Digital Commons Network^™

Bereavement Experiences Of African American Women In Georgia Ages 30 To 50 As Impacted By Income, Religion, And Career, Doliah Derrelle Snead

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to describe the grief experiences of African American women in the state of Georgia, ages 30 to 50, who have faced the loss of a spouse, parent, sibling, or child. The research questions were: How do African American females describe their experiences with grief resulting from loss in their immediate family? How do African American females describe the grieving process before, during, and after the loss of a loved one? How do African American females describe the coping strategies they used as they moved through their grieving process? How do African American females …

Biblical Servant Leadership And Physical Therapists' Clinical Decision Making For Breast Cancer Patients After Breast Cancer Surgery: A Correlational Study, Cleve Carter Iii

Doctoral Dissertations and Projects

The purpose of this quantitative, correlational study was to determine whether a relationship exists between physical therapists’ (PTs’) perceptions of their manager’s or director’s application of BSL and the clinical decision-making of the PT when treating patients of varying socioeconomic status (SES) and race after breast cancer surgery (e.g., mastectomy, lumpectomy) in the United States (U.S.). This study utilized case-based vignettes for a patient population seeking skilled physical therapy services after breast cancer surgery within the U.S. healthcare system context. The sample population consisted of PTs from across the U.S. who actively evaluate and treat patients following breast cancer (BC) …

Unseen Warriors: A Phenomenological Study Of Female Veterans' Post Military Experiences In Central Texas, Natasha D. Smith

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to describe female veterans' post-military experiences in Central Texas. Female veterans faced challenges post military service, including reintegrating into society, seeking resources through veteran and community programs, maintaining overall well-being, building relationships, and establishing their identities as veterans. Although programs and services were implemented to address barriers such as the lack of gender-specific healthcare, difficulties navigating community support systems, limited information about resources, and persistent social stigmas continued to exist. The goal of this phenomenological study was to understand female veterans’ lived experiences by using Alfred Schuetz’s Homecoming theory and Nancy Schlossberg’s Transition …

Keep The Family Close: A Hermeneutic Phenomenological Study On Family Support And Successful Re-Entry, Kerry Lynn Shipman

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study is to understand successful reintegration with positive family support for formerly incarcerated African American men in a major metropolitan city in North Carolina. Individuals released from prison face challenges that result in the likelihood of recidivism. Previous studies regarding these individuals have focused on the requirements for their successful re-entry into society, including financial stability, housing, employment, and family support; however, there is a need to understand what forms of support are needed from families. The theory guiding the current study is the social support theory, as it explains that support from communities, …

Uncovering The Parental Self Identification Process, Danita M. Baber

Doctoral Dissertations and Projects

This dissertation sought to uncover the first-time parent’s novel journey of transforming their identity from individual to parent. Through highlighting the well-established theories that describe the self-identification process, this study centered around concepts related to the conceptualization of the self, the developmental process of self-identification, and the establishment of one’s self-concept, through the lens of parenting. Specifically, this study asked, “For first time parents, does the age of one’s infant impact one’s level of obtained parental identity?” To best answer this question, this study followed a quantitative research design to discover if there was a positive relationship between measured parental …

Online Child Sexual Grooming: Understanding The Origins And Problems Within The Criminal Justice System, Tara Kristich

Doctoral Dissertations and Projects

Grooming children for sexual abuse is complex and challenging to understand because it is constantly evolving due to technology. Prior to the eruption of social media and internet platforms, predators typically had to be in a position to gain access to children or be close to a family with children to sexually groom, abuse, and exploit children. Technology has enabled predators to have instant access to children through chat applications and various internet platforms globally. This qualitative study explored the current platforms that impact child sexual victimization, the impact on victims' mental health, and the laws pertaining to online child …

Church Survivability: A Qualitative Study On Planters’ Leadership Development Role In Southern Baptist Texas Convention Planting, Alton R. Mckinley

Doctoral Dissertations and Projects

Since the pandemic, there has been an accelerated decline in church membership, and within groups of young adults, there are alarming trends that raise concern for the direction of the church. Wang (2022) wrote that the decline is about 10 percentage points between 2019 and 2021 for those under age 35 and those 65+, but only four percent for the middle-aged group. This increased decline in attendance can be addressed by developing leaders who are well-equipped to handle many issues and problems simultaneously. Many secular leadership development concepts will help leaders become more efficient and practical. Winston (2018), in his …

Nurse Preceptors' Perceptions Of Effectiveness Precepting Senior Baccalaureate Nursing Students: A Transcendental Phenomenological Study, Kelly Anne Arraf

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore how clinical nurse preceptors perceive their effectiveness when working with senior baccalaureate nursing students in East Texas. The study was guided by two theories: Invitational Education Theory, introduced by Purkey and Novak, used to understand how preceptors teach, and Bandura’s Social Learning Theory, used to understand how preceptees learn. The central research question was: What is the lived experience of being a nurse preceptor to senior baccalaureate nursing students in East Texas? Data were collected from semistructured virtual interviews, field and journal notes, and a demographic survey. Braun and Clarke’s …

Providing Evidenced Based Practice Interventions To Direct Care Providers In Long-Term Facilities To Increase Knowledge Of Mental Health Care In Older Adults: An Educational Toolkit, Chelisa Ann Crabtree

Doctoral Dissertations and Projects

The purpose of this scholarly project is to increase the knowledge of mental health (MH) care among direct care providers in long-term facilities by developing an educational toolkit focused on evidence-based education and training, with the goal of enhancing staff competencies in MH care, improving the management of residents’ MH needs, and ultimately optimizing care and quality of life. With the increasing number of younger and sicker individuals, particularly those with MH issues, residing in long-term facilities and lack of specialized training for direct care providers which leads to inadequate/complicated care and poor patient outcomes, there is a pressing need …

The Relationship Of Worship Drumming On Christian Spiritual Well-Being: A Qualitative Case Study, Micah Joseph Holland

Doctoral Dissertations and Projects

The purpose of this case study was to bridge the knowledge gap and discover the relationship between worship drumming and Christian spiritual well-being. It also examined the spiritual disciplines developed from worship drumming that impact Christian spiritual well-being. The theory guiding this study was the religious attribution theory, as it is used to describe how people use religious explanations to understand events that cannot be explained by natural causes. The theoretical framework that falls under the religious attribution theory was the Feedback Loop Model for Religious Worship Experiences, which showed the dynamic of how music and the environment can provoke …

Incorporating Industry-Standard Technical Writing Into A Materials Testing Laboratory, Caleb Levi Head

Theses and Dissertations

The fluid analysis and materials testing laboratories are crucial for engineering students to learn experimental procedures and data interpretation. Engineers spend a significant portion of their workday on report writing, yet many feel their undergraduate education did not adequately prepare them for this task. At the University of Arkansas at Little Rock, students were given an industry-influenced lab report template to expand their knowledge of the necessary information required in technical writing, thereby teaching and improving their technical writing skills actively. These reports were evaluated qualitatively and quantitatively against previous submissions over two semesters in the mechanical engineering fluids and …

Experience Matters: An Application Of The Operative Value Index For Lumbar Fusions, Danyal Quraishi, Advith Sarikonda, D. Mitchell Self, Steven R. Glener, Arbaz A. Momin, Emily L. Isch, Ashmal K. Sami, Matthews Lan, Nicholas Clark, Ashwini Sharan, Srinivas Prasad, Jack Jallo, Joshua Pelta-Heller, Alex R. Vaccaro, James Harrop, Ahilan Sivaganesan

Department of Neurosurgery Faculty Papers

INTRODUCTION: As healthcare systems transition to value-based care models, it is critical to understand factors influencing costs and outcomes in neurosurgery. This study utilizes Time-Driven Activity-Based Costing (TDABC) to assess the impact of surgeon experience and case volume on costs, clinical outcomes, and operative value in lumbar fusions. While TDABC has been applied in various surgical specialties, its use in neurosurgery, particularly in analyzing surgeon-specific factors, remains limited.

METHODS: A retrospective cohort study was conducted at a single center, analyzing lumbar instrumented arthrodesis procedures from 2017 to 2019. Primary variables included surgeon experience (years) and case volume (annual procedures). Confounding …

Parole/Probation Officers’ Perspective On Understanding Crime Among Liberian Immigrant Youths In Southwest Philadelphia, Jamil J. Morris

Walden Dissertations and Doctoral Studies

This research explored challenges of crime and delinquency among Liberian immigrant youth in Southwest Philadelphia, focusing on the social and structural factors that influence their lived experiences. Utilizing qualitative in-depth interviews with 17 juvenile parole/probation officers of Liberian immigrant youths, the purpose of this study was to uncover the underlying reasons that lead Liberian immigrant youth to engage in crime and delinquency, and how they cope with the obstacles they encounter. Employing social disorganization theory, differential association theory, and subcultural theory, the study underscored the impact of neighborhood instability, peer influences, and differing value systems on understanding the youths’ criminal …

Improving Staff Knowledge Of Insulin Protocols, Farzana Dalal

Walden Dissertations and Doctoral Studies

A midwestern inpatient hospital experienced a rise in insulin-induced hypoglycemic events on an acute medical-surgical floor as evidenced by 6-23 incidences per month between September 2024 to February 2025. A gap in practice revealed deficiencies in knowledge on the use of insulin protocols, which led to the project question addressing if nursing education on the use of insulin protocols would improve nursing staff knowledge as measured by pre- and post-educational surveys, thus resulting in decreased hypoglycemic events. This educational project utilized the ADDIE pedagogy, the John Hopkins evidence-based practice (JHEBP) model, and the Walden University's DNP Project Process Guide. This …

Unintentional Drowning In Florida: An Analysis Of Demographic And Water Type Associations Among Youth And Young Adults, Michelle Sterling

Walden Dissertations and Doctoral Studies

Unintentional drowning is a leading cause of preventable injury fatalities among youth and young adults in the United States. Despite the preventability, drowning continues to affect specific populations disproportionately. Limited research has examined demographic and environmental factors that contribute to drowning fatalities among individuals aged 5 to 25 years old in Florida. Understanding these patterns is key to informing targeted prevention strategies. This quantitative, retrospective study explored the relationship between demographic characteristics (i.e., gender, race, and ethnicity), environmental context (i.e., water type), and drowning fatalities of 5- to 25-year-olds in Florida from 2018 to 2022. Data for this study, which …

Enhancing Hypertension Management In Correctional Facilities: Educating Advanced Practice Providers On Effective Strategies, Kimbreya E. Otey

Doctoral Dissertations and Projects

Hypertension is a leading risk factor for cardiovascular disease and remains a significant public health concern, particularly within correctional facilities where access to consistent guideline-based care is often limited. Incarcerated individuals experience higher rates of chronic conditions, including hypertension, yet standardized approaches to management are frequently lacking. To address this gap, an evidence-based educational program was developed for nurse practitioners (NPs) and physician assistants (PAs) working in the correctional setting. Grounded in the International Society of Hypertension (ISH) guidelines, the program was developed to enhance awareness and knowledge among NPs and PAs regarding evidence-based hypertension management practices using the International …

Crisis Preparedness And Professional Quality Of Life: Exploring The Influence Of Self-Efficacy, Mental Well-Being And Job Satisfaction In Crisis Counselors, Courtney Pierce

Doctoral Dissertations and Projects

Crisis services are a growing division of mental health programs. While recent CACREP updates in 2009 and 2016 have placed an emphasis on crisis preparation in counselor education programs, many counselors are not adequately prepared for work in crisis settings. Inadequate preparation could heighten counselors’ risk for burnout and secondary traumatic stress, posing a threat not only to their well-being, but also to the advancement of crisis programs. It is important to investigate protective factors for crisis counselors to support their well-being and the viability of essential crisis services. Existing literature examines individual and organizational factors that predict and protect …

Precision Care In Screening, Surveillance, And Overall Management Of Barrett's Esophagus, Yeshaswini Reddy, Madhav Desai, Bernadette Tumaliuan, Nirav Thosani

Faculty, Staff and Student Publications

Barrett's esophagus (BE), a metaplastic transformation of an esophageal squamous epithelium into an intestinal-type columnar epithelium, is the primary precursor to esophageal adenocarcinoma (EAC). Traditional management strategies have relied heavily on selective screening, tailored surveillance intervals, and early dysplasia detection and treatment algorithms. However, the heterogeneity in progression risk among BE patients necessitates a more nuanced, personalized approach involving precision care, tailoring decisions to individual patient characteristics, promises to enhance outcomes in BE through more targeted screening, personalized surveillance intervals, and risk-based therapeutic strategies. This review explores the current landscape and emerging trends in precision medicine for Barrett's esophagus, highlighting …

Timing Of Nodal Metastasis In Patients With Eyelid Sebaceous Carcinoma And Implications For Surveillance And Survival, Tracy Lu, Casey Anthony, Xinyang Jiang, Jing Ning, Ryan Goepfert, Bita Esmaeli

Faculty, Staff and Student Publications

Background/aims: Sebaceous carcinoma (SC) is a rare cancer with periocular predilection. Studies focused on patterns and timing of nodal metastasis are scarce.Our aim is to report patterns of regional nodal metastasis in patients with eyelid SC, including results of sentinel lymph node biopsy (SLNB).

Methods: All consecutive patients with eyelid SC treated during 1999-2023 were retrospectively reviewed.All subjects had standard of care surgery for eyelid SC and regional lymph node evaluation using physical examination and ultrasonography (US) at baseline and during the surveillance period. 38 patients with negative findings on US had SLNB to rule out microscopic metastasis.The frequency and …

The Adaptation And Translation Of A Transition Readiness Scale For Young Adults With Autism Spectrum Disorder, Antonio F Pagán, Katherine A Loveland, Ron Acierno

Faculty, Staff and Student Publications

Autistic young adults often face significant challenges during the transition to adulthood, yet few tools exist to assess their readiness in a developmentally appropriate and culturally responsive manner. This study presents the development and initial validation of the Transition Readiness Scale for Autistic Adolescents and Adults (TRS-A), a brief caregiver- and self-report measure designed to assess key domains of transition readiness. Guided by qualitative input from Latino families, community stakeholders, and clinicians, the TRS-A was piloted with 114 autistic young adults, 66 Spanish-speaking parents, and 48 English-speaking parents. Psychometric analyses supported the scale's internal consistency and construct validity, mirroring the …

An Alternative Neural Basis Underlying Leptin Resistance, Hongli Li, Cunjin Su, Yuanzhong Xu, Mette Q Ludwig, Jon Davis, Qingchun Tong

Faculty, Staff and Student Publications

Overconsumption of a palatable Western diet, a condition linked to central leptin resistance, contributes extensively to the current obesity epidemic. In this context, intensive efforts have focused on detailing the molecular mechanisms underlying leptin resistance. Here, we demonstrate that chronic inhibition of hypothalamic arcuate GABAergic neurons (ArcGABA) effectively reduced diet-induced obesity (DIO). Interestingly, palatable food exposure increased the activity level of ArcGABA neurons, which do not express the leptin receptor (non-LepR neurons; nonresponsive to leptin). Chronic activation of ArcGABA non-LepR neurons led to massive obesity, which was associated with normal leptin-induced pSTAT3 signaling but phenotypic leptin resistance; i.e., high leptin …

Navigating Health Management Decisions In Pediatric Food Allergy: Exploring Caregiver Needs, Experiences, And Behaviors, Perry Allen Catlin

Dissertations (1934 -)

Food allergy (FA) is a prevalent and often severe condition affecting approximately 8% of U.S. children (Gupta et al., 2018; Robson & Assa’ad, 2024). The responsibility for daily management of FA, including making critical health management decisions, often falls to caregivers. These responsibilities can impose significant psychosocial demands on caregivers, particularly as treatment options expand and require more nuanced decision-making (Collins et al., 2024; Hamadi et al., 2024; Knibb & Jones, 2024; Lieberman, 2024; Umetsu, 2024). Caregivers' decisions are shaped by a range of individual needs, experiences, and sociodemographic characteristics (Dale & Hemmerich, 2009; Hoefel, O’Connor, et al., 2020). As …

Longitudinal Analysis Of Gut Microbiome And Metabolome Correlates Of Response And Toxicity With Idecabtagene Vicleucel, Satabdi Saha, Lubna Rehman, Abdur Rehman, Faezeh Darbaniyan, Donna M Weber, Melody Becnel, Mahmoud Gaballa, Sheeba K Thomas, Hans C Lee, Chia-Chi Chang, Reetakshi Arora, Meghan Menges, Salvatore Corallo, Marco L Davila, Frederick L Locke, Mark R Tanner, Sattva S Neelapu, Elizabeth J Shpall, Christopher R Flowers, Robert Z Orlowski, Robert R Jenq, Michael D Jain, Christine Peterson, Doris K Hansen, Neeraj Y Saini, Krina K Patel

Faculty, Staff and Student Publications

Increasing evidence suggests that the gut microbiome may influence the responses and toxicities associated with chimeric antigen receptor T-cell (CAR-T) therapy. We conducted whole-genome shotgun sequencing on stool samples (N = 117) collected at various times from patients with multiple myeloma (n = 33) who underwent idecabtagene vicleucel (ide-cel) anti-B-cell maturation antigen CAR-T therapy. We observed a significant decrease in bacterial diversity after ide-cel infusion, along with significant differences in the bacterial composition linked to therapy response and toxicities. Specifically, we found significant enrichment of Flavonifractor plautii, Bacteroides thetaiotaomicron, Blautia fecis, and Dysosmobacter species in ide-cel responders. A notable finding …

Belumosudil Reduces Oral Chronic Graft-Versus-Host Disease Tissue Inflammation And Fibrosis: A Rockstar Companion Study, Rubina Sharma, Noa G Holtzman, Iskra Pusic, Corey Cutler, Nathaniel Treister, Rohtesh S Mehta, Amin S Alousi, Nadarajah Vigneswaran, Ayesha Javaid, Francis Boksa, Drashty P Mody, Ana C Costa-Da-Silva, Olivier Schueller, Sandrine Macé, Yu Yao, Ran Ji, Beifang Hu, Kathy Marshall, Bruce R Blazar, Stephanie J Lee, Steven Z Pavletic, Jacqueline W Mays

Faculty, Staff and Student Publications

Belumosudil (KD025), an oral, selective, Rho-associated, coiled-coil-containing protein kinase 2 (ROCK2) inhibitor, is approved for third-line treatment of chronic graft-versus-host disease (cGVHD). Previous studies demonstrated that ROCK2 inhibition reduces blood interleukin-17 (IL-17) activity and promotes regulatory T-cell (Treg cell) recovery. However, these studies did not evaluate immune responses within cGVHD-affected tissues. This study assessed tissue-level immune dynamics in 20 patients with oral cGVHD from the phase 2 ROCKstar trial, before and after 6 months of belumosudil treatment, focusing on key effector sites (oral mucosa [OM], minor salivary glands [MSGs], and skin) and the peripheral blood. After belumosudil treatment, reduction in …

Detection Of Oncogenic Fusions In Colorectal Cancer Using A Partner-Agnostic Next-Generation Sequencing Approach, Andrew J Pellatt, Reagan M Barnett, Sante Gnerre, Kristin Edwards, Jason A Willis, Michael J Overmann, Kanwal Raghav, Christine M Parseghian, Arvind Dasari, M Pia Morelli, Alisha Bent, Madhulika Eluri, Nicholas Hornstein, Leylah M Drusbosky, Scott Kopetz, Van K Morris

Faculty, Staff and Student Publications

Background: Gene fusions exist with low prevalence in colorectal cancer (CRC), and the clinical utility of fusion testing in advanced CRC remains unclear. We sought to identify oncogenic fusions in patients with advanced CRC using a fusion partner-agnostic circulating tumor DNA (ctDNA) assay to better understand their clinical relevance.

Methods: We performed a retrospective analysis using de-identified data from 18,558 patients with advanced CRC who underwent ctDNA next-generation sequencing with Guardant360® from 2017 to 2022. These samples were subsequently reanalyzed with a partner-agnostic bioinformatics method to identify both clonal and non-clonal fusions. We analyzed for associations between fusions and MSI-H …

The Environmental Impact Of Temperatures And Rain Quantities On The Vegetation In The Eastern Parts Of Jazan Region Using Geographic Information Systems (Gis) And Remote Sensing, Mona Salem Al-Harbi Dr.

Journal of Arabic Sciences and Humanities

This study investigates the environmental impact of temperature and rainfall on vegetation in the eastern parts of the Jizan region from 2011 to 2023, using geographic information systems (GIS) and remote sensing. A descriptive-analytical approach was applied, with vegetation classified by density and area using LandSat 8 satellite imagery. The study employed the NDVI (Normalized Difference Vegetation Index), a key remote sensing indicator of plant health. The results revealed a statistically significant correlation (at the 0.01 confidence level) between the study variables. Specifically, a positive correlation was found between rainfall and the NDVI index: as rainfall increases, NDVI values rise …

Role Of Progesterone Action In Inguinal Hernia Formation Via Skeletal Muscle Fibrosis And Atrophy, Tianming You, Mehrdad Zandigohar, Tanvi Potluri, Natalie Piehl, John S Coon V, Elizabeth Baker, Maya Kafali, Yang Dai, Jonah J Stulberg, David J Escobar, Richard L Lieber, Hong Zhao, Serdar E Bulun

Faculty, Staff and Student Publications

More than 1 in 4 men will undergo surgery for inguinal hernia, which is commonly associated with fibrotic degeneration of the lower abdominal muscle (LAM) in the groin region. Utilizing a male mouse model expressing the human aromatase gene (Aromhum), previous studies showed that locally produced estradiol acting via estrogen receptor α in LAM fibroblasts leads to fibrosis, myofiber atrophy, and hernia development. Here, we found that upregulation of progesterone receptor (PGR) in a LAM fibroblast population mediates this estrogenic effect. A PGR-selective progesterone antagonist in Aromhum mice decreased LAM fibrosis and atrophy, preventing hernia formation and stopping progression of …

Unburden The Pastoral Chair To Create A More Effective Minister, William Travis Boyd

Doctoral Dissertations and Projects

This dissertation explores how to alleviate the burden on senior pastors to create more effective ministers. This research aims to explore the implications of the pastoral chair’s duties and responsibilities and focuses on how the church community can support the senior pastor through encouragement and awareness of the importance of maintaining the pastoral chair’s mental, emotional, and professional health. This research features a comprehensive literature review on the current state of senior pastors’ professional health and the impact that overwhelming duties and responsibilities impose on their professional confidence, ministry, and overall sense of productivity and accomplishment in providing pastoral services …

Maintaining Elementary Student Engagement And Motivation During Stem Activities: A Phenomenology, Christopher Feiler

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to describe the lived experiences of maintaining student engagement and motivation during STEM activities in elementary classrooms across the United States. For this research, I applied Bandura's self-efficacy theory as my foundational framework. The study highlights that a teacher’s perception of their efficacy affects their instructional practices and the achievement levels that students reach in STEM disciplines. As such, the primary guiding research question in this case was framed as follows: In what ways do elementary educators articulate their experiences fostering engagement and motivation in students during STEM activities? Data collection for …

Social Media Marketing Impacts On Sme Customer Engagement And Prodictivity, La'keisha J. Morton-Carter

Doctoral Dissertations and Projects

This qualitative multiple case study explored the underutilization of social media marketing among small and medium-sized enterprise (SME) entrepreneurs and its impact on customer engagement and business productivity. Grounded in the Technology Acceptance Model (TAM) and the Diffusion of Innovations (DOI) theory, the study examined how SME owners perceive, adopt, and apply social media platforms in their marketing efforts. Data were collected from 38 participants through semi-structured interviews and surveys and analyzed using NVivo 15 software. Thematic analysis revealed five emergent themes: Digital Hesitancy, Strategic Gaps, Customer Engagement Variability, Resource Constraints, and Peer Influence. Findings indicated that while entrepreneurs recognized …