Digital Commons Network^™

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 …

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 …

Listening, Learning, Accommodating: A Critical Look At Inclusive Research Help, Michelle Lee, Laura Beane, Kristina Lang, Jillian Speck, Kristina Clement

Faculty Articles

Research consultations continue to be a valuable means of connecting with users and supporting their research needs. As we’ve received an increasing number of research consultations where one or more accommodations have been requested, the Kennesaw State University Libraries have been exploring ways to provide accommodations in research consultations. Since there is a lack of research on this specific facet of research consultations, this literature review focuses on the related topics of assistive technology in libraries, accommodations in library services and spaces, and library anxiety to show how these topics relate to providing accommodations in research consultations. The objective of …

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 …

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 …

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 …

Teamwork Under Pressure: Ob Emergency Simulation With Nursing, Midwifery & Nurse Anesthesia Students, Wendy R. Gibbons, Russ Branch, Katie Cole, Desiree Mullis Clement, Lisamarie Wands

International Nursing Research Congress (INRC)

Background: Midwives, nurses and nurse anesthetists frequently work together in one of the most enduring and consistent patient care settings, obstetrical care units. Interprofessional teamwork is a core competency for advanced practice and pre-licensure nursing students and interdisciplinary simulation offer students in prelicensure and advanced practice nursing programs the ability to collaborate, effectively communicate, and learn each other’s roles.

Methods: Faculty within a large university’s midwifery and nurse anesthesia programs designed and implemented an interdisciplinary simulation experience involving students from pre-licensure, midwifery, and nurse anesthesia cohorts. The students performed in the roles of the certified registered nurse anesthetist, certified nurse …

Silver Linings Among Youth Living With Hiv: An Integrated Mixed Methods Analysis, Emily Anne Barr, Mary Catherine Lingwall, Himabindu Reddy Basani, Joanna S. Vennekotter, Alyssa Goldsmith, Joseph Crane, Leah Jane Anthony, Re'undre Malone, Veronica Brady

International Nursing Research Congress (INRC)

Purpose: Youth living with HIV experience stigma, mental health challenges, and barriers to engagement in care. Silver linings are positive shifts in perception, connection, or opportunity that arise from adversity. This project examined silver linings across two studies of youth living with HIV and explored associations with stigma, trust, mental health, and viral suppression.

Methods: An integrated mixed methods design was used. The first study (Colorado, USA) was a cross-sectional survey of 109 youth that assessed stigma, mental health, trust in the healthcare relationship, viral load, and one open-ended item on silver linings. The second study (Texas, USA) included semi-structured …

"Tithing Is An Insurance Premium": A Framing Analysis Of Speaker Innovation And Diachronic Trends In Latter-Day Saint Religious Discourse, Reid Empey

Theses and Dissertations

Religious language relies on shared metaphor and frames that contextualize religious experience and practice. Current approaches to frame semantics (Fillmore 1982) and cognitive metaphor (Lakoff & Johnson 1980) lend important insight into religious language, particularly in describing the role that figurative language serves in a religious speech community. However, a vital component of many religious speech communities is the presence of and engagement with a scriptural canon, which often contains metaphorical and framing language that religious speakers can directly reference. Yet, past conceptualizations of speech communities have not accounted for this engagement with a shared canon. To illustrate the role …

Synthetic Strategies For Bioactive Peptides: From Aggregation Inhibitors To The Total Synthesis Of Tunicyclin C, Stephanie Graciela Garcia Morin

Theses and Dissertations

In Alzheimer's disease (AD), a brain protein called "tau" abnormally clumps and forms neurofibrillary tangles (NFTs), causing damage to brain cells. Ac-PHF6-NH2 is a hexapeptide segment of tau protein that plays a dominant role in tau aggregation and is used as a model to design tau protein aggregation inhibitors. In this research we synthesized four dehydroamino acid (□AA) containing PHF6 analogues with △Abu (derived from L-threonine) and △Val (derived from □-OH-Valine) at position 2 or 3 via dehydrations or azlactone ring-openings as key reactions. We evaluated their proteolytic resistance, ability to inhibit aggregation of PHF6, and impact on the morphology …

Measuring Proteostasis Changes In Apolipoprotein E Mouse Models Using Quantitative And Kinetic Proteomic Methods, Ariel E.A. Denos

Theses and Dissertations

Alzheimer's Disease (AD) is a neurological disorder associated with brain mass loss and cognitive decline. It affects millions of elderly people and is currently uncurable. Since 1906, when the disease was first described, researchers have uncovered many components of AD pathology. However, it is now evident that curing Alzheimer's Disease will require intervention before the pathological onset of amyloid beta plaque deposition, tau neurofibrillary tangles, and associated neuronal loss. Studying AD from the perspective of early intervention requires special attention to small changes that may disrupt the normal processing of cells. Cells undergo a natural cycle of creation and destruction …

Midweek Memo, Georgia Southern University

Midweek Memo

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

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 …

Staff Education To Integrate The Cdc Prediabetes Risk Test Into Primary Care Intake, Helen Ndangam

Walden Dissertations and Doctoral Studies

This staff education project involves addressing the gap in using a standardized prediabetes screening protocol at an outpatient primary care clinic in Maryland, which leads to missed early interventions. Standardizing this process is vital for nursing practice to promote preventive care and optimize workflows. The practice-focused question was for medical support assistants (MSAs) at an outpatient primary care clinic: How does implementing a competency-based education program on the Centers for Disease Control and Prevention (CDC) Prediabetes Risk Test (Centers for Disease Control and Prevention [CDC], n.d.) affect staff knowledge, workflow confidence, and screening compliance over a 7-week period? The purpose …

Staff Education To Reduce Burnout Among Psychiatric Nurses Caring For Patients With Schizophrenia, Gloria Laizer

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project addressed occupational burnout among psychiatric registered nurses caring for patients with schizophrenia. Workplace violence, compassion fatigue, emotional exhaustion, and staffing shortages place psychiatric nurses at high risk for burnout, threatening nurse well-being, workforce retention, and patient safety. The practice site lacked a standardized resilience education program. The practice-focused question was, In psychiatric nurses caring for patients with schizophrenia, does implementation of an evidence-based resilience education program, compared with current practice, reduce occupational burnout? The purpose was to implement and evaluate such a program, informed by the Johns Hopkins evidence-based practice (JHEBP) Model …

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 …

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 …

How Racial Bias And Job-Related Stressors Impact The Prospect Of Police Misconduct, Jean Emmanuel Brutus

Walden Dissertations and Doctoral Studies

Police use of excessive force is an enduring challenge for criminal justice institutions and the public, particularly, affecting minority communities. This has contributed to diminished public confidence in U.S. policing institutions. Prior empirical studies among law enforcement officers, indicate that Black minorities have been discriminated by police officers. Stress research links social stress to mental health and identifies police brutality as an anticipatory stressor for minority groups. The purpose of this qualitative case study was to identify factors, including job-related stressors, and racial bias, that contribute to officers using excessive force, so to fill the gap in research, and develop …

Effective Strategies To Implement Equitable And Transparent Artificial Intelligence Technologies To Improve Employee Productivity, Ijeoma Appolonia Chukwunyelu

Walden Dissertations and Doctoral Studies

Ineffective artificial intelligence (AI) implementation strategies can undermine transparency and ethics in AI technology use for organizational performance and diminish employee productivity. Without these strategies, information technology (IT) leaders risk reduced employee productivity, lower organizational adoption of AI technologies, and inequitable outcomes. The purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies IT leaders use to implement transparent, ethical AI technologies to improve employee productivity. The conceptual framework that grounded this project was transformational leadership theory. The project participants were six IT business leaders in the United States with experience implementing AI technologies within their organizations. …

Effective Leadership Strategies To Recruit And Retain A Multigenerational Workforce, Nnamdi Cajetan Onwuzulike

Walden Dissertations and Doctoral Studies

A lack of effective leadership strategies for recruiting and retaining a multigenerational workforce poses a significant challenge for organizational leaders. Failure to address the diverse needs and expectations of employees across generations can reduce employee retention, hinder organizational effectiveness, and increase operational costs. Grounded in transformational leadership theory, the qualitative pragmatic inquiry identified and explored effective leadership strategies used by some organizational leaders to recruit and retain a multigenerational workforce. Participants were six organizational leaders from large organizations in the United States with experience leading multigenerational workforces. Data were collected through semistructured interviews and secondary data from publicly available sources …

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 …

Stewardship In Action: Reducing Unnecessary Antimicrobial Use In Long-Term Care, Mariatu Sulaiman

Walden Dissertations and Doctoral Studies

Antimicrobial overuse in long-term care facilities (LTCFs) contributes to antimicrobial resistance, avoidable healthcare costs, and adverse drug events, particularly when antibiotics are prescribed for asymptomatic bacteriuria rather than symptomatic urinary tract infections (UTIs). Evidence-based clinical practice guidelines, including the McGeer Criteria, provide standardized approaches for differentiating true UTIs from asymptomatic bacteriuria and supporting appropriate antimicrobial prescribing. The purpose of this evidence-based practice project was to evaluate the development and implementation of a clinical practice guideline incorporating the McGeer Criteria into an antibiotic stewardship program in an LTCF. The practice-focused question examined what evidence supports strategies for reducing unnecessary antimicrobial use …

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) …

Operating Room Scheduling And Workflow Optimization In Acute Care Hospitals, Waleed Tawfik

Walden Dissertations and Doctoral Studies

Operating room scheduling inefficiencies in acute care hospitals contribute to delays, prolonged turnover times, cancellations, underused capacity, overtime, higher costs, and reduced timely access to surgery. This integrative review examined evidence-based, systems-oriented scheduling and workflow strategies to improve operating room utilization, reduce delays, and enhance operational efficiency. Guided by general systems theory, a structured search identified 196 database-level records; 28 articles underwent full-text review, and 20 sources were retained for thematic synthesis after critical appraisal using the Johns Hopkins Evidence-Based Practice criteria. The thematic analysis revealed four main themes: standardized workflow coordination, data-driven scheduling and decision support, integrated resource and …

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 …

Shape: A Photovoice Study Exploring Student And Educator Perceptions Of School Built Environments, Megan L. Jester, Dawn Loraas, Cian L. Brown, Madelynn Henderson

International Nursing Research Congress (INRC)

Background: School buildings shape daily experiences, well-being, and professional satisfaction for those who work and learn within them. Schools are increasingly primary access points for student health services.¹ Teaching in public schools ranks among the most stressful occupations, driving burnout and turnover.² As these groups spend most days in schools, the built environment serves as a crucial social determinant of health.³ Factors like extreme temperatures, poor air quality, and noise pollution impact health outcomes^4-6, creating barriers to learning.⁷ Limited nurse-driven research exists on how building attributes impact well-being. Spatial Habits Advance Personal Excellence examines …

Opioid Overdose Simulation Training For Staff: An Educational Development Project, Brooke Van Buskirk, Tyler Langley, Nancy S. Goldstein

International Nursing Research Congress (INRC)

Outpatient medical facilities have become more likely to encounter in-office emergencies related to opioid overdoses. Literature analysis found gaps in health team response capability in outpatient healthcare settings.¹

Our aim was to design and implement an opioid overdose simulation at an outpatient substance use disorder clinic. Literature reviewed found 4 essential themes to guide our curriculum development: simulation training, emergency action protocols, response training and equipment readiness.^2,3,4,5 These themes were used to create an algorithm on best-practice for overdose response and guided our simulation development.

A four-step simulation was designed including pre-brief education, low-fidelity mannequin simulation, high-fidelity simulation …

Life Of Patients After Laryngectomy Before Hospital Discharge, Kaori Haba, Kumiko Kotake, Mami Kurita, Kazuyo Iwanaga, Ichiro Kai, Yoshimi Suzukamo, Aya Takahashi, Yoko Ishibashi, Yoriko Hara, Ichiro Ota, Hirokazu Uemura

International Nursing Research Congress (INRC)

Purpose: This study aims to identify how patients after laryngectomy (PaL) feel about their lives before discharge.

Methods: The participants received total laryngectomy for peri-laryngeal cancer. They were interviewed for physical condition and concerns in daily lives, and how they coped with them before discharge. Qualitative induction was used to analyze. This study was conducted by obtaining the approval of the Ethical Review Committee of the university the researcher belongs to.

Results: All 9 participants were male, and the mean age was 68.2 years.
They “felt their bodies were recuperating” from the surgical invasion with free from respiratory distress and …