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Quantum Smart Entangled Fusion Reactor, Peter Branton

Defensive Publications Series

The invention relates to a compact, high-efficiency energy generation system employing

quantum-entangled hydrogen isotope fusion within nanoscale confinement structures. It

comprises a multiplicity of individually controlled fusion traps formed at nanometer scale, each

configured to receive pre-entangled pairs of hydrogen isotopes such as protium, deuterium, or

tritium. Each trap is stimulated by attosecond-timed electromagnetic resonance pulses to induce

fusion via quantum tunneling. Fusion events are monitored and optimised through an integrated

artificial intelligence (AI) control layer that ensures only coherence-validated, phase-aligned

pairs are activated. The system includes capacitive and inductive energy reclamation

components, and operates in inert gas environments without …

Cover And Forewords, James W. Gallagher

The Geographical Bulletin

Cover and Forewords

Index The Geographical Bulletin, James W. Gallagher

The Geographical Bulletin

INDEX THE GEOGRAPHICAL BULLETIN

Volume 7 Complete Issue, James W. Gallagher

The Geographical Bulletin

Volume 7 Complete Issue

Spatial Variations In Women's Share Of The Manufacturing Labor Force In Tennessee: A Statistical Analysis, Ted Klimasewski

The Geographical Bulletin

A neglected facet of the geographic literature is the role of women employed in the labor force. Women make up a significant share of the labor force, and comprise approximately a third of the manufacturing employment in the United States during 1970. But the relative magnitude of female employment in manufacturing varies throughout the United States, and in some areas of the South, women make up more than half of the manufacturing employment. The purpose of this study is to introduce the manufactural aspect of women's role in the labor force by (1) examining the spatial variation in women's share …

Spatial Ordering In Social Area Typology, Larry B. Bubacz

The Geographical Bulletin

The primary purpose of this paper is to provide tentative evaluation of the general applicability of two statistics, the weighted mean areal center and standard distance, to the question of spatial ordering in social area analysis. More specifically, does the use of these statistics identify whether social phenomena tends to conform to either a concentric (doughnut) ring or a sector (pie-shaped) pattern? The weighted mean areal center is defined as the "balancing point" or "center of gravity" for a population distributed in twodimensions (x-y coordinates) which is comparable to the arithmetic mean of the conventional linear frequency distribution.' The descriptive …

Systems Approach In Physical Geography, Hubert B. Stroud

The Geographical Bulletin

The concept of a system is not new and the emergence of systems analysis in academia has caused controversy over the significance of this approach as a viable means of scientific analysis. Some geography scholars feel that the use of systems analysis would definitely put us on the research frontier,1 while others view the term " systems" as nothing more than jargon. Nevertheless, the simplest definition for system is " a set of interrelated elements." The demand for the systems approach arose because scholars in a number of disciplines recognized in their own research that individual components of a problem …

The American State Capital, A Twentieth Century Growth Pole, Frederick A. Hirsch

The Geographical Bulletin

A fall-out of our avoidance of " capes and bays" geography has been a " benign neglect" of political capitals. In addition to the mental block arising from past tedious memorizations of their existence has been a second factor of sparseness of cases. The United States with fifty state capitals has more than the number of capitals in most of the other federally organized sovereignties. The scientifically oriented among academic geographers have preferred to analyze phenomena in greater abundance such as central places or stream beds.

Utilization Of Plat Books For Determination Of The Rural-Urban Fringe, Douglas J. Kocher

The Geographical Bulletin

This paper has as its purpose the identification of the Valparaiso, Indiana rural-urban fringe' through an analysis of property boundary changes as evidence in county plat books. It is designed to test two hypotheses dealing with the nature of Valparaiso expansion and subdivision of land : one, greater urban expansion of Valparaiso will tend to be linear in nature and in the direction of major industrial areas and population centers; and two, the subdivision of land will show a marked increase with time as the urban area expands.

City Structure And City Change: A System Analysis Approach, A. Y. Abu-Ayyash

The Geographical Bulletin

The structure of the city and the transformation processes which generate changes in its structure have fascinated intellectuals from many disciplines. Sociologists are mainly concerned with the social structure and the demographic characteristics of the inhabitants of the city as a base for understanding its structure. Economists are concerned with economic forces in terms of locational competition as the main reasons for the changing structure of the city. Engineers are concerned with the architecture of the city.

Editor's Comments, James W. Gallagher

The Geographical Bulletin

With the recent proliferation of periodicals which cater to geographers, it is probably a satisfaction for an editor to know that his periodical is still in business. At the recent annual meeting of Gamma Theta Upsilon the intent was clear on the part of the Executive Committee to stay in business. That is gratifying. But most satisfaction comes with the publication of this volume. You really are never aware of the breadth and depth of the articles offered until an index is made. A review of the index to volumes 1-6 show a considerable range of topics for our readers …

Enhancing Nurse Competency: Proper Application Of Chlorhexidine Gluconate Dressings To Prevent Central Line Associated Bloodstream Infections, Joseph Earich

Doctor of Nursing Practice Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) pose a significant risk to patient safety and healthcare outcomes. The proposed Doctor of Nursing Practice (DNP) project addresses the knowledge gap among nurses regarding the correct procedures for changing chlorhexidine gluconate (CHG) dressings on central lines. The goal is to enhance nurse education and adherence to best practices, thereby reducing the incidence of CLABSIs. The project employs a quasi-experimental design with a pre-test and post-test methodology. Nurses will complete a pre-test to assess their baseline knowledge of CHG dressing changes. The nurse will participate in a hands-on educational session to improve their understanding and …

A Multicomponent Quality Improvement Initiative For The Early Identification, Prevention, And Management Of Delirium In The Medical-Surgical Setting, Sarah K. West

Doctor of Nursing Practice Scholarly Projects

Hospital-acquired delirium affects older adult patients, across the healthcare continuum. The incidence in frail older adults is high, costly, and often deemed preventable. Hospital-acquired delirium is associated with a multitude of short- and long-term complications, resulting in an increased rate of morbidity and mortality. The challenges of early recognition and management are prevalent in healthcare literature. While published guidelines exist, hospital systems continue to struggle with the standardization of geriatric delirium care. Given medical-surgical nursing is the cornerstone of hospital care, it is imperative to establish a standardized delirium prevention and management guideline, at this level of care, to optimize …

Enhancing Advanced Practice Nursing: Implementing A Simulation-Based Point-Of-Care Ultrasound Training Program, Brandy Younge, John Chovan, Bonnie Fagan, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

Nurse practitioners (NPs) are advanced practice nurses entrusted with diagnosing and treating illnesses, managing acute and chronic diseases, and engaging in continuous education to remain knowledgeable of evidence-based advancements. NPs offer a comprehensive range of healthcare services, catering to patients from wellness check-ups to those requiring complex care, such as individuals hospitalized with sepsis. One technological advancement that can support NPs in delivering optimal patient care is point-of-care ultrasound (POCUS). In the United States, over 385,000 NPs practice in patient care settings that may use POCUS. Numerous medical societies have issued position statements supporting the use of POCUS in the …

A Reading Curriculum Teaching “Text-To-Self" Connections Using Literature With Diverse Characters At The Early Elementary Level, Elise N. Buzza

Masters Theses/Capstone Projects

This research project’s focus was to answer the question of how can texts featuring realistic diverse characters be used to teach “text-to-self” connections at the kindergarten level? With a rapid increase of diverse demographics in the classroom, students’ accessibility to diverse literature becomes crucial. While the need for diverse literature is heightened, students and teachers instead are met with curriculum that’s focus remains on animal characters. Researchers argue that with a lack of diverse visibility in literature, this presents a significant issue pertaining to a reader’s engagement. Thus, “text-to-self” connections become vital. This is when readers use their experience to …

Character Education: Morning Meetings On Responsibility And Citizenship; A Curriculum Development, Kelsie Fike

Masters Theses/Capstone Projects

This project explores character education, morning meeting, and social emotional learning (SEL). It highlights a need for the curriculum being created and how it can be accomplished in a morning meeting format. It also highlights interactive read alouds, reflective writing, interactive discussion, and interactive drama. The purpose of this capstone project is to create a curriculum that educates on the character education traits of responsibility and citizenship. The curriculum is supported by Ohio’s SEL standards. It is also research supported. The project’s aim is to create a curriculum that can be differentiated and adapted to fit the various needs of …

Birds Of A Feather: An Integrated Outdoor-Based Bird Study P-3 Curriculum Guide, Erin A. Buzza

Masters Theses/Capstone Projects

In a post-pandemic world that places technology at the at the forefront, educators are searching for ways to help students connect with the natural world. This project aids teachers in tackling this challenge by using the study of birds as a motivation to engage students with the outdoors and local wildlife. To demonstrate how ornithology topics can be used as an integrated thematic unit, research regarding components of ecological literacy is presented. They include nature-based learning, outdoor learning, environmental education, and wildlife education. In addition to these pedagogies, the benefits of incorporating interdisciplinary learning within the classroom are also provided …

Final Scholarly Project: Evidence-Based Practice Guidelines For The Perioperative Management Of Blood Glucose Levels In The Cardiac Surgery Patient, Chelsey Benner

Doctor of Nursing Practice Scholarly Projects

Cardiovascular disease is the leading cause of mortality worldwide, necessitating a high demand for cardiac surgery. A unique stressor for cardiac surgery is an increased surgical stress response involving hyperglycemia. Perioperative hyperglycemia contributes to adverse postoperative outcomes following cardiac surgery. Current evidence examines blood glucose control and its effect on adverse postoperative outcomes, including sternal wound infections, acute kidney injury, prolonged mechanical ventilation, and an increased length of stay in the intensive care unit. Despite the link between hyperglycemia and poor postoperative outcomes, most facilities lack standardized guidelines for the perioperative management of blood glucose levels in cardiac surgery patients. …

Final Scholarly Project: Development And Initial Validation Of An Evidence-Based Guideline For Presurgical Medication Hold Times, Alyscia Defrancisco

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Presurgical testing is a critical component for preventing surgery delays and postsurgical complications. A major focus of presurgical testing is educating patients on hold times of medications prior to surgery. Medication guidelines vary across ambulatory surgery centers.

Methods: Creating a standardized evidence-based medication guideline could improve some surgical complications. This project is the creation and pilot evaluation of an evidence-based medication guideline. After the development of the guideline participants attended an educational session. The evaluation of the effectiveness of the guideline, used a preintervention and postintervention questionnaire. The participants of the project are presurgical testing practitioners at …

Division Iii Soccer Athlete Ankle Stability In An Ankle Brace Compared To Ankle Tape During Functional Testing, Caitlin M. Craig

Masters Theses/Capstone Projects

Objective/ Context: A common injury to athletes and non-athletes is a lateral ankle sprain. There is a higher incidence of a lateral ankle sprain occurring during sports participation. Additionally, soccer athletes are at an increased risk for lateral ankle injuries due to the high impact of cutting and turning, which can lead to the mechanism of injury. As a means of injury prevention and ankle stability, ankle taping and ankle bracing provide athletes with similar support. There is an ongoing debate on whether one method is better at providing stability to at-risk populations; however, the answer is still being determined. …

Using The Bispectral Index Monitor To Decrease The Incidence Of Unintended Intraoperative Awareness In The High-Risk Population, Bridget Hayes

Doctor of Nursing Practice Scholarly Projects

Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence …

Final Scholarly Project: The Administration Of Transversus Abdominis Plane Blocks In Patients Undergoing Anesthesia For Open Ventral Hernia Repairs, Brennon Pinion

Doctor of Nursing Practice Scholarly Projects

Ventral hernia repairs are the only definitive treatment for umbilical or abdominal hernias. These procedures are prevalent and often lifesaving but also carry high risks of adverse effects. Some of the problems that follow include postoperative ileus, increased opioid use, and prolonged length of stay. Due to the rate of complications, there was a need to improve these outcomes. One way to improve outcomes is to implement superior anesthetic techniques. This Final Scholarly Project (FSP) followed the Plan-Do-Study-Act (PDSA) model to conduct evidence-based practice (EBP) and quality improvement (QI) sections. The plan phase included a thorough literature search and analysis …

Development Of Evidence-Based Clinical Practice Guidelines For Pediatric Preoperative Anxiety, Whitney R. Stant

Doctor of Nursing Practice Scholarly Projects

Preoperative anxiety is a problem that occurs frequently in pediatric patients. Preoperative anxiety creates physical and psychological changes that impact a child’s surgical experience. Pediatric patients who experience preoperative anxiety may also experience prolonged postoperative care, long-term psychological complications, and increased postoperative pain. Sedating medications are often administered to prevent and treat preoperative anxiety. Commonly, midazolam is administered intranasally to prevent preoperative anxiety. Midazolam increases the risk of cognitive impairment and respiratory depression. Dexmedetomidine is an effective alternative to midazolam. Dexmedetomidine is a highly selective alpha-2 agonist and provides arousable sedation without respiratory depression. Dexmedetomidine is safe and effective at …

Guidelines For Intraoperative Use Of Quantitative Neuromuscular Monitoring, Alex Thompson

Doctor of Nursing Practice Scholarly Projects

Chemical paralysis with neuromuscular blocking agents is common practice in anesthesia. Adequate reversal of these medications is essential for postoperative recovery and return to physiologic baseline. Inadequate reversal may lead to residual paralysis and respiratory complications such as hypoxemia, upper airway obstruction, atelectasis, and pneumonia. Quantitative neuromuscular monitoring was introduced as an objective measure of adequate recovery from neuromuscular blockade. The American Society of Anesthesiologists recommends utilizing quantitative neuromuscular monitoring before tracheal extubation in their 2023 practice guidelines, as the research involving quantitative neuromuscular monitoring shows a reduction in postoperative residual paralysis rates and adverse respiratory complications postoperatively. In this …

Diabetes Self-Management Education For Older Adults In Primary Care, Makilah Rae Furlan

Doctor of Nursing Practice Scholarly Projects

Type 2 Diabetes (T2DM) is a chronic disease that impacts 27.2 million seniors 65 and older. Evidence-based care for T2DM includes a combination of medication and disease-management behaviors. Access to education to teach patients healthy behaviors to manage their disease is limited and even less accessible to geriatric patients with aging learning needs. The scholarly project addresses this gap in patient education by implementing evidence-based diabetes self-management education for geriatric patients to increase patient knowledge and confidence in implementing self-management behaviors. The scholarly project aims to assess health behaviors in patients aged 65 and older with established type 2 diabetes …

Proposed Final Scholarly Project: Pediatric Provider Attitudes And Clinical Practices For Physical Activity Interventions In The Treatment Of Attention-Deficit/Hyperactivity Disorder, Andrea Zanders

Doctor of Nursing Practice Scholarly Projects

Attention-deficit hyperactivity disorder (ADHD) is one of the most common mental health conditions diagnosed in children and adolescents. First line treatments of psychopharmacology and psychotherapy can be ineffective, come with intolerable side effects, or not be available to all youth. Physical activity is among the most effective adjunctive interventions. However, many mental health providers report insufficient education or training on physical activity interventions as a barrier to implementing them into clinical practice. Using the transtheoretical model of behavior change principle of consciousness-raising, the proposed scholarly project aims to impact provider attitudes and knowledge about the use of evidence-based guidelines for …

Evidence-Based Practice Guidelines For Perioperative Use Of Dexmedetomidine In Pediatric Congenital Cardiac Surgery, Kayla Thomsen

Doctor of Nursing Practice Scholarly Projects

Tachyarrhythmias are common postoperatively in the congenital cardiac surgery population. About 1% of the population is born with congenital heart disease (CHD), with 50% of patients undergoing surgery for CHD experiencing arrhythmias. Complications can arise from postoperative arrhythmias, including hemodynamic instability and myocardial depression, having catastrophic health repercussions. Despite the high prevalence and complications, there is no standard practice for postoperative tachyarrhythmia prevention in the chosen population, and prevention is at the provider's discretion. However, literature exploring the effects of dexmedetomidine notes promising results for using the drug for postoperative tachyarrhythmia prevention. The project aims to address the lack of …

Implementation Of Guidelines For Preprocedural Ultrasound In Neuraxial Placement For Obstetric Patients With Scoliosis, Luther Nyirenda

Doctor of Nursing Practice Scholarly Projects

Neuraxial anesthesia including epidural, spinal, and combined spinal-epidural, is used with 65% of parturients in the United States for the management of pain and discomfort. Conventional landmark palpation has been the mainstay technique for neuraxial anesthesia, but unfamiliar spinal anatomy can lead to incomplete blockade or an increased incidence of complications. Scoliosis causes lateral curvature and rotation of the spine leading to arthritis and soft tissue changes that can present obscure anatomical landmarks, cause difficulty in needle passage, and result in inadequacy of local anesthetic efficacy. The literature illustrates that preprocedural ultrasound is recommended for needle placement in parturients with …

Final Scholarly Project: Enhanced Recovery After Surgery (Eras) Guidelines For Pancreaticoduodenectomies, Rebecca Wheeler

Doctor of Nursing Practice Scholarly Projects

A pancreaticoduodenectomy, or Whipple procedure, is the only curative option for pancreatic cancer. For those eligible for tumor resection, the Whipple procedure is a difficult surgery for both the patient and provider. Complications following pancreaticoduodenectomy are numerous and include infection, delayed gastric emptying, high hospital costs, and pancreatic fistulas. Enhanced Recovery After Surgery (ERAS) protocols exist to provide evidence supporting standardization of practices that lead to the improvement of these patient outcomes. An ERAS protocol for the pancreaticoduodenectomy, first established in 2012, is inconsistently implemented in healthcare facilities. Researchers collected data involving the use of the Whipple procedure ERAS guidelines …

Development Of Evidence-Based Practice Guidelines For Utilizing Erector Spinae Plane Blockade For Patients Undergoing Cardiac Surgery, Gabrielle Metoyer

Doctor of Nursing Practice Scholarly Projects

In the United States, the aging population and high rates of cardiovascular disease leads to increased cardiothoracic surgeries. Analgesia for cardiac surgeries often involves high-dose opioids. However, with an ever-increasing opioid epidemic and adverse effects on the postoperative healing process, recent literature seeks to decrease opioid consumption by utilizing alternative methods of analgesia. The American Association of Nurse Anesthetists recommends the use of regional anesthesia techniques to reduce the incidence of undertreated postoperative pain that can occur from opioid-sparing methods of analgesia. This project aims to create an evidence-based analgesia guideline for adult patients undergoing cardiac surgery. Interventions will include …