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  • 1. Chung, Lisa AN EXPLORATION OF SELECTED CHARACTERISTICS OF REGISTERED NURSES AND THEIR USE OF EVIDENCE-BASED PRACTICE IN ACUTE CARE SETTINGS.

    Doctor of Nursing Practice , Case Western Reserve University, 2015, School of Nursing

    The purpose of this study is to investigate the practice, attitude and knowledge of evidence-based practice among registered nurses (RN) in acute care settings. A descriptive correlation design was used with a convenience sample of 108 registered nurses working in acute care units across a Health System. Study participants completed an online survey that included demographic information and questions from the Evidence Based Practice Questionnaire (EBPQ) tool developed by Upton and Upton (2006). Results showed significant differences among the mean scores in registered nurses for the three scales of practice, attitude and knowledge. Attitude score for this sample of RN's was significantly higher than practice and knowledge. Educational preparation was found to have a significant correlation with practice and knowledge of EBP. While controlling for other related factors, data was nested into sub-groups according to educational preparation, including EBP class attendance and committee membership. The practice and knowledge scores support the original findings that educational preparation (Associate, Bachelor, and Masters) is related to EBP. However, that relationship is only evident when nurses have not been exposed to EBP classes or committee membership. The two variables of class attendance and committee membership appear to have a substantial effect on practice and knowledge of EBP. It appears that the effect of educational level is diminished when nurses attend classes on EBP.

    Committee: Faye Gary (Committee Chair); Jacquelyn Slomka (Committee Member); Launette Woolforde (Committee Member) Subjects: Continuing Education; Education; Health Care; Medicine; Nursing; Teaching
  • 2. Berkoh, Joshua The Application of Open-Source Intelligence on Criminal Investigation

    MS, University of Cincinnati, 2024, Education, Criminal Justice, and Human Services: Information Technology

    There has been a gross expansion of social media platforms and other platforms that generate lots of information that is very useful in the digital space called open-source intelligence (OSINT). A growing space where this information is of immense importance is criminal investigations and this research is to understand how we can apply open-source intelligence to help with criminal investigation. This research seeks to answer the question that is how the utilization of open-source intelligence has impacted the effectiveness of criminal investigations across various geographical locations and how software functionalities and capabilities for leveraging (OSINT) have evolved to support criminal investigations over the last couple of years. A multivocal literature review was adopted to help answer the research questions. This was adopted because there are not so many peer-reviewed articles that address our questions and wanted to include grey literature that captures the importance of open-source intelligence in criminal investigation. The research study revealed that most open-source intelligence applications are geared toward threat intelligence and darknet intelligence and have automation at the heart of their operations which helps the inclusion of intelligence from multiple sources. This research study embodies a comprehensive overview of the applications of OSINT to criminal investigations and establishes the various jurisprudence of OSINT application.

    Committee: Saheed Popoola Ph.D. (Committee Member); M. Murat Ozer Ph.D. (Committee Chair) Subjects: Information Technology
  • 3. Kean, Emily Development and Testing of the Reliability and Validity of the IRMAT: Integrative Review Methodology Appraisal Tool

    PhD, University of Cincinnati, 2023, Nursing: Nursing - Doctoral Program

    Background: Expert literature reviews and evidence synthesis, such as systematic, scoping, or integrative reviews, represent some of the highest levels of evidence in the health sciences. There is a paucity of research concerning the methodology of integrative reviews, which are prevalent in the nursing literature. Because integrative reviews may incorporate the retrieval, appraisal, and synthesis of a variety of evidence types (empirical [quantitative, qualitative, and/or mixed methods], non-empirical, theoretical, and/or methodological), the integrative review is a somewhat unique type of evidence synthesis. While there is a growing body of literature concerning the methodological rigor of integrative reviews in nursing, advancements in methodological tools are lacking. Purpose: The overarching aim of this dissertation research is to develop and test an appraisal tool to assess the methodological and reporting elements of nursing integrative reviews. The Integrative Review Methodology Appraisal Tool (IRMAT) appraises whether recommended methodological elements are present in published integrative reviews in the nursing literature. Methods: A scoping review was conducted to identify methodological elements of nursing integrative reviews. The 210 methodological elements identified from the scoping review were coded and thematically analyzed to align to the Ellis Model of Information-Seeking Behavior, which resulted in 34 items being generated. Generated items were analyzed by a panel of five nursing integrative review experts for face and content validity. The subsequent version of the tool was used by 204 survey participants and two independent raters so that construct validity, internal consistency reliability, and inter-rater reliability could be analyzed statistically. Results: The expert ratings were used to calculate content validity at the item level using the Content Validity Index (CVI). Twenty-eight items demonstrating sufficient conte (open full item for complete abstract)

    Committee: Elaine Miller Ph.D. (Committee Chair); Carolyn Smith Ph.D. (Committee Member); Youn Seon Lim Ph.D. (Committee Member) Subjects: Nursing
  • 4. Rotshtein, Regina Coordination of Theory and Evidence and the Role of Personal Epistemology and Prior Knowledge When Reading About the Controversial Topic of Vitamin Supplement Use

    Doctor of Philosophy, University of Toledo, 2019, Foundations of Education: Educational Psychology

    This qualitative multiple case study examined the ways in which undergraduate and graduate students coordinate theory and evidence on the controversial topic of vitamin supplement use when faced with evidence that supports and evidence that contradicts their existing beliefs, as well as the roles of personal epistemology and prior knowledge in this process. Coordination of theory and evidence is an essential skill in both scientific and everyday reasoning, as it allows individuals to accurately evaluate conflicting information to arrive at an informed decision about important issues. Participants completed an online questionnaire in which they read three articles of differing stances on the topic of vitamin use and asked to describe the position and evidence used within each article and to state whether they agreed or disagreed with the article's core position. Participants' personal epistemologies and prior knowledge on the topic were also assessed. A majority of participants were largely successful in being able to articulate their existing theories as well as alternative theories, identify theory and evidence within the articles, and to integrate the information they read to develop, refine, and in some cases modify their theories. Many participants in this study held evaluativist epistemological beliefs which may have contributed to their success with these components of theory and evidence coordination. However, participants often struggled to fully differentiate between theory and evidence and rarely discussed the quantity and quality of sources cited as a factor when evaluating the articles. Participants who held at least some accurate knowledge about vitamins and nutrition were more likely to change their initial theories at the end of the task and to indicate a desire to do more personal research on the topic compared to those who lacked knowledge or held misconceptions.

    Committee: Florian Feucht PhD (Committee Chair); Dale Snauwaert PhD (Committee Member); Joan Kaderavek PhD (Committee Member); Charlene Czerniak PhD (Committee Member) Subjects: Adult Education; Education; Educational Psychology; Higher Education; Teacher Education
  • 5. Ge, Jianye Computational Algorithms and Evidence Interpretation in DNA Forensics based on Genomic Data

    PhD, University of Cincinnati, 2009, Engineering : Biomedical Engineering

    DNA based genetic analysis has been an essential part in modern biomedical research. Professor Sir Alec Jeffreys first used multilocus DNA analyses to determine the relationship between individuals in an immigration case, and heralded a new field, DNA fingerprinting or DNA forensics. Nowadays, almost all DNA markers, those that reside on autosomal chromosomes, Y chromosomes and mitochondria DNA (mtDNA), have been utilized in DNA forensic investigations. The Short Tandem Repeats (STR) markers on autosomal chromosomes are the cornerstone of current DNA crime databases. Investigations are also extended to Y chromosomes and mtDNA for paternal and maternal lineage comparisons, respectively. Panels based on Single Nucleotide Polymorphisms (SNP) were also developed as an adjunct tool in forensics, especially for degraded samples. Discovery of block structure of human genome offers new avenues for future exploration. DNA forensics involves three main applications: transfer evidence evaluation (i.e., compare DNA profiles of evidence samples with those of known subjects), mixture interpretation (i.e., determine the number of contributors in mixture sample and identify the possible contributors), and kinship analysis (i.e., identify the relationships between individuals). All DNA materials (e.g. STR, SNP, Y chromosome, mtDNA etc.) could be exploited for these applications. Applications will be more complicated by incorporating both population substructure and mutation of DNA markers. This study is conducted to enhance forensic applications for complex situations with DNA analyses. First, a new algorithm for identifying missing persons based on autosomal markers (i.e., STR or SNP) was developed by incorporating both population substructure and mutation. The software was validated by the International Commission on Missing Persons. Second, I developed two maximum likelihood methods with population substructure to interpret DNA mixture evidence base on SNPs. Third, a new type of (open full item for complete abstract)

    Committee: Ranajit Chakraborty (Committee Chair); David Butler (Committee Co-Chair); Bruce Budowle (Committee Member); Marepalli Rao (Committee Member); Jarek Meller (Committee Member) Subjects: Bioinformatics; Biostatistics; Genetics
  • 6. Garvey, Patrick Evidence-Based Practice Guidelines for the Risk Stratification and Anesthetic Management of Geriatric Surgery Patients at High Risk for Postoperative Cognitive Dysfunction Undergoing Non-Cardiac Surgery

    DNP, Otterbein University, 2026, Nursing

    As the global geriatric surgical population rapidly expands, managing complications like postoperative cognitive dysfunction is increasingly essential, given its adverse impacts on recovery, quality of life, and healthcare costs. Postoperative cognitive dysfunction can lead to extended hospital stays, delayed recovery, and significant cognitive decline, particularly among elderly patients exposed to general anesthesia. This quality improvement final scholarly project develops and hypothetically implements evidence-based practice guidelines for anesthetic management in geriatric patients at high risk for postoperative cognitive dysfunction undergoing non-cardiac surgery. This Doctor of Nursing Practice (DNP) project uses preoperative cognitive assessments, such as the Mini-Cog tool, to identify patients at elevated risk for postoperative cognitive dysfunction and inform anesthetic strategies tailored to reduce cognitive decline. Using the Iowa Model of Evidence-Based Practice, a multidisciplinary team, including anesthesia providers, nursing staff, and quality improvement personnel, will pilot, implement, and continuously evaluate these evidence-based practice guidelines to monitor their effectiveness in reducing postoperative cognitive dysfunction incidence. The project emphasizes quality improvement and data-driven adjustments to the guidelines, ensuring alignment with patient safety and optimal outcomes. Findings will contribute valuable insights for clinical settings, supporting safer, evidence-based anesthetic practices for the aging surgical population and improving geriatric care through targeted risk assessment, adjusted anesthetic techniques, and structured postoperative interventions.

    Committee: Brian Garrett (Advisor); Amy Bishop (Committee Member); Kirk Hummer (Committee Member); Danielle Winch (Committee Member) Subjects: Health Care; Medicine; Nursing; Pharmacology
  • 7. Kleinfelder, Luke Implementation of Evidenced Based Practice Guidelines for Reducing Emergence Delirium in Elderly Patients Undergoing a Total Hip Replacement

    DNP, Otterbein University, 2026, Nursing

    A total hip replacement is a common surgery for the elderly population, as it is a successful treatment option for hip fractures and end-stage osteoarthritis, a common condition associated with aging. Recovery from surgery is critical, and any postoperative complication can delay recovery, increase cost, lengthen hospital stay, and lead to a poorer long-term surgical outcome. One of the most common and severe postoperative complications for elderly patients following general anesthesia is emergence delirium. Traditional practice focuses on treating the symptoms of emergence delirium reactively instead of proactively and lacks standardized guidelines. Recent literature found a promising decrease in the incidence of emergence delirium for elderly patients undergoing a total hip replacement with general anesthesia using evidence-based practice interventions. In this proposed project, after receiving approval from hospital administrators, the project team will educate recovery nurses on appropriate assessment tools to collect baseline data for the current rates of emergence delirium for three months or roughly 50 patients. The project team will then educate staff on changes to practice for the proposed evidence-based practice guidelines and gather data for another three months or approximately 50 patients. After completion of data collection, a data analysis will be used to assess the impact of the proposed guidelines on emergence delirium. The final scholarly project team anticipates a statistically significant reduction in the incidence of emergence delirium using the proposed guidelines. If the desired outcomes are unmet, additional investigation will be necessary to determine causative factors and adjust the guidelines as required.

    Committee: Bonnie Fagan (Advisor); Amy Bishop (Committee Member); Brian Garrett (Committee Member) Subjects: Medicine; Nursing; Surgery
  • 8. Nicholas, Diana Design Thinking for Health Environments: Case Study Research on Innovation, Design Leadership, and Healthcare Complexity

    Ph.D., Antioch University, 2025, Leadership and Change

    As healthcare costs are skyrocketing, of the 6,093 hospitals in America, 53% will lose money in the current year (Coleman-Lochner, 2022). Design health innovation centers (DHICs) are formed in Europe and the United States to create efficiencies in healthcare related to budget challenges. DHICs exist in unique contexts both in America and Europe that are not yet well understood. These efforts are difficult to lead due to the lack of understanding of their worth and how their process is valuable to healthcare settings (Bhattacharyya et al., 2022). The specific problem examined here is that little is known about how DHIC leaders and teams create and sustain these centers, including how design and health team leaders work together and what resources encourage the success of DHICs (Romm & Vink, 2019). The purpose of this qualitative case study is to examine how ambidextrous leadership and growth play out in team and leader behaviors and experiences at one DHIC in Europe. The goal of this work is to contribute to an improved understanding for DHIC creation in the United States health system. Of particular interest to this study are leader behaviors that seem to directly link to areas in DHICs of innovation. These behaviors may be the key to understanding how leaders are innovating and staying successful across multiple silos and communities. While traditional metrics of success often focus on implementation, research into DHICs should examine the interrelationship between the creative and the practical, including how leaders create the right environments for teams to form and operate toward successful metrics and social impact (Dyrda, 2018; Hostetter et al., 2015). This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

    Committee: J. Beth Mabry PhD (Committee Chair); Aqeel Tirmizi PhD (Committee Member); Elizabeth Sanders PhD (Committee Member) Subjects: Architecture; Arts Management; Design; Health; Health Care; Health Care Management; Health Education; Management; Public Health
  • 9. Murray, Emma Mental Health Clinicians' Use of Evidence-Based Treatment Practices for Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

    Doctor of Philosophy (PhD), Ohio University, 2024, Clinical Psychology (Arts and Sciences)

    The current study sought to examine clinicians' use of evidence-based treatment practices for children and adolescents with ADHD in community settings and examine potential individual and contextual factors relevant to clinicians' treatment choices. A sample of 171 licensed mental health clinicians (55 psychologists, 68 counselors, 48 social workers) completed an online survey of their treatment practices for youth with ADHD and factors hypothesized to be associated with use (e.g., knowledge, attitudes, perceived social norms). More than half of clinicians in this study reported limited or inconsistent use of the three treatments with the strongest evidence base for treating children with ADHD. Greater self-reported knowledge, more positive treatment-specific attitudes, and greater perceived social norms were associated with increased clinician-reported use dependent on the treatment examined. These findings highlight malleable factors that can be targeted to support implementation and increase access to high-quality care for children and adolescents with ADHD.

    Committee: Steven Evans PhD (Committee Chair); Julie Owens PhD (Committee Member); Darcey Allan PhD (Committee Member); Mingun Lee PhD (Committee Member); Jennifer Lackey PhD (Committee Member) Subjects: Clinical Psychology
  • 10. Richardson, Colleen Examining Teachers' Perceptions of Implementation Fidelity of a Multi-Tiered Systems of Support Framework in an Online Middle School Environment

    Doctor of Education (Educational Leadership), Youngstown State University, 2024, Department of Teacher Education and Leadership Studies

    In the dynamic realm of virtual education, the successful execution of Multi-Tiered Systems of Support (MTSS) becomes essential for promoting student achievement. This study examines a particular aspect of this educational framework, explicitly investigating the teachers' perceptions of the fidelity of implementing an MTSS framework within an online middle school environment. MTSS is a significant advance in evidence-based practices for improving learning outcomes. However, most school districts find it challenging to maintain elevated levels of fidelity in the implementation of each framework element. Without following the implementation process, it is difficult to determine the main cause of poor academic achievement and performance. This undermines the effectiveness of the MTSS framework. This mixed methods study aims to examine the teachers' perceptions of the fidelity of implementation of the elements of the MTSS framework within a cyber school. Examining teacher perceptions of fidelity of implementation can be a complex task, which is best measured through a mixed methods approach using Q-methodology. The study investigated the teachers' perceptions of which components, structures, processes, and practices facilitate and hinder the implementation of the MTSS framework. This research has been conducted within a middle school of a cyber charter school in Pennsylvania that has been open since 2002. The concourse statements for this study are adapted from certain sections of the Pennsylvania MTSS Needs Assessment, a survey formulated by the Pennsylvania Training and Technical Assistance Network (PaTTAN). This tool was created to assist district teams in evaluating the processes and frameworks that either facilitate or impede the creation of a MTSS. In addition to the statements within the Q-sort, an online survey was included which collected basic demographic data such as what grade level they currently teach, as well as their years of virtual teaching exper (open full item for complete abstract)

    Committee: Karen Larwin PhD (Committee Chair); Lauren Cummins EdD (Committee Member); Matthew Erickson EdD (Committee Chair) Subjects: Education; Educational Leadership; Middle School Education; Teacher Education; Teaching
  • 11. Ruiz, Jesus Columbia-Suicide Severity Rating Scale Impact In A Suburban Diverse Community

    Doctor of Healthcare Administration (D.H.A.), Franklin University, 2024, Health Programs

    This investigation aimed to evaluate the impact of the implementation of the Columbia Suicide Severity Rating Scale tool in the Emergency Department. The setting of the study focused on a non-profit community-based hospital that serves the Hispanic-dominant population in a Suburban area. The utilization of secondary data from 2022 and 2023 was analyzed statistically to evaluate the success of the implementation of the Columbia Suicide Severity Rating Scale tool pre- and post-implementation. The study focused on the impact on risk level assignment, arrival to provider assessment times, and discharge disposition, pre-and post-implementation. The analysis aims to bring awareness and aid in necessary changes to the delivery of care for patients who seek care with suicide ideation or suicide attempts. The statistical analysis utilized a Mann-Whitney U test, Chi-square test, and two sample t-tests to determine the statistical impact pre- and post-implementation of the Columbia Suicide Severity Rating Scale tool. The results showed no statistically significant differences between pre- and post-implementations. Though the outcome shared no statistically significant difference, clinical significance was observed as minor shifts in data were noted. Future studies suggest integrating theoretical themes into the patient's plan of care to accommodate the population being served. The analysis and findings of this study identified vital prospective areas of focus that brought awareness to the psychiatric population, enhance care plans for high-risk patients, and expand on post-discharge education.

    Committee: Gail Frankle Dr. (Committee Chair); Cynthia Smoak Dr. (Committee Member); Tonia Young-Babb Dr. (Committee Member) Subjects: Health Care; Mental Health
  • 12. Wayne, Nieh FAMILY PRESENCE DURING RESUSCITATION: A DESCRIPTIVE STUDY OF PERCEPTIONS OF NURSING STUDENTS

    BS, Kent State University, 2024, College of Nursing

    Family Presence During Resuscitation (FPDR) first proposed in 1987, has been recommended by numerous professional nursing organizations. Although studies have been conducted investigating the views of family members and healthcare professionals concerning FPDR, little is known about perceptions of nursing students. Due to this gap in the literature, we investigated the attitudes of nursing students toward FPDR as they will be future members of the largest healthcare profession in the United States. This study was guided by the Relationship Based Care Model, which is a way to provide care for our patients and their families. A descriptive cross-sectional study using Qualtrics was designed to identify the attitudes of nursing students from the largest BSN program in Northeast Ohio toward FPDR. The secondary aim was to investigate if age and work experience in a healthcare setting impacted the attitudes of nursing students towards FPDR. Funding for the project was provided by Kent State University Research Council, and Institutional Review Board approval was obtained prior to data collection which commenced in Summer 2023. By the end of Fall 2023 semester, a total of 96 participants were enrolled in the study which yielded a response rate of 53.6% of 179 eligible students enrolled in a senior-level critical care course. This study did not reach statistical significance in attitudes toward FPDR based on age and work experience in healthcare. However, 67.2% of the participants reported they would support FPDR.

    Committee: Amy Petrinec (Advisor); Alison Smith (Committee Member); Daniela Popescu (Committee Member); Jessica Larubina (Advisor); Cindy Wilk (Committee Member) Subjects: Nursing
  • 13. Hill, Caitlin Athletic Trainers' Knowledge and Perceived Ability of Recognizing and Treating Panic Attacks

    Master of Athletic Training, Marietta College, 0, Athletic Training

    Objective/Context: Mental health is a condition of mental wellness that enables people to manage life's stressors, develop their potential, study and work effectively, and give back to their communities. One mental health condition is anxiety. Anxiety is the expectation of a threat in the future. There are multiple subtypes of anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, separation anxiety, and panic disorder. This study investigates the relationship between ATs' knowledge and their perceived ability to identify and treat panic attacks. Design and Setting: Mixed methods, cross sectional survey consisting of 22 questions. Participants: The study used the NATA survey service, convenience, and snowball sampling for participant requirements. This study targeted athletic trainers who are currently certified and practicing clinically in a secondary school or collegiate setting. The study was completed by 86 participants, with 54 meeting inclusion criteria. Out of the participants, 59.3% worked in a collegiate setting, and 40.7% worked in a secondary school setting. Participants had a wide variety of years of practice, which 51.9% of participants having practiced for <5 years. Intervention: Participants completed an electronic survey consisting of demographic and Likert style questions to assess perceived ability level in recognizing, treating, and referring for panic attacks. The participants also answer a portion of the survey that assesses knowledge of panic attacks with research from the DSM-5. The survey was developed by the research team. The survey's validity was assessed through a pilot study. Main Outcome Measures: The primary research question was assessed by analyzing the score of the twelve questions at the survey's end. Participants were graded on these questions to give a score on knowledge of panic attacks. Descriptive statistics wer (open full item for complete abstract)

    Committee: Chyrsten Gessel Ed.D, AT (Committee Chair); Jaclyn Tate Ed.D, AT (Committee Chair) Subjects: Sports Medicine
  • 14. Dittoe, MaKyah Final Scholarly Project: Optimal Perioperative Analgesic Management Guidelines for Elective Hip Arthroplasty in Adults

    DNP, Otterbein University, 2025, Nursing

    Hip arthroplasty, a frequently performed orthopedic surgery, is gaining popularity. However, postoperative pain, opioid utilization, nausea, and vomiting are common side effects associated with this procedure. Perioperative analgesic management for hip arthroplasty varies among providers, leading to possible inadequate pain management. The goal of this scholarly project is to provide an optimal perioperative analgesic guideline to decrease postoperative pain, opioid consumption, nausea, and vomiting in adults undergoing elective hip arthroplasty utilizing evidence-based practice. The evidence suggests that a multimodal analgesic approach incorporating multiple drug classes and types of anesthesia is most effective in reducing adverse postoperative outcomes. Using the Johns Hopkins Evidence-Based Practice Model's process of practice, evaluation, and translation, project managers developed a plan to implement evidence-based practice guidelines over a year at an urban outpatient surgical center specializing in elective hip arthroplasties. The project's metrics included a visual numerical rating scale, total morphine milliequivalents utilization, and postoperative nausea and vomiting intensity scale. Chi-square and t-tests are used for outcome analysis with a p-value of less than 0.05 considered significant.

    Committee: Ruth Chavez DNP, CNP, BC-FNP (Advisor); Amy Bishop DNP, AGCNS-BC (Committee Member); Brian Garrett DNP, CRNA (Committee Member) Subjects: Health Education; Nursing
  • 15. Altman, Rachel Therapist Competency Using Transference-Focused Psychotherapy to Treat Borderline Personality Disorder

    Psy. D., Antioch University, 2024, Antioch New England: Clinical Psychology

    Empirical research on clinician experience of competency treating borderline personality disorder is scarce, and that which does exist focuses on the negative experiences of those who treat this population. Utilizing an interpretive phenomenological analysis approach, this qualitative research investigation explored the lived experience of feelings of competency in clinicians treating borderline personality disorder using the evidence-based model of Transference-Focused Psychotherapy. To better comprehend this phenomenon and address research questions, data were collected via one, semi-structured interview given to five different clinicians who practice Transference-Focused Psychotherapy. Four themes emerged from the researched data: Positive treatment outcomes for patients, Using negative countertransference for positive therapeutic intervention, Reliability of treatment framework, and Effectively dealing with crisis and suicidality. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu)

    Committee: Theodore Ellenhorn Ph.D. (Committee Chair); Gina Pasquale Psy.D (Committee Member); Sabine Dorleans Psy.D. (Committee Member) Subjects: Psychology
  • 16. Piedra, Alexandra PREDICTORS OF IDENTITY-AFFIRMING MENTAL HEALTH INTERVENTION PREFERENCES IN LGBTQIA+ ADOLESCENTS AND THEIR PARENTS

    Doctor of Philosophy, Case Western Reserve University, 2024, Psychology

    LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, and other) individuals, including children and adolescents, have higher rates of mental health disorders than their heterosexual peers, and this population requires access to evidence-based mental health care treatments. Prior research has shown that traditional interventions such as CBT and DBT are equally efficacious in treating mood, anxiety, and personality disorders in heterosexual, bisexual, gay, and lesbian participants. However, dropout rates in these studies are as high as 72.2%. High dropout rates indicate that these treatments may not be seen as unacceptable or preferred. Few studies to date have explored mental health treatment preferences in LGBTQIA+ adolescents. This study aimed to explore which personal factors predict preferences for various features of treatment. Data was collected from LGBTQIA+ adolescents aged 14-17 and one parent (N = 191 dyads). Results indicated that negative attitudes toward mental health predicted a greater preference for CBT. Greater family conflict predicted stronger preferences for DBT. Overall, participants preferred therapeutic techniques related to CBT, ACT, and DBT equally. Results indicate that therapists and mental health clinicians would benefit from mindful rapport-building and attentiveness to patient factors early on in treatment, as this diverse population has varied preferences for treatment.

    Committee: Amy Przeworski PhD (Committee Chair); Matthew Garrett PhD (Committee Member); Sarah Hope Lincoln PhD (Committee Member); Arin Connell PhD (Committee Member) Subjects: Clinical Psychology
  • 17. Abdelmonem, Mohamed The Impact of Liquid Plasma in Massive and Emergency Blood Transfusion

    Doctor of Healthcare Administration (D.H.A.), Franklin University, 2023, Health Programs

    Massive bleeding remains one of the leading potentially preventable causes of death in the United States, accounting for more than 50% of mortality rates (Marietta, Marco et al., 2011). Massive transfusion protocol (MTP) is a rapid transfusion of a large amount of blood and blood products (more than ten units of red blood cells in twenty-four hours, or four units of red blood cells in an hour, or any four blood components in 30 minutes) in a short period of time (Thurn et al., 2019). The blood products' ratios included in the massive transfusion protocol are distinct and composed of red blood cells, fresh frozen plasma, and platelets. Developing and establishing electronic records for massive transfusion protocols may improve patient outcomes (Broxton et al., 2017). Using liquid plasma during a massive transfusion protocol may improve patient survival rate by decreasing the blood product delivery time to the patient's bedside and reducing healthcare costs by lowering blood product waste (Beckermann et al., 2022). In this quantitative study, the researcher analyzed retrospective medical records from a Level One Medical Trauma Center in the Southwest United States to answer the research question. Data regarding using liquid plasma in massive blood transfusion outcomes were collected from the hospital records for pre- and post-liquid plasma usage implementation. The study investigated the following research question: For patients who require emergency and massive transfusion, what is the impact of using liquid plasma compared to fresh frozen plasma on blood product wastage and plasma-saving cost one year before and after using liquid plasma?

    Committee: Alex Akulli (Committee Chair); Jesse Florang (Committee Member); Gail Frankle (Committee Member) Subjects: Comparative; Health Care; Health Care Management; Health Sciences; Medicine; Pathology; Science Education
  • 18. McIntire, Hannah Evaluating the Effectiveness of Prompts and Performance Feedback on Teacher Integrity of Behavior Specific Praise and Behavioral Outcomes for Students on the Autism Spectrum

    PhD, University of Cincinnati, 2023, Education, Criminal Justice, and Human Services: School Psychology

    Over recent decades, numerous evidence-based practices have been identified for supporting students on the autism spectrum. These evidence-based practices, however, are typically not implemented consistently or as planned in school settings (Alexander et al., 2015). Implementation science highlights the importance of effective implementation and supporting evidence-based practice to ensure the intended outcomes of interventions. Treatment integrity is critically important as low levels of treatment integrity may render an evidence-based intervention less effective, less efficient, or produce less predictable responses (Wilder et al., 2006). Implementation prompts and performance feedback show promise for increasing treatment integrity, however there are significant gaps in the research regarding the effectiveness of these consultant supports to improve teachers' implementation of evidence-base practices with students on the autism spectrum (Alexander et al., 2015). The purpose of the study was to evaluate the effectiveness of two consultant supports, implementation prompts and performance feedback, alone and in combination with one another. The study examined these consultant supports to increase treatment integrity of teachers' behavior specific praise (BSP) for students. A reversal research design was used to evaluate the effectiveness of implementation prompts and performance feedback for the purpose of increasing treatment integrity of BSP in the classroom. Results of the study provide preliminary evidence that a combination of implementation prompts and performance feedback increased treatment integrity of the evidence-based practice as compared with the implementation prompts and performance feedback only phases.

    Committee: Julie Morrison Ph.D. (Committee Chair); Daniel Newman Ph.D. (Committee Member); Todd Haydon Ph.D. (Committee Member) Subjects: Behavioral Sciences
  • 19. Martin, Jared Influence of External Pressures on the Adoption of Evidence-Based Practices for Youth Experiencing Homelessness

    Doctor of Philosophy, The Ohio State University, 2023, Human Ecology: Human Development and Family Science

    Research documents high rates of behavioral health needs among youth experiencing homelessness (YEH); however, recent evidence indicates that behavioral health evidence-based practices (EBPs) may not be widely used by organizations serving YEH. Implementation and organizational theory describe the importance of the external organizational environment on EBP adoption, including the influence of external social pressures such as policy mandates, professional norms, funder expectations, and competition and collaboration with peer organizations. This cross-sectional multiple case study explored the influence of external pressures on EBP adoption among organizations serving YEH. Theory-based sampling was used by combining expert opinion and stakeholder involvement to obtain nominations of organizations for study inclusion. Thirteen organizations were recruited for focus groups/interviews, surveys, and collection of EBP funding documents. Qualitative content analysis described the type of external pressures experienced by organizations and organizational responses to those pressures. Convergent mixed-method analysis was used to classify organizational-level adopter behavior using a modified version the Fidelity, Attitudes, and Influence Typology (FAIT) and specify the most common external pressures associated with each FAIT category. Results showed that organizations adopted a high number of EBPs (median = 7) and the most significant pressure for EBPs is federal and state/county funders; however, expectations for EBP adherence/oversight varied across funding sources. Organizations learn about EBPs through their government funders, a variety of external professional support groups, and peer organizations who help appraise EBPs prior to adoption. Positive reactions to external pressures included the mission alignment of adopted EBPs, the ability of EBPs to provide concrete skills and structure to novice staff, an increase in organizational data informed decision making, an (open full item for complete abstract)

    Committee: Natasha Slesnick (Advisor); Alicia Bunger (Committee Member); Keeley Pratt (Committee Member) Subjects: Mental Health; Organization Theory; Social Research
  • 20. Chapman Rodriguez, Rose Evidence -based practice attributes across nursing roles in a Children's Hospital

    Doctor of Nursing Practice , Case Western Reserve University, 2023, School of Nursing

    Problem: Evidence-based practice (EBP) attributes are significantly associated with EBP implementation science, which improve patient care outcomes. Nurses influence EBP, yet little is known of the specific EBP attributes of pediatric nurses in their clinical sub-specialties. Aim: To investigate the relationship between nursing academic degree, years of experience, and clinical specialty, with mean survey scores on EBP belief, organizational culture, and implementation scales, across all levels of nursing in a Children's Hospital. Methods: A convenience sample of nurses (n=185), participated in a descriptive, cross-sectional, correlational study in May 2023. The electronic surveys comprised 11 demographic questions and nine survey items from the short-version EBP Beliefs Scale (Cronbach α = 0.81), Organizational Culture and Readiness Scale for System-wide Integration Scale (Cronbach α = 0.87); and EBP Implementation Scale (Cronbach α = 0.89). Findings: EBP belief scores were notably higher in nurses working in neonatology (m=4.33); critical care (m=4.47), and among nurse leaders (m=4.50). There was a statistically significant difference in EBP organizational culture among nurse leaders (m = 3.95, p=0.039), compared to clinical nurses (m = 3.34), and advanced practice nurses (m = 3.34). EBP implementation was favorable in neonatology (m=4.20), acute care (m=4.05), and nurse leaders (m=4.33). No significant difference or correlation was found in EBP belief, organizational culture, or implementation mean scores related to nurses' age, academic nursing degree, or years of experience in our cohort (EBP beliefs (r = -.06, p = .400), organizational readiness (r = .02, p = .770), and implementation scales (r = .01, p = .867). Conclusions: This study identified nurse's EBP attributes in a Children's Hospital using key variables studied with EBP social cognitive and learning theory. Magnet status, shared governance structure, specialty certification, and nurse l (open full item for complete abstract)

    Committee: Joyce Fitzpatrick (Advisor); Schreiner Nathaniel (Committee Member); Reynaldo Rivera (Committee Member) Subjects: Health Care; Management; Nursing