Digital Commons Network^™

Enhancing Inpatient Sleep Quality In Patients On An Intermediate Care Unit Through Healthcare Staff Education: A Quality Improvement Project, Avery B. Drouin

Master's Theses and Capstones

Background

In the Intermediate Care Unit (IMCU), patients often suffer from poor sleep quality due to continuous overnight care and inherent hospital environment noise. Poor sleep can adversely affect recovery, especially for cardiac patients, who constitute a significant portion of the IMCU population. Improving sleep quality in these patients is essential for their recovery and overall well-being.

Local Problem

Despite the importance of adequate sleep, only 47% of patients in the hospital that houses the microsystem reported a quiet environment at night using the Hospital Compare online survey platform. Disruptions from alarms, phones, and care activities significantly impact sleep quality, …

Annual Reports Of The Town Of Seabrook, New Hampshire For Year Ending December 31, 2023 As Compiled By Town Officers., Seabrook Town Representatives

Seabrook, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

2023 Annual Report Of The Officers, Town Of Orange, New Hampshire., Orange Town Representatives

Orange, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

Annual Reports Of The Selectboard And Other Town Officers, Charlestown, N.H., For The Year Ending December 31, 2023., Charlestown Town Representatives

Charlestown, NH Annual Reports

This is an annual report containing vital statistics for a town/city in the state of New Hampshire.

Comm-Entary 2024 Author And Board Member Brochure

Comm-entary

No abstract provided.

Long Covid And Political Party, Renee Franzini

Comm-entary

The essay discusses how the two major US political parties use presence and framing to represent long covid, as well as if these representations differ over time. Through this, we can more easily see the similarities and differences between representations of the condition.

Burning Issues: An Analysis Of Penguin Random House's ‘The Unburnable Book' Campaign, Jacqueline Law

Comm-entary

This essay delves into the intricacies of a public relations endeavor launched by Penguin Random House LLC in collaboration with renowned author Margaret Atwood. The campaign, known as “The Unburnable Book,” aimed to spotlight the rising prevalence of book banning and censorship in America while supporting PEN America's mission to safeguard free speech. Through the creation and auction of a fireproof edition of Atwood’s iconic novel “The Handmaid’s Tale,” Penguin Random House supported its own corporate social responsibility initiatives as well as its mission and values. This analysis provides a comprehensive examination of the campaign's conception, execution, and impact, shedding …

Savoring Memories: The Impact Of Ryan Vansylvong's Legacy On Sonny's Tavern And Its Publics, Ella Cox

Comm-entary

This essay explores the life and passing of Ryan Vansylvong, a dedicated chef at Sonny's Tavern in Dover, New Hampshire, whose untimely passing has dramatically influenced the restaurant's ethos and patrons. The narrative intertwines authentic anecdotes, tributes, and expressions of grief to inspire communal resilience and empathy, nurturing a culture that resonates with staff and customers. This paper analyzes how disseminating memories and stories can lead to the convergence of fact and fiction. Using fictional elements can make conveying factual information more compelling and relatable, enhancing audience engagement. The profound impact of Ryan's legacy is a testament to the power …

Highly Significant Detection Of X-Ray Polarization From The Brightest Accreting Neutron Star Sco X-1, Fabio La Monaca, Alessandro Di Marco, Juri Poutanen, Matteo Bachetti, Sara Elisa Motta, Alessandro Papitto, Maura Pilia, Fei Xie, Stefano Bianchi, Anna Bobrikova, Enrico Costa, Wei Deng, Ming-Yu Ge, Giulia Illiano, Shu-Mei Jia, Henric Krawczynski, Eleonora Veronica Lai, Kuan Liu, Guglielmo Mastroserio, Fabio Muleri, John Rankin, Paolo Soffitta, Alexandra Veledina, Filippo Ambrosino, Melania Del Santo

Faculty Publications

The Imaging X-ray Polarimetry Explorer measured with high significance the X-ray polarization of the brightest Z-source, Sco X-1, resulting in the nominal 2–8 keV energy band in a polarization degree of 1.0% ± 0.2% and a polarization angle of 8° ± 6° at a 90% confidence level. This observation was strictly simultaneous with observations performed by NICER, NuSTAR, and Insight-HXMT, which allowed for a precise characterization of its broadband spectrum from soft to hard X-rays. The source has been observed mainly in its soft state, with short periods of flaring. We also observed low-frequency quasiperiodic oscillations. From a spectropolarimetric analysis, …

On The Role Of Alfvénic Fluctuations As Mediators Of Coherence Within Interplanetary Coronal Mass Ejections: Investigation Of Multi-Spacecraft Measurements At 1 Au, Camilla Scolini, Noé Lugaz, Réka M. Winslow, Charles J. Farrugia, Norbert Magyar, Fabio Bacchini

Faculty Publications

Interplanetary coronal mass ejections (ICMEs) are defined as “coherent” if they are capable of responding to external perturbations in a collective manner. This implies that information must be able to propagate across ICME structures, and if this is not the case, single-point in situ measurements cannot be considered as indicative of global ICME properties. Here, we investigate the role of Alfvénic fluctuations (AFs) as mediators of ICME coherence. We consider multipoint magnetic field and plasma measurements of 10 ICMEs observed by the ACE and Wind spacecraft at 1 au at longitudinal separations of 0.5°–0.7°. For each event, we analyze the …

Asynchronous Movement Patterns Between Breeding And Stopover Locations In A Long-Distance Migratory Songbird, Theodore Zenzal, Andrea Contina, Hannah Vander Zanden, Leanne Kuwahara, Daniel Allen, Kristen Covino

Faculty Publications

The species-specific migratory patterns and strategies of many songbirds remain unknown or understudied, as research in animal ecology is biased toward the breeding period, with the fewest studies on the migratory period across taxa. Identifying large-scale spatiotemporal migratory patterns is challenging, as individuals within a species may vary in their migratory behavior and strategies. The Yellow Warbler (Setophaga petechia) is a Nearctic-Neotropical migrant that is relatively well studied during the breeding season, but its species-wide migratory patterns remain understudied. Our aim in studying Yellow Warbler movement ecology was to characterize temporal migration patterns during fall migration. We sought to determine …

Highly Significant Detection Of X-Ray Polarization From The Brightest Accreting Neutron Star Sco X-1, Fabio La Monaca, Alessandro Di Marco, Juri Poutanen, Matteo Bachetti, Sara Elisa Motta, Alessandro Papitto, Maura Pilia, Fei Xie, Stefano Bianchi, Anna Bobrikova, Enrico Costa, Wei Deng, Ming-Yu Ge, Giulia Illiano, Shu-Mei Jia, Henric Krawczynski, Eleonora Veronica Lai, Kuan Liu, Guglielmo Mastroserio, Fabio Muleri, John Rankin, Paolo Soffitta, Alexandra Veledina, Filippo Ambrosino, Melania Del Santo

Faculty Publications

The Imaging X-ray Polarimetry Explorer measured with high significance the X-ray polarization of the brightest Z-source, Sco X-1, resulting in the nominal 2–8 keV energy band in a polarization degree of 1.0% ± 0.2% and a polarization angle of 8° ± 6° at a 90% confidence level. This observation was strictly simultaneous with observations performed by NICER, NuSTAR, and Insight-HXMT, which allowed for a precise characterization of its broadband spectrum from soft to hard X-rays. The source has been observed mainly in its soft state, with short periods of flaring. We also observed low-frequency quasiperiodic oscillations. From a spectropolarimetric analysis, …

Uas-Based Detection And Quantification Of Pavement Roughness And Vertical Deviations Due To Frost Heave, Farah Zaremotekhases

Doctoral Dissertations

This research leverages Unpiloted Aerial Systems (UAS) equipped with advanced sensing technologies—optical imaging and Light Detection and Ranging (LiDAR)—to accurately detect and measure pavement frost heaves, which cause significant structural damage and surface roughness, particularly in cold climate regions. The use of UAS platforms is driven by the need to provide measurements over large areas and to offer high-precision, accessible, and efficient data collection methods capable of operating in challenging and difficult-to-access regions. Furthermore, UAS technology enhances safety and saves time and labor, enabling quicker, and safer assessments with minimal disruption. Experiments were conducted on both simulated and actual pavements …

Three Essays On The Economics Of Sustainable Consumer Choices, Muhammad Jawad Khan

Doctoral Dissertations

This dissertation examines consumer preferences and willingness to pay (WTP) within key sustainability contexts, focusing on the remediation of forever chemicals (PFAS) in municipal water systems, forest diversification for climate-resilient maple syrup production, and reduced ecological footprints in farming. The first chapter highlights factors influencing public support for a municipal water filtration system. A contingent valuation survey was conducted in September 2021 among the New England households to estimate their WTP for PFAS filtration in municipal drinking water systems. Health factors are primary: those concerned about water quality show a higher WTP. Income, water expenditures, and filtration status at home …

Connecting Conservation: Modeling And Socializing Climate Connectivity For Land Conservation, Melissa M. Clark

Doctoral Dissertations

As the climate changes, species must either adapt, relocate, or face extinction. This pressing reality underscores the importance of promoting climate connectivity, which ensures that habitats and landscapes remain interconnected, allowing species to move and adapt as climate conditions shift. Given the challenges posed by ongoing climate change, it is crucial that land conservation decisions incorporate climate connectivity. Conservation goals should be informed by the latest connectivity models and be practical for implementation by on-the-ground practitioners. This dissertation aims to bridge the gap between these two critical needs, which are not always well-integrated in conservation work. Modeling connectivity in a …

Who Is "Women's Health" For? Lgbtq+ Inclusion In Sexual And Reproductive Health Care, Evan Thomas England

Doctoral Dissertations

Throughout modern Western history, access to fully affirming and supportive sexual and reproductive health care (SRH) has been denied to most women and sexual and gender minorities. Also, as demonstrated by the ubiquity of the term “women’s health,” SRH often reflects a cisgender heterosexual (cishet) women-centered approach, alienating transgender, non-binary, gender nonconforming, and sexual minority individuals who are not cishet women but are in equal need of the same life-saving screenings, treatments, and counseling services. Due to the operationalization and reproduction of gendered ideologies and unequal social hierarchies within SRH, inadequate access to quality sexual health education for youth, and …

Olli Spring 2024 Catalog, Toniann Leavitt

Osher Lifelong Learning Institute

No abstract provided.

Neurodiversity In Workplace, Jacqueline L. Zindell

M.S. in Leadership

This research paper explores the intricate relationships between neurodiverse and neurotypical individuals within the workplace. Through an exploration of the literature, the research focuses on the specific challenges faced by neurodiverse individuals, including those with conditions such as autism, attention-deficit/hyperactivity disorder (ADHD), and dyslexia. The topic of neurodiversity will provide support to leaders in navigating interactions with neurodiverse individuals and fostering inclusivity in the workplace. This research serves as a foundational step towards creating a toolbox for the workplace. A survey was conducted using Survey Monkey to gauge respondents' familiarity with the concept of Neurodiversity and to identify effective strategies …

The Multidisciplinary Approach To The Development Of Quality Clinical Practice Guidelines: Piloting Management Of The Patient Requiring Inhaled Nitric Oxide For Acute Pulmonary Hypertension In The Neonatal Intensive Care Unit, Amanda Koennecke

DNP Scholarly Projects

BACKGROUND: Clinical practice guidelines communicate recommendations to health care professionals. Poor quality guidelines decrease compliance, foster differences in practice, discordance with resources, and compound inequity in healthcare. The goal of this project was to develop a clinical practice guideline and chronicle the process. The intervention implemented was the creation of a clinical practice guideline with a family integrated and equity endorsing approach.

METHODS: A multidisciplinary team was formed and worked collaboratively to write a clinical practice guideline for inhaled nitric oxide for the management of acute pulmonary hypertension in neonates. The guideline was evaluated using the AGREE II instrument and …

Reducing Wait Times In The Medical Clinic Of The Homeless Intake Center: A Quality Improvement Project, Otuodichinma Christy Nwankpa, Otuodichinma Christy Nwankpa

DNP Scholarly Projects

Background: Homelessness in the U.S. is a critical issue, with New York City experiencing significant challenges due to an increasing number of families requiring shelter. The Department of Homeless Services (DHS-NYC) faces operational inefficiencies, particularly in the medical clinic at the intake center, leading to prolonged wait times.

Local Problem: Families with children experience long wait times in the DHS-NYC medical clinic, which impacts their overall health and well-being. Reducing these wait times is essential for improving service delivery and families satisfaction.

Purpose:

This quality improvement project aims to reduce wait times for families with children at the medical clinic …

Reducing Burnout And Enhancing Resilience Of Psychiatric Nurses Through Self-Care Practices., Bosede Akilo

DNP Scholarly Projects

ABSTRACT

Background: Burnout is a pervasive issue among healthcare workers, particularly mental health nurses (MHNs), leading to emotional exhaustion, depersonalization, and decreased job satisfaction. Burnout is responsible for a high turnover in MHNs, low motivation, and medical errors which is the third leading cause of death, due to the stressors within the work environment. Mental health settings are marked with huge emotional challenges that lead to the characteristic burnout presentations exhibited by the staff. The local problem being addressed is that MHNs face significant stressors, including high workloads, aggressive patient interactions, and lack of support, which contribute to burnout. The …

The Impact Of Multidisciplinary Just-In-Time Training On Confidence In The Delivery Of Care In The Humanitarian And Disaster Response Environment, Jennifer Verstreken

DNP Scholarly Projects

Background: Team Rubicon International deploys emergency medical teams with little targeted training on the health and illness patterns common to the geographic region and the type of disasters to which they respond, such as cholera, malaria, and malnutrition. These high-risk, low-incidence illnesses are infrequently seen in Western medical practices. Medical, nursing, and paramedical training programs address these illness patterns in the curriculum. Still, a lack of consistent exposure to the care and treatment of patients with these illnesses can lead to a lack of knowledge and confidence in delivering appropriate care.

Purpose: This quality improvement project aimed to determine if …

Enhanced Neuroprotection And Neuropromotion In Extremely Premature Infants Through Mindful Hands-On Care And Increased Family Involvement, Kristen Sergott

DNP Scholarly Projects

Background: Medical breakthroughs including antenatal corticosteroids and exogenous surfactants have improved survival in extremely premature and extremely low birth weight (EP-ELBW) infants. Currently, babies as young as 22 weeks’ gestation are being actively resuscitated and provided with intensive care in neonatal intensive care units (NICUs) around the world. As a consequence of premature delivery, fragile and immature newborns are at risk for significant morbidities affecting their multiple organ systems. Additionally, such infants encounter neurodevelopmental trauma induced by recurrent stressful experiences ubiquitous to the NICU. Postnatal stress contributes to alterations in the hypothalamic-pituitary-adrenal (HPA) axis and is associated with alterations in …

Tbp1: An Essential Regulator Of Transcription In Toxoplasma Gondii, Robert Kelly

Master's Theses and Capstones

Transcription is well-conserved across eukaryotes, lending itself to countless studies in model organisms. Still, some early-diverging eukaryotes, such as Apicomplexans, continue to deviate from canonical gene expression. One such Apicomplexan is the single-celled parasite, Toxoplasma gondii. Toxoplasma maintains many elements of conventional eukaryotic transcription but demonstrates a relatively short 8-hour replication time. This suggests that transcription is tightly regulated in these parasites, consistent with their ability to differentiate between life stages per the demand of the host environment. Transcription initiation has, however, remained elusive in Toxoplasma. The formation of a preinitiation complex (PIC) has not been characterized as the parasites …

On The Role Of Alfvénic Fluctuations As Mediators Of Coherence Within Interplanetary Coronal Mass Ejections: Investigation Of Multi-Spacecraft Measurements At 1 Au, Camilla Scolini, Noé Lugaz, Réka M. Winslow, Charles J. Farrugia, Norbert Magyar, Fabio Bacchini

Faculty Publications

Interplanetary coronal mass ejections (ICMEs) are defined as “coherent” if they are capable of responding to external perturbations in a collective manner. This implies that information must be able to propagate across ICME structures, and if this is not the case, single-point in situ measurements cannot be considered as indicative of global ICME properties. Here, we investigate the role of Alfvénic fluctuations (AFs) as mediators of ICME coherence. We consider multipoint magnetic field and plasma measurements of 10 ICMEs observed by the ACE and Wind spacecraft at 1 au at longitudinal separations of 0.5°–0.7°. For each event, we analyze the …

X-Ray Polarized View Of The Accretion Geometry In The X-Ray Binary Circinus X-1, John Rankin, Fabio La Monaca, Alessandro Di Marco, Juri Poutanen, Anna Bobrikova, Vadim Kravtsov, Fabio Muleri, Maura Pilia, Alexandra Veledina, Rob Fender, Philip Kaaret, Dawoon E. Kim, Andrea Marinucci, Herman L. Marshall, Alessandro Papitto, Allyn F. Tennant, Sergey S. Tsygankov, Martin C. Weisskopf, Kinwah Wu, Silvia Zane, Filippo Ambrosino, Ruben Farinelli, Andrea Gnarini, Iván Agudo, Lucio A. Antonelli

Faculty Publications

Cir X-1 is a neutron star X-ray binary characterized by strong variations in flux during its eccentric ∼16.6 day orbit. There are also strong variations in the spectral state, and it has historically shown both atoll and Z state properties. We observed the source with the Imaging X-ray Polarimetry Explorer during two orbital segments, 6 days apart, for a total of 263 ks. We find an X-ray polarization degree in these segments of 1.6% ± 0.3% and 1.4% ± 0.3% at polarization angles of 37° ± 5° and −12° ± 7°, respectively. Thus, we observed a rotation of the polarization …

The Intersection Of Gender, Caregiving, And Research Productivity During The Covid-19 Pandemic: A Multi-Method Study, Elizabeth A. Moschella-Smith, Sharyn J. Potter

Faculty Publications

The COVID-19 pandemic differentially impacted the productivity of women researchers with children compared to men, with and without children. The purpose of the present study was to examine the relationship between gender, caregiving responsibilities, and research productivity before and during the pandemic. We quantitatively and qualitatively analyzed survey (n=227) and follow-up interview data (n=44) collected from faculty and staff at a Carnegie Classification Research 1 public university. Findings suggest that women researchers with children faced increased caregiving demands and diminished research productivity during the pandemic, compared to men with children and researchers without children. As illustrated by the qualitative data, …

X-Ray Polarization Of The Eastern Lobe Of Ss 433, Philip Kaaret, Riccardo Ferrazzoli, Stefano Silvestri, Michela Negro, Alberto Manfreda, Kinwah Wu, Enrico Costa, Paolo Soffitta, Samar Safi-Harb, Juri Poutanen, Alexandra Veledina, Alessandro Di Marco, Patrick Slane, Stefano Bianchi, Adam Ingram, Roger W. Romani, Nicolò Cibrario, Brydyn Mac Intyre, Romana Mikus̆Incová, Ajay Ratheesh, James F. Steiner, Jiri Svoboda, Stefano Tugliani, Iván Agudo, Lucio A. Antonelli

Faculty Publications

How astrophysical systems translate the kinetic energy of bulk motion into the acceleration of particles to very high energies is a pressing question. SS 433 is a microquasar that emits TeV γ-rays indicating the presence of high-energy particles. A region of hard X-ray emission in the eastern lobe of SS 433 was recently identified as an acceleration site. We observed this region with the Imaging X-ray Polarimetry Explorer and measured a polarization degree in the range 38%–77%. The high polarization degree indicates the magnetic field has a well-ordered component if the X-rays are due to synchrotron emission. The polarization angle …

Increasing Pediatric Vaccination Rates Through Parental Education At A Federally Qualified Community Health Center: An Evidence-Based Quality Improvement Project, Dayna Dicola

Master's Theses and Capstones

Background: Childhood immunization rates for children aged 2 years and under at a community health center were assessed and determined to be below optimal levels. Immunizations protect against preventable diseases (Hill, 2023). The project assessed the microsystem to understand low immunization rates and to guide strategies for improvement.

Methods: The Plan-Do-Study-Act (PDSA) model was used. In the planning phase, key stakeholders were consulted to assess current rates and barriers contributing to immunization rates. The chosen intervention was placed simplified immunization schedules in pediatric exam rooms to educate parents and promote adherence.

Intervention: A visual guide detailing the recommended vaccination schedule …

A Quality Improvement Initiative To Redefine The Process Of Instrument Decontamination From The Surgical Field In The Operating Room To The Sterile Processing Department., Nicole Dannett Denton

Master's Theses and Capstones

Background: The Operating Room (OR) faces a significant challenge with the increasing presence of bioburdens on instruments. Research-based on evidence has demonstrated the critical role of precleaning at the point of care with sterile water in reducing bioburden incidence. While current practices recommend the use of an enzymatic solution post-procedure to spray instruments, it is clear that a more comprehensive approach is needed to effectively manage bioburdens and reduce the risk of Surgical Site Infections (SSI).

Methods: Utilizing the Plan-Do-Study-Act (PDSA) model to create a Quality Improvement (QI) solution, the project leader recommended using sterile water at the point of …