Digital Commons Network^™

Neurobiological Markers For Remission And Persistence Of Childhood Attention-Deficit/Hyperactivity Disorder, Yuyang Luo

Dissertations

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in children. Symptoms of childhood ADHD persist into adulthood in around 65% of patients, which elevates the risk for a number of adverse outcomes, resulting in substantial individual and societal burden. A neurodevelopmental double dissociation model is proposed based on existing studies in which the early onset of childhood ADHD is suggested to associate with dysfunctional subcortical structures that remain static throughout the lifetime; while diminution of symptoms over development could link to optimal development of prefrontal cortex. Current existing studies only assess basic measures including regional brain activation …

Correlates Of Fatigue In Lymphoma Patients Undergoing Autologous Peripheral Blood Stem Cell Transplantation, Majeda M. El-Banna

Dissertations

Fatigue is the most prevalent and disturbing symptom in cancer patients; however, little research explains the correlates and predictors of fatigue. The purposes of this study were to describe the fatigue patterns in lymphoma patients undergoing autologous peripheral blood stem cell transplantation (APBSCT) and to examine the relationships among these fatigue patterns and the changes in the patterns of melatonin, depression, pain, nausea, hemoglobin level, total sleep time within 24 hours, and number of awakenings at night that contribute to the changes in fatigue during the baseline, chemotherapy and recovery periods. The conceptual framework of this prospective, descriptive, correlational, and …

The Effects Of Art Therapy On Hypertension In Black American Women, Ellen Layton Mullarkey

Dissertations

70 million Americans have hypertension affecting one out of three Americans. Heart disease was the leading cause of death in America in 2015. The American Heart Association published an algorithm for implementing alternative approaches to treating hypertension. Creative art therapy was not included. Art therapy blends the therapeutic process of psychotherapy with the art of painting, drawing and sculpture to help express emotions and beliefs that are too difficult to convey in verbal and written communication. The health belief model is a framework that examines why people do not follow the recommendations of health care providers due to real and …

The Relation Between Patient Education And Picc Line Occlusion And Infection, Patricia L. Cameron

Dissertations

The purpose of this study was to test the feasibility of using an electronic tablet to supplement patient and caregiver education about PICC line maintenance and to compare the percentage of PICC line complications in the intervention group with national percentage rates for patients and caregivers.

Life Balance In Nurse Educators: A Mixed Methods Study, Joan M. Owens

Dissertations

The topic of nurse educator life balance is significant to the nurse educator community, which is facing a national nurse faculty shortage, challenges in producing enough new nurses, and a continuing shortage of nurses. This compromises patient safety and the quality of care. Major factors identified as contributing to the shortage of nurse educators are educator dissatisfaction with workload and work life balance. Life balance is described as an enjoyable array of daily activities that is meaningful and contributes to the individual's health. Professional quality of life is described as the quality one feels in relation to one's work as …

Physical Activity Improves Depressive Symptoms In Older Adults, Karen Lee Fahey

Dissertations

Engaging in physical activity can help older adults to take part in community activities, maintain relationships, and initiate new friendships, thus preventing loneliness and depression. The purpose of this quality improvement (QI) project was to evaluate whether participation in physical activity improved depressive symptoms in 15 older adults at a local senior center. Pender's health promotion model was used to determine nursing and behavioral science views on components that affect health behavior.

Substance Use And Hiv Among Young Black Men Who Have Sex With Men (Msm), Raymond Austin Nation

Dissertations

In the United States, young Black men who have sex with men (MSM), between the ages of 13 and 29 years have the highest rates of new HIV infections. The prevalence of HIV among this population is three to four times higher than their White MSM counterparts. Research indicates substance use is strongly associated with HIV infection among young Black MSM. Twelve HIV-negative and HIV-positive participants from the Bay Area were recruited for this qualitative narrative study to explore the following three aims: (a) describe the role substance use plays in the lives of young Black MSM, (b) describe their …

Syndemic Conditions And Medication Adherence In Older Hiv-Positive Men Who Have Sex With Men, Roland Zepf

Dissertations

For people living with HIV, lack of adherence to medication regimen is a significant problem with serious deleterious outcomes. Reasons for non-adherence are co-concurring psychosocial health conditions—also known as syndemic conditions—such as symptoms of depression, post-traumatic stress disorder (PTSD), past physical or sexual abuse, intimate partner violence (IPV), stimulant use, and binge drinking. Majority of all new HIV infections in the United States are among men who have sex with men (MSM). This dissertation reports on a secondary analysis of cross-sectional data from older MSM living with HIV receiving treatment at two outpatient HIV clinics in San Francisco.

How Does Standard Use Of A Rectal Acetaminophen/Intravenous (Iv) Opioid Combination Compare To Iv Opioid Alone In Improved Comfort Levels And Decreased Overall Opioid Use In Full-Term Infants Post Open Heart Repair?, Jacqueline M. Ochsenreither

Dissertations

Pediatric cardiothoracic surgical patients experience varying degrees of pain in the immediate post-operative period. Multiple analgesic modalities can be utilized to effectively manage pain in this specific patient population. Routinely, IV opioid only is prescribed post-operatively to manage acute pain needs in this select group of patients. However, standard use of rectal acetaminophen as an adjunct to IV opioid to improve comfort levels and decrease overall opioid use in the immediate post-operative period in this select population has not been examined. This retrospective, 18-month, quantitative study was conducted at a large urban children's teaching hospital incorporating electronic medical inpatient chart …

Pain And Spiritual Distress At End Of Life, Kathryn Lee Robinson

Dissertations

Purpose: The purpose of this study is to examine the relationship between unmanaged pain and spiritual distress in adults newly admitted to hospice.

Background/Rationale: Current evidence supports the presence of a positive relationship between increased physical pain and spiritual distress for those with advanced cancer and/or receiving palliative care services. Nonetheless, spiritual distress remains a relatively understudied area; anecdotally, assessment and management of physical symptoms often take precedence over interventions for spiritual distress in patients at end of life (EOL) on hospice. Research is needed to examine the relationships between physical pain, spiritual distress, and other relevant variables specific to …

Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods

Dissertations

Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …

African American Females Holding Executive Administrative Positions At California Community Colleges: A Phenomenological Study Of Cultural Influences And Opportunities, Daria Reynolds

Dissertations

Purpose: The purpose of this phenomenological study was to explore the lived

experiences of African American female presidents, vice presidents, deans, associate deans, and directors serving at a California community college (CCC) and to explore what African American cultural influences or other opportunities contributed to their becoming administrators.

Methodology: This phenomenological study explores the lived experiences of African American female administrators of CCCs. This study highlighted the essence of those lived experiences. The respondents were chosen based on specific criteria. The researcher then conducted structured web-conference interviews that described the essence of the lived experiences of the 10 African American …

The Role Of Socioeconomic Status And Prior Industry Exposure On The Attitudes, Career Goals, And Career Decision Self-Efficacy Of Undergraduates Studying Hospitality And Tourism Management, Laura Mckenzie Shroder

Dissertations

The hospitality and tourism industry struggles with high employee turnover, and many hospitality management students graduate and subsequently leave or choose not to enter the industry. Scholars have found it beneficial to study students’ industry attitudes, career goals, demographics, and career decision self-efficacy to further understand how these variables influence students’ perceptions, engagement, and retention. This quantitative study measured these variables as well as prior industry exposure, which is based on the Social Cognitive Career Theory. Results of an online survey of hospitality students in the Western United States (n = 315; response rate 79.9%) suggested that students’ prior industry …

Navy Seals - Crossing Cultures: Cross-Cultural Competence And Decision Styles, Robert Newson

Dissertations

U.S. military cross-cultural competence is currently deficient, as Special Operations Forces (SOF) personnel assessments fail to explicitly consider aspects related to cross-cultural competence and lack processes specifically tailored to cross-cultural personnel assignments. Researchers, however, have identified eleven attributes that contribute to military cross-cultural competence; this study uses these attributes to explore whether decision styles and demographics correlate with cross-cultural competence. Building on existing work on the attributes of military cross-cultural competence (defined in this study as the ability to quickly and accurately assess, then effectively act, in a culturally complex environment to achieve mission results), I first examined the attribute …

The Impact Of The Language Of Instruction On Second-Grade Latinx Emergent Bilinguals’ Understanding Of Place Value In Two Spanish-English Transitional Bilingual Classrooms: An Exploratory Study, Angela Maria Rengifo

Dissertations

The relationship between mathematics learning and the language of instruction in bilingual settings has been observed and analyzed widely in educational research. As Latinx Emergent Bilingual students start developing their mathematics knowledge and skills in elementary classrooms, the role that language plays in the process has been studied as a key aspect of classroom practice. A convergent parallel mixed-method approach was used to examine fourteen second-grade Latinx Emergent Bilingual students’ understanding of the concept of place value and whether this process was related to the language of instruction chosen in each of the two Spanish-English transitional bilingual classrooms. Findings from …

Understanding The Barriers, Bridges And Bases To Inclusion Instruction For Secondary Students With Mild To Moderate Disabilities, Angela Renee Lyte Crowther

Dissertations

Inclusion is the practice of educating students with disabilities and students without disabilities in the same learning environment. For secondary students with mild/moderate disabilities, inclusion is rooted in the philosophical mindset of social justice, equity, and legislation. Inclusion is a complex and sometimes controversial topic few educational systems want to tackle. The purpose of this multi-method research was to gather and analyze secondary site administrators' and teachers’ opinions on the barriers, bridges, and bases needed for the furtherance of inclusion practices and the elimination of the segregated classrooms for students with mild-moderate disabilities. A plethora of research on this topic …

Expanding And Improving High-Quality Early Care And Education In California: Is There Alignment Between Policymakers And The Public?, Heidi Schmidt Emberling

Dissertations

Although there is widespread agreement about the life-long benefits of high-quality childcare and preschool, access for all children in California is limited. The negative effects of this inadequate landscape are borne predominantly by children living in poverty, and middle-income families who do not qualify for subsidies and cannot afford full-fee care. This mixed-methods study examines specific factors that impede expansion and improvement of childcare/preschool in California, from the perspective of five diverse policymakers. Findings reveal a variety of policy solutions in the areas of funding, teacher workforce, quality of care, policy development, and public perception of the importance of high-quality …

A Mixed Methods Study Identifying And Describing Factors To Promote Psychological Safety In Middle School Professional Learning Communities: Making The Bread Rise, William Cloo

Dissertations

Purpose: The purpose of this mixed methods explanatory study was to identify and describe factors of risk-taking behavior among Riverside County Professional Learning Community (PLC) middle school teachers. It elicited teacher perspectives of a psychologically safe PLC that promotes risk-taking. Additionally, it sought to identify factors that increase psychological safety in a PLC.

Methodology: This mixed methods study uses a sequential explanatory 2-step process to produce results. The quantitative-qualitative study started with a quantitative survey that collected and analyzed numerical data on levels of risk among the population. Qualitative interviews provided context and further explanation on the methods to foster …

Engagement Of Primary Stakeholders To Tailor A Comprehensive Transitional Care Model For Persons Who Have Experienced A Stroke And Their Caregivers, Lorre Laws

Dissertations

Stroke is the leading cause of disability in the US, affecting approximately 795,000 persons annually. Stroke care is delivered across multiple settings from hyperacute care in a hospital through chronic stroke management in the community. Considerable advancements have been made in the delivery of hyperacute and acute stroke care. Science and practice gaps exist in providing stroke transitional care across multiple providers and settings once an individual is discharged from an in-patient care facility to home.

Using a qualitative descriptive design, this study engaged and elicited descriptions from stroke survivors and caregivers affected by stroke to inform the refinement and …

Dimensions Of Racial Identity As Predictors Of Physical Activity In Midlife African American Women, Elaine Clarista Hardy

Dissertations

Physical inactivity leads to serious health consequences, particularly for midlife African American (AA) women. Midlife African American (AA) women are less physically active and have higher obesity-related morbidity and mortality than midlife White women. Studies to examine these disparities typically view AAs as a homogeneous group, despite evidence of important within-group variance. Using a culturally-adapted identity-based motivational model, the purpose of this study was to determine whether dimensions of racial identity have differential influence on physical activity in midlife AA women.

The Relationship Between New Nurses Who Volunteer And The Caring Behavior New Nurses Exhibit In The Practice Setting, One Year Post Graduation, Nicolette Fiore-Lopez

Dissertations

Volunteering is engaged in by millions world-wide and nurses comprise a significant portion of those who provide their professional talents, unpaid, to the underserved in local, national and international efforts. Nurses who have engaged in volunteer activities anecdotally describe personally transforming experiences gained through their efforts and for many nurses volunteering becomes part of their professional mandate. Although many social disciplines have studied volunteering, to date there has been a paucity of research on nurses who volunteer. The purpose of this study was to describe the characteristics of novice nurses who volunteer and determine the influence of volunteering and associated …

Distress After Preterm Birth: A Discourse Analysis Of Parents' Accounts And Photographs, Ira Kantrowitz-Gordon

Dissertations

Preterm birth is a distressing experience for parents. This distress may continue into early childhood, with negative consequences for parents' mental health and child development. The purpose of this study was to take an in-depth look at how parents formed their accounts of premature birth, postpartum distress, and lives as parents and partners. Discourse analysis of semi-structured interviews and photo-elicitation assignments were used to analyze the parents' experiences in the context of the couple relationship.

Implementing An Early Mobility Protocol For Patients In Intensive Care Unit, Allison Nicole Crane

Dissertations

Limited mobility and prolonged bedrest were thought of as necessary to promote safety and hemodynamic stability in critically ill intensive care patients historically, but recent research does not support this idea. Newer research is suggesting that mobilizing critical ill patients in the intensive care unit can limit the negative effects of immobility and improve patient outcomes (Adler & Malone, 2012; Morris, et al., 2008; Perme & Chandrashekar, 2009; Perme, Lettvin, Throckmorton, Mitchell, Masud, 2011).

The objective of this clinical scholarly project is to educate the healthcare team about the importance of early mobility in the intensive care unit (ICU) patient …

Exploring Intergenerational Value Changes Across Three Generations Of Emirati Women Using Focused Ethnography, Ebtesam Ali Alteneiji

Dissertations

Intergenerational value change, influenced by technological advancements, economic development, formal education, and urbanization, becomes especially complex when it occurs in times of rapid changes, as in the case of the United Arab Emirates (UAE). Through the lens of social change and human development theory, heavily constructed in the Gemeinschaft/Gesellschaft paradigm, this focused ethnography explored the push and pull of traditional boundaries within a collectivist society and the necessary navigation of infused Westernized philosophies promoting individualism and autonomy. Participants in this study (N = 24) were members of 8 family triads of grandmothers, mothers, and daughters who represented 8 different …

An Examination Of Gaming Environments In Dungeons And Dragons Groups, Joe Lasley

Dissertations

Tabletop Role-Playing Games (TRPG) like Dungeons & Dragons are unique phenomena within the topics of game-based learning and gamification of leadership development. Games in general are used for both game-based learning (learning from playing games) and as sources of inspiration for gamification: the application of game design elements in non-game contexts like business or education. Many potential benefits of playing TRPGs have been observed including transformative experiences linked to collective creativity. Knowing more about the transformative potential of TRPGs can inform facilitation of creative learning environments and guide the use of TRPGs for leadership development.

The concept of a holding …

La Maestra’S Circle Of Care: Studying The Impact Of An Integrated Service Model On The Health And Well-Being Of Vulnerable Populations, Zara Marselian

Dissertations

ABSTRACT

There is an urgent need to reform the health care delivery system in the United States, as recognized through current bipartisan efforts. Society’s vulnerable populations especially need health care reform as health care outcomes are the poorest among disadvantaged populations. Moreover, vulnerable populations are twice as likely to develop chronic diseases than the general population and they remain ill due to other contextual, societal factors affecting their ability to achieve health and well-being. This population is subjected to adverse life events that suggest a more comprehensive approach to health and well-being is called for.

The Circle of Care is …

The Relationship Between Race And Ethnicity And Serious Safety Events In Hospitalized Patients, Samantha Crandall

Dissertations

Purpose. This study explored the association between patient sociodemographic characteristics and the occurrence of serious safety events (SSE) in hospitalized patients. Specific aims were to describe among patients who have experienced an SSE: 1) patient sociodemographic variables (age, gender, race, ethnicity and language spoken), health insurance coverage, patient zip code, payer mix, site of care location, and severity of event; 2) the relationships between the select patient sociodemographic variables, health insurance coverage, patient zip code, payer mix, site of care location and SSE level of harm; and 3) what factors increase or decrease the odds of experiencing higher levels of …

A Phenomenological Qualitative Study To Discover The Attitudes And Perceptions Of Police Officers On The Legalization Of Recreational Cannabis And Crime, Izedomi Ayeni

Dissertations

Purpose: The purpose of this phenomenological qualitative study was to discover the attitudes and perceptions of police officers on the legalization of recreational cannabis and crime.

Methodology: This qualitative, phenomenological methodology employed the use of semi-structured interview questions consisting of open-ended questions to understand the lived experiences of Colorado Police and Sheriff Officers and their perspectives on the experiences with the legalization of cannabis and crime. The sample size of 16 officers was selected from the sampling frame, which included Denver Police officers and Larimer County Sheriff officers.

Findings: Analysis of the data from interviews resulted in the identification of …

The Effect Of Using Virtual Manipulatives On Students’ Ability To Mentally Compare Proper Fractions, William Wilson Mcneary Iii

Dissertations

This study proposes a method to analyze the effects of the use of virtual fraction models (circle/bar/number line) on students’ ability to mentally compare proper fractions. Since developing a sense of magnitude with both whole numbers and rational numbers is highly correlated with improved performance on standardized assessments and improved performance in later algebra classes, special attention is directed to the bar and number line as they are linear representations.

The study used an experimental pretest/posttest group design by randomly assigning subjects within class sections to a control group (physical fraction circles) and treatment groups with seven different methods of …

Women’S Sexual Satisfaction In The Context Of Midlife Relationships: Examining An Ecological Model And Intergenerational Caregiving, Katherine M. Arenella

Dissertations

This study examined an ecological model of sexual satisfaction in midlife women in relationships, and paid particular attention to the role of intergenerational caregiving in predicting satisfaction. Participants were 1,411 midlife women in relationships who participated in the Midlife in the United States (MIDUS) national study. Using split samples for replication purposes, data from this survey were examined to test the hypothesis that an ecological model - including the macrosystem level variable of religiosity, the exosystem level variables of SES, social support, and parenthood, the mesosystem level variables of relationship satisfaction, affectual solidarity, relationship length, and sexual functioning, and the …