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The Immobilization Of Ticagrelor On Implant Materials And Corrosion And Biofouling Inhibition By Novel Layered Polymer Thin Films For Marine Application, Tell Lovelace Dec 2021

The Immobilization Of Ticagrelor On Implant Materials And Corrosion And Biofouling Inhibition By Novel Layered Polymer Thin Films For Marine Application, Tell Lovelace

Electronic Theses and Dissertations

Percutaneous coronary interventions are a widely used cardiovascular surgery which is typically accompanied by the insertion of a vascular stent. After the procedure patients are put on dual anti-platelet therapy (DAPT) to prevent stent thrombosis, a common complication to this procedure in which platelets aggregate in the blood vessel on the inserted stent. Systemic deactivation of platelets in patients via oral DAPT results in patients becoming bleeding risks in future medical procedures, necessitating the development of a localized delivery system for anti-platelet medications from the surface of the stent. A novel anti-thrombogenic vascular stent coating has been prepared by covalent …


Examining The Interaction Of Adverse Childhood Events, Dental Issues, Asthma And Autism, Cathy Koetting Dec 2021

Examining The Interaction Of Adverse Childhood Events, Dental Issues, Asthma And Autism, Cathy Koetting

Electronic Theses and Dissertations

Dissertation supervised by Dr. Rebecca Kronk

Purpose: Adverse childhood events (ACEs) have a profound and long-term effect on the health outcomes of many children and adults. However, few studies have focused on specific ACEs and health outcomes in children with autism spectrum disorder (ASD). The aim of the study was to investigate if ASD moderated the relationship between ACEs and specific health outcomes in children who had been the subject of a child welfare system report.

Design and Methods: Using the second National Survey of Child and Adolescent Well-Being (NSCAW II), a secondary analysis was performed on a sample of …


Counselors Dumbfounded: Implications For Counseling Ethics, Ivan Irizarry Dec 2021

Counselors Dumbfounded: Implications For Counseling Ethics, Ivan Irizarry

Electronic Theses and Dissertations

How counselors should make ethical decisions frequently differs from how counselors actually make ethical decisions, which is often a non-linear process. Social Intuitionist Theory (Haidt, 2003) suggests this process entails a socially influenced intuitive judgment followed by post hoc rationale. The purpose of this study was to examine whether moral dumbfounding, which entails maintaining a moral judgment without supporting reason, occurs with practicing counselors. The results of survey data and open-ended coding showed that 58.5% of counselors were dumbfounded at least once when presented with four moral or ethical vignettes. Additional analyses exploring differences in dilemma-based vs. non-counseling vignettes, moral …


Relational And Social Aggression: A Scoping Literature Review, Angela Fidazzo Dec 2021

Relational And Social Aggression: A Scoping Literature Review, Angela Fidazzo

Electronic Theses and Dissertations

School violence is an omnipresent problem within the United States, at worst, resulting in the death of children and teachers across the nation. Over time, numerous strategies and tools have been introduced in order to reduce aggression within schools. However, as both overt and covert forms of aggression contribute to school violence, it is necessary for researchers to investigate covert, indirect forms of aggression as a way to better identify and prevent a salient contribution to this problem. Although much research has investigated bullying in general, further research is needed in better understanding the forms of covert bullying, relational and …


Does Speech-To-Text Assistive Technology Paired With Graphic Organizers Improve The Written Expression Of Students With Traumatic Brain Injuries?, Kayla Cuifolo Dec 2021

Does Speech-To-Text Assistive Technology Paired With Graphic Organizers Improve The Written Expression Of Students With Traumatic Brain Injuries?, Kayla Cuifolo

Electronic Theses and Dissertations

A traumatic brain injury (TBI) can range from mild to severe and can cause debilitating outcomes that require children to need specialized medical or educational services post-injury. Outcomes vary and are dependent on the location of injury, age, severity, and environmental factors. Some common deficits that happen as a result of a brain injury are fine motor and executive functioning skill difficulties. Fine motor and executive functioning skills are an important component of written expression. Therefore, this current study utilized a brief experimental analysis in order to determine the effects that speech-to-text assistive technology along with a graphic organizer has …


Piloting A Theoretical Framework For Understanding Teacher Resilience In Hard-To-Staff Schools, Traci Durant Dec 2021

Piloting A Theoretical Framework For Understanding Teacher Resilience In Hard-To-Staff Schools, Traci Durant

Electronic Theses and Dissertations

The study examined the nature of hard-to-staff schools in relation to teacher resilience. The study proposes a theoretical framework that blends theories of self and collective efficacy, critical race, and resilience theories with Bronfrenbrenner’s ecological systems theory to examine personal and organizational factors that contribute to or weaken the resilience of teachers in challenging urban schools.

Two research questions guided the study: What are the personal factors that strengthen resilience in teachers in hard-to-staff schools? And, What organizational factors impact teacher resilience in hard-to-staff schools?

Participants were recruited using convenience sampling methods. School administrators were asked to identify teachers who …


Detecting Viral Particles In Vitro Using Photoacoustic Flow Cytometry, Anie-Pier Samson Dec 2021

Detecting Viral Particles In Vitro Using Photoacoustic Flow Cytometry, Anie-Pier Samson

Electronic Theses and Dissertations

The Covid-19 pandemic is a powerful example of just how damaging the rapid spread of an unknown virus can be. Viruses have the ability to spread rapidly amongst individuals if not treated and controlled. The first key step towards treatment is the timely and specific diagnosis of the virus causing the infection. An innovative method for the rapid detection of viral particles in solution consists of tagging the viral particles paired with using photoacoustic flow cytometry to irradiate the particles and get a signal. The high affinity of Streptavidin for Biotin can be used to bind Streptavidin-coated microspheres to biotinylated …


The Effect Of School-Based Mindfulness Intervention On Student Attention And Executive Function: A Meta-Analysis, Sarah E. Rea Dec 2021

The Effect Of School-Based Mindfulness Intervention On Student Attention And Executive Function: A Meta-Analysis, Sarah E. Rea

Electronic Theses and Dissertations

Schools are facing increasing responsibility to foster the social-emotional development of students. One way in which schools can improve student functioning is through school-based mindfulness interventions. Using mindfulness practices, in particular, can teach students to increase their attention of surroundings and internal experiences, and awareness of their thoughts and behaviors. While the evidence-base for mindfulness interventions in schools continues to grow, there are several studies that show promising outcomes. The purpose of this study was to determine how large the effect sizes for school-based mindfulness studies are in regard to increasing student attention, cognitive flexibility, and working memory. Results indicate …


Loneliness, Interpersonal Goals, Life Satisfaction, And Subjective Well-Being In Older Adults, Francesca C. Ezeokonkwo Dec 2021

Loneliness, Interpersonal Goals, Life Satisfaction, And Subjective Well-Being In Older Adults, Francesca C. Ezeokonkwo

Electronic Theses and Dissertations

Background: Loneliness is detrimental to health and is linked to numerous physiological and psychological problems. People across the age spectrum can be affected by loneliness at one point or another in their lives; however, older adults are disproportionally affected.

Aims: This study investigated the effect of interpersonal goals (compassionate and self-image goals), life satisfaction, and subjective well-being on loneliness in older adults and the influence of demographics and social support. The Ecosystem-Egosystem Theory of Social Motivation served as the theoretical framework.

Design and Method: This descriptive cross-sectional correlational study used the 2016 Health and Retirement Study. Participants were 65 years …


Forced Together, Growing Apart: An Exploration Of Heterosexual African American Males' Disengagement In Romantic Relationships With African American Females, Kenya Johns Dec 2021

Forced Together, Growing Apart: An Exploration Of Heterosexual African American Males' Disengagement In Romantic Relationships With African American Females, Kenya Johns

Electronic Theses and Dissertations

The decline of intraracial dating has been more pronounced among African Americans in comparison to other racial groups. There is lack of available research tailored towards Black men’s dating experiences. The purpose of this study was to explore the lived experiences of heterosexual African American males related to their disengagement in romantic relationships with African American females.

A phenomenological study explored the lived experiences of 10 African American males and the dynamics that appear to contribute to the decline in intraracial dating in the African American community. Five themes emerged from the study: – self-regard, family matters, proximity, the new …


Hip Muscle Function In Individuals With Chronic Ankle Instability, Lindsay Carroll Dec 2021

Hip Muscle Function In Individuals With Chronic Ankle Instability, Lindsay Carroll

Electronic Theses and Dissertations

Purpose: Hip muscle function has been reported to be altered in individuals with chronic ankle instability (CAI). The purpose of this study was (1) to determine whether the single leg squat test (SLST) could be used to detect differences in proximal muscle activation between individuals with and without CAI and (2) to determine if there was a difference in maximum isometric body weight normalized torque output of the hip lateral rotators, extensors, and abductors between individuals with and without CAI.

Subjects: Forty-eight subjects (14 males, 34 females; median age = 22.00 years, interquartile range (IQR) = 1.00; median height = …


Philosophical Anthropology And Biblical Interpretation In John Paul Ii’S Theology Of The Body, Shawn Conoboy Dec 2021

Philosophical Anthropology And Biblical Interpretation In John Paul Ii’S Theology Of The Body, Shawn Conoboy

Electronic Theses and Dissertations

In the Theology of the Body, through a series of Wednesday Catecheses, John Paul II presents a magisterial understanding of the sacrament of marriage and of marriage and family ethics. At the same time, John Paul II presents a theological anthropology, which forms a basis for the magisterial teaching. His theological anthropology is developed through an exegesis of selected biblical texts, especially Genesis 1-3 and Ephesians 5, and through an application of a philosophical anthropology articulated by Karol Wojtyła. This dissertation draws the connection between the philosophical anthropology of Wojtyła, especially as it is articulated in his major works, …


Investigating Relationships Between Diabetes Distress, Diabetes Self-Care Behaviors, Intention To Use And Actual Use Of A Personal Health Record Within 30 Days Of Hospital Discharge In Persons With Type 2 Diabetes, Khaliah Fisher-Grace Dec 2021

Investigating Relationships Between Diabetes Distress, Diabetes Self-Care Behaviors, Intention To Use And Actual Use Of A Personal Health Record Within 30 Days Of Hospital Discharge In Persons With Type 2 Diabetes, Khaliah Fisher-Grace

Electronic Theses and Dissertations

Background: Diabetes distress (DD) is defined by emotional and behavioral challenges caused from diabetes and its management. Diabetes self-care behaviors can be compromised by DD. Personal Health Record (PHR) use has been associated with improvements in HbA1c, blood pressure, and LDL-C, but the relationship between DD and PHR use is unknown. Aims: 1) to determine differences between sociodemographic variables and intention to use and actual use of PHR in hospitalized persons with Type 2 Diabetes Mellitus (T2DM), 2) to investigate the relationship between DD, intention to use a PHR and actual use of a PHR within 30 days of hospital …


Heavenly Clothing Liturgically Worn: The Clothing Metaphor In The Book Of Revelation As Exegetically Performed In The Byzantine Liturgical Rite, Elias Issa Dec 2021

Heavenly Clothing Liturgically Worn: The Clothing Metaphor In The Book Of Revelation As Exegetically Performed In The Byzantine Liturgical Rite, Elias Issa

Electronic Theses and Dissertations

Problem

The subject of these hermeneutical and performative approaches to the biblical texts and the liturgical dimensions and metaphors in the Book of Revelation are of particular interest to this dissertation, whose ultimate goal is to ask how the Byzantine rites, as practiced in the Orthodox Church, actualize the liturgical dimensions of the Book of the Revelation. The question will focus on a case study of the clothing metaphor as used in Revelation and related apocalyptic texts.

Method

The question of this dissertation is framed within this context of the liturgical performative exegesis. The question will be approached in its …


Culturally Therapeutic Approaches To Prejudice And Discrimination: Formulations, Interventions, And Structural Change, Jayme J. Jenkins Dec 2021

Culturally Therapeutic Approaches To Prejudice And Discrimination: Formulations, Interventions, And Structural Change, Jayme J. Jenkins

Electronic Theses and Dissertations

Aims. Though psychologists are generally well-positioned to implement micro- and macro-level interventions from their roles as clinicians, educators, researchers, and consultants, there is a paucity of formal guidance on how to approach client-generated or structural prejudice and discrimination. The current study addresses this literature gap by integrating previous literature and implementation models from a related field toward a novel treatment approach.

Background. A critical literature review supported intervention-focused conceptualizations of “supremacism” and demonstrated that mutually reinforcing micro- and macro-level discrimination generates demographic disparities in safety, liberty, and well-being. This typically emerges in the United States as White supremacist heteropatriarchy while …


Building A New Model Of Church-State Collaboration On Environmental Care In Ghana Based On Catholic Social Teaching And African Theological Traditions, Emmanuel Abbey-Quaye Dec 2021

Building A New Model Of Church-State Collaboration On Environmental Care In Ghana Based On Catholic Social Teaching And African Theological Traditions, Emmanuel Abbey-Quaye

Electronic Theses and Dissertations

Abstract

The care of the environment has always been considered by the Ghana Catholic Church as an important aspect of her pastoral care and evangelizing mission in Ghana. Hence, in their various teachings in communiqués and other pastoral documents from 1965 till now, the Ghana Catholic Bishops’ Conference has consistently addressed the major environmental challenges confronting Ghana such as deforestation, mining, pollution, etc., applying the principles of stewardship and care of creation, intergenerational solidarity, integral ecology, etc., to ground these teachings.

Besides, in acknowledging that neither the Catholic Church nor the Ghanaian Government alone can resolve the various ecological crises …


The Lived Experiences Of Self-Concealment Among Lgbq+ Counselors In The Workplace, Richard Charette Ii Dec 2021

The Lived Experiences Of Self-Concealment Among Lgbq+ Counselors In The Workplace, Richard Charette Ii

Electronic Theses and Dissertations

This study sought to unearth the narratives of LGBQ+ counselors’ experiences of self-concealment in the workplace. Self-concealment was an identity management strategy that was defined as an active, and sometimes persistent effort to conceal LGBQ+ identity. Self-concealment of affectional identity was well researched in workplace contexts, however only one study existing study examined self-concealment among LGBQ+ counselors. In that previous qualitative inquiry, Jeffery and Tweed (2014) called for further exploration of self-concealment among LGBQ+ counselors when self-concealment emerged as a surprising finding.

The phenomenon of self-concealment was under-researched in counseling but has been extensively conceptualized as both a developmental stage …


Design And Synthesis Of Fused Pyrimidines As Single Agents With Combination Chemotherapy Potential, As Tubulin Polymerization And One-Carbon Metabolism Inhibitors For Cancer, Tasdique Quadery Dec 2021

Design And Synthesis Of Fused Pyrimidines As Single Agents With Combination Chemotherapy Potential, As Tubulin Polymerization And One-Carbon Metabolism Inhibitors For Cancer, Tasdique Quadery

Electronic Theses and Dissertations

This dissertation describes the design, synthesis, and biological evaluation of bicyclic fused pyrimidines as single agents with combination chemotherapy potential with both antiangiogenic and cytotoxic effects. The dissertation also discusses one-carbon metabolism inhibitors and tumor targeting proteolysis targeting chimeras (PROTACs).

In cancer chemotherapy, the two major limitations are the dose-limiting toxicities of clinically used agents and the development of resistance to the treatment. Combination chemotherapy with antiangiogenic agents and microtubule targeting agents has shown an advantage against both these drawbacks. Single agents with both antiangiogenic activity and cytotoxicity would afford a therapy that circumvents pharmacokinetic problems of multiple agents, avoid …


Real-Time Monitoring Of Cell Death Progress Using Capacitance Spectroscopy, Suyang Wu Dec 2021

Real-Time Monitoring Of Cell Death Progress Using Capacitance Spectroscopy, Suyang Wu

Electronic Theses and Dissertations

Biologics, including the monoclonal antibody (mAb), has experienced rapid development in the last decade. However, the price of biologics is often prohibitively high because of the low process efficiency. Delaying the inevitable cell death improves the productivity of upstream bioprocessing, whose success relies on monitoring the cell death onset that indicates the timing for preventive actions.

This study proposes to develop a real-time monitoring model that quantifies the dying cell percentage in lab-scale bioreactors using capacitance spectroscopy. The capacitance spectroscopy contains cell death-related information due to various physical properties changes during the cell death process, e.g., cytoplasmic conductivity change. The …


Understanding Snow Leopard (Panthera Uncia) Population Structure, Diet, And Human-Wildlife Dimensions Using Noninvasive Genetic Approaches, Charlotte Hacker Dec 2021

Understanding Snow Leopard (Panthera Uncia) Population Structure, Diet, And Human-Wildlife Dimensions Using Noninvasive Genetic Approaches, Charlotte Hacker

Electronic Theses and Dissertations

Snow leopards (Panthera uncia) are a large cat endemic to the mountains of Central Asia. Despite their status as a flagship species, there are numerous knowledge gaps surrounding their population status, dietary ecology, and relationship with humans. Such knowledge gaps are prohibitive for effective conservation action for the species. Snow leopards are threatened by habitat loss, decreased prey availability, retaliatory killings, and large-scale negative impacts associated with climate change. In order to help bridge these gaps, noninvasive genetic methodologies were deployed in this work across several disciplines. Population genetic metrics were garnered at local, regional, and range-wide scales, …


Analysis Of Spore Shape Determination In Streptomyces, Ning Sun Dec 2021

Analysis Of Spore Shape Determination In Streptomyces, Ning Sun

Electronic Theses and Dissertations

Streptomycetes are Gram-positive, soil-dwelling bacteria that possess a complex life cycle with the alternation of vegetative mycelium, aerial mycelium, and spores. Streptomyces. coelicolor spore maturation is a complex process that involves spore shape metamorphosis from cylindrical pre-spores into ellipsoid spores, but the details of this process have remained enigmatic. Previously, our lab identified a novel gene ssdA that might play a role in spore shape determination using a transposon-based insertion mutagenesis in S. coelicolor. In this study, I isolated a S. coelicolor ssdA-null mutant that showed increased colony hydrophobicity and misshapen spores in sizes and shapes, confirming the …


Cgrp-Driven Lateralization Of Pain Modulation By The Central Amygdala, Heather Allen Dec 2021

Cgrp-Driven Lateralization Of Pain Modulation By The Central Amygdala, Heather Allen

Electronic Theses and Dissertations

The central amygdala (CeA) is a bilateral, mid limbic brain region involved in the processing of pain and emotion. Interestingly, the left and right CeA are functionally lateralized in the context of bladder pain, with the left and right CeA having opposing effects on bladder pain-like behavior. However, the specific mechanisms driving these divergent functions are unknown. Nociceptive signals from the bladder are relayed to the CeA via projection neurons in the parabrachial nucleus (PBN) that express high levels of calcitonin gene-related peptide (CGRP). In these studies, we investigated the influence of PBN CGRP signaling in the left and right …


Connecting Human Dignity, Non-Violence, And Environment For Healthcare Ethics In Nigeria, John Mark Ogu Dec 2021

Connecting Human Dignity, Non-Violence, And Environment For Healthcare Ethics In Nigeria, John Mark Ogu

Electronic Theses and Dissertations

Abstract

Connecting Human Dignity, Non-violence, and Environment in Health Care for Nigeria

By

John Mark Chinaemerem Ogu

December 2021

Dissertation supervised by Peter Ikechukwu Osuji, Ph.D.

This dissertation presents a global public health ethical approach based on social justice that connects human dignity, non-violence, and the environment in Nigeria. Recently, different places globally are witnessing uprisings and violence; some of these are linked to environmental scarcity. These are threats to global health, peace, development, and security because violence of any type or form is a global public health and security menace and an affront to human dignity. Environmental scarcity, especially …


A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty Dec 2021

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …


The Contribution Of Bioethics To Home Healthcare (Hhc) In Saudi Arabia, Saeed Alghamdi Dec 2021

The Contribution Of Bioethics To Home Healthcare (Hhc) In Saudi Arabia, Saeed Alghamdi

Electronic Theses and Dissertations

This dissertation examines the contribution of bioethics to Home Healthcare (HHC) In Saudi Arabia (SA). Through exploring the critical bioethical issues that have influenced the implementation of home health care, the dissertation highlights the significance of incorporating bioethics in home health care. Organizational ethics has led to the regulation of healthcare professionals, patients, and the stakeholders within clinical care settings. Healthcare organizations and other stakeholders, such as global health bodies, should formulate laws and policies that promote bioethics in contemporary healthcare. The Kingdom of Saudi Arabia, through the Ministry of Health, should promote the adoption of home health care services …


The Role Of Embodied Metaphor In The Relationship Between Vestibular Dysfunction, Anxiety And The Self, Kaitlyn Abrams Dec 2021

The Role Of Embodied Metaphor In The Relationship Between Vestibular Dysfunction, Anxiety And The Self, Kaitlyn Abrams

Electronic Theses and Dissertations

There is considerable evidence that vestibular dysfunction and anxiety are correlated. Clinical and philosophical arguments suggest that a loss of sense of self, experienced through symptoms like derealization and depersonalization, might contribute to this relationship. The present study used a mixed methods approach, including Systematic Metaphor Analysis, to analyze written short answer and quantitative survey data from one hundred and thirteen participants with vestibular disorders. The Systematic Metaphor Analysis revealed several primary metaphor concepts which elucidated the connections between concrete experience and abstract concepts in vestibular dysfunction. These included metaphors of Agency, Stability, Orientation, Self-Object, and Figure-Ground. Primary metaphors for …


Exploring And Understanding The Culture Of Young Adults Who Vape: A Focused Ethnography, Beth Tremblay Aug 2021

Exploring And Understanding The Culture Of Young Adults Who Vape: A Focused Ethnography, Beth Tremblay

Electronic Theses and Dissertations

Introduction: Vaping, the act of inhaling an aerosolized liquid, is associated with health risks. The 18- to 25-year-old age group has the highest rate of vaping among adults. Understanding culturally held values, beliefs, and experiences associated with the behavior of vaping in young adults may uncover the social mechanisms that underpin vaping initiation and influence continued use. The purpose of this study was to explore and understand the cultural values and beliefs about vaping among young adults. Method: The method used for this study was a focused ethnography. Young adults who currently vape nicotine (N=24) were recruited via snowball method …


Trauma Informed Care In Alternative Education Settings, Cydney V. Quinn Aug 2021

Trauma Informed Care In Alternative Education Settings, Cydney V. Quinn

Electronic Theses and Dissertations

Schools are considered to be the primary location for providing children with prevention and treatment for mental health symptoms, however, it is well documented that children’s mental health needs remain underserved. Especially at risk are children who have experienced trauma and other adverse childhood experiences (ACEs). Many children in this group are subject to disciplinary action, and are often removed from primary classrooms to alternative education placements (AEP) in an effort to manage behaviors. Therefore, it is important that alternative education teachers are trained in trauma-informed care (TIC). While it may be presumed that AEP staff would be well-versed in …


Different Strokes: A Critical Race Discourse Analysis Of The Experiences Of Four Black Women Rowing For A Predominantly White Institution (Pwi), Carol Schoenecker Aug 2021

Different Strokes: A Critical Race Discourse Analysis Of The Experiences Of Four Black Women Rowing For A Predominantly White Institution (Pwi), Carol Schoenecker

Electronic Theses and Dissertations

Collegiate athletics has the remarkable ability to serve as a catalyst for positive and widespread social change and identity formation. For Black women, the formation of identity comes with the added intersections of race and gender in addition to sport. Collegiate rowing is one of the most heavily scholarshipped sports coming out of the passing of Title IX legislation in 1972 and requires no previous rowing experience for participation (Garran, 2012). Despite the opportunity for rowing to serve as an access point for innumerable young athletes to obtain financial and social support through a pathway to higher education, there remains …


Inviting Friendship: A New Approach To Nonprofit Communication, Stacia Glenn Wetherington Aug 2021

Inviting Friendship: A New Approach To Nonprofit Communication, Stacia Glenn Wetherington

Electronic Theses and Dissertations

Beginning with Greeks’ concept of virtuous friendship philanthropy has been part of society. Metaphors of civitas, caritas and social responsibility dominated man’s understanding of charity until the explosion of neoliberal thought in the 1980s. The Band Aid movement in response to the Ethiopian famine permanently changed the way we view philanthropy. This movement created an environment of extreme commodification of charity which has created a highly competitive nonprofit sector and a loss of the collective spirit upon which it was founded. This competitive atmosphere has led nonprofits to chase dollars at the expense of their missions while also relying heavily …