Digital Commons Network^™

Testing And Refining An Integrated Ethically-Driven Environmental Model Of Clinical Decision-Making In Emergency Settings, Lisa Adams Wolf

Dissertations

The purpose of the study was to explore the relationship between multiple variables within a model of critical thinking and moral reasoning that support and refine the elements that significantly correlate with accuracy and clinical decision-making.

Increasing Testicular Self-Examination Practices In Male College Students, Christopher Mccoy

Dissertations

A significant number of males attending colleges and universities in the United States have limited or no current knowledge of testicular cancer and screening practices (Tosun, Gul, & Arikan, 2020).

Lack of knowledge of testicular cancer and practice of testicular self-examinations.

The evidence-based health promotion project aimed to increase testicular self-examination practices in male college students and increase their knowledge of testicular cancer.

Exploring The Influence Of County Government Collective Bargaining On High-Performance Work Practices, Jay Peno

Dissertations

Purpose: The purpose of this qualitative multicase study was to identify and describe the high-performance work practices (HPWP) of county government management lead negotiators who have negotiated in the collective bargaining agreement (CBA). In addition, it was the purpose of this study to describe the challenges and benefits of negotiating HPWP in the CBA as perceived by management lead negotiators. Lastly, it was the purpose of this study to identify and describe the strategies used by management lead negotiators to mitigate challenges when negotiating HPWP in the CBA.

Methodology: A qualitative multiple-case study methodology was used. I conducted semistructured, in-depth …

Moving Forward By Looking Back: How Family Firms Create Competitive Advantage By Embracing Their History, Adam Goldman

Dissertations

Family businesses are the engine that drives the United States economy. While extensive implications have been made in the literature about the advantages or disadvantages of family-owned businesses compared to non-family-owned businesses, the focus of this study was to show how small to medium-sized family-owned firms (FF SMEs) based in the United States can use their unique history to create a competitive advantage. Drawing on imprint theory and the resource-based view (RBV), this history-informed study helped identify the impact that founder imprints, business traditions, and storytelling have on the business performance of FF SMEs. Using quantitative methods, the findings of …

Perceptions Of And Approaches To Social Support Exchange While On Probation And Parole, Andrea Giuffre

Dissertations

The vast number of individuals on community supervision (i.e., probation and parole) remains at around 4.5 million Americans and suggests a need for research that delves deep into the nature of challenges faced by this population. Research demonstrates individuals on community supervision tend to rely on others for and provide social support to manage the challenges and conditions of community supervision. Simultaneously, many criminological theories incorporate elements of social support and speak to the importance of social relationships as predictors of criminal behavior, but less is known about the mechanisms underpinning social support exchange. Examination of the delivery and perceptions …

Activities Of The Mind And Soul: Eudaimonia, Identity, And Implicit Theories Of Giftedness In Secondary Gifted Students, Megan Roegner

Dissertations

The purpose of this qualitative study was to explore the experience of secondary gifted students, more specifically their implicit theories of giftedness, how they incorporate giftedness into their sense of identity, and their eudaimonic development. The following four research questions guided the study: (a) What do the narratives of secondary gifted students reveal about their eudaimonic well-being? (b) What do the narratives of secondary gifted students reveal about their implicit theories of giftedness? (c) What do the narratives of secondary gifted students reveal about the extent to which giftedness is a part of their identities? (d) What are the relationships …

Implementation Of A Validated Health Literacy Tool With Teach-Back Education In A Super Utilizer Patient Population, Maribeth Lebreton

Dissertations

As health care costs continue to rise in the United States, there are associated concerns over use of services and where the utilization is occurring. Consumption of large amounts of health care resources has been attributed to a specific patient population, called the Super Utilizer patient population. An evidenced-based practice improvement project was developed and implemented in Lancaster County, called Care Connections. The purpose of the practice improvement project was to design, implement and evaluate health literacy and teach-back education in a Super Utilizer patient population.

The Impact Of Firm Size, Job Embeddedness, And Job Engagement On Turnover In Public Accounting Firms, Amy Cooper

Dissertations

Retention in public accounting firms has been and continues to be a top concern in the accounting profession. The direct and indirect cost of turnover; the decrease in accounting enrollment and graduation; the Great Resignation; and changes to work environments due to the pandemic elevate what was already a serious problem into a critical problem for the accounting profession. The size of public accounting firms is a well-used descriptor when employees talk about where they work. The purpose of this study was to examine the role of the size of firm in predicting an employee’s level of job embeddedness and …

Topological Data Analysis Of Weight Spaces In Convolutional Neural Networks, Adam Wagenknecht

Dissertations

Convolutional Neural Networks (CNNs) have become one of the most commonly used tools for performing image classification. Unfortunately, as with most machine learning algorithms, CNNs suffer from a lack of interpretability. CNNs are trained by using a training data set and a loss function to tune a set of parameters known as the layer weights. This tuning process is based on the classical method of gradient descent, but it relies on a strong stochastic component, which makes the weight behavior during training difficult to understand. However, since CNNs are governed largely by the weights that make up each of the …

Effects Of The Imposter Phenomenon On First-Generation Students’ Academic And Co-Curricular Engagement, Ethan Sykes

Dissertations

First-generation college students experience many barriers transitioning to college, such as impostorism. Administrators must understand how the imposter phenomenon impacts student engagement, to increase retention. The researcher utilized a mixed-methods approach to explore the prevalence of the imposter phenomenon among community college and private university students. Furthermore, the study examined how impostorism manifested in academic and co-curricular settings. The survey sample consisted of 216 total participants, with 91 who identified as first-generation students. Eight students participated in the interviews. For the purpose of the study, first-generation students were those whose parents did not complete a bachelor’s degree. The researcher utilized …

Improving Screening And Referral For Hereditary Cancers In New Breast Cancer Patients, Lisa J. Henczel

Dissertations

Breast cancer is a commonly diagnosed cancer in women. Early recognition and identification of those at risk for germline mutations have been difficult at the project site due to patients' lack of knowledge of their family cancer history, which is critical to improving access to the hereditary cancer program. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if the implementation of Kiran et al.'s family cancer history nursing telephone prompt impacted screening and referral rates to the provincial hereditary cancer program among adult patients recently diagnosed with breast cancer at an urban outpatient cancer clinic located …

A Phenomenological Study Of The Shared Governance Experience For Nurses Working In The Pharmaceutical Industry, Adele Mueller

Dissertations

Healthcare has evolved over the past 30 years in response to exciting and tumultuous changes. Challenges encompassed innovative strategies to improve patient safety outcomes while facilitating a shared governance platform that resulted in best practice, enhanced job satisfaction, and improved patient outcomes. Nurses comprise the largest and fastest growing segment of healthcare occupations. A significant number of nurses have successfully transitioned into roles within the pharmaceutical industry to protect vulnerable patients. As a core value of nursing practice, the existence of shared governance or the change in the experience for nurses who had made this transition affects the nursing profession …

The Lived Experience Of Hmong Women In Leadership Roles, Nou Vang

Dissertations

Purpose: The purpose of this qualitative phenomenological study was to explore and understand the lived experiences of Hmong women who have achieved leadership positions.

Methodology: This qualitative phenomenological study explored the lived experience of 12 Hmong women who have ascent to leadership roles through personal, face-to-face, in- depth, open-ended questions. Interviews were recorded, transcribed, and analyzed for emergent themes. Related artifacts from the participants, along with the participant interviews, were collected to triangulate data. Research findings were a result of the correlating themes based on the qualitative data analysis and research question.

Findings: The findings of the study indicated that …

K-12 Teachers’ Retention Of Arts Integrated Professional Development, Roxane Mcwilliams

Dissertations

Arts integration is an interdisciplinary teaching model in which the arts become a conduit for the contextualization and understanding of non-arts content. Research has shown this approach increases academic engagement and content retention (Rinne et al., 2011). The use of arts integration also provides gains for teachers. Teachers perceive their practice more innovative and better able to reach the needs of diverse learners (Bellisario & Donovan, 2012). For the benefits of arts integrated learning to be achieved, teachers must acquire the knowledge and techniques of this teaching model. This requires knowledge in both arts content as well as the pedagogical …

Factors Influencing The Development Of Advanced Practice Nursing In Singapore, Madrean M. Schober

Dissertations

The development of advanced practice nursing (APN) roles has become a worldwide trend as healthcare planners explore innovative options for the provision of healthcare services. The integration of these new nursing roles presents a dynamic change for healthcare professionals and the systems in which they practice. Suitable policies should ideally support the inclusion of APN roles and their practice potential, however, a review of the literature found no evidence that demonstrated relevant policymaking, these policy processes and subsequent implementation of the intent of policy. The aim of the research was to investigate APN policy development from the beginning periods of …

Factors Associated With Newly Graduated Nurses' Intent To Leave Current Position In U.S. Acute Care Hospitals: A Descriptive Research Study Using Secondary Data Analysis, Mary N. Meyer

Dissertations

This study aimed to identify the individual, unit-based, and hospital-based characteristics correlated with new nurse intent to leave their current positions (ITLcp) in U.S. acute care hospitals.

A Delphi Study Of Possible, Probable, And Desirable Futures At 4-Year U.S. Higher Education Institutions By 2035, Mary Cutia-Pluff

Dissertations

Purpose: The purpose of this study was to identify and describe educational changes at 4-year higher education institutions that are possible and probable by 2035 as perceived by a panel of experts. Additionally, the purpose was to determine the level of desirability of educational changes identified as probable by a panel of experts. Finally, the purpose was to describe actions necessary to promote the desirable educational changes by 2035 as perceived by the panel of experts.

Methodology: The Delphi method was used to survey 17 higher education experts from diverse disciplines. Four survey rounds gathered qualitative and quantitative data regarding …

Parents’ Expectations Of Developmentally Delayed Children With Special Education Needs (Sen) When Transitioning Out Of Non-Classroom Based Independent Studies Charter High Schools, Yolanda Vazquez

Dissertations

Purpose: The purpose of this phenomenological study was to identify and describe the expectations of parents of developmentally delayed special education needs (SEN) high school children regarding their children’s transition out of independent studies charter high schools. In addition, it was the purpose of this study to identify how parents perceived independent studies charter high school schools addressed the needs of their SEN children during the transition process.

Methodology: This study used qualitative methodology to gain insight into the lived experiences and perceptions of parents with SEN high school students in a NCB ISP high school transition program. Data was …

A Delphi Study Of Possibilities Of Learning By 2035: Identify And Describe The Educational Changes For High Schools In California That Are Possible And Probable By 2035 As Perceived By A Panel Of Experts, Guillermo Lopez

Dissertations

Purpose: The purpose of this Delphi study was to identify and describe the educational changes for high schools in California that are possible and probable by 2035 as perceived by a panel of experts. In addition, the purpose was to determine the level of desirability of educational changes identified as probable by a panel of experts. Finally, the purpose was to describe the actions necessary to promote the desirable educational changes by 2035 as perceived by the expert panel.

Methodology: The Delphi method was used as a mixed methods approach to build consensus among experts. Fifteen experts from diverse secondary …

Effects Of Adaptive Expertise On Counseling Self-Efficacy: The Mediating Role Of Adaptive Performance, Jiaying Meyer

Dissertations

Counseling and psychotherapy expertise research have been focused on three major areas, namely, characterization of Master Therapists, performance of Healing Involvement, and application of Deliberate Practice. The constructs of adaptive expertise and adaptive performance have never been investigated in the context of counseling or psychotherapy. Therefore, the purpose of this study is to examine the relevance of adaptive expertise in psychotherapy by studying the relationships between adaptive expertise, adaptive performance, and counseling self-efficacy. A total of 460 psychotherapy practitioners from a variety of disciplines and experiences participated in the study, and they included counseling, psychology, social work, and others with …

Phenomenological Study: The Perceived Impact Of The Intersectional Barriers Created By Gender And Race On African American Females’ Advancement To A Senior Executive Service Within The Federal Government, Nicole Oliver

Dissertations

Purpose. This phenomenological study aimed to investigate the perceived impact of intersectional barriers created by gender and ethnicity on the advancement of African American females to the Senior Executive Service (SES) corps of the United States federal civil service. Additionally, the study sought to identify strategies used by African American females to overcome these barriers because of intersectionality and advance to the SES corps of the United States federal civil service.

Methodology. This qualitative phenomenological study used a convenience sampling method to select eight African American females who have advanced to an SES position in the Washington, DC metropolitan area. …

Leading With Cultura Y Corazón: Culturally Responsive Leadership And Latina Mid-Level Leaders In The California Community Colleges, Gabriela Lopez

Dissertations

Purpose: The purpose of this ethnographic study was to identify and describe how California community college Latina mid-level leaders are culturally responsive in their leadership strategies, based on Horsford, Grosland, and Gunn’s (2011) culturally relevant leadership framework.

Methodology: This ethnographic study identified and described how Latina mid-level leaders within the California community colleges utilize culturally responsive leadership strategies using Horsford et al.’s (2011) culturally relevant leadership framework. The researcher was part of a thematic team of 6 researchers who developed and vetted a semi-structured interview protocol aligned with the theoretical framework. Sixteen participants were identified and selected using purposeful criterion …

Transition To The New Revenue Standard: A Study Of Firms’ Decisions To Adopt Asc 606 Early, Irene Y. Zhang

Dissertations

The Financial Accounting Standards Board has issued a new revenue standard through a series of updates since May 2014 (collectively, ASC 606). The standard allowed firms to adopt it a year early before the required effective date. This study provides evidence of the adoption effects of ASC 606 on firms’ financials and examines the relationship between the likelihood of early adopting ASC 606 and firm-specific characteristics. The results show that early adopters are distributed across 12 industries and 40% of them are concentrated in the computer programming and software industry. Early adopters in the software industry reported the largest cumulative …

The Efficacy Of An Antenatal Probiotic Intervention To Reduce Residual Group B Streptococcus, Emily M. Malloy

Dissertations

Group B Streptococcus (GBS) is a leading cause of neonatal morbidity and mortality. The current prevention strategy involves universal antenatal screening for GBS and IV intrapartum antibiotic prophylaxis (IAP) for those who test positive. Despite this approach, up to 80% of cases of early onset GBS neonatal disease are in infants born to birth givers who screened negative for GBS, which can be described as residual GBS.

Probiotics are a primary prevention strategy for antenatal GBS. This was a substudy of a randomized, double-blind, placebo-controlled trial. Participants in the parent study were randomized to probiotics verses placebo and the major …

Older African Americans Perceptions Of Living With Asthma And Satisfaction With Care, Judith L. Martin-Holland

Dissertations

African Americans are disproportionately affected by asthma in the U.S. with a mortality rate that is three to five times that of Caucasians. Asthma-related mortality rates have soared in the older adult and elderly African Americans. In the elderly, asthma-related death is associated with under-treatment by healthcare providers, and a poor appreciation for the disease severity, and non-adherence to recommended treatment regimens by patients. Patient satisfaction with asthma care may be an important determinant of successful management, use of provider-recommended self-management strategies, and improved asthma outcomes. The purpose of this research was to examine the relationships among perceived asthma severity, …

The Influence Of Contextual Characteristics, Individual Characteristics, And Health Behaviors On Patient Satisfaction For African American Men Treated For Prostate Cancer In North Carolina, Angelo D. Moore

Dissertations

Patient satisfaction is an outcome of health services utilization; however, health services utilization can be predicated by contextual characteristics, individual characteristics, and health behaviors (Andersen, 2008). Since prostate cancer is one of the medical conditions that disproportionately affects the mortality of African American men (AAM) in North Carolina, it is imperative to evaluate the factors or combination of factors that influence patient satisfaction for AAM diagnosed and treated for prostate cancer.

A modified version of Andersen's Behavioral Model for Health Services Use was used to guide this study (Andersen, 2008). The model has four broad domains: contextual characteristics, individual characteristics, …

Synthesis And Evaluation Of Biologically Active Phosphorous Heterocycles And Lipid A Antagonist Compounds, Saroj Kafle

Dissertations

Cyclophostin and cyclipostins are naturally occurring organophosphates with common structural core units and different phosphate ester substituents. Cyclophostin is a cyclic phosphate triester with a chiral center at phosphorous and C-3a carbon atom while the cyclipostins have characteristic alkyl substituents with varying chain lengths at the phosphate center. Long-chain substituted monocyclic phosphate (2b) and phosphonate (2a) analogs of cyclophostin and cyclipostin are promising inhibitors against serine hydrolases acetylcholinesterase with an IC₅₀ in the nanomolar range.

Biologically active β-lactones and lactams owe their activity, in part, to ring strain. The ring opening of β-lactones and lactams …

Facilitators And Barriers To Evidence-Based Cancer Pain Management, Linda H. Eaton

Dissertations

Evidence-based pain management (EBPM) is essential in relieving cancer pain. This dissertation explores nurse-level and organization-level factors for adopting, implementing, and sustaining EBPM practices. A descriptive cross-sectional mixed methods design involving two inpatient oncology units was used for this study.

Implementation Of Established Guidelines To Determine The Correlation Of Antipsychotic Use And Fall Rate Occurrence Amongst Inpatient Long-Term Care Residents, Cynthia L. Hardy

Dissertations

The use of psychotropic medications may impact fall rates among senior adults. Despite evidence-based approaches to minimize psychotropic medications use, the project site had a gap in implementing one leading to high fall rates. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of the Center for Assisted Living Guidelines for Reducing the Use of Antipsychotic Medications in Nursing Homes would impact fall rates when compared to current practice among geriatric patients in a long-term care facility in rural New Mexico over four weeks. Neuman's Systems Model provided the theoretical underpinnings for this project.

Community College Executive Leaders And Emotional Intelligence: A Phenomenological Study Exploring How Community College Executive Leaders Utilize Emotional Intelligence (Ei) To Lead Their Organizations, Seblewongel Ayalew

Dissertations

Purpose: This phenomenological research aimed to identify and describe the lived practices of California community college executive leaders who lead their institutions using Emotional Intelligence (EI) through the lens of Goleman’s four EI domains.

Methodology: This study used phenomenological research that identified and explained California community college executive leaders’ lived practices associated with the leaders using EI in the workplace to determine their EI skills and emotional awareness. The community college executive leaders participated in interviews in formal and informal settings to identify and describe their lived experiences.

Findings: Examination of the qualitative data from 15 community college executive leaders …