Digital Commons Network^™

The Effect Of A Contextualized Dosage Calculation Learning Intervention On Pre-Nursing Students' Math Self-Efficacy And Ability To Pass High Stakes Dosage Calculation Examination On First Attempt, Eileen V. Weatherby

Dissertations

Many students in pre-licensure nursing programs struggle with calculating accurate medication dosages even though they meet the numeracy requirements for application to the nursing programs. Most pre-licensure programs require that nursing students pass dosage calculation exams at a specified level of accuracy before progressing to the next term. Students typically have three tries to pass at the specified level and should they not succeed, they must withdraw. If they wish to continue in the program, they must complete the requirements for reentry which may include space availability restrictions. Factors influencing dosage calculation performance include fear of mathematics, low math self-efficacy, …

National Identity Constructions In United States Foreign Policy Approaches To International Conflict, Frederick W. Tillman Ii

Dissertations

This study observes the role of national identity as a tool of the presidents of the United States in framing foreign policy approaches. Examining application for such phenomena reveals the puzzle of how strategic vs subjective decision-makers are when articulating policy addressing international conflicts. The interplay between the two aspects brings together the multiple traditions of national identity and the Wittkopf-Holsti-Rosenau approach model. Occurring over a longitudinal design, this study cuts across four administrations as they address events during the War in Afghanistan and the conflict regarding Taiwan. By coding and analyzing the statements from Presidents George W. Bush, Barack …

Evaluation Of A Clincally-Integrated Community Health Worker Program To Support Adults With Cardiovascular Conditions: Guided By The Prism Framework, Cynthia Orofo

Dissertations

Chronically ill individuals with cardiovascular diseases (CVDs) have been extensively challenged by the complexities of disease management. Cardiovascular disease remains the leading cause of death in the U.S. Although clinically integrated community health worker (cCHW) support interventions have been increasingly implemented to help manage CVDs, a comprehensive analysis of interventions implemented in real-world settings is lacking. The purpose of this study was to observe and evaluate a cCHW support intervention in a real clinical setting serving adults with CVD using an implementation science perspective, guided by the PRISM Framework.

Enzymological Revisionism: Employing Transient State Approaches To Define The Catalytic Sequences Of Poorly Understood Systems, Madison M. Smith

Dissertations

Flavin is a molecule composed of a tricyclic isoalloxazine ring linked to a ribityl. Flavins are utilized as a cofactor by many enzymes to facilitate a myriad of chemistries. Flavoproteins were first discovered in the late 1800 s and have since been an interest to researchers, largely due to the unique spectrophotometric characteristics that make it a valuable reporter molecule. Flavin cofactors (typically either flavin adenine dinucleotide (FAD) or flavin mononucleotide (FMN)) are chemically versatile as the isoalloxazine ring can form one and two-electron reduced states. The reduced states are prone to react with molecular oxygen and numerous observations have …

Factors Impacting The Empirical Identification Of The Bifactor Irt Model Of Rating Data, Wenya Chen

Dissertations

Response data corresponding to educational and psychological instruments may represent different dimensional structures to account for different patterns of the dependencies in the data. One of the dimensional structures that has been increasingly discussed in the literature is the bifactor structure. This structure can effectively separate different sources that influence the responses, which contributes to score validity and provides theoretical insights about the measured trait. Unfortunately, estimating this structure in practice comes with challenges. One such challenge is an empirical identification issue that is seldom discussed in the literature. This issue occurs when an item’s discriminations on the general and …

Implementation Of Tai Chi Fall Prevention Program In A Community-Based Setting, Shabnampreet Kaur

Dissertations

The increasing rate of falls among older adults is a health concern that may lead to injuries and reduced quality of life. At the project site there was no systematic process to impact fall rates, so an evidence-based solution was sought. The purpose of this quality improvement project was to determine if the translation of Li et al.'s research regarding the Tai Chi fall prevention program would impact the rate of falls among adults 65 years and older. The project was piloted over 12 weeks in a community-based setting in urban New York. Imogene King's goal attainment theory and Kurt …

Jewish Laws For Gentiles: Purity In The Pseudo-Clementine Homilies, Joshua T. King

Dissertations

This dissertation is an analysis of the concept of purity in the Pseudo-Clementine Homilies. The argument proceeds in two parts. In the first, I argue that the Homilies’ presentation of purity reflects an ancient Jewish background. Thus, the Homilies, like other ancient Jews, divides its concept of purity in two domains: a domain related to the body (bodily purity) and a domain related to ethics (purity of the heart). I then track the differences between these two kinds of purity, noting particularly how they are defiled and how such defilements are removed. Thus, while bodily defilement comes from occasional bodily …

Liberating Bioethics Through Agape: A Feminist Perspective From The Periphery, Kimberly Vargas Barreto

Dissertations

Despite the vast number of cultures and peoples that reside in the West, ethical action in bioethics is determined through the perspective of la Totalidad, which does not include the Other or individuals from the periphery. In my dissertation, I argue that the universalization of U.S. clinical bioethics (la bioética estadounidense) and the coloniality of knowledge that extends from it are, at its core, imperialistic in nature and result in the exclusion of patients with intersectional identities. While clinical bioethics was first conceived as a critical tool for medicine, the acceptance of principlism as the central theory in the field …

Reconceiving Virtue: A Mengzian Adaptation Of Eudaimonic Virtue Ethics In Response To Contemporary Criticisms, Gina Elizabeth Lebkuecher

Dissertations

The primary question my dissertation aims to answer is: how might eudaimonic virtue ethics be reimagined to respond to contemporary criticisms from disability scholars, feminists, and empirical psychology? To answer this, I introduce the Eudaimonic View of Virtue, or EV, and propose a Mengzian adaptation of the EV (EV-M) in response to these criticisms. The EV captures the four core claims to which eudaimonic virtue ethical theories are committed: (i) virtues, in the sense of excellent character traits or dispositions, are the foundation of ethics or ethical action (i.e., aretaicism); (ii) virtue is at least partially constitutive of human well-being/flourishing …

The Impact Of Risk And Trust On Confrontations Of Sexism: The Role Of Goals, Emily H. Budde

Dissertations

Sexism is still persistent in the United States (Swim et al., 2001), especially in the workplace (Fitzgerald, 1993; Loy & Stewart, 1984), leading to many negative outcomes for women. Unfortunately, there is an assumption in America that targets of bias will confront the perpetrator in the moment. However, this is often not the case leading to a disconnect in society at the cost of the target (Gutek & O’Connor, 1995). Looking at targets’ decision-making process and the factors that influence it can provide more context for why targets respond the way they do. I tested whether behaviors following bias (i.e., …

The Role Of Affect In Regulating The Influence Of Belief Superiority On Open-Minded Cognition And Information Selection Bias, Whinda Yustisia

Dissertations

Previous studies show that people high in belief superiority tend to hold higher attitude confidence and certainty, increasing information selection bias. However, it remained unclear why and when such an effect occurred. Two studies were conducted to address these questions. Study 1 aimed to examine the effect of belief superiority on information selection bias and its potential mediator: situation-specific open-minded cognition (SOMC). In line with the logic of earned dogmatism hypothesis, I posit that belief superiority induces a sense of entitlement to be close-minded, consequently leading to information selection bias. In study 2, I examined the role of affect (happy/sad) …

Factors Influencing Purpose In Life In Middle-Aged And Older Adults, Kelly Bergstrom

Dissertations

Purpose in life is an important dimension of psychological well-being with associated health benefits. The current study used a path analysis model to examine how perceived cognitive control, health locus of control- self, engagement in physical activity, and engagement in challenging cognitive activities relate to purpose in life longitudinally. Multimorbidity status was also examined as a potential moderator of paths in the model. Participants were middle-aged and older adults who participated in the Midlife in the United States (MIDUS) longitudinal national study (n = 2,481). After controlling for relevant covariates, engagement in physical activity, engagement in challenging cognitive activities, …

High Risk Medication Regimens And Medication Related Predictors Of Hospital Readmission In Elderly Home Care Patients, Mary T. Dierich

Dissertations

Adverse drug events are a primary cause of hospitalization in the elderly. Nearly 70% of the $177.4 billion dollars spent on drug related morbidity and mortality in the U.S. is due to hospitalizations. Polypharmacy, inappropriate medications or medication regimen complexity have all been implicated as precursors to adverse drug events and as indicators of high risk medication regimens. Understanding the relationship between medication regimens and readmission is important when evaluating potential errors in administration, risk-benefit ratios, and readmission risk. However, due to definitional and measurement issues, the high risk medication regimen remains an elusive concept. This study characterizes medication regimens, …

Using Evidenced-Based Practice To Increase Knowledge And Awareness Of Sexually Transmitted Infections, Amanda M. Brickey

Dissertations

The purpose of this quality improvement (QI) project is to increase the knowledge and intent to change practice through education on the importance in assessing sexual health history in patients at a federally qualified health center (FQHC) in Western Washington State by providing continuing education to primary care providers.

Remote Vibration Based Monitoring Of Bridge Scour, Alan Kazemian

Dissertations

The gradual erosion of the sediment around a bridge foundation is called Scour. This erosion is caused by water flow and increases during times of high-water flow such as flooding. The scour leaves the bridges structurally unsound over time and jeopardizes the safety of the structure. Approximately 60 percent of bridge failures in the United States are caused by scour. A variety of types of devices have been used to detect scour. Most of these devices only observe the scour and not the structural integrity of the bridge. The typical approach has relied on visual inspections of the bridges after …

Settler Colonial Determinants Of Indigenous Health: Relationship Between Indigenous Women's Level Of Allostatic Load And High Blood Pressure During Pregnancy; A Secondary Analysis Of The Strong Heart Study, Nicole A. Thomas

Dissertations

There is a dearth of comprehensive literature relevant to the relationship between settler colonialism and health outcomes of Indigenous peoples residing in the United States (U.S.). Critical analysis of settler colonial determinants of Indigenous health will help to further shape discourse, research priorities, and policy relevant to Indigenous population health and disease distribution. This thesis will bring awareness to settler colonialism, propose relationships between settler colonialism and health outcomes, and identify specific settler colonial determinants of Indigenous health to help guide development and use of nursing theory. This dissertation argues that the structure of settler colonialism threatens and implicates the …

Certified Registered Nurse Anesthetists' (Crna) Perceived Ease And Usefulness Of Video Laryngoscopes For Endotracheal Intubation Of Surgical Patients With Difficult Airways, Uwe G. Klemm

Dissertations

Anesthesia providers frequently encounter patients with difficult airways. The inability to effectively ventilate and oxygenate a patient due to failed endotracheal intubation increases patient morbidity and mortality (Detsky et al., 2019; Joffe et al., 2019). Video laryngoscopes appear to provide benefits by improving airway visualization and first-attempt endotracheal intubation success and decreasing the rate of failed endotracheal intubation attempts (Lewis et al., 2017; Pieters et al., 2017; Vargas et al., 2021). This research study examined the perceived usefulness and ease of use of video laryngoscope technology by CRNAs for initial endotracheal intubation when confronted with a difficult airway. The study …

Caring Behaviors Of Nursing Students And Their Attitudes Toward Older Adults, Jacquelyn D. Lambert-Davis

Dissertations

Caring is an emotion. It is a feeling of compassion and an understanding of the difficulties of others. Research indicates that caring behaviors and attitudes are an important part of the knowledge base for nursing students. Caring behaviors and attitudes are an important part of the knowledge base for nursing students in order to provide competent care for older adults. This descriptive cross-sectional study reports findings of caring attitudes and behaviors of nursing students using the Caring Dimensions Inventory (CDI). The purpose of this study was to examine the self reported attitudes and caring behaviors of nursing students toward older …

Development And Evaluation Of A Nurse Practitioner Directed Early Palliative Care Initiative And Its Impact On Goal-Concordant Care At A Cancer Center, Ashley V. Weinmann

Dissertations

Seriously ill patients often experience discordant care. Delivering high-quality healthcare requires effective communication to support goal-concordant care.

Pancreatic cancer has a 5-year survival rate of 12% with a high symptom burden. Pancreatic cancer patients often have unmet needs that lead to increased psychological, spiritual, social, and physical needs. Early integration of palliative care can provide high-quality communication and goal-concordant care. A retrospective analysis of MDACC's pancreatic patients found that 34% were referred to palliative care.

Estimating And Applying Parameters Necessary To Plan Cluster Randomized Trials (Crts) And Multisite Cluster Randomized Trials (Mscrts), Dea Mulolli

Dissertations

Cluster randomized trials (CRTs) are commonly used to study the effectiveness of educational interventions. During the design phase of a study, it is critical for researchers to ensure their studies are adequately powered to detect meaningful treatment effects, including both main and moderator effects. Designing CRTs with adequate power to detect main and moderator effects requires accurate estimates of design parameters. This research aims to advance the literature on design parameters for power analyses, specifically focusing on empirical estimates of intraclass correlations (ICCs). The work consists of three research papers that examine the role of including the teacher level in …

A Contingency Table Alternative To Poisson Regression In Comparing The Frequency Distributions Of Two Populations, Sandra Tay

Dissertations

When testing the conditional independence between a binary outcome and a binary treatment indicator, conditioned on a categorical variable with k levels, typically represented by a K × 2 frequency table, researchers often turn to Poisson regression and the Cochran-Mantel-Haenszel (CMH) test. However, a common challenge encountered in these analyses is the presence of treatment effect heterogeneity. Introducing an interaction term between treatment indicators and effect modifiers in log-linear regression offers potential solutions, yet the equidispersion assumption of Poisson regression remains problematic. On the other hand, the CMH test assumes similar treatment effects across all strata, disregarding potential variations among …

A Microgenetic Learning Analysis Of Contextuality In Reasoning About Exponential Modeling, Elahe Allahyari

Dissertations

This work explores the complex cognitive processes students engage in when addressing contextual tasks requiring linear and exponential models. Grounded within Piagetian constructivism and the Knowledge in Pieces (KiP) epistemological perspective (diSessa, 1993, 2018), this empirical study in a clinical setting develops a Microgenetic Learning Analysis (MLA) of the reasoning of 14 students from an Algebra II course. It reveals the critical role of cognitive disequilibrium as an essential cognitive state for conceptual development and the process of reorganizing knowledge systems. The study uncovers the fluctuations in students’ reasoning patterns and the significant impact on students’ reasoning patterns of task-specific …

A Model For Spacecraft Relative Motion Using Continuous Periodic Thrust, Philip Alan Hittepole

Dissertations

A model for modifying the relative orbit of a deputy satellite with respect to a chief satellite in a near-circular orbit using continuous periodic thrust is presented. This model is built on the Lovell-Spencer relative orbital elements (ROEs). The four linear ROEs (xr, yr, ar, and Az) can be linearly modified. The two angular ROEs (Er and ) can be set to advance at a desired, constant rate. Each ROE can be modified individually but may cause intra-orbit variations in other ROEs which return to their original values at the end of a thrust cycle. A method to easily calculate …

Infusing Values Into Written Exposure Therapy: A Comparison Study, Maegan Campbell

Dissertations

Written Exposure Therapy is a brief, efficacious intervention for the treatment of PTSD symptoms. The WET protocol calls for the infusion of values into therapeutic work, however, does not detail how to incorporate these values work into the highly scripted treatment. This study compared the standard WET protocol with WET infused with values. The study examined differences across the two conditions on seven variables (PTSD scores, depression scores, value importance and consistency, quality of life, psychological flexibility, customer satisfaction, and therapeutic alliance). The sample was largely homogenous in gender, ethnicity, sexuality, and reported index trauma. The sample was largely white …

An Experimental Study Of Supervised Machine Learning Techniques For Minor Class Prediction Utilizing Kernel Density Estimation: Factors Impacting Model Performance, Abdullah Mana Alfarwan

Dissertations

This dissertation examined classification outcome differences among four popular individual supervised machine learning (ISML) models (logistic regression, decision tree, support vector machine, and multilayer perceptron) when predicting minor class membership within imbalanced datasets. The study context and the theoretical population sampled focus on one aspect of the larger problem of student retention and dropout prediction in higher education (HE): identification.

This study differs from current literature by implementing an experimental design approach with simulated student data that closely mirrors HE situational and student data. Specifically, this study tested the predictive ability of the four ISML classification models (CLS) under experimentally …

Using Video Prompting To Teach Daily Living Skills To Young Adults With Disabilities, Melissa Anne Rajter

Dissertations

Young adults with disabilities may experience difficulties with the daily living skill of meal preparation. Such skills are significant for independent living, employment, and overall quality of life. Previous research has identified video prompting daily living skills as an effective practice that supports independent living. Furthermore, research on young adults with disabilities and video prompting daily living skills has shown an increase in the percentage of correct responses for meal preparation, compared to no use of video prompting. The purpose of the present study was to teach and assess three cooking recipes as a daily living skill for seven young …

Drug Use And Harm Reduction: Community Readiness As Pathway To Well-Being And Reintegration, Lauretta Ekanem Omale

Dissertations

Drug abuse negatively impacts the life and well-being of those who use drugs; this harm often extends to their loved ones, communities, and society. One presumptive set of psychological explanations for drug abuse is an addictive personality, a psychological susceptibility resulting from challenging family relationships, inadequate reinforcement, the absence of healthy role models, conflicting parental expectations, and a lack of love and respect. Harm reduction is a public health approach that focuses on minimizing the harmful effects of drugs and reducing judgment. It aims to meet people where they are in life and provide judgment-free, empathetic, supportive, and needed medical …

Persistence Of Female Faculty In Stem, Andrea Constantinou

Dissertations

The lack of women entering certain STEM fields impacts female representation in research faculty, teacher faculty, and leadership positions in higher education. Through a narrative inquiry methodology utilizing the theoretical paradigms of self-determination theory and relational autonomy, this study extended understanding of the factors that motivate persistence for women in certain STEM fields. While prior research focused on understanding the barriers to retention, this study sought to identify the factors motivating retention for women in certain STEM fields. The results of this study contribute to understanding the motivating factors that influence a woman’s persistence in STEM. The data gathered from …

Black Students Matter: A Phenomenological Approach To Exploring Sense Of Belonging Among Black Students Attending A Hispanic-Serving Institution, Alison K. Chandler

Dissertations

As the number of Black college students who have enrolled in federally designated Hispanic-serving institutions (HSIs) has risen, it has become necessary to examine how their sense of belonging has been fostered, particularly given the educational disparities and equity gaps in retention, persistence, and graduation rates. Furthermore, the focus on initiatives geared towards Latinx students may contribute to feelings of inadequacy among Black students, which is compounded by racialized experiences that have occurred in educational settings both prior to and during college. This phenomenological study explored the experiences of nine Black undergraduate students at a private four-year HSI in the …

Professional Learning Communities: Structures And Implementation For Small Middle Schools And Singleton Teachers, Gerrie Aulisa

Dissertations

Professional Learning Communities are essential to building interdependent collaborative teacher teams to elevate teaching and learning for students. One struggle with implementing PLCs comes about when you have singleton teachers who do not have a colleague who teaches the same grade and content as them. This study reviewed the research-based PLC implementation strategies used at one small middle school. The main research question was: How can PLCs work effectively for small middle schools and singleton teachers? Other related questions were:

● How can PLCs feel relevant to our elective area teachers?

● What determines a successful PLC?

● Should middle …