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Examining The Gender- And Sexuality-Related Cognitive “Stuck Points” Of Men And Women With Experiences Of Adult Sexual Assault: Implications For Cognitive Processing Therapy, Marin Beagley

Dissertations

Cognitive Processing Therapy (CPT) is considered a gold-standard psychotherapy protocol for the treatment of posttraumatic stress symptoms secondary to a variety of traumatic events. Despite its demonstrated efficacy, there is research to suggest CPT may not be as effective in reducing PTSD symptoms for men with an adult sexual assault trauma as it is for their female counterparts. The purpose of the present study was to determine whether CPT treatment outcome discrepancies may be attributable to gender differences in posttraumatic cognitions, or “stuck points.” As the act of sexual victimization is incongruent with socially prescribed masculine gender norms, it was …

Exploring The Characteristic Triad Of Resilience: Personal Disposition, Family Support And The Environment Within The Cultural Context Of Quality Mariachi Academies In The Impoverished Central Valley Of California, Lucia Vazquez

Dissertations

Purpose: The purpose of this qualitative multiple case study, was to explore through the lens of the Characteristic Triad of Resilience: personal disposition, family support and environment, how participation in community-based Quality Mariachi Academies (QMA) in impoverished counties contribute to educational resilience.

Methodology: This qualitative multi-case study explored the lived experience of ten resilient students in the impoverished San Joaquin Valley of Central California, utilizing the Characteristic Triad of Resilience as the framework in the context of Quality Mariachi Academies. Data collected from resilient students was triangulated with data from parents, grandparents and site staff.

Findings: Community-based Quality Mariachi Academies …

Exploring Restorative Justice, Suspensions, And Expulsions With African American Males, Dorothy L. Mosby

Dissertations

Zero tolerance programs led to unequal consequences for African American males because the programs targeted behaviors African American students were more likely to receive discipline for, which resulted in an increase of disciplinary situations for the students. With the disproportionate suspensions and expulsions of African American male students in public schools, Illinois Senate Bill 100 addressed the discipline issues to reduce the number of long-term suspensions and expulsions. In the 2016–2017 school year, the state of Illinois implemented Senate Bill 100. The bill reconstructed the procedures on how school administrators suspended and expelled students; Restorative Justice was a technique used …

The Intersection Of Andragogy And Courtroom Practice, Grant Shostak

Dissertations

Learning takes place not only in a traditional classroom setting, but in a plethora of avenues outside of the lecture hall. Learning paradigms like life-long learning and Andragogy, the teaching of adults, have been used by adult educators for fields such as education, finance, accounting, law enforcement, nursing, technology, and many others. A review of the existing literature has revealed an absence of the application of andragogy to the courtroom setting. This paper investigates and discusses the andragogical orientation of successful trial lawyers in Missouri. This study has shown that successful trial lawyers have adapted and share particular principles of …

The Perceptions Of Online Community College Instructors Regarding The Most Effective Collaborative Instructional, Content Specific, And Social Interaction Learning Strategies To Help Online Students Succeed, Maureen Curry

Dissertations

Purpose. The purpose of this phenomenological study was to discover what collaborative instructional, content specific, and social interaction learning strategies online community college instructors perceive to be most effective in helping students succeed.

Methodology. Data were collected through interviews and review of artifacts. The target population consisted of online community college instructors in southern California. Twelve participants from three community colleges were chosen using both criterion and convenience sampling procedures.

Findings. Most online community college instructors apply a variety of collaborative instructional strategies through shared discussions, relevant group projects for content specific learning, and community building interaction …

Capabilities And Limitations Of The Spin Hamiltonian Formalism In Single Molecule Magnets, Philip Ferko

Dissertations

The rational design of molecular magnetic materials is an ongoing effort involving physics, materials science, and chemistry. A common approach to design of complexes and interpretation of magnetic data is the spin Hamiltonian formalism. In this approach, magnetic data is interpreted through constants extracted from the parameterization of data. In design, certain structural motifs are pursued, rationalized by the minimization or maximization of terms in the spin Hamiltonian. In this work, monometallic complexes were prepared to simplify magnetic behavior and allow the examination of specific factors that influence single molecule magnetism like coordination geometry, ligand identity, symmetry, and spin-orbit coupling. …

The Influence Of Social Capital On Community Sustainability In Meacham Park, Missouri During 1996 -1999, Sheila Green-Samuels

Dissertations

Abstract

The purpose of this study was to examine the influence of social capital on the phenomenon of community sustainability in Meacham Park Missouri, a Black neighborhood located in south St. Louis county. It is believed that social capital influences the collective action needed to create structures which lead to economic growth essential to community sustainability (Farrell, 2007, Ginwright, 2015; Putnam, 1993). The core idea of Robert Putnam’s social capital theory is there is value in social networks (Putnam, 2000, 1993). Examined were experiences of current and past residents of Meacham Park using social capital constructs to analyze the significance …

Taxonomy, Species Limits, And Phylogenetic Relationships Of Anoura Gray 1838 (Chiroptera: Phyllostomidae), Camilo Andres Calderon Acevedo

Dissertations

This dissertation addresses several aspects of the diversity and species limits in the nectarivorous bat genus Anoura Gray 1838(Chiroptera: Glossophaginae). Based on morphometric approaches, the current taxonomic arrangement for Anoura includes 8 to 10 species; however, previous taxonomic revisions did not include all closely related species in the genus. In Chapter 1, I investigate the identity of Anoura carishina and its position in the morphospace of the large-bodied Anoura using craniodental and external variables. I analyze traits thought to be diagnostic for these species, including 1) an elliptical Fourier transformation analysis of the shape of the third upper premolar …

Same-Sex Sexual Coercion Among Women: The Impact Of Minority Stress On Perpetration And Victimization Experiences Of Women Of Diverse Sexual Identities, Allison Kirschbaum

Dissertations

The purpose of the current study was to investigate women’s experiences with same-sex sexual coercion perpetration and victimization. Specifically, I sought to explore the role that the stress of living as a sexual minority plays in these experiences as well as to determine whether the psychological variables of perceived powerlessness, psychological distress, social support, and alcohol use mediate the relationship between minority stress and perpetration and victimization experiences. Data were collected online from self-identified women and individuals assigned female at birth who reported experiencing genital sexual contact with another woman (N=339). Of the cisgender women in the sample, 31.6% reported …

Factors Of Women-Founded High-Growth Technology Startup, Renee Gillard

Dissertations

Purpose: The purpose of this mixed-methods study was to identify and describe critical startup factors of high-growth technology startups as identified by women founders in Seattle, Washington.

Methodology: This mixed-method study identified and described 15 women founders of high-growth technology startups in Seattle. Participants were chosen based on specific criteria and recommendations of a sponsor and expert panel. Interviews were conducted with the participants and they completed an online survey.

Findings: Ten major findings emerged from the data. Founders fostered a strong network of professional and personal relationships to help develop and solidify their identity; they also …

A Survey Of Healthcare Workers On Safe Patient Handling And Mobility Resource Availability, Utilization, And Adherence, Kimberly Waltrip

Dissertations

The purpose of this study was to examine the current status of safe patient handling and mobility—specifically resource availability, utilization, and adherence to established safe patient handling and mobility standards—and measure any relationships among these factors. This study builds on the reliability and validity of the adapted American Nurses Association’s (2016) Safe Patient Handling and Mobility Self-Assessment Resource. Responses came from a one-shot survey of healthcare workers in direct patient care across several private and Veterans Health Administration healthcare organizations in the Midwestern United States. The risk of injury is higher in patient handling than in many other professions; …

Barriers To Mental Health Treatment In Patients Referred By Primary Care, Rebecca Palmer

Dissertations

Problem: Limited access to mental health treatment is one of many potential barriers to treating mental illness in the United States. Where resources are readily available, reportedly high no-show rates for established mental health appointments suggests further investigation is necessary to identify frequent barriers within that population. This was a quality improvement project to identify common themes in patient-reported barriers to care.

Methods: A 4-question phone survey was offered to individuals that did not appear at their mental health appointment. Data was analyzed to identify the most commonly reported barriers to mental health treatment. Additional data collected includes reported history …

A Quality Initiative To Reduce Pneumonia Readmissions And Mortality In Older Adults, Terri Morris

Dissertations

The United States (U.S.) healthcare system journey for making improvements in the quality and value of healthcare continues. Hospital organizations are required to compose and make publically available their health quality outcome data. The publication transparency and increased availability of local, regional and national health quality metrics, including readmission and mortality rates, to governmental agencies, health plans, investors, other hospitals, providers and potential patient and families’ knowledge, creates a competitive pressure for a hospital to assure their quality outcomes data are the best. Despite breakthrough improvements using innovative care models that target vulnerable and potentially high cost of care areas …

Referrals To An Opioid Overdose Program With Ems Involvement: Comparing Treatment Outcomes, Courtney Haas

Dissertations

Problem. The rising rates of opioid overdose deaths continue to be a significant public health concern. Innovative programs utilizing a Recovery Coach in the Emergency Department (ED) have demonstrated initial success. However, there is limited evidence to support their effectiveness for improving treatment or recovery outcomes for people living with opioid use disorder. The purpose of this study was to evaluate whether the method of arrival to the ED for an opioid overdose affects engagement and retention in an opioid overdose project in a midwestern metropolitan area, which utilizes a Recovery Coach in the ED. Methods: Utilizing the Plan-Do-Study-Act framework, …

Nitrous Oxide Use For Minor But Painful Pediatric Procedures, Samantha Kremer

Dissertations

Problem: Nitrous oxide (N₂O) is used for mild to moderate pain control and anxiolysis. Registered nurses (RN) as providers of N₂O administration may decrease the number of missed opportunities for pain control or anxiolysis. The purpose of this quality improvement initiative was to evaluate the type of procedures and rate of N₂O administration by providers, and cost difference between them.

Method: A descriptive, cohort-design for pediatric patients in the Imaging and Sedation Department between October through November of 2017 and 2018. Data was compared between physicians in 2017 and either a physician or RN …

Race-Based Trauma Care Training For Veteran’S Health Administration Nurse Practitioners, Vanessa Loyd

Dissertations

Abstract

Problem: Trauma informed care has become a priority for persons exposed to psychological, physiological, emotional consequences as a result of traumatic experiences. Veterans are from different cultures, including gender, race, religion, sexual orientation and other social groups. The Veterans Health Administration (VHA) is responsible for the health of this culturally diverse patient population. Healthcare providers without any prior military experience may experience difficulty obtaining an accurate history and physical exam due to the military’s cross-cultural environment. The project aim was to increase confidence and competence in race-based trauma care by incorporating training into a new acute care fellowship …

Adult-Geriatric Acute Care Nurse Practitioner Fellowship For The Veterans Health Administration, Karen Scaglione

Dissertations

Problem: Nurse practitioner (NP) fellowship programs assist the novice NP in transitioning from a traditional nursing role to advanced practice. The Veteran’s Health Administration (VHA) utilizes a NP primary care fellowship program. An acute care fellowship may assist with role transition, confidence and competence for acute care NPs. The purpose of this evidence-based pilot project was to develop a transition to practice acute care fellowship program at a Midwestern VHA hospital.

Methods: A prospective, descriptive design utilizing a convenience sample of senior adult-geriatric nurse practitioner (AGNP) students during a pilot study of an acute care fellowship program. Outcome measures …

Management And Support Of Uninsured Patients With Diabetes Type Ii Within A Nurse Managed Clinic, Emma Spencer

Dissertations

The purpose of the project was to improve the quality of care for the uninsured, Type II Diabetics residing in a Midwestern urban underserved community. Community Health in Partnership Services (CHIPS) was a nurse-managed clinic, located in that area, that sought to lessen the burden of being uninsured. An annual fee of $35.00 allowed an uninsured community member access to a variety of different health care providers including specialists. In order to utilize this health care team efficiently, it was necessary to implement nurse-led care coordination for patients diagnosed with Type II Diabetes. This quality improvement project followed the Plan …

Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff

Dissertations

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission …

A Vaccine Administration Training Program To Increase Adolescent Vaccination Rates, Claire Jensen

Dissertations

Abstract

Immunizations have been proven to control life-threatening diseases. Often Registered Nurses (RNs) administer vaccines but are unsure how to discuss vaccines with vaccine hesitant patients. Missouri’s adolescent vaccination rates are below its neighboring states. This initiative’s purpose was to increase adolescent vaccine administrations at a Missouri County Health Department (MCHD).

This quality improvement initiative had an observational, cross-sectional, descriptive design. RNs employed at three MCHD clinics attended an adolescent vaccine administration training program (VAT) and completed pre-/post-tests regarding the Advisory Council on Immunization Practices recommendations. Medical record reviews from March 1-April 30, 2018 and March 1-April 30, 2019 compared …

Increasing Nursing Competence And Confidence During Obstetric Emergencies Through Simulation: A Quality Improvement Project, Tram Wallen

Dissertations

Problem: This quality improvement project aimed to improve the knowledge and confidence of the mother/baby nursing staff during postpartum hemorrhages through in situ simulation. PPH is a leading cause of maternal death. Hospitals across the U.S. lack a standard approach to managing obstetric emergencies; the complications of childbirth are often identified too late. Multidisciplinary simulation-based team training has been associated with improved outcomes in obstetrics.

Methods: A convenience sample of 26 registered nurses (RNs) that care for postpartum patients attended a one-hour instructor-led presentation followed by in situ simulations of postpartum hemorrhage. A knowledge assessment and confidence survey were administered …

Evaluating The Delivery Of Diabetes-Related Care Among The Asian Population, Lyly Bui

Dissertations

Purpose: This project evaluated current practices for Type 2 diabetes mellitus (T2DM) screening and management among Asian Americans (AAs) presenting to a primary care clinic and determined whether these practices adhered to the American Diabetes Association (ADA)’s 2018 guidelines.

Methods: A retrospective chart review was performed to extract data from clinical case records of AAs who visited the Vietnamese Health Center (VHC) between November 1, 2017 and November 1, 2018. Descriptive statistics were utilized to analyze the data.

Results: Of 173 charts reviewed, 76.3% of AAs had no previous T2DM diagnosis and 23.7% had a previous diagnosis. Among those without …

A Rural Telehealth Objective Structured Clinical Examination, Devon Schlottach

Dissertations

Problem Rural healthcare consumers experience increased health disparities, especially when accessing health care. The use of telehealth to improve access has become an essential competency for nurse practitioner (NP) students. This study evaluated NP students’ confidence and competence of rural social determinants of health (rSDOH) before and after a telehealth simulation.

Methods A descriptive, cohort design was used to review NP students’ pre- and post-surveys, written case studies, and a video-recorded telehealth OSCE for a patient living in a rural area.

Results Student self-rated knowledge of rural health care did not improve despite didactic learning and simulation (z = …

Enhancing Scalability In Genetic Programming With Adaptable Constraints, Type Constraints And Automatically Defined Functions, George Gerules

Dissertations

Genetic Programming is a type of biological inspired machine learning. It is composed of a population of stochastic individuals. Those individuals can exchange portions of themselves with others in the population through the crossover operation that draws its inspiration from biology. Other biologically inspired operations include mutation and reproduction. The form an individual takes can be many things. It, however, is represented most of the time as a computer program. Constructing correct efficient programs can be notoriously difficult. Various grammar, typing, function constraint, or counting mechanisms can guide creation and evolution of those individuals. These mechanisms can reduce search space …

Decoding The History Of The Early Solar System Using Comet Volatile Compositions, Nathan Roth

Dissertations

Understanding the evolution of the solar system, as well as its current volatile content, requires knowledge of the initial conditions present in the solar nebula. As some of the first objects to accrete in the solar nebula, cometary nuclei are among the most primitive remnants of solar system formation, and their present-day volatile composition likely reflects the composition and conditions where (and when) they formed. As such, the volatile compositions of cometary nuclei may serve as "fossils" of solar system formation. High-resolution near-infrared spectroscopy offers a valuable tool for sampling the primary volatile (i.e., ices subliming directly from the nucleus) …

Decreasing Opioid Overprescription Following Outpatient Gynecology Surgery, Monica Kistler

Dissertations

Problem: Opioid abuse may be a result of overprescribing opioids. There are no opioid prescribing recommendations for minor gynecologic surgery. As a result, there is a wide variation in prescribing practices at a privately-owned surgery center where excessive opioid prescription occurs.

Methods: A quality improvement initiative with a descriptive, cohort design. A retrospective review of medical records and telephone surveys over three months resulted in the development of a series of posters describing prescription data for three procedures: hysteroscopy dilation and curettage (HDC), uterine ablation (UA), and laparoscopy (LAP). The trends and changes in opioid prescription practices were displayed throughout …

Depression Screening In Antepartum Females, Michelle Burk

Dissertations

Problem: Perinatal mood disorders, including depression, affects one in five pregnant or postpartum females. The American College of Obstetricians and Gynecologists (ACOG) and the US Preventative Task Force (USPTF) recommended screening for depression at least once during the antepartum and postpartum periods. The purpose of this quality improvement initiative was to introduce depression screening using the patient health questionnaire (PHQ) in antepartum women in a Midwestern private OB-GYN practice.

Methods: An observational, descriptive, cohort design utilizing a retrospective record review was used to evaluate for PHQ depression screening. A convenience sample of antepartum patients at/or around 36-weeks gestation was studied. …

Examining Opioid Ordering Rates Of Advanced Practice Providers In An Emergency Department, Bridgette Thompson

Dissertations

Problem Opioid abuse has become a major public health issue in America. Many Americans die daily from an opioid overdose. The Centers for Disease Control and Prevention (CDC) has identified prescription drug abuse and overdose as a major health threat.

Methods Descriptive cohort design with a retrospective record review of the number of opioids ordered by the advanced practice provider six weeks before and six weeks after a didactic and simulation educational experience.

Results The total sample was four (N=4). Using the paired samples t test there was no difference (t = 0.65, p = 0.56) between the number …

Primary Care Delays In Underserved Areas: A Strategic Plan To Improve Access To Care, Debra Connell-Dent

Dissertations

Hypertension (HTN) and Diabetes Mellitus Type 2 (DM2) are two chronic conditions contributing to morbidity and mortality. 23.1 million people have DM2 and 7.2 million people have it an are undiagnosed in the U.S. During 2015-2016, the prevalence of HTN was 29.0% and increases with age (CDC, 2018). This purpose of this article was to discuss the benefits of developing a Transition Clinic (TC) in a highly traveled metro transit area and the development of a strategic plan on implementing this project, as well as the barriers that may be encountered when implementing such a clinic similar to this. A …

Depression In Hiv-Positive Individuals Living In A Residential Housing Community, Danielle Njeri

Dissertations

Problem: Depression is the most prevalent psychiatric disorder among individuals living with HIV. Depression rates are three times greater than those found in the general population . Undiagnosed and untreated depression can have a negative effect on the management of HIV infection, resulting in increased mortality and a poorer quality of life. The purpose of this quality improvement initiative was to assess the incidence of depression in HIV-positive individuals living in a residential community.

Methods: A prospective, descriptive, cohort design. Convenience sample of HIV-positive adult residents living in an HIV residential community. The nine-question patient health questionnaire (PHQ-9) …