Digital Commons Network^™

Rural Emergency Nurses' Suggestions For Improving End-Of-Life Care Obstacles, Kelly Elizabeth Smith

Theses and Dissertations

Introduction: In 2010, of the 129 million visits to the emergency department (ED), 240,000 resulted in the patient dying or being pronounced dead on arrival. This number is likely to continue to increase as a significant portion of the American population ages and seeks care in the ED. Though care in the ED is focused on saving lives, death cannot always be prevented. Consequently, nurses face many barriers to providing quality end-of-life (EOL) care in the ED when death occurs. The purpose of this study was to identify suggestions emergency nurses have to improve EOL care specifically in rural ED's. …

Attitude Of Thai Instructors And Students Toward A Distance Learning System For Agricultural Extension And Development Programs For Participating In The Asean Community, Chalermsak Toomhirun

Theses and Dissertations

The purpose of this study was to determine the attitudes of students and instructors at Sukhothai Thammathirat Open University (STOU) toward a distance learning system for agricultural extension and development programs for participating in the ASEAN community. It was also to determine the difference in attitude between undergraduate students and graduate students toward 9 factors involving the STOU distance learning system and programs. The study used mixed methods. Descriptive survey and focus groups were used to collect quantitative and qualitative data. Data were analyzed by descriptive statistics and the Mann-Whitney U test. STOU students were employed adults who lived around …

Rethinking The Achievement Gap: A Wholistic Humanistic View Of Student Academic Performance And Lack Of Performance, Immaculata Anayo Chukwunyere

Theses and Dissertations

This dissertation is an ethnographic case study that explored minority and low SES inner city high school students’ perception and sense-making of school, learning, academic behaviors, and academic achievement through an integrated theory of human development, learning, and achievement. I sought an understanding of the reason behind the persistent academic failure of inner city minority and low SES high school students, as well as the academic achievement gap within and between this subgroup of students. The aim of this study was threefold. First, I explored the factors operating in high school students’ thoughts, feelings, actions, and reactions to school and …

Identifying Barriers To Mental Health Services For Limited And Non-English Speaking Clients In A Rural Homogenous Environment: An Approach To Reduce Barriers With Technology, Alma Torres

Theses and Dissertations

The purpose of this study was to explore the current protocols set in place by local agencies when working with limited English proficiency clients (LEP). Due to the homogenous environment in the state of North Dakota and Northwestern Minnesota and the increase of immigrants, migrants and refugees to the area, the use of interpreters has become a necessity. A questionnaire was used as means of collecting data regarding the number of agencies that service limited English proficiency clients, employ interpreters, how interpreters are trained and the use of technology for interpretation purposes. Interpreter is defined for this purpose as an …

The Experience Of Siblings Of Youth With Type 1 Diabetes, Stephanie Miller

Theses and Dissertations

Background. Type 1 diabetes requires intensive management, including blood glucose monitoring, carbohydrate counting and dietary modification, and administering insulin. When a child is diagnosed with type 1 diabetes, family dynamics are often altered as family schedules revolve around care for the child with diabetes. In addition, siblings face unique challenges as they become involved in the care of the child with type 1 diabetes. Therefore, it is important to understand experiences of siblings of youth with type 1 diabetes. Aims and Objectives. To identify experiences of siblings of children with type 1 diabetes from their own perspectives. Sample. As part …

Undocumented Hispanic Students And The Postsecondary Transition: A Narrative Perspective, Alfred Trafford

Theses and Dissertations

Undocumented students transition to college in extremely low numbers due to a high degree of marginalization, inequity in access to higher education, and constitutional confusion regarding federal and state issues of supremacy and inferiority in immigration, tuition, and financial aid policies. Such students must contend not only with traditional challenges of teenagers in high school "including identity and development concerns and academic and social pressures" but also with the issue of not being in the United States legally. A narrative strategy of inquiry was used to collect, analyze, and interpret data from extensive participant interviews and a research journal; the …

Assesing Interactivity In The Websites Of Human Rights Organizations' Websites In Egypt, Andalib Mohamed Fahmy

Theses and Dissertations

The Internet has many advantages over the other media in the provision of information services especially in the field of human rights. In Egypt the image of the human rights organization has been affected severely after the Egyptian revolution due to continuous media attack on them; therefore, it became vital to change this image. As the websites is the primary tool that permits the organizations to connect with their audience and permit the audience to know their activities, analyzing the websites of the human rights in Egypt from user perspective become vital This study aims to assess the interactivity and …

Survival Strategies And Coping Mechanisms Of Syrian Female Head Of Household In Egypt, Mirette Bahgat

Theses and Dissertations

The objective of this research is to analyze the coping mechanisms that Syrian females head of household employ in Egypt in absence of survival strategies, and how different they are from the coping mechanisms employed by males head of household. The two questions I seek to answer through this research are : (1) What are the main challenges faced by Syrian female and male head of household in Egypt in five main areas: a. Safety and security b. Access to education c. Access to health services d. Social cohesion e. Access to economic opportunities and livelihoods (2) How do the …

Helping Students Graduate: An Examination Of The Services Provided By A Dropout Prevention Program, Caren Putzu

Theses and Dissertations

The Alliance for Excellent Education (2011) estimates every 26 seconds in America, a student drops out of school. Numerous intervention and prevention approaches have been implemented to reduce the incidents of school dropout. One program, Communities In Schools (CIS), has shown promise in impacting the issue of school dropout by attending to both academic and non-academic factors at play in influencing a student’s risk for dropping out. The primary aim of this secondary data analysis was to develop an increased understanding of CIS services, to explore whether service provision varies systematically in relation to student outcomes and student characteristics, and …

Parent To Parent Support For Parents Of Children With Autism Spectrum Disorders: Perspectives Of Parents And Program Staff, Nina Nelson

Theses and Dissertations

This short-term longitudinal qualitative study used grounded theory methods to explore how parents of children with autism spectrum disorder (ASD) benefit from one-to-one support (P2P), factors affecting success, and how these relationships evolved. In-depth interviews were conducted with 6 staff, 12 referred parents, and 11 support parents.

Most referred parents found P2P helpful, deriving informational/practical, emotional, and a few social benefits. Six interrelated factors affected success including a) parent-support relationship; b) program level; c) support parents’ experiences with P2P and the disability community; d) practical/logistical factors; e) psycho-emotional factors; and f) referred parents’ expectations relationship program level. The relationship was …

Assessing Lgbtq Youth Cultural Competency In Direct-Care Behavioral Health Workers: Development And Validation Of A Measure., Megan E. Gandy

Theses and Dissertations

Direct-care workers can provide an array of service types to children, adolescents, and their families in behavioral health treatment. They may also work in a variety of settings (e.g., group homes, inpatient units/hospitals, residential treatment, treatment foster care, day treatment, in-home treatment, etc.). Direct-care workers typically are involved in the supervision of youth and in the implementation of a treatment plan developed by the youth’s treatment team. For youth who are lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) and are receiving behavioral health services, such workers form a critical part of their therapeutic experience. However, …

Reflective Judgment: Can Problem-Based Learning Approach Make A Difference?, Nicole Marie Cavanagh

Theses and Dissertations

For counselors to be successful in current and future practice, they must be proficient reflective thinkers and be able to use reflective judgment skills to manage the daily complex problems presented by complex clients. Reflective thinking and reflective judgment are not elements of counseling curricula unless faculty explicitly design learning activities to develop these skills.

This study examined the relationship between reflective judgment and problembased learning (PBL) by comparing pretest and posttest scores on the Reasoning about Current Issues test. Data was collected from a convenience sample of graduate level Counselor Education Ed.S students at the University of South Carolina …

Veterans In Higher Education: A Qualitative Examination Of Student Veterans At Peach University, Debra Wales

Theses and Dissertations

With the passage of the Veterans Educational Assistance Act in 2008, better known as the Post 9/11 GI Bill and with the downsizing of military forces (2011-2015) many veterans were given the incentive to start college. Since the implantation of the veterans’ educational benefits, little research had been conducted to identify if documents and policies espoused by institutions of higher education, created barriers for veterans as they transition on to campuses. This qualitative study explored student veterans’ perceptions of Peach University, analyzed the printed documents and policies pertaining to student veterans, and examined to what extent there were differences between …

Women In Nonprofit Leadership: Strategies For Work-Life Balance, Amanda Colleen Green

Theses and Dissertations

The nonprofit sector is the third largest employing industry in the United States and impacts almost 10% of the economy (Roeger, Blackwood, & Pettijohn, 2012; Salamon, Sokolowski, & Geller, 2012). Women comprise over 75% of the nonprofit workforce, yet men hold over 80% of leadership positions (Bronznick & Goldenhar, 2009; McInnes, 2008). The purpose of this qualitative, phenomenological study was to examine the work-life balance practices of women leaders in nonprofit organizations and determine experiences impacting their life course. The ultimate goal was to gain insight from women leaders in nonprofit organizations to identify strategies for more women to advance …

Building Capacity For Advocacy For Local Food Systems Change: An Ethnographic Study Documenting The Process Of Change In South Carolina Communities, Casey Denise Childers

Theses and Dissertations

The Guide to Community Preventive Services currently does not have sufficient evidence to recommend any nutrition strategies for obesity prevention. Nonetheless, food systems changes are recommended for childhood obesity prevention by the C.D.C., U.S.D.A., and many thought-leading organizations. Creating healthy food communities will require physical and social environmental changes. Community-based groups need to build their capacity to frame community health issues as physical and social environmental issues. This research partnered with community-based groups to build their capacity for advocacy by using media framing research and strategic communications training. Specifically we: 1) conducted a media content about food systems, childhood obesity …

Examining Therapists' Perceptions Of Barriers To Treatment With Youth And Their Families : A Mixed Methods Study, Gimel Rogers

Theses and Dissertations

The present study identified and quantified five main barriers to treatment categories, deducted first from the qualitative dataset, then consolidated with the results of the quantitative dataset. Clinicians (N=36) that worked with youth and their families participated. The main findings suggested five parent themes (practical obstacles, poor alliance with the therapist, therapist's perceptions, socioemotional, and cultural) and seven concept groups (transportation, financial, logistical, attendance, therapeutic relationship, lack of communication, and lack of engagement). Implications provide strategies to ratify some of these barriers, such as gathering data on youth clients and their families. For the purposes of this study, the terms …

The Effects Of Parent-Child Agreement On Academic Achievement, Alea A. Baron

Theses and Dissertations

Achievement in youth across America has been defined by youth report card grades and standardized test scores, with higher scores typically being the gateway to college, scholarships, and future financial success. There is abundant evidence that shows parenting factors and the parent-child relationship are correlated with high academic achievement in youth. Therefore, the aim of this study was to investigate if the effects of high parent-child agreement on youth self-esteem and self-efficacy significantly correlated with high youth academic achievement on classroom achievement scores. Data from Dr. Judy Ho's The STAGES Project in student's entering the 6th grade was utilized in …

A Phenomenological Study Of Women In India Striving To Achieve Work-Life Balance In Finance With Competing Priorities, Linda Shahisaman

Theses and Dissertations

There is a common phrase used in India, Na Stree Swathantrayam Arhati, which translates into women not deserving independence. This ideology gives women a disadvantage at an early age in life. This study strives to strengthen the ability of women that are enduring disabilities, gender issues, and inequality in the home and work place. There has been increased research on the topic in India especially due to the increased discrimination against women in the country. Women's empowerment can be viewed as women gaining control or power over their lives and this study strived to gain that. This particular study is …

The Organization Culture Assessment Of Area Agencies On Aging In The State Of California, Maria Carmen Victoria E. Painter

Theses and Dissertations

The world is undergoing a key demographic shift and a restructuring of its population due to the increase in the relative size of the aging population. Based on the latest world census data, the number of people aged 65 or older is expected to increase from an estimated 416 million in the year 2000 to 853 million in the year 2025. The US Census Bureau estimated that in 2050 the number of Americans aged 65 and older would reach 88.5 million, more than double the projected population of 40.2 million in 2010. The state of California has 3.5 million people …

Processes And Mechanisms Of Change In Integrative Behavioral Couple Therapy: A Case Study Of One Couple With Distress Over Child Rearing, Jessica S. Schachter

Theses and Dissertations

Marital distress is common and can have a tremendous influence on an entire family. Spousal conflict related to children is known to have a particularly negative impact on both the parenting and marital relationship. A number of evidence-based therapies exist to support couples in need including integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998), which focuses on emotional acceptance and behavior change as mechanisms that improve marital satisfaction. While IBCT is well documented as an effective treatment with lasting outcomes (Christensen, et al., 2004), how and why IBCT works remains less clear. The current study used qualitative methodology to …

Identifying Differences Between Privatized, Partially Privatized, And Non-Privatized State Foster Care Systems: A Comparative Study Examining Efficiency And Effectiveness, Dorothy C. Coles

Theses and Dissertations

Privatization of the public child welfare system has become increasingly popular since its introduction in the early 1990s. State governments that initiate the privatization of foster care services rationalize the changes with claims of effectiveness and/or increased efficiency of services for children and families. There has been no real focus on identifying what efficiency of the system means for children and their families, nor what aspects of effectiveness focuses on children in foster care. As a result, the unintended consequences of this total restructuring of foster care bureaucracy, through the privatization of the state foster care system – and its …

Disclosure Of Personal Reactions That Occur During Therapy To Supervisors And Supervisory Alliance Among Marriage And Family Therapy Trainees And Interns, Anneka Busse

Theses and Dissertations

The purpose of this study was to investigate the likelihood of disclosure and comfort in disclosure of personal reactions occurring in the conduct of psychotherapy in the clinical supervision of marriage and family therapy trainees and interns/associates. This study replicated and expanded on Pakdaman, Shafranske and Falender's (2014) and Daniel's (2008) analog studies of the effects of supervisory alliance on self-reported comfort and likelihood of disclosure of personal reactions in therapy with psychology interns and trainees. This study also investigated the relationship between working alliance and experiences of isomorphism and parallel process. There were a total of 161 participants; 56 …

The Nature And Frequency Of Countertransference Reactions In Psychoanalysts, Michelle Walker

Theses and Dissertations

Psychotherapist personal factors, often referred to as countertransference reactions, are widely believed to impact the therapeutic process. While the existence of the countertransference is commonly accepted by contemporary psychotherapists, there is continued debate over its nature, quality and therapeutic utility. Further, there have been relatively few empirical studies on the countertransference reactions of practicing psychologists and other mental health professionals. This study aimed to address this lack by examining the frequency and nature of countertransference experiences as reported by psychoanalysts. Additionally, this study sought to explore the relationship between countertransference reactions and patient symptomology as suggested by recent findings (Betan, …

The Rise And Fall Of Self-Esteem: A Critical Review, Reconceptualization, And Recommendations, Tamara Shawn Levy Eromo

Theses and Dissertations

Self-esteem, viewed for decades as psychology’s Holy Grail, has proved to be an elusive and surprisingly barren destination. One of the oldest concepts in psychology, self-esteem likely ranks among the top three covariates occurring in personality and social psychology research. Propelled by the self-esteem movement of the 1970s, it was popularly believed that self-esteem played a significant causal role in determining a wide range of both positive and negative social behaviors. However, the results of a 2003 large-scale literature review showed that it is actually not a major predictor of almost anything, with the exception of positive feelings (happiness) and …

Vocational Readiness: The Effect Of Pre-Prison And Incarceration-Based Trauma On Cognitive Appraisals And Self-Perceptions Of Incarcerated Women, Joi Dykes Anderson

Theses and Dissertations

The number of women incarcerated in the United States has grown at an alarming rate. This research study presents a conceptual framework for examining pre-prison and incarceration-based trauma and its effects on cognitive appraisals and self-perceptions. Literature from psychology, feminist psychology and neuropsychiatry are integrated to discuss how pre-prison trauma creates pathways to crime for females, how incarceration serves as a form of traumatization (or retraumatization), how the social dynamics of the prison environment potentially exacerbates mental health issues (i.e., PTSD, anxiety, depression), how this negatively affects a female inmates vocational readiness—the ability to obtain and maintain employment once engaged …

What Do We Know About Technical Assistance? Enhancing The Science And Practice Of Technical Assistance Via A Research Synthesis, Jason S. Katz

Theses and Dissertations

Introduction. Each year billions of dollars are spent on providing technical assistance (TA) to build the capacity of host settings (e.g., organizations, communities) to implement innovations, but there is little consensus (or even discussion) about: what the essential features of TA are, how to provide TA with quality, and how a quality-based accountability perspective can help us to enhance the science and practice of TA. To begin to address these needs, a research synthesis methodology was used for conducting a content analysis of the current evidence base for TA using three frames: (1) applying a conceptual and operational model (Getting …

The Role Of Psychology In Integrated Primary Care For Complex Patients: Effects On Mental Health, Utilization Of Medical Services, And Physiological Markers Of Health, Danielle C. Worthington

Theses and Dissertations

This study served as an initial evaluation of integrated psychology services within a clinic designed to serve uninsured patients with complex medical concerns and high utilization histories at the Medical College of Virginia in Richmond, Virginia. The current study evaluates patient outcomes, and more specifically, it further quantifies and describes the role that psychologists play in the primary care setting and their impact on utilization of medical care and in improved health outcomes. Additionally, the study evaluates psychologists’ success at treating mental and behavioral health conditions within the primary care model. The present study demonstrates that patients with complex medical …

Exploring Dimensions Of Well-Being Among Spouses Of Active-Duty Service Members, Lisa A. Gray

Theses and Dissertations

During an era when the United States has been engaged in the longest waging wars in U.S. history, military families have been exposed to extraordinary amounts of stress and have had to learn to adapt in a culture where repeated deployments, recurrent family separations, and frequent relocations have become the norm. A surge in research in recent years on the families of Service members has brought increased attention to the unique challenges and demands of spouses, raising concerns about how to best meet their needs. Despite the increased attention, few studies have focused on spousal well-being. Acknowledging this lack of …

Measuring Mental Health Provider Stigma: The Development Of A Valid And Reliable Self-Assessment Instrument, Jennifer L.K. Charles

Theses and Dissertations

Provider-based stigma is defined as the negative attitudes, beliefs, and behaviors of mental health providers toward clients they serve. Often unintentional and unknowingly conveyed, this phenomenon has been indicated in previous research (e.g. Lauber, Nordt, Braunschweig, & Rössler, 2006; Nordt, Rössler, & Lauber, 2006; Hugo, 2001; Schulze, 2007). Other instruments crafted to measure provider stigma have utilized theory in their development, without incorporating the voice of the client (e.g. Wilkins & Abell, 2010; Kennedy, Abell, & Mennicke 2014). To better address the social injustice posed by provider stigma, the profession requires a valid and reliable measure, guided by theory, which …

Dual Pi3k/Mtor Inhibition With Bez235 Augments The Therapeutic Efficacy Of Doxorubicin In Cancer Without Influencing Cardiac Function, David E. Durrant

Theses and Dissertations

Cancer continues to be a leading cause death in the United States despite improved treatments. Cancerous lesions form after acquiring oncogenic driver mutations or losing tumor suppressor function in normal cells. Traditional therapies have included use of genotoxic substances that take advantage of the increased growth rate and loss of tumor suppressor function to cause cell death. One such drug is the anthracycline antibiotic doxorubicin (DOX). DOX interchelates into DNA and disrupts transcriptional machinery while also poisoning topoisomerase II. This results in single and double stranded DNA breaks, which if severe enough leads to either necrotic or apoptotic cell death. …