Digital Commons Network^™

Utilizing Gsk3beta And Integrin Inhibitors To Target Stat3 Activity In Triple Negative Breast Cancer, Emily Anne Pratt

Master's Theses and Capstones

Triple negative breast cancer (TNBC) is the most aggressive subtype of breast cancer associated with poor prognosis and characterized by increased rates of proliferation and metastasis. TNBC gets its name due to the lack of the three receptors commonly found in other breast cancer types: estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Breast tumors expressing these receptors can be treated with hormonal therapies, but TNBC tumors will not respond to such treatments and are therefore more difficult to treat. To circumvent this, targeted therapies that inhibit proliferation and migration are of great research …

United States V. Sioux Nation Of Indians: A History Of Indigenous Diplomacy In The Black Hills, Elliott Lelaure

Master's Theses and Capstones

This thesis traces the history of Sioux-American competition for the Black Hills region of South Dakota from the Lakota’s discovery of the mountains in 1776 to the aftermath of United States v. Sioux Nation of Indians, a landmark 1980 Supreme Court case that awarded financial compensation to the tribes for the unconstitutional seizure of sacred lands. It argues that treaty negotiations in the nineteenth century – and attempts to resolve treaty-based disputes in the twentieth – testify to an international quality in the Sioux-American relationship. Far from passive victims of American expansion, it shows that Lakotas have consistently developed, debated, …

Occurrence And Fate Of Per- And Polyfluoroalkyl Substances (Pfas) In Atmospheric Deposition, Surface Waters, And Sediments Discharging To The Great Bay Estuary, New Hampshire, Katherine Alexina Wieck

Master's Theses and Capstones

Per- and polyfluoroalkyl substances (PFAS) are a class of several thousand synthetic organic compounds commonly utilized in the manufacturing of consumer products and in industrial processes since their initial development in the 1940s. Although the widespread presence of PFAS in environmental matrices derives from many different industrial and domestic sources, recent studies characterizing their fate in aqueous systems have primarily focused on point source discharge, such as those from wastewater treatment facilities, airports, and industrial complexes. Focusing on point sources neglects atmospheric deposition, an important diffuse background source of PFAS into surface waters and sediments. Furthermore, atmospheric deposition is likely …

Looking For The Answer: Exploring The Choice Between Ai And Search Engines, Joseph Driscoll

Honors Theses and Capstones

With the meteoric rise of artificial intelligence, consumers have found themselves faced with an abundance of options for information retrieval. This study is designed to explore when consumers choose to use an AI tool as opposed to a traditional search engine, as well as determining what the user segments look like for AI tools. The results of this study indicate that there are two AI user segments, along with a third segment of non-users that were not included in the study. One segment has fully embraced the use of AI, while the other has tested it and only uses it …

Investigation Of The Causative Agent Of Canine Leproid Granuloma Infection Cases In The Northeastern United States, Nicole J. Marcotte

Honors Theses and Capstones

Canine leproid granuloma syndrome (CLGS) is a form of disease in dogs of many breeds that is characterized by a skin infection in the subcutis and/or dermis. The granulomas that form as a result of infection are typically non pruritic, alopecic, raised, and firm. These mass-like granulomas can ulcerate, causing further infection beneath the skin surface, and are present in areas of the body such as the ears, head, neck, and extremities. CLGS has been known to infect dogs of different breeds and ages, but has most commonly been reported to infect shorthaired, large sized breeds. This disease is suspected …

The Economic Impacts Of Digital Nomads In Medellin, Colombia, Bernadette Patricia Farmer

Honors Theses and Capstones

As a result of increasing internet accessibility and the rise in popularity and possibility of remote work following the COVID-19 pandemic, workers from advanced economies have applied the work-from-home routine while visiting different countries. These destination cities have lower living costs and remote workers can experience increased purchasing power and new cultures. To fully take advantage of their professional autonomy, these workers, known as digital nomads, stay in each international location for one to three months before traveling elsewhere – conveying their propensity for nomadism. Digital nomads (hereafter referred to as DNs) have economic impacts on their host cities in …

Impact Of Hdac Inhibitors On The Efficiency Of Cardiomyocyte Differentiation, Lauren Mary Sargent

Honors Theses and Capstones

Heart disease and injury is the leading cause of death worldwide, with much of its severity caused by the low regenerative capacity of cardiomyocytes (CMs). One of the strategies to counteract the poor regeneration of CMs is the production of CMs via differentiating stem cells. However, the low efficiency of obtaining CMs from stem cells is an issue because there are numerous inconsistencies in the process. Histone deacetylase (HDAC) inhibitors have been researched as ways to increase efficiency of CM differentiation by increasing histone acetylation, and thereby allowing differentiation to occur more efficiently. In this study, the HDAC inhibitor, trichostatin …

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 …

Examining Relationships Between Methane Emissions And Aquatic Vegetation In Arctic Lakes Using Remote Sensing Techniques And Field Measurements, Helen B. Sears

Master's Theses and Capstones

Lake ecosystems are significant contributors to atmospheric methane (CH4) budget. Aquatic vegetation provides inputs to lake sediments of carbon that then influence the production and emission rates of CH4 from those sediments. Understanding the spatial variability and seasonal changes in the distribution of aquatic plants and CH4 emissions can help identify potential feedback with climate warming. Stordalen Mire, located in the discontinuous permafrost zone in Northern Sweden, is an ideal area to study the relationship of vegetation cover to CH4 emissions from lakes in the Mire, because there are extensive datasets relating to both these parameters for this location. Still, …

Improving Patient Safety And Continuity Of Care By Educating Nurses About Standardized Handoffs In The Post-Anesthesia Care Unit: A Quality Improvement Project, Remi Dos Santos

Master's Theses and Capstones

Background: Effective communication during patient handoffs is crucial for ensuring patient safety and continuity of care. The I-PASS handoff tool has been identified as an effective method to standardize communication and reduce errors during these critical transitions.

Local Problem: In the Post-Anesthesia Care Unit (PACU) of a hospital in New England, the lack of standardized procedures for nurse handoffs posed a risk to patient safety and care quality.

Methods: A quality improvement project was conducted using the Plan-Do-Study-Act (PDSA) cycle to implement and evaluate an educational intervention aimed at improving PACU nurses' proficiency with the I-PASS handoff tool. Pre- and …

Incorporating Educational Interventions To Improve Nursing Adoption Of Electronic Medical Record Technology: A Quality Improvement Project, Andrew Oratovsky

Master's Theses and Capstones

Background: Use of Electronic Medical Records (EMRs) has become the standard for medical information management and exchange amongst acute care hospitals in the United States. The Epic® electronic medical record has been identified as a popular EMR software for adoption by many healthcare organizations. Associated with the adoption of this technology is a large investment in training medical professionals on its specific processes.

Local Problem: In the outpatient, primary care setting of a hospital in New England, the adoption of Epic® has come with much fear and resistance regarding the ability of nursing staff to efficiently learn and …

Promoting Inpatient Mobility To Improve Patient Outcomes: A Quality Improvement Project In A Rural Critical Access Hospital, Chantal Laplante

Master's Theses and Capstones

Background: Although beneficial to patient outcomes, inpatient ambulation is not a prioritized care intervention, and a task often deferred to physical therapy. Patient immobility is a complex problem that requires a multifaceted approach.

Local Problem: In a rural, critical access hospital, on an 18-bed medical surgical unit, nursing staff lacked ownership of patient mobility. There was no standardized process to document ambulation and mobility tasks were not scheduled, falling to the end of the nursing work list. Many patients did not have activity orders upon admission and nurses lacked resources for ambulation assessment and daily goal setting. There was no …

Using The Stop5 Debriefing Model To Increase Utilization Of Debriefing Practice In The Emergency Department: A Quality Improvement Project, Hallie Chancey

Master's Theses and Capstones

Abstract Background: The practice of debriefing has been an important process in critical care settings to promote team unity as well as best care practices. Literature has shown that debriefing can not only influence quality care and improved operations, but the process can also influence the emotional support staff receive. These implications are particularly important for nurses that work in critical care settings as the job can often be stressful and lead to moral distress as well as the need for evidence-based care practices is crucial when a patient’s life is on the line. Literature supports that any form of …

Re-Educating Proper Blood Culture Collection With Emphasis On Initial Blood Waste To Decrease Contamination Rates: A Quality Improvement Project, Samantha A. Dickinson

Master's Theses and Capstones

Background: A critical access hospital in New England experienced an increase in blood culture contamination rates within the Emergency Department (ED). There was a disconnect between the current standardized collection protocol within the ED and the action of staff collecting which has led to an increase of blood contamination (BCC) rates.

Local Problem: The disconnect between the current collection standard and staff collecting caused the Emergency Department to rise above 3.0% in blood cultures contaminations. This rise in contamination rates contributes to longer patients stays and unnecessary treatments.

Methods: Using the Plan-Do-Study-Act model, an educational flyer was implemented to remind …

Using Education To Improve Glycemic Management Within An Emergency Department, Rebecca Olson

Master's Theses and Capstones

Background: Patients with diabetes mellitus (DM) frequently visit acute care facilities for a variety of reasons. Proper management of this comorbidity increases patient safety, satisfaction, and quality care. Patients with persistent dysglycemic events in acute care facilities have an increased risk of complications and death during their stay. Lack of education can contribute to gaps in proper management within this population and therefore must be improved for better patient outcomes.

Methods: The Plan-Do-Check-Act design from the A3 Problem Solving model was used to guide a quality improvement project which focused on improving staff education and confidence surrounding glycemic management. The …

Increasing Patient Awareness About Fall Risk Through Patient Education Pamphlets On A Medical-Surgical Floor: A Quality Improvement Project, Nicole Madden

Master's Theses and Capstones

Introduction At a nonprofit hospital located in New Hampshire, a thorough 5P Assessment was executed to identify the root cause behind an increase in falls occurring on a medical-surgical floor. Subsequently, a comprehensive quality improvement initiative was launched with the dual goals of minimizing falls and enhancing patients' awareness regarding their susceptibility to experiencing a fall during their length of stay. Patient falls are the most common adverse events reported in hospitals and are considered a sentinel event (LeLaurin & Shorr, 2019). Hospitals need to adopt a multifaceted approach to minimize the risk of patients experiencing falls during their inpatient …

4-H Horse Knowledge Bowl Entry Packet, Extension

UNH Cooperative Extension

No abstract provided.

Water Tent: Investigation Data Sheet Grades 3-8, Haley F. Wicklein

Earth Around Us

No abstract provided.

Water Tent: Biotic Index Calculation, Haley Wicklein

Earth Around Us

No abstract provided.

Water Tent: Practice Water Quality Measurements, Haley F. Wicklein

Earth Around Us

No abstract provided.

Water Tent: Macroinvertebrate Practice Activity, Haley Wicklein

Earth Around Us

No abstract provided.

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Improving Postpartum Depression Education Within The Microsystem, Mackenzie A. Sturdevant

Master's Theses and Capstones

BACKGROUND: Postpartum depression (PPD) is a significant mental health issue affecting a substantial percentage of new mothers, ranging from "baby blues" to severe forms like postpartum psychosis. Maternity nurses play a crucial role in early detection and education due to the gap in postpartum care follow-up appointments, which can delay necessary interventions.

LOCAL PROBLEM: Despite the critical role of maternity nurses, there is variability in their preparedness to educate and support patients regarding PPD during the immediate postpartum period. This study aims to enhance maternity nurses' knowledge and confidence in providing PPD education through a quality improvement (QI) project within …

Improve Dysphagia Screening In Patients With Neurological Conditions Through Education: A Quality Improvement Project, Kendra Mcintosh

Master's Theses and Capstones

Background: A macrosystem in Southern Massachusetts faces challenges in patients with neurological conditions recieveing a dysphagia screening prior to anything enter the patients mouth in the Emergency Room.

Local Problem: The educational gap identified in Registered Nurses regarding the frequency of screening being completed and the knowledge of the indications for a dysphagia screening.

Methods: Using the Plan-Do-Study-Act model, an educational intervention was implemented. An educational poster was displayed in the microsystem. Data was collected pre-and post-intervention through a survey to measure change.

Interventions: The educational poster was displayed in high-traffic areas of the microsystem. This educational poster included …

Implementing Change: Training For Adult Emergency Assessment, Recognition, And Stabilization For Novice And Non-Critical Care Nurses, Shannon C. Clancy-Burgess

Master's Theses and Capstones

Abstract

Background At a macrosystem in New England hospital nurses are requesting more training for better preparedness in situations of clinical deterioration in the patient. Current education offerings were focused on cardiac and respiratory arrest situations. Review of the literature reveals the need for training in recognition and response to clinical deterioration. Simulation training can be a useful training tool.

Methods Several assessments were conducted to determine the need for a new course that focuses on recognition and response for stabilization. These assessments included an AHRQ Gap Analysis, a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, Stakeholder feedback using Qualtricsä, …

Increasing Education And Staff Knowledge Of Delirium Care: An Evidence-Based Quality Improvement Project, Serena Martinath

Master's Theses and Capstones

Introduction At a small, community hospital in Massachusetts a gap analysis was conducted leading to a quality improvement project to increase staff education and knowledge regarding delirium and evidence-based best practices for delirium care. Delirium is a growing, often under recognized medical condition that occurs in hospitalized patients (Loftus & Wiesenfeld, 2017). Delirium is characterized by acute changes in congnition, level of consciousness, and attention (Loftus & Wiesenfeld, 2017). A better understanding of this condition is expected to result in improved patient care.

Methods The clinical microsystem studied in this gap analysis project was assessed by using the AHRQ Gap …

Enhancing Chest Pain And Oxygen Supplementation Protocol Adherence Through Nurse Education In The Emergency Department For Patients With Acute Coronary Syndrome And Unspecified Chest Pain: A Quality Improvement Project, Leah Gamble

Master's Theses and Capstones

Abstract Background: Acute Coronary Syndrome (ACS) and unspecified chest pain are common presentations in the Emergency Department (ED). Proper management, including appropriate oxygen supplementation, is crucial for optimal patient outcomes. However, discrepancies between current practice and evidence-based guidelines have been identified, highlighting a need for targeted educational interventions.

Local Problem: In the ED, knowledge gaps among nurses regarding the correct administration of supplemental oxygen for patients with ACS and unspecified chest pain have been observed. This inconsistency with the American Heart Association (AHA) and American College of Cardiology (ACC) guidelines may lead to poor patient outcomes.

Methods: The Plan-Do-Study-Act (PDSA) …

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 …

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, …

Enhancing Postpartum Depression Screening Tools To Improve Maternal Mental Health Outcomes: A Quality Improvement Initiative, Jillian Squires

Master's Theses and Capstones

Abstract

BACKGROUND:

Postpartum depression (PPD) is a prevalent and serious condition affecting new mothers, often underdiagnosed due to challenges in traditional screening methods. Early detection and intervention are crucial for improving maternal and infant health outcomes.

LOCAL PROBLEM:

On the maternity unit, existing PPD screening processes were insufficient, with significant barriers including patient reluctance to disclose mental health concerns, leading to missed or inadequately addressed PPD cases.

METHODS:

This quality improvement (QI) project utilized the Plan-Do-Study-Act (PDSA) framework. Pre-intervention surveys were conducted to identify current challenges and perceptions. An at-home PPD screening tool using the Edinburgh Postnatal Depression Scale (EPDS) …