Outlaw Operators: Prevention Failures And The Resurgence Of Black Lung In Central Appalachia, Aysha Bodenhamer

Carsey School of Public Policy

In this brief, author Aysha Bodenhamer describes how prevention failures in the coal mining industry have resulted in the resurgence of black lung disease. Caused by the chronic inhalation of coal and silica dust, black lung is progressive, incurable, life-altering, and fatal. Despite it being a preventable disease, black lung is resurgent among coal miners in Kentucky, Virginia, and West Virginia. Fieldwork including in-depth interviews with miners, clinic workers, black lung attorneys, government employees, and lay advocates, and a case-study analysis of two black lung clinics in southwest Virginia inform this analysis. These data reveal that coal operators routinely evade …

Youth Homelessness - State Policy Review, Adam Mercer

Student Research Projects

This project was sponsored by Waypoint within their runaway and homeless youth continuum. Waypoint is a private non-profit operating in New Hampshire and supporting homeless youth statewide. The objective of the project was to review state policies affecting youth for the purpose of increasing Waypoint’s ability to advocate for legislative changes that can prevent and bring an end to youth homelessness.

The rights and freedoms of minors in unsafe situations are often limited and tied to another person’s guardianship, which may not be the best option for them. Expanding their rights through new policy could improve their safety, quality of …

Ideology Affects Trust In Science Agencies During A Pandemic, Lawrence C. Hamilton, Thomas G. Safford

Carsey School of Public Policy

In this perspectives brief, authors Lawrence Hamilton and Thomas Safford discuss the importance of government and public respect for scientific advice in mitigating the impacts of COVID-19. Striking political divisions in attitudes toward science have recently been evident in U.S. government statements and actions regarding the pandemic, and in opinions or behavior reported by general-public surveys. Although the COVID-19 crisis is breaking news, these political divisions in respect for science during a pandemic have deeper roots. A nationwide survey conducted by Carsey School researchers in 2016, immediately after the elections, found 25-point gaps between Trump and Clinton voters, or between …

Improving Transitions In Care: Focus On The Revocation Of Conditional Discharge Process In New Hampshire, Stacy A. Sorrell

DNP Scholarly Projects

Background: At this time there is no standardized education for providers of New Hampshire Hospital addressing the Revocation of Conditional Discharge Process. Psychiatric patients in New Hampshire most at risk for harm to self or others are managed through Involuntary Commitment Orders. These orders are intended to support those most at risk of destabilization and treatment non-compliance. The Revocation of Conditional Discharge Process is one of the procedures used to re-hospitalize a patient whose care is managed through an Involuntary Commitment Order when needed. The psychiatric providers at New Hampshire Hospital must complete this last step in the revocation process, …

Using The Bedside Care Conference To Improve The Patient Experience, Eileen Keefe

DNP Scholarly Projects

Abstract

Improving the patient experience of hospital care is a priority for nursing leaders. The terms patient satisfaction and patient experience have been used interchangeably to define the patient’s unique perspective on care quality and the impact of patient engagement on health outcomes. Patients and families experience suffering when their expectations are not congruent with their care in the hospital setting, and there are significant cost and financial implications for organizations that do not reach performance thresholds. Communication with nurses is highly correlated to overall patientsatisfaction in the Center for Medicare and Medicaid (CMS) Hospital Consumer Assessment of Providers and …

Tick-Borne Infections In New Hampshire: An Evaluation Of The Diagnostic Process In A Local Patient Population, Katherine Anderson

Honors Theses and Capstones

Overall, approximately 95 percent of reported cases of vector-borne disease were associated with ticks, making these the most medically important group of arthropods in the United States.¹ Despite the prevalence of tick-borne infections, the process for the diagnosis of this condition is not well studied. This study aims to analyze data from a pool of 100 patients who underwent testing for tick-borne disease in the same institution in Dover, New Hampshire during the most recent peak tick season of 2019. Information utilized in this study included: patient age, sex, location of testing (inpatient versus outpatient), diagnostic testing methods used …

Integrating Yoga Into A Medication Assisted Treatment Program To Improve Retention, Linda Davidson

DNP Scholarly Projects

Background: In 2017, Health and Human Services declared the opioid epidemic a public health emergency (US Department of Health & Human Services, 2017). As a response, access to medication assisted treatment (MAT) programs was encouraged. In 2016, a community health center in Western North Carolina started a MAT program integrating buprenorphine treatment with behavioral health (BH) services. Data from May 2018 through May 2019 demonstrated retention in the MAT program ranged from 65-75% at a given time with behavioral health attendance under 50%.

Aims: The aim of this quality improvement project was to examine if integrating yoga, an …

Promoting A Culture Of Civility Among Oncology Nurses In The Ambulatory Care Setting To Improve Patient Safety And Nurse Retention, Sheila Evans

DNP Scholarly Projects

INTRODUCTION: Nurse incivility is a well-documented phenomenon discussed in the literature and woven into the nursing lexicon. Nurse incivility results in negative consequences for nurses, patients and organizations. Adding to its complexity is the fact that nurses may be unable to identify and address covert uncivil behaviors and lack an effective tactic to mitigate situations.

AVAILABLE KNOWLEDGE: The nursing literature describes the existence of nurse-to-nurse incivility and its correlation with negative outcomes. Regulatory bodies such as The Joint Commission (TJC) also recognize the adverse outcomes resulting from civility and issued two alerts addressing workplace behavior. Additionally, the American Nurses Association …

Adults On The Autism Spectrum: A Quality Improvement Project To Develop A Patient-Centered Nursing Care Guideline For The Acute Care Setting, Elizabeth Cirelli

DNP Scholarly Projects

Abstract

Background: Incidence of autism spectrum disorder is increasing. Current prevalence rate is 1 in 59 people, which translates to roughly 1% of the U.S. population. These adults have higher rates of epilepsy, gastrointestinal disorders, obesity, cardiac dysfunction, and mental health disorders. Healthcare system utilization is resultantly greater than their neurotypical counterparts, coupled with longer lengths of stay and decreased patient satisfaction reports.

Purpose: Most nurses report little to no formal training about the disorder or how to develop interventions sensitive to the needs of this population yet are crucial care givers to ensure patient-centeredness. A guideline to …

Moving A Licensed Practical Nurse To A Registered Nurse In New Hampshire: A Health Policy Initiative, Vicki Gamez

DNP Scholarly Projects

Background: The United States is expected to experience a shortage of Registered Nurses (RN) due to a demand for more nurses to care for an aging population. Not only is there a current deficit in the number of RNs, but there is also a lack of ethnic and racial diversity among RNs. Licensed Practical Nurse (LPN) transition programs increase workforce mobility and allow LPNs to build upon their education and clinical experience as they transition to the RN roles. Therefore, the aim of this DNP project was to implement a health policy change initiative that addresses the barriers of workforce …

Creating Buy-In From Nurse Leaders To Implement Inpatient Education And Screening For Human Trafficking: A Quality Improvement Initiative, Andrea Macdonald

DNP Scholarly Projects

BACKGROUND: Human trafficking is an under-recognized healthcare issue affecting an

estimated 20 to 40 million individuals globally. Professional nursing organizations, healthcare

regulatory bodies and legislators have declared the need for education and screening practices. A

quality improvement initiative designed to create buy-in from nurse leaders to create and

implement education, screening and a protocol to guide care of human trafficking victims who

may present to inpatient and clinic settings at the organization was developed to bridge gaps in

knowledge and inform evidence-based practice.

METHODS: Literature review informed the development of an education intervention presented

to nurse leaders using multi-modal learning …

Timely Follow Up Care After Initiation Of Adhd Medication In Children: A Quality Improvement Project, Rebecca Haas

DNP Scholarly Projects

Background: Enhancing medication safety, strengthening compliance and mitigating side effects requires close monitoring. A child, defined by Centers for Medicare and Medicaid Services, as being between the ages of 6 years and 12 years of ages, with Attention Deficit Hyperactivity Disorder (ADHD) must have an initial medication visit within 30 days of a first-time trial of ADHD medication. Increasing staff awareness of organizational policy of expected timeframe for medication checks and annotating appointment slots as initial medication checks will decrease the number of days between the first-time trial of ADHD medication and a child’s medication assessment. Methods: The Model for …

Engaging Patients With Dementia In The Acute Care Setting: A Quality Improvement Initiative For Staff, Andrea Lee

DNP Scholarly Projects

Caring for dementia patients in the acute care setting can be challenging. Staff is trained to manage the acute illness and the symptoms of dementia can impact that care. Training for the care and management of the patient with dementia is not routinely provided for the acute care setting. According to the Alzheimer’s Association (2018), 5.7 million people are living with Alzheimer’s Dementia with the numbers projected to continue to rise. Training in the management of symptoms can alleviate stress and complications for not only the patient but staff members as well. The goal of this project is to educate …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

A Quality Improvement Initiative To Manage Shingrix Vaccine Inventory In Ambulatory Clinics, Tracy Colburn

DNP Scholarly Projects

Abstract

Background: Inventory control practices for adult vaccines, specifically Shingrix, in ambulatory clinics are not well known or researched. This quality improvement project takes place at a small healthcare organization consisting of a hospital and thirteen ambulatory clinics in Northern New England. Seven of the thirteen clinics have the Shingrix vaccine in their inventory.

Purpose: The aim of this quality improvement project was multifaceted. The first matter was the establishment of a two-week PAR level at seven of the thirteen ambulatory clinics connected to the organization. The second was the design and implementation of a Shingrix vaccine management program …

The Efficacy Of The Healthy Families Flourish Program For Families Raising Children With Autism Spectrum Disorder, Carli Madalena Rita

Honors Theses and Capstones

The family unit is the driving force that creates a foundation for life satisfaction and wellbeing of a child that extends across the lifespan. Understanding family health and family participation in meaningful daily activities are critical components of family life lacking in current research, especially for families raising children with autism spectrum disorder (ASD). This study seeks to determine the effectiveness of an occupational therapy intervention program designed to support families raising children with ASD to identify and overcome barriers to everyday family activities. The Healthy Families Flourish Program is a 10-session occupational therapy intervention program developed for this study …

Changes In Bone Health Of Female College Students, Sarah E. Pogany, Jesse Morrell, Maggie Dylewski Begis, Gretchen Arnold

Honors Theses and Capstones

Objective: Identifying individuals with low bone ultrasound attenuation (BUA) z-scores under the age of 30 can allow for improvements of bone health through increased intake of calcium and vitamin D, physical activity, and avoidance of excessive alcohol or caffeine intake. The goal of this study was to assess changes in bone health and observe related risk factors among female college students.

Participants and Methods: Female students (n=38) enrolled in the Nutrition Program at the University of New Hampshire (UNH) who participated in the College Health and Nutrition Assessment Survey (CHANAS) were recruited to participate in a follow-up study …

The Relationship Between Social Media Engagement And Psychological Well-Being In College Students At The University Of New Hampshire, Emily G. D'Antonio

Honors Theses and Capstones

Social media use has increased substantially in recent years, and for the college-aged population, social media is often the leading method of communication. Research indicates this reliance on digital connection could have a negative impact on the health of young adults (Bagroy et al., 2017). The college years are a time of personal growth and defining actions, yet can also be burdened by mental health issues related to stress, anxiety, and depression (Hunt & Eisenberg, 2010). Acknowledging these trends, the current study explores how college students’ specific frequency and intentionality while interacting on social media relates to their psychological well-being. …

The Role Of Socio-Economic Status On The Language Output Of 3-6 Year Old's During A Naturalistic Museum Study, Serena K. Mueller

Honors Theses and Capstones

Over the past 50 years, the lexical nature of young children’s multi-word utterances has been disputed. We ask how socioeconomic status (SES) impacts content and function word usage, and how function word use impacts MLU. Findings show that SES positively correlates with content word production and MLU, which contributes to our knowledge on how SES shapes language and highlights the need for its consideration across settings.

Examining The Relationship Between Adverse Childhood Experiences (Aces) And Health-Risk Behaviors Among Adolescents In New Hampshire, Riana S. Malik

Honors Theses and Capstones

Adverse Childhood Experiences (ACEs) are traumatic instances in the first 18 years of life including abuse, neglect, and household dysfunction. The Centers for Disease Control and Prevention (CDC) has outlined priority health-risk behaviors among adolescents as substance use, violent behaviors, unhealthy diet, physical inactivity, and unsafe sexual behaviors. Previous research has linked both ACEs and health-risk behaviors to negative health outcomes including disability, chronic disease, and substance use. That said, understanding and preventing risky behaviors among adolescents and working to reduce the lasting harm caused by ACEs can lead to healthier adults and communities going forward.

This research defines ACEs …

The Cholera Crisis In Yemen: Case Studies On Vulnerability And Resilience In Sana'a, Al Hudaydah, And Ma'areb, Noor Albannein A. Al-Saad

Honors Theses and Capstones

The largest recorded cholera epidemic in history is happening right now in Yemen, a country which has reported over 2 million cases of cholera as of 2020. Yemen has a history of endemic cholera, but prolonged conflict in the country has led to deteriorating conditions that have triggered massive outbreaks of the disease. The purpose of this study is to investigate the direct and indirect causes of the cholera epidemic in Yemen by proposing factors that may confer vulnerability and resilience in Yemeni governorates. Case studies were constructed for three governorates: Sana’a and the inner municipality of Amanat Al Asimah; …