Digital Commons Network^™

Mri As An Adjunct To Conventional Mammography Screening For Cancer In Dense Breast Tissue, Rachel Sunmattie Connett

Walden Dissertations and Doctoral Studies

Diagnostic methods to effectively image dense breast tissue (DBT) can pose challenges for breast cancer screening. While conventional mammography is the gold standard for breast cancer screening, this technique has a low sensitivity to DBT and can miss about 78% of cancers in DBT, but magnetic resonance imaging (MRI) has a high sensitivity for imaging DBT, and produces a smaller number of false positives. The purpose of this study was to determine the extent to which conventional mammograms can miss breast cancer in women with DBT and to determine if an adjunct method of imaging DBT might detect breast cancers …

The Effects Of A K-12 Dual Language Instruction Program On Student College Readiness, Danielle Adair Cortes

Walden Dissertations and Doctoral Studies

Diverse student populations are increasing in local, state, and national settings. There are achievement gaps in college readiness which must be closed between various student demographic groups. It is important for schools to know what methods work best for language acquisition to close the gaps and open postsecondary opportunities for all students. The purpose of this sequential, explanatory, mixed-method, formative program evaluation study was to examine the effects of a dual language (DL) program on improving the college readiness of students. Guided by the framework of learning and second language acquisition, college readiness levels between DL and non-DL students were …

Moderating Effect Of Psychological Hardiness On The Relationship Between Occupational Stress And Self-Efficacy Among Georgia School Psychologists, Jennifer B. Crosson

Walden Dissertations and Doctoral Studies

School psychologists have unique advisory, consultative, interventional, and therapeutic leadership functions within schools. Consequently, they are confronted with increased levels of occupational stress, which test their cognitive appraisal, coping mechanisms, and feelings of self-efficacy. Although studies have included school psychologists, none have examined the moderating effect of psychological hardiness on the relationship between occupational stress and self-efficacy. A cross-sectional, nonexperimental, and quantitative design used convenience, single-stage, and self-administered web-based surveys with 112 Georgia school psychologists. Using a framework structured by the theory of psychological hardiness, self-efficacy theory, and transactional model of stress and coping, sequential multiple linear regression revealed that …

Analysis Of An Early Intervention Reading Program For First Grade Students, Elizabeth Nicole Matthews

Walden Dissertations and Doctoral Studies

Poor early literacy performance in public elementary schools has been a concern for many years. To that end, the purpose of this study was to examine an Early Intervention Program (EIP) in a public school. First grade students at the participating elementary school struggled with reading skills and were not meeting the grade standards of the local school district. In order to remedy this problem, the school implemented early support to provide struggling students with specific and targeted small group reading instruction. This quantitative program evaluation was intended to explore the effect of the EIP used at the participating elementary …

The Association Of Maternal Health Literacy Levels And Preterm Birth, Aimee Moynihan

Walden Dissertations and Doctoral Studies

According to the CDC, each year approximately 0.06 % of the world's population dies in infancy. The March of Dimes indicated that the leading causes of infant mortality include birth defects, preterm birth, low birth weight, sudden infant death syndrome, maternal complications of pregnancy, and respiratory distress syndrome, most of which are considered preventable with access to adequate prenatal care by mothers. The goal of this study was to examine the association between maternal health literacy levels and preterm birth. This research was based on the theoretical framework of the Interaction Model of Client Health Behavior. The hypothesis for this …

Predictors Of Physician Use Of The New Nia Alzheimer's Assessment Protocols, Richard Norman Schultz

Walden Dissertations and Doctoral Studies

Consensus is lacking on early diagnostic criteria and the exact symptoms of Alzheimer's disease (AD). A new, in-office test may help physicians detect the early symptoms of AD, based upon new National Institute of Aging (NIA) criteria. However, a gap exists in knowledge regarding physicians' current use or intent to use the new protocols. Choreographing the descriptive AD terminology in the Diagnostic and Statistical Manual of Mental Disorders IV-TR and the International Classification of Diseases (ICD-10) is recommended. Thus, the purpose of this study was to understand possible contributing factors to physician's use or intent to use of the new …

Oral Care Practice Guidelines For The Care-Dependent Hospitalized Adult Outside Of The Intensive Care Unit Setting, Cynthia Susan Drapal

Walden Dissertations and Doctoral Studies

Many nurses lack evidence-based knowledge to deliver appropriate oral care, view oral care in the care-dependent patient as a comfort measure, and give it a low clinical priority. An estimated 44%-65% of hospitalized care-dependent patients do not receive adequate oral care, an intervention that can prevent aspiration pneumonia or pneumonitis. The purpose of this project was to develop a policy for use of an oral assessment tool and evidence-based guidelines for oral care in hospitalized care-dependent adults outside of the intensive care unit setting at a regional health system in the Southeast United States. The project used the theoretical foundations …

A Transition-To-Practice Residency That Supports The Nurse Practitioner In A Critical Access Hospital, Nancy Jean Stock

Walden Dissertations and Doctoral Studies

Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs or physician assistants without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in education and practice expectations and leading to significant role transition stress and turnover. The purpose of this project was to construct an evidence-based transition-to-practice residency program to support NPs providing emergency department care in the CAH. Theoretical frameworks used to …

Extended Instruction In Business Courses To Enhance Student Achievement In Math, Lessie Mcnabb Houseworth

Walden Dissertations and Doctoral Studies

Poor achievement on standardized math tests negatively impacts high school graduation rates. The purpose of this quantitative study was to investigate if math instruction in business classes could improve student achievement in math. As supported by constructivist theory, the students in this study were encouraged to use prior knowledge and experiences to make new connections between math concepts and business applications. The key research question examined if there was a significant increase in the standardized mathematics test scores of students enrolled in business classes with extended mathematics instruction compared to the standardized test scores of students not enrolled in business …

Technology As A Health Intervention And The Self-Efficacy Of Men, Karen Denise Maxwell

Walden Dissertations and Doctoral Studies

Mortality rates in the United States are higher for men than they are for women as a result of chronic diseases such as heart disease, cancer, and diabetes. Despite these disproportionate rates, few health interventions are targeted to men, and limited knowledge exists regarding the specific components needed to design technology health tools to appeal to men. The purpose of this quantitative study was to examine the relationship between the use of technology health tools and the role of self-efficacy in men and the influence on participation in healthy lifestyle behaviors. A quasi-experimental design was used to analyze data collected …

The Design And Implementation Of A Relationship-Based Care Delivery Model On A Medical- Surgical Unit, Paula Ann Rodney

Walden Dissertations and Doctoral Studies

The Design and Implementation of a Relationship-Based Care Delivery Model on a Medical- Surgical Unit

by

Paula A. Rodney

MSN, California University of Pennsylvania, 2011

BSN, University of Virginia, 1979

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

April 2015

Patient satisfaction and clinical outcomes have become important issues in healthcare since the introduction of the Value Based Purchasing Program. Patient satisfaction, as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, was declining and hospital-acquired pressure ulcers (HAPU), falls, and catheter-associated urinary tract infections (CAUTI) were …

Faculty Perceptions Regarding Best Practices In Clinical Dental Hygiene Assessment, Brenda Kaye Walstead

Walden Dissertations and Doctoral Studies

This qualitative case study explored faculty perceptions regarding best practices and uses of assessment in a dental hygiene program at a small northwestern college. It was discovered that faculty in the program were assessing students in their clinical courses using widely varied methods, designs, and scoring tools. Faculty neither calibrated processes nor communicated about this problem. In addition, a review of the assessments in this local setting indicated a significant gap in the current guidelines for best practices in clinical assessment procedures. Knowles' adult learning theory served as the foundation for this study. Research questions were designed to obtain clinical …

Communication Satisfaction Of Charismatic Leaders In Virtual Teams, Felicia Latrice Chachere

Walden Dissertations and Doctoral Studies

Over the last 2 decades of advances in technology, organizations have used virtual teams (VTs) as one way to expand globally. Strong leadership and communication skills with followers are essential qualities for successful VTs. It is important to conduct research related to charismatic leadership and communication satisfaction of team members as many organizations now use VTs. The purpose of the survey study was to examine the relationship of perceived charismatic leadership qualities in VT leaders and communication satisfaction in VT members. The research questions examined the association between charismatic leadership qualities and the subdimension of communication satisfaction. Charismatic leadership was …

Mental Health Therapists' Attitudes On Adoption Of Evidence-Based Practices And Organizational Culture, Jennifer Guerguis

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) in mental health was initiated in the United States due to state legislation. The EBP implementation process is complex due to multiple factors related to organizational culture. Mental health agencies implementing EBP processes can expect significant personnel changes due to higher turnover rates, which may have a negative effect on the quality of services. The purpose of this study was to investigate the relationship between providers' attitudes toward the adoption of EBPs and organizational culture. The theoretical framework for this study was organizational culture theory and the Denison organizational culture model. This correlational and predictive study examined …

The Effects Of Motivational Interviewing With The Dual Diagnosis Population, Martina S. Moore

Walden Dissertations and Doctoral Studies

Dual diagnosis clients continue to have low treatment completion rates. The purpose of the current study was to understand if motivational interviewing helped to increase completion rates for clients receiving cognitive behavioral therapy (CBT). Studying the problem was necessary for identifying an evidenced-based model for mental health counselors to help clients with dual diagnoses complete CBT treatment. There were no studies available for understanding the effectiveness of motivational interviewing as a tool for improving treatment completion rates for dual diagnoses clients in intensive outpatient programs. The research question examined if motivational interviewing was effective for improving treatment completion rates for …

An Exploration Of Human Resource Personnel And Toxic Leadership, Sabrina Michele Maxwell

Walden Dissertations and Doctoral Studies

An Exploration of Human Resource Personnel and Toxic Leadership

by

Sabrina Michele Maxwell

MA, Pepperdine University, 2006

MA, BIOLA University, 2003

BS, BIOLA University, 2001

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Management

Walden University

May 2015

'

Toxic leaders are destructive of morale, productivity, and organizational effectiveness. Literature has reported the perspectives of followers, and sometimes how organizations address those toxic behaviors, but research has not examined the perspectives of human resource (HR) managers who must detect the existence of toxic behaviors and handle with the consequences of them. To address …

Exploring Punishment For Driving While Intoxicated (Dwi) And Driving Under Influence (Dui) Offenders, Franklyn Johnson Scott

Walden Dissertations and Doctoral Studies

Drinking and driving has been the focus of research since the 1960s, but researchers have not defined the meaning of punishment for offenders who continue to drink and drive. The purpose of this study was to explore the impact of punishment on driving while intoxicated (DWI) and driving under the influence (DUI) defendants to assess the likelihood of preventing subsequent offenses. This study also sought to describe the behaviors of defendants who are perpetrating multiple offenses. The protection motivation theory was the theoretical foundation of this qualitative case study. The sample included a diverse group of 16 men between the …

The Effects Of Differentiated Instruction On The Achievement Scores Of Struggling Fourth Grade Readers, Carol Elaine Boges

Walden Dissertations and Doctoral Studies

Identifying an effective instructional strategy to remediate struggling readers is a goal for educators. Differentiated instruction (DI) has received much attention as a possible strategy to rectify literacy problems, but quantitative research on its effectiveness is limited. This quantitative study used a quasi-experimental, nonequivalent, pretest-posttest design to determine if DI provided a significant difference in reading comprehension scores between struggling readers instructed with DI strategies and students instructed with whole group strategies. Philosophies grounded in cognitive constructivism constituted the theoretical framework for this study which examined the archival STAR reading assessment pre- and posttest instructional reading level scores of 120 …

School Principal Attitudes Toward The Inclusion Of Students With Disabilities, Taleshia Lenshell Chandler

Walden Dissertations and Doctoral Studies

Inclusion is a philosophy and practice of educating students with and without disabilities in the same learning environment. Previous researchers have indicated that principals play a key role in implementing successful and effective inclusive programs. However, there remains a gap in the literature regarding the attitudes of principals and assistant principals toward including students with disabilities at both elementary and secondary school levels. Therefore, the purpose of this nonexperimental, quantitative study, based on transformational leadership theory, was to examine the attitudes of principals toward the inclusion of students with disabilities in general education classrooms. An electronic version of The Principals' …

Transgender Identity Development In A Rural Area: A Multiple Case Study, Nicholaus Lee Erber

Walden Dissertations and Doctoral Studies

A transgender person develops an identity over time and must overcome several obstacles such as stigma, transphobia, discrimination, and sexism, which can be even more difficult for transgender people who choose to come out and transition in a rural area. Grounded in queer theory, social constructivism, and rural identity development theory, the purpose of this qualitative multiple case study was to explore the lived experiences of 4 transgender persons who came out and transitioned in a rural area, and who accessed online communities as a source of information during their identity development. A 4-stage process was used to collect data, …

The Impact Of A Nonpublic Schools Early Childhood Development Program On Readiness Achievement, Catina Pierre

Walden Dissertations and Doctoral Studies

Researchers recognize that if certain academic skills are not present upon entrance into formal schooling, literacy achievement can be affected. The impact of a local early childhood program on student school readiness was unknown at the study elementary school. The purpose of this quantitative study was to compare the academic readiness between kindergarten students who participated in the Nonpublic School Early Childhood Development Program and those who did not. The theoretical framework was based on Bruner's constructivist theory of scaffolding, which highlights the importance of providing support to students in the initial stages of learning. Early achievement data from a …

Teachers' Experiences Concerning The Rise In Student Aggression, Doris Massey Works

Walden Dissertations and Doctoral Studies

This research study addressed the problem of aggressive and disruptive behaviors for kindergarten through Grade 12 students in a school district located in Southeastern United States. The study examined classroom teachers' daily lived experiences with student aggression. Using a phenomenological design and guided by the frustration aggression theory and the social learning theory, the research questions explored teachers' responses to what can be done to help with disruptive and aggressive students and how social learning could help students with these behaviors. Data were collected from interviews with 5 individual teachers who had experienced aggressive and disruptive behaviors; data were also …

Employees' Perceived Effectiveness Of Outsourcing Department Of Defense Functions, Theresa J. Corzine

Walden Dissertations and Doctoral Studies

The United States Department of Defense spends billions of dollars annually on outsourcing functions to private contracted companies without knowing if their actions are effective. Guided by Feigenbaum, Henig, and Hamnett's theory of privatization and President Eisenhower's warnings of the impending military-industrial complex, the intent of this grounded theory study was to develop relevant theory regarding how the Department of Defense might accomplish missions through outsourcing during current and future fiscal constraints. This study sought to understand the perceived effectiveness of outsourcing Department of Defense functions through the perspectives of 2 employment groups directly affected by such outsourcing: federal employees …

Professional Development Effects On Teachers' Perceptions In Analyzing And Using Student Data, Toni Johnson

Walden Dissertations and Doctoral Studies

In a school district in Southern New Jersey, teachers have struggled to analyze student district data to make informed instructional decisions. There is a demand for teachers to use data to inform instruction, but teachers often lack sufficient knowledge in data disaggregation. The purpose of this study was to note the effects of professional development (PD) on data-driven decision making practices by collecting survey data before and after participation in a training module. Guided by the theories of knowledge management (KM) and data literacy, the research questions examined teachers' perceptions on PD's impact toward using data. A quasi-experimental quantitative study …

Examining Barriers With Implementing Augmentative And Alternative Communication In A Midwest School, Ashley Renee Fields

Walden Dissertations and Doctoral Studies

Many speech-language pathologists (SLPs) in a Midwest urban public school system have experienced barriers that prohibit the effective use of augmentative and alternative communication (AAC). The result has left some students with speech language impairments (SLI) without the communication skills for meaningful relationships and success in and out of school. The purpose of this exploratory case study was to determine the perceived barriers of 8 local school SLPs regarding the successful implementation of AAC and their suggestions for addressing the problem. Data were collected from semi-structured interviews with the SLPs. Data collection and analysis were grounded by Ely's conditions of …

Exploring Government Contractor Experiences Assessing And Reporting Software Development Status, Putnam P. Texel

Walden Dissertations and Doctoral Studies

Reports from academic, commercial, and government organizations have documented software-intensive system cost and schedule overruns for decades. These reports have identified lack of management insight into the software development process as one of many contributing factors. Multiple management mechanisms exist. However, these mechanisms do not support the assessment, and subsequent reporting, of software completion status. Additionally, the conceptual framework, based on industry standards, is limited in its relevance to this study due to an emphasis on what is needed while deferring implementation details. The purpose of this phenomenological study was to explore U.S. government contractors' lived experiences of assessing and …

Practice Guidelines For Self-Management Of Osteoarthritis Pain In The Home-Based Settings, Oyesola Omowunmi Akintan

Walden Dissertations and Doctoral Studies

Osteoarthritis (OA) is a debilitating chronic illness that can prevent older adults from accomplishing their activities of daily living or ambulate without pain. The project's purpose was to develop and disseminate multidisciplinary educational practice guidelines to nurses for use in older homebound male Veteran's Administration OA patients to improve home-based pain management and self-care preventative strategies. Orem's theory of self-care management constituted the theoretical framework. The design was a quality improvement project and involved formation of 6 panels of interdisciplinary teams who reviewed the American Society of Anesthesiologist (ASA) and Osteoarthritis Research Society International (OARSI) guidelines. The ASA and OARSI …

Facilitating Weight Tolerance Among Health And Fitness Majors Toward Obese Persons, Stephanie Boss

Walden Dissertations and Doctoral Studies

Weight bias exists in some health-related degree programs. Overweight and obese persons who experience weight bias in health-related services often delay or avoid medical attention altogether. Guided by the attribution theory, the purpose of this sequential explanatory study was to examine weight bias among health majors at a southwest regional university to illuminate how attitudes can affect the level of care provided to overweight persons. The Attitudes toward Obese Persons (ATOP) scores from a convenience sample of 184 health majors revealed that participants' scores were found to be significantly lower than the midpoint (60) of the ATOP scale, M = …

Nitrate In Private Wells:Knowledge, Oppinions,And Perceptions Of Stakeholders, Augustus D. Jaja

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine data describing nitrate concentration and cases of congenital cardiac defects. Residents with private wells and other stakeholders need data to make informed environmental decisions about the adverse health implications of nitrate contamination of private well water. Researchers have examined the exposure of nitrate in contaminated groundwater, but they have not examined nitrate levels in unregulated water systems. This gap in the literature highlighted the need to provide nitrate data for future research and private well users. Guided by the social ecological model, a quantitative, cross-sectional, nonexperimental design was used to survey …

The Effect Of A State Legitimation Process On Child Support Payments And Father-Child Relationships, Chalonda L. Smith

Walden Dissertations and Doctoral Studies

For noncustodial fathers, having legal rights and leaving an inheritance to their child or children are important aspects of being an active father. Georgia state law sees a difference between paternity and legitimation, and for some noncustodial fathers, although paternity is established and they are responsible for supporting that child financially and medically as deemed through child support enforcement, they have no legal rights to their children, nor can they petition the courts for visitation until legitimation is established. This correlational study examined the impact that the legitimation policy has on noncustodial fathers and their relationship with their child, as …