Digital Commons Network^™

Grounded Leadership: Exploring Health And Wellness Strategies Of Company Grade Officers In The California Army National Guard, Greg Montanio

Dissertations

Purpose: The purpose of this explanatory mixed methods study was to identify and describe what exemplary California Army National Guard (CA ARNG) company grade officers do to maintain their physical, emotional, intellectual, social, vocational, and spiritual health. Methodology: This study used a mixed methods approach relying on the collection of data to provide for a more flexible platform to triangulate multiple data sources and increase the validity of the study’s findings. The study used a quantitative survey to examine how exemplary company grade officers in the California Army National Guard rated their use of grounded leadership strategies along with follow-on …

An Efficient Computational Method For Causal Inference In High-Dimensional Data: Neighborhood-Based Cross Fitting, Oluwagbenga David Agboola

Dissertations

High-dimensional data are increasingly popular in various physical science and social science disciplines. This study proposed a new computationally efficient sample splitting method called Neighborhood-Based Cross Fitting (NBCF) for double machine learning in causal inference on high-dimensional data. A common existing approach of repeatedly splitting data was suggested to address the overfitting problem in high-dimensional statistics, however it is computationally expensive. The proposed method deals well with the problem of post-selection bias in causal inference in the presence of high-dimensional confounders. Also, it provides an equivalent performance in unbiased estimation as repeated data splitting, which is suggested to expand the …

Transplantability In Burdened Populations: A Regional Analysis Of The Robotic-Assisted Kidney Transplant Impact On Access Given Socioeconomic And Demographic Factors, Earnest James Davis Jr.

Dissertations

Introduction/Background

The social contract of health (SCOH) in America that governs healthcare interactions has listed toward provider organizations and away from the patient. End stage renal disease treatment provides an explicatory case to examine an unbalanced SCOH. The study evaluates whether the robot-assisted kidney transplantation (RAKT) technique allows for patients with higher body mass indices and of burdened socioeconomic and sociodemographic status improved access to transplant compared to traditional open kidney transplant (OKT).

Methods

The study set combined extant data for patients transplanted at Chicago from two data sets. Investigators used independent t-tests, chi-squared tests, survival analysis, analysis of frequencies, …

Bayesian Joint Modeling For Longitudinal Outcomes Of Exponential Families And Informative Time Points, Michael Safo Oduro

Dissertations

The benefits of longitudinal data in clinical research are immense, owing to the potential to detect phenomenon changes and trends over time. An avalanche of traditional methods exist for the analysis of this data kind, most of which are predicated on the assumption of fixed time design for study individuals. This assumption however, is not always tenable. Consider occurrences that can alter the time or visit profile of subjects in a clinical trial, such as adverse events. These may result in not just irregular visit times, but also unbalanced data on subject outcomes. Hence, one can consider visit times to …

Mothers’ Perspectives On Language And Literacy Development In Children With Disabilities Adopted From China, Jessica B. Hovland

Dissertations

Children with disabilities and special needs make up the vast majority of those currently being adopted internationally into the United States (U.S.). China has been a leading sending country for international adoption since the 1990s and remains one of the few nations with thousands of orphaned or abandoned children, many with congenital disabilities or significant medical needs, in government welfare institutions. While most children adopted internationally (CAI), whether from China or other nations, experience developmental catch-up after adoption, children with disabilities and those who spent time in institutional settings exhibit persistent language deficits that impact literacy and academic skills as …

Are Natural Killer Cells Novel Mediators Of The Effects Of Cannabidiol On Mental Health, Sleep Quantity, Sleep Quality, And Immune Function?, Jacob Norbert Kisiolek

Dissertations

Cannabidiol (CBD) has increased in popularity since the United States Farm Bill legalized hemp production in 2018 and is now projected to become a $24.4 billion dollar industry by 2025. Since its legalization, CBD is thought to be an antiepileptic, anxiolytic, and antipsychotic, as well as an agent to improve mental health, quality of life, aspects of sleep and immune function. However, many of these claims lack scientific evidence. The purpose of this randomized, double blind, placebo-controlled trial was to determine the effects of an 8-week CBD intervention on measures of mental health, sleep quantity, sleep quality, and natural killer …

Biomarkers And Factors Related To Risk Of Acute Kidney Injury, Mary Ann David

Dissertations

Background: Acute kidney injury (AKI) is associated with increased mortality, morbidity, length of hospital stay, and in-hospital cost. Timely intervention is needed to prevent disease progression, but the delay in diagnostic process often results in delayed treatment. Recent studies show a significant increase in novel urine biomarkers (UB), TIMP-2 and IGFBP7, has been linked to an increased risk of AKI.

Objectives: The purpose of this study was to examine the relationships among participants’ sociodemographic and clinical characteristics, including select biomarkers, care management processes, treatments, and patient outcomes in a sample of hospitalized critically ill patients in southern California.

Findings: Study …

Promoting Safe Sleep Education For At Risk Mothers, Breanna James

Dissertations

Sudden infant death syndrome (SIDS) is an unexplained scary phenomenon that has plagued parents for years until research determined there was a link between the infants sleeping position and sudden death. Local community leaders in health and advocacy review fetal and infant deaths on an annual basis to identify ways that infant mortality may be prevented. Barriers related to social determinants of health and lack of knowledge specific to safe sleep were identified root causes. Evidence-based recommendations for safe sleep set forth by the American Academy of Pediatrics have demonstrated effectiveness in reducing mortality. The purpose of the quality improvement …

Exploring Psychological And Situational Factors That Influence Female College Students' Participation In Oral Sex, Margaret Bergeron

Dissertations

Although sexually transmitted infections (STI) are not officially reported via the route of transmission, the CDC (2016) reports that individuals who provide fellatio have the highest risk of oral transmission of a STI. Therefore, females who engage in fellatio are at risk for acquiring a STI. The majority of research studies on young adult heterosexual female sexual activities primarily focus on vaginal sex and the associated risks of pregnancy and sexually transmitted infections. Limited research exists on the oral sex behaviors of female college students and their understanding of the risk for contracting an STI through fellatio. The purpose of …

The Ripple Of Influence: The New Roi For Nonprofit Human Service Ceos, Lucinda Perry Jones

Dissertations

Purpose: The purpose of this phenomenological study was to describe how exemplary nonprofit human service CEOs lead their organizations through the lens of Grenny et al.’s (2013) six sources of influence.

Methodology: This phenomenological study explored the lived experiences of 15 nonprofit human service CEOs and how they lead as influencers. Study participants were CEOs of basic needs organizations drawn from the Bank of America’s Neighborhood Builders^® award recipients from 2015-2020. The researcher collected qualitative data by utilizing an interview protocol and examining organizational artifacts.

Findings: Analysis of the qualitative data from 15 nonprofit human service CEOs yielded 14 …

Advanced Nursing Education: Critical Factors That Influence Diploma And Associate Degree Nurses To Advance, Rose L. Mcghie-Anderson

Dissertations

Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of the nurse as educator, manager, nurse leader, and researcher who will effect policy changes and assume leadership roles as revolutionary thinkers in addition to implementing paradigmatic shifts.

This grounded theory study sought to unearth the critical factors that motivate nurses to advance academically. The study aimed to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance their nursing education.

Transitional Care Interventions As Implemented By Faith Community Nurses, Deborah J. Ziebarth

Dissertations

Hospitals are seeking innovative and efficient methods of decreasing avoidable readmissions. Despite the volume of nursing literature exploring the use of advanced practices nurses in providing transitional care, only one study mentions the use of a faith community nurse. The faith community nurse operates in the community and has the skills to provide transitional care. The purpose of this study was to describe transitional care as implemented by faith community nurses using a standardized nursing language: the Nursing Intervention Classification (NIC). A mixed method descriptive design was selected to facilitate a thorough exploration of the interventions implemented by faith community …

Emotional Responses And Mother-Infant Interactions Of Mothers With Early-Preterm, Late-Preterm, And Full-Term Infants In Malawi, Kaboni Whitney Gondwe

Dissertations

Malawi has the highest preterm birth rate in the world and preterm birth contribute to more than one-third of the neonatal deaths annually. Malawi is also faced with limited resources, both human and material. The lack of incubators led to the adoption of Kangaroo Mother Care (KMC) as routine care for preterm infants. Families also provide support, physical and emotional during this entire period. Evidence from developed countries has shown that preterm birth contributes to maternal emotional distress (depressive, anxiety, and posttraumatic stress symptoms and maternal worry about child's health) and fewer maternal and infant interactive behaviors. The majority of …

Liquid Biopsies For Type 2 Diabetes Mellitus: Biomarkers For Disease Risk And Diagnosis, Stephanie Chidester

Dissertations

Background: Type 2 diabetes mellitus (T2DM) has reached epidemic proportions in the United States. There is a critical need for earlier and more effective screening and diagnostic tools. Innovative liquid biopsy technologies may play a key role in meeting this need. Liquid biopsies are a non-invasive, adjunctive tool for determining diagnosis, prognosis, and therapeutic response. This dissertation focuses on two potential applications of liquid biopsy technologies to T2DM: (1) epigenome-wide association studies to identify epigenetic markers of risk for T2DM, and (2) extracellular vesicle (EV)-based biomarker studies to identify and detect markers associated with T2DM development and progression. Dissertation studies: …

Breastfeeding Intention And Initiation Among Rural, Low-Income Native Americans And African American Adolescent Mothers In North Carolina: Testing The Theory Of Planned Behavior, Cynthia H. Herndon

Dissertations

Infant feeding practices can greatly impact a child's life with far reaching implications based upon decisions a mother makes for her newborn. Breastfeeding is the preferred method of infant feeding because of its association with health benefits to both the mother and child. The prevalence of breastfeeding among rural, low income, disadvantaged groups to include Native American (NA) and African American (AA) adolescent mothers is low. NAs and AAs bear a disproportionate burden of illness and health risks compared to other races and ethnic groups in the United States. Breastfeeding is a targeted public health strategy to improve the health …

Modifiable Cardiovascular Risk Factors In The Early Adolescent Period, Julia A. Greenawalt

Dissertations

The purpose of this study is to describe patterns and relationships among the modifiable cardiovascular risk factors of smoking behavior, overweight, physical inactivity and poor dietary behaviors within a ninth grade population. Four modifiable cardiovascular risk factors; smoking behavior, overweight, physical inactivity and poor dietary behavior were analyzed from the 2003 Youth Risk Behavior Surveillance System (YRBS) to explore associations in early adolescents, a critical developmental time frame. The specific aims of this study were to: 1) conduct a factor analysis of questions selected from the 2003 YRBS to represent the constructs of smoking behavior, physical inactivity and poor dietary …

An Investigative Analysis On Female Presence And Highly Ranked Positions In Professional Kitchens In Ireland, Roann Byrne

Dissertations

This study aims to gain an understanding of the state of the cheffing industry currently, to analyse whether there is a lack of women within the industry particularly in positions of high power. This research intends to understand the causes for the lack and showcase possible solutions and recommendations for this. It exists as a role of advocacy; hoping to inspire more people into the career of cheffing, and to retain women within it. It aspires to challenge and thus forth change the narratives that have pushed many people, particularly women, out of this work for so long. This research …

A Mixed-Methods Investigation Of A Comprehensive Clinical Examination In An Accredited Athletic Training Program, Tom Godar

Dissertations

This study aimed to examine the impact and potential benefits of a comprehensive skills-based clinical examination within an accredited athletic training program. It was hypothesized that a comprehensive clinical examination could accurately assess student preparedness for the BOC examination and support the students’ continued academic and clinical development. The clinical examination was developed and adapted over several years, and it consisted of multiple psychomotor skills assessments and scenario-based modules with standardized models. The validity of the clinical examination was examined retrospectively, using historical academic data representing four academic cohorts from a single institution. Student demographic profiles and academic data were …

Perinatal Nurses' Therapeutic Attitudes Towards Women Who Use Addictive Substances During Pregnancy, Karen D. Neary

Dissertations

The use of addictive substances during pregnancy continues to rise despite the known deleterious effects of addictive substances on the developing fetus. Neonates exposed to addictive substances in-utero suffer from a variety of negative outcomes that result in the need for specialized care. To improve neonatal outcomes, current research promotes involvement of the mother, who used addictive substances during pregnancy, in her newborn's care. However, women who use addictive substances during pregnancy often feel judged and ridiculed by nurses who care for them, or their newborns, leading these women to be less involved in their newborn's care. The purpose of …

Developing And Maintaining Resilience In Charter School Executive Directors, Erika Vanderspek

Dissertations

Purpose: The purpose of this exploratory phenomenological study was to identify and describe the strategies used by charter school executive directors to develop and maintain personal resiliency based on Everly, Strouse, and McCormack’s (2015) five factors of personal resilience (active optimism, decisive action, moral compass, relentless tenacity, and interpersonal support).

Methodology: This exploratory phenomenological study identified and described the lived experiences of exemplary charter school executive directors in San Diego, Riverside, and Orange counties. Based on recommendations from expert entities who worked with the target population, the researcher used purposeful sampling to select eight exemplary charter school executive directors. The …

Barriers To Physical Activity Among Asian Indian Women In The United States, Anjana Mathews

Dissertations

Asian Indian women have a higher prevalence of cardio-metabolic diseases compared to women from other ethnicities and Asian Indian men in the United States. This is due to the lower level of physical activity behaviors among this population. The purpose of this study was to explore the perceived barriers to physical activity among Asian Indian women living in the United States. The theoretical framework that guided this study was Bandura's social cognitive theory and the research design used was qualitative ethnographic approach. Participants were recruited from 2 Christian churches in Southern California using purposive and snowballing sampling strategies. Fifteen participants …

Parental Self-Efficacy, Feeding Practices, And Weight Gain During Infancy: A Secondary Analysis, Jessica S. Bahorski

Dissertations

Mechanisms contributing to childhood obesity begin during early life, including infant feeding practices and an excessive rate of infant growth. Parental decisions regarding their infant contribute to these mechanisms. Parental self-efficacy (PSE) is the belief parents have in their ability to accomplish the tasks of parenting and is associated with infant outcomes. A high sense of PSE, breastfeeding self-efficacy, or self-efficacy for feeding has been found to be associated with healthy infant feeding practices. However, this research is limited in scope and has not been conducted in populations at greatest risk for childhood obesity such as low-income or African-American infants. …

The Relationship Between The Perceptions Of Implicit Rationing Of Nursing Care And Emotionally Intelligent Leadership Style Among Direct-Care Nurses, Hazel Linda Blizzard

Dissertations

Implicit rationing of nursing care and emotionally intelligent leadership style of nurse managers has been found to contribute to patient outcomes. No studies had been done prior to this study to examine possible links between implicit rationing of nursing care and emotionally intelligent leadership style of nurse leaders on a hospital unit. The purpose of this cross-sectional survey design study was to examine relationships between amounts of perceived implicit rationing of nursing care and perceptions of emotionally intelligent leadership style of nurse leaders on the acute-care hospital unit.

Examination Of The Informed Consent Process As Experienced By Patients Who Underwent De Novo Transjugular Intrahepatic Portosystemic Shunt, Chemoembolization Or Radioembolization Procedure, Marsha A. Hughes-Gay

Dissertations

The purpose of this study is to examine the informed consent (IC) procedure as it was experienced by patients who had undergone a de novo transjugular intrahepatic portosystemic shunt (TIPS), chemoembolization (TACE), or radioembolization (TARE) procedure in an Interventional Radiology (IR) Department. The three main study aims and a fourth exploratory aim are as follows: (1) Describe how patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department described the IC procedure; (2) Describe what information patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department recalled being told during …

Intervention Effects Of A Cognitive Behavioral Skills Building Program On Newly Licensed Registered Nurses, Marlene Sampson

Dissertations

The well-being of healthcare clinicians is considered a national crisis. Healthcare clinicians, including nurses, have higher rates of substance abuse, depression and suicide than the national average. Depression and poor health in nurses are linked to medical errors and patient dissatisfaction. Ninety-one percent of NLRNs report high stress levels resulting in stress-related illness, absenteeism and burnout. In 2017, the National Academy of Medicine launched the Action Collaborative on Clinician Well-being to develop evidence-based solutions to reduce this public health epidemic. The purpose of this study was to examine the effects of a Cognitive Behavioral Therapy (CBT)-based skills building program entitled …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh A. Williams

Dissertations

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse's (RN) assessment of their patient's health literacy of those who live in a ruralborder region. The study's sample consisted of 84 pairs of …

The Impact Of Health Literacy, Culture And Psychological Factors On The Pap Testing Behaviors Of African Immigrant Women In The United States, Joycelyn Cudjoe

Dissertations

African immigrant (AI) women have low Pap testing rates. Limited health literacy is a barrier to cancer screening among racial/ethnic minority populations. Sources and types of health information can shape health literacy. However, how health literacy, sources and types of health information along with cultural and psychosocial correlates impact the Pap testing behaviors of AI women remains unknown.

To examine how sources and types of health information impact health literacy and health information exchange, and in turn, how health literacy, culture and psychosocial (cancer knowledge, self-efficacy, decisional balance, cultural beliefs) factors influence the Pap testing behaviors of AI women.

Acculturative Stress, Psychological Flexibility, And Cardiovascular Health Behaviors Among Second Generation Arab Americans In The Greater Washington Dc Region, Randa Merizian

Dissertations

Arab Americans are under-represented in cardiovascular (CV) research, but recent evidence reveals they are at disproportionate risk for poor CV health behaviors when compared to the overall United States of America population. The proposed study is designed to measure the impact of two factors, acculturative stress and psychological flexibility, on CV health behaviors among second generation Arab Americans in the Greater Washington DC region. The outcome variable will be measured using the CV Health Behaviors Questionnaire adapted from the American Heart Association Life's Simple 7 (LSS). Participants will be recruited from five local churches and mosques and George Mason University …

Chlorhexidine Gluconate Bath Project: A Program Evaluation, Yavesh Crawford

Dissertations

Patients' safety outcomes are a reliable measure of how well a unit performs within any hospital. One of the most impactful patient safety factors is bloodline infections within the hospital. Blood line infections are associated with over 28,000 fatalities in the United States. The cost of central line bloodstream infection (CLABSI) in the United States is over $2 billion annually. Therefore, there is a need for a way to reduce CLABSI rates within care facilities. Considering the possible interventions, this program evaluation chose chlorhexidine gluconate (CHG) bathing to reduce infections. To establish the efficacy of the proposed solution, the program …

A Descriptive Mixed-Methods Study Examining Resilience And Transitioning To Adulthood Among Emerging Adults With Disabilities, Jennifer Emilie Mannino

Dissertations

Transitioning to adulthood is not without challenges. The move away from family influence towards independence and self-determination is filled with uncertainty. Increased challenges and vulnerabilities in transitioning are evident among emerging adults with disabilities because they face additional challenges related to their disability over and above what others of this developmental stage experience.