Digital Commons Network^™

Evaluation Of A Nursing-Led Telephonic Self-Management Program For Patients With Copd On Health Care Utilization, Esther Pavlovsky

Yale School of Nursing Digital Theses

In 2010, it was estimated that the U.S. spent approximately $50 billion to treat chronic obstructive pulmonary disease (COPD). Nurse-driven interventions are essential in value-based care. The purpose of this quality improvement (QI) project is to reduce the number of preventable COPD-related admissions and emergency department (ER) visits by implementing a telephonic nurse-led evidence-based COPD self-management program. A 50-patient pilot has been initiated. A pre-and-post test will be used to evaluate the effect on preventable hospitalizations and ER visits. If the outcomes of the program are unfavorable, a root cause analysis will be conducted to obtain nursing feedback on perceived …

Preventing Recurrent Falls In Elderly Home Bound Health Plan Members, Debra Sylvester

Yale School of Nursing Digital Theses

Falls have become a major public health concern. As the population ages, the prevalence of falls among older adults continues to increase, as does mortality and morbidity. Evidence-based assessment and intervention tools are widely available, though in practice, providers experience challenges utilizing them. Homebound older adults are at particular risk since they have mobility and transportation barriers that prevent access to community fall screening and primary care sites. This project focused on the provision of fall assessment, interventions, and coordination of fall-prevention services for community-dwelling, homebound older adults covered by a managed health plan. A standardized fall assessment and intervention …

Designed And Biologically Active Protein Lattices, Shih-Ting Wang, Brian Minevich, Jianfang Liu, Honghu Zhang, Dmytro Nykypanchuk, James Byrnes, Wu Liu, Lev Bershadsky, Qun Liu, Tong Wang, Gang Ren, Oleg Gang

Advanced Science Research Center

Versatile methods to organize proteins in space are required to enable complex biomaterials, engineered biomolecular scaffolds, cell-free biology, and hybrid nanoscale systems. Here, we demonstrate how the tailored encapsulation of proteins in DNA-based voxels can be combined with programmable assembly that directs these voxels into biologically functional protein arrays with prescribed and ordered two-dimensional (2D) and three-dimensional (3D) organizations. We apply the presented concept to ferritin, an iron storage protein, and its iron-free analog, apoferritin, in order to form single-layers, double-layers, as well as several types of 3D protein lattices. Our study demonstrates that internal voxel design and intervoxel encoding …

Breakdown Of Universal Scaling For Nanometer-Sized Bubbles In Graphene, Renan Villarreal, Pin-Cheng Lin, Fahim Faraji, Nasim Hassani, Harsh Bana, Zviadi Zarkua, Maya N. Nair, Hung-Chieh Tsai, Manuel Auge, Felix Junge, Hans C. Hofsaess, Stefan De Gendt, Steven De Feyter, Steven Brems, E. Harriet Åhlgren, Erik C. Neyts, Lucian Covaci, FrançOis M. Peeters, Mehdi Neek-Amal, Lino M. C. Pereira

Advanced Science Research Center

We report the formation of nanobubbles on graphene with a radius of the order of 1 nm, using ultralow energy implantation of noble gas ions (He, Ne, Ar) into graphene grown on a Pt(111) surface. We show that the universal scaling of the aspect ratio, which has previously been established for larger bubbles, breaks down when the bubble radius approaches 1 nm, resulting in much larger aspect ratios. Moreover, we observe that the bubble stability and aspect ratio depend on the substrate onto which the graphene is grown (bubbles are stable for Pt but not for Cu) and trapped element. …

Interpretive Entrepreneurs, Melissa J. Durkee

Scholarly Works

Private actors interpret legal norms, a phenomenon I call "interpretive entrepreneurship." The phenomenon is particularly significant in the international context, where many disputes are not subject to judicial resolution and there is no official system of precedent. Interpretation can affect the meaning of laws over time. For this reason, it can be a form of "post hoc" international lawmaking, worth studying alongside other forms of international lobbying and norm entrepreneurship by private actors. The Article identifies and describes the phenomenon through a series of case studies that show how, why, and by whom it unfolds. The examples focus on entrepreneurial …

Originalism From The Soft Southern Strategy To The New Right: The Constitutional Politics Of Sam Ervin Jr, Logan E. Sawyer Iii

Scholarly Works

Although originalism’s emergence as an important theory of constitutional interpretation is usually attributed to efforts by the Reagan administration, the role the theory played in the South’s determined resistance to civil rights legislation in the 1960s actually helped create the Reagan coalition in the first place. North Carolina Senator Sam Ervin Jr., the constitutional theorist of the Southern Caucus, developed and deployed originalism because he saw its potential to stymie civil rights legislation and stabilize a Democratic coalition under significant stress. Ervin failed in those efforts, but his turn to originalism had lasting effects. The theory helped Ervin and other …

One Child Town: The Health Care Exceptionalism Case Against Agglomeration Economies, Elizabeth Weeks

Scholarly Works

This Article offers an extended rebuttal to the suggestion to move residents away from dying communities to places with greater economic promise. Rural America, arguably, is one of those dying places. A host of strategies aim to shore up those communities and make them more economically viable. But one might ask, “Why bother?” In similar vein, David Schleicher’s provocative 2017 Yale Law Journal article, Stuck! The Law and Economics of Residential Stagnation urged dismantling a host of state and local government laws operating as barriers to migration by Americans from failing economies to robust agglomeration economies. But Schleicher said little …

The Settlement Trap, Lindsey Simon

Scholarly Works

Mass tort victims often wait years for resolution of their personal injury claims, but many who successfully navigate this arduous process will not receive a single dollar of their settlement award. According to applicable bankruptcy and state law, settlement payments may be an asset of the estate that the trustee, exercising its significant authority, administers and distributes to creditors instead of a claimant who had filed for bankruptcy. This distribution power maximizes repayment, a critical counterbalance to the robust protections and benefits that debtors receive in bankruptcy.

Setting aside the perceived unfairness of taking desperately needed money from tort victims, …

The Relationship Between Sexual Orientation Outness, Heterosexism, Emotion Dysregulation, And Alcohol Use Among Lesbian, Gay, And Bisexual Emerging Adults, Lillianne Villarreal, Ruby Charak, Rachel M. Schmitz, Claire Hsieh, Julian D. Ford

Psychological Science Faculty Publications

Introduction

Research demonstrates that both proximal personal characteristics (e.g., outness, emotion dysregulation) and distal stressors (e.g., heterosexism) may be associated with harmful alcohol use among lesbian, gay, and bisexual (LGB) individuals. No study has systematically examined the factors linking LGB identity outness to harmful alcohol use. The current cross-sectional study bridges this gap by testing a sequential mediation model wherein heterosexist experiences (HE) and emotion dysregulation (ER) were hypothesized to mediate the relationship between outness and alcohol use.

Method

Participants were 264 LGB emerging adults in the age range of 18-29 years (M/SD = 25.46/2.74; 16.7% lesbian, 23.1% gay, …

State Of The University Annual Report - 2020-2021, Office Of The President, East Tennessee State University, University Marketing And Communication, East Tennessee State University

Office of the President State of the University Annual Report

No abstract provided.

Optimization And Assessment Of Phytoplankton Size Class Algorithms For Ocean Color Data On The Northeast U.S. Continental Shelf, Kyle J. Turner, Colleen B. Mouw, Kimberly J.W. Hyde, Ryan Morse, Audrey B. Ciochetto

Graduate School of Oceanography Faculty Publications

The size structure of phytoplankton communities influences important ecological and biogeochemical processes, including the transfer of energy through marine food webs. A variety of algorithms have been developed to estimate phytoplankton size classes (PSCs) from satellite ocean color data. However, many of these algorithms were developed for application to the global ocean, and their performance in more productive, optically complex coastal and continental shelf regions warrants evaluation. In this study, several existing PSC models were applied in the Northeast U.S. continental shelf (NES) region and compared with in situ PSC estimates derived from a local HPLC pigment data set. The …

On The Road To Translanguaging In A Dual Language Classroom: Teaching Math And Science In Mandarin And English, Xiaodi Zhou

Bilingual and Literacy Studies Faculty Publications

This article examines the evolving instructional practice of one Chinese dual language instructor in the US as she employs a translanguaging-inspired approach in her math and science Mandarin medium classes. Contrary to the school language allocation policy requiring 90% Mandarin in her Chinese classes, she encourages the utilization of English as well as Mandarin in her instruction. This offers comprehensible input to learners, also making possible greater student participation. Findings from observations and interviews reveal how a focus on meaning-making in instruction resulted in the gradual evolution of bilingual language use and effective communication of content by students and the …

Strategies And Barriers To Work Behavior Changes: Perceptions Of Prevocational Rehabilitation Professionals, Yuleinys A. Castillo, Kathryn Rinehart, Jerome Fischer, William Weber

School of Rehabilitation Services & Counseling Faculty Publications

Adequate work behavior can increase job retention and job satisfaction for employees with disabilities. Employment modification strategies are practicable tools to address challenging work behavior negatively affecting employment of individuals with disabilities in rural areas. The purpose of this study was to conduct a phenomenological qualitative study of prevocational rehabilitation professionals in a focus group concerning rehabilitation services and training needs for rural vocational services for people with disabilities. Three themes emerged: (a) strategies to improve employment retention; (b) strategies to develop employment skills; and (c) barriers to the implementation of strategies provided. Results also suggested that training rehabilitation programs …

The Effect Of The Vocabulary Spelling City App On Student Performance In Spelling, Vocabulary, And Reading Comprehension In Grades 5-8 At Glenview Adventist Academy, Fernando Oleynick Lista

Dissertations

Problem and Purpose

Students in fifth through eighth grades at Glenview Adventist Academy (GAA) presented difficulties in the subjects of spelling, vocabulary and reading comprehension. The school had not followed the previous 10-year trend of technology implementation in the classroom, in spite of conclusive research on its advantages. This study was conducted to determine to what extent teaching methodology and the use of technology could affect academic performance in the areas of spelling, vocabulary, and reading comprehension. Research on the implementation of software and the use of tablets (iPad Minis) in the classroom has been scarce and contradictory in the …

Marketing Adventist Higher Education In North America : College Choice - Motivators And Barriers, George Charles Dart Jr.

Dissertations

Purpose/Problem

It is estimated more than 75% of Seventh-day Adventist (SDA) college-bound students (rising freshmen) who live in the North American Division (NAD) do not attend an SDA college/university. This is a major challenge for the NAD colleges/universities. Discovering motivators and barriers for SDA college-bound students is vital in understanding what influences this population in their college choice selection.

Method

This is a quantitative, cross-sectional, comparative study. An electronic survey using Qualtrics was sent to over 14,000 students with 461 respondents as the sample size. Respondents were sorted into four study groups, using the type of high school attended and …

How Faculty And Student Preferences For Active And Traditional Instructional Methods Relate To Their Beliefs, Quantity, And Quality Of Experiences, Knowledge Of The Benefits, And Professional Training, Tammy R. Shilling

Dissertations

Purpose

The complexity of preparing students for clinical practice and the mitigating factors that influence pedagogical preferences impact the current realities of health professional education. The purpose of this quantitative, correlational study is to explain the relationships between faculty preferences and student preferences for active over traditional methods and their beliefs, the frequency and positiveness of their experiences, and the amount and extent of the knowledge or training they have had regarding active and traditional teaching methods. Results may further inform and refine health professional education infrastructure changes to support faculty in pedagogical change as they prepare students with the …

Healthcare Leadership In The Context Of Cognitive Diseases Of Aging: A Community-Based Participatory Research Model, Dean Sherzai

Dissertations

The Problem

The world is facing a tsunami of chronic diseases of the brain such as dementia, Parkinson's, and stroke. But all populations are not affected equally. Though we are all at greater risk of developing these diseases, minority communities such as the Black and Hispanic populations are at much greater risk of succumbing to these conditions. To date we have spent billions of dollars on research and public health measures that have repeatedly failed, but over the last decade it has become evident that much of these diseases can simply be averted through effective public health and community-based measures …

Servqual Measurement In A Healthcare Setting: Before And After Corrective Strategy Implementation, Jerome Christia, Aaron Ard, Lorraine Runion

Atlantic Marketing Journal

In the United States, the most dominant industry is services, yielding the highest volume of total employment and gross domestic product. Due to this insight, academics and business professionals continue to research and apply strategies to achieve distinctive competitive advantages in the services arena. The steady growth and increasing significance of the service sector in the United States and other developed markets has resulted in a sizeable body of related research addressing a variety of issues such as service quality and its characteristics. Healthcare is an impactful service industry that has received a considerable amount of attention. In the healthcare …

Hello, Are You There? Creating And Measuring Online Student Engagement, Kirsten Passyn

Atlantic Marketing Journal

Engaging students in an online environment is frustrating for faculty and a concern of administration. Faculty and students report lower levels of satisfaction and lower engagement in online versus face to face learning. Dropout rates in fully online courses are often two times higher than face to face courses. This research attempted to engage online students by embedding a gamification-based scavenger hunt in an online course. Engagement was measured using a combination of quantitative and qualitative measurements. Although the scavenger hunt didn't significantly engage low performing students, it did motivate and deepen top-performing students' engagement. Interestingly, qualitative-based engagement measures proved …

Resilience In Nicaragua: Preliminary Factor Analysis And Validation Of The Cyrm-28, Kelly B.T. Chang, B. Cameron Stumpf

Faculty Publications - Psychology Department

Objectives: The current study used factor analytic techniques to examine the performance of the Child and Youth Resilience Measure (CYRM-28) in Nicaragua.

Methods: Nicaraguan youth from Managua, León, Chinandega, and Granada (n = 2,764) completed the CYRM-28 and the Personal Wellbeing Index (PWI-A). The CYRM-28 and PWI-A are self-report measures that were translated into Spanish in previous studies.

Results: A confirmatory factor analysis on the CYRM-28 did not support the eight-factor model from previous research. An exploratory factor analysis yielded a six-factor model: Social Belonging, Cultural Context, Caregiver Context, Social Skills, Spiritual Context, and Responsibility. Seven items …

An Analysis And Comparison Of The Missional Doctrine Hermeneutics Of Kevin J. Vanhoozer And Veli-Matti KäRkkäInen, With Emphasis On Their Notions Of God, Eschatology, And Mission, Elmer Arrais Guzman

Dissertations

This dissertation analyzes Veli-Matti Kärkkäinen’s and Kevin J. Vanhoozer’s theological method, in order to understand its structural elements, and thereby to facilitate comprehension of their missional doctrinal hermeneutics, and the ramifications of those hermeneutics for the construction and development of Christian theology. Missional doctrinal hermeneutical models conceive the missional dimension of doctrine in various ways. Some privilege the maintenance of theological identity cohering with the foundational sources of theological authority. Others privilege theological constructions that assimilate the context and the missional situational framework of understanding. This dissertation strives to examine the diverging missional hermeneutics of Kärkkäinen and Vanhoozer, the foundational …

Aerosol Spacers With Asthma Inhalers: Best Practice For School Health Nurses, Casey Page

Doctor of Nursing Practice Projects

Healthcare providers do not have adequate knowledge regarding the use of aerosol spacers and asthma inhalers. Inappropriate use of asthma inhalers may lead to poor medication distribution in the lungs and poor asthma control. The utilization of aerosol spacers with asthma inhalers is shown to increase medication distribution to the lungs. Asthma is the number one chronic condition seen by school health nurses. An online learning module was created for school health nurses to reiterate the best practice use of aerosol spacers with asthma inhalers. After completion of the online learning module, school health nurses answered nine questions on an …

The Air That We Breathe: Neutral And Volatile Pfas In Indoor Air, Maya E. Morales-Mcdevitt, Jitka Becanova, Arlene Blum, Thomas A. Bruton, Simon Vojta, Melissa Woodward, Rainer Lohmann

Graduate School of Oceanography Faculty Publications

Sources of exposure to per- and polyfluorinated alkyl substances (PFAS) include food, water, and, given that humans spend typically 90% of their time indoors, air and dust. Quantifying PFAS that are prevalent indoors, such as neutral, volatile PFAS, and estimating their exposure risk to humans are thus important. To accurately measure these compounds indoors, polyethylene (PE) sheets were employed and validated as passive detection tools and analyzed by gas chromatography–mass spectrometry. Air concentrations were compared to dust and carpet concentrations reported elsewhere. Partitioning between PE sheets of different thicknesses suggested that interactions of the PEs with the compounds are occurring …

Human Centeredness: The Foundation For Leadership-As-Practice In Complex Local/Regional Food Networks, Maryann Martinez

Antioch University Dissertations & Theses

Our local and regional food systems are predominately modeled on a failed capitalist market-based economy. In the absence of corporate accountability, and/or support on the federal policy level, local and regional leadership and self-organized networks are critical to the scaling across and evolution of a moral and equitable food system. Networked food systems leaders are developing the capacity to solve wicked problems, and spark change. Understanding the values and practices of local food systems leadership that initiate, influence, and support activities is essential to understanding how to foster conditions for local and regional food network growth. My dissertation research is …

Surviving Heatwaves: Thermal Experience Predicts Life And Death In A Southern Ocean Diatom, Toby Samuels, Tatiana A. Rynearson, Sinéad Collins

Graduate School of Oceanography Faculty Publications

Extreme environmental fluctuations such as marine heatwaves (MHWs) can have devastating effects on ecosystem health and functioning through rapid population declines and destabilization of trophic interactions. However, recent studies have highlighted that population tolerance to MHWs is variable, with some populations even benefitting from MHWs. A number of factors can explain variation in responses between populations including their genetic variation, previous thermal experience and the cumulative heatwave intensity (°C d) of the heatwave itself. We disentangle the contributions of these factors on population mortality and post-heatwave growth rates by experimentally simulating heatwaves (7.5 or 9.2°C, for up to 9 days) …

Higher Education's Immunity To Change: Understanding How Leaders Make Meaning Of Their Student Success Landscape, Brittany Motley

Antioch University Dissertations & Theses

Closing equity gaps in the higher education sector is a long-standing issue. This issue has become exacerbated with the impact of COVID-19 and racial injustices happening across America. Now more than ever it has become imperative to use participatory action research to understand how leaders make meaning of their student success landscape and use that meaning to influence their strategic action for equity. I engaged two student success stakeholders from one university as co-researchers to help identify a problem in practice as it relates to equity gaps in student success. We used a modified approach to immunity to change (ITC) …

States And Laws, Jews And Palestinians: Yadgar's Traditionist Alternative. A Reflection On Yadgar, Israel's Jewish Identity Crisis (Cambridge, 2020), James J. Friedberg

Intercultural Human Rights Law Review

This essay reviews Israel's Jewish Identity Crisis: State and Politics in the Middle East, published last year by Yaacov Yadgar (Stanley Lewis Professor of Israel Studies at the University of Oxford School of Global and Area Studies). His book connects Israel's sometimes arcane internal identity debates to core issues in the Israel/Palestine conflict, a connection largely unexamined prior to this book.

Genome Evolution In Bacteria Isolated From Million-Year-Old Subseafloor Sediment, William D. Orsi, Tobias Magritsch, Sergio Vargas, Ömer K. Coskun, Aurele Vuillemin, Sebastian Höhna, Gert Wörheide, Steven D'Hondt, B. Jesse Shapiro, Paul Carini

Graduate School of Oceanography Faculty Publications

Beneath the seafloor, microbial life subsists in isolation from the surface world under persistent energy limitation. The nature and extent of genomic evolution in subseafloor microbes have been unknown. Here, we show that the genomes of Thalassospira bacterial populations cultured from million-year-old subseafloor sediments evolve in clonal populations by point mutation, with a relatively low rate of homologous recombination and elevated numbers of pseudogenes. Ratios of nonsynonymous to synonymous substitutions correlate with the accumulation of pseudogenes, consistent with a role for genetic drift in the subseafloor strains but not in type strains of Thalassospira isolated from the surface world. Consistent …

Effects Of Advance Refunding Municipal Bonds After The U.S. Tax Cuts And Jobs Act, Sarah Curry

Doctor of Business Administration Dissertations

The process when U.S. municipalities retire callable bonds early and refinance them with bonds of a lower coupon rate is called advance refunding. The advance refunding of debt is a widespread practice in municipal finance; however, the Tax Cuts and Jobs Act of 2017 removed the option to keep this debt tax-exempt and now requires municipalities to convert from tax-exempt to taxable. The purpose of this research was to evaluate the impact eliminating advance refunding of municipal debt into tax-exempt status has on the municipality’s advance refunding decision making process, specifically at the state level. Municipal governments are still …

Diversity In Mdl Leadership: A Field Guide, Elizabeth Chamblee Burch

Scholarly Works

Multidistrict litigation (MDL) includes some of the most high-profile torts of our day—opioids, talc, RoundUp, to name a few—but the attorneys who spearhead these proceedings often look a lot like they did fifty years ago: predominately white and predominately male.

A debate has emerged over whether attorneys best positioned to fill MDL leadership roles are the grizzled repeat players who appear time and again—and who are largely white, older, and male—or newcomers with fresh ideas and energy who may not always look like their predecessors. And if diversity is important, what kind of diversity matters?

In this short essay, I …