Digital Commons Network^™

Implementation Of A Risk Assessment Tool To Increase Screening For Extragenital Gonorrhea And Chlamydia In Men Who Have Sex With Men, Andrew P. Tharp

Doctor of Nursing Practice Projects

INTRODUCTION: Gonorrhea and chlamydia account for the majority of sexually transmitted infections (STIs) in the United States and are often thought to infect only the urogenital tract. Infections can also be harbored at extragenital sites (rectum and oropharynx), and these infections can increase susceptibility to HIV. Extragenital screening recommendations exist for populations deemed high risk, including men who have sex with men (MSM); yet, routine screening is not consistently completed.

PURPOSE: To improve screening rates for extragenital gonorrhea and chlamydia in MSM within a primary care setting by using an STI risk assessment tool.

METHODS: Clinicians completed a baseline knowledge …

Short Term Medical Mission Antibiotic Protocol, Greg Jennings

Doctor of Nursing Practice Projects

Background/Introduction: Short term medical mission trips are growing in popularity and with this growth the level of care provided must remain evidenced based. Mission groups traveling to developing countries consist primarily of volunteers. And while many of those serving on mission trips are medically trained, some have minimal healthcare knowledge. Pharmacists are not always available to dispense medications on mission trips and therefore it is common for registered nurses in the pharmacy to dispense the medications prescribed by the providers. Because the medications available on mission trips are limited, often times substitutions must be made, especially when it comes …

Improving Access To Reproductive Life Planning Following Implementation Of One Key Question® In Practice, Ashley Wittler

Doctor of Nursing Practice Projects

Abstract

Inadequate reproductive life planning (RLP) education is a widespread problem for women in the United States. This deficit leaves women without necessary guidance regarding contraceptive choices and maximizing pre-conception health. Use of RLP is endorsed by the American College of Obstetricians & Gynecologists (ACOG) and the Center for Disease Control (CDC). Lack of use of an RLP tool in a large, multi-site obstetrical and gynecological practice located in the Metro East is an issue that greatly impacts the patient population. The goal was to initiate the use of an evidence-based RLP tool, known as One Key Question®. The use …

It’S Hapi Hour: An Action Plan On Preventing Hospital-Acquired Pressure Injuries, Emira Maureen A. Romero

Master's Projects and Capstones

Hospital-Acquired Pressure Injuries (HAPIs) are detrimental to both the hospital and the patient as they are costly, painful, and can lead to further infection and an increased length of stay. Although this problem is seen across the country, this action plan focuses on a microsystem (i.e. medical-surgical telemetry unit) in Hospital A in the San Francisco Bay Area. The target population includes medical-surgical telemetry patients at high risk for HAPIs (i.e. Braden score <18, moisture/mobility scores <2, patients with devices at risk for device-related pressure injuries). The proposed intervention is an evidence-based HAPI prevention bundle that includes utilization of wound care champions and turn teams, increasing attendance of daily huddles, implementing a standardized algorithm for escalation and documentation, and reinforcement of evidence-based HAPI prevention measures. Effectiveness of this bundle will be measured through chart audits, nursing questionnaires, and staff interviews. These measures will be conducted 12 months post-implementation and findings will be compared to the baseline data in order to investigate whether there is a reduction in HAPI incidence. Since this project is currently in the Study phase of the proposed Plan, Do, Study, Act (PDSA) cycle, this action plan concludes with recommendations of how the team can continue to move forward in addressing the project’s specific aim.

Hapi Prevention Bundle: An Initiative To Prevent Hospital-Acquired Pressure Injuries, Karla D. Penilla Lozano

Master's Projects and Capstones

Problem: Hospital-Acquired Pressure Injuries (HAPI) are a serious health problem as they increase patient morbidity and mortality. They are detrimental to patients, families, and healthcare systems. Context: Research supports HAPI prevention bundles are a way to standardize care processes and reduce the incidence of pressure injuries. This evidence-based practice intervention was initiated to develop a HAPI prevention bundle in an adult Medical-Surgical Telemetry unit. A literature review was conducted to identify the best HAPI prevention practices. Intervention: The evidence-based pressure injury preventive bundle includes interventions consistent with proper skin assessments and documentation, patient risk identification, development of Wound Care Champions, …

The Relationship Between Surgical Site Infections And Hand Hygiene Discharge Teaching, Eishlee Renel A. Jasa

Master's Projects and Capstones

Problem: In the span of a nine-month period, the incidence of surgical site infections (SSIs) in a singular perioperative unit reached 13. SSIs have been linked with negative consequences for both the patient and healthcare system, decreasing quality of life and increasing costs.

Context: The 20-bed post-anesthesia care unit (PACU) primarily serves adult patients in the East Bay Area, where a variety of surgeries including elective and emergent procedures are performed. This facility specializes in general surgeries, where laparoscopic excisions and hernia repairs were the most commonly observed.

Intervention: The Standardized 3-Step Hand Hygiene Discharge Teaching is aimed to improve …

Aidet And Commit To Sit Implementation In The Outpatient Surgical Setting, Olivia V. Meehan

Master's Projects and Capstones

Problem: This quality improvement project implements AIDET and commit to sit to improve communication and increase the patient satisfaction of an outpatient surgery microsystem. The microsystem’s patient satisfaction is assessed, and it is currently scoring below the reach goal of 85^th percentile. The detractors from their overall score mainly stem from the patient not feeling listened to, informed, or updated on the timeline. AIDET and commit to sit are ideal tools for addressing those deficits.

Context: The microsystem being addressed is an outpatient surgery unit that specialized in general surgery for the pediatric population. The pediatric population that the …

Poor Acclimation To Experimental Field Drought In Subalpine Forest Tree Seedlings, Alex Goke, Patrick H. Martin

Biological Sciences: Faculty Scholarship

The ability of tree species to acclimate and tolerate projected increases in drought frequency and intensity has fundamental implications for future forest dynamics with climate change. Inquiries to date on the drought tolerance capacities of tree species, however, have focused almost exclusively on mature trees with scant in situ work on seedlings, despite the central role that regeneration dynamics play in forest responses to changing conditions. We subjected naturally established seedlings of co-dominant subalpine conifer species (Abies lasiocarpa and Picea engelmannii) in the southern Rocky Mountains to 2 years of in situ summer precipitation exclusion, simulating summer drought …

Spawning Site Selection Of Coho Salmon Oncorhynchus Kisutch In Susitna River Tributaries, Alaska, Betsy W. Mccracken

Fisheries

Coho Salmon Oncorhynchus kisutch are the most widely distributed Pacific salmon species across Alaska. The lack of knowledge surrounding the habitat requirements of this species results in challenges for conservation and management due to natural and anthropogenic pressures. Tributaries of the Susitna River drainage in Alaska support many small and distinct Coho Salmon populations. Heterogeneity of in-stream spawning habitat is an ecological concept known to promote resiliency of salmonid populations. The goal of this study was to investigate the best habitat predictors of spawning site selection and the scale by which spawning habitat should be evaluated for management insights. Scale …

The Mrna-Lnp Platform's Lipid Nanoparticle Component Used In Preclinical Vaccine Studies Is Highly Inflammatory, Sonia Ndeupen, Zhen Qin, Sonya Jacobsen, Aurélie Bouteau, Henri Estanbouli, Botond Z. Igyártó

Department of Microbiology and Immunology Faculty Papers

Vaccines based on mRNA-containing lipid nanoparticles (LNPs) are a promising new platform used by two leading vaccines against COVID-19. Clinical trials and ongoing vaccinations present with varying degrees of protection levels and side effects. However, the drivers of the reported side effects remain poorly defined. Here we present evidence that Acuitas' LNPs used in preclinical nucleoside-modified mRNA vaccine studies are highly inflammatory in mice. Intradermal and intramuscular injection of these LNPs led to rapid and robust inflammatory responses, characterized by massive neutrophil infiltration, activation of diverse inflammatory pathways, and production of various inflammatory cytokines and chemokines. The same dose of …

Increase Access To Community-Based Health Care For Underserved Individuals: A Quality Improvement Project, Piper Oneal

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background: Health care access disproportionately affects certain populations. Health care opportunities for uninsured adult members of a rural community can be limited. Suwannee County is a rural community with a population of 43,814 of which 40.8 % live below the 200% poverty income level (WellFlorida Council, 2020). Problem: In 2016, 23.8% of adults in Suwannee County were unable to see a doctor in the past year due to the inability to pay and lack of insurance (Florida Department of Health, 2020). Community-based health care initiatives can address such issues by targeting underserved individuals, reducing barriers, and making health services …

Achieving Fairness Through Load-Balancing In Social Cloud Computing Networks, Kaiyi Huang

Master's Projects

Cloud-based computing networks have taken over the digital landscape. From small non-profits to large multinational corporations, more and more entities have been offloading computing effort to the cloud in order to take advantage of the increased cost-efficiency and scalability of cloud computing. One of the new types of cloud that have emerged is the P2P cloud, which disengages from a traditional datacenter setup by allowing users to instead share their own computing hardware into a cloud to take advantage of cloud computing’s advantages at an even lower cost. However, this new paradigm comes with a slew of challenges, notably, security …

Effective Cancer Detection Using Higher-Order Genome Architecture And Chromatin Interactions, My Chung

Master's Projects

Cancer is a complex disease which requires interactions between cell-intrinsic alterations and tumor microenvironment. The connection between epigenetics and genomic structure plays a key role in chromatin interaction which promotes enhancer-promoter interactions for transcriptional activities. Alterations of chromatin states in oncogenic signaling pathway potentially cause cancer cell-intrinsic changes and inappropriate instructions to normal cell cycles, leading to abnormal cell growth. Resulting phenotypic changes are correlated to underlying changes in higher-order chromatin structure such as topologically associating domains (TADs) and compartments. In cancer cells, TAD structure is usually altered to facilitate the communication between enhancers and promoters in addition to higher …

Fasting Status Of Steller Sea Lion Pups, Stephanie G. Crawford

Biological Sciences

Following population declines in species of concern, wildlife managers often seek to identify underlying causes to understand and predict population dynamics for better future management. Often, physiological and/or behavioral metrics are measurable markers of decline, and these are often detectable well before declines are measurable through population surveys. During the 1970's, 80's, and 90's Steller sea lion (SSL; Eumetopias jubatus) populations in the western portion of their breeding range declined by ~85%. Though declines in most regions have since stabilized or exhibited modest recovery, some subpopulations breeding in the Aleutian Islands continue to decline. In contrast, SSL subpopulations in eastern …

Systems And Methods For Scalable Retinal Screening Programs, Jeremy Richard Benson

Computer Science ETDs

This dissertation addresses gaps in artificial intelligence-based computer vision tasks in the medical image processing field. We demonstrate effective methods for standardizing and augmenting digital fundus photographs so that robust convolutional neural network-based systems can perform high-throughput disease classification and generalize to never-before-seen data from novel camera technologies, scaling with the changing hardware landscape, as well as keeping up with vast amount of incoming data from the ever-increasing population. We also tackle the problem of discovering relevant samples in an unlabeled cohort of image data, thus widening the bottleneck to all downstream supervised machine learning tasks.

Who Pays To Clean Up What A Dying Industry Leaves Behind?, Audrey Carleton

Capstones

As the birthplace of oil and gas, Pennsylvania is home to the highest number of orphaned abandoned oil and gas wells in the country — an estimated 300,000 to 500,000 dot the Keystone State, all remnants of a dying industry. These wells emit methane, a potent greenhouse gas, and have, for decades, caused alarm to hundreds of residents, documents obtained in a months-long capstone investigation show. The state is currently plugging 10 to 12 abandoned wells per year, on average, out of hundreds of thousands, in part because it has not collected enough in cleanup funds from producers to fund …

Trans Sex Workers - A Community In Resilience, Alejandra Pedraza Buenahora

Capstones

By exploring the ways the trans sex worker community supports itself and all the tactics community leaders are using to support community members, this engagement journalism projects details the way journalist can service the trans community and aid in their information acquisition needs. By using an array of journalistic skills this capstone explores what journalist can and should do to build trust with trans community members to better report on the experiences of individual community members. Here you will find detailed lessons learned from interviews, informal chats, reporting and gatherings with trans community leaders in the city of New York.

"Our Strength Is Unity:" Delivery Bikers In Their Own Words, Connor W. Zaft

Capstones

"Our Strength Is Unity" is a year-long photographic essay on food delivery workers and their attempts to self-organize during the pandemic.

Filling Information Gaps In Milwaukee’S Metcalfe Park Neighborhood, Kynala J. Phillips

Capstones

While in the Craig Newmark Graduate School of Journalism’s Engagement Journalism program, I got the chance to work with residents in Milwaukee’s predominantly Black Metcalfe Park neighborhood and the organizations and people that communicate most frequently with its residents.

During these past 18 months, I have practiced deep listening and slow and engaged journalism to build trust with my community. The goal: to create a product that is useful to the residents of Metcalfe Park.

To accomplish this, I joined a small group of journalists and community leaders to produce a print and SMS neighborhood newsletter titled “North 2 Center” …

Working In New York City With A Disability: Nowhere Near Easy, Milette S. U. Millington

Capstones

This project investigates the common challenges that people with disabilities faced prior to COVID-19 when finding a job and keeping it, and explores how the pandemic may have changed things.

Project link: https://milettem98.wixsite.com/portfolio/capstone

Poetic Self Expression, Impact, And Activism, Mariah Thomas

Capstones

Poetic Self Expression, Impact, and Activism revolves around Black women activists and how they used poetry to fight against racial and social injustice.

Link: https://medium.com/@mariaht/poetic-self-expression-impact-and-activism-a98c7f3385b2

The Healthcare Changemakers Podcast And Existing Conditions .Press, Emily Lowinger

Capstones

A podcast made from live interviews with healthcare changemakers.

http://existingconditions.press/podcast

“The New Pinkertons”: Anti-Union Consultants And Surveillance Tech Thwart Organizing, Jo Constantz

Capstones

In 2020, just 6.3% of U.S. private-sector workers were union members, despite the fact that 68% of Americans approve of labor unions, the highest since 1965, and nearly half of non-union workers say they would join.

After World War II, wage growth kept pace with GDP growth, but then began to diverge in the 1970s, according to a study by the RAND Corporation. After 1975, incomes of the bottom 90% rose more slowly than the economy as a whole, while incomes of the top 10% grew faster. The declining wage growth coincided with and is closely related to a drop-off …

The Impacts Of Speculative Investments On New York City’S Rent Stabilized Tenants, Olivia J. Bensimon

Capstones

Landlords who bought buildings with rent stabilized apartments for much more than they were worth are now faced with the risk that their investment will not pay off, often at the expense of tenants. https://olivia-bensimon.com/capstone

Improving First Case Starts For A Neurosurgery Or, Tara L. Goodall

Master's Projects and Capstones

Problem: On-time first cases for operating rooms (OR) is a worldwide focus for improvement. OR delays have many adverse effects, including economic costs and patient and facility staff satisfaction.

Context: The site for this improvement project is a medium-sized hospital in Northern California. There are 12 ORs, with an average of 600-700 cases. Neurosurgery was the chosen specialty due to low on-time starts and long delay minutes. The focus was working with one OR to improve first case on-time starts by 20%.

Interventions: A worksheet was created to track room setup, delay reasons, and delay minutes. A visual setup guide …

Examining The Interaction Of Adverse Childhood Events, Dental Issues, Asthma And Autism, Cathy Koetting

Electronic Theses and Dissertations

Dissertation supervised by Dr. Rebecca Kronk

Purpose: Adverse childhood events (ACEs) have a profound and long-term effect on the health outcomes of many children and adults. However, few studies have focused on specific ACEs and health outcomes in children with autism spectrum disorder (ASD). The aim of the study was to investigate if ASD moderated the relationship between ACEs and specific health outcomes in children who had been the subject of a child welfare system report.

Design and Methods: Using the second National Survey of Child and Adolescent Well-Being (NSCAW II), a secondary analysis was performed on a sample of …

Improving Medication Administration Safety In A Correctional Facility With An Electronic Medication Administration System, Rosalinda Salazar

Master's Projects and Capstones

Problem: According to the World Health Organization (2020), medication errors are one of the leading causes of injury and avoidable harm in health care globally.

Context: The county jail houses approximately 700 inmates/patients on a daily basis, and the potential for error when administering medications is high as medications are prepared manually using a paper medication administration record.

Interventions: The jail began using an electronic health record/barcode administration system on October 19, 2020.

Measures: Unusual occurrence reports related to medication errors were reviewed. The time frame included 6 months before electronic implementation, and 6 months after implementation.

Results: Unusual occurrence …

Multicultural Music Education: Preparedness, Perceptions, And Practice Among Virginia Elementary Music Educators, Benjamin J. Luna

Masters Theses, 2020-current

Benjamin Joel Luna, M. M.

James Madison University, 2021

Supervisor: Lisa M. Maynard

The purpose of this study was to examine the Multicultural Music Education (MME) practices of established (i.e. more than three years of music teaching experience) Elementary Music Teachers in the state of Virginia by examining their responses to a series of survey questions specific to the topic. Participants (N=18) were all current Elementary Music Teachers in the state of Virginia with more than three years of experience.

Participants were asked to use Likert-scale ratings for the majority of the questions but were also given the …

Assessing Moral Distress And Substance Use Among Nurses In The Time Of Covid-19 To Improve Patient Safety, Lauren Childers

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The COVID-19 pandemic has brought rapid changes, increased stress, and ethical challenges to nurses across the globe. These factors may place nurses at increased risk for developing moral distress and substance use disorder. This stress can also increase nurse vulnerability to substance use. Previously there was little evidence about the rates of moral distress and substance use disorder among nurses during the COVID-19 pandemic. The primary objective of this evidence-based project was to describe levels of moral distress and substance use among nurses in a community hospital during the COVID-19 pandemic and to make recommendations for interventions to improve nurse …

Financial Facts From The Seed For Oklahoma Kids Child Development Account Experiment, Center For Social Development

Center for Social Development Research

How does a Child Development Account (CDA) opened at a child’s birth shape their access to assets for higher education?

This Fact Sheet highlights findings from Financial Outcomes in a Child Development Account Experiment: Full Inclusion, Success Regardless of Race or Income, and Investment Growth for All (CSD Research Summary 21-06). Products of the SEED for Oklahoma Kids (SEED OK) experiment, both the Fact Sheet and the Research Summary indicate that the automatic CDA in SEED OK greatly increases the likelihood that disadvantaged children have assets for their future education. When given a CDA structure and support for …