Digital Commons Network^™

Care Coordination In Pediatric Primary Care, Alyssa K. Durzo

Dissertations

No central documentation of care plans exists for children with special healthcare needs (CSHCN) in the electronic health record (EHR). Providers of a large pediatric primary care office in St. Louis Missouri were asked to identify CSHCN in the practice. Clinic nurses completed a comprehensive chart review of the patients identified and constructed care coordination documents using a pre-established smart-text phrase. Subsequently, these were documented centrally in the EHR under the Problem List.

Likert score data was obtained from providers on the acceptability, appropriateness, and feasibility of the intervention through the verified tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness …

Evaluation And Expansion Of Posttraumatic Avoidance Assessment: Proposal Of A Novel Measure Of Posttraumatic Positive And Negative Experiential Avoidance For Use In Research And Clinical Practice, Marissa A. Yetter

Dissertations

Avoidance is a well-established mechanism in the development and maintenance of posttraumatic stress disorder (PTSD) and a central treatment target in gold standard evidence-based interventions. While traditionally defined as avoidance of trauma-related distressing thoughts, emotions, and reminders, emerging research highlights the need for a broader conceptualization of posttraumatic avoidance that includes both negative and positive emotional experiences. The current study aimed to explore an expanded conceptualization of clinically relevant posttraumatic avoidance using an experiential avoidance framework, a more generally defined unwillingness to remain in contact with distressing thoughts, feelings, memories, and other internal experiences. A sample of non-treatment seeking U.S.-based …

Nanoporous Gold Nanoparticles And Model Membrane Systems Applied To The Study Of Lipopolysaccharide (Lps), Dhanbir Lingden

Dissertations

Lipopolysaccharide (LPS), a key structural component of Gram-negative bacteria, is a major trigger of sepsis and septic shock, the systemic inflammatory conditions responsible for millions of deaths annually. Even at concentrations as low as 1 ng/mL, LPS can activate the immune system and initiate inflammatory cascades. According to the Global Burden of Disease Study 2017, sepsis accounted for 48.9 million cases globally, with 11 million deaths, emphasizing the urgent need for improved diagnostic and therapeutic strategies.

Accurate and rapid detection of LPS is vital for early intervention and improved clinical outcomes. While traditional detection methods are still widely used, modern …

Truth, Resilience, And Healing: Deepen Understanding Of Native American Federal Boarding School Histories, Toya D. Holiday

Dissertations

Indigenous communities have endured the long-standing impacts of U.S. Federal Indian boarding school policy. The history of Indigenous boarding school policies and the underlying intent to enact cultural genocide is unknown and unacknowledged. The perspectives of Indigenous Peoples have been excluded from dominant narratives, and until recently, from heritage site programming, leading to intergenerational trauma, fragmented identities, and the misrepresentation of Indigenous cultures and experiences. This basic qualitative study asked the question: When the four-truth framework, developed by the South African Truth and Reconciliation Commission, is applied to U.S. Federal Indian boarding school policy, Native American boarding school history, and …

District Impact On State-Wide Charter School Policy: Has Normandy Schools Collaborative Punctuated The Equilibrium? Charter School Policy Analysis Of The Missouri Department Of Elementary And Secondary Education, Tracey L. Cannon

Dissertations

Abstract

Punctuated Equilibrium Theory, as applied by Niles Eldredge and Stephen Jay Gould (1941-2002) to the study of species evolution, examined the infrequency of morphological change or stasis discontinuity.1 While groundbreaking in the field of Paleontology and the study of fossil change, the theory has been well-fitting to the decision sciences as introduced by Baumgartner and Jones2, in their 1993 and 2010 publications. Recognizing typical, incremental policy change, its use in this research looks at how stasis, stagnant policy can be punctuated by changes in political or societal views. This study examines the impact of heightened problem discussion for agenda …

Post-9/11 Navy Service Members’ Barriers To Using Military Educational Benefits, Karen D. Cross

Dissertations

There are studies explaining how many service members are using military educational benefits or the challenges service members incur after they have enrolled in school and are attending classes. There are also studies that report how many service members use military educational benefits. However, studies exploring why some service members, or some Post-9/11 service members in particular, do not use military educational benefits has been limited. The purpose of this study was to discover why many service members in the United States Navy do not or did not take advantage of military educational benefits. This study also sought to find …

Illuminating Trauma & Resilience In Educational Spaces: Expanding Narratives To Promote Historical And Critical Civic Empathy At Little Rock Central High School National Historic Site, Chakakuan Johnson, Linda Nance, Byron Witherspoon

Dissertations

Abstract

The 1957 desegregation crisis at Little Rock Central High School marked a defining moment in the Civil Rights Movement and continues to symbolize the broader struggle for racial equality. This dissertation examines equity in educational spaces through a four-truth lens that was first articulated by the South African Truth and Reconciliation Commission and explores forensic, personal, social, and healing truth. Using Little Rock Central High School National Historic Site (CHSC) and park interpretation as the focal point, our qualitative research study used reflexive thematic analysis to examine oral interviews, onsite observations, and various documents and artifacts, and to illuminate …

Remote Home Blood Pressure Monitoring For Management Of Hypertension, Kathleen M. Oliphant

Dissertations

Remote home blood pressure (BP) monitoring has the potential to improve patient engagement and adherence with the prescribed treatment plan for managing hypertension. This DNP project examined the effects of daily remote BP measurement using transmission of biometric data through a Bluetooth-equipped device paired to participants' smartphones. The clinical management of a chronic condition such as hypertension is a long-term process, but the findings of this DNP project supported the empirical evidence showing that remote BP monitoring improves patient outcomes.

Grounded Leadership: A Look Into California Community College Mid-Level Leaders, Vicki Hou

Dissertations

Purpose: The purpose of this explanatory mixed-method study was to identify and describe what exemplary California Community College mid-level leaders do to maintain their physical, emotional, intellectual, social, vocational, and spiritual health based on the six dimensions of Rosen’s healthy leader model.Methodology: This study employed a purposive sampling method to select 15 mid-level leaders from two California community college districts. Data collection involved two instruments: the Stay Grounded Survey, administered to all 15 participants, and semi-structured interviews conducted with a subset of five participants. Quantitative data were analyzed using descriptive statistics including mean scores, frequency distributions, and standard deviations. Qualitative …

Educational Technologist Perceived Self-Efficacy During Emergency Remote Teaching Due To A Nonpharmaceutical Intervention, Katherine R. Rapp

Dissertations

This paper discusses the challenges and opportunities of educational technologists (ETs) during emergency remote teaching (ERT) in a non-pharmaceutical intervention (NPI), due to the COVID-19 pandemic. The study was guided by Albert Bandura’s social cognitive theory and self-efficacy framework. The study highlights the positive and negative reflections of self-efficacy for ETs during the transitions to different strategies in classroom teaching. It acknowledges the positive and negative effects on ETs from self-regulation, observational learning, and reciprocal determinism. The study design used was qualitative, aiming to identify the perceived self-efficacy of ETs during ERT in an NPI. Eight ETs from rural school …

Variable Importance, Knockoff Filters, And Improving False Discovery And False Negative Rates, Nicholas Ehlman

Dissertations

Tree ensemble methods such as Random Forests and Boosted Trees have introduced a range of variable importance statistics, offering powerful tools for feature selection. The advent of knockoff filters marked a significant advancement by combining the use of these variable importance statistics with the ability to control the False Discovery Rate (FDR). However, achieving a low FDR frequently comes at the cost of a high False Negative Rate (FNR), limiting the power of such approaches. In this work, we propose a novel method for leveraging knockoff variables to keep both FDR and FNR low. While this method does not have …

Giftedness In A Post-Secondary Environment: Academic, Social, And Affective Results And Recommendations, Justin Villet

Dissertations

The field of gifted education has been present in America since the early 20th century (Jolly, 2009). After scholars developed a list of gifted characteristics in the 1950s, the concept of giftedness became far more controversial (Terman & Oden, 1959). Over the last 75 years, gifted education in America has gone from a shining star to complete ambiguity, owing partially to politics and partially to decentralized process (Ford, 2013; Gallagher, 2015; Hodges et al., 2018). This study included an examination of the gifted experience from the secondary to post-secondary environments. The researcher examined various qualitative and quantitative secondary data, including …

A Four-Truth Exploration Of Memory, Social Connection, And Belonging In Fairground And Tower Grove Parks In St. Louis, Missouri, Kenya D. Womack, Adeola N. Adewale, Marie E. Boesch, Gelene M. Strecker-Sayer

Dissertations

Historic racism supported practices such as redlining, discriminatory zoning, and racial steering that separated people and determined the flow of resources and investment into neighborhoods. Communities continue to experience the long tail effects of historic patterns of racism. That is, historic inequities influence the opportunities that residents have to connect with each other and thrive in urban areas. Urban neighborhood parks have the potential to bridge social divides and bring a community together. This basic qualitative research study examines two contested heritage sites in St. Louis, Missouri: Fairground Park, a park in a Black neighborhood that has been historically disinvested …

Beyond "Thanks For Your Service": Navigating The Challenges Of Memorializing The Global War On Terrorism, James Craig

Dissertations

As objects of public commemoration, the American public expects our national war and veteran memorials to draw coherent narratives from diverse, often contradictory, experiences. In return, our society bestows these places with extraordinary authority, allowing them to define the essence of events from years ago. This dissertation explores that phenomenon in the context of the national Global War on Terrorism (GWOT) Memorial, which has been approved for placement in the National Mall and is in its design phase. As its framework, this dissertation uses the four truth framework developed by the South African Truth and Reconciliation Commission. With a focus …

In Living Memory: Curatorial Perspectives Of Jewish Heritage In Holocaust Public Histories, Hannah M. Lahti

Dissertations

Holocaust Museums present a history of the genocide of European Jews, while Jewish Museums represent the long history and diverse cultures of Jewish life. By examining Holocaust public histories in Poland and the United States, this dissertation outlines the historical and memorial conditions that inform museum exhibits, as well as the curatorial approaches that synthesize historical information, spatial contexts, and material culture into exhibition narratives and historical representation. This dissertation employs exhibition analysis to explain existing curatorial approaches in Holocaust public histories and identifies curatorial principles and methods of display that might translate to new exhibits. Informed by the models …

Enzymatic Characterization Of Bacterial Enzymes And Inhibitors As Potential Antibiotics With New Mechanisms Of Action, Emma Helene Kelley

Dissertations

Bacteria have become increasingly resistant to antibiotics, therefore there is an urgent need for new drug classes of antibiotics to help fight antibiotic infections. To this end, our research is focused on inhibitors of dizinc metalloenzymes N-succinyl-L,L-diaminopimelic acid desuccinylase (DapE), an enzyme in the lysine biosynthesis pathway, N-acetyl-L-ornithine deacetylase enzyme (ArgE), an enzyme in the arginine biosynthesis pathway, and sodium-dependent NADH: ubiquinone oxidoreductase (Na+-NQR) enzyme, a respiratory complex enzyme as promising drug targets. DapE, ArgE, and Na+-NQR and are only present in bacteria, including ESKAPE pathogens that can cause potentially deadly infections, thus inhibitors of DapE, ArgE, and Na+-NQR offer …

Development Of Novel Force Fields For Metal Ions, Madelyn Smith

Dissertations

Many biological proteins require the presence of a metal ion in order to properly function. However, metal ions’ complex nature charge poses several challenges to accurately and efficiently simulate computationally. For example, metal ions can exhibit multiple oxidation states, electronic state degeneracy, flexible coordination numbers, and significant polarization effects. To address these problems, this dissertation aims to enhance force fields for modeling metal ions in molecular dynamics simulations. First, a comprehensive set of van der Waals radii for metal ions is derived, demonstrating the importance of using physically meaningful parameters in force fields. Second, a comprehensive set of atomic and …

The Hitching Post: American Poetry And Chinese Mythology, Xiamara Elena Hohman

Dissertations

In this dissertation, I examine the ways in which Chinese mythology has figured in American poetry, focusing particularly on the ways Chinese mythologies have served—and continue to serve—as “hitching posts,” quasi-material sites from which meaning can be created and explored. As I am defining it, a myth is a narrative that gives meaning to a lived experience. It explains what we commemorate and worship and renders meaningful both celebration and life. In the first three chapters of this study, I discuss the ways in which Chinese myths and cultural practices have been both used as hitching posts and appropriated by …

Modernism’S Mythic Mothers: Queering Motherhood Through Classical Matrilineage, Samantha Marie Lepak

Dissertations

I position this dissertation at the intersection of modern/contemporary literature, queer/feminist theory, and ancient Greek classics in the hopes of better understanding the spaces in which they meet, engaging with writers from the late modernist era to the present in order to highlight the connections between theories, themes, and practices of queerness from the modernists forward. Using the work of H.D. and writers following in her footsteps, I argue that exploring adaptations of Greek classics written primarily by female and gender-variant authors from the modernist era forward illuminates the extent to which the classics enables writers to “think queerly,” considering …

Maternal Access For Depression In Rural Environments, Simone Parlier

Dissertations

Significance –As many as 25% of birthing persons experience postpartum depression (PPD) within the first year after childbirth making this one of the most common postpartum disorders. PPD is prevalent, incapacitating, and treatable. The first step is identifying those at risk. Rural birthing persons are understudied, and may have unique predisposing characteristics as well as geographic challenges for optimal detection and treatment of PPD. Purpose -The long-term goal is to improve the health of rural families. Using The Theory of Unpleasant Symptoms, the purpose of this descriptive, cross-sectional research was to describe the prevalence of PPD in rural birthing persons …

The Impact Of Substrate Structure And Catalyst Identity On The Lewis-Acid Catalyzed Carbonyl-Olefin Metathesis Reaction, Cory William Schneider

Dissertations

The formation of carbon-carbon double bonds is one of the most important transformations in organic chemistry, as they are integral to the structural scaffold of many organic molecules. Thus, the development and understanding of reactions that form such bonds is crucial. Lewis-acid catalyzed carbonyl-olefin metathesis is one such reaction. Like many others, this reaction is sensitive to both the identity of the catalyst, as well as the structure of the substrate. In this dissertation, I present empirical and theoretical works investigating how the catalyst identity and the substrate direct the reactivity of the Lewis-acid catalyzed carbonyl-olefin metathesis reaction.

Exploring Latinx Students' Experience With School Connectedness: A Hybrid Thematic Approach To Deductive And Inductive Analysis, Maria Olivia Mendez

Dissertations

This qualitative study aimed to deepen the understanding of school connectedness experienced by Latinx high school students. Specifically, the researcher sought to explore how Latinx students described their connection to school during their high school years. Additionally, to examine whether their experiences aligned with the social and ecological structures outlined in the theoretical model supporting adolescent connectedness to school. If there is alignment, in what ways did it manifest? If not, how did the experiences differ? The study had two primary objectives: (a) to gain insight into how Latinx students experienced school and their sense of connection through their narratives, …

St. Louis, Missouri’S Gayborhood And Washington, Dc’S Black Lives Matter Plaza: Revealing The Healing Potential Of Resistance Stories That Are Grounded In Place, Ryan R. Lindsay, Lotte I. Lent, Ackesha J. Patrick

Dissertations

Oppressed people resist, even when facing severe consequences for doing so. At the core of systemic oppression—genocide, slavery, racism, and sexism—is a drive to control and dehumanize. Resistance, however, can serve as a powerful act of rehumanization. From enslaved individuals fleeing plantations to LGBTQ+ individuals risking arrest to gather in mid-20th-century bars, resistance reclaims power and autonomy under oppressive regimes. This study applies South Africa’s Truth and Reconciliation Commission (TRC) “four truths” framework—comprising forensic, personal, social, and healing truths—to the interpretation of contested heritage sites. We argue that sites commemorating resistance hold transformative potential for individual and community healing. Using …

Toward Culturally Responsive Interpretation: Native American Histories, Lifeways, And Ways Of Knowing At The High Desert Museum, Carol Fitzsimmons, Ajena Cason Rogers

Dissertations

Many public museums and historic institutions reflect settler colonial culture and are primarily non-Native led. Although these institutions are trusted, many have perpetuated cultural harm through the theft of belongings, the misrepresentation of stories and histories, and the inaccurate portrayals of cultural content. When interpreting Native American experiences, many non-Native institutions struggle to co-create culturally responsive interpretation. The purpose of this basic qualitative study was to apply the four-truth framework, developed by the South African Truth and Reconciliation Commission, to better understand how the High Desert Museum approached the interpretation of Native American content and stories and to explore how …

Evaluating Depression In Adults Undergoing Substance Abuse Treatment: A Program Evaluation Of Intensive Outpatient Program, Chidochomoyo E. Zvirawa

Dissertations

Problem: Depression and substance use disorders (SUDs) frequently co-occur, complicating recovery outcomes. Despite screening recommendations, depression remains underdiagnosed in many SUD treatment settings.

Methods: This mixed-methods program evaluation examined depressive symptoms among adults in an Intensive Outpatient Program (IOP) using the Patient Health Questionnaire (PHQ-8). Depression screenings were conducted at intake, four weeks, and eight weeks. Eight participants meeting inclusion criteria were assessed. Data included demographics, treatment engagement, and PHQ-8 scores.

Results: PHQ-8 scores significantly declined from baseline (M = 11.75, SD = 6.52) to eight weeks (M = 5.13, SD = 5.05), t(7) = 2.76, p = .028, indicating …

The Clinical Utility Of Measuring Emotion Dysregulation In Autistic Youth, Monica S. Trevino

Dissertations

Autistic youth experience disproportionately high rates and severity of emotion dysregulation, which is linked to behavioral challenges, psychiatric comorbidities, familial stress, and increased emergency service and hospitalization use. Despite its clinical significance, emotion dysregulation in autistic youth remains relatively understudied and misunderstood, partly due to the lack of standardized assessment tools and limited research on its heterogeneity within autistic populations. In the present study, structural equation modeling was used to 1) validate the Emotion Dysregulation Inventory (EDI) and assess measurement invariance in a diverse sample and 2) explore associations among emotion dysregulation, autism symptoms, and related child and family characteristics, …

Transforming Heritage Narratives: Harnessing The Power Of Four Truth Inquiry To Reclaim Women’S History And Reinvent Climate Communication At Interpretive Sites, Pamela Blair-Bruce

Dissertations

Abstract

Heritage sites, particularly national parks, serve as powerful spaces for storytelling that shape public understanding of American history, cultures, ecological processes, and diverse landscapes. However, their narratives often omit critical aspects of women’s history and climate change, perpetuating historical erasure and selective storytelling. This qualitative research study applies the Four-Truth Framework developed by the South African Truth and Reconciliation Commission to examine how heritage interpretation can improve the recognition of women’s contributions and strengthen climate communication at heritage sites. To explore approaches to women’s history interpretation, the study employed semi-structured, focus group interviews with educators, historians, and interpreters across …

Interrogating The Dispersal Process And Relevant Genes In Vibrio Fischeri, Jeremy Esin

Dissertations

Biofilms are aggregates of bacteria encased in a matrix that shields bacteria from environmental hazards. These structures are formed in response to cues from the environment and drive colonization of new niches. Biofilms can be both beneficial and detrimental. Largely, research focuses on biofilms that have negative outcomes in clinical, environmental, and economical settings. However, the value of beneficial biofilms is recognized and studied. The marine bacterium Vibrio fischeri is part of a model system for studying symbiotic biofilms in a eukaryotic host. V. fischeri produces a transient biofilm at the surface of a specialized light organ and then disperses …

Testing For Broad Alternatives In Stratified Contingency Tables, Nan Mi

Dissertations

In medical and social sciences fields, data are measured in terms of discrete categories. The primary question of interest involves the relationship between a set of factors and a set of response variables under studies. Moreover, the distribution of the response variables may be influenced by another set of variables called confounders. The data from such studies are summarized in 3-way tables. The hypothesis we are interested in can be expressed in terms of "no partial association" between the sub-populations and the response levels.

The methods for testing the association or independence in a 2x2 contingency table have been developed, …

Investigating The Effects Of Brief Video Interventions On White Undergraduate Students’ Racial Attitudes, Alyssa Powers

Dissertations

In this experimental study, a pretest posttest between-groups design was utilized to investigate the efficacy of two brief multicultural educational video interventions in improving the colorblind and affective racial attitudes of White undergraduate students. Ninety-eight self-identified White undergraduate students from a large, Midwestern university were randomly assigned to one of three conditions: (a) viewing a video on the pervasiveness of individual racism and White privilege in the United States (True Colors); (b) viewing a video on institutional racism in the United States (Segregated by Design); (c) viewing a study tips video as the neutral control condition. Participants’ colorblind and affective …