Digital Commons Network^™

Palatal Expansion Using The Invisalign Palatal Expander, Hassan Chihab

ETDs from 2020-2029

Palatal expansion has been used in orthodontics to treat a narrow maxilla and to primarily correct posterior dental crossbites. In younger patients, palatal expansion can readily be achieved through opening of the mid-palatal suture, as it is not fused at that age. As the mid-palatal suture matures, expansion will gradually be difficult to achieve, and more dental expansion is obtained rather than skeletal. In addition, there is a tendency to get more dental tipping. Palatal expansion has been recommended not only to correct crossbites but also to improve breathing in patients with sleep disorders such as obstructive sleep apnea (OSA). …

The Effect Of Part-Time Vs Full-Time Integrated Clinical Education On Student Physical Therapists’ Self-Efficacy And Clinical Reasoning, William J. Buchala

Student Dissertations

Integrated clinical education (ICE) varies across Doctor of Physical Therapy (DPT) programs, particularly in the use of part-time and full-time clinical experiences. Limited research has examined relationships between ICE structure, self-efficacy, and clinical reasoning. The purpose of this quantitative ex post facto study was to examine relationships between part-time and full-time ICE models and self-efficacy and self-assessed clinical reasoning in DPT students. Survey responses were collected from DPT students who had participated in ICE experiences. Self-efficacy was measured using the Physical Therapist Self-Efficacy Scale, and self-assessed clinical reasoning was measured using the Self-Assessment of Clinical Reflection and Reasoning Scale. Independent-samples …

Examination Of Maternal Mortality, Mental Health Conditions, And Co-Occurring Factors, Laura Eileen Skaarer

Walden Dissertations and Doctoral Studies

Maternal mortality (MM) continues to be a public health concern in the state of Arizona. There is little to no research investigating the relationship between MM and mental health conditions co-occurring with contributing factors among women who have died in Arizona while pregnant or within 1 year of the end of a pregnancy. The purposes of this quantitative study, guided by the three delays model (3DM), were to examine (a) MM and mental health conditions as the primary underlying cause of death; (b) MM and mental health conditions surrounding death; and (c) significant contributing factors (i.e., discrimination, knowledge, lack of …

An Exploration Of Factors Affecting Investments In Productivity Improvement, Gregory Springate

Walden Dissertations and Doctoral Studies

Canada has exhibited lower productivity growth since 1990, resulting in substantially reduced gains in citizens’ standards of living despite the importance of sustainable productivity to economic prosperity. Understanding the primary factors that influence productivity growth is a critical concern for Canadian government leaders, as it is a key indicator of the nation’s economic vitality, competitiveness, and citizens’ quality of life. The purpose of this qualitative multiple case study was to explore the factors that influenced the investment in productivity improvement of organizations in the energy sector in the Edmonton region of Alberta, Canada. The COSO internal control framework guided this …

Clinical Practice Guideline To Improve Medication Adherence In Adults With Chronic Conditions In Outpatient Settings, Mulumbwa Chishimba

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice project was conducted to develop and assess a clinical practice guideline (CPG) to enhance medication adherence among adult patients with chronic illnesses in an outpatient setting. Adverse health-related outcomes include worsening chronic illness and developing complications, frequent hospital admissions, and rising costs of healthcare services. While some interventions are recommended based on the available literature, most outpatient facilities do not have systematic practices for monitoring and enhancing medication adherence among patients with chronic conditions. The evidence-based question was: What evidence, based on content expert review using the Appraisal of Guidelines for Research and Evaluation II …

Staff Education To Decrease Workplace Violence Through De-Escalation Training In The Emergency Department, Tyrani Anderson

Walden Dissertations and Doctoral Studies

Workplace violence remains a significant issue in healthcare settings, particularly in emergency departments where psychiatric patients may present with aggressive behaviors. Nurses and healthcare staff are frequently exposed to verbal threats, intimidation, and physical aggression, which negatively impact staff safety, job satisfaction, and patient care quality. Despite workplace violence prevention policies, gaps remain in staff preparedness when managing escalating patient behaviors. The purpose of this Doctor of Nursing Practice project was to implement an evidence-based de-escalation training program to improve staff knowledge about managing aggressive psychiatric patients in the emergency department. The practice- focused question was: Can staff education on …

Bahamian Human Resource Practitioners' Perceptions Of Public Service Performance, Lanisha Tamar Rolle

Walden Dissertations and Doctoral Studies

Strong, capable public service systems are essential to meeting society's needs, and perceptions of public-service performance indicate how people ultimately respond to and value public sector systems and performance. While the literature documented the perspectives of public service employees and citizens, and found that they generally believed that public service was inefficient and ineffective due to excessive bureaucracy, autocratic leadership, and political influence, little was known about the perspectives of other stakeholders who participate in or are affected by the public service performance process. The purpose of this generic qualitative study was to bridge the knowledge gap by gathering Bahamian …

Gender Disparities In The United States Federal Government Stem Leadership, Naomi Hirose-Gormally

Walden Dissertations and Doctoral Studies

Persistent gender disparities continue to limit women’s representation in senior science technology, engineering, and mathematics (STEM) leadership roles within the United States federal government, particularly at the GS‑13, GS‑14, GS‑15, and subject matter expert/senior executive service (SME/SES) levels. The purpose of this qualitative descriptive phenomenological study was to explore how women in senior STEM leadership experience and interpret gender disparities as they pursue and attain leadership positions. Data were collected through individual semi‑structured interviews with women serving in senior STEM leadership and analyzed inductively using phenomenological coding procedures to identify categories and themes that were grounded in participants’ lived experiences. …

Leadership Characteristics Driving Positive Patient Experience Outcomes In Behavioral Healthcare Organizations, Sophia Iovenitti

Walden Dissertations and Doctoral Studies

Patient experience is a key indicator of healthcare quality and performance; however, limited evidence exists regarding the specific leadership characteristics that influence patient experience outcomes in behavioral healthcare. The purpose of this qualitative case study was to explore the leadership characteristics associated with positive patient experience outcomes, examine how leadership behaviors influence patient perceptions, and identify leadership development strategies to enhance patient experience. The study was guided by the Baldrige excellence framework and the Beryl Institute’s definition of patient experience. Data were collected through semi structured interviews with executive and operational leaders and triangulated with organizational artifacts, including aggregated patient …

How Children Recognize Emotions: Familiarity, Emotional Information Processing, And Autism Spectrum Disorder, Katy Wagner Brooks

Electronic Theses and Dissertations

The ability to identify facial emotional cues is an important nonverbal communicative skill that may be impaired in individuals with Autism Spectrum Disorder (ASD), although prior research has produced inconsistent findings regarding the nature and extent of these impairments. The present study examined facial emotion recognition (FER) abilities in 105 children aged 3 to 8 years, including 32 children with ASD and 73 typically developing (TD) children. Relationships between FER performance and resting-state electroencephalographic (EEG) activity were explored in a smaller subsample. The study investigated effects of emotion type, facial familiarity, emotional intensity, and stimulus presentation format (dynamic versus static) …

Enhancement Of A Copolyester’S Impact Resistance Via Inorganic Reinforcement, David Felipe Gonzalez

Electronic Theses and Dissertations

Thermoplastic copolyester elastomers (TPEEs) are widely used in engineering applications because of their flexibility, toughness, and chemical resistance. However, prolonged exposure to marine environments can reduce their mechanical performance through moisture-induced degradation. This research investigated the use of titanium dioxide (TiO2) nanoparticles and APTES-functionalized TiO2 nanoparticles to improve the mechanical, thermal, and environmental durability of Hytrel 5556. Nanocomposites containing 1 wt.% and 2 wt.% TiO2 were fabricated through melt blending and compression molding. Mechanical properties were evaluated through tensile, compression, flexural, and impact testing, while thermal behavior was characterized using differential scanning calorimetry (DSC). Nanoparticle dispersion was examined using scanning …

A Graduate Recital In Voice, Morgan Horning-Griffin

Dissertations and Theses @ UNI

Artists have long been captivated by the myth of Ariadne. Her story is depicted in a multitude of musical settings, and in a range of genres dating back to the early seventeenth century. In addition, there are many dramatic works and visual art this legendary female has inspired. This leads one to question: what is it that creators and audiences alike continue to find so compelling about Ariadne? To understand this question, it is necessary to revisit the Ariadne myth. The story begins with the grotesque Minotaur, a monster trapped within a labyrinthine prison and appeased by offerings of Athenian …

Experiences Of Reproductive Health Care Practitioners In North Carolina After The Dobbs Decision, Arwyn Lapella

Walden Dissertations and Doctoral Studies

Since the Supreme Court of the United States made the decision to overturn Roe v. Wade, providing access to reproductive health care in the state of North Carolina has been a challenge for medical professionals. Findings from existing literature indicate that a lack of access to reproductive health care can have a negative impact on society from socioeconomics, food and home inequality, and other health care complications. The purpose of this study was to focus on the impacts that health care providers faced when providing care for those who live in the state of North Carolina since the Supreme Court’s …

The Use Of Breathing Meditation With Bipoc Trauma Survivors, Keerthi Sundaramurthy

Doctoral Dissertations

There is a growing body of evidence supporting the use of mindfulness-based practices to reduce psychological distress. Although interest in mindfulness-based care is growing, studies investigating virtual interventions for BIPOC trauma survivors remain limited. The goal of this study was to evaluate the effects of a breathing meditation intervention on mental health outcomes in a sample of trauma-exposed BIPOC adults, using a randomized post-test only design. Participants in the intervention group were asked to complete a 10-minute box breathing meditation daily for four weeks. Quantitative analyses revealed that those in the intervention group reported significantly lower symptoms of anxiety and …

Toward An Integrated Framework For Character Education: A Comparative Analysis Of Character.Org’S 11 Principles, The Jubilee Centre Character Education Framework For Schools, And Primed For Character Education, Liliana Borrero

Dissertations

Abstract

Character education is widely recognized as an essential component of schooling; however, it lacks a coherent framework that draws on the shared conceptual ground underlying the current dominant frameworks. This qualitative study systematically compared three influential character education frameworks: Character.org’s 11 Principles for Schools, the Jubilee Centre’s Framework for Character Education in Schools, and PRIMED for Character Education. The purpose of the study was to determine the extent to which these frameworks converge and diverge in their conceptualizations of effective character education and to assess the feasibility of integrating their cross-cutting elements into an integrated framework. Using thematic analysis …

Improving Antimicrobial Stewardship In Pediatric Acute Otitis Media Management In Urgent Care Settings, Madison Haines, Gina Crudden

Group: Nebraska Methodist College

Problem: Acute otitis media (AOM) is a leading cause of pediatric antibiotic prescribing in urgent care (UC) settings. Despite guidelines recommending watchful waiting, inappropriate prescribing persists, contributing to increased antimicrobial resistance and healthcare costs. This quality improvement project aimed to enhance antimicrobial stewardship through provider education and clinical decision-making support tools.

Intervention: Utilizing the Plan-Do-Study-Act framework, the 30-day intervention was implemented across Midwestern UC centers. The intervention involved asynchronous provider education focused on evidence-based prescribing, watchful waiting strategies, and caregiver communication.

Measures: Primary outcomes included provider confidence in implementing watchful waiting and perceived adherence to clinical guidelines, measured via pre- …

Increasing Patient Education On Obesity, Claire Maddux, Linda Hughes

Group: Nebraska Methodist College

Obesity is a prevalent and undertreated chronic disease associated with significant morbidity and mortality, yet patient education and engagement in treatment remain limited in primary care. This quality improvement project aimed to evaluate the effectiveness of a brief, theory-driven educational handout in improving patient knowledge, self-awareness, and readiness to engage in obesity-related care. The intervention was implemented in a Midwestern primary care clinic and targeted adult patients with a body mass index of 30 or greater. Participants were provided with an educational handout and completed pre- and post-handout tests assessing knowledge of obesity etiology, risks, and treatment options, as well …

Correctional Officers' Perceptions Of Inmate Suicide In Florida State Prisons, Chrishelle Robbins

Walden Dissertations and Doctoral Studies

Correctional officers are responsible for the care, custody, safety, and supervision of inmates within jails, prisons, and correctional institutions. They face many hardships within a prison setting including inmate suicides. The purpose of this qualitative study was to explore and understand the perceptions of Florida state correctional officers who have experienced inmate suicide firsthand. This study was formulated using the transcendental, descriptive phenomenology approach and addressed the study’s research questions. Participants included nine Florida state certified correctional officers who witnessed an inmate suicide. Participants were selected using purposive snowball sampling. Interviews were scheduled and conducted via ZOOM or by telephone …

Community Health Workers’ Experiences Distributing Harm Reduction Supplies During Covid-19 In The Barren River Area Development District, Angel Nichole Shoemake

Walden Dissertations and Doctoral Studies

Community health workers (CHWs) distributing sterile injecting equipment help reduce infectious disease transmission among people who inject drugs; however, limited research exists regarding their experiences delivering harm reduction services during public health emergencies in rural areas. The purpose of this qualitative study was to explore CHWs’ experiences and perceptions of health risks, operational barriers, and social influences affecting harm reduction service delivery during the COVID-19 pandemic in the Barren River Area Development District. The health belief model guided this study, emphasizing perceived susceptibility, severity, barriers, benefits, and self-efficacy. Data were collected through semistructured Zoom interviews with eight purposively sampled CHWs …

Seasonal Affective Disorder’S Prevalence And Impact On Organizational Outcomes In The Northeastern United States, Tommaso Bruce Fernandes

Walden Dissertations and Doctoral Studies

Seasonal affective disorder (SAD), a type of depression linked to seasonal changes, primarily affects individuals during fall and winter. More insight was needed on the prevalence of SAD and the role of social support in moderating its impact on organizational outcomes. The purpose of this study was to examine the relationships between SAD and organizational outcomes, including employee well-being, absenteeism, job satisfaction, and productivity, in the Northeastern United States, where SAD symptoms are more prevalent due to environmental factors. Engel’s biopsychosocial model and Cullen’s social support theory provided a theoretical framework for the study. A quantitative cross-sectional design, featuring structured …

Examining Hiv Testing In Black Americans In The Southern United States: Association Between Sexual Orientation, Gender Identity, Healthcare Access, And Hiv High-Risk Behaviors, Shavon Wolfe

Walden Dissertations and Doctoral Studies

Examining factors that affect HIV testing in the Black/African American population is important because socioeconomic hardship, stigma, and restricted access to healthcare all lead to gaps in early diagnosis and prevention treatment to prevent further spread of infection. However, most studies have focused on these factors separately, leaving less understanding of how they work together to influence HIV testing behavior. Guided by the health belief model, this study examined the relationship between sexual orientation, gender identity, healthcare access, and HIV high-risk behaviors. The study examined the relationship between sexual orientation, gender identity, healthcare access, and HIV testing, and the influence …

The Impact Of Super Political Action Committee Spending On Abortion Legislation In A Post-Dobbs Era, Jeni Atchley

Walden Dissertations and Doctoral Studies

Super political action committee (Super PAC) spending has become a prominent feature of U.S. elections, yet limited research had examined how independent expenditures related to electoral success in competitive U.S. House races and whether that relationship varied by candidates’ abortion policy positions in the post-Dobbs era. Prior research has shown that Super PAC independent expenditures expanded sharply after Citizens United and can influence candidate visibility in competitive races, yet findings on whether that spending translates into electoral success have been mixed, and few studies had examined it in relation to candidates' abortion positions after Dobbs. The purpose of this correlational …

A Reduced-Order Framework For Stochastic Criticality Estimation In Granular Energetic Materials, Philip T. Melton

LSU Master's Theses

Granular energetic materials (EMs) exhibit stochastic shock initiation because pore collapse, frictional dissipation, and localized thermal activation depend on microstructural descriptors that vary between nominally identical samples. Fully resolved mesoscale and atomistic calculations can represent these mechanisms, but their computational cost limits direct ensemble evaluation of microstructure-conditioned criticality thresholds. This thesis introduces a reduced-order framework for stochastic criticality estimation in granular EMs by coupling five explicitly defined model components: first, a one-dimensional steady compaction-shock model that maps initial solid volume fraction and shock pressure to a bulk mass-specific dissipated-work budget; second, an SEM/synthetic-image segmentation workflow that extracts pore area, perimeter, …

Sophisticated Song: Exploring The Evolution And Ontogeny Of Large Repertoires And Syntax Usage In The Bachman’S Sparrow (Peucaea Aestivalis), Heather Jean Wolverton

Electronic Theses and Dissertations

While humans have the most complex vocal communication system, many of the features that make human language so intricate can be found in other taxa. One building block of language commonly studied in animal communication is syntax, or the organization of vocalizations. Birds, wolves, and cetaceans all display complex vocal signaling that utilizes syntax. Understanding how syntax functions in different taxa can help illuminate the evolution and development of human language and the role it plays in social cognition. The Bachman’s sparrow (Peucaea aestivalis) is a species of songbird that utilizes syntax in the form of preferred transitions …

Scattered Light Noise At Ligo Livingston Observatory Induced By Microseismic Ground Motion, Debasmita Nandi

LSU Doctoral Dissertations

Gravitational waves are “ripples” in the fabric of spacetime and create a minuscule change in the distance between two points. After publishing his theory of general relativity in 1915, Albert Einstein predicted the existence of gravitational waves as a consequence of the theory. Almost 100 years after the theoretical prediction, gravitational waves were detected for the first time in 2015 by the Advanced LIGO detectors in Livingston, Louisiana, and Hanford, Washington. Gravitational waves have a very small amplitude, making it very challenging to detect them. Different types of noise sources either of instrumental or environmental origin can reduce the astrophysical …

Nurse Staffing Variation Viewed Through The Lens Of Institutional Isomorphism, Mara Raggi

Electronic Theses and Dissertations

Nurse staffing is strongly associated with organizational and patient quality outcomes. Existing studies have not adequately explained why nurse staffing levels vary across hospitals operating under similar external institutional isomorphic pressures. Secondary and administrative datasets, along with random-effects regression models, were used to analyze 6 years of data (2014-2019) and examine the relationship between institutional factors and hospital nurse staffing in the general acute care setting. The results indicate that coercive factors of state laws were significantly associated with nurse staffing. Staffing mandates and staffing committees were significantly associated with increases in nurse staffing, while public reporting was significantly associated …

Co-Designing Translanguaging-Informed Transformative Socioemotional Learning With Bilingual Kindergarten Teachers In Colombia, Catherine Restrepo-Widney

Electronic Theses and Dissertations

Emergent bilingual children enter early childhood classrooms with rich, dynamic linguistic repertoires that span languages, cultural practices, and ways of knowing. Socioemotional learning (SEL) often fails to meaningfully incorporate children’s linguistic and cultural repertoires, reflecting critiques that many SEL frameworks privilege individualistic, culturally narrow competencies that may marginalize learners from diverse backgrounds. This is particularly consequential in early childhood dual language bilingual education (DLBE), where children's heritage languages are central to authentic emotional connection and identity development, and where empirical models for culturally sustaining SEL remain limited. Through a participatory design research approach structured around iterative cycles of collaborative inquiry, …

A Chorus Of Voices: Student And Teacher Shared Dialogical Experiences And Insights, Jennifer Anne Reynolds

Theses and Dissertations

Dialogue is inherently tied to learning, but as a secondary English Language Arts (ELA) classroom teacher it can be difficult to facilitate classroom dialogue that provides authentic learning opportunities for every student. I wanted to learn more about the student experience, so I implemented an action research study to increase my understanding of how students learn through dialogue. My research question was: How does collaborative languaging, to facilitate student-teacher interaction, lead to improved classroom mediation, authentic learning, dialogue, and development? I conducted transformative action research in my classroom, focusing on students enrolled in my general English 10 classes. In an …

The Effects Of Social Impact Mentoring On Women Seeking Employment, Adriano Santos Carneiro

Theses and Dissertations

Women seeking employment often face barriers such as limited professional networks, reduced access to career guidance, and lack of consistent support during the job-search process. This study examined the effects of a social impact mentoring program that connected women seeking employment with women professionals who served as mentors. Participants included 11 mentees who were seeking employment opportunities and 11 mentors who were employed or recently employed in professional roles. Using a mixed-methods pre-post design, the study collected quantitative survey data and open-ended responses before and after four virtual mentoring sessions. Mentee measures focused on confidence in securing employment and readiness …

The Primary Care Brief Intervention Competency Assessment Tool (Bi-Cat): Examining Reliability And Validity, Arielle Guillod

Dissertations

Within primary care, the Primary Care Behavioral Health (PCBH) model integrates behavioral health services into medical settings through brief, population‑based interventions delivered by behavioral health consultants (BHCs). Although effective performance in this role requires competencies distinct from traditional mental health practice, few psychometrically sound tools exist to assess clinical skills in primary care. The Brief Intervention Competency Assessment Tool (BICAT) is commonly used for this purpose but lacks published evidence supporting its reliability and validity. This dissertation examined the psychometric properties of the BICAT across two studies. Study 1 evaluated factor structure, internal consistency, and construct validity in a heterogeneous …