Digital Commons Network^™

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, …

Humanizing History: Empowering Educators To Navigate Difficult History Through Museum-Led Professional Development, Andrea Miskewicz

Dissertations

As museums increasingly serve as educational hubs, this research examines how teachers' participation in such programs contributes to their perceived efficacy for teaching topics of difficult history. Employing a mixed-methods approach, the study utilizes a survey with quantitative and qualitative measures to evaluate changes in teacher self-efficacy before and after a museum-led intervention. With a pre and posttest design, this study provides deeper insights into participants' experiences and challenges. Preliminary findings suggest museum-led professional development has a significant positive impact on teachers’ perceived self-efficacy, highlighting the resources and opportunities museums have available and the importance of humanizing history in social …

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.

Neonatal Intensive Care Nurses' Perceptions Of Nurse Leader Behaviors And Their Impact On The Workplace Environment, Meggan R. Mcculley

Dissertations

Nursing leadership is a crucial component in today's healthcare organizations as nurses make up the largest profession in healthcare overall. Nurse leaders have the ability to affect the environment of the nurses' workplace in both positive and negative ways, thus impacting their Quality of Nurse Work Life (QNWL). QNWL is an indicator of nurse satisfaction within their workplace, and the ability of the nurse to make meaningful contributions to their home units and the organization. The purpose of this qualitative, interpretative phenomenological analysis (IPA) study was to describe what it meant to experience nursing leadership from the perspective of Level …

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 …

The Cultivation And Integration Of Cultural Humility And Cultural Competence In Lgbtiq+ Client Work: A Constructivist Grounded Theory Approach, Gon Ratanashevorn

Dissertations

Previous researchers have highlighted the lack of consistency and standards in LGBTIQ+ cultural competence trainings which may cause negative therapy experiences for LGBTIQ+ clients. This research empirically explored counselors’ (n = 12) process of the cultivation and integration of LGBTIQ+ cultural competence and cultural humility to inform training which leads to better services for LGBTIQ+ clients through constructivist grounded theory method. The theory of the life-long cultivation and integration of LGBTIQ+CC and cultural humility emerged with five categories: (1) motivation to do right by queer clients, (2) cultivating the right soil for queer folks, (3) walking the walk to …

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.

Instructor Characteristics That Increase Self-Efficacy In Nursing Students, Kaycee J. Jacobson

Dissertations

With the current nursing shortage, finding ways to increase nursing retention in graduate nurses can help ease the shortage. Self-efficacy is a factor that contributes to an individual's well-being and can affect their professional accomplishments. The purpose of this study, guided by Bandura's theory of self-efficacy, was to identify instructor characteristics that may impact student perceived self-efficacy in the clinical setting. Bandura identified self-efficacy as a factor that contributes to an individual's well-being as a whole and can affect their professional accomplishments. A sample of 19 nursing students who were enrolled in a clinical course were recruited and completed the …

3d Automated Surgeon’S Hand Motion Assessment Using A Cascade Fuzzy Supervisor During Intelligent Box-Trainer System Skills Training In A Multi-Thread Video Processing, Fatemeh Rashidi Fathabadi

Dissertations

For certain surgical procedures, Minimally Invasive Surgery (MIS) has become more advantageous than traditional open surgery. Therefore, mastery of laparoscopic skills is an essential component of surgical training and requires considerable time and effort. The Fundamentals of Laparoscopic Surgery (FLS) program has been developed as a tool to improve and assess fundamental surgical skills. In fact, using a low-cost Box-Trainer or a simulator, laparoscopic surgeons are required to train using a set of structured tasks that can be objectively used to assess their laparoscopic skills, which must be mastered before carrying out real-life laparoscopic procedures. These tasks include peg transfer, …

Long Covid Patients: A Phenomenology Study Exploring Mental Health And Psychosocial Adaptation To Disability, Tonia Joy Lans

Dissertations

In the United States, approximately 1 in 13 long COVID patients experience adverse complications two to three years post-recovery (Centers for Disease Control and Prevention, 2022), including physical, psychological, and cognitive impairment, issues with daily functioning, and difficulties returning to work (del Rio et al., 2020; Greenhalgh et al., 2020; Ladds et al., 2020; Logue et al., 2021). Moreover, collective research has indicated the debilitating complications of long COVID often result in impaired mental health, chronic illness, and disability. While significant research efforts have started to accumulate data to understand and treat the physical and neuro-logical manifestations of this chronic …

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 …

Macroevolution Meets Community Ecology: Does Species Interaction Influence Tempo And Mode Of Diversification In Fishes That Cross The Marine/Freshwater Boundary?, Victor De Brito

Dissertations

Evolutionary transitions between marine and freshwater ecosystems are an extreme ecological shift and expose fish lineages to novel abiotic and biotic settings. Yet, it remains unclear how those habitat transitions and the interaction with the newly invaded communities have altered the macroevolutionary dynamics of fish clades. The theory of ecological opportunity predicts that lineages that colonize species-poor regions will have greater potential for phenotypic diversification and speciation than lineages invading species-rich regions. Thus, transitions between marine and freshwaters in depauperate regions may promote adaptive radiation. While most major fish clades are restricted to either marine or freshwaters, so called transmarine/ …

The Role Of Evaluation Terms In The Quality Of Final Evaluation Reports In International Development Cooperation: A Multi-Phase Mixed Methods Study, Fanny J. Hernandez De Alvarez

Dissertations

In international development cooperation there is constant discussion about how to improve evaluation practices. Too little is known about where and which factors influence the quality of evaluation reports. Arguably, one influential factor is the quality of the terms of reference (TORs), which, in many sectors, are referred to as Requests for Proposals (RFPs). This study examines the role of the quality of TORs in positively affecting the design and conduct of evaluations, as well as the overall quality of final evaluation reports. This study also examines other factors that may contribute to the quality of final evaluation reports.

The …

The Synthesis, Characterization, And Application Of Polysaccharide-Based Additive To Improve Wet And Dry Strength And High-Barrier Properties Of Paper Products, Cornellius Marcello

Dissertations

Paper products play an essential role in our daily lives owing to their low cost, environment-friendly character, renewability, and recyclability. Paper manufacturers have been using petroleum-based strength additives (cPAM, GPAM, PAE) to meet the perceived needs of customers. On the other hand, paper produced from cellulose is hydrophilic and porous, leading to shallow water and grease resistance, causing paper manufacturers to use many kinds of coating materials such as poly-fluoroalkyl substances (PFAS) and synthetic plastic to improve water resistance, especially for food packaging paper products like cups, plates, food boxes, and packaging. However, PFAS are identified as likely carcinogenic to …

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 …

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 …

Alternative Adjacency Matrices And Spatial Analysis, Jaeseong Hwang

Dissertations

Spatial analysis is essential for comprehending the spatial distribution of diseases and various phenomena across geographic regions. This study investigates the utilization of alternative adjacency matrices in spatial analysis, with a specific focus on implementing Poisson regression models. This study intricately explores the methodology behind constructing alternative weight matrices, specifying weight matrices, and comparing the performance of Poisson models using five different weight matrices.

The popular Poisson model model is described, and five different definitions of weight matrices are defined, which are the following: binary weight matrix, inverse distance weight matrix using Euclidean distance, Graph distance matrix, Path matrix, and …

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 …

Addressing The Importance Of Recruitment And Retention Of Black And Latinx Teachers: Strategies Designed To Diversify The Teacher Pipeline, Shavon Pittman

Dissertations

The United States student demographic has shifted significantly, with minorities, particularly Black and Latinx students, now constituting almost half. However, the diversity of the teaching profession, historically led by White females, lags behind, with Black and Latinx teachers comprising less than 30%. This lack of representation poses challenges for students without culturally similar educators. My research explores the impact of teacher diversity on Black and Latinx students' success, revealing positive outcomes. Yet, attracting and retaining minority teachers faces obstacles, including feelings of isolation and financial concerns. Recommendations include educational pathways, scholarships, mentoring programs, salary incentives, and professional learning communities to …

The Impact Of Grade-Level Switching In The Elementary School Setting, Christine Priester

Dissertations

Teaching a new grade level in elementary school requires developing extensive grade- level-specific knowledge. In many school districts, the support for teachers who move grade levels within a district is glaringly absent. In this study, the frequency and impact of teacher grade switching in a school district were examined through a mixed-methods study that included surveys with teachers, interviews with teachers, and student data. The research question was: What is the impact of grade-level teacher movement on instruction? The findings of this study show how students are affected by teachers switching grade levels in elementary school. Results shed light on …

Exploring Secondary Teachers' Digital Curricular Autobiographies As A Path Towards Digital Equity: A Currere Journey, Douglas S. Vandyke

Dissertations

Combining a narrative approach with portraiture and theoretically framed by reconceptualism and critical digital pedagogy, this study explores participants’ beliefs about and experiences using information and communication technologies (ICT) for learning. It also explores participants’ understanding of digital learning as essential to educational equity in a postdigital society. Participants were secondary teachers serving socio-economically marginalized Black and Latinx students across four public high schools in Chicago. Through a series of semi-structured interviews each constructed a version of their digital curricular autobiography (currere). Through this reflection, participants recalled their own experiences being excluded from learning which contributed to their …

Encendiendo La Intuición/Igniting Intuition: A Bilingual Reading Specialist's Lived Experiences And Reclaiming Of Literacies, Dora M. Guzmån

Dissertations

This autoethnography explores the researcher’s lived experiences as a first-generation Latina, bilingual reading specialist who developed biliteracy in English/Spanish from childhood through adulthood and how this ignited her cultural intuition. Framed by a critical, Chicana feminist lens, she analyzed her personal and professional biliteracy practices and cultural intuition to understand how she supported young bilingual readers. Qualitative data were collected retroactively and in-the-moment (e.g., voice/written reflective memos, journals). The study research focused on how her cultural intuition guided: a) her role and practice as a bilingual reading specialist; b) her role and practice as a bilingual literacy practitioner of bilingual …

A Convergent Parallel Mixed Methods Examination Of The Impact Of Graduate Student Loan Balances On Overall Quality Of Life Among Clinical Psychologists With Psyd Degrees, Lekai James

Dissertations

Graduate student loan debt in psychology, particularly for those with Doctorate in Psychology (PsyD) degrees in clinical psychology, is highly problematic. Previous research has shown that student loan debt negatively impacts quality of life (QOL) by affecting subjective well-being (SWB) and life satisfaction (LS). This study used a convergent parallel mixed method approach, guided by bottom-up spillover theory and Maslow’s hierarchy of needs, to explore the relationship between QOL and total graduate student loan balances, as well as the effects of income and monthly student loan payments on QOL among PsyD graduates. Participants (N = 16) completed a survey with …

الحماية القانونية للمساهم في شركة المساهمة العامة, سيف درويش المري

Dissertations

Legal Protections for A Shareholder in A Public Joint Stock Company

There is no doubt that legal protections for a shareholder in a public joint stock company have become one of the key pillars on which the UAE national economy rests as it examines shareholder protections by critically analyzing shareholders' voting and related rights, the right to information, expulsion right, dissolution of a company, derivative actions and direct actions.

This thesis critically assesses and attempts to provide a solution to the problem of minority shareholder protection, that is, the available methods by which minority shareholders can ensure their protection against …

A Quantitative Analysis Of University Counselors And Student Affairs Personnel's Knowledge And Confidence In Working With Students With Autism Spectrum, Sandra Araiza Salazar

Dissertations

University counselors and student affairs personnel often find themselves unprepared to address the needs of undergraduate students with autism spectrum disorder. Many of these professionals are not receiving the proper training or education to prepare for the unique social, emotional, and academic needs of these neurodiverse students. Due to this trend, many university counselors and student affairs personnel may lack the necessary knowledge and confidence in serving this neurodiverse population. In this first-of-its-kind study, university counselors and student affairs personnel’s knowledge and confidence in working with undergraduate students with autism spectrum was analyzed. A nonrandom sample of university counselors and …

Germination And Seedling Growth Of Native Uae Plant Species: The Combined Effects Of Elevated Co2 And Temperature, Nour Elhouda Debouza

Dissertations

Understanding how indigenous plant species respond to arid environmental stressors is critical for biodiversity preservation and the development of sustainable agricultural practices in the United Arab Emirates (UAE). This study investigated the morphological and physiological aspects of the germination and early growth stages, along with the adaptation strategies of three indigenous plant species—Senna italica, Prosopis cineraria, and Tephrosia nubica. The controlled chamber experiments aimed to subject the three selected indigenous species to elevated CO2 (400 ppm ambient to 800 ppm) and temperature (35°C ambient to 50°C) for simulating future atmospheric carbon dioxide (CO2) and temperature scenarios. …