Digital Commons Network^™

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 …

Intersections Of Inattention: A Qualitative Inquiry Into The Experiences Of Multiply Marginalized Students In Community College Settings, Jana N. Knibb

Open Access Dissertations

Educational research has examined the impact of expanded access to higher education for historically marginalized groups. However, research on the experiences of students who are both racially minoritized and dis/abled is limited. Findings suggest that, due to their intersectional identities, multiply marginalized dis/abled students (MMDS) navigate policies and practices related to racist ableism, which further marginalize them and create additional barriers in their higher education experiences. Expanding this research requires theoretical frameworks that account for students' identities, experiences, and barriers in higher educational spaces and contexts. This qualitative study, grounded in Dis/ability Studies and Critical Race Theory in Education (DisCrit), …

Per- And Polyfluoroalkyl Substances (Pfas) Effects On Tissue Disposition, Proteome, And Health Effects, Juliana Agudelo Areiza

Open Access Dissertations

Per- and polyfluoroalkyl substances are a class of nonbiodegradable synthetic aliphatic environmental toxicants that are ubiquitous in the environment. A small subset, specifically perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), have been designated as highly hazardous to human health by the Environmental Protection Agency (EPA) under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). PFOA and PFOS-associated adverse health effects include, but are not limited to, immune suppression, thyroid dysfunction, increased serum cholesterol, liver damage (i.e., alanine aminotransferase (ALT)), and developmental toxicity (i.e., low fetal birth weight and neurotoxicity). In this doctoral dissertation, it was hypothesized that environmental PFAS …

Real-World Clinical And Cost Effectiveness Of Osteoporotic Treatments In Men, Yu Ren

Open Access Dissertations

Osteoporosis is a condition characterized by the loss of bone mass, which increases the risk of fractures. In 2017-2018, the age-adjusted prevalence of osteoporosis among adults aged 50 and over was 12.6%, with 19.6% in women and 4.4% in men. Untreated osteoporosis can lead to a cycle of recurrent fractures that severely impact quality of life and place significant emotional, physical, and financial strain on patients, families, and healthcare resources. Approximately 50% of women and 20% of men will experience at least one fracture in their lifetime. In the United States, an estimated 1.5 million osteoporotic fractures occur each year, …

Essays On Human Decisions Related To Water Quality Problems In The United States, Sonia M. Refulio Coronado

Open Access Dissertations

Water pollution remains a pervasive and inequitable environmental threat in the United States, with mounting evidence that its burdens - whether in recreational or drinking water contexts - are unevenly distributed across communities. Urbanization, aging infrastructure, and industrial contamination have degraded both coastal waters and drinking water systems, posing serious public health and welfare concerns. At the same time, the extent to which water quality influences behavioral decisions, such as beach recreation or household adoption of water filters, remains poorly understood. Although drinking water pollution is widely ranked as a top environmental concern in national surveys, public knowledge of specific …

A Socio-Ecological Investigation Of Ulithian Spearfishing, Joshua Pi

Open Access Dissertations

Coral reef socio-ecological systems (SESs) characterize the interconnected relationships between coral reef ecosystems and reef-dependent communities. One such SES exists in Ulithi Atoll, Federated States of Micronesia, where Ulithians fish, steward, and govern their reefs through customary marine tenure, traditional ecological knowledge, and cultural taboos. In recent decades, rapid modernization in Ulithi has introduced new fishing technologies, transformed fishing practices, and ultimately reshaped the functioning of Ulithi’s traditional SES. One significant change was the introduction of spearfishing during the mid-20^th century, which is more selective and individualistic compared to other community-centric fishing methods that have existed for generations. This …

Will I Go To My Appointment? Case Management And Environmental Drivers Of Missed Transportation In Medicaid, Mark Donald Kraics

Open Access Dissertations

This dissertation examines the behavioral, clinical, and operational drivers of chronic missed appointments within Medicaid non-emergency medical transportation (NEMT) systems. Chronic member no-shows undermine care adherence and introduce operational inefficiencies across Medicaid delivery systems. This two-phased quantitative retrospective cohort study used statewide Rhode Island Medicaid data from 2020 to 2024 to evaluate whether environmental factors (e.g., weather, daylight) influence member missed trips and whether targeted managed care case management interventions reduce no-show rates among high-acuity Medicaid beneficiaries.

Phase I employed a correlational design to assess relationships between monthly environmental conditions and appointment adherence by clinical condition. Results showed no significant …

The Predictive Validity Of Implicit, Explicit, And Subtle Racism Measures On Nonverbal Behavior And Explicit Evaluations Of Black And White Women Interviewers, Adele E. Weaver

Open Access Dissertations

Statement of the Problem: A long-standing history of the oppression of Black Americans has resulted in racism manifesting through White individuals’ nonverbal behavior in interracial interactions’ specifically by way of unfriendly behavioral cues, or on the other end of the spectrum, overly positive and patronizing nonverbal behavior. Regardless of the underlying sentiment, White people’s nonverbal behavior in interracial interactions affect Black people’s mental and physical health and longevity. However, there is a dearth of research on how well-established measures of implicit and explicit racism predict racist nonverbal behavior, and even more so for subtle self-report measures. Methodology: To this …

“What’S Supp” Developing An In Vitro Model For Healthy Oral Biofilms, Alex Labossiere

Open Access Dissertations

The study of oral plaque has largely been influenced by the study of pathogens. Here in Chapter 1, I will discuss how this pathogenic focus has been dominant until the onset of microbiome research and begin to explain microbiomes in the context of supragingival plaque in homeostatic communities. From there we will then discuss the possible roots where dysbiosis may arise from plaque to cause disease and ways in which we can study healthy supragingival plaque by in vitro models.

In chapter 2, I will discuss molecular commensalism and how it can be viewed as a tool to further understand …

"Understanding Obesity Experiences And Treatment Decision-Making In Hispanic-Latino Communities”, Viviane Fornasaro-Donahue

Open Access Dissertations

Obesity disproportionately affects Hispanic-Latino adults in the United States, yet rates of metabolic and bariatric surgery (MBS) remain lower in this population compared with non-Hispanic White adults. This dissertation comprises three interconnected phases aimed to (I) explore perceptions of obesity, obesity treatment, and patient-provider communication, (II) inform the development of a culturally responsive bilingual educational material about obesity and MBS, and (III) evaluate its acceptability among Hispanic-Latinos adults with obesity.

Phase I involved a qualitative exploration using semi-structured interviews with Hispanic-Latino adults (n=26) recruited from a community and a clinical MBS setting. These interviews explored participants’ perceptions of …

Ischemia-Induced Cytoskeletal And Nuclear Disruptions Drive Neuronal Death And Dysfunction: Insights Into The Connection Between Stroke And Dementia From In Vitro And In Vivo Models Of Stroke, Emily Potts

Open Access Dissertations

Stroke and Alzheimer’s disease and related dementias (ADRD) represent two of the leading causes of neurological disability worldwide, and their prevalence is expected to rise as the global population ages. Although stroke is traditionally viewed as an acute vascular event, a growing body of evidence suggests that transient ischemic injury can trigger lasting cellular disturbances that increase neuronal vulnerability to later neurodegeneration. Understanding how ischemic stress alters neuronal structure and function, and how these changes may overlap with pathways implicated in ADRD, is an emerging focus for stroke and neurodegenerative researchers. This dissertation addresses these questions through an integrated combination …

Coastal Perspectives: An Analysis Of Resident And Visitor Attitudes And Motivations Of Coastal Resilience Measures In Rhode Island, Jamie-Lynn Ward

Open Access Master's Theses

Anthropogenic impacts of climate change negatively affect the geographic structure, economic stability, and environmental conservation of coastal communities at exhaustive rates. Coastal resiliency planning and frameworks have been widely credited and criticized for their ability to mitigate climate risks in vulnerable communities. Yet, the rapid impacts of climate on communities' socioeconomic and environmental sectors have led to outcries from researchers and users for integrated and holistic coastal resilience approaches. Approaches highlighting stakeholders’ views of risks, coastal resilience measures, and place values to form localized adaptation and politically supported management strategies directly involving and benefiting communities. This mixed-method study was designed …