Digital Commons Network^™

Free To Be You But Not Me?, Leah Litman

Reviews

In Gendered Liberty, Prof. Laura Portuondo presents a doctrinal puzzle: While claims to individual liberty are in decline in some spaces, they are ascendant in others. As Portuondo describes things, constitutional law has become increasingly hostile to claims by people who seek to defy gendered stereotypes. That includes the women who, for whatever reason, do not want to become mothers when they are pregnant, as well as the women whose lives, health, or fertility would be in jeopardy if they became mothers. The Supreme Court overruled their claims to liberty in Dobbs v. Jackson Women’s Health Organization.

Skills Evaluation Of Adjunct Nursing Faculty: A Quality Improvement Project, Ada Dimino Luong

DNP Scholarly Projects

Abstract

BACKGROUND: With rising student enrollment, colleges and universities are relying more on adjunct clinical nursing faculty as Clinical Nurse Educators (CNEs). Recruiting and retaining qualified CNEs is essential to high-quality clinical education. Although clinically proficient, CNEs may face challenges with teaching methods, instructional strategies, and formative feedback. This quality improvement (QI) project evaluated CNE’s competencies and developed a sustainable multimedia educational tool to enhance feedback skills in clinical education.

METHODS: The Academic Clinical Nurse Educator Skill Acquisition Tool (ACNESAT), a validated 40-item Likert-scale instrument created by Shellenbarger and Sebach, was used to assess CNE competencies. Pre and post intervention …

Recognizing And Responding To Moral Distress: Using Transformational Leadership To Increase Nurse Leader Thriving, Miriam Dowling-Schmitt

DNP Scholarly Projects

Background: Moral distress, burnout, and compassion fatigue in acute care nurses has increased significantly since the Covid-19 pandemic and has been associated with high levels of nursing turnover and increased costs to healthcare systems. Nurse leaders at the study organization had never received education on recognizing and responding to moral distress. Nursing engagement scores were low at the study organization in the areas of leadership support and well-being investment in nurses.

Problem Description: Between 2017 and 2021 job satisfaction for nurses with direct patient care responsibilities decreased in 20 of 21 categories according to the Bureau of Health Workforce. High …

Improving Transitions In Care: The Post-Discharge Follow-Up Process For Va Hospitalizations, Kristina Huntoon

DNP Scholarly Projects

BACKGROUND: Transitions in care from hospitalization to home are a high-risk period for patients. Without care coordination during these transitions in care, patients are left trying to manage their care without any support. The VA has a mandated two-day post-discharge contact process that requires a member of the patient’s primary care team to contact the patient within two business days of a VA discharge.

METHODS: The Plan-Do-Study-Act method of quality improvement was used for this project. Baseline assessment included review of patient medical records for 15 months before the intervention, which included 27 discharges from unit 78C. The patient medical …

A Care Expansion Initiative: Providing Awareness And Access To Resources For Patients With Celiac Disease: A Quality Improvement Project, Jennifer Kumin

DNP Scholarly Projects

Background: Celiac disease (CD) is projected to be the most common genetic autoimmune disease in the world with 1% or 3 million people effected in the United States. It is estimated that as many as 70% of those effected are not aware. Diagnosis routinely takes 10-12 years from the initial onset of symptoms, exposing patients and the healthcare system to significant cost and stress through excess testing and misdiagnosis. One area that is often referenced in barriers around celiac disease is the lack of awareness and education specifically with patients, healthcare providers, and the community at large.

Methods: In this …

Critical Incident Debriefing: Impact On Oncology Nurses And The Infusion-Related Reaction Care Bundle, Megan A. Corbett

DNP Scholarly Projects

Background: A critical incident is a sudden, unexpected, emotionally distressing event commonly experienced by oncology nurses. Debriefing is an evidence-based best practice that facilitates communication, reflection, and learning to identify quality improvement opportunities to enhance clinical practice, patient safety, and quality of care. However, debriefing within oncology care settings is inconsistent despite the demonstrated benefit and availability of frameworks. Infusion-related reaction management follows an algorithm that directs care delivery, aligning with a care bundle approach. Care bundles, when consistently and reliably applied, help identify connections between the critical incident (i.e., infusion-related reaction) and opportunities for improvement to ensure clinicians follow …

An Integrated Approach To Patient Safety In The Medical Device Industry: A Quality Improvement Project, Kaylee Boisvert

DNP Scholarly Projects

Background: The currently established product surveillance process at Boston Scientific is a reactive one which presents compliance risks, patient safety risks, and quality risks. Evolution to a proactive process is necessary to protect public health, allow for commercialization of devices that have a robust safety, reliability, and efficacy profile, and to identify and react to risk before or at the early stages of a problem.

Methods: A pre-implementation survey of baseline opinions associated with decision-making, efficiency, effectivity, and safety of the current product surveillance system was performed. A baseline time study was performed associated with the process, which was separated …

Developing An Evidence-Based Culture Through Journal Club: A Pilot Study, Allison Davidson

DNP Scholarly Projects

Evidence-based practice is essential for improving patient outcomes and reducing healthcare costs, yet its implementation in nursing remains limited due to persistent barriers such as lack of knowledge, leadership support, time, and resources. Despite these challenges, nurses generally hold positive attitudes toward EBP, indicating a strong foundation for future initiatives aimed at enhancing education, training, and organizational commitment. To fully integrate evidence-based practice into nursing care, healthcare systems must address these barriers and invest in sustained support, ensuring that clinical decisions are consistently guided by the best available evidence. A pilot nursing journal club, led by an evidence-based practice mentor …

Enhancing Resilience In Oncology Nurses Through The Implementation Of A Peer Support Program, Denise M. Robinson-Smith

DNP Scholarly Projects

ABSTRACT

Background: Oncology nurses face high rates of burnout and compassion fatigue, contributing to significant turnover and threatening the stability of the oncology nursing workforce. The projected increase in cancer incidence and the resulting demand for oncology services underscore the urgent need for interventions that enhance nurse resilience. Local Problem: At a major hospital in Jacksonville, Florida, it was found that oncology nurses face a significant gap in emotional support, especially during critical incidents such as patient deaths or traumatic events. Existing resources were insufficient to address the unique stressors faced by this team. Methods: A quality …

A Quality Improvement Initiative To Improve Nurse Reassessment And Documentation Of Administered Prn Pain Medication, Stacy L. Brady

DNP Scholarly Projects

BACKGROUND: Effective pain management remains a critical challenge both globally and with the United States, where more than 51 million adults suffer from pain. Veterans are particularly vulnerable due to the lasting impact of service-related injuries. “Pro re nata” (PRN or “as needed”) pain medications are frequently used to manage pain, but timely reassessment and documentation following a PRN pain medication administered is often missed or delayed. Reassessing and documenting the results after the administration of the PRN pain medication is required by The Joint Commission and the Veterans Affairs Providence Healthcare System’s (VAPHS) standard operating procedure (SOP) states reassessment …

Feeding With Competence: Empowering Parents In Ng Feeding For Nicu Graduates: A Quality Improvement Project, Karen Marsh

DNP Scholarly Projects

Abstract

Background: Infants who are born prematurely stay in a neonatal intensive care unit (NICU) until they are able to take full enteral nutrition by mouth. While in the NICU a nasogastric tube (NG tube) would be used to supplement the volume needed to be ingested for optimal nutrition. Infants typically feed better with a consistent caregiver and at home in an environment with less stimulation. Allowing infants to be discharged with an NG tube allows the parents to be more involved in their infant's care with a shorter hospital stay. An increased number of infants being discharged home with …

Developing A Rural Family Health Curriculum To Promote Retention Of New Graduate Nurse Practitioners, Molly G. Boudreau

DNP Scholarly Projects

Background: There is a critical shortage of primary care providers (PCPs) in rural areas of the United States. Nurse Practitioners (NPs) are essential for addressing the primary care shortage especially in rural communities. However, significant barriers exist to the retention of NPs in rural communities, especially new graduate NPs in the first year of practice. Evidence in the literature suggests bolstering the focus on transition-to-practice for new graduate NPs to improve retention and turnover rates.

Purpose: The aim of this quality improvement project was to develop a structured, postgraduate, on-boarding curriculum at a rural outpatient family medicine clinic with the …

Promoting Rapid Identification Of Oncological Emergencies In The Emergency Department : A Quality Improvement Project, Christine Hart Brown

DNP Scholarly Projects

BACKGROUND: The American Cancer Society estimates 2,041.90 new cases of cancer in the U.S. (1 in 18 Americans) with a global projection of thirty-five million new cases annually by 2050. With this alarming increase, early recognition of oncological emergencies in the Emergency Departments is essential. Life-threatening conditions require rapid assessment, accurate diagnosis, and immediate interventions. Qualified emergency nurses must understand the effects that cancer and treatment have on the immune, metabolic, and hematologic systems. This quality improvement (QI) project focuses on assessing emergency nurses’ oncological knowledge of acute emergencies and providing a resource for rapid identification.

PROBLEM STATEMENT: …

The Relationship Between Pillar[5]Arene And Pillar[6]Arene In The Synthetic Route To A Water-Soluble Pillar[6]Arene: A Case Of Kinetic And Thermodynamic Products Or Two Distinct, Competing Reactions, Helice A. Gillis

Open Access Dissertations

Pillar[n]arenes, discovered in 2008, have already made their mark as a formidable addition to the field of supramolecular chemistry, largely due to their host-guest chemistry. While the synthesis of pillar[5]arene is well established, the synthesis of pillar[6]arene, with its larger core, has not been so straightforward and mainly accomplished through the use of bulky solvents. Here we present an optimized method for a reproducible, acid-catalyzed synthesis for a brominated pillar[6]arene, starting with a brominated monomer and using chloroform as the templating solvent. Our studies have demonstrated the ratio of brominated pillar[6]arene to brominated pillar[5]arene increases with both decreasing concentration of …

Incentives, Performance Metrics, And Healthcare Supply Chain Waste, Sharon Ann Franzetta

Open Access Dissertations

Healthcare spending in the United States (US) is increasing at a rate higher than the US gross domestic product while the demand for healthcare services is simultaneously increasing. With supply costs posing as the second highest cost in hospital expenditures, reducing supply expenses by means of eliminating supply management waste could potentially reduce overall healthcare costs. Supported by evidence found through three manuscript studies, this study expounds upon the findings from previous studies to better understand the relationship between medical supply inefficiency due to the influence of stakeholders’ misaligned decision-making in efforts to achieve performance goals. This exploratory, mixed-methods study …

Quantifying Links Between Phytoplankton Physiology And The Environment, Gabrielle M. Armin

Open Access Dissertations

Phytoplankton are microscopic, primary producers in aquatic ecosystems worldwide. They are key links in global biogeochemical cycles, converting inorganic compounds into bioavailable nutrients which fuel fisheries. Through photosynthesis, phytoplankton play an essential role in the carbon cycle and marine biological pump, drawing carbon from the atmosphere, which is eventually sequestered in the oceans, regulating our Earth’s climate. Due to their influential role in large scale processes, there have been many efforts to characterize and quantify phytoplankton impacts to ecosystem health and global nutrient cycles. Often, phytoplankton physiology has been highly simplified in global or ecosystem models, limiting their representation to …

Development And Deployment Of In Situ Fiber Optic Distributed Temperature Sensing Systems And Data Processing Workflows For Oceanographic Observatories In Coastal And Deep-Sea Environments, Johann Sebastian Becker

Open Access Dissertations

Over the last two decades, fiber optic distributed temperature sensing (DTS) has emerged as a transformative technology capable of providing unprecedented spatiotemporal resolution observations of temperature in a broad range of environmental sensing, industrial, and civil engineering monitoring applications. DTS uses a single interrogator unit to measure temperature continuously along an optical fiber, effectively turning the fiber into the equivalent of an array of temperature probes that can be interrogated synoptically. Modern commercially-available DTS systems are capable of continuous sensing with sampling frequencies up 5 sec, spatial resolution of 0.25 m, and temperature precision up to 0.01 °C) observations, on …

More Than Just Food And Money: An Exploration Of College Students’ Challenges With Food Access And Insecurity, Orianna Duncan Carvalho

Open Access Dissertations

There has long been a popular prototypical image of the starving college student surviving on cheap ramen noodle meals, but research suggests there is more to this than meets the eye. Food insecurity, the condition in which individuals are unable to secure enough food to support a healthy lifestyle, has been investigated and reported with increasing frequency on college campuses, including the university at which the present study is conducted. Thus, the purpose of the present study was to delve further into college student food insecurity to gain a better understanding of how students experience and perceive it. To achieve …

Investigating Mono-Driver Versus Multi-Driver Oncogenesis Via Alterations To Cell Signaling Pathways, Abygail Chapdelaine

Open Access Dissertations

The latest edition of Global Cancer Statistics released by the American Cancer Society reported approximately 20 million newly diagnosed cancer cases worldwide in 2022 with 9.7 million deaths. This ranks cancer as the second leading cause of death worldwide. For the majority of cancer patients, the standard treatment approach is chemotherapy and/or radiation therapy, and while this has been successful in some patients, a lack of specificity to cancer cells causes severe side-effects when these agents damage healthy cells. Despite extensive efforts that have gone into developing targeted cancer therapeutics that block functions specific to cancer, they have not been …

College Health Provider Experiences With Inclusive And Affirming Care Of Sexual And Gender Minorities, Somatra Lynn Connolly

Open Access Dissertations

Increasing numbers of individuals in the U.S. are identifying as sexual and gender minorities (SGM). Approximately 17-21% of U.S. college students identify as SGM, comprising a sizable portion of minoritized groups on college campuses. College students who identify as SGM are at significant risk for physical and mental health issues, experiences of victimization, and poorer health outcomes. It is essential that colleges and universities ensure their campuses are meeting the needs of their entire student body, including SGM students. This study aims to: (1) obtain an in-depth understanding of college healthcare provider (HCP) experiences and their perceptions with inclusive and …

The Effect Of Maternal Diet On Developmental Programming: A Cross Species Analysis, Lindsey Eileen Eaton

Open Access Dissertations

Maternal nutrition plays an important role in shaping offspring health through developmental programming, with lasting implications on metabolic function and disease susceptibility. This dissertation explores the molecular and physical consequences of maternal nutrition, particularly its effects on pancreatic development and function in offspring. Chapter one provides a comprehensive review of the literature, detailing the mechanisms of fetal development, epigenetic regulation, and metabolic programming. It highlights the thrifty phenotype hypothesis, the role of DNA methylation and histone modifications, and the impact of maternal nutrition, emphasizing how nutrient availability during pregnancy influences fetal organogenesis and long term metabolic health.

Chapter two examines …

Democratizing Deep-Sea Technology Development Using Rapid Prototyping Techniques, Breanna Motsenbocker

Open Access Dissertations

Deep-sea research and exploration have consistently been inaccessible to a broader oceanographic community due to the lack of affordable technology and resources that are required for this type of work. Traditionally, to investigate the deep sea, large research vessels are required to operate the expensive and massive equipment that can withstand the intense pressure and harsh environment beyond 200 meters of water. Not only does this lessen the capacity for exploring the deep sea but it also introduces an extreme inequity for who can participate and lead these efforts. With a growing demand for the global Blue Economy and a …

Light, Symbiosis, And The Biology Of Corals, Taylor R. Lindsay

Open Access Dissertations

Light is critical for the survival of most shallow water scleractinian corals. Corals are mixotrophs, acquiring energy via both feeding on water column plankton and photosynthesis via a symbiotic relationship with dinoflagellates living within their tissues. Corals rely heavily on photosynthetically derived metabolites through this symbiotic relationship, intrinsically linking their biology to light availability. Corals are known to modulate their biology to maximize light capture. However, there is a limited understanding of the interaction between morphology, physiology, and energetic strategy, as well as how light may affect these relationships. In Chapter 1, we quantified the morphology, physiology and energetic …

A Qualitative Case Study Exploring The Implementation And Influence Of An Inter/Intragenerational Digital Equity Training Program, Josie Santilli

Open Access Dissertations

Background: Many older adults are unable to fully engage in society because of the digital divide, leaving them disconnected from essential services, social networks, and community engagement. This lack of access to technology leads to greater isolation and loneliness, significantly increasing their risk of physical and mental health issues. It also threatens their ability to age in place, as they struggle to navigate everyday tasks like managing healthcare, finances, and communication. Without digital literacy, maintaining independence becomes an increasingly difficult challenge, leaving them vulnerable and reliant on others for support. The purpose of the research completed in manuscript 1 …

Novel Methodology And Proof-Of-Concept For Proton Ct Using Spot Profile Rather Than Bragg Peak Location, Brett Albert Ruben

Open Access Dissertations

Proton radiation therapy offers a highly precise method for cancer treatment, theoretically providing superior dose deposition characteristics compared to conventional X-ray radiation therapy. Its steep and finite dose fall-off region allows for superior tumor coverage while reducing, though not eliminating, dose to surrounding healthy tissue. However, its full potential is limited by range uncertainties, particularly those arising from the reliance on X-ray-based imaging methods called computed tomography (CT) for proton-based treatment. CT image Hounsfield Units (HU) must be converted to stopping power ratios (SPR) as these ratios are the clinically relevant value for accurately planning particle interactions during proton therapy. …

The Effects Of Ph And Oncometabolites On Dna Repair Mediated By Alkb Family Enzymes, Quentin Mylie

Open Access Dissertations

Modifications of DNA and RNA, in particular methylations - such as N⁶-methyladenine (m6A), 5-methylcytosine (m5C), 1-methyladenine (m1A), and 3-methylcytosine (m3C) are crucial for gene regulation, genome integrity, and cellular adaptation. This dissertation investigates the role of the ALKB family of alpha-ketoglutarate (αKG) and iron-dependent dioxygenases in modulating these modifications, with a focus on how their activity is influenced by pH and metabolic factors, underscoring the connection between environmental conditions and epigenetic and genetic stability.

Chapter 1 provides a comprehensive literature review on the epigenetic and genetic regulation of DNA and RNA modifications, with a particular focus on methylation …

Substance Use In Justice-Involved Youth: The Roles Of Adhd And Cd, Avery Beatty

Open Access Dissertations

The present study aimed to investigate the relationships between ADHD, CD, and comorbid ADHD and CD on cigarette, cannabis, and alcohol use among justice-involved youth (JIY). Data for the present study were derived from a randomized controlled trial (RCT) that compared the effectiveness of various interventions in reducing cigarette use among youth at a state juvenile correctional facility in the Northeastern United States. The total sample (N = 302) comprised incarcerated and detained youth (n = 243) who ranged in age from 13 to 19 years (M = 16.01, SD = 1.01). Additionally, the present finding revealed that the total …

Idea To Implementation In Social Entrepreneurship: A Case Study From A Veteran Urban Farm And Housing Initiative, Jason Thomas Phillips

Open Access Dissertations

Unaffordable housing, food insecurity, and mental health challenges are three of the most pressing issues facing many veterans in the United States. Research demonstrates that agricultural initiatives for veterans have the potential to positively impact veterans’ quality of life while also providing an accessible source of income, fresh healthy food, and community engagement. A veteran urban farm and housing initiative has the potential to create power for veterans through a community approach to entrepreneurship and business model innovation. This approach reflects both the community experience of many veterans during their military service as well as offers a path to individual …

Advancing Sampling And Expanding Measurement Of Per- And Polyfluoroalkyl Substances In Natural Waters., Jarod Snook

Open Access Dissertations

Per- and polyfluoroalkyl substances (PFAS) have gained much attention over the last several years in environmental science and engineering communities. They pose a unique challenge: persistent and toxic like several other legacy pollutants, but with additional surfactant and amphiphilic properties increasing the complexity of chemical interactions. Thus, many scientific questions remain regarding the environmental transport, fate, and interactions of PFAS released into natural waters. The dissertation research presented here has focused on several of these questions and knowledge gaps in a vast range of scales - from molecular interactions to global transport of PFAS - all addressing the challenge of …

Characterization Of Methodological Variability In Compound Specific Isotope Analysis Of Amino Acids (Csia-Aa), Audreyana Brown-Nash

Open Access Dissertations

The use of isotopes in the natural sciences stems from the principle that chemical reactions predictably alter the isotopic composition of a given sample. Recent advances in compound specific isotope analysis of amino acids (CSIA-AA) have paved the way for studies of increasingly complex ecological relationships, including the identification and characterization of organismal physiology, consumer-resource linkages, biogeochemical cycling, and movement ecology. The analytical power of CSIA-AA has caused an exponential increase in the number of application-based studies since its inception in the 1990s. With the technique constantly evolving to accommodate new research goals, it is important to understand how variation …