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Essays On The Economics Of Vaccination, Andrew Evans Whitaker

Doctoral Dissertations

I examine vaccination behavior during a measles outbreak. By abandoning the rationalexpectations framework, I develop a model of vaccine behavior which recreates empirically observed vaccine hesitancy, as well as vaccination spikes during an outbreak. I use an agent-based model to simulate disease spread and agent behavior in a measles outbreak, in which rational agents minimize their expected costs by choosing their vaccination state. I allow some agents to instead use a heuristic, and others to have misinformation regarding vaccine risks, and finds that both reduce welfare. Including a social network has an ambiguous effect, as using more relevant local data …

Using Machine Learning Techniques On Real-World Data To Understand The Characteristics Of The Manchester, Nh Health Care For The Homeless Patient Population For Risk Factor Identification And Intervention Improvement, Kyle Partridge Rasku

Master's Theses and Capstones

This thesis aims to use health care domain knowledge, statistical techniques, and machine learning methods to conduct an exploratory real-world evidence study of the characteristics of the Health Care for the Homeless of Manchester, NH (HCHM) clinics’ patients in collaboration with academic and clinic partners and the public and community health stakeholders supporting their work. By constructing and analyzing a multivariate feature set created from a sample of anonymized patient data from January 1, 2018, through December 31, 2019, I hope to use machine learning methods to accurately represent 2,265 HCHM clinic patients experiencing homelessness or housing insecurity during the …

Building Awareness Around The New American Community In Concord N.H., Heather Mckinnon

M.S. in Leadership

The purpose of this Capstone is to create an opportunity to explore resettlement. The research seeks to understand the resettlement process in the context of exploring immigration in the United States Research will focus on Concord, N.H. This project was chosen as a result of my experiences working with the New American population as a home visitor and home-based manager for the Early Head Start program in Concord, N.H. Depending on demographic statistics, publications, and case studies, this data is both quantitative and qualitative in nature. The findings indicate that in order to advocate for new American populations, the community …

Motivation In Healthcare Personnel, Jessica Horton

M.S. in Leadership

The purpose of this research is to provide an overview of the unique individual motivating factors that play a role in healthcare personnel’s job satisfaction, engagement as well as explore the leading causes of burnout. Prior to the Covid-19 pandemic and presently, healthcare workers nationally and internationally, have been experiencing burnout. Determining what factors motivate and demotivate employees is equally critical in ensuring that these skilled healthcare individuals continue to provide high quality, effective, and productive healthcare services especially during a global pandemic. In this paper motivational theories are explained, evaluated, and explored. Both qualitative and quantitative research methods from …

Implementing A Health-Related Quality Of Life Assessment Tool In An Outpatient Hematology/Oncology Clinic: A Pilot Quality Improvement Project, Jennifer Holl

DNP Scholarly Projects

BACKGROUND: Although overall and disease-free survival remain the goals of cancer care, health-related quality of life (HRQOL) during and after treatment is increasingly acknowledged as vital to the patient’s outcomes. The purpose of this project was to identify and implement a valid, reliable HRQOL assessment tool into daily clinical practice in an outpatient hematology/oncology clinic at a 25-bed critical access hospital in rural New Hampshire.

METHODS: This project used a methodological design. Descriptive and inferential statistics, plus qualitative analysis were used to determine results. Three nurses and seven patients participated in this quality improvement project.

INTERVENTIONS: The interventions …

Increasing Awareness Of Personal Harm Reduction Interventions In The Clinical Setting: A Quality Improvement Project, Shawn Theberge

DNP Scholarly Projects

Abstract

The ever-rising concern for safety in the healthcare setting has become increasingly prevalent and levels of hostility and violence more publicly visible. Over the last decade both patients and clinicians have been targeted in healthcare facilities at record levels. These incidents have created an environment of not only risk but increased anxiety and feelings of uncertainty for most clinical personnel. The study will initially measure clinician’s viewpoint of the clinical setting that they work in; and over the span of the project, track and evaluate the effects of the interventions on clinicians’ overall feelings and perceptions. The expected outcome …

Implementation Of A Standardized Suicide Risk Screening Tool: An Improvement Project In A University Counseling Center, Clint Emmett

DNP Scholarly Projects

This article describes a quality improvement project undertaken at the University of Idaho Counseling and Testing Center (CTC). This quality improvement project describes the use of the Ask Suicide Questions (ASQ) screening tool to accurately assess the severity of suicide risk during an initial assessment or crisis visit. Clinicians were provided with education and demonstration of the ASQ and shown how to incorporate this tool into their practice. 86 eligible appointments were included in the project for analysis. Simple descriptive statistics were used to present the resulting data. Results indicate that 30.3% of eligible appointments were screened. 43.8% of clinicians …

Tackling Burnout: Investing In Nurse Managers To Secure The Future Of Nursing, Enhance Manager Effectiveness, And Support High Quality Patient Care, Corey French

DNP Scholarly Projects

Background: Burnout is a widespread, pervasive issue the healthcare industry. Many efforts related to burnout reduction have been focused on front line caregivers but there is continued opportunity to address burnout in leadership. The global aim of this quality improvement project was to reduce burnout among the nursing leadership team at a large, academic medical center in the greater Boston area.

Problem Description: A preliminary survey was completed to assess for the presence of burnout within the leadership team. Results revealed that more than half of the nurse leaders surveyed were experiencing burnout at least 50% of the time. This …

Implementation Of Oncology Standardized Scheduling Bundle Impacting Staff Productivity And Patient Satisfaction, Carolyn Brausch

DNP Scholarly Projects

BACKGROUND: Patients having timelyaccess to healthcare services is the entryway to quality of care and patient safety. Timely access is essential in cancer treatment and often requires complex scheduling requiring multiple, highly coordinated, time sensitive appointments. To facilitate optimal clinical care, timely appointment scheduling must be patient-centered. With the heavy scheduling workload growing at the the Cancer Network at Froedtert & the Medical College of Wisconsin and recognition of timely scheduling as a quality indicator, the need to examine the workflow and improve the process became apparent.

METHODS: The goal of the quality improvement project was to provide patients with …

Implementation And Evaluation Of A Psychoeducation Training Program For Correctional Psychiatric Nurses, Katie Lyn Araja

DNP Scholarly Projects

This article describes a quality improvement project undertaken at a northeastern prison focusing on the psychiatric hospital unit. The project's primary aim is to implement training in nurse-led psychoeducation groups for psychiatric hospital unit nurses with the outcome of increasing confidence and competency through improved self-efficacy. The secondary aim of this project is to positively impact the psychiatric hospital unit nurses' intuition as a component of clinical decision-making through skill training that improves KSAs and care delivery to the highest level of the nurses' licensure. Participating nurses received pre and post-intervention surveys, including the Psychiatric Nurse Self-Efficacy Scales and the …

Integrating Implicit Bias Education Into Cultural Diversity Training Via A Portable Web Page, Anne Durant

M. S. in Management

Implicit bias impacts healthcare access and treatment by coloring decisions and judgements unconsciously. Enhancing awareness of implicit bias requires acquiring self-awareness and awareness of others. The addition of implicit bias education to the cultural diversity annual required education at New Hampshire Hospital for nursing staff using a portable web page adds to the range of inclusiveness within the organizational culture. The web page’s variety of subject matter offers narratives, explanatory tools, free test sites to examine individual biases, and videos to exemplify why implicit bias education is relevant. Examination of unconscious biases are recommended by the Joint Commission to investigate …

Management’S Role In Telework Employee Engagement, Stephanie Read

M. S. in Management

This research breaks down the importance of management’s role in employee engagement in the virtual work environment by analyzing previously conducted academic literature. The academic literature highlights the factors that contribute to employee success while working from home, which is more prominent due to the global pandemic caused by COVID-19. The contributing factors are: mentorship, technological support, communication, age (stage of life), and burnout. Throughout the research conducted, a major focal point in how employee engagement relies on the importance of management influence and involvement.

The Mediating Role Of Parental Context And Social Support On The Relationship Between Polyvictimization And Juvenile Delinquency: A Longitudinal Study, Kristen Graham

Master's Theses and Capstones

Polyvictimization and non-victimization adversity in adolescence is a prevalent and evolving issue that poses many implications for families, teachers, policymakers, and others. This study sought to examine whether polyvictimization and adversity longitudinally predict later delinquency, and the possible mediating role of parental context and social support on this relationship. Data was collected as part of the THV survey and the NatSCEV II and yielded a final sample of 791 youths ages 10-20. Poisson regression analyses and structural equation modeling were conducted. Results demonstrated that over and above the impact of demographics, delinquency at Time 1, and community disorder, experiencing composite …

Telehealth! Policy, Practice And Patients, Deborah H. Fournier, Marcy Ainslie, Marcy Doyle

All Materials

No abstract provided.

Facilitating A Quality Improvement Approach To Childhood Adversity Screening In Primary Care: A Handbook, Felicity Bernard, Corina Chao, Holly Tutko, Dee Watts

All Materials

Facilitating a Quality Improvement Approach to Childhood Adversity Screening in Primary Care: A Handbook, owned by the University of New Hampshire and authored by Felicity Bernard, Corina Chao, Holly Tutko, and Dee Watts, licensed under CC BY NC ND 2.0.

“Wilfrid Sellars And Liberal Naturalism”, Willem A. Devries

Faculty Publications

An examination of Wilfrid Sellars' somewhat problematic relation to liberal naturalism

Improving Patient Safety In The Post-Anesthesia Care Unit By Identifying Nurses’ Perceived Barriers To The Implementation Of Barcode Medication Administration, Colleen Gauvin

Master's Theses and Capstones

Background: In the landmark report To Err is Human: Building a Safer Health System published by the Institute of Medicine in 1999, it was estimated that 98,000 Americans die annually due to medical mistakes (Institute of Medicine et al., 2000). Since then, major advancements have been made to improve patient safety in the United States relating to safe medication administration. Barcode medication administration (BCMA) is a technology that was designed to help decrease medication errors by automating the five rights of medication administration (Thompson et al., 2018). BCMA was first utilized at a Veteran Affairs (VA) Medical Center in …

Addressing Job Satisfaction In Nursing Staff Through Mindfulness: A Quality Improvement Project, Abigail Isenberg

Master's Theses and Capstones

Background: As the single largest group of healthcare professionals, comprising a workforce of over 4 million in the United States, keeping nurses satisfied in their positions is a vital component of providing quality patient care (Perry et al., 2018). It is estimated that 68% of nurses will experience significant job dissatisfaction at a point in their career (Ayalew et al., 2018). Mindfulness practice, specifically Mindfulness-Based Stress Reduction (MBSR) is a recognized tool to lower work-related stress and increase job satisfaction of nursing staff (Henry, 2014).

Local Problem: The state of the specific microsystem had been high levels of dissatisfaction among …

Let’S Get Moving To Reduce Falls: Nurses Increase Patient Mobilization After Brief Training, Thomas Langley

Master's Theses and Capstones

BACKGROUND: Patients in hospitals are at a high risk for falls. There are many reasons for this, but one common reason is that patients in hospitals spend a lot of time being inactive. The less time patients spend being mobile, the less capable they are of maintaining mobility and the more likely they are to fall. During the first two years of the COVID-19 pandemic, Wildcat Hospital experience their fall rates increase two- to three-fold on inpatient units.

METHODS: This quality improvement project was guided by the Plan, Do, Study, Act (PDSA) framework to improve nurse knowledge of mobility and …

Did The Political Climate Exacerbate The Pandemic In The U.S.?, Brittany T. Morin, Joanna Gyory, Anthony F. Morin

Master's Theses and Capstones

The global pandemic that began in the United States in early 2020 continues to be a topic of controversy. The added aspect of affect polarization in the country’s political realm may have exacerbated the effects of COVID-19. In their published article in Nature Human Behaviour, Gollwitzer et. al. found that it was possible to link voting partisanship, physical distancing, and COVID-19 outcomes showing that a county’s partisanship might be used to predict the degree to which that county would socially distance and then, therefore, the rate of cases and fatalities in that error on a lagged timescale. This researcher attempted …

Supporting The Oral Language Development Of Young Dual Language Learners: Perspectives Of El Teachers In Nh, Maria C. Chouinard

Honors Theses and Capstones

Demographic shifts in the US over the last two decades have increased the diversity gap between teachers and their students. The majority of multilingual children entering US public schools face the challenge of learning academic content in not just one, but two languages. Despite many of the positive effects of being bilingual, Dual Language Learners (DLLs) often face more challenges in education achievement and opportunities than their monolingual English-speaking peers. A key factor of this challenge is the fact that DLLs tend to have monolingual English-speaking peers, and teachers have been shown to play a critical role in student learning. …

Affective Forecasting And Mood Disorder Symptoms: How Clinical Symptoms Relate To The Prediction Of Future Emotions, Madison R. Bouchard-Liporto

Honors Theses and Capstones

The ability to accurately predict future feelings and emotions, termed affective forecasting, is an important skill as it has a significant impact on the decisions individuals make throughout daily life. Previous research has suggested that depression and anxiety symptoms may be linked to biases in affective forecasting. Here, we hypothesized that greater symptom severity of depression and anxiety would be associated with increased predictions and experiences of negative affect in response to negative stimuli and decreased predictions and experiences of positive affect in response to positive stimuli among a random sample of undergraduate college students. Participants read descriptions of 20 …

College Of Health And Human Service Faculty’S Confidence And Inclusion Of Lgbtq+ Health Content In Curriculum, Carley S. Kanter

Honors Theses and Capstones

In the health care system, those who identify as lesbian, gay, bisexual, transgender, queer, (LGBTQ+) face discrimination and health disparities. Students who are better prepared in higher education to provide care for this population have higher levels of confidence in LGBTQ+ health content than those who have less exposure. Therefore, faculty who teach curriculum related to health and wellness have an opportunity to prepare students to provide high quality, patient centered care by teaching culturally competent care that is inclusive of LGBTQ+ populations. The aim of the study is to determine whether the degree of confidence in teaching LGBTQ+ health …

A Comparison Of Perceptions Of Labor Support Before And During The Covid-19 Pandemic, Sarah Grace Krein

Honors Theses and Capstones

Satisfaction with the experience of birth has been shown to be affected by the quality of support received by the birthing individual and how closely the experience aligns with their expectations. This is important because the hospital and societal restrictions put in place during the COVID-19 pandemic may have altered individuals’ experiences of birth during this time. This is further concerning as there is a known correlation between a negative birth experience and the risk for postpartum depression. This study aimed to identify birthing parents’ perceptions of support during birth and how the COVID-19 pandemic impacted support practices. A survey …

Nursing Student Self-Efficacy In Clinical Skills, Levels Of Anxiety, And Utilization Of Alternative Education Experiences During The Covid-19 Pandemic, David Hart

Honors Theses and Capstones

Background: Higher education students, especially those studying nursing, faced many challenges during the COVID-19 pandemic. Many higher education institutions decided to transition their clinical experiences into a virtual, e-learning format (Chandratre, 2020). As an area of study with high levels of stress and anxiety to begin with, these emotions may have been exacerbated during the pandemic for those studying nursing. Sudden changes in clinical format caused increased anxiety levels in senior nursing students (García-Gonzalez et al., 2021). Graduating students are entering a workforce of healthcare workers who have battled the COVID-19 illness and exposed themselves and their families to this …

Perinatal Patient Education On Substance Use Risk Factors In The Age Of The Opioid Crisis, Rebecca Ane Leary, Alyssa O'Brien

Honors Theses and Capstones

From 2014 to 2016, NH ranked first for fentanyl and all opioid-related overdose deaths per capita in the United States (Moore et al., 2021). In 2016 the New Hampshire Department of Health and Human Services (NH DHHS) found that there are many repercussions of this opioid crisis including overdose deaths, child and elder abuse, and newborns experiencing withdrawal. In utero substance exposure places a child at a higher risk for developmental, behavioral, and physical health concerns. To address this gap, a secondary data analysis using NH Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2013 to 2020 was conducted. PRAMS …

Literary Fiction And Sympathy: How Reading Makes You A Better Person, Emma Rose Wick

Honors Theses and Capstones

I argue in this thesis that literary fiction enhances our ability to sympathize with others as a result of observing—and thereby coming to feel for—the perspectives of the characters by engaging in mental perspective-taking. As a result, we become able to sympathize with an array of individuals whose experiences are unlike our own, and which we may never understand otherwise. I argue that the ability to sympathize with others is valuable for the sake of being a morally good person, and for having an overall good character. This has value in and of itself, particularly from an Aristotelian perspective. I …

Sensory Scouting: An Analysis Of Supports For Sensory Needs Of Children In Local Businesses, Alison Whitman

Honors Theses and Capstones

Families with children with challenging sensory needs may experience a decline in community participation, leading to decreased quality of life, personal feelings of well-being, and identity as a member of the community (Little et al., 2015 & Silverman & Tyszka, 2017). The purpose of this study was to examine and report the sensory experiences such as the sights, sounds, and physical movement opportunities within local businesses in the Seacoast New Hampshire area. To accomplish this, nine family-focused businesses were evaluated using the Sensory Scout Business Assessment-4^th Edition (SSBA). Many businesses were found to have potentially overwhelming movement, auditory and …

The Association Between Knowledge And Confidence Related To Lgbtq+ Health Topics Among University Educators, Chloe Kilkelly

Honors Theses and Capstones

Introduction: Many healthcare professionals may have inadequate knowledge or training to care for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) patients. Educational curriculum based on LGBTQ+ populations has been found to be inadequate in higher education. Little is known about how university educators' knowledge of LGBTQ+ topics or how that knowledge relates to their confidence in teaching this material. This study aims to explore how the healthcare educators' knowledge of LGBTQ+ topics impacts their confidence teaching this material.

Methods: Data was collected via an online survey sent to University of New Hampshire faculty. Respondents were asked to answer 12 knowledge …

California Senate Bill 826: Implications On Female Executive Compensation And Representation, Elizabeth Ann Dion

Honors Theses and Capstones

In 2018, the State of California passed Senate Bill 826, requiring that all public companies headquartered within the state have at least one female on the board of directors. Prior literature has identified a significant connection between female board representation and the impact on female executives and their pay. The prominence of female leaders has been shown to enable fellow females to pursue leadership positions. In addition, prior studies have found that female board members have encouraged an increase in female executives, and an increase in female executive pay has been identified due to the role of the board in …