Digital Commons Network^™

Environmentally Conscientious Orchards Connection, William Mp Burgess, Michael Iwata, Sarah Schomp, Andrew Wooldridge

Student Showcase

California’s almond industry uses over 1.2 trillion gallons of freshwater annually, more water than is used by almost any other crop. Although California is in a severe drought, its almond industry is expanding because the crop is a valuable commodity, providing California with more than $11 billion to its gross state product each year. While almond production is inherently water intensive, current agricultural processes in the San Joaquin Valley waste almost 50% of the freshwater it uses each year from over-watering, runoff ₆ , evaporation, and contamination ₃₅.

Much of this waste can be eliminated if various California stakeholders …

The Effects Of Increasing The Minimum Wage On Prices: Analyzing The Incidence Of Policy Design And Context, Daniel Macdonald

PERI Working Papers

We analyze the price pass-through effect of the minimum wage and use the results to provide insight into the competitive structure of low-wage labor markets. Using monthly price series, we find that the pass-through effect is entirely concentrated on the month that the minimum wage change goes into effect, and is much smaller than what the canonical literature has found. We then discuss why our results differ from that literature, noting the impact of series interpolation in generating most of the previous results. We then use the variation in the size of the minimum wage change to evaluate the competitive …

Associations Between The Patient-Centered Medical Home And Preventive Care And Healthcare Quality For Non-Elderly Adults With Mental Illness: A Surveillance Study Analysis, Jennifer J. Bowdoin, Rosa Rodriguez-Monguio, Elaine Puleo, David Keller, Joan Roche

Health Promotion and Policy Faculty Publication Series

Background

Patient-centered medical homes (PCMHs) may improve outcomes for non-elderly adults with mental illness, but the extent to which PCMHs are associated with preventive care and healthcare quality for this population is largely unknown. Our study addresses this gap by assessing the associations between receipt of care consistent with the PCMH and preventive care and healthcare quality for non-elderly adults with mental illness.

Methods

This surveillance study used self-reported data for 6,908 non-elderly adults with mental illness participating in the 2007–2012 Medical Expenditure Panel Survey. Preventive care and healthcare quality measures included: participant rating of all healthcare; cervical, breast, and …

Fair Allocation Of Disputed Properties, Biung-Ghi Ju, Juan D. Moreno-Ternero

Economics Department Working Paper Series

We model problems of allocating disputed properties as generalized exchange economies. Therein, agents have preferences and claims over multiple goods, and the social endowment of each good may not be sufficient to satisfy all individual claims. We focus on market-based allocation rules that impose a two-step procedure: assignment of rights based on claims first, and voluntary exchange based on the assigned rights afterwards. We characterize three focal egalitarian rights-assignment rules that guarantee that the allocation rules are fair. We apply our results to problems of greenhouse gas emissions and contested water rights.

Momentum Building: Progress Towards A National Oer Movement, Nicole Allen, Steven J. Bell, Marilyn S. Billings

University Libraries Publication Series

In this update to our original article on Open Educational Resources published in November 2014, we share those most recent developments, which to our way of thinking, generate high enthusiasm for even greater progress towards higher education's transition to a culture of openness.

Breast Milk Stem Cells: Current Science And Implications For Preterm Infants, Carrie-Ellen Briere, Jacqueline M. Mcgrath, Todd Jensen, Adam Matson, Christine Finck

Elaine Marieb College of Nursing Faculty Publication Series

Background: The benefits of breast milk are well described, yet the mechanistic details related to how breast milk protects against acute and chronic diseases and optimizes neurodevelopment remain largely unknown. Recently, breast milk was found to contain stem cells that are thought to be involved in infant development.

Purpose: The purpose of this review was to synthesize all available research involving the characterization of breast milk stem cells to provide a basis of understanding for what is known and what still needs further exploration.

Methods/Search Strategy: The literature search was conducted between August and October 2015 using the CINAHL, PubMed, …

Management Of Adolescent Depression In The Primary Care Setting: An Educational Program For Providers, Kelly Clow

Doctor of Nursing Practice (DNP) Projects

Background: The prevalence of adolescent depression is estimated at 15-20% in the general population and often under-treated. The primary care provider is in a prime position to identify and treat depression in this age group. However, many providers feel uncomfortable with treating and managing depression in adolescents, due to a lack of education or experience. Purpose: The focus of this quality improvement project was to educate primary care providers on the current recommendations for the management of adolescent depression and provide an education sheet for both the medical and non-medical treatment of adolescent depression. An educational intervention was presented to …

Implementing The Step It Up Walking Program For Hospital Nurses To Increase Physical Movement, Molly Persby

Doctor of Nursing Practice (DNP) Projects

Nurses are at risk for obesity due to shift work, long hours, abnormal eating patterns and job stress. Obesity places nurses at risk for chronic health conditions such as diabetes and coronary artery disease. The goal for this project was to translate evidence of weight loss using the Step it Up Program by launching a pedometer-based walking program for nurses. Measurement methods included pre-intervention measurements of waist and hip circumference in order to calculate waist/hip ratio, and calculate Body Mass Index using a standard BMI Calculator. Fifteen nurses from an inpatient unit of a hospital in southeastern Ohio were issued …

Implementation Barriers Of The Phq-9 In Primary Care: A Quality Improvement Project, Angela P. Miller

Doctor of Nursing Practice (DNP) Projects

Purpose: The purpose of this research translation project was to mitigate the consequences of under-recognition, and under-treatment of depression through use of an evidence-based depression-screening tool, the PHQ-9, in a primary care setting.

Methods: A plan-do-study-act model was utilized for the implementation of this initiative. An informal educational intervention about administration and interpretation of the PHQ-9 first took place at the provider level in a primary care practice. Next, a pre and post-test study design (n=12) was administered to providers, nursing, and ancillary staff. A report was shared at monthly quality meetings with representatives from each practice in the health …

Obesity Group Medical Visits, Brenda L. Jaeger

Doctor of Nursing Practice (DNP) Projects

Background: Obesity is a major risk factor associated with multiple chronic diseases, presenting a significant global health challenge. Current evidence supports that group medical visits, an alternative format for the provision of primary care, are effective in disease management.

Purpose: The goal of this project was to examine the effectiveness of group medical visits for the management of obesity in primary care.

Methods: Individuals with a BMI greater than 30 participated in a series of six multidisciplinary group medical visits over a 12-week period. Each session included a brief individual medical visit followed by group education and discussion. Topics …

Higher Fat Low Carbohydrate Diet To Improve Health Related Quality Of Life For Overweight Or Obese Diabetics In A Primary Care Clinic, Breck Baker

Doctor of Nursing Practice (DNP) Projects

Diabetes and obesity are chronic diseases that affect individuals worldwide. The American Diabetes Association (ADA) and the American Heart Association (AHA) have developed guidelines for management of diabetes and obesity. The DNP student examined the use of the Higher Fat Low Carbohydrate (HFLC) diet, which conflicts with these frequently used guidelines. The literature on a HFLC diet suggests positive effects for type 2 diabetics, including weight loss, improved HA1c, lower BMI and no detrimental impact on metabolic markers such as cholesterol, triglycerides, or low and high density lipoproteins. The purpose of this project was to provide type 2 diabetics who …

An Evaluation Of An Educational Program For Improving The Accuracy Of Ecg Interpretation In Athletes By Primary Care Clinicians, Stephen F. Segatore Jr

Doctor of Nursing Practice (DNP) Projects

Background: In order to identify athletes at risk for sudden cardiac death (SCD), comprehensive screening that includes ECG interpretation is needed. Many primary care providers, including physicians and nurse practitioners, have reservations about including electrocardiograms (ECG) in the screening process because they lack confidence in their ability to correctly identify normal variants in the ECG of an athlete.

Method: An educational program with previously validated interpretation criteria for normal variants of the athletic heart was presented to providers at a university based healthcare clinic the Northeast. A pre and post design was used to compare the accuracy of ECG …

Using A Delayed Antibiotic-Prescribing Education Intervention To Prevent Antibiotic Overuse In The Treatment Of Respiratory Tract Infections, Catherine L. Muhia

Doctor of Nursing Practice (DNP) Projects

Background: Antibiotics have been overprescribed to patients with respiratory infection in outpatient clinics in the United States. Antibiotic overuse has led to increased risk for antibiotic resistance and complications related to side effects. A review of the literature suggests that delayed antibiotic prescribing is an effective intervention that can be used to prevent antibiotic overuse. Delayed antibiotic prescribing is an evidence-based strategy where a patient is either issued with an antibiotic prescription and advised to delay filling it or to pick it up at an agreed location only if symptoms persist beyond the expected natural history of illness or deteriorate. …

Motivational Interviewing For Smoking Cessation In Primary Care, Kara E. Pool-Krok-Horton

Doctor of Nursing Practice (DNP) Projects

Smoking is hazardous to human health and continues to be devastating to a patient’s physical health as well as to the entirety of the health care system. Smoking is both a public and personal health concern. The overall prevalence of tobacco dependence has decreased since smoking became a known health hazard, but it remains high in the general population as well as for the patients utilizing primary care in Rutland, Vermont. Nurse practitioners are holistic practitioners and are well suited to assist patients to change unhealthy behaviors. Behavior change, especially smoking cessation, is particularly difficult for patients. Motivational interviewing is …

Improving Adherence To Antihypertensive Medications Among Somali Patients In A Primary Care Clinic, Nimo S. Abdi

Doctor of Nursing Practice (DNP) Projects

Purpose: To evaluate if the use of an evidenced-based educational program delivered to adult Somali hypertensive participants at a community-based clinic in Minneapolis can improve their adherence to antihypertensive medications and blood pressure control. Methods: A convenient sample of 10 participants who met the inclusion criterion consented to take part of the educational program. The Hill-Bone Compliance to High Blood Pressure Therapy Scale was utilized to measure outcomes of the program. In addition to that, each participant’s blood pressure was checked at pre and post intervention. Results: The statistical test of paired t-test was used to analyze data. The pre …

Educational Intervention For Identification Of Metabolic Syndrome (Icd-10 E88.81): Presentation Of A Toolkit For Providers And Staff In Two Primary Care Settings, Sadie Russell

Doctor of Nursing Practice (DNP) Projects

Metabolic syndrome plays a vital role in present-day primary care. The ICD-10 diagnostic coding for this set of symptoms more comprehensively identifies patients with increased risk of cardiovascular events and comorbidities. Metabolic syndrome affects one-third of adults in the US and is defined as the presence of three of the following characteristics: abdominal obesity, hypertension, elevated triglycerides, low high-density lipoprotein, and elevated fasting plasma glucose. Proper screening for metabolic syndrome can identify complex patients before conditions like hypertension or type II diabetes develop. Management of metabolic syndrome emphasizes prevention and prioritizes lifestyle modifications as first-line treatment. Despite strong evidence supporting …

Improving The Detection And Management Of Hypertension In Adults In The Primary Care Setting: A Quality Improvement Project Based On The Chronic Care Model Using Blood Pressure Monitoring And Clinical Practice Guidelines, Michelle A. Cutler

Doctor of Nursing Practice (DNP) Projects

Background: Hypertension (HTN) is a common, costly, and deadly disease that is often under recognized, under diagnosed, and undertreated in the primary care setting. Despite the presence of effective treatment strategies, uncontrolled HTN remains a persistent problem.

Purpose: The aim of this Doctor of Nursing Practice (DNP) project was to improve the quality of HTN care delivered to adults in a primary care practice. Goals were targeted to decrease providers’ clinical inertia by improving their ability to make better diagnosis and treatment decisions after reviewing more comprehensive objective data.

Methods: Using the Chronic Care Model in an independent primary care …

Improving Hpv Vaccination Initiation And Completion Rates: A Qi Project, Princy M. Varughese

Doctor of Nursing Practice (DNP) Projects

Human papillomavirus (HPV) is a common sexually transmitted infection in the United States and is the cause of most cervical cancers in women, as well as anogenital cancers, oropharyngeal cancer, and genital warts in both men and women (Centers for Disease Control [CDC], 2014b). The HPV vaccine is recommended for preteen girls and boys to protect against HPV infections (CDC, 2011). In line with the goal of Healthy People 2020, the purpose of this evidence-based quality improvement (QI) project was to implement a text message reminder system, and calculate the completion rate of the 3-dose HPV vaccination series among adolescents …

Increasing Cultural Awareness And Competency In A Community Hospital In Northwest Minnesota, Gladys N. Nyabwari

Doctor of Nursing Practice (DNP) Projects

Background: Cultural competency is an essential component in the delivery of healthcare services in all sectors of health. Therefore, educating healthcare professionals on cultural competency requires understanding evidence-based studies, having the ability to translate these research findings to practice, and providing the resources to implement best practice in the work place. The process requires individuals to have cultural awareness and humility to be able to attain any given level of cultural competency. Purpose: To improve cultural awareness in a community hospital in Minnesota by implementing an on-going process that allows employees to both acquire knowledge and maintain their skills …