Digital Commons Network^™

Clinical Care Protocol For Enhanced Nurse Competency In Caring For The Patient With An External Ventricular Drainage (Evd) Device, Lauren Orson

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The focus of this Doctor of Nursing Practice Project surrounds the need for an evidence-based clinical nursing protocol to augment nurse competency and therefore streamline care to patients with an external ventricular drain (EVD).
Methods: A clinical protocol alongside tailored education was used to promote nurse competency for EVD management. A pre-implementation survey was completed evaluating the nurses’ baseline competency when managing an EVD. The nursing protocol was then implemented for bedside use. After 2 months, the survey was completed once again and paired for statistical analysis.
Results: Statistical analysis using the Wilcoxon signed-rank nonparametric test with dependent matched …

Sick Day Plans For Pediatric Home Health To Reduce Unplanned Hospitalizations:, Katie Anderson

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background/Purpose: Pediatric home health patients with chronic respiratory conditions often have a higher risk of developing respiratory tract infections leading to emergency room (ER) visits and unplanned hospitalizations. A sick day plan (SDP) can help nurses recognize signs of illness early and prompt them to intervene with supportive respiratory care, thus preventing worsening illness and hospitalization.
Methods: A SDP respiratory assessment and intervention tool was implemented in a pediatric home health organization. The number of pre and post intervention ER visits and unplanned hospitalizations were compared.
Results: The total mean ER rates over 1 year before project implementation was found …

Implementing A Walking Program For Sedentary Patients In A Weight Management Clinic, Bailey Tetrault

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Promoting physical activity in weight management patients promotes better patient outcomes.
Methods: Weight management clinic patients were enrolled in the 6-week Walk with Ease (WWE) program. At the first session, each participant’s walking distance was measured over a 20-minute timeframe using pedometers. WWE group met 3 times weekly for six weeks for walking activities and with education on movement, mobility, and strength. At each session, the walking distance of participants was measured over 20 minutes. Race, gender and age descriptive were also collected.
Results: Statistical tests included the Friedman Test, ANOVA, and linear regression were calculated at the 5% …

Implementation Of A Venous Thromboembolism Protocol And Its Impact On Nurses’ Attitudes And Knowledge, Mikelle Eliason

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Venous thromboembolism (VTE) is a leading cause of preventable death following a surgical procedure in the United States. To reduce this risk, it is crucial that nurses are able to recognize VTE risks, perform a VTE risk assessment, and follow appropriate prophylactic recommendations.
Methods: Nurses received VTE education and the Caprini risk assessment model (RAM) was initiated at a rural outpatient surgery center. A pre- and postquestionnaire approach was utilized to evaluate nurses’ attitudes and knowledge on VTE risk assessment. Utilization of the Caprini RAM was tracked. Results: There were 8 nurse participants. At a 5% level of significance, …

Development And Validation Of Microrna Markers For Forensic Body Fluid Identification Using Rt-Qpcr, Jane Goble

Master of Science in Forensic Science Directed Research Projects

Body fluid identification is one of the first and most fundamental steps in the forensic DNA workflow. It allows analysts to determine where a sample might exist on an item of evidence, as well as the type of sample that they are dealing with. However, current serological methods have been documented to produce false or inaccurate results in some cases, and may consume large amounts of sample during processing. Molecular methods, such as the use of microRNA and microbial profiles have been introduced as a means to increase specificity of testing, and have even been combined into a singular assay …

Assessment Of The Acidified Hydrogen Peroxide Method On Uncontrolled Fired Cartridge Case Samples, Kylie S. Richardson

Master of Science in Forensic Science Directed Research Projects

The use of fingerprints to identify individuals in forensic cases has been useful for many years due to the persistence and individuality of the prints. In addition, the presence of firearms in forensic casework is steadily increasing over the years. This study aims to expand upon prior research in the development and recovery of latent prints on fired, brass ammunition using an acidified hydrogen peroxide method. Although latent prints are left on the cartridge casing of ammunition during the handling and loading of ammunition into the firearm, it is hypothesized that the pressure within the barrel of the firearm during …

Analysis Of Forensic Relevant Cell Mixtures Using Cellular Autofluorescence And Fluorescence Activated Cell Sorting (Facs), Shayla Smith

Master of Science in Forensic Science Directed Research Projects

Biological mixtures containing DNA from more than one contributor can make DNA profile interpretation challenging, especially for ‘touch’ or trace biological evidence. One approach to improve this is by differentiating cell populations from separate individuals prior to DNA profiling by utilizing intrinsic features of cells such as size, shape, and biochemical profiles. The goal of this study was to develop a new method for detecting and separating contributor populations in biological mixture samples using flow cytometry, a rapid and non-destructive approach with an unexplored potential for forensic casework. To accomplish this, two different mixture systems were investigated (1) mixtures containing …

Working Class Roots, Joanne Detore

Publications

No abstract provided.

Strengthening New Hampshire’S Primary Care Workforce Pipeline: Utilization Of Alternative Scheduling Models, Elizabeth Harrison

DNP Scholarly Projects

Abstract

BACKGROUND: Traditional clinical scheduling coupled with the current reimbursement system have created systematic barriers leading to decreased clinical education opportunities. Alternative scheduling models such as longitudinal integrated clerkships, one preceptor to two students and wave scheduling have the potential to eliminate these barriers and provide financial gains and increased access to care.

INTERVENTION: Interventions to meet this quality improvement project's objectives included (1) pre-intervention planning (2) focus groups, (3) video presentations and (4) a pilot program of alternative scheduling models in clinical practice.

RESULTS: A pilot program utilizing the alternative scheduling models increased the relative value units (RVU) of …

A Comparison Of Outcomes For Lipid Emulsions In Total Parenteral Nutrition Among Home Infusion Patients, Gregory W. Wesley-Lynch

DNP Scholarly Projects

This quality improvement project aimed to compare the outcomes of lipid emulsions used in total parenteral nutrition among home infusion patients. The quality improvement project included 45 patients who received four weeks or more of either Intralipid or SMOFlipid. Paired t-tests were used to compare SMOFlipid and Intralipid regarding three liver function test (LFTs) values; (Alkaline Phosphate (ALP), Aspartate transaminase (AST,) and Alanine transaminase (ALT). Results demonstrated that SMOFlipid was superior to Intralipid, resulting in lower LFTs for ALP, AST, and ALT. This study provides evidence to support the use of SMOFlipid over Intralipid in total parenteral nutrition for home …

Decreasing Post-Operative Ventilator Time In The Cardiovascular Surgical Patient: A Nursing Education Quality Initiative, Amanda J. Bruno Roberts

DNP Scholarly Projects

Extended mechanical ventilation times after open heart surgery can contribute to complications prolonging recovery and length of stay, as well as increasing mortality. Standardized staff education of immediate post-open-heart recovery and ventilator weaning protocols, combined with the use of ABCDE and VAP bundles can reduce these complications. At Hospital X during summer of 2022, the average length of time patients remained mechanically ventilated after open heart surgery increased. After an initial needs survey was distributed to nursing staff, a set of novel QR codes was created to simplify and centralize training for staff in the ICU to facilitate early extubation …

Improving Emergency Department Patient Experience Through The Engagement Of A Patient And Family Advisory Council To Create And Implement A Patient Rounding Tool, Rosemary Ostendarp

DNP Scholarly Projects

BACKGROUND: Patient experience is an essential indicator of healthcare performance. Understanding and improving patient experience in an Emergency Department is a complex issue.

INTERVENTION: The goal of the quality improvement project was to improve the patient experience by engaging with a Patient and Family Advisory Council to create a Patient Rounding tool. The Patient Rounding tool was used to obtain patient feedback, identify concerns, enhance patient comfort, and provide an opportunity for positive staff recognition. Patient Experience Scores were measured via the Emergency Department Consumer Assessment of Healthcare Providers and Systems (ED CAHPS) survey.

RESULTS: Five hundred twenty rounding sessions …

A Quality Improvement Initiative: Addressing Workplace Violence Toward Nurses To Promote A Culture Of Safety In An Inpatient Psychiatric Facility, Ernestina Danso

DNP Scholarly Projects

This quality improvement initiative aimed to address workplace violence against nurses in inpatient psychiatric facilities and promote a culture of safety. The QI project involved 27 participants, including inpatient psychiatric nurses and mental health counselors from Cahill 4 and 7 West units at the Cambridge Campus. The primary objective was to identify challenges that hindered the effective utilization of the Broset Violence Checklist (BVC) tool for referring patients to sensory modulation rooms.

Pre- and post-intervention surveys were conducted to assess participants' self-reported knowledge and barriers to BVC and sensory room utilization. Educational sessions covering workplace violence, debriefing techniques, and the …

Exploring & Mitigating Workplace Incivility At A Rural Community Hospital, Jacquelyn Ethier

DNP Scholarly Projects

Workplace Incivility (WI) is a well-known challenge in healthcare, with decades of mounting evidence showing the effects on workplace culture, healthcare worker retention and patient safety. The nursing workforce has become increasingly vulnerable to all stressful elements of the work environment. Organizational leadership must develop and deploy mitigation strategies to minimize the negative consequences of these behaviors for nurses, and the entire healthcare team. The purpose of this quality improvement project is to assess the current state of nurse perceptions of WI at a rural community hospital and deploy evidence-based education on strategies to address and mitigate WI. The method …

Show-Me Resilience: Assessing And Reconciling Rural Leaders’ Perceptions Of Climate Resilience In Missouri, Zachary J. Miller, Caleb O'Brien, Casey I. Canfield, Lauren Sullivan

Engineering Management and Systems Engineering Faculty Research & Creative Works

Rural areas of the United States play a vital role in coping with, adapting to and mitigating climate change, yet they often lag urban areas in climate planning and action. Rural leaders—e.g., policymakers, state/federal agency professionals, non-profit organization leadership, and scholars – are pivotal for driving the programs and policies that support resilient practices, but our understanding of their perspectives on climate resilience writ large is limited. We conducted semi-structured interviews with 23 rural leaders in Missouri to elucidate their conceptualizations of climate resilience and identify catalysts and constraints for climate adaptation planning and action across rural landscapes. We investigated …

Deep Reinforcement Learning For Approximate Policy Iteration: Convergence Analysis And A Post-Earthquake Disaster Response Case Study, Abhijit Gosavi, L. (Lesley) H. Sneed, L. A. Spearing

Engineering Management and Systems Engineering Faculty Research & Creative Works

Approximate Policy Iteration (API) is a Class of Reinforcement Learning (RL) Algorithms that Seek to Solve the Long-Run Discounted Reward Markov Decision Process (MDP), Via the Policy Iteration Paradigm, Without Learning the Transition Model in the Underlying Bellman Equation. Unfortunately, These Algorithms Suffer from a Defect Known as Chattering in Which the Solution (Policy) Delivered in Each Iteration of the Algorithm Oscillates between Improved and Worsened Policies, Leading to Sub-Optimal Behavior. Two Causes for This that Have Been Traced to the Crucial Policy Improvement Step Are: (I) the Inaccuracies in the Policy Improvement Function and (Ii) the Exploration/exploitation Tradeoff Integral …

A Genome-Wide Association Study Coupled With Machine Learning Approaches To Identify Influential Demographic And Genomic Factors Underlying Parkinson’S Disease, Md Asad Rahman, Jinling Liu

Engineering Management and Systems Engineering Faculty Research & Creative Works

Background: Despite the recent success of genome-wide association studies (GWAS) in identifying 90 independent risk loci for Parkinson's disease (PD), the genomic underpinning of PD is still largely unknown. At the same time, accurate and reliable predictive models utilizing genomic or demographic features are desired in the clinic for predicting the risk of Parkinson's disease. Methods: To identify influential demographic and genomic factors associated with PD and to further develop predictive models, we utilized demographic data, incorporating 200 variables across 33,473 participants, along with genomic data involving 447,089 SNPs across 8,840 samples, both derived from the Fox Insight online study. …

Improving Social Bot Detection Through Aid And Training, Ryan Kenny, Baruch Fischhoff, Alex Davis, Casey I. Canfield

Engineering Management and Systems Engineering Faculty Research & Creative Works

Objective: We test the effects of three aids on individuals' ability to detect social bots among Twitter personas: a bot indicator score, a training video, and a warning. Background: Detecting social bots can prevent online deception. We use a simulated social media task to evaluate three aids. Method: Lay participants judged whether each of 60 Twitter personas was a human or social bot in a simulated online environment, using agreement between three machine learning algorithms to estimate the probability of each persona being a bot. Experiment 1 compared a control group and two intervention groups, one provided a bot indicator …

Approximation Of Optimal Control Surfaces For The Bass Model With Stochastic Dynamics, Gabriel Nicolosi, Christopher Griffin

Engineering Management and Systems Engineering Faculty Research & Creative Works

The Bass diffusion equation is a well-known and established modeling approach for describing new product adoption in a competitive market. This model also describes diffusion phenomena in various contexts: infectious disease spread modeling and estimation, rumor spread on social networks, prediction of renewable energy technology markets, among others. Most of these models, however, consider a deterministic trajectory of the associated state variable (e.g., market-share). In reality, the diffusion process is subject to noise, and a stochastic component must be added to the state dynamics. The stochastic Bass model has also been studied in many areas, such as energy markets and …

Usdot Tier-1 University Transportation Center For Advancing Cybersecurity Research And Education, Yunpeng Jack Zhang, Kailai Wang, Lingguang Song, Amaury Lendasse, Houbing Herbert Song, Zhu Han, Rakesh Verma, Arlei Silva, Carlos Rubio-Medrano, Zhixia Richard Li, Guohui Zhang

Engineering Management and Systems Engineering Faculty Research & Creative Works

The Transportation Cybersecurity Center for Advanced Research and Education (Cyber-Care) is a Us Department of Transportation (Usdot) Tier-1 University Transportation Center (Utc) Funded in 2023. Cyber-Care Primarily Focuses on the Usdot Statutory Research Priority Area of 'reducing Transportation Cybersecurity Risks.' Cyber-Care Aims to Establish a Fundamental Knowledge Basis and Explore Advanced Theory to Mitigate the Impacts of Large-Scale Cyberattacks on Transportation Infrastructure and Connected and Automated Vehicle (Cav) Systems. the Research Projects at Cyber-Care Will Develop Conceptual Frameworks, Construct Comprehensive Datasets, Explore Novel Analytical Approaches, Support the Implementation of Public Policies and Infrastructure Investments, and Build a High-Quality Industry Workforce …

Improved Quantification Of Defect Cross-Section For Active Microwave Thermography, Logan M. Wilcox, Kristen M. Donnell

Electrical and Computer Engineering Faculty Research & Creative Works

Active microwave thermography (AMT) is an integrated nondestructive testing and evaluation (NDT&E) technique that features a microwave-based excitation and subsequent thermographic inspection via an infrared camera. AMT has been successfully employed in several industries including aerospace and civil for NDT&E inspections. Since the excitation is microwave-based, an antenna is used to irradiate the sample under test and hence the heating pattern will vary spatially (following the antenna pattern). This nonuniform thermal excitation may limit the ability of AMT to quantify defect cross-sections. Therefore, this work seeks to expand the capabilities of AMT by incorporating a post-processing technique to improve defect …

Optimal Adaptive Tracking Control Of Partially Uncertain Nonlinear Discrete-Time Systems Using Lifelong Hybrid Learning, Behzad Farzanegan, Rohollah Moghadam, Sarangapani Jagannathan, Pappa Natarajan

Electrical and Computer Engineering Faculty Research & Creative Works

This article addresses a multilayer neural network (MNN)-based optimal adaptive tracking of partially uncertain nonlinear discrete-time (DT) systems in affine form. By employing an actor–critic neural network (NN) to approximate the value function and optimal control policy, the critic NN is updated via a novel hybrid learning scheme, where its weights are adjusted once at a sampling instant and also in a finite iterative manner within the instants to enhance the convergence rate. Moreover, to deal with the persistency of excitation (PE) condition, a replay buffer is incorporated into the critic update law through concurrent learning. To address the vanishing …

Lifelong Learning-Based Multilayer Neural Network Control Of Nonlinear Continuous-Time Strict-Feedback Systems, Irfan Ahmad Ganie, S. (Sarangapani) Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

In This Paper, We Investigate Lifelong Learning (LL)-Based Tracking Control for Partially Uncertain Strict Feedback Nonlinear Systems with State Constraints, employing a Singular Value Decomposition (SVD) of the Multilayer Neural Networks (MNNs) Activation Function based Weight Tuning Scheme. the Novel SVD-Based Approach Extends the MNN Weight Tuning to (Formula Presented.) Layers. a Unique Online LL Method, based on Tracking Error, is Integrated into the MNN Weight Update Laws to Counteract Catastrophic Forgetting. to Adeptly Address Constraints for Safety Assurances, Taking into Account the Effects Caused by Disturbances, We Utilize a Time-Varying Barrier Lyapunov Function (TBLF) that Ensures a Uniformly Ultimately …

Efficient High Order Ensemble For Fluid Flow, John Carter

Doctoral Dissertations

"This thesis proposes efficient ensemble-based algorithms for solving the full and reduced Magnetohydrodynamics (MHD) equations. The proposed ensemble methods require solving only one linear system with multiple right-hand sides for different realizations, reducing computational cost and simulation time. Four algorithms utilize a Generalized Positive Auxiliary Variable (GPAV) approach and are demonstrated to be second-order accurate and unconditionally stable with respect to the system energy through comprehensive stability analyses and error tests. Two algorithms make use of Artificial Compressibility (AC) to update pressure and a solenoidal constraint for the magnetic field. Numerical simulations are provided to illustrate theoretical results and demonstrate …

Tradeoffs May Counteract Effects Of Telecommunication Towers On Osprey Nesting, Gage R. Barnes, Kate G. Slankard, John B. Hewlett, Andrea K. Darracq

Human–Wildlife Interactions

The number of telecommunication towers (TCTs) throughout the United States has and continues to increase exponentially. Increased TCT placement has been implicated in local population increases in platform nesting birds such as ospreys (Pandion haliaetus). However, osprey use of artificial structures can cause conflicts with humans because of economic costs and risks to human safety. Managers require better information regarding the effect of artificial nesting surfaces, such as TCTS, on osprey reproduction to make informed decisions regarding species conservation and to mitigate potential conflicts. The objective of our study was to evaluate the influence of TCTs on osprey …

Do Trap-Neuter-Return (Tnr) Practices Contribute To Human–Coyote Conflicts In Southern California?, Danielle M. Bucklin, Jennifer M. Shedden, Niamh M. Quinn, Robert Cummings, Paul Stapp

Human–Wildlife Interactions

One possible contributor to the unusually high number of conflicts between coyotes (Canis latrans) and people in urban southern California, USA, may be the abundance of free-roaming domestic cats (Felis catus; cats) subsidized by feeding and augmented by trap-neuter-return (TNR) programs. To determine if coyotes regularly prey on and consume cats, we combined visual and molecular-genetic approaches to identify prey items in stomachs of 311 coyotes from Los Angeles County and Orange County, provided to the South Coast Research and Extension Center, in Irvine, California, between June 2015 and December 2018. We detected cat remains in …

Falconer Perceptions Of, And Support For, Rabbit Hemorrhagic Disease Biosecurity Actions, Hannah G. Shapiro, Elizabeth F. Pienaar

Human–Wildlife Interactions

Rabbit hemorrhagic disease virus 2 (RHDV2) is a highly contagious virus that primarily infects wild and domestic rabbits and hares (lagomorphs). In the United States, state wildlife agencies rely on stakeholders to report RHDV2-related mortalities and engage in voluntary biosecurity actions to prevent the spread of RHDV2. However, stakeholder perceptions of RHDV2 and relevant biosecurity actions have not been evaluated. We conducted the first study in the United States on how falconers’ risk perceptions, knowledge, trust in state wildlife agencies to manage RHDV2, hunting behaviors, and demographic characteristics influenced their willingness to engage in voluntary biosecurity actions and support potential …

An Unmanned Aircraft System For Marking Live Power Lines To Prevent Bird Collisions, Mattheuns D. Pretorius, Lourens Leeuwner, Kaajial Durgapersad, Constant Hoogstad, Peter Beckedahl, Michael D. Michael, Kishaylin Chetty

Human–Wildlife Interactions

Collisions with overhead power lines represent a significant cause of mortality for a number of large bird species worldwide. Certain threatened species are severely impacted by power line collisions, particularly those for which there are no other known significant threats. In South Africa, bird collisions with overhead power line cables, including collisions with phase conductors and shield wires, contribute significantly to annual threatened bird species mortalities associated with Eskom power lines. The most practical mitigation measure is to attach bird anti-collision devices as markers on the cables. Current marking methods involve installations by hand, where linemen are hoisted up to …

Navigating The Soviet Experiment: Travels And Writings Of John Dos Passos And Edmund Wilson In Soviet Russia, 1928-1935, Robert Allan Winslow

Graduate Student Theses, Dissertations, & Professional Papers

The travel accounts of Soviet Russia by John Dos Passos (1896-1970) and Edmund Wilson (1895-1972) vividly demonstrate how Western writer-travelers were drawn into Soviet cultural experiments. Only rarely was this process one of literary influence. This thesis focuses on published travel writings by Dos Passos (In All Countries, 1934) and Wilson (Travels In Two Democracies, 1936), as well as journals, letters, and essays, in terms of Soviet cultural developments both writers noted as historically significant in shaping Western views of the Soviet state, and of the methods involved in building socialism and Communism.

In the …

Beliefs About False Allegations Of Sexual Violence: Intergroup Contact Theory And Rape Myth Acceptance At A Rocky Mountain University, Alexandra Marie Buscaglia

Graduate Student Theses, Dissertations, & Professional Papers

False allegations of sexual assault represent approximately 2% to 10% of all sexual assault allegations reported to law enforcement (Lisak et al., 2010). Despite this low prevalence rate, people tend to overestimate the occurrence of false allegations, and give false allegations excessive weight in arguments about rape myths and policy-making decisions. This excessive weight is given despite a lack of research evidence that false reports of sexual violence occur more frequently than those of any other crime (Ask, 2010; McMillan, 2018; Stabile et al., 2019). This overestimation is likely influenced by the overrepresentation and sensationalization of false allegations in the …