobiomodulation And Tailored Brushing Method In A Patient With Maxillofacial Trauma – A Case Report, Shruthi Reghunath, Roshni Ramesh, S Santhosh Kumar, Anoop Sasi, Shahana C. Mohamed, Bilha Joy, Aswathy Jayasree

Journal of Dentistry Indonesia

Patients who report to the dental outpatient department following maxillofacial trauma often exhibit suboptimal oral hygiene, which is frequently attributed to challenges in sustaining oral care stemming from pain and restricted mouth opening after the injury. This case report aims to provide an individualized protocol of oral care and pain management for patients with maxillofacial trauma. Case report: A treatment protocol combining the Tailored Brushing Method (TBM), a personalized approach for at-home oral hygiene, and photobiomodulation using low-level laser was performed on a 24-year-old patient with maxillofacial trauma and poor oral hygiene. Results: The TBM is successful in achieving good …

Rebuttal Comments To The Us Trade Representative On The Operation Of The Usmca Agreement, Barry Appleton

Other Publications

These rebuttal comments incorporate insights from US Trade Representative Jamieson Greer's public remarks on December 10, 2025 to the Atlantic Council,2 that sheds additional light on the administration’s approach to the USMCA, its overall US trade strategy, and the nature of this review. This better understanding of the USTR’s approach permits a more informed rebuttal commentary. My core submission remains the same as in my oral statement: law, not leverage, builds North American prosperity.

Enhancing Flu Vaccination Rates Through Improved Electronic Health Record User Workflow Training, Grace Sayre

Master's Projects and Capstones

A quality improvement project was implemented at an urban community health clinic primarily serving low-income, underinsured, and Latinx individuals. The site had a history of poorly organized flu vaccine rollout and low vaccination rates among the patient population. Seasonal influenza infects millions of people across the US each year, resulting in hundreds of thousands of deaths (Garza et al., 2023), and vaccination is the best prevention. Electronic health record training has been shown to reduce user burnout and improve efficiency (Gordon et al., 2022). The QI project aims to increase medical assistant satisfaction with the flu vaccine rollout by 15%, …

Charting The Course: Improving Psychotropic Medication Documentation Through Staff Education To Promote Patient Safety And Cms Compliance, Anne J. Bertram Rn

Master's Projects and Capstones

The University of San Francisco master’s level nursing program culminates with a clinical nurse leader (CNL) quality improvement project. The objective of this project is to reinforce the program’s didactic CNL classes by allowing students the opportunity to design, implement, and analyze a quality improvement project in a microsystem. SETTING: Skilled nursing facilities often prescribe psychotropic medications to help manage residents’ behavioral and psychological symptoms. Due to the possibility of side effects and increased sedation, there are concerns for patient safety and quality of life. Inadequate management of these patients and symptoms compromises patient safety and breaches state and federal …

From Incomplete To Impactful—Finalizing Unfinished Nursing Projects In Nart And Polypharmacy For Lasting Improvement, Paula Thanh Nhat Pham, Armine Lianna Chamichyan, Anastasia Yerofeyeva, Stelene Alexis Tragus

Master's Projects and Capstones

This quality improvement project addressed the problem of incomplete or unsustained clinical initiatives at a long-term care facility by introducing Kotter’s Change Model, an evidence-based framework designed to support and sustain lasting improvements in clinical practice. Within the context of a religious-based residential community for older adults with complex chronic needs, the objective was to strengthen the facility’s capacity to implement and sustain change more effectively. By using two previously unfinished initiatives, the NaRT triage tool and Polypharmacy management process, the project applied Kotter’s model to evaluate how structured change strategies can improve staff engagement, leadership alignment, and long-term project …

Beyond Compliance: How Targeted Education Improves Psychotropic Medication Documentation And Patient Safety In Skilled Nursing Facilities, Dyani Williams

Master's Projects and Capstones

Psychotropic medications are routinely prescribed in skilled nursing facilities to manage behavioral and psychological symptoms, but inadequate documentation poses risk to patient safety and leads to regulatory noncompliance. Objective: This project aimed to improve nursing staff knowledge and confidence in documenting psychotropic medication use in order to safeguard patient safety and follow Center for Medicare and Medicaid Services (CMS) guidelines. Aim: A targeted education session and standardized flowsheets were developed to enhance documentation adherence and staff confidence in psychotropic medication administration. Methods: To assess knowledge, comfort, and adherence to documentation standards a pre- and post-intervention survey were administered to nursing …

A Visual Nudge Toward Safer Skin: Reducing Hospital-Acquired Pressure Injuries (Hapi) At The Bedside, Iris Quach

Master's Projects and Capstones

Objective: With the increasing prevalence of hospital-acquired pressure injuries (HAPIs) among trauma patients at Highland Hospital, a quality improvement initiative was developed as a call to action. The overarching goal of this project was to design and implement a Quality Assurance and Performance Improvement (QAPI) intervention that was both feasible and cost-effective to address existing gaps and disparities during hospitalization at Highland Hospital, part of Alameda Health System in the Bay Area. Aim: The project aimed to evaluate whether a bedside visual cueing system could strengthen nursing compliance with pressure-injury prevention protocols and improve the consistency of communication among interdisciplinary …

Association Between Gonial Angle And Mandibular Residual Ridge Resorption In Implant-Overdenture Patients, Pl Ranganayakidevi S Palaniappan, Norsiah Yunus, Norliza Ibrahim, Siti Fauzza Ahmad, Anitha Krishnan

Journal of Dentistry Indonesia

Objectives: The gonial angle could be one of the contributing factors for the continuous bone resorption in edentulous persons. This study aimed to examine the association between the gonial angle and RRR in edentulous patients receiving mandibular implant-supported overdenture (ISOD) and to compare different gonial angle measuring techniques. Methods: Twenty-three individuals with opposing mandibular ISOD and maxillary full dentures were recruited. The proportional area index was used to calculate the posterior RRR. Orthopantomographs (OPGs) pre- and four years post-implant insertion were compared. Comparison of the gonial angle measurements was made on 5 patients using four measurement methods: (i) Two different …

The Evil Historical Twin: How The Requirement Of A Historical Analogy Could Result In Further Discrimination In The Law, Bryanna Mall

The Scholar: St. Mary's Law Review on Race and Social Justice

In 2024, the Supreme Court decided the case of United States v. Rahimi. The Court, unpersuaded by Rahimi’s objection regarding federal law which prohibited an individual subject to a domestic violence restraining order from possessing a firearm, decided the restriction was constitutional. While the holding of this case represents a win for survivors of domestic violence, the legal reasoning plants itself of flimsy concepts of history. The Court utilized a historical analysis test and looked to precedent rooted in social customs, legislation, and court holdings. The first major issue of this test is the dueling interpretation between a historical …

Successful Strategies For Sustaining Women-Owned Businesses Beyond 5 Years, Antoinette Stowers-Lewis

Walden Dissertations and Doctoral Studies

A lack of successful strategies can lead to a high failure rate among small businesses. Women small business owners often express concerns about identifying successful strategies, which research shows are a key predictor of business sustainability. Grounded in entrepreneurship theory and participative leadership theory, the purpose of this qualitative pragmatic inquiry was to identify and explore the successful strategies that some women small business entrepreneurs use to sustain their businesses beyond 5 years. The participants were five women small business owners from different sectors in the East Coast region of the United States who had sustained their businesses beyond 5 …

Schemata Of Barbershop Tags, Brian A. Cromer

Electronic Theses and Dissertations

This thesis explores the genre of barbershop tags, brief musical compositions in the barbershop style. After the introduction in Chapter 1, Chapter 2 describes the barbershop style and outlines a modified roman numeral system that reflects barbershop norms. Chapter 3 analyzes the 125 entries of the Classic Book of Tags based on two features: the harmonic point of interest (HPI) and the penultimate chord. Patterns emerging from these two criteria include eleven primary schemata along with a few secondary schemata accounting for the harmonic design for a majority of tags. Chapter 4 analyzes two barbershop arrangements: “Come Fly With Me” …

Improving Doula Visibility And Integration In The Labor & Delivery Unit Through The Implementation Of Creative Standardized Visual Strategies, Ninna Alessandra Arcena Acebedo

Master's Projects and Capstones

Objective: The 22-bed, Labor and Delivery (L&D) unit lacks a standardized model to introduce doulas, clarify their scope of practice, or communicate the value of the services they provide. To address this gap, the team implemented a standardized doula awareness poster that included each doula’s name, photo, years of experience, and personal interests. Aim: The goal is to enhance visibility and promote integration of doula support to strengthen team collaboration and patient engagement. Methods: A pre- and post- implementation survey was distributed exclusively to the volunteer doulas. After the doula awareness poster was displayed for four weeks, …

Increasing Nursing Staff Confidence And Documentation Compliance For Psychotropic Medication Use, Ei Chit Paing

Master's Projects and Capstones

Objective: Psychotropic medications place a high risk for side effects such as confusion, dizziness, falls, and death in older adults above age 65 (Seifert et al., 2024). Educational training on appropriate psychotropic drug use to nursing staff is linked to a decrease in penalties (Jung et al., 2021), side effects, and an increase in staff knowledge in caring for patients with behavioral and psychological symptoms (Pinazo-Clapés et al, 2020). Aim: Facility A in Northern California is currently non-compliant with the Centers for Medicare and Medicaid Services (CMS) guidelines for appropriate psychotropic use due to limited staff understanding of regulations and …

Improving Dka Protocol Adherence In The Emergency Department, Anjolaoluwa Lawani

Master's Projects and Capstones

Problem There was inconsistency in implementation of the DKA protocol by nurses in the emergency department at the Hospital A. Only 58% of the nurses reported feeling comfortable following the DK protocol, and 84% of the nurses described the DKA order set as confusing. Context Hospital A is a large magnet-recognition hospital system in the Bay Area. The emergency department at Hospital A averages about 12 DKA patients per quarter. Intervention Education sessions were held during pre-shift cuddles across day and night shifts to clarify the DKA protocol and answer any questions or nurses may have. Measures Baseline surveys and …

Is Public Website Design An Administrative Burden? The Case Of Snap, Guangli Zhang, Stephen Roll, Mathieu Despard

Center for Social Development Research

How do websites for public-benefit programs affect access to benefits?

This brief examines the state websites for the Supplemental Nutrition Assistance Program (SNAP), investigating whether there is a relationship between site design and experience of administrative burdens in SNAP. The authors examine page design using Google’s Lighthouse service and draw upon data from the Workforce Economic Inclusion and Mobility Survey of a nationally representative sample of 2,511 low-wage U.S. workers to examine administrative burdens in SNAP. Data from the U.S. Department of Agriculture are used to investigate the relationship between SNAP page design and SNAP quality-control measures. The finding suggest …

Effects Of Communication Boards On Improving Communication In Assisted Living Care Facilities, Koleen Beatrice Arribas

Master's Projects and Capstones

Problem: A Residential Care facility utilizes paper charting causing limited access to vital information such as code status, allergies, and/or diet for those caring for the resident.

Context: Exceptional charting only when a resident’s condition changes may not provide enough vital information for the caregiver to administer medication or provide proper support during an emergency, such as the resident’s DNR status.

Interventions: A communication board was placed in a secure space near the nurses’ station with key resident information. Nurses would huddle at the board at before the change of shift and make updates as necessary.

Measures: Staff input in …

Improving Pressure Injury Prevention With Educational Programs For Caregivers And Nurses, Michella B. Kahanding

Master's Projects and Capstones

Problem: Pressure injuries are preventable with adequate interventions and knowledge by healthcare staff; however, skilled nursing facilities struggle with pressure ulcer prevention (PUP). Patient suffering and associated costs with treating these injuries are considerable.

Context: Staff education in knowledge regarding PUP is lacking, and annual PUP education is ineffective in reducing the number of pressure injuries in these facilities.

Interventions: Staff education on prevention strategies includes education, pre- and post-knowledge assessments, return demonstration and product use will be implemented

Measures: Results from the baseline knowledge of appropriate PUP in caregivers, pre- and post-test for knowledge retention, teach back techniques to …

Language Attrition As A Social Process, Or Barzilay

Master's Projects and Capstones

Language attrition is a process in which the gradual decline in proficiency of a language occurs when another language becomes more prominent among individuals, families, and broader societies. This shift often occurs not by choice but by necessity, as speakers are expected to adapt to the other language in educational settings, for employment, and to conform to societal pressures in their new environments. Although language attrition is often described as an individual loss of proficiency, contemporary research reveals a far more complex picture—one shaped by factors that determine which languages are valued and which fade into obscurity. These forces collectively …

Optimizing Electronic Health Record Workflow To Improve Flu Vaccinations In A Primary Health Clinic, Xzalyn Arianah Hernandez

Master's Projects and Capstones

Among the Latinx population influenza vaccination rates remain disproportionately low due to vaccine hesitancy, misinformation, limited access to healthcare, and socioeconomic barriers. Influenza related hospitalizations and deaths have risen in recent years as rates continue to drop across all age groups, as a result of this issue. This quality improvement project aims to increase staff satisfaction and flu vaccination rates among Latinx patients by the implementation of a more efficient workflow process. Different interventions were designed to address workflow inefficiencies and medical assistant dissatisfaction. These interventions included 1) integrating the Immunization Clinic function in EPIC to streamline flu vaccine documentation …

Reducing Hospital-Acquired Pressure Injuries Through Targeted Nurse Education On The Braden Scale And Skins Bundle, Sarah Nicole Farkas

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries (HAPIs) continue to rise nationally despite overall reductions in other hospital-acquired conditions. This project sought to address gaps in nurse knowledge, inconsistent prevention practices, and workflow barriers contributing to HAPI development on a Trauma Medical-Surgical Unit (Unit A). Aim: This project aims to decrease the number of HAPIs on the Trauma Medical Surgical Unit by 11%, from nine HAPIs to eight HAPIs, following implementation of nurse education on the proper use of the Braden Scale and the SKINS Bundle from October 6, 2025, to November 14, 2025. Methods: A pre-intervention survey was administered to identify baseline …

The Pressure Is On: A Quality Improvement Project To Educate Nurses On Hospital Acquired Pressure Injuries, Lance Ward

Master's Projects and Capstones

Objective Hospital acquired pressure injuries (HAPIs) are injuries developed by admitted patients, from treatment interventions that they encounter during their hospital stay. If a patient acquires a HAPI during their stay, the hospital is required to cover all expenses related to the injury. An in-patient trauma unit at a large medical center wishes to improve patient care by educating nursing staff on preventive measures of HAPIs. A review of relevant literature on HAPIs from the past five years was conducted to identify HAPI preventions tools, such as the Braden Scale and SKINS bundle, as well as the best methods to …

Enhancing Psychotropic Medication Documentation Through Staff Education To Promote Increased Compliance Rates And Patient Safety, Matalyn F. Kirkes

Master's Projects and Capstones

Objective: Inappropriate psychotropic medication use and documentation poses a risk to patient safety and health as well as premature death while also leading to regulatory noncompliance (Bednarczyk et al., 2022). Improving nurse documentation can help patients maintain safe and adequate prescriptions and doses. Context: Baseline data collected within our microsystem revealed gaps in nurse comfort and knowledge around documentation requirements. The nursing staff (LVNs/RNs), who we received the baseline data from, are responsible for assessments, documentation, and patient monitoring, for which there is significant variability in understanding the required expectations. Interventions: The education for the skilled nursing staff as well …

Stop, Look, And Save A Spot! Implementing The Hapi Prevention Tool, A Visual Cuing System That Aims To Reduce Hospital-Acquired Pressure Injuries In Acute Care Units, Jada Baldoza

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries continue to be a major challenge in many healthcare settings as it poses increased risk in patient safety. Additionally, it creates a significant financial burden on hospitals as it increases operational costs that can increase strain on healthcare resource demands. Nurses play a major role in mitigating these injuries through practicing quality patient care and utilizing prevention strategies that have been proven effective. Aim: A quality improvement project was conducted by introducing a visual cueing system, the HAPI Prevention Tool to investigate its potential sustainability on reducing HAPI rates in the medical-surgical unit. Methods: The QI …

Implementing A Standardized Doula Awareness Tool To Improve Team Collaboration And Patient Understanding, Stephanie Wong

Master's Projects and Capstones

Setting: 22-bed, Labor and Delivery (L&D) unit in the Bay Area serving diverse birthing patients. Problem & Context: The unit lacks a standardized model to introduce doulas, clarify their roles, or communicate their value. Evidence shows that doulas feel unseen by other hospital staff (Kett et al., 2022) and report that their role can be misunderstood, undervalued, or unrecognized, creating barriers to effective partnership (Louis-Jacques et al., 2024). Pre-survey: Only 19.2% of the participating volunteer doulas felt patients understood their role as a doula, and 11.5% felt patients were only slightly knowledgeable. In terms of collaboration, just 15.4% felt consistently …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Evaluation Of Remote Sensing Technologies For Bull Kelp Detection In The Greater Farallones National Marine Sanctuary, Melina Shak

Master's Projects and Capstones

The Greater Farallones National Marine Sanctuary (GFNMS), located off the coast of Northern California contains approximately 90% of the region’s bull kelp. Bull kelp is a foundational species that provides food and shelter supporting diverse marine ecosystems, but due to recent anthropogenic stressors, 90% of kelp forests along the California coast have been lost. The Greater Farallones Association (GFA) is actively working on restoration efforts, where monitoring is essential for assessing recovery success. My research addresses GFA’s need to reduce reliance on intensive, time-consuming Unmanned Aerial Systems (UAS) surveys by identifying accurate, cost-effective, and scalable remote sensing technologies for kelp …

Improving Knowledge To Improve Care: Strengthening Nurse Expertise In The Emergency Management Of Diabetic Ketoacidosis, Minda Murphy

Master's Projects and Capstones

Abstract

Setting: A high acuity emergency department within a large hospital system. Problem: Nurses in the emergency department reported inconsistent understanding and utilization of the existing Diabetic Ketoacidosis (DKA) protocol. Pre-intervention survey results showed that 84% of nurses identified the DKA order set as confusing, and only 15% reported feeling “very comfortable” with the protocol. These knowledge gaps contributed to delays in glucose monitoring, inconsistent insulin administration, uncertainty about order-set responsibilities, and variable adherence to evidence-based management. Context: DKA is a time-sensitive, high-risk emergency that requires precise, protocol-driven actions to prevent complications such as electrolyte imbalance, cerebral edema, prolonged hospitalization, …

Lost In Translation: Navigating Cultural And Linguistic Barriers For Indian Learners In Tesol Classrooms, Shivam Jaynarayanbhai Gohel

Master's Projects and Capstones

ABSTRACT

This thesis examines the cultural, linguistic and emotional issues of the Indian multilingual students in the U.S. TESOL classroom and explains the value of decolonized and culturally responsive pedagogies to ameliorate foreign language anxiety and create equitable education. Based on the frameworks of Culturally Responsive/Sustaining Pedagogy and Affective Filter Theory, the study integrates existing and existing research to investigate the role of colonial heritage in influencing TESOL practice, the undermining effect of anxiety on academic achievement and the empowering effect of instructions that are inclusive and responsive. Chapter I presents the problem, including how multilingual and multicultural identities of …

Decarbonizing California Wine: Navigating Scope 3 Emissions Challenges And Opportunities, Olivia Regalia

Master's Projects and Capstones

Climate change is already impacting the California wine industry through increases in extreme weather, such as prolonged heatwaves and atmospheric rivers. For the industry to survive, it is important for California wineries to mitigate the effects of climate change and adapt to current and future impacts. Scope 3 greenhouse gas emissions (i.e., emissions generated throughout the supply chain) from glass packaging make up 29% of a typical California winery's carbon footprint, representing both the largest Scope 3 climate impact and greatest opportunity for reductions. This research examined key factors shaping California wineries’ Scope 3 emissions reductions efforts. A mixed-methods approach …