The UA Honors Theses collection provides open access to W.A. Franke Honors College theses produced at the University of Arizona, submitted electronically since 2008. Not all students opt to include their theses in the repository, so the collection is not comprehensive.

W.A. Franke Honors College theses from the late 1960s to 2005 are not online and are available only in Special Collections. These theses are not listed in the online catalog, but a separate card catalog for them is available in Special Collections.

Individuals trying to obtain a record or copy of their own W.A. Franke Honors College thesis, such as electronic submissions since 2008 that are not included online, or paper submissions from 2006-2007, should contact the W.A. Franke Honors College.

Important note for students submitting Honors Theses: your thesis must be submitted directly to the W.A. Franke Honors College (not to the repository). The W.A. Franke Honors College delivers approved theses to repository staff at regular intervals when all requirements have been met for Graduation with Honors. Check with your W.A. Franke Honors College advisors and see Honors Thesis/Capstone for more information.


Please refer to the Theses & Dissertations guide for more details about UA Theses and Dissertations, and to find materials that are not available online. Email repository@u.library.arizona.edu with your questions about UA Theses and Dissertations.

Recent Submissions


    Burt, Janis; Silva-Mendoza, Diego (The University of Arizona., 2021)
    Heart tissue beats synchronously due to the electrical coupling provided by intercellular channels termed gap junction channels. In the ventricles of the heart, these channels are composed of connexin 43 (Cx43); large numbers of these channels localize at the intercalated discs, the site of mechanical as well as electrical coupling in the heart. The colligative properties of these channels support passage of electrical signals from cell to cell, signals that lead all cells of the ventricles (myocytes) to contribute simultaneously to each contraction. Heart attacks, blood clots, or other events that restrict blood flow to (and diffusion of oxygen into) the myocytes for 30 minutes or more, disrupt electrical coupling in the affected (ischemic) region and negatively impact coordinated contraction in the heart, often with deadly effect. Interestingly, loss of blood flow for a brief period of time can protect the heart and electrical coupling from subsequent longer periods of lost blood flow. This protection may, at least in part, reflect phosphorylation, the addition of a phosphate group, to a specific amino acid residue, serine 368 (S368) in the Cx43 protein. Phosphorylation at this residue changes the function of Cx43 channels in a manner that minimizes ischemia-induced damage. In the current project we aim to delineate an accurate time course for phosphorylation of S368, and dephosphorylation of CK1 sites (S325, S328, S330). Dephosphorylation of CK1 sites is associated with ischemic damage. To do so, we are using separate antibodies that specifically detect only the phosphorylated S368 (pS368), and only the phosphorylated CK1 sites (pCK1) in hearts ischemic for 0, 5, 10, 20, and 30’. Results are compared to total Cx43 in the same hearts. Our data suggest that pS368 appears in the first 5-10’ of ischemic time, and that pCK1 levels are reduced simultaneously. Further research into the localization of pS368 and pCK1 Cx43 is necessary to assess the movement of total Cx43 or mechanism of reduction of CK1 Cx43.

    Sharkey, Nancy; Grabinski, Alyssa Rose (The University of Arizona., 2021)
    The purpose of this project was to highlight various alumnae from the University of Arizona who have gone on to pursue careers in what many label “soft news.” Here at the University of Arizona, the journalism major focuses on “hard news,” the straight-forward, unbiased, basic description of the facts. The journalism program fails to recognize that entertainment is a growing field, even though many of our own alumnae have gone on to pursue careers in this industry. In this magazine, seven alumnae were interviewed on their career path. These alumnae have worked at places like Teen Vogue, TMZ, Entertainment Tonight, J. Crew, and more. With ever-changing curriculum, my hope is that the journalism program can implement some entertainment, fashion, and lifestyle courses to reflect the ever-growing possibilities of journalism.
  • Coding of the Unseen: Place Cells in Unmarked Reward Influencing Areas

    Fellous, Jean-Marc; Gerken, Blake Anthony (The University of Arizona., 2021)
    Research has shown that the CA1 region of the hippocampus contains specialized pyramidal cells that encode locations and rewards, termed place cells and reward cells respectively. Methodologically, rewards are used to produced preferred areas while adverse stimuli such as a foot shocks are used to elicit avoidance behavior. How positive or aversive areas affect place cell firing is generally unknown but can give important insights into the nature of place cells, reward cells and their interactions. The effects of reward influencing areas was studied using an open octagonal maze using unmarked zones. When a given unmarked zone was entered it would randomly trigger a sound and a reward at one of eight sites of the maze. If the zone was negative, it would instead de-activate an already primed reward zone and trigger a delay before the next reward becomes available. Behaviorally, it was shown that the rats learned to go to the positive zone to receive a reward elsewhere on the maze and avoid the negative zone. Pilot tetrode recordings in CA1 of the dorsal hippocampus further showed intriguing remapping patterns of place fields when an unmarked zone was present. This presents evidence that a rat can learn and encode locations that affect future delivery or withdrawal of rewards even if those locations are themselves devoid of rewards or punishment.

    Schon, Robert; Yao, Ruijie (The University of Arizona., 2021)
    This research pays some attention to the cultural contact, economic commerce, and diplomatic relation between Egypt and the Aegeans from the entire Bronze Age phase by interpreting the archaeological evidence from both Middle Kingdom, Second intermediary, and New Kingdom Egypt and Aegean sites. The cultural, economic, and diplomatic contact between Egypt and the Aegean world seems to be a great part of systematic networks in the Bronze Age Mediterranean. The trade, tributary alignment, and the royal marriage between Egypt and Minoan for diplomatic purposes were all fruitions of international relationships in the Eastern Mediterranean world. The power wrestling of these different ancient superpowers boosted the prosperity of the commercial economy and ideological exchanges in some unexpected way, and the influences of these grandiose historic contexts had influenced some periphery parts of the existing world at that time. The archaeological evidence from the Aswan, Avaris-Pirameses complex, el-lisht, Kahun, and Abydos will be intentionally collected to demonstrate the trajectory of interregional contacts between Egypt and the Aegeans under the hegemonial power structure. In this thesis, I will coordinate the two regional studies under one theoretical approach. I viewed the Neo-Marxism theory as a juncture for analyzing ancient IR and ancient political economy. I used Neo-Gramscian theory to deconstruct the apparatus of Egypt-centric hegemony.

    Willerton, John P.; Sone, Joshua Jared (The University of Arizona., 2021)
    The coronation of Nicholas II in 1894, marked a shift in the dynamic of Imperial Russia. What was beginning to become a modernized society under Alexander II seemed to be undone shortly within the reigns of both Alexander III and Nicholas II. However, it was Nicholas II who significantly transitioned the empire away from a path toward modernity and instead steered the empire for a path of oppression and economic hardship for all classes but the nobility. The Jewish community in Imperial Russia had been targeted by a series of organized, often violent attacks beginning in the 1800s. This, in addition to discrimination by the general population, caused a wave of anti-Semitism to spread throughout the Russian territories. Those who fled did so due to unfair treatment by the government, rampant ethno-nationalist agendas, and poor economic conditions at the hands of Tsar Nicholas II. An analysis of the factors that can lead to economic downturn and inequality among citizens within societies that emphasize authoritarianism and propaganda is essential in understanding the governmental policies that led to the Jewish diaspora of the late 19th and early 20th centuries. The February Revolution was the culmination of ineffectual leadership of a top-down autocracy that failed to modernize economically in an attempt to maintain control over the population and not spark uprising, leading to the eventual diaspora of many religious minorities, most notably Jews.

    Johnson, Ryan; Shulman, Kennedy Anne (The University of Arizona., 2021)
    The NCAA, previously known as the IAA until 1910, was developed to regulate intercollegiate athletics. In response to the increasing commercialization of college athletics and public pressures, the NCAA implemented more stringent regulatory systems to govern student-athletes. In doing so, they limited the financial and opportunistic benefits athletes were allowed to receive and backed their governing structure on the ideal of amateurism. Until recently, NCAA rules prohibited student-athletes from being compensated for their names, images, and likenesses in any form. This includes financial aid exceeding the cost of attendance at their respective schools, contracts with any professional team, endorsements, and any other pay based on athletic ability. The NCAA’s amateurism model has come under attack for the exploitation of student-athletes. In several major cases, concerns were raised that the NCAA’s stringent rules were subject to antitrust laws and created unlawful restraints of trade. Through heavy litigation in cases such as O’Bannon v. NCAA and NCAA v. Alston, these concerns were confirmed. Using the Rule of Reason to interpret the Sherman Antitrust Act, it was held that the NCAA’s rules restricting education-related benefits violated federal antitrust laws. This ruling did not concern restrictions untethered to education, but in response to state laws being passed regarding such matters, the NCAA opened up existing constraints. This study aims to look at the implications of this ruling and its impact on student-athletes and NCAA member schools. These implications include how NIL activities will proceed without a federal law, how competitive balance will be preserved between bigger and smaller schools, and how student-athletes and member schools alike will be financially impacted.

    Braithwaite, Alex; Sheets, Ryan Brent (The University of Arizona., 2021)
    The forced recruitment of child soldiers is a widespread practice employed by rebel groups around the world. What determines when rebel groups engage in this brutal strategy? We argue that it depends on their susceptibility to audience costs imposed by the local community. Rebel groups that rely on local constituencies for food, funds, and shelter have a strong incentive to maintain their support base and refrain from abusive practices like the forced recruitment of children. Utilizing data from three distinct datasets, we test the effect of political movement parent organizations and rebel leader elections on the forced recruitment of child soldiers. We demonstrate empirically that rebel groups that are founded from political movements are less likely to forcibly recruit child soldiers. Our analysis also shows that when combined, groups that both form out of political movements and hold elections as a form of leader ascension are far less likely to engage in forced child soldier recruitment. We argue that our explanatory variables indicate an underlying susceptibility to audience costs and that our results demonstrate the importance of audience costs in rebel group strategy and the perpetration of human rights abuses.

    Pace, Thaddeus; Parikh, Sneha Hiral (The University of Arizona., 2021)
    Despite dramatic improvements in survival time over the last several decades, many survivors of solid tumor cancers experience impairments in health-related quality of life (HRQOL), both during and after cancer treatments end. Relevant to this problem are socioeconomic factors, such as household income and education, that may be predict various domains of HRQOL, including psychological distress (i.e., depression and anxiety). While cancer survivorship studies usually control for these demographic characteristics, few studies directly focus on how income and education may relate to psychological distress when developing interventions intended to improve well-being for solid tumor cancer survivors (as well as their informal caregivers, i.e., family and close friends). This study therefore investigated how household income and educational background may influence how a meditation-based intervention and an active attention control group impact depression and anxiety in solid tumor cancer survivors. Cognitively-Based Compassion Training (CBCT®) is an eight-week meditationbased intervention that focuses on the cultivation of compassion and empathy for oneself and others. Forty-one solid tumor cancer survivor-informal caregiver dyads were randomly assigned to CBCT or a cancer health education (CHE) control. Participants completed HRQOL questionnaires, including measures of depression and anxiety, before and after the interventions. We predicted that household income and education would influence how CBCT and CHE, inclusive of caregivers, change survivor depression and anxiety. Although we did not find evidence that household income and education influence how CBCT versus CHE may change survivor depression and anxiety, the findings suggest that lower household income and less education may be associated with higher survivor depression and anxiety. Future research with interventions to improve HRQOL and decrease psychological distress for cancer survivors and informal caregivers should continue to control for education and household income, and may also actively address these important demographic characteristics when tailoring interventions intended to improve well-being for survivors and informal caregivers.

    Nicolazzo, Z; Ogg, Griffin A. (The University of Arizona., 2021)
    The purpose of this thesis is to see if policies protecting incarcerated transgender, nonbinary, intersex and gender nonconforming individuals are being implemented, and if it is being done so in an equitable way. To research this topic, a survey was sent out to these individuals, which asked about topics such as their access to appropriate housing, protection from crossgender strip searches, access to hormones, access to gendered items, housing, and placement in solitary confinement. The research aimed to find any correlation between these and demographics such as gender identity, race, and income. Participants from both supposedly progressive jurisdictions and more conservative jurisdictions took the survey. While the survey found some demographic groups did have a higher chance of receiving transphobic mistreatment while incarcerated, it also found that these correlations did not always benefit privileged demographics. However, placement in solitary confinement was less likely for less privileged demographics. The report suggests more forcefully implementing existing policy for future change, and enacting more changes to protect this vulnerable population.

    Cohen, Zoe; Moreno, Gabriela Mercedes (The University of Arizona., 2021)
    As a result of the COVID-19 pandemic, reports of anxiety and depression within college students are higher than pre-pandemic. The already persistent mental health crisis has only worsened in the past couple of years due to the chaos of illness, loss, and isolation. The University of Arizona and other colleges around the world, must learn how to tend the needs of its students, and craft a plan that will allow for a smooth transition into and out of online learning. Research from pre-COVID reports the most prominent causes of depression and suicide in college students. The greatest of these causes include romantic relationships, family troubles, and maintaining grades. Results from a University of Arizona Campus Health survey in May 2020 showed that fear of illness, the potential infection or loss of a family member, and juggling school took the greatest toll on students. These apparent psychological issues, all have physiological explanations. Serotonin, and important component in neuroendocrine signaling within the brain, as well as the brain structures themselves, and common genetic mutations all play a part in the biology of depression. Serotonin levels along with illness, loss, and traumatic events all have direct physical effects on the body. SSRI’s and counseling have shown promising results as treatments for depression. The mental health challenges presented pre and post-COVID are very similar, meaning changes put in place now, like greater access to counseling and psychiatric services can help students regardless of the pandemic.

    Oñate, Andrés D.; Kusy, Annalise Nicole (The University of Arizona., 2021)
    In modern China, environmental deterioration quickly transforms into one of the country's most severe problems. Despite pressures of modernization on water resources, reforms and policies unsuccessfully manage this crisis. The lack of genuinely productive actions towards a Chinese ecological civilization traces back to the tension between environmental protectionism and economic growth. The majority of literature on Chinese environmental policy does not consider the influence of globalizing forces on governing bodies. Thus, this research analyzes these gaps in Chinese environmental protection from globalization, a catalyst for China's lacking environmental infrastructure. Here, environmental science, history, policy, and globalization synthesize into a holistic perspective on Chinese water issues. The study finds that mainstream free-trade economic globalization is China's most significant barrier to sustainable water. Historical causations of China's opening-up, foreign environmental implications, and currently operational ineffective environmental protection policy illustrate this barrier. Although this research finds current practices of economic globalization to be ineffective in maintaining a sustainable world, David Boje offers his Mother Earth Economy as an alternative. Overall, the conclusions drawn about China's environmental degradation apply to global environmental degradation. The whole world would do well to be wary of the implications of unchecked globalization on a sustainable future.

    Barnes, Katherine; Kane, Morgan (The University of Arizona., 2021)
    This paper explores the effects of pre-trial publicity on criminal case proceedings, and how publicity impacts a defendant’s right to a fair trial. Balancing the First Amendment against the Sixth Amendment of the United States Constitution, a defendant’s right to due process is affected by the media’s right to the freedoms of the press. Two cases – Irvin v. Dowd (1961) and Sheppard v. Maxwell (1966) – first introduce the concept of pre-trial publicity. As courts decided how to manage such publicity in the courtrooms, unconstitutional issues arose as demonstrated through Nebraska Press Association v. Stuart (1976), Richmond Newspapers v. Virginia (1980), and Mu’Min v. Virginia (1991). Following what is deemed unconstitutional, the current pre-trial publicity test is evaluated, and the issues surrounding it are discussed. The paper details the court’s solution and the defense attorney’s solution on how to combat the effects of pre-trial publicity, which introduces the Jodi Arias case. The legality of gag lawsuits in Australia and Canada are discussed and are compared to how the United States prohibits such bans on the press. In the conclusion, the ideas of pre-trial publicity are finalized and future implications as media outlets grow are considered.

    Tax, Frans; Haws, Erika Brooke (The University of Arizona., 2021)
    The role of CYP83A1, CYP79F1, and CYP79F2 in auxin accumulation and lateral root initiation in Arabidopsis thaliana was explored. These enzymes are at branch points between auxin synthesis and synthesis of plant defense compounds, found in nearly all plants of the order Brassicales, known as glucosinolates: our hypothesis was to test whether these enzymes functioned with XIP1/CEPR1 to control auxin levels or perform some other unknown function. Two lines of knockout or null mutants for each gene were obtained to cross into a line homozygous for a semi-quantitative auxin reporter (R2D2), a null mutation of an auxin biosynthetic enzyme (NIT1), and a receptor that acts in nitrogen foraging and interacts with NIT1 (CEPR1). The genotypes of the CYP83A1 and CYP79F1 knockout lines were confirmed. Both CYP83A1 knockout lines were successfully crossed into the R2D2 line. One of the CYP83A1 lines, ref2-1, was crossed into all the relevant mutants, selfed for three generations and plants homozygous for ref2-1, xip1-1, and R2D2 were isolated; these plants are heterozygous for nit1-1.

    Weber, Chris; Guske, Tanner Keaton (The University of Arizona., 2021)
    The last few decades have shown increased polarization within the United States political sphere. The hampered ability of political institutions to enact legislation due to a failure to cooperate has led to greater political violence, decreasing support for the government, and increasing anti-democratic rhetoric. I aim, with the aid of Dr. Weber, to explore the reasoning behind these disturbing changes and seek solutions. After reviewing the subject of polarization and voting in political science, I propose that it is the authoritarian attitudes of voters that are driving the negative outcomes. Through the use of 2020 election data and analysis models, I show that this is correlated, though not to the extent I expected. Lastly, I discuss future prospects of research and possible solutions to our political woes.

    Ottusch, Timothy; Flowers, Jonathon Jeffrey (The University of Arizona., 2021)
    The American education system is a long established and structured portion of American society. For the majority of everyone’s lives, this system has remained fairly consistent and unchanging, that was until March of 2020 when the novel coronavirus disease, 2019, (COVID-19) swept through the world, forcing everyone into social isolation and forcing the majority of the education system to move to an online format. The pandemic, and its associated changes, especially affected the way that K-12 schools delivered their material to young people throughout the United States. This study sought to explore the decision making of parents that have children younger than high school, specifically the decisions made around the modality of their child’s education throughout the pandemic. One semi-structured interview was conducted with a parent of two elementary-aged children, covering the decisions made throughout different periods of the COVID-19 pandemic, and what may have influenced those decisions. Results indicated that decisions were made around maintaining structure, as well as meeting each child’s educational needs. Results also indicated that the concept of familial interdependence, which states that decisions made by one member of the family will ultimately affect all members of the family, was extremely present and played a huge role in how decisions were made in regard to educational approaches.
  • Giant Unilamellar Vesicle Generation Platform

    Zacher, Brian; Ferrante, Sam (The University of Arizona., 2021)
    This paper describes a platform for producing giant unilamellar vesicles (GUVs) with specified volume and contents, repeatedly, in a controlled environment. GUVs are membrane systems approximately the size of a cell used to study the function and structure of biological systems. Actively manipulating the contents of a GUV to determine its function provides many applications in biochemistry and medicine. However, artificially forming GUVs of monodisperse size, which can also contain essentially any contents such that they can be manipulated and studied, is difficult. We designed a system to produce GUVs repeatedly based on methods found in related literature. The technique involves microfluidic jetting of a desired solution from a standard syringe through a fitted glass needle using a piezoelectric actuator as the injection mechanism. Formation of the vesicles via a lipid bilayer and microfluidic jetting is similar to blowing a bubble on the microscopic scale. The customized components of our set-up include an infinity chamber where the vesicles are formed, the chamber base fitted to a Nikon Eclipse TE300 inverted microscope, and a syringe holder. Each of the manufactured components are relatively robust, cheap, and easily replaceable using designs detailed in this paper. Modeling the techniques and methods described in the article from Coyne, “Lipid Bilayer Vesicle Generation Using Microfluidic Jetting” [1], we developed our own stage for use in generating GUVs at the University of Arizona.
  • An Analysis of the Unintended Consequences of the United States Constitution

    Westerland, Chad; Cunning, Emily (The University of Arizona., 2021)
    Revolutionaries throughout the globe have helped establish some of the most complex forms of governments, including that of the United States democratic republic. The United States Constitution has continuously evolved over time, from its conception to the modern era. Constitutional Amendments have been made in an attempt to keep up with the evolving world, but what happens when a new issue arises that has never been discussed before? There are a plethora of ideas that the United States’ Founding Fathers could not have fathomed at the creation of the Bill of Rights. The First Amendment’s Freedom of Speech and Freedom of Religion clauses, as well as the Fourth Amendment’s implicit Right to Privacy clause, have resulted in dissent over the past two centuries on the meanings of them and how we, as a country, should interpret them. Should we choose to interpret the United States Constitution with strict or loose constructionism? Or should the law be looked at solely as a case by case basis on whether or not strict or loose interpretation of the Constitution applies? Through the analysis of Supreme Court cases, legal precedents, and historical trends, we will dive into the true meaning of the Constitution and how to interpret it in modern times when compared to its original intent.

    Goldsmith, Melissa; Clark, Elisa Pauline (The University of Arizona., 2021)
    Purpose: To develop evidence-informed best practice recommendations to reference for nursing professionals and individuals with chronic low back pain when considering different treatment options. Background: Adults in the United States are at risk for developing chronic low back pain and the susceptibility rate is more than doubled for nursing professionals. Integrative yoga therapy is a non-pharmacological intervention that is gaining evidence-informed support. This first line of treatment is superior to other more invasive interventions such as taking opioids. Approach to practice: The best practice recommendations in this thesis are constructed from the literature review conducted through PubMed with the terms “chronic pain” and “integrative therapies” used. The following filters were used, “clinical trial,” “review,” “free full text,” and “5 years.” Four articles were included in the literature review which is seen in chapter two of this thesis. Outcomes: The evidence-informed best practice recommendations are for healthcare professionals to consider as a course of treatment to offer to individuals suffering from chronic low back pain prior to using a pharmaceutical approach. The recommendations are also for nurses to use for themselves to prevent/reduce chronic low back pain. Conclusions: As more research is conducted on integrative yoga therapy, alterations in the recommendations can be made to help reduce/prevent chronic low back pain and improve overall quality of life.
  • The Hitchhikers Guide to Mental-Contrasting: Exploring the Intersection of Mindfulness & Mental Time Travel

    Chambers, Katherine (The University of Arizona., 2021)
    Beneficial correlates of mindfulness as a trait and intervention are widely researched. However, this phenomenon as a quality of consciousness remains ambiguous, especially in regards to its relationship with time. Mindfulness emphasizes intentionality; has been proposed to represent healthy time perspectivity; and is correlated with goal conceptualization, pursuit, and achievement. As a preliminary measure in closing this research disparity, probing mindfulness and its relationship with the goal conceptualization strategy mental-contrasting emerged as an intuitive addition to the body of research. This strategy professes three tenets: goal inception, obstacle generation, and solution cultivation. As present-minded action is accentuated, mindfulness is anticipated to be compatible with this model. The Mindful Attention Awareness Scale (MAAS) assessed subjects (n=78) instructed with a Think Aloud protocol during which they vocalized organically-emerging thoughts for ten-minute recorded intervals. A qualitative scoring analysis was applied so as to discern the proportion of mental-contrasting. Linear regression models demonstrated a positive correlation (p <0.001, r-value: 509) between trait mindfulness and the utilization of the full three tenets of mental-contrasting. Fantasizing possessed an inverse relationship with trait mindfulness (p-value: 0.012, r-value: -0.289), while failing to generate solutions to goal obstacles was also negatively correlated with trait mindfulness (p <0.001, r-value: -0.467). Mindfulness as an intervention may be calibrated to encompass such adaptive temporal implementation.

    Goldsmith, Melissa; Blawn, Kamryn Danielle (The University of Arizona., 2021)
    The purpose of this thesis is to explore how postpartum interventions impact the rate of maternal mortality and morbidity caused by postpartum hemorrhage and to provide evidenced based recommendations for postpartum hemorrhage interventions. Postpartum hemorrhage is the causal factor for 11% of maternal deaths in the country. Also, between 54% to 93% of deaths caused by obstetric hemorrhage may be prevented (ACOG, 2019). Evidenced based practice recommendations provide nurses and healthcare professionals with the knowledge and guidelines to treat postpartum hemorrhage. The best practice recommendations for postpartum hemorrhage prevention and treatment include providing standardized education for mothers on postpartum complications, assessing the readiness of nurses to treat a hemorrhage, providing annual training and protocol education, and educating nurses on PPH risk factors, so they can assess patients for risk factors on admission. Intervention specific recommendations are using quantitative methods for measuring blood loss, actively managing the third stage of labor with oxytocin administration and uterine massage, assessing the patient’s condition and vital signs during a hemorrhage, starting a second large bore IV, administering Lactated Ringers and medications for uterine atony, and ensuring the patient has an empty bladder. Finally, if the patient continues to hemorrhage, refractory PPH interventions should be initiated, and massive transfusion protocol should be activated. The final chapter includes a proposal for the implementation and evaluation of the best practice recommendations using the Plan-Do-Study-Act framework. Ultimately, nurse should continue to seek out updated journal articles and professional guidelines throughout their careers to ensure they provide quality patient care.

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