University of North Carolina at Greensboro
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College and career readiness and its impact on the lives of minoritized secondary school students in North Carolina
Full text linkThis research study aims to examine College and Career Readiness (CCR) curriculum as it is experienced by North Carolina’s Native American, Latinx, and African American secondary school students. The project was conducted using an Art Based Research methodology and a Critical Race Theory framework and it was focused on the impact that CCR curriculum has had upon the lives of minoritized students. Eleven college students from Thompson State University were interviewed in an initial round of conversations about their CCR experiences. The interviews were conducted virtually, using the Zoom conferencing platform, and the data was analyzed to produce a travel list for visiting all of the schools and communities that the study participants attended for secondary school. Black and white photographs were taken of these schools and the negatives were later developed and printed in a makeshift darkroom in the home of the researcher. These prints were then analyzed to formulate second-round and focus group questions which were then used for the next two rounds of data gathering. Publicly accessible school documents were also analyzed for information pertaining to college and career readiness. The study participants were exceptionally frank during the conversations and the data that they provided suggests that CCR curriculum is not being provided equally to all secondary school students in North Carolina. Many of the students were acutely aware of instances when they felt that they were being discouraged from taking a challenging college-preparatory curriculum or were not receiving the support necessary to successfully matriculate at a competitive-admission college or university. One of the major discoveries was the significant role that school guidance counselors played in determining the collegiate futures of their student caseloads. The study has limitations, but it contributes to the body of CCR knowledge
Be Fearless! Be Knowledgeable! Get Your Stool Checked!
Full text linkBackground: Colorectal cancer (CRC) is the second leading cause of cancer death and third most commonly diagnosed cancer in the United States. Primary care providers play a critical role in educating patients on screening options and placing screening orders as well as encouraging adherence to recommendations. Purpose: The purpose of this DNP project was to increase colorectal cancer screenings at an underserved suburban primary care clinic located in Kernersville, NC, through a protocol of patient education which enhanced shared decision making between the patient and their primary care provider (PCP). Methods: For three months, an educational handout developed by the American College of Gastroenterology (ACG) was given to patients, aged 45-75, who were checking in for their physical. Providers were also given a pocket guide with updated CRC guidelines. Results: The study concluded that the educational handout increased completed CRC screening. Although the goal was not met for the metric goal, there was a significant increase in the number of CRC screenings from the same months in the previous year. Recommendations and Conclusion: In conclusion, it was found that education played a significant role in increasing CRC screening. Allowing patients more time to read over the educational handout prior to the provider entering the room allowed more time for shared decision making. Recommendation was made to provide colorful, laminated copies to be posted in all patient rooms for continued education related to CRC screenings
Initiating a Standardized Screening Tool for Sexual Histories in College Students
Full text linkBackground: Sexually transmitted infections (STIs) are a consistent and growing problem in the United States. Individuals at risk for contracting an STI are adolescents and young adults. Most college students fall within this category, making them particularly vulnerable to acquiring and spreading these infections. If left untreated, STIs cause detrimental effects such as infertility, pelvic inflammatory disorders, reproductive cancers, and spread of infections (Van Gerwen et al., 2022). Obtaining sexual health histories using the Center for Disease Control and Prevention’s protocol involving the “5 P’s” can ensure early diagnosis and treatment of STIs.. This protocol represents each category of a complete sexual health history: partners, practices, protection from STIs, past history of STIs, and pregnancy intention (CDC, 2022a). Purpose: The purpose of this project was to implement a standardized sexual health history protocol at a college health center to allow staff to obtain a more thorough history so patients can be treated more effectively. Methods: Providers at a student health clinic were surveyed using a LIKERT scale before and after incorporating the CDC’s standardized protocol in the EMR to assess their opinions on the sexual health template. Results: After implementation, most providers believed the protocol provided enough information to develop a plan before meeting and assessing the patient. Recommendations and Conclusion: This project included a very small sample size, which did not allow for any statistically significant data to be collected so future studies should involve a larger sample size
Perioperative Anesthesia Considerations for Patients with Alpha Gal Syndrome
Full text linkAlpha-gal syndrome (AGS) is a lesser-known allergic syndrome that is prevalent in North Carolina and presents a significant risk to perioperative patients. Perioperative patients with AGS are at high risk for an allergic reaction as they are exposed to many triggering agents in a short period of time. The purpose of this project is to increase anesthesia provider knowledge regarding AGS and its perioperative implications. This quality improvement project was conducted at a large, tertiary hospital and included a preintervention survey, educational intervention, introduction of a cognitive aid, and post-intervention evaluation. Surveys showed a large knowledge gap in anesthesia providers regarding AGS. This project found a statistically significant increase in knowledge scores of anesthesia providers post-intervention. AGS education for anesthesia providers and other perioperative providers is therefore recommended to increase knowledge and safety of AGS patients. Anesthesia providers should be encouraged to foster discussions with multidisciplinary teams to identify patients with AGS and avoid triggering agents for these patients. Pharmacy involvement is recommended to maintain up to date information regarding safety for AGS patients’ exposure to medication and surgical products
Does an Educational Intervention on the Benefits of Remimazolam for Endoscopic Procedures Change Practice and Improve Patient Outcomes
Full text linkBackground: Current anesthetics used for endoscopic procedures include primarily propofol, with or without midazolam or fentanyl. Common side effects of these frequently used medications include injection site pain, respiratory depression, hypotension, and prolonged return to baseline neurologic function. While these medications have been the standard, anesthesia techniques are constantly changing to improve patient outcomes. Recent studies have examined the use of remimazolam for sedation on patients undergoing endoscopic procedures such as endoscopy, colonoscopy, bronchoscopy, or transesophageal echocardiogram (TEE) to reduce adverse effects associated with currently utilized anesthetics for these procedures. Purpose: This DNP project intended to change practice and improve patient outcomes by utilizing current literature to educate anesthesia providers on the benefits of using remimazolam for endoscopic procedures in patients over the age of 65. Methods: This project used a pretest-posttest quantitative design with an additional survey component to address knowledge and barriers. An educational intervention was presented to anesthesia providers at the facility. Data collected and analyzed included pre and post intervention patient chart reviews, and post intervention anesthesia provider survey responses. Results: Provider use of remimazolam did not increase or decrease following the intervention, but overall patient outcomes were improved post-intervention. The survey found that anesthesia providers understood and agreed with the presented material and addressed barriers to implementation of the EBP recommendations presented. Conclusion: Findings support that an educational intervention for anesthesia providers on the use of remimazolam for endoscopic procedures in elder patients improves patient outcomes. Increased access to the anesthetic and additional follow up education is recommended to increase provider implementation of EBP recommendations of using remimazolam in the target population
Effects of economic pressure and social support on parental depression and Head Start children’s behavioral problems
Full text linkThe importance of Head Start cannot be understated. This federal program, created out of necessity to address the disparities found in low-income families, has greatly expanded their focus to include the families of the attending children. As low-income families face many stressors, this study seeks to examine how social support could buffer parents from experiencing depression and how it may buffer children from experiencing externalizing behavioral problems. This study aimed to look at the association between parental depression and the interaction of economic pressure by total social support. I hypothesized that parents who live under conditions of high economic pressure and experience higher levels of social support will report lower levels of depressive symptoms. I further expect that children living in the same conditions will experience lower levels of externalizing behavioral problems. This study was conducted as a secondary analysis using a sample (n = 156) children attending Head Start and (n = 134) of their caregivers. Pearson correlations and linear regression models were used in order to test the hypothesis. I created an interaction variable of economic pressure and total social support to test our hypothesis. Results indicated that high economic pressure is associated with higher parental depression, while higher social support was associated with lower parental depression. The interaction between economic pressure and social support, unexpectedly, was not significant. Additionally, child externalizing behavioral problems was not predicted by economic pressure or social support or their interaction. These results highlight the importance of social support and further contributes to the growing literature on Head Start families
A cultural digital jury : a multi-essay exploration of cancellation events, user motivations to participate, and the resulting information asymmetry's economic effects
Full text linkThis dissertation is a multi-essay collection that aims to develop an in-depth conceptualization of recent cultural phenomenon, fueled by widespread use of social media, known as "cancel culture". In this dissertation, we explore the cancellation event, examine users’ motivations in participating in such events, and investigate any information asymmetry that results from them and their effects on a company’s financial performance. We address each of these examinations with the respective methods: a systematic literature review and rendering, a logistic generalized linear model, and a generalized linear model regression. In the first paper, we discovered eight components that make up a working framework of a cancellation event. This working framework includes Judgment, Social Media Engagement, Morality, Collective participation, Emotion, Social Norms, Power, and Accountability. In the second paper, we find factors that drive people to engage in cancellation events, like ambient awareness, morals, message framing, and social capital calculus. The new construct, Social Capital Calculus, has the potential to advance our understanding of cancellation events because we obtain a more nuanced perspective on social capital by shedding light on how users' influence and diversity of information intertwine to shape online conversations and collective perceptions. In our final essay, we find several interesting findings. Firstly, initial tweets sentiment and influence scores of tweets in a cancellation event impact the company's response, suggesting user sentiment guides company communication strategies. Secondly, high topic entropy (unfocused discussion), amplified by information asymmetry, negatively affects stock prices. Overall, this dissertation provides a comprehensive understanding of cancellation events through a novel framework, explores user motivations with a new construct ('Social Capital Calculus'), and identifies information asymmetry's moderating effects on company responses and stock prices. These findings offer valuable insights for companies, users, and researchers studying this online phenomenon and its impact
The associations among childhood surgency, self-perceived popularity, and adolescent risk-taking behaviors considering sex differences
Full text linkAdolescent risk-taking behaviors, including substance use and risky sexual behaviors, contribute to the leading causes of death and disability among youth and adults (CDC, 2020). It is important to understand developmental and contextual variables that predict risk-taking behaviors to mitigate harmful outcomes and inform prevention efforts. Developmental literature has considered childhood temperament as it relates to risk-taking behavior in adolescence. Specifically, temperamental surgency has been linked to risk-taking outcomes (e.g. Youssef et al., 2016; Cooper et al., 2001; Honomichl & Donnellan, 2012). Peer popularity has also been positively associated with risk-taking outcomes in adolescence due, in part, to increasing salience in social rewards and motivations for high peer status (Brechwald & Prinstein, 2011). While sex differences in the association between popularity and risk-taking have been noted in the literature (e.g. Prinstein et al., 2011), little is known about sex differences in childhood surgency and how potential differences may be related to risk-taking behaviors. Therefore, this study examined sex differences in the association between surgency, self-perceived popularity, and risk-taking. Using a sample of 271 children (125 males, 146 females) at 4 and 15-year assessments, we examined whether the association between early temperamental surgency (age 4) and its relation to risk-taking (age 15), is moderated by self-perceived popularity (age 15) and sex. Results of the three-way interaction indicated a significant association between surgency, self-perceived popularity, and sex predicting risk-taking in adolescence; the association between surgency and risk-taking was exacerbated at high levels of self-perceived popularity for females only. Implications for prevention and intervention efforts in the context of peer relationships are discussed
The parts I've lost: An autoethnographic study of a transition program designed to aid former wilderness therapy field instructors
Full text linkThe efficacy of wilderness programs incorporating therapeutic methods has long been researched, and studies have found wilderness interventions beneficial for youth and adults suffering from various mental and behavioral challenges (Berman & Davis-Berman, 2008). The success and safety of the clients often fall on the field instructors (FI) employed in these types of programs. FI oversee the day-to-day safety of the clients and assist in leading expedition-based therapeutic outdoor programming for youth. Due to the volatile and unpredictable nature of wilderness therapy (WT) and outdoor behavioral healthcare (OBH) programs, these instructors are uniquely positioned to encounter various traumatic experiences and other potential life-altering mental health conditions (Bunce, 1989). Field Instructors face numerous challenges, including (1) constant awareness to keep clients safe, (2) lack of time for self-care, (3) threats or acts of violence from clientele, (4) stress that arises from working with clients with mental issues such as self-harm (Kirby, 2006; Kirk & O’Connell, 201;). Many wilderness therapy instructors encounter and develop various mental health issues, including post-traumatic stress disorder (PTSD), secondary traumatic stress (STS), transference, and shared and vicarious trauma (Marchand & Russell, 2013; Wilson, 2009). Instructors become adept at caring for their clients; however, the same field instructors often forego their needs for the health and safety of the children and young adults they look after.Therefore, my research proposes that an intentionally designed transition program for wilderness therapy instructors, either currently employed or leaving the field, will provide individuals with the space to reflect on their experiences and the resources to set themselves up for success. The purpose of this study is to explore my experiences in said transition program. I ask two questions to guide my research: (1) What are my experiences on a self-designed, 3-day backpacking course for former wilderness therapy instructors? (2) How did the course impact my physical, emotional, and psychological transition out of the wilderness therapy field into everyday life
Discoveries for wellbeing in and with the Project EXPLORE community
Full text linkProject EXPLORE (PEX) is a nature-based learning (NBL) program designed by the NC Arboretum to help North Carolina K–12 teachers implement community or citizen science-based curricula in their classrooms. Teachers in the program receive materials and on-site coaching to facilitate the NBL curricula. PEX and similar programs are part of ongoing efforts to reconnect youth with the natural environment through formal curriculum initiatives (Jordan & Chawla, 2019; Williams & Dixon, 2013). Despite successes, many real and perceived barriers prevent the broader adoption of nature-based learning (NBL) in public education systems (Oberle et al., 2021; Waite, 2020). Teachers’ lack of confidence has been identified as critical to mainstream implementation (Jordan & Chawla, 2019). Furthermore, classroom stress and teacher attrition are symptoms of a crisis in teacher wellbeing, factors that negatively impact students (Lever et al., 2017). This study queries whether eacher stress and burnout may be mitigated by the same positive outcomes of NBL that students experience—like improved student-teacher relationships (Toropova et al., 2021), emotional regulation (Williams & Dixon, 2013), and enhanced motivation (Dettweiler et al., 2017). Few studies take teachers’ wellbeing or their perceptions of nature-based stress management into account. This study considers whether more teachers might incorporate NBL practices if we promoted outdoor education as much for teachers’ wellbeing as for students’. The purpose of this study is to explore how participating in PEX impacts teachers’ “wellbeing.” We specifically investigate how participating in Project EXPLORE impacts teacher wellbeing and what Project EXPLORE experiences teachers associate with their sense of wellbeing. Informed by critical feminist theory, we used an amended two-part collective memory work (CMW) design. The collaborative process of CMW centers individual experience and reality while locating these within societal and cultural contexts (Johnson, 2018). We invited all 200+ former PEX participants to share a short video narrative about a memory of the program’s impact on their wellbeing. Three teachers responded with videos and chose to participate as co-researchers in the focus group. As with traditional CMW, co-researchers analyzed the video diary entries for meaning. The group discussed ways PEX supported identity development, self-actualization, student-teacher relationships, and importantly, was a powerful tool for self-liberation within a neoliberal school context. The co-researchers elected for the results to be presented in a short video format