Digital Commons Network^™

Judging Our New Judges: Why We Must Remove Artificial Intelligence From Our Courtrooms Now, Kieran Duffy Newcomb

Honors Theses and Capstones

In this paper, I explore some of the ways in which artificial intelligence might enhance the sentencing process through recidivism prediction technology. Notably, this technology can increase the accuracy of risk predictions and the speed with which sentencing decisions are reached. I then show, however, that the recidivism prediction technology is likely to turn into what data scientist Cathy O’Neil calls a Weapon of Math Destruction. The potential harmfulness of this technology is due not to the inherent nature of the technology, but the symbiotic relationship it will have with our already harmful criminal justice system. I argue that the …

Implementation Of Stronger Community Resilience In The United States Before Natural Disasters Strike, Andrew J. Widdekind

Honors Theses and Capstones

Since 2000, the United States has not sustained viable mitigation and preparedness solutions to combat the frequent and intense onset of natural disasters; more must be done on how communities can adapt and withstand them. Instead, environmental and human-induced factors have exacerbated the likelihood of these threats, which has caused billion-dollar weather events to occur more often. This paper focuses on how congressional policymakers would have to incorporate new mitigation/preparedness approaches into current emergency management methodology by creating a new federal statute known as the National Resiliency Act (or similar). A policy like this would strengthen the overall resilience of …

Investigating The Function Of Protein S-Acyltransferase 2 In Arabidopsis Thaliana Using Crispr Mutants, Nicole Benjamin

Honors Theses and Capstones

Arabidopsis thaliana contains 24 Protein Acyl Transferases (PATs). These enzymes are responsible for catalyzing the addition of a palmitate to a target substrate (palmitoylation). However, beyond its broad enzymatic function, it is unknown how PATs interact on a cellular level. This research focuses on identifying the function of PAT2. CRISPR-Cas9 was used to create deletion mutations that would result in a non-functional PAT. Two plants homozygous for a pat2 deletion were identified: pat2-5 and pat2-6. Preliminary results suggest that pollen grains in both pat2 mutants are larger in both length and width. Additionally, it appears that mutant pollen tends to …

An Updated Outline For Clearing And Staining Of Preserved Specimens, Sadie E. Smith

Honors Theses and Capstones

This protocol outlines a enhanced clearing and staining procedure for persevered specimens, focusing on the visualization of cartilage and bone in small taxa. With origins from O. Shultze's diaphonization methodology in 1897, the process of clearing and staining improves the clarity and contrast of intricate tissues. It is essential for studies in developmental biology, histology and anatomy. This protocol covers the key steps of the process while detailing the materials, solutions and estimated timeline for each step pertaining to specific taxa. The aim of the protocol is to standardize and provide guidance for procedures in the Biological Sciences department at …

Prospective Associations Of Fish Consumption In Cognitive Function And Depressive Symptoms Among Puerto Rican Adults, Johanna Grace Koroma

Honors Theses and Capstones

Johanna Koroma, Anne Bodenrader, and Sherman Bigornia

Objectives

Fish intake has been linked to certain neural benefits, specifically in slowing cognitive decline and attenuating depressive symptoms. However, existing evidence is conflicting and insufficient. The present study aimed to investigate the association of fish consumption with depressive symptoms and cognitive function among Puerto Rican adults.

Methods

Data is acquired from the Boston Puerto Rican Health Study, comprised of 1517 adults residing in the Boston Metro Area. Dietary patterns were evaluated using a validated food frequency questionnaire (FFQ) with follow-up surveys conducted 2 years from baseline. Consumption was organized into quartiles based …

The Influence Of Drd2 Polymorphism Exon 8 C/T (Rs6276) On Manifestations Of Delirium Tremens & Alcohol Withdrawal Seizures, Naomi Schneider

Honors Theses and Capstones

This study explores the correlation between the DRD2 Polymorphism exon 8 C/T (rs6276) and manifestations of delirium tremens (DT). DT is a condition that is clinically diagnosed utilizing two characteristic symptom manifestations: the presence of delirium and severe alcohol withdrawal. It is not entirely understood why DT can occur in some patients, but evidence has suggested that genetic predisposition can play a role. Utilizing the National Institutes of Health (NIH) All of Us Research database and performing a secondary analysis of existing genomic data, this candidate gene association study aims to determine the genotype frequencies within three cohorts: a healthy …

Legalization, Medical Exemptions, And Decriminalization Of Marijuana Laws. An Exploratory Study Of Campus Police Officers’ Perceptions And Policing Practices In Response To New Marijuana Laws, Eric Kulberg

Doctoral Dissertations

This dissertation is an exploratory study of how campus police officers perceive and respond to the changes in marijuana laws. It focuses on campus police departments in states that have passed marijuana laws that fit into one of three categories of laws: – the legalization of marijuana, a medical exception to the use of marijuana, and the decriminalization of marijuana for possession of small amounts. Because of its exploratory nature, this research focuses on campus police departments at each state’s flagship institutions that have passed legislation that fits into one of the three categories of laws. Lipsky’s theory of street-level …

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 …

Pristine Or Perilous? Evaluating The Risks Of Cyanotoxin Production, Exposure, And Accumulation In Gye Lakes, Katherine Low

Doctoral Dissertations

Toxins produced by cyanobacteria (hereafter, cyanotoxins) are among the most lethal known biotoxins. Cyanotoxin exposure is assumed to occur mainly through direct contact with surface-bloom-forming cyanobacteria that are most commonly observed in warm, nutrient-rich lakes. However, recent observations of cyanotoxin accumulation in the Greater Yellowstone Ecosystem (GYE), an area where cyanobacteria blooms are rarely observed, have raised concerns over wildlife health in this highly protected region. In response, we sampled twelve clear-water lakes in the GYE to identify potential sources of cyanotoxins (particularly the neurotoxin beta-methylamino-L-alanine, BMAA), exposure routes, and health risks.Despite nutrient limitations and cool water temperatures, the sampled …

Sepsis Screening And Bundle Adherence: Staff Education As An Intervention To Increase Knowledge In A Medical Surgical Clinical Microsystem, Nicole Elise Maheu

Master's Theses and Capstones

Background: Sepsis-related deaths outnumber those caused by opioids, breast cancer, and prostate cancer combined (Nguyen, 2020). Sepsis places a significant health burden and cost burden on both an individual and a systemic level, emphasizing the need for proper care of the sepsis patient in all inpatient settings.

Local Problem: Within a medical-surgical microsystem, it was found that care of the sepsis patient was inadequate. A pre-intervention survey was conducted which demonstrated a lack in knowledge of the inpatient sepsis workflow, including use of the sepsis best practice advisory (BPA) within EPIC® and the sepsis bundle of care. Additionally, according to …

Utilizing Health Literacy Universal Precautions And The Teach-Back Method To Improve Hospitalized Patients' Experience With Medication Education: A Quality Improvement Project, Kathleen Meyer

DNP Scholarly Projects

BACKGROUND: Patients, especially the elderly, are at high risk for post hospital complications related to poor medication adherence. Addressing health and medication literacy limitations during their inpatient encounter closes critical gaps in a patient’s understanding of their medication regimen. The project goal was to improve the patient experience related to communication about medicines during their inpatient encounter. The intervention implemented was the introduction of health literacy universal precaution concepts and teach-back methodology for medication education.

METHODS: Interdisciplinary educational sessions were created and implemented for nurses, hospitalists, and respiratory therapists. Additionally, at the elbow support was provided throughout the implementation phase …

Peer Support To Enhance Safe Alcohol Use In University Students: A Quality Improvement Project, Kerri Reynolds

DNP Scholarly Projects

BACKGROUND: College is a period of transition to adulthood where many students experiment with alcohol consumption. Peer educators can bring access to evidence-based alcohol consumption education through student-centric strategies. This quality improvement project aimed to implement an evidence-based training program for college peer educators followed by the delivery of campus alcohol education in a six week period. Feasible ideas for sustainable college peer educator training were generated at this medium-sized public university. The impact of training on six peer educators’ self-reported professional leadership skills, knowledge, and confidence was measured.

METHODS: The Certified Peer Educator (CPE) training program (NASPA) was used …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care Using A Collaborative Care Model, Christina Stephens

DNP Scholarly Projects

Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in …

Empowering Nurse Leaders To Achieve Harmony: Fostering Work-Life Balance, Gilberto Gamba

DNP Scholarly Projects

BACKGROUND: Balancing professional and personal life demands has become a focal point in today’s healthcare organizational culture. Despite the technological advances in providing better and faster healthcare, team members often struggle to achieve work-life harmony while meeting the demands of a growing population of healthcare clients. The evidence highlights nurse leaders as one group for which the identification and implementation of work-life balance interventions is crucial.

METHODS: An original tool based on available evidence was developed and used with a group of nurse leaders participating in an educational activity to engage them in behaviors supporting work-life harmony. A post-educational survey …

Optimizing The Assisted Living Experience: Integration Of Value-Based Care To Foster Augmented Resident-Centered Quality, Jennette Pietrzak

DNP Scholarly Projects

Background: Fee-for-Service models are quantity-focused reactive approaches and have historically been at the forefront of healthcare. Value-based models focus on proactive, resident-centered care that is aimed at quality care over quantity. Implementation of ValueBased Care models can positively impact healthcare and fiscal outcomes

Purpose: The quality improvement project aimed to develop, integrate, and implement a valuebased model in Memory Care as an alternative to traditional Fee-for-Service models. The project aimed to improve key performance indicators by reducing hospitalizations, emergency room visits, and falls following the implementation of Value-Based Care (VBC) models.

Method: Data metrics for hospitalizations, emergency room visits, and …

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 …

Evaluating The Impact Of Simulation On Perceived Knowledge And Confidence Of New Graduate Nurses (Ngns) In Maternal-Newborn Care, Disa Seymour

DNP Scholarly Projects

Abstract

Background: Nursing education worldwide varies in duration and training process, with nurses often facing rapid immersion into patient care complexities when entering the workforce. While new nurses contribute significantly to the nursing community with contemporary knowledge, their transition to practice can be daunting, necessitating support for both competence and retention. As specialty care settings integrate more new graduate nurses (NGNs) to address workforce shortages, collaboration between leaders and educators becomes crucial. Simulation emerges as a vital tool in building confidence while learning, offering a safe space for skill development and growth of confidence.

Purpose: This project’s objective was to …

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 …

Impact Of Personal Continuous Glucose Monitor Use During Hospitalization On Rates Of Hypoglycemia And Provider Confidence, Rebecca Longo

DNP Scholarly Projects

Continuous Glucose Monitors (CGMs) are an essential tool for managing diabetes in the outpatient setting, helping individuals achieve glucose goals. However, CGMs are not currently FDA-approved for use in the hospital setting. Despite this limitation, many individuals continue using their personal CGM during hospitalization or begin using them prior to discharge if the care team believes the technology will support glucose management during and after leaving the hospital.

This project aimed to evaluate whether individuals using personal CGMs during hospitalization experienced less hypoglycemia and whether reviewing CGM data could improve provider confidence in insulin dosing. While initiating CGM use during …

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 …

Implementation Of Advanced Airway Management Course: A Pilot Quality Improvement Project For Improved Emergency Outcomes For Operating Room And Pacu Nurses, Elizabeth Patry

DNP Scholarly Projects

Background: Airway management has always been central to critical care; it is a complex skill to learn and necessary for patient survival. To properly care for a patient’s airway, the provider must fully understand airway anatomy including upper and lower anatomy and how they work together to allow for oxygen transportation (Day, 2022). Unfortunately, many nursing school curriculums and department orientations are not able to provide the level of education and training necessary. Due to an extreme nursing shortage, many hospitals are not able to provide in depth orientations upon hire and annual review, this lack of professional support affects …

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 …

Effectiveness Of Diversion Tube On Peripheral Blood Culture Contamination Rates From Intravenous Catheters In A Community Hospital Emergency Department, Anne Meginniss

DNP Scholarly Projects

BACKGROUND: Obtaining blood cultures is routine care for patients who are suspected to have sepsis. Contaminated blood cultures can lead to increased healthcare costs for patients suspected of sepsis. Reducing contaminated specimens could improve the quality of care delivered as well as increase patient satisfaction.

AIM: This quality improvement project aimed to reduce the number of contaminated blood cultures in a community hospital emergency department by using an initial specimen diversion tube to meet the new national benchmark of below 1% contamination rate.

METHODS: Twenty-seven diversion specimens were collected over an eight-week period via initial intravenous catheter insertion in a …

Enhancing Safety Surveillance During Clinical Trials: The Development Of A Safety Data Review Handbook To Support Pharmacovigilance Clinicians, Lauren Wilson

DNP Scholarly Projects

Abstract

BACKGROUND: Pharmacovigilance (PV) Sciences include activities related to safety surveillance of pharmaceutical products, and is critical for developing safe and effective medications, vaccines and medical devices. Safety monitoring starts with preclinical research and continues through clinical trial and post marketing phases. PV scientists ensure patient safety during clinical trials through regular review and analysis of safety data. Regulations have become increasingly complex, leading to inadequately defined methods for reviewing large clinical trial safety datasets. Inconsistent safety data review (SDR) practices can result in delayed detection of adverse drug reactions (ADRs) or safety signals.

METHODS: This quality improvement project used …

30 Years Of Change In The Forest Of Northern Maine, Kelsi J. Anderson

Master's Theses and Capstones

In managed forests, harvesting practices are one of the main factors that determine forest structure, composition, and the provision of ecosystem services. We resurveyed a 238,000-ha portion of the Wabanaki-Acadian Forest in northern Maine after 30 years of changes in ownership and harvesting practices. We found significant changes in forest structure and composition across a suite of forest types within the study region. Notably, there was a shift from spruce (Picea rubens, P. glauca, and P. mariana) to balsam fir (Abies balsamea) in the overstory of softwood stands and an increase in American beech (Fagus grandifolia) in the understory of …

Natural Laboratories Of The Deep Sea: Linking Community Composition And Environmental Variables On Low-Temperature Venting Outcrops Of Ridge Flank Hydrothermal Systems To Explore Potential Impacts Of Climate Change, Inform Habitat Suitability Models, And To Understand The Impacts Of High Bathymetric Resolution On Seafloor Characterization, Anne Marie Hartwell

Doctoral Dissertations

The deep sea covers over two-thirds of the globe and represents 95% of the ocean. Most life on Earth is suspected to live on or near the seabed. Yet, these ecosystems are the least known on Earth and are important to explore as they are home to a diverse array of species that are currently under threat because of multiple anthropogenic pressures, including warming oceans. Exploration of these systems is critical to further the understanding of species interactions, biodiversity and their overall relationship to environmental and terrain variables. Many of these variables are used in species distribution models and technological …

Scares: A Clinician Guide To Spinal Cord Awareness, Response, And Emergency Support Creation And Implantation Of Scares Protocol Among Hospitalist Advanced Practice Providers, Brittany Biega

DNP Scholarly Projects

While they are more common in patients with oncological disease and trauma, SCE still exist among patients without these comorbidities. Less has been established regarding care protocols in this population. The absence of standardized procedures has been linked to preventable, adverse patient outcomes, including cases of permanent damage due to delayed treatment. This project employs Lean Six Sigma methodologies and Johns Hopkins Evidence- Based Practice to devise a robust SCE protocol, aimed at standardizing care and improving patient outcomes. A multidisciplinary team including general medicine, neurology, neurosurgery, and neuroradiology developed “Spinal Emergency Management Guidelines” protocol, which was implemented within the …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care For Medically Underserved Community Using A Collaborative Care Model, Christina M. Stephens

DNP Scholarly Projects

Primary care, an extension of family medicine remains a key access point for patients entering the healthcare system. Accessing specialty psychiatric services can be limited in rural communities due to provider shortages and geographical constraints. Primary care providers can facilitate improved access to behavioral health services by introducing a collaborative approach to the traditional medical model. This quality improvement initiative adopted the collaborative care model originally produced by the University of Washington to treat common mental health conditions in the medical setting (2023). A team consisting of a primary care provider, behavioral health case manager and psychiatric consultant served nine …

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 …

Assessing Barriers And Facilitators To School Nurse Recommendations Of Human Papillomavirus Vaccination, Amy E. Dark

DNP Scholarly Projects

Background Vaccine hesitancy among students and caregivers is a pervasive challenge for educational leadership and school health staff, leaving the school community at risk for vaccine preventable disease. The human papillomavirus (HPV) vaccine is an underutilized primary prevention strategy against six HPV related cancers.

Purpose The purpose of this quality improvement (QI) project was to measure the effect of an evidence-based educational intervention and facilitated role play on the knowledge and confidence of school nurses (SNs) when discussing HPV vaccination.

Methods This QI project was performed using a brief educational presentation with facilitated role play and a pre/post survey design. …