TCU Digital Repository (Texas Christian Univ.)
Not a member yet
54550 research outputs found
Sort by
The interaction of language, executive functioning and structured physical activity for children at risk for secondary communication disorders
No full textThis three-manuscript dissertation evaluates how the domains of language, executive functioning and physical activity interact for children with communication disorders, and how those domains may differentially influence development across different etiologies. The first study explores the relationship between executive functioning and language in children who are deaf and hard of hearing. Parent reports of inattention and hyperactivity are related to child language knowledge and fatigue. The second study evaluates the impact of introducing movement to word learning instruction for children with Down syndrome. More words were learned in the movement condition than in a business-as-usual teaching condition. The third study combines all three domains across etiologies of hearing loss, Down syndrome, and typical development. Results indicate that etiology does impact outcomes in these domains. Executive functioning predicts language outcomes for all children, and etiology impacts this relationship. Further, physical activity interacts with executive functioning skills to strengthen language. The findings of this dissertation have implications for differentiated language interventions according to disability and incorporation of multiple domains
Factors Influencing a Woman¿s Decision for Breast Conservation vs. Mastectomy with Contralateral Prophylactic Mastectomy in Early-Stage, Hormone-Sensitive, Breast Cancer: A Systematic Review
No full textResearch Question: What factors influence a woman¿s decision for breast conservation vs mastectomy and contralateral prophylactic mastectomy in early-stage, hormone-sensitive, breast cancer?Background and Significance: Breast conservation (BC) is a viable option for many patients diagnosed with early-stage breast cancer. With proper medical management and radiation, there is no difference in overall survival (OS) between BC and mastectomy in patients who lack genetic mutations. While this data is well-established, women are opting for mastectomy with contralateral prophylactic mastectomy (CPM) at increasing rates. A better understanding of factors influencing a patient¿s desire for mastectomy and CPM can honor the approach of shared decision making and autonomy, while potentially leading to less invasive surgical intervention. We completed a systematic review of both quantitative and qualitative studies exploring factors impacting patient decision making for mastectomy and contralateral prophylactic mastectomy vs breast conservation surgery in patients with early state breast cancer.Materials and Methods: Studies were identified via database searches of Cochrane, Embase, and PubMed. Articles of interest were identified and then selected based on inclusion and exclusion criteria. Data was then extracted by one author using a standardized criterion and analyzed. Quality was assessed using standardized criteria through Covidence.Results: 366 citations were reviewed with 68 meeting the specified inclusion criteria. Analysis showed that factors most influential for CPM included anxiety (45%), lack of knowledge regarding their cancer (43%), lack of understanding regarding future cancer risk (44%), and the desire to extend/prolong life while avoiding future treatment (35%). Surgeon preference (35%) and a desire for symmetry (31%) also were important factors when choosing CPM.Conclusion: While patients are satisfied with their decision to undergo the more invasive treatment option of mastectomy with CPM, patients will benefit from education techniques that target the risks and benefits and address the common misconceptions surrounding both surgical options for breast cancer. This approach honors both patient autonomy and shared decision making, while staying true to the basic principle of ¿do no harm.¿ Understanding specific factors influencing the patient decision making process can help ensure patients receive an individualized approach to their cancer care
Does Pre-Testing Enhance Learning When it is Done Covertly?
No full textStudents wonder how to prepare for an upcoming exam, while instructors wonder how to best introduce materials to students. Research has found that practice testing after material is studied leads to better memory compared to other strategies like restudying (Dunlosky et. al, 2013). Practice testing tends to be more effective when students recall material verbally or write it down (overt learning) compared to when they only mentally recall the material (covert learning; Tauber et al., 2018). Other research evaluates the value of pretesting individuals before they learn subject matter. Studies show that answering pretest questions before studying, even if people provide wrong answers, leads to beneficial learning outcomes compared to just studying material (Pan & Carpenter, 2023). I aimed to combine both research areas and investigate how covert and overt learning applies to pretesting: When taking a pretest, is it better to just think about the answer, or is it better to write it down? Undergraduate students at TCU were instructed to learn passages about the planet Saturn or Yellowstone National Park. For one of the passages, students simply read the passage (read-only condition). For the other passage, they were asked short-answer pretest questions about the passage prior to reading (pre-test condition). A random half of the participants complete their pretests overtly (typing their responses to the questions), whereas the other half of participants completed their pretests covertly (answering the questions in their mind). All participants completed a final multiple-choice test on the material they learned. Performance on this final test was higher for the pretest condition compared to the read-only condition, and this was true for both overt and covert pretesting. In strategy ratings made after the experiment, participants seemed to recognize that pretesting was more effective than learning because it helped them absorb relevant information while reading the passage. The results suggest that pretesting is an effective learning strategy, even when learners do not provide articulated responses
Black Instinct: The Survival Kit for the Black and Marginalized at a Predominantly White Institution
No full textThis autoethnographic archive encapsulates my intersectional experiences navigating predominantly white institutions (PWI), including Texas Christian University and studying abroad. Through the theoretical frameworks of Black women's rhetoric and muted group theory, I questioned the preparedness of Black women college students in culturally exclusive environments, I interrogated how race, ethnicity, nationality, and gender has equated to the absence of my transnational identity as a Black American woman, and I examined how the mutation of Black women affects discourse and experiences in the academy.
By examining Black travel narratives, I use zines as a rhetorical device to analyze how memory influences Black women's historical and transnational identity and storytelling while navigating PWIs. This zine collection encourages literary autonomy and enables scholars to question how systems play a part in the power dynamics of marginalized and dominant groups, and serves to protect Black women's identities, bodies, and language while studying abroad. This archival method justifies the use of zines and digital platforms as alternative forms of research to empower Black women and marginalized people to document our experiences.
TCU's relationship with the global community exposed the necessity for enhanced preparation for Black women, in navigating PWIs including study abroad processes and environments that are culturally exclusive. I identified a rhetorical deficiency in resources that overlook Black women?s needs and upholding barriers that prevent them from accessing opportunities, and oppose non-linear and community-based research. In short, Black women's rhetorical expressions challenge the norms of traditional research to make space and provide opportunities for Black women to navigate predominantly white spaces
The Use of Preoperative CRP and ESR as Predictive Markers of Prosthetic Joint Infection in Primary Total Hip and Knee Arthroplasty
No full textResearch Question: Do patients who undergo primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) with elevated pre-operative C-reactive protein (CRP) and/or erythrocyte sedimentation rate (ESR) produce a higher incidence of post-operative periprosthetic joint infection (PJI), compared to THA and TKA patients that had normal pre-op labs? Further, what proportion of patients that developed PJI post-operatively had elevations in only CRP, only ESR, or both CRP and ESR? Lastly, we will investigate whether patients had pre-operative elevations in CRP and/or ESR due to the presence of a modifiable risk factor, such as an acute infection or inflammation. How did such conditions correlate with PJI development when compared to patients with non-modifiable risk factors (age, sex, chronic disease)?Background and Significance: CRP and ESR are commonly utilized indicators of inflammation in the diagnosis and management of PJI among patients undergoing THA and TKA. The frequency of these surgeries is expected to increase significantly, with projections indicating a rise from 400,000 THAs and 700,000 TKAs annually to 635,000 THAs and 1,260,000 TKAs by 2030. PJI poses a notable challenge, contributing to 20% of revision THA cases and 25% of revision TKA cases. The economic burden of PJI is substantial, estimated to reach 1.1 billion for TKA by 2030. Given the transition to value-based healthcare, optimizing patients before surgery is paramount. This study aimed to evaluate the association between preoperative CRP/ESR levels and the subsequent development of PJI following primary THA and TKA, as well as to identify modifiable and non-modifiable risk factors among patients exhibiting elevated preoperative inflammatory markers.Materials and Methods: retrospective review was conducted on 806 patients from a single healthcare facility who had undergone either THA (n=291) or TKA (n=515). As part of the preoperative assessment, CRP and ESR levels were measured for all patients. Data regarding patient demographics, medical conditions, and incidences of PJI were collected. A CRP value greater than 0.3 mg/dL and an ESR value exceeding 30 mm/hr were considered positive indicators.Results: Our study revealed no statistically significant correlation between pre-operative CRP or ESR and PJI. However, it is worth mentioning that a greater percentage of patients diagnosed with PJI exhibited elevated preoperative CRP levels (70.6%) compared to PJI cases with normal CRP levels (29.4%).Conclusion: This study did not validate the use of preoperative CRP and ESR as reliable predictors of PJI in primary THA and TKA. However, it offers valuable quantitative data on the prevalence of elevated preoperative CRP and ESR levels in all patients undergoing THA and TKA, with a significant portion having modifiable risk factors. Given that a significant number of patients with elevated CRP and ESR levels did not develop PJI, we do not advise cancellation of THA and TKA unless there are obvious modifiable risk factors significantly increasing the risk of PJI
Loneliness and Relationship Well-Being: Investigating the Mediating Roles of Relationship Awareness and Distraction among Romantic Partners
No full textLoneliness arises when there is a discrepancy between one's desired and actual social connection with others. Studies examining the effects of loneliness in romantic relationships show that people who are lonely are less satisfied and committed to their romantic relationships. The present study explored the association between loneliness and romantic relationship well-being. Using a cross-sectional design, loneliness was correlated with relationship commitment, trust, and conflict. Relationship awareness, but not relationship distraction, statistically mediated the association between loneliness, relationship conflict, and relationship trust. The indirect effect of loneliness on relationship well-being was only present in people reporting low and medium levels of psychological inflexibility. Implications are discussed for acceptance- and mindfulness-based interventions for persons in romantic relationships
Analyzing the Functional Interdependence of Verbal Behavior with Multiaxial Radar Charts
No full textThe functional analysis of complex verbal behavior requires an evaluation of topographically similar responses under multiple sources of control. Traditional graphical displays of behavior were designed to show the manipulation of isolated controlling variables and may not be amenable to displaying the multidimensional properties of complex behavior. Researchers have recently demonstrated the use of multiaxial radar charts for comparing the functional performance of biological systems. Here we extend the use of multidimensional analyses to compare the relative performance distributions of verbal behavior across four potential controlling variables. First, we provide a conceptual analysis of intraverbal and extraverbal control as continua along which stimuli range from formal to thematic and explain how the intersection of these stimulus fields creates a radar chart for multidimensional analysis. Then we demonstrate how data may be gathered through a verbal operant experimental analysis. We employed repeated measures to map the conditioning history of a child with autism spectrum disorder across 2 years of early intensive behavioral intervention and analyzed the results using shape descriptors for quantitative comparisons. We also compared the polygonal language profiles of children with autism against that of a neurotypical peer. Extending a multidimensional analysis to the field of verbal behavior provides the basis for a language growth chart that researchers and clinicians can use to monitor language acquisition over time. We discuss the use of radar charts as a framework for understanding the interdependence of verbal operants and suggest their use for complex analyses of complex verbal behavior
Medicare Reimbursement Trends for Total Joint Arthroplasty: What Does the Future Hold?
No full textResearch Question: Is Medicare total joint arthroplasty at risk financial unsustainability due to falling reimbursement rates now and in the future?Background and Significance: While multiple studies have assessed the trends of Medicare reimbursement for orthopaedic total joint arthroplasty(TJA) surgeries, none have forecasted reimbursement in relatable per-hour figures. The purposes of this study are to examine trends of reimbursement for primary and revision TJA and translate forecasted primary TJA reimbursement to relatable per- hour compensation.Materials and Methods: The Center for Medicare and Medicaid Services(CMS) reimbursement data from 1992-2024 was used to create a historical view of reimbursement for primary and revision TJA. All monetary values were converted to 2023 USD to account for inflation. Polynomial and linear forecast equations were used to predict the future of the TJA reimbursement to 2030. Relative Value Scale Update Committee (RUC) standard times for procedures were used with the forecasts to establish per-hour rates.Results: Total reimbursement for primary total hip arthroplasty(pTHA)/total knee arthroplasty (pTKA) is forecasted to decrease 85.36%/86.14% by 2030. Using prior trends in reimbursement, TJA procedures are predicted to reimburse at or less than 13.93/hr per-pTHA and $14.97/hr per- pTKA by 2030.Conclusion: This study highlights the concerning trends for both primary and revision arthroplasties as TJA surgeons are on a path to earn below minimum wage for primary TJAs by 2030. Mathematical models forecast a bleak future for orthopaedic TJA reimbursement. This downward trajectory poses risk to access and quality of care
Transcolonial Carceralities: Memories of Algerian and Japanese Civilian Internment and Denaturalisation
No full textThis article examines the overseas French empire’s denaturalisation, civilian internment, and carceral policies vis-à-vis Algerians in North Africa and the Japanese in New Caledonia during and after the Second World War. Illuminating the histories of Algerian and Japanese civilian internment, this article analyses how overlapping, uneven colonial policies pertaining to incarceration spanning multiple empires produced complex settler-colonial entanglements with racial implications. This article reveals how multifarious colonial policies gesturing to a global, carceral, and colonial continuum against Algerians and Japanese reinforced parallels between diasporic and ideological movements from francophone North Africa to Oceania
The Mediating Role of Hesitancy in the Associations Between Mental Disorders and Social Support Seeking During the COVID-19 Pandemic
No full textThe COVID-19 pandemic has consequential impacts on not only physical but also mental health. However, the types of social support that individuals with mental health needs sought during the pandemic and their underlying reasons for it are not well known. Drawing on a community needs survey with 4282 participants, we found a positive association between self-reported anxiety and seeking social support from health professionals, family and friends, and mediated sources. There was also a positive association between self-reported depression and seeking support from medical professionals and mediated sources but a negative association with seeking support from family and friends. Importantly, a positive indirect effect was observed between mental health and seeking support from family and friends through hesitancy, whereas negative indirect effects were documented between mental health and seeking support from health professionals and mediated sources through hesitancy. Theoretical, practical, and methodological implications were discussed