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Assessing Change in Knowledge, Attitudes, and Beliefs of Primary Care Providers, Nursing, and Supportive Staff in Providing Transgender and Gender-Diverse Care after a Virtual Education Module
No full textD.N.P.This doctoral project included the assessment of a virtual education module on healthcare personnel and its impact on their knowledge, attitudes, and beliefs concerning transgender and gender-diverse patients. The study employed a validated Likert scale Transgender Knowledge, Attitudes, and Beliefs (TKAB) survey tool to gauge the module's efficacy in cultivating a more inclusive and competent healthcare environment for this demographic.Drawing from concepts of intersectionality and transgender justice, the project highlights the unique challenges faced by transgender and gender-diverse patients due to overlapping systems of discrimination and privilege stemming from multiple social categories, such as race, class, and gender. Embracing principles of transgender justice, this study highlighted the need for access to quality healthcare services for this population.
The virtual education module was designed to address the specific needs of healthcare providers, nursing staff, and allied supportive staff, fostering a comprehensive basic understanding of transgender and gender-diverse patients' health concerns and experiences. The two-tiered modules delivered essential information on gender identity, transgender health disparities, and evidence-based care practices.
Employing a quantitative research design, the study utilized pre, post-, and one-month post-module implementation survey assessments of knowledge, attitudes, and beliefs using the validated TKAB scale. Data analysis encompassed statistical, clinical, and thematic approaches to capture changes in TKAB scale scores and identified emergent themes from the data gathered. This project found some statistically and non-statistically significant score improvements from pre-survey to post-survey, however only clinically significant improvements at the 1-month survey follow-up likely due to attrition from the sample population.
This doctoral project adds to the expanding literature on transgender and gender-diverse healthcare, investigating the effectiveness of education as an intervention. This work’s findings noted that education did influence participants' knowledge, attitudes, and beliefs, and promoted more affirming and respectful interactions with transgender and gender-diverse patients. The study offers a unique perspective on understanding the intricate healthcare needs of this population, informing the development of more inclusive healthcare education, policies, and practices. This initiative added to the educational cache surrounding the healthcare education on the care of transgender and gender-diverse individuals, promoting greater health equity and improved patient outcomes.
Cross-modal Interactions between Neural Systems Underlying Language and Speech during Reading, Spoken Language, and Visual Speech Processing
No full textPh.D.Language is a unique skill used by humans to communicate thoughts and feelings. For most individuals, language is understood through different sensory modalities—for instance, hearing auditory words relies on audition, while perceiving visual speech via lipreading and reading written text both utilize the visual system. Although these different ways to perceive language are often discussed as distinct systems in the brain separated by modality, there are considerable cross-modal interactions between language modalities (e.g., learning to read new words by reading aloud, or the simultaneous audiovisual speech processing during face-to-face conversations). As a result, there must exist neural pathways that connect language systems separated by modality to reflect cross-modal processes.These integration pathways should exist even during uni-modal processing (i.e., during silent reading, hearing auditory words, and silent lipreading). To test hypotheses on cross-modal integration, for instance how regional activation and networks differ for stimuli in different language forms (i.e., written, auditory, and visual forms), studies would need to investigate not only responses in specific regions-of-interest (ROIs), but also delineate stimulus-driven connections between regions. Furthermore, it is crucial to examine cross-modal interactions beyond traditional language regions like the posterior superior temporal cortex (pSTC) and the inferior frontal cortex (IFC), as integration may occur in other areas. Traditional functional magnetic resonance imaging (fMRI) studies are also limited in the use of group ROIs, which do not account for the substantial variability in the locations of language-related regions nor accurately represent individual selectivity.
To address these methodological concerns, the current dissertation leveraged data from several datasets to examine cross-modal interactions during reading, spoken language, and visual speech processing. Specifically, I used functional localizer scans to define language-ROIs for each individual subject and examined cross-modal coupling. In Chapter 2, I investigated cross-modal coupling between reading and spoken language processing by analyzing the activation and connectivity between ROIs during written and auditory word processing. Then in Chapter 3, I delineated how visual speech processing involves integration with pathways associated with spoken language processing. Altogether, the extensive findings from my dissertation provide a better understanding of cross-modal mechanisms underlying language processing in the brain
Real-World AI Scenarios in Academic Integrity
No full textAli Whitmer, the Executive Director of the Georgetown Honor Council, and Alex Theos, Faculty Chair of the Honor Council, will facilitate an exploration of real-world AI scenarios from the Honor Council caseload. This session will explore the nuances of various cases involving AI the Council has encountered. Whitmer and Theos will share perspectives on the ethical considerations these students faced. Additionally, the session will cover faculty responsibilities in upholding academic integrity, as well as the collaborative efforts required between students and faculty to maintain the highest ethical standards
Influence of Span of Control on Nurse Manager Job Satisfaction
No full textD.N.P.Literature related to hospital nurse manager span of control and its impact on patient outcomes and nurse retention was explored. There are limited studies on using a comprehensive span of control assessment tool, which includes more variables such as complexity, hours of operations, turnover, staff tenure, and direct reports, to assess acute care nurse manager job satisfaction. Healthcare organizations have typically used only one variable, budgeted Full-Time Equivalents, as a measurement of nurse managers' span of control. This singular metric does not accurately depict the complex job responsibilities of the nurse manager. This is a quantitative, exploratory study that utilized an electronic cross-sectional survey conducted over a two-week period at one organization across 12 hospitals in the mid-Atlantic region. The primary aim of this study was to understand if span of control, as measured by a comprehensive tool, influences the acute care nurse manager job satisfaction. The secondary aim was to compare job satisfaction scores from the Minnesota Satisfaction Questionnaire with demographic data. Results were analyzed using the nurse manager span of control categories from the modified Ottawa Hospital Tool, previously collected by the healthcare organization.
There were 58 nurse managers who met the inclusion criteria and participated in the study. Nurse managers with the largest span of control responsibilities (Category 3) were more satisfied with their jobs than those with a lesser span of control (Categories 0, 1, and 2), with significant differences in questions related to “being able to do things that don’t go against my conscience” (p=0.019), “the chance to tell people what to do” (p=0.021), and “the way my co-workers get along with each other” (p=0.025). Logistic regression determined that span of control was the only positive influence on nurse managers' general job satisfaction.
When evaluated with the Ottawa Hospital assessment tool, a nurse manager's span of control positively influenced their job satisfaction. Contributing factors that could be associated with favorable job satisfaction in acute care nurse managers with large span of control responsibilities are positive organizational culture, recognition, and employees feeling valued. Building the groundwork for a healthy work environment is necessary for organizational success
Analysis of a Simulation to Evaluate De-Escalation Confidence in Nursing Staff
No full textD.N.P.Workplace violence against healthcare workers by patients is problematic in the United States (US), with nursing staff as the most targeted group. Simulation using patient actors may improve early de-escalation and confidence in nursing staff responding to disruptive and aggressive patients. The New World Kirkpatrick Model was chosen as the theoretical model because it focuses on building confidence through hands-on training and practice. This quality improvement (QI) project sought to assess the confidence level of nursing staff working in a US Mid-Atlantic region government hospital through the escalation of normal levels of stress to disruption and aggression. Thackrey’s (1987) Clinical Confidence in Coping with Patient Aggression (CCCPA) questionnaire assessed pre- and post-simulation confidence levels of nursing staff responding to a disruptive and aggressive patient. Additional questions assessed if staff felt unit-based training changed their confidence level versus classroom training alone. The prerequisite required participants to complete the facility’s evidence-based Prevention and Management of Disruptive Behavior (PMDB) Level III classroom training and work in a single acute medical-surgical unit to participate, resulting in the utilization of a convenience sample (N = 20). Data were collected and analyzed using a paired t-test. The results showed a statistically significant increase in CCCPA scores from pre- to post-training, indicating increased confidence in dealing with patient aggression, t(19) = 5.42,
The Atlantic Machiavellians: Republican Realism, Renaissance Historiography, and Twentieth Century Political Thought, 1915-1975
No full textPh.D.In the twentieth century, the political legacy of Niccolò Machiavelli (1469-1527) was the subject of fierce debate among historians of political thought. This dissertation traces the place of Machiavelli and “Machiavellianism” in the twentieth century Atlantic world, focusing on the works of Friedrich Meinecke (1862-1954), Hans Baron (1900-1988), Felix Gilbert (1905-1991), and J. G. A. Pocock (1924-2023). It examines how these scholars engaged with the themes of republican self-government, political realism, Renaissance historiography, and international relations––exploring how their studies on the former Florentine secretary became the prism through which they debated questions of Machiavelli’s own intellectual development as well as the geopolitics of their age. The first chapter examines Meinecke’s return to Machiavelli during the First World War to “understand the changes in the nature and spirit of power politics since the Renaissance,” eventually resulting in The Idea of the Reason of State in Modern History (1924). As a “republican by reason,” Meinecke used Machiavelli as a counterexample to his political evolution and charted how the idea of the “reason of state” was a “bridge” between Ethos (ethics) and Kratos (power). The second and third chapters follow the lives and careers of Baron and Gilbert, two German-Jewish historians who studied under Meinecke at the University of Berlin. Both chapters trace the early careers of these scholars in Germany through their emigration to the United States in the 1930s, where they offered “civic humanist,” “republican,” and “realist” readings of Machiavelli that made significant contributions to the fields of Renaissance Studies and International Relations. The fourth chapter analyzes Pocock’s politics of language and his account of the “Atlantic republican tradition” in The Machiavellian Moment (1975), surveying the New Zealand historian’s efforts to reconstruct the discourse of early modern republicanism that he believed still shaped American political thinking into the twenty-first century. By uncovering the intellectual and political origins of these engagements with Machiavelli, this dissertation shows how layers of thinking on republican “crisis” formed American conceptions of state power, civic virtue, and interstate relations in the twentieth century. The conclusion speculates on the implications of these readings with the contemporary “return of great power rivalry.
Navigating Agency and Culturally Responsive Instruction for Dual-Identified Students: Special Education Teachers’ Voices of Advocacy and Collaboration
No full textPh.D.Despite comprising almost 15% of students in U.S. public schools (NCES, 2022), dual-identified students—those classified as requiring both Special Education (SpEd) and English as a Second Language (ESL) services—remain an understudied population. Scholars have pointed to the lack of integrated instructional models that address both language acquisition and disability support (Kangas, 2014; Lopes-Murphy, 2019), and called for teacher preparation programs that equip educators with the skills and knowledge to effectively support their dual-identified students’ educational trajectories (Moore, Klingner, & Harry, 2013; Waitoller & King Thorius, 2016). Prior research also highlights the need for the inclusive educational framework of Culturally Responsive Pedagogy (CRP) to accommodate the intersectional identities of students (Aceves & Orosco, 2014; Foster, 1995; Gay, 2002), though there remains a gap in understanding its application within SpEd contexts.This qualitative case study investigates the pedagogical and professional challenges faced by SpEd teachers in four schools in the Philadelphia School District (PSD) as they employ CRP to address the complex educational needs of their dual-identified students. Interviews with 17 participants probed their views of the instructional strategies that have worked well in their classrooms, their perceptions of disability, and their enactments of agency amidst various systemic and sociocultural challenges. Findings suggest that SpEd teachers, even with piecemeal training in CRP, intuitively integrated its principles by leveraging students’ cultural and linguistic assets, maintaining high expectations, and advocating for equity and social justice in their work. Moreover, the analyses unearthed important tensions SpEd teachers face in navigating disparate institutional and cultural perceptions of disability and how they attempted to reconcile these with their professional practices. Lastly, the interview data revealed the distinct challenges and expectations placed on White teachers and teachers of Color as they strove to become more culturally responsive.
This dissertation contributes to disciplinary understandings of the expansion of CRP into SpEd contexts and makes practical recommendations to address the intersectionality of disability, language, and culture in education, as well as to enhance the educational experiences and outcomes for this vulnerable student population
Problematic Social Media Use and Child Well-being: Examining the Role of Cultural Context
No full textM.P.P.This study explores the role of cultural context in the relationship between problematic social media use (PSU) and well-being in children. Given concerns about the high rates of social media use and its effects on children, as highlighted by the U.S. Surgeon General’s 2023 Advisory, it is important to understand what factors may heighten or lessen the negative impact of PSU on children. Prior research has established a link between PSU and adverse mental health outcomes in children, yet the role of cultural factors in this relationship remains largely unexplored. Using cross-sectional data from the 2018 Health Behaviour in School-aged Children survey, this study examines if cultural environments mediate the relationship between PSU and well-being in children. Countries are categorized using Hofstede’s cultural dimension theory, which includes aspects like individualism, indulgence, and perceptions of power. This study finds that high levels of individualism and indulgence in a country intensify the negative association between PSU and well-being. In contrast, low levels of individualism and indulgence, along with both high and low levels of power distance, diminish the negative association between PSU and well-being. These findings underscore the critical need for incorporating cultural considerations into policies and interventions aimed at addressing the impact of problematic social media use on children’s well-being
Riding Toward Equity: The Socioeconomic Effects of Transit Investment in U.S. Urban Areas
No full textM.P.P.Public transportation serves as a lifeline for millions of households in urban areas across the United States, providing crucial access to essential services and economic opportunities. This thesis examines the impact of public transportation investment on wage inequality and poverty rates, positing that increased expenditure will enhance transit quality and availability, thereby facilitating economic access and poverty reduction. Utilizing recently available panel data spanning from 2012 to 2021, the thesis employs both ordinary least squares (OLS) and fixed effects regression models to analyze the relationship between public transportation expenditure, measured by per capita expenses, and socio-economic outcomes. Specifically, the focus is on income inequality measured by the Gini index and poverty rates defined by the federal poverty line. The findings suggest a correlation between higher transit expenditure and lower poverty rates, yet the influence on income inequality remains less clear and potentially influenced by multiple factors beyond transportation investment. Recommendations for future research focus on the long-term effects of transit investments and considerations of demographic and geographic nuances to guide evidence-based policymaking for equitable urban development