Factor Fiction? Identifying A Putative Toxoplasma Gondii Transcriptional Complex, Julia M. Paquette

Honors Theses and Capstones

Toxoplasma gondii is a highly prevalent protozoan parasite that is estimated to infect 30-50% of the global population, though there is no treatment for chronic infection and current treatments for acute infection may have serious side effects. Transcription is a tightly regulated process in T. gondii, allowing the parasite to successfully invade and replicate within host cells, and it is thus a promising avenue to study gene regulation and to investigate possible novel therapeutics. In our lab’s previous research, a TFIID-like complex was identified in T. gondii and found to be associated with the parasite specific bromodomain protein BDP3. …

Impact Of An Educational Module On Female Collegiate Athlete Knowledge Regarding The Female Athlete Triad, Cayla Marie Barretto

Honors Theses and Capstones

The Female Athlete Triad was defined in women’s sport as early as 1992, by the American College of Sports Medicine (ACSM). The guidelines regarding the Triad emphasis the importance of education in the prevention of the disorder. However, there is little research supporting if this education is occurring and if it is effective. A quantitative, quasi-experimental study was conducted at the University of New Hampshire. Twenty-five female collegiate athletes participated in a pre-test, educational intervention, and post-test to determine baseline knowledge and if there was any improvement in knowledge after education. Percent changes in scores from pre-test and post-test were …

Genomic And Physiological Bioremediation Characteristics Of The Actinobacteria Frankia, Erik Swanson

Doctoral Dissertations

Introduction: Frankia is a genus of symbiotic, nitrogen fixing actinobacteria found in the soil and root tissue of actinorhizal plants throughout the world. Both Frankia and actinorhizal plants are resistant to a wide range of environmental and chemical stresses including heavy metals, high salinity, and drought. This makes Frankia and the actinorhizal symbiosis an interesting candidate for bioremediation applications. However, the microbial community found in the actinorhizal rhizosphere and surrounding soil has been implicated in some of the symbiotic and resistance traits attributed to Frankia. This necessitates thorough investigation of the genomic and genetic components of any bioremediation traits possessed …

Three Essays In Applied Microeconomics: Spillover Effects Of Anti Discrimination And Anti Violence Policies, Gokhan Kumpas

Doctoral Dissertations

In this research, I examine the intended and unintended consequences of three highly debated policies at the state and federal level: enactment of Title IX, state anti-bullying laws, and warrantless arrest laws aimed at curbing domestic violence. My first essay examines the causal relationship between athletic participation and means-tested program participation. I use the variation in the implementation of Title IX and find that a 30 percentage-point increase in female athletic participation induced by Title IX increased program participation among 25 to 40-year-old females by 2.8 percentage-points. This effect persists across SNAP, TANF, and Medicaid recipiency. Event study analysis and …

Presentation Slides For Implementing Socially Just Climate Adaptation: A Case Study Of Boston, Massachusetts, Jeffrey T. Malloy

Doctoral Dissertations

The urgency to adapt to climate change presents important questions about who stands to benefit from these efforts. The previous two decades of scholarship devoted to social justice in climate adaptation has established an important theoretical basis to evaluate these questions. Less understood however, is how and under what conditions climate adaptation policy implementation promotes or inhibits justice for socially vulnerable populations. This work draws upon the disciplines of urban climate change governance, climate adaptation, urban planning, social justice theory, and policy implementation, to evaluate ongoing climate adaptation policy initiatives in Boston, Massachusetts. Through a case study approach, this dissertation …

Characterizing Forest Stands Using Unmanned Aerial Systems (Uas) Digital Photogrammetry: Advancements And Challenges In Monitoring Local Scale Forest Composition, Structure, And Health, Benjamin T. Fraser

Doctoral Dissertations

Present-day forests provide a wide variety of ecosystem services to the communities that rely on them. At the same time, these environments face routine and substantial disturbances that direct the need for site-specific, timely, and accurate monitoring/management (i.e., precision forestry). Unmanned Aerial Systems (UAS or UAV) and their associated technologies offer a promising tool for conducting such precision forestry. Now, even with only natural color, uncalibrated, UAS imagery, software workflows involving Structure from Motion (SfM) (i.e., digital photogrammetry) modelling and segmentation can be used to characterize the features of individual trees or forest communities. In this research, we tested the …

Implementing Socially Just Climate Adaptation: A Case Study Of Boston, Massachusetts, Jeffrey Thomas Malloy

Doctoral Dissertations

The urgency to adapt to climate change presents important questions about who stands to benefit from these efforts. The previous two decades of scholarship devoted to social justice in climate adaptation has established an important theoretical basis to evaluate these questions. Less understood however, is how and under what conditions climate adaptation policy implementation promotes or inhibits justice for socially vulnerable populations. This work draws upon the disciplines of urban climate change governance, climate adaptation, urban planning, social justice theory, and policy implementation, to evaluate ongoing climate adaptation policy initiatives in Boston, Massachusetts. Through a case study approach, this dissertation …

Unmanned Aerial Systems (Uas) As A Tool For Investigating Edge Influences In New Hampshire Forests, Heather Marie Grybas

Doctoral Dissertations

The continued decline in forest cover across New England becomes more concerning when faced with the fact that these same forests may be playing an important role in the fight against climate change. New Hampshire, in particular, is experiencing a 0.27% annual net loss in forest cover as of 2018. Increased population growth and accompanied development has resulted in the removal of forest cover and the fragmentation of once continuous forest blocks. Fragmentation can lead to further degradation of the remaining forest stands via alterations of the biotic and abiotic process at their edges. The use of unmanned aerial systems …

The Effect Of Deep-Water Multibeam Mapping Activity On The Foraging Behavior Of Cuvier’S Beaked Whales And The Marine Acoustic Environment, Hilary Suzanne Curran Kates Varghese

Doctoral Dissertations

Sound can propagate great distances underwater and is an important mode for marine life to obtain information. Human activities in the ocean such as global shipping, coastal construction, gas and oil exploration, and mapping navigation routes intentionally and unintentionally emit sound into the ocean, potentially interacting with marine life. Therefore, it is essential that the effects of anthropogenic noise on marine life and the ambient marine acoustic environment be understood. Most of the work, to date, has focused on the impact of low-frequency (<1 kHz) sources such as shipping noise, which is ubiquitous in the ocean, and mid-frequency (1-10 kHz) sources such as naval sonar, to which many marine mammals have shown to be sensitive. The effect of these sources can be as salient as a mass stranding event or as benign as an animal swimming away from a source of noise with no other effect. Less work has focused on higher frequency sources (>10 kHz), including ocean-mapping sonar systems. However, most marine mammals, namely toothed whales (odontocetes), are capable …

Preventing Violence Among Adolescents: The Many Roles Of School Personnel, Andrew Rizzo

Doctoral Dissertations

Youth violence can encompass a range of types of harmful behaviors that each have their own definitions, high prevalence rates, and litany of negative consequences for both adolescent victims and perpetrators. It includes behaviors that can be labeled based on the nature of the act itself such as physical assault, verbal harassment, relational violence, sexual violence, or cyber violence (Basile et al., 2020; Hasbrouck, 2020). One of the primary avenues of youth violence prevention is through school-based programs that often involve school personnel (Butchart et al., 2019). This dissertation contributes to the extant knowledge about school personnel’s impact on preventing …

Implementation Of An Individualized Onboarding And Training For Nurse Managers, Marcelo Castro

DNP Scholarly Projects

Abstract

BACKGROUND: The onboarding and training of nurse managers varies drastically in healthcare institutions across the US, even within the same organization. Though evidence-based studies have demonstrated that the onboarding and training process are related to employee engagement, retention, and to the achievement of positive departmental and institutional goals and outcomes, most healthcare organizations do not invest in providing an effective onboarding and training based on evidence models and frameworks. This project was conducted at a 345-bed tertiary teaching medical center in the Boston area to determine the need for instituting an effective evidence-based onboarding and training process for nurse …

Use Of A Simplified Protocol For The Prevention Of Postoperative Nausea And Vomiting In Adult Ambulatory Surgical Patients, Roger Horne

DNP Scholarly Projects

Postoperative nausea and vomiting (PONV) remains a common complication affecting surgical patients after receiving anesthesia. Prevention of PONV is important in an ambulatory surgical setting where patient access to rescue treatment is limited after discharge. A quality improvement (QI) project introduced a simplified PONV prevention strategy to decrease the incidence of PONV at a Veterans Health Administration ambulatory surgery center. A retrospective chart audit of all facility surgical patients receiving anesthesia care (n = 94), excluding ophthalmology patients, was conducted prior to COVID-19 restrictions to establish baseline PONV incidence. An evidence-based, simplified PONV prevention protocol was developed and implemented. …

Impact Of A Comprehensive Clinician Educational Program On Health Literacy And Patient Satisfaction, Jennifer Yokopenic

DNP Scholarly Projects

BACKGROUND: The Institute of Medicine has defined health literacy as “the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”. Health literacy is a significant social determinant of overall health and can be particularly challenging in the critical care environment. According to the U.S. Department of Health and Human Services, only 12% of adults have proficient health literacy, 53% have intermediate health literacy, 21% have basic health literacy ability, and 14% have below basic health literacy (AHQR.gov, 2008).

METHODS: A pre- and post-intervention survey of satisfaction with clinician communication and assessment of …

Reducing Turnaround Time From Pathology Collection To Patient Awareness In Gastroenterology Practice, Adrianna Hyams

DNP Scholarly Projects

Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.

Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project. …

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …

Implementing A Transitional Care Protocol To Reduce Psychiatric Rehospitalizations, Charles Wangui

DNP Scholarly Projects

Readmission rates in hospitals across the country are at an all-time high. Patients being
discharged from the hospital may feel fearful, especially if they are experiencing a new onset of
illness. Many patients wonder how they will deal with or manage their illness once they return
home. The goal for hospitals should be to reduce readmissions by addressing the factors that
impact readmission. Improved care coordination is one of the goals of transitional care. Patients'
functioning and quality of life increase when hospital readmissions are reduced. Readmissions
can be reduced by addressing care management before and after discharge in all …

A Patient-Facing Dashboard To Promote Shingrix™ Vaccination In A Continuing Care Retirement Community: A Quality Improvement Project, Emily S. Stewart

DNP Scholarly Projects

BACKGROUND: Shingles is considered one of the most significant vaccine-preventable diseases of older adults based on its morbidity and public health burden, which increase drastically with age. Adult vaccine awareness and promotion programs are undervalued in the U.S.; in particular, educational programs targeting older adults are needed. Older adults have increasing rates of adoption of health information technology (HIT) to seek guidance and support for their medical needs. Leveraging HIT in the form of clinical dashboards is an option for providing reliable, safe and cost-effective vaccine education to older adults at high risk of vaccine-preventable disease.

METHODS: The specific aims …

Addressing Medical Mistrust In In-Patient Psychiatric African American (Aa) Patients, Eselle Molua

DNP Scholarly Projects

Abstract

Background: Medical Mistrust (MM) is associated with patient dissatisfaction, treatment nonadherence, and poor health outcomes. In the United States, MM is prevalent in African American patients in In-Patient Psychiatric settings. Caregiver training and education on MM and cultural sensitivity can help identify mistrust and provide strategies to increase trust and reduce mistrust.

Purpose: The aim of this project was to implement an educational tool to improve caregiver awareness about knowledge of MM. By doing so, it was the goal to enhance cultural sensitivity skills and patient-centeredness in the African American population at the adult psychiatric unit in Northwest …

Implementation Of Community Health Worker Education Toolkit To Promote Compliance In Managed Care Organization, Lamonica Johnson

DNP Scholarly Projects

Community health workers provide case management and care coordination services to high-risk members enrolled in Louisiana Department of Health’s Medicaid program. Centers for Medicare and Medicaid Services require states entering contracts with managed care organizations to conduct external quality reviews by an independent External Quality Review Organization. Healthcare Effectiveness Data and Information Set are quality metrics managed by the National Committee for Quality Assurance. These metrics are reported annually and required by Louisiana Department of Health. Community health workers are required to demonstrate quality accreditation and meet state specific requirement compliance through documentation. The aim of this project was to …

Improving Employee Engagement On An Inpatient Unit: A Quality Improvement Project, Holly Mccormack

DNP Scholarly Projects

BACKGROUND: Engaged employees are paramount to the success of an organization. They are more invested in their organization and the unit on which they work. This investment in the organization results in higher patient satisfaction and safety, less staff turnover, and improved quality. According to the literature, generational differences may be necessary to consider when improving employee engagement. To successfully lead a multigenerational workforce, nurse leaders should consider these differences and incorporate them into their strategic plan for employee engagement.

METHODS: A pilot survey was conducted on a medical-surgical unit to assess a perceived lack of engagement. Subsequently, work engagement …

Post-Liquefaction Residual Strength Of Saturated And Partially Saturated Soils, Ian Douglas Gates

Master's Theses and Capstones

Post-liquefaction response and residual strength play important roles in stability assessment of liquefied ground. Considering the recent advancements in application of induced partial saturation for liquefaction mitigation, the state of knowledge in estimating the residual strength should be extended for liquefied desaturated soils. In this thesis, the residual strength response of a clean sand at different saturation levels was investigated using a Ring Shear Device (RSD). Direct air injection was used to desaturate the soil, which helped mitigating the liquefaction under cyclic loading. However, by raising the shear strain level, both saturated and partially saturated soils were liquefied followed by …

Large Scale Organizational Intervention To Improve Emergency Department Throughput In A Community Hospital, Karen Elliott

DNP Scholarly Projects

Abstract

BACKGROUND: Emergency Department boarding is a well-documented systemic problem across the country. ED-2b, the time from decision to admit a patient to Emergency Department departure, is specified by the Joint Commission as a quality measure for Emergency Department boarding. ED-2b metrics have been a longstanding challenge at this community hospital outside the nation’s capital. The aim of this study was to reduce median ED-2b times by 10% compared to fiscal year 2020 (FY20). To accomplish the reduction in time, a multidisciplinary throughput committee was developed with subsequent action plans designed to improve Emergency Department throughput.

METHODS: The Plan Do …

Improving Emr Usability And Clinical Efficiency Using An Immunization Tool For School Nurses In A Primary School Setting, Cathy Loiselle

DNP Scholarly Projects

BACKGROUND: School nursing has a foundation in population health and an essential role within the community, which needs to be structured by the developing field of health informatics in order to compete and communicate with all stakeholders. This quality improvement project specific aim was to improve the electronic medical record (EMR) usability and clinical efficiency.

METHODS: A school district with three elementary, one high and one middle school was chosen, using the school information system (SIS)/EMR currently in place at each school health office. The school health staff participating in this project included 5 registered nurses and 5 clinic assistants. …

Impact Of Audit And Feedback On Timing Variation In The Point Of Care Glucose Collection-Insulin Administration Workflow: A Quality Improvement Study, Paula S. Hudon

DNP Scholarly Projects

BACKGROUND: Multiple roles contribute to the point of care glucose collection and insulin administration workflow. Diabetes care associations and safety advocates provide recommendations since the time-action profile of prandial insulin requires knowledge and performance to deliver insulin safely.

PROBLEM: Variation of practice in relation to the time that point of care glucose was collected and meal and insulin administration assessments were completed failed to meet parameters.

PURPOSE: A quality improvement project aimed to test the effect audit and feedback has on rapid acting insulin administration and point of care glucose collection practice at meals.

METHOD: Audit and feedback, a knowledge …

Improving Employee Mental Health: Addressing Depression At The Workplace, Gerald G. Chia Dr.

DNP Scholarly Projects

Abstract Background: Depression is a serious mental health challenge in the US. As frontline workers who are responsible for taking care of a myriad of patients daily, health workers are usually exposed to depressive situations which eventually results in them developing the mental health condition. The purpose of the current project was, therefore, to develop an intervention which helps to improve employee mental health in healthcare settings with focus on depression and examine workplace factors which influence depression among employees of the Outpatient Mental Health Clinic in Washington District of Columbia. Methods: A pre-intervention survey was conducted among 43 employees. …

Improving The Diagnosis Of Major Depression In A Primary Care Practice Using The Patient Health-9 Questionnaire, Chukwudi C. Orji

DNP Scholarly Projects

Abstract

Background: Major depression is a serious health problem that affects both children and adults. It is a leading cause of disability worldwide. Most cases of major depression are treated in primary care settings. Many cases of major depression presenting in primary care are missed. Many PCPs do not routinely use screening tools. The aim of this project is to improve the diagnosis of major depression in adults in a primary care practice through routine use of the Patient Health Questionnaire-9 (PHQ-9) during initial encounter with patients and during follow-up visit for patients who are receiving treatment for depression to …

Improving Care Transitions For Individuals With Suicide Risk After Discharged From Acute Unit, Maureen Ndu

DNP Scholarly Projects

Background: Suicide is a public health problem and the 10th leading cause of death in the US. Suicide accounted for more than 47,5000 deaths in the US in 2017, translating to about 130 suicide deaths each day. An average of 20 veterans commits suicide each day compared to 93 suicides in the general population in the US. Individuals with suicide risks are 300 times at an increased rate of suicide death in the first week and 200 times in the first month of hospital discharge. Nurses are in a strategic position to improve the care transition of individuals with suicide …

A Comparison Of Health Habits Between Nursing And Non Nursing Majors, Reilly K. Gilmour

Honors Theses and Capstones

No abstract provided.

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

“We Do Not Believe Him To Be Sick… But Completely Worthless:” Victorian Character, Self-Mastery, And Pension Outcomes For Disabled Union Veterans, Matthew L. Castagna

Honors Theses and Capstones

No abstract provided.