Digital Commons Network^™

A Systems Approach To Moral Distress In Long Term Care, Margaret Lemley

Electronic Theses and Dissertations

Abstract: The question that this dissertation seeks to answer is whether or not a Systems Approach to Moral Distress can serve to positively address issues of moral distress within the Long-Term Care setting. Because moral distress has largely been understood as a phenomenon of the individual, efforts to address and reduce incidents of moral distress have focused almost entirely on the individual and his or her reaction to specific triggers. Building upon the existing literature this dissertation argues that previous efforts to understand moral distress within the healthcare setting have been limiting in two very important aspects. The first …

Burden Of Illness And Pharmacoeconomic Evaluation Of Lumacaftor/Ivacaftor In Cystic Fibrosis, Pratyusha Vadagam

Electronic Theses and Dissertations

Objectives: (1) To estimate the burden of illness in cystic fibrosis (CF) using 2010-2014 Medical Expenditure Panel Survey (MEPS) data, and (2) to conduct a pharmacoeconomic evaluation of lumacaftor/ivacaftor in the treatment of CF.

Methods: The study was conducted in two parts. Part 1 involved a retrospective analysis using individuals in MEPS database with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of 277.00 for a principal diagnosis of CF. Dependent variables were cumulative and out-of-pocket (OOP) expenditures and independent variables included patient demographics and clinical characteristics. Unweighted and weighted estimates of expenditure in CF group, …

A Phenomenological Investigation Of Sport And Fandom Through Hans-Georg Gadamer And Maurice Merleau-Ponty, Alexander Regina

Electronic Theses and Dissertations

This project aims to uncover the phenomenological and communicative roots of sport fandom from the fan perspective, taking into account the many ways in which fans come to contact sport and integrate corresponding experiences into their own lives and sense of being in the world. Hans-Georg Gadamer and Maurice Merleau-Ponty are used to understand the conventions of play that manifest in sport, leading not only to the co-creation of the game experience due to the intertwining of spectators and players but also to the interplay of temporal realms that leads to what Gadamer calls the fusion of horizons. Through …

Primate Proteomic Composition Of Seminal Plasma And Prostate-Specific Transglutaminase Activity In Relation To Sexual Selection., Amanda M.C. Zielen

Electronic Theses and Dissertations

Humans (Homo sapiens), chimpanzees (Pan troglodytes), and gorillas (Gorilla gorilla) have diverse mating systems with varying levels of sperm competition. Several seminal plasma genes have been claimed to evolve under positive selection, while others are altered or lost. This study aims to identify biologically relevant differences among seminal plasma proteomes of primates in relation to mating systems and previous genomic studies. Seminal plasma from three individuals of each species were run in triplicate in shotgun liquid chromatography – tandem mass spectrometry (LC-MS/MS) and confirmed with Western blots. Over 7,000 peptides were identified across all …

Molecular Analysis Of The Mating System Of A Population Of Fantail Darter (Etheostoma Flabellare) In Bates Fork, Greene Co., Pa, Ashley Seitz

Electronic Theses and Dissertations

In May 2013, we examined the mating system of the Fantail Darter, Etheostoma flabellare, from a population inhabiting Bates Fork, a small tributary of the Monongahela River in Greene County, PA. Guarding adult male Fantail Darters excavate an area under a flat rock in moderately flowing rifles. Females select a male or his territory and deposit clusters of eggs on the underside of the nest rock. The guarding male provides all parental care. The locations of 23 nests were mapped over a 139m² stream segment before collecting embryos and attending males for a genetic parentage analysis. DNA was …

“Forming Ranks”: The Impact Of Negative-Destructive Leadership In The Aftermath Of Military Sexual Assault And Reporting, Jessica Payton

Electronic Theses and Dissertations

Military leaders play central roles in responding to sexual assault in the military social ecology, yet their impacts on victims’ post-assault and reporting experiences remain understudied. Using standpoint epistemology and a military-specific social ecological approach, this two-stage project investigated how military leaders impacted survivors’ post-assault and reporting experiences, as well as their experiences with military peers, community resources, and justice and separation processes. Data were gathered through an initial focus group with eight subject matter experts in advocacy, legal work, and policy reform, followed by subsequent in-depth individual interviews with eight female survivors of military sexual assault, seven of whom …

Hospitality In Communication: Applying The Rule Of Saint Benedict To The Home, Karen Fetter

Electronic Theses and Dissertations

Hospitality is a tradition that has been immersed into all cultures for thousands of years. Philosophically and religiously, it has roots among ancient philosophers and in the Bible. Before the modern technologies and development of the tourism industry, hospitality was found in churches and monasteries. The reciprocal relationship between the host and the stranger give metaphorical meanings to life in general because it is how we treat each other that forms the moral balance in society and gives the human person what is necessary for a healthy and full life. St. Benedict was a man who experienced the benefits of …

An Organizational Ethics Framework To Balance Individual Privacy And Population Interests Regarding Genetic Technologies, Christine Trani

Electronic Theses and Dissertations

The American culture holds the right to privacy as one of the most esteemed rights for individuals. As such, the culture adamantly defends the right to privacy to ensure individuals have the opportunity to live freely. In the American healthcare system, the right to privacy is critical for individual autonomy. However, genetic science has pushed this boundary as it emphasizes the interdependency between individual and population health. Genetic technologies for healthcare have been increasing at an exponential rate since the early 2000s. Their implantation into clinical care has been a slower process due to ethical dilemmas. Specifically, ethical dilemmas revolve …

Improving The Practice And Culture Of Early Learning In Ohio, Diana Morello-Deserio

Electronic Theses and Dissertations

How can preschool programs situated in public schools “get better at getting better?” This dissertation suggests a framework based on the principles of Improvement Science as one-way school districts can include preschool in their continuous improvement efforts. Document Analysis, is the method used to examine a continuous improvement protocol used in Ohio school districts known as The Ohio Improvement Process (The OIP Guide was the document analyzed). Additionally, Portraiture as “lived” experiences including both early learning educators and traditional school age leaders were reflected upon. The following research questions guided the study: What are the key operational components of the …

Mammography Utilization In African American Women, April D. Kidd

Electronic Theses and Dissertations

Purpose: Breast cancer presents differently among women causing breast cancer health disparities with women of color disproportionally shouldering later-stage screening, incidence, and treatment, and greater mortality. This study assessed 10 predictors and rates of recent and long-term mammography utilization for women 43-79 years of age to better understand differences among age strata and races. This was the first study to use both the calculated Gail Risk scores (calculates absolute breast cancer risk over time intervals) from the 2010 National Health Interview Survey (NHIS) and a temporary homelessness variable in predicting mammography utilization using national-level data.

Theoretical Framework: A modified Behavioral …

The Normative Approach Of The Catholic Tradition In The Ethical And Religious Directives For Resolving Ethical Dilemmas Regarding Medical Technology, David G. Garvis

Electronic Theses and Dissertations

The dissertation engages the Catholic Tradition enunciated in the Ethical and Religious Directives for Catholic Health Care Services to provide a normative approach for resolving ethical dilemmas regarding pivotal breakthroughs in medical technology.

This normative ethical approach has two components: a normative framework for Catholic health care ethics that adopts practical ethical principles as enunciated in the Ethical and Religious Directives (Chapter 2) and secular decision-making models in organizational and clinical ethics that are consistent with the Catholic Tradition (Chapter 3).

At the end of the theoretical analysis in these chapters, the conclusion to Chapter 3 explains how this normative …

Clients' Experiences Of Recovery-Oriented Care For Schizophrenia: A Qualitative Research Study, Sarah A. Hamilton

Electronic Theses and Dissertations

A recovery model of care has been widely accepted and instituted both in the U.S. and internationally, but research suggests that the model has not been employed uniformly. While existing research has focused on creating consensus regarding application of the model, the lived experience of those receiving the care has not yet been considered. In order to address this gap, the present study proposed a qualitative analysis of mental health consumers’ experiences of recovery-oriented care for schizophrenia. Potential participants were recruited through a Regional Mental Health Board and the author individually interviewed four participants in semi-structured interviews. A qualitative analysis …

Modeling The Binding Of Neurotransmitter Transporter Inhibitors With Molecular Dynamics And Free Energy Calculations, Bernandie Jean

Electronic Theses and Dissertations

The monoamine transporter (MAT) proteins responsible for the reuptake of the neurotransmitter substrates, dopamine, serotonin, and norepinephrine, are drug targets for the treatment of psychiatric disorders including depression, anxiety, and attention deficit hyperactivity disorder. Small molecules that inhibit these proteins can serve as useful therapeutic agents. However, some dopamine transporter (DAT) inhibitors, such as cocaine and methamphetamine, are highly addictive and abusable. Efforts have been made to develop small molecules that will inhibit the transporters and elucidate specific binding site interactions. This work provides knowledge of molecular interactions associated with MAT inhibitors by offering an atomistic perspective that can guide …

Retention And Attrition In Bariatric Surgery Research: A Qualitative Study, William F. Gourash

Electronic Theses and Dissertations

Problem: Longitudinal bariatric surgical research studies often lack information on retention and attrition of study participants and the strategies utilized to optimize these. The potential for attrition bias with adverse effects on validity, reliability, and generalizability increases over time. The many factors potentially affecting retention and attrition in research, have been under studied.

Purpose: The purpose was to explore factors affecting research participation of bariatric surgical patients who are subjects in the Longitudinal Assessment of Bariatric Surgery (LABS) study. The research questions explored research participants’ perceptions, motivations, and attitudes concerning participation in the study, specifically participation in annual in-person visits …

Parents Of Children Who Had Hypoxic-Ischemic Encephalopathy: A Mixed-Methods, Exploratory Study, Natalene Kramer

Electronic Theses and Dissertations

Background: There is scant literature addressing the parents of children who had hypoxic-ischemic encephalopathy (HIE). therefore only inferences may be made as to issues of that experience affecting parents.

Purpose: The purposes of this study was to uncover the lived experiences of parents of children who had HIE, evaluate issues of stress, depression, coping, and impact of neurologic disability in order to better care for them and thus their families

Methods: A parallel, convergent mixed-methods design was used to explore experiences and perceptions of these parents regarding their experiences and life changes. The quantitative strand addressed four research questions which …

Outsourcing Our Memory 2.0: Using Walter Ong's Orality/Literacy Studies To Recognize Technologies Effects On Memory, Rishi Raj Bahl

Electronic Theses and Dissertations

At the heart of media ecology is the principle that technology not only deeply influences society, but also controls most aspects of daily life. Additionally, media ecology investigates how media and communication processes profoundly affect human perception and understanding. The pervasive role that technology plays in modern life today has exacerbated the results of technology on human beings. Some of these outcomes are not desirable and may be a hindrance to the progress of our society. This dissertation takes particular interest in the multifaceted consequences that the overuse of technology imposes on our ability to fully utilize our memory.

In …

An Ethical Framework For Global Governance For Health Research, Kiarash Aramesh

Electronic Theses and Dissertations

Global Governance is the way by which various affairs of human social life at the global scale are governed in the absence of a global governance. This field is composed of complex networks of role players. Global Health Governance is a branch of Global Governance that governs the health-related affairs. An important branch of this huge complex of networks that has not been analyzed sufficiently in the scholarly literature yet is Global Governance for Health Research. Global health research, although it is a part of global health affairs, has its own features and conditions that bring about its specific issues …

A Cacrep-Informed Counselor Educator Developmental Model: Identifying Counselor Skills And Supports Needed For Neophyte Counselor Educators, Ryan Bowers

Electronic Theses and Dissertations

The field of counseling has been undergoing radical change for the past 40 years as it changes with the demands of the population and as new problems arise with changes in societal needs. Groups such as the Council for Accreditation of Counseling and Related Educational Programs are working to create a program of counselor education that is singular and comprehensive to meet the needs of these changes. This mixed-methods study explored skills and supports that are needed to help counseling education students become effective future counselor educators. The researcher introduces a model of counselor educator development that will help to …

My Do Over: A Case Study Of An Intentional Focus On Relationship Building, By The School Leadership, In A Newly Formed School, Jean Marie Livingston

Electronic Theses and Dissertations

The closing of public schools is occurring each school year in cities across the country. This case study will look at one public school that endured the closure of three school buildings and the reconfiguration of the entire school district during the 2015-2016 school year. The main focus of this case study was on one building in this district and the question to be answered was, “Does an intentional focus on relationship building, by the school leadership, influence school culture and instructional practice in a newly formed school?” The literature will discuss school closures and the impact on stakeholders, grief …

The Ethics Of Futility Across The Age Continuum, Katherine D. Mccord

Electronic Theses and Dissertations

Much has been written on the topic of medical futility with reports of its existence dating back to the time of Hippocrates. However, the majority of the research on the topic has been on the adult population. Very little literature addresses the presence of medically futile treatment across the age continuum identifying issues that impact neonates, pediatrics, as well as adults.

This dissertation addresses the gap in the literature by considering the ethical problem of medical futility across the age continuum. By addressing the common thread of futility, there is an imperative for a call to action that encompasses the …

Counselor Education Unplugged? An Exploration Of Current Attitudes Surrounding The Use Of Online Learning As A Modality In Graduate Counselor Education, Eric James Perry

Electronic Theses and Dissertations

This dissertation qualitatively investigates counselor education faculty perceptions regarding online courses or programs and the overall perception of counselor education faculty regarding the effectiveness of online learning. A total of 154 counselor educators completed the CEATOLS instrument, a survey designed to capture demographic information, perceptions of effectiveness of online learning in counselor education, and concerns related to online learning in counselor education. Results indicate that, overall, counselor educators have a markedly lower perception of the effectiveness of online counselor education courses than of traditional Analysis of the concerns expressed by counselor educators reveal a five-factor structure similar to that which …

Revamping The United States Organ Donation System: An Ethical Justification For Compensated Live Organ Donation, Jordan Potter

Electronic Theses and Dissertations

With over 100,000 Americans currently on organ waiting lists in the United States, the mass shortage of viable organs for transplantation is one of the most pressing healthcare issues that we face as a country today. Thousands of these individuals on organ waiting lists will ultimately die waiting on an organ transplant that will never come. Many differing proposals have been discussed with the aim of increasing organ donation rates and the raw number of organs available for transplant, including changing our default consent status for cadaveric organ donation and the option of incentivizing organ donation by compensating live donors …

Exiles On Main Street: A Pedagogy Of Popular Music Through Technology And Aesthetic Education, Jordan Mroziak

Electronic Theses and Dissertations

This dissertation investigates the application of instructional technology within the specific context of popular music education. Synthesizing the work of Mishra & Koehler (2006) and Bauer (2014), this dissertation operationalizes a broader, more contemporary definition of instructional technology that goes beyond the traditional conception of mere instructional tool towards one that is more protean, unstable, and opaque. Research questions about technology’s impact on music education are central to this curriculum study and evolve into considerations on how the relationship of popular music and instructional technology shape a pedagogy for popular music education. Making use of principles rooted in aesthetic education, …

How Can The Use Of Human Enhancement (He) Technologies In The Military Be Ethically Assessed?, Philip Andrew Taraska

Electronic Theses and Dissertations

War is a terrible price to pay for the prospect of peace. Yet every nation has a moral obligation to protect its citizenry from unjust aggression and threats to security. To be sure, war is always a failure. It is a failure of mankind to come together in mutual respect for the inherent dignity of the human person. The issue of the use of HE in the military is relevant today because the Global War on Terror (GWOT) and the rapid rise of emerging technologies have led to a never-before-seen type of asymmetrical warfare. The rise of these technologies can …

Truth Telling Beyond Borders: An African Perspective, John Twinomujuni

Electronic Theses and Dissertations

The dissertation focuses on answering the question of how can patient’s autonomy, privacy and liberty be safeguarded especially within cultures that do not regard them as primordial principles? In some communities, truth-telling is one of the moral principles unquestioningly inherited from the West. The dissertation will try to compare African and Western perspectives. The African perspective has been chosen to explore through this search hoping that such venture would help in showing how the issue of truth-telling may be approached from such perspective. For instance in the African communalism based on the cardinal point that “I am because we are; …

Development Of Binary Composite Solid Microparticles For Improved Intranasal Absorption Of Low Permeation Drug Molecules, Dipy Madhukar Vasa

Electronic Theses and Dissertations

The objective of this work was to introduce a novel formulation strategy for intranasal delivery of two low permeation candidates: levodopa (L-DOPA; antiparkinsonism drug) and ribavirin (RBVN; an antiviral drug). The central hypothesis states that preparation of binary composite microparticles with Pluronic® triblock copolymers (polyethylene glycol-polypropylene glycol-polyethylene glycol) should allow increased drug transport across nasal mucosal tissue relative to drug alone. Testing the hypothesis necessitated execution of specific aims directed to addressing issues inherent to the proposed approach. The work herein is presented with respect to two separate subjects: (1) material understanding and (2) formulation development. In the first two …

Race, Retreat, And Refuge: Black Voices, American Nature Writing, And Ecocritical Exile, Bryon Patrick Williams

Electronic Theses and Dissertations

While existing scholarship has begun to recognize the extensive environmental experience of African Americans during the nineteenth century, black-authored environmental writing from the era is conspicuously scant in studies and anthologies into the present, even in volumes devoted to ecocritically-inflected texts by authors of color. My dissertation argues that contemporary, racially-aligned divides and gaps in environmental discourse have roots in the 1840s and 50s, when the nature writing genre coalesced into its most enduring form in the works of Henry David Thoreau, literary artist turned cultural icon. This key era—during which black Americans were frequently subject to systematic deprivation of …

The Experiences Of Registered Nurses Injured By Interpersonal Violence While On Duty In An Emergency Department, Salena Wright-Brown

Electronic Theses and Dissertations

Numerous studies and reports identify the concerning incidence of work place violence directed toward healthcare workers (Centers for Disease Control, 2013; Gerberich et al., 2004; Government Accountability Office, 2016; U.S. Department of Labor, 2016). Despite efforts over the past few years to reduce workplace violence in healthcare facilities and specifically in emergency departments, the incidence of violence has not substantially lessened (Government Accountability Office, 2016). In March, 2016, the Government Accountability Office (GAO) released a report that was prepared by congressional request. The GAO found that workers in in-patient healthcare facilities experienced work-place violence that resulted in lost time from …

Cultural Care And Inviting Practices: Building Relationships In An Urban Elementary School. Teacher Perspectives In Forming Positive Teacher-Student Relationships Based On Care And Equity, Eva J. Allen

Electronic Theses and Dissertations

This dissertation in practice investigates teacher perceptions of the influence of cultural care and invitational education (IE) on the formation of a positive teacher-student relationship with students of color in an urban elementary school. Cultural care is a theory of practice that utilizes a social-emotional approach for school improvement and to promote positive student outcomes. It is defined as a verbal or nonverbal gesture that displays a genuine interest in another person’s social, emotional, mental, and physical well-being; simultaneously recognizing and acknowledging race and culture as a vital part of a person’s identity. Cultural care must include respecting, valuing, and …

Trauma And Aggression In Juvenile Offenders, Cassandra M. Berbary

Electronic Theses and Dissertations

Indirect aggression has been found to be more common among females than males and may be an unconsidered contribution to aggression shown in delinquent girls. Although there are no research studies to date that have investigated the link between relational aggression and law violations, there are some studies that have considered indirect and overt aggression in females; however, this research has been largely inconclusive. An additional obstacle for offenders is the presence of previous traumas, which has been closely linked to both overt and indirect aggression. Although both males and females in the juvenile justice system are likely to have …