Digital Commons Network^™

Exploring How Tourism Majors’ Perceived Professional Competence Influences Their Choice Of Tourism Careers In China, Zhixin Sun, Lihong Wang, Miao Zhao

Dissertations

With the rapid development of tourism in China, various economic sectors such as agriculture, sports, food and beverages, cultural heritage, and outdoor adventure have become integrated into the tourism industry. China's tourism industry has changed and these changes now require tourism practitioners to adapt. Chinese universities must also adapt their tourism curriculum and educational practices to reflect changes in the tourism sector. Research suggests that university training programs should increase their emphasis on developing students’ professional competency and expand the range of competencies they address in their curriculum. At the same time, tourism enterprises in China are unable to recruit …

Bringing Hospital And Community Together: Interventions To Bridge The Transitional Care Gap, Jeremy Yates

Dissertations

Abstract

Problem

As healthcare spending continues to increase and overall quality lags in comparison to other developed countries, hospital readmission has been targeted to increase quality while decreasing cost. Components of the Affordable Care Act (ACA) have placed an emphasis on preventative and transitional care which has created programs aimed at reducing readmission, including the Community Health Access Programs (CHAP). One program in St. Louis, Missouri consisted of advanced practice paramedics and an occupational therapy assistant that performed discharge follow-up through in-home, in-office, and telephone visits. An in-depth program evaluation can create a foundation to build other programs in communities …

The Role Of Counseling Trainee Adversity, Attachment Style, And Trauma-Informed Principles In Clinical Supervision, Nicole Hurless

Dissertations

Current supervision literature suggests that supervisees with insecure attachment styles may perceive a poorer relationship with their supervisor and feel less satisfied with supervision. Studies across disciplines indicate a relationship between traumatic and/or adverse experiences and insecure attachment; however, this association has not been studied within the context of supervision. This dissertation explores a structural equation model assessing the associations between student’s adverse experiences, insecure attachment, and quality of the supervision relationship. It was hypothesized that greater prevalence of adverse experiences would negatively relate to supervision relationship quality, and this relationship would be mediated by insecure attachment. The results of …

Complexation Of Glycoalkaloid Α- Tomatine With Sterols And Its Potential Application As An Anti-Cancer Drug, Bishal Nepal

Dissertations

Glycoalkaloids (GAs) are secondary metabolites found mostly in higher plant species and some marine invertebrates. They are known to form complexes with 3β-hydroxy sterols such as cholesterol causing membrane disruption. So far the visual evidence showcasing the complexes formed between glycoalkaloids and sterols has been mainly restricted to some earlier studies using Brewster angle microscopy. This study aimed to develop a method for topographic and morphological analysis of sterol-glycoalkaloid complexes. Langmuir-Blodgett (LB) transfer of monolayers comprising of glycoalkaloid tomatine, sterols, and lipids in varying molar ratios onto mica followed by AFM examination was performed. The AFM method used required minimal …

Discovering Hidden Signs And Symptoms Of Heart Failure In The Electronic Health Record Using The Omaha System, Anita Reger

Dissertations

Purpose/Background/Significance: For the past 30 years, heart failure has been in the top 3 readmission diagnoses with patients discharged to community care. This is costly to the healthcare system and negatively impacts the patient’s quality of life. The purpose of this study is to evaluate a community care database to determine if previously under-considered latent variables exist that could provide early detection of heart failure signs and symptoms. Theoretical/Conceptual Framework: The theoretical and conceptual frameworks surrounding this work are the Omaha System and Donabedian’s structure, process, and outcomes theory for healthcare quality improvement supported by Neuman’s Systems Model. The Omaha …

Gender And The Authoritarian Dynamic: An Analysis Of Social Identity In The Partisanship Of White Americans, Bradley Dimariano

Dissertations

This dissertation examines the influence of authoritarianism and gender on the political behavior of white Americans. Authoritarianism and gender are two prominent variables in the formation of political preferences. Authoritarianism is regarded as a dynamic psychological disposition toward order and structure in social relations. Meanwhile, gender reflects external cultural markers attached to sex to indicate appropriate social behavior. Environmental factors like resource disparities and social conventions contribute to the production of gender. Both gender and authoritarianism have become increasingly contentious subjects in the context of contemporary partisanship. Scholars believe that each variable uniquely contributes to polarization, and have studied the …

Fostering The Non-Academic Trait Of Grit To Increase Nursing Student Success, Marianne Biangone

Dissertations

In nursing education, there are few challenges as elusive as determining why attrition occurs. Attrition has been attributed to factors such as academic underperformance, adverse life events, and financial issues. It is imperative to identify additional tools for students to increase the opportunity for program success despite his or her challenges. Grit is passion and perseverance for long-term goals. Grit has had a positive impact on academic achievement, and the need is present for research on the ability to foster the development of the characteristics that make up grit in undergraduate nursing students. The purpose of this study is to …

Improving Post-Operative Infection Rates Using My Five Moments For Hand Hygiene, Reginald Mark R. Dimailig

Dissertations

Adequate hand hygiene is known to diminish surgical site infections (SSIs) and prevent healthcare-associated infections (HAIs) in the post-operative settings. An increase in SSIs due to poor hand hygiene compliance was observed at the chosen project site. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of the World Health Organization's (WHO) Five Moments of Hand Hygiene, would improve hand hygiene compliance and reduce post-operative infection rates among orthopedic patients in a same-day surgery unit. The project took place in a medical center located in the Northeast United States. The health belief model (HBM) …

Academic Intensive Care Units: What Is The Impact On Student Achievement?, Brandi Compass

Dissertations

The purpose of this study was to determine if academic intensive care units along with no-zero grading policies at the high school level result in students having higher achievement levels on state EOC assessments. A mixed-methods approach was taken in order to obtain both qualitative and quantitative data from surveys and interviews. Additional quantitative data were analyzed from archival data. Two separate schools were chosen for the populations. High School A implemented academic intensive care units and no-zero grading polices while High School B did not. Participants in the study consisted of both teachers and students at High School A …

Mentorship Program To Improve Nursing Knowledge On Prevention Of Hospital-Acquired Pressure Injuries, Terri Lo

Dissertations

In the United States, hospital acquired pressure injuries (HAPIs) is one persistent patient safety problems with an increasing incidence rate resulting in patient harm and patient deaths. Pressure injuries can lead to problems for the patient and family related to wound care and quality of life. Prevention of HAPIs is an essential aspect of nursing practice. Education and mentorship about HAPI prevention can help facilitate translation of evidence-based research findings to clinical nursing practice to improve patient care outcomes.

Impact Of Comfort Management On Narcotic Use In The Cardiopulmonary Surgical Icu, Caroline Janga Doe

Dissertations

Patients may experience acute pain after cardiopulmonary surgery. Narcotic pain relievers may reduce pain, yet many patients still complained of discomfort at the project site despite the medications provided to reduce it. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of Kolcaba's comfort verbal and comfort daisies scale assessments combined with the use of non-pharmacologic comfort measures would reduce the narcotic dose and increase the patients' comfort levels among post-cardiopulmonary surgical intensive care patients in an acute care hospital in urban New York over four weeks. Kolcaba's comfort theory guided the project. Narcotic …

Lived Experiences Of Or Nurses Working Off Peak Hours, Tashma E. Watson

Dissertations

Nursing plays a vital role in the care and safety of patients. Compared to other health care disciplines, nursing spends the greatest amount of time at the bedside. As health care continues to evolve, nursing will be an active participant in effecting the delivery of patient care. However, there is a paucity of research focused specifically on experiences of nurses caring for patients in the OR. Recent research explores the phenomenon of the "weekend effect." This phenomenon suggests variations in patient outcomes on weekends and nights (off-peak hours) compared to weekdays. The purpose of this hermeneutic phenomenological study was to …

Fluctuating Cohesion: A Grounded Theory Study Of Nursing Students Engaged In A Hybrid Debriefing Format, Carol L. Senette

Dissertations

Debriefing is a key component of simulation that promotes development of students' reflective processes. Instructor-led debriefing (ILD) is considered the gold standard; however, research conducted over the past decade demonstrates the negative effects of anxiety on student reflection during ILD. Nursing students' experiences with ILDs have been substantially investigated; yet scant research explores students' perceptions and experiences of more learner-centered debriefing formats that deemphasize the instructor role.

Epoxy Curing: Paramount Or Trivial? A Cure Path Dependent Inquiry, Jared Bates

Dissertations

The presented research delves into epoxy network formation corroborating reactant concentration profiles and physical property development throughout cure, providing an experimental basis for burgeoning molecular dynamics and coarse-grained simulation methodologies. Herein, three primary subjects were investigated: the first two examine neat and toughened epoxide/amine network formation with respect to various cure profiles aimed at altering reaction pathways, the final chapter intends to augment traditionally utilized activation energy (E_a) methodologies.

Neat and toughened epoxide/amine slurries were monitored in-situ throughout cure via near infrared (NIR) spectroscopy and rheological techniques. Functional group conversion and moduli development were related with specific attention …

Documenting The Journey Towards Becoming An Anti-Racist White Educator, Heather Mccord

Dissertations

As a White teacher in public education, I have had the great pleasure of educating students from all over the globe. My career began in a district that served predominantly White students from middle class families. The only Black students I interacted with were those bused in from the city while participating in the desegregation program. There were noticeable biases and beliefs teachers held toward those students. However, since I was early on in my career with little experience, I was unaware of damage being done to these students. Once I began working for an extremely diverse district, in a …

Budget Gaming: Politics, Ethics, And Compensation, Gretchen Decker

Dissertations

Practitioners are frustrated with the budgeting process, frequently complaining that budgets cause undesirable and political behaviors in the organization (Jensen, 2001). One of the most frequent problems is budget gaming, which critics consider non-value added and frustrating. In a 2010 survey, over 95% of respondents acknowledged that budget gaming exists at least “occasionally” (Libby & Lindsay, 2010). Previous studies indicate budget gaming is frustrating, prevalent, and wasteful (Hansen et al., 2003; Libby & Lindsay, 2007; Neely et al., 2003).

I conducted an experiment to investigate organizational influences (organizational politics, compensation condition, ethics attestation) and their impact on budget gaming. The …

An Empirical Analysis Of Factors Affecting Autonomous Truck Adoption, Christopher Mondy

Dissertations

Autonomous vehicles have the potential to revolutionize the transportation industry. The segment of truck transportation is no exception. Autonomous vehicles have the potential to improve trucking safety, to increase shipping velocity, and to decrease costs. Additionally, autonomous trucks could be an important tool to help alleviate the ongoing driver shortage that the trucking industry is contending with.

Autonomous truck adoption is not guaranteed. Transportation equipment decisions are market-based, and autonomous trucks must present a compelling business case to transportation professionals. As such, it is imperative to understand the decision-making factors that drive transportation solution adoption, and how autonomous trucks could …

Thriving In Student Affairs Professionals: An Exploration Of Supporting Constructs, Shawn Brodie, Phillip Campbell, Gretchen Day Fricke, Kawanna Leggett, Norris Manning

Dissertations

Student affairs professionals provide vital services to college students while also facing various challenges that impact their ability to thrive at work. This study examined overall thriving, its constructs and a set of predictors that impact thriving in student affairs professionals. Seligman’s (PERMA) theory of thriving provided the conceptual foundation for this study. Understanding the constructs that support thriving for student affairs professionals will help institutional leaders and professional organizations develop work environments and strategies that promote thriving. A global pandemic occurred during the time of this research, allowing exploration of how COVID-19 impacted thriving. This study also included variables …

The Culturally Intelligent School Leader: Leadership Strategies Of Exemplary Elementary School Principals In Creating A Culture Of Inclusiveness, Leila Dodge

Dissertations

Purpose: It is the purpose of this explanatory mixed-method study to identify and describe the leadership strategies that exemplary elementary school principals use to create an organizational culture of inclusiveness using Kennedy's five leadership qualities of cultural differences.

Methodology: For this study, an explanatory mixed-method design was used to conduct research to identify and describe the leadership strategies that exemplary elementary school principals use to create an organizational culture of inclusiveness using Kennedy's five leadership qualities of cultural differences. The study's quantitative part was conducted using a SurveyMonkey delivered to each participant. In the survey, participants were asked if they …

Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton

Dissertations

Abstract

Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.

Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …

Stereocontrolled Mannosylation By Hydrogen-Bond-Mediated Aglycone Delivery, Catherine Alex

Dissertations

Stereocontrolled Mannosylation by Hydrogen-Bond-Mediated Aglycone Delivery

Carbohydrates are the essential bio-molecules of life as they form the forefront of interactions with receptors, proteins, pathogens, or neighboring cells. On cell-surfaces, carbohydrates are mostly found as linear or branched glycoconjugates, and a majority of them are linked via either 1,2-cis or 1,2-trans O-glycosidic linkages. There is no template-driven pathway for achieving the synthesis of glycans unlike other biomolecules like proteins and nucleic acids. The synthesis of 1,2-trans glycosides can be reliably achieved via the neighboring group assistance. The synthesis of 1,2-cis glycosides is difficult because, beyond weak anomeric effects, there are …

A Correctional Study Of Nursing Instructor Use Of Best Practice With Multiple Choice Questions, Diane Droutman

Dissertations

Multiple choice questions are used as evaluations in nursing schools. Nursing instructors and nursing book publishers develop exam questions. The specific problem addressed by the study was how best practice in multiple choice test items, item analysis, and revision of choice test items used by nursing instructors. Using a survey method, this correlational design research looked at the relationship of faculty use of best practice in test item construction, analysis, and revision of multiple choice test item in nursing programs in the United States. Even though a relationship was noted, the statistical effect level was minimal. There was no correlation …

Safe Opioid Prescribing Through Proper Screening, Joelle M. Carson

Dissertations

It is known in today's healthcare that opioid abuse is on the rise in the United States. The project site noted aberrant behaviors and the seeking of narcotics from certain clients in the occupational health clinic. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of Webster's Opioid Risk Tool (ORT) would impact the number of opioid prescriptions written for acute pain among patients seen an occupational health clinic in central Indiana over four-weeks. The theoretical frameworks utilized in the project included Skinner's behaviorist theory, Bandura's social cognitive theory, and Orem's self-care deficit theory. …

Religious Leadership: Agents Of Social Change, Jacqueline Carter

Dissertations

Historically, churches in the United States acquired respect as institutions that cultivated spiritual maturity and advocated for social equality in Black communities. Religious leaders represent the voice of reason for communities facing complex social problems, then and today. How educational attainment influences religious leaders’ social action strategies and decisions to engage or disengage in social activism is under explored. Additionally, it is unclear what strategies religious leaders use for social advocacy in their communities. Using andragogy and social cognitive theory as theoretical frameworks, the purpose of this phenomenological study was to explore the educational experiences of religious leaders to understand …

Academic And Demographic Patterns Of Students Placed In Early Algebra I Acceleration, Jill Smith

Dissertations

In the United States, there had been a push for Algebra for All in the early 1990’s in an effort to increase performance on international assessments and provide equity for low-income students and students of color. As the number of students in eighth grade Algebra I increased, a small number of students enrolled in seventh grade Algebra I also increased. The purpose of this quantitative study is to identify and evaluate demographic and academic patterns of students placed in this early acceleration at the middle school level looking at the continuation of acceleration, higher achievement, and an increase in the …

The Impact Of Spiritual Leadership On The Leadership Practices Of Public School Superintendents, Mark D. Hedger

Dissertations

The role of the superintendent is crucial in providing the form of leadership necessary to meet the needs of all stakeholders within a school district, it takes clarity and consistency for a leader to deliver on this promise of public education (Fullan & Quinn, 2016). By demonstrating the qualities of a spiritual leader, the superintendent can play a critical role in accomplishing the goals of a school district through relationships with employees that exemplify the transformational process (Northouse, 2016). Björk et al. (2018) pointed out that superintendents must research and act on information from reliable sources to make the best …

Registered Nurses' Perceptions Of Obesity, Elizabeth Pettifor

Dissertations

Obesity has become an epidemic in the United States (U.S.) population. Obesity is a risk factor for many health problems that ultimately lead to death or disability. Nurses in the U.S have a higher-than-average rate of overweight and obesity. The purpose of this exploratory, qualitative case study was to identify and recommend areas for change in the hospital environment to assist bedside nurses in the U.S to have a healthier lifestyle. Social media was used to conduct a purposeful sampling technique and recruit 10 registered nurses working full time at the bedside in the U.S who struggle with obesity. Semi …

Use Of An Affective Teaching Intervention To Impact Connections Between Academic And Professional Integrity, Deborah Morrill

Dissertations

Dishonesty and misconduct of nursing students during their education is a continuing concern, especially as it relates to expected professional behaviors. This quasi experimental pre-and post-interventional study explored the impact of an affective learning module on developing beliefs and perceptions of ethicality of academic and professional misconduct of students in a BSN program. A modified version of McCrink's (2008) tool, entitled "Nursing Student Experiences and Perceptions of Academic and Professional Conduct Survey" measured these constructs. The affective learning module, based on Rest's theory of moral development, and Krathwohl's affective taxonomy, actively engaged students in ethical decision-making with connections to professional …

Vocational Education: Cna Students’ Perspectives Of Soft Skills In Training And The Workplace, Kimberly S. Mcclendon-Payton

Dissertations

Purpose: The purpose of this quantitative study was to identify CNAs’ perceptions about the most important soft skills used by CNAs in training and the workplace.

Methodology: This quantitative research study identified CNAs’ perceptions of the most important soft skills they used based on the composite model for soft skills. CNAs were selected based on purposeful sampling. Likert scores were collected from the survey responses.

Findings: Examination of the quantitative data from the 35 CNAs revealed that brainstorming is the most important collaboration soft skill in CNA training and the workplace.

Conclusions: Results based on the findings of this study …

Educating Nurses To Engage In Health Policy And Advocacy, Donna J. Barry

Dissertations

Few nurses engage in developing health policy from the local to global level. For a scholarly practice project, American Association of Colleges of Nursing (AACN) accredited nursing schools in New England were surveyed to measure what recommended AACN Essentials content on health policy is taught in their baccalaureate and master's programs. The online, quantitative-descriptive survey captured whether content is taught in stand-alone courses and if those courses are required. Barriers to teaching health policy at both levels and barriers to nurses engaging in health policy and advocacy were also solicited. A majority of responding programs include most AACN content in …