University of North Carolina Hospitals

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    95038 research outputs found

    RECONCEPTUALIZING TEACHER EDUCATION THROUGH CRITICAL POSTHUMANISM: CULTIVATING RELATIONAL CONSCIOUSNESS AND JUSTICE ORIENTATIONS IN PRESERVICE TEACHERS

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    This research stems from an urgent need to integrate critical thinking about both social and ecological injustice in the space of teacher education. Critical posthumanism is a philosophy that offers a way to conceptualize social and ecological injustices together, yet its application and integration in the space of teacher education has been sparse. My dissertation was guided by the following questions: 1) How can critical posthumanism be applied and integrated within a teacher education course?; and 2) What is the impact of integrating critical posthumanism in a teacher education course for preservice teachers? To answer the first of my research questions, I use diffractive analysis to formulate a working framework for a critical posthuman teacher education. Integrating my findings and using Arts-Based Learning methods, I reconceptualize an existing Masters of Teaching course. To answer the second of my research questions, I used an action research methodology in my implementation of this course within a teacher education program in the Southeastern US. Using methods of thematic analysis and triangulation, I analyzed the course artifacts from nine participants to understand the impact critical posthumanism had on their thinking. Notably, I find that critical posthumanism shifts participants’ conceptualizations of identity and positionality, learning, teaching, and education; enhances participants’ relational consciousness; and expands participants’ justice orientations. The implications of my findings for teacher education are discussed, as are directions for future research.Doctor of Philosoph

    Market Society, Open Society? Contemporary Protestant and Catholic Critiques of Market-Oriented Liberalism

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    Conflicts between liberalism and religion abound. Most of the immense scholarly literature on this topic centers on the use and abuse of state power. However, the state is hardly the only institution in liberal theory and religious critics of liberalism do not only (or even primarily) target the state. Markets and commerce play a substantial role in our common life—and so must be the subject of analysis. Advocates of market society maintain it is a distinctly open society allowing many ways of life to coexist. Christian critics disagree: market society privileges ways of life which are friendly to capitalism–it is “open for business” but not much else. My dissertation assesses these contemporary Protestant and Catholic objections to defend a more open, pluralistic social order. Critical reflection on consumption, the local church, and the small farm each highlight how market society can limit access to ways of life for all, religious or not. Chapters deal in detail with the way that the market society does—or does not—facilitate the pursuit of a range of ways of life. In the process I reframe and advance liberal ideas. Ultimately, I argue market society can be salvaged–and openness expanded for all. I theorize improvements within our society, paving the way to a more open, flourishing social order. More than critique, Market Society, Open Society? draws on market-oriented liberal theory, political economy, and the theology and practice of religious groups to cultivate change, opening ways of life which are not so bound to the ways and means of capitalism thereby expanding access to many ways of life, religious or not.Doctor of Philosoph

    Improving Multimodal Analgesia Medication Administration in a Total Joint Replacement Enhanced Recovery After Surgery Pathway

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    Enhanced Recovery After Surgery (ERAS) pathways are multidisciplinary, evidence-based care practices that improve patient outcomes following surgery and emphasize multimodal, opioid-sparing analgesia for pain management. The primary aim of this project was to meet the project site’s 80% adherence goal to the preoperative multimodal analgesia component of a total joint replacement ERAS pathway. Analysis of orthopedic surgeons' order sets revealed variations in preoperative multimodal analgesia medication orders. A resource guide was created for anesthesiologists to supplement orthopedic surgeons’ orders and meet ERAS requirements. Prior to project implementation, anesthesiologists received education on the ERAS pathway and resource guide. Three months of baseline data was compared to three months of project implementation data. Adherence to ERAS multimodal analgesia improved slightly between the baseline and project implementation periods but the 80% adherence goal was not achieved. Ongoing provider education, use of standardized order sets, and increased interdisciplinary involvement may improve ERAS pathway adherence.Doctor of Nursing Practic

    MEASURING THE IMPACT OF CULTURALLY RESPONSIVE TEACHING TRAINING ON ADVANCED PLACEMENT TEACHERS’ SELF-EFFICACY TO MEET DIVERSE ADVANCED PLACEMENT LEARNERS’ NEEDS AT PORTER HIGH SCHOOL

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    The purpose of this study is to examine how AP teachers’, at Porter High School (PHS), self-efficacy in meeting the needs of diverse learners in advanced spaces is impacted by Culturally Responsive Teaching (CR Teaching) training. This paper examines the Achievement, Opportunity, and Excellence Gaps, and how these gaps are connected to AP courses in the United States. Finally, the study examines how teacher-designed and facilitated Professional Development (PD) on Culturally Responsive competencies support AP teachers’ sense of self-efficacy, impacting the likelihood of their incorporating Culturally Responsive (CR) Teaching practices into their AP instruction. This study aims to empower teachers to lead school-level reform through professional collaboration to address the needs of racially, culturally, ethnically, and linguistically diverse (RCELD) students more effectively at the grassroots level, ultimately enhancing AP programming.Doctor of Educatio

    IMPACT OF STAKEHOLDER ENGAGEMENT AND UNDERLYING FACTORS ON THE DESIGN, EVALUATION, AND KNOWLEDGE TRANSFER OF AUTOMATED QA TOOLS IN TWO RADIATION ONCOLOGY DEPARTMENTS PRIOR TO IMPLEMENTATION

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    The physics pre-treatment quality assurance (QA) step is the step mostly likely to detect potential safety events in the radiation therapy process. However, there is a need for improving the physics pre-treatment QA checklist with the process relying heavily on human inspection and evidence that errors still occur. The purpose of this study is to explore the impact of stakeholder engagement and underlying factors in the design and evaluation of an automated physics pre-treatment QA checklist. This work was done through knowledge transfer between two radiation oncology departments at the University of North Carolina (UNC) and the University of California-San Diego (UCSD) prior to implementation by first exploring factors underlying the design, use, and maintenance of the current physics pre-treatment QA checklists using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. An automated physics pre-treatment QA checklist (“PhyCheck”) prototype was developed at UNC, which demonstrated increased usability and decreased cognitive workload (CWL) compared to the current checklist. Safety events captured using the current physics pre-treatment QA checklist and qualitative data on automation and safety demonstrate the potential for automation to catch safety events and outline key barriers for automation. The engagement of stakeholders led to knowledge transfer between institutions and both institutions meeting the threshold for pre-implementation outcomes. This study highlights the importance of stakeholder involvement and engagement and outlines the underlying factors in the design, evaluation, and pre-implementation of health technology tools.Doctor of Philosoph

    DISASTERS IN NIGERIA’S COLONIAL HISTORY: A CASE STUDY OF THE 1957 LALUPON TRAIN ACCIDENT

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    On September 29, 1957, three years before the Union Jack was lowered in Nigeria, a train carrying approximately 700 passengers derailed near Ibadan (Lalupon). The train derailment resulted in the deaths of around 200 passengers, including about thirty-three students from the Nigerian College of Arts, Science, and Technology, Zaria Branch. While the British colonial authorities attributed the cause of the train accident to flooding, the West African Pilot (WAP), a nationalist newspaper, contended that the disaster stemmed from the incompetence of the colonial government in managing the Nigerian Railway Corporation. This paper examines the Lalupon derailment as a pivotal moment in the history of Nigerian nationalism. Utilizing primary sources such as oral interviews, WAP, the Nigerian Daily Times, and colonial documents, this paper argues that the Lalupon disaster represented an epiphany for ordinary Nigerians – who were not actively engaging in politics – to exercise collective action and voice their opposition to British rule. It was a key moment that amplified existing anticolonial critiques and decades of grievances. The paper examines responses to colonial rule and provides insight into grassroots nationalism in Southwestern Nigeria that might otherwise remain invisible.Master of Art

    C–C BOND FORMATION REALIZED BY AMIDYL-RADICAL-MEDIATED CHAIN REACTIONS

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    I. X–H Functionalization as a Means for Achieving C–C Bond Formation An overview of the benefits and challenges related to site-selective, intermolecular C(sp3)–H and carboxylic acid O–H functionalizations are discussed, particularly as they pertain to enabling C–C bond formation. II. Strategic Introduction of Carbon Fragments Onto Building Blocks and Late-Stage Molecules The development of an amidyl-radical-mediated chain reaction to convert aliphatic C(sp3)–H bonds into a variety of C–C bonds is discussed. The methods disclosed include (a) C–H functionalizations of tertiary alkylamines and (b) α-heteroatom C–H thioetherification followed by alkylation with an organometallic species. III. Decarboxylative Homologation Using a Radical–Polar Conjunctive Reagent The development of one-carbon homologation of aliphatic carboxylic acids is discussed. Particular attention is paid to the iterative design of a two-carbon SOMOphile that was critical to achieving the desired synthon for the overall transformation. IV. Rapid Access to Α-Ketoesters via C–H and Decarboxylative Pyruvylation Alpha-ketoesters are regarded as highly diversifiable intermediates in organic synthesis, with numerous applications ranging from unnatural amino acid construction to heterocycle formation. A late-stage approach to installing these functional handles onto C(sp3)–H and carboxylic acid-containing molecules is discussed.Doctor of Philosoph

    EXPLORING THE EFFECTS OF PRESCRIBING AND IMPLEMENTATION TECHNIQUES ON THE ADOPTION OF VIRTUAL REALITY THERAPEUTICS

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    Anxiety, depression, and pain are among the most prevalent and disabling health conditions globally. Digital therapeutics (DTx), especially virtual reality-based therapeutics (VRx), are emerging as effective non-pharmacological treatments for at-home symptom management. Despite growing evidence of clinical efficacy, widespread adoption of both DTx and VRx in routine care remains limited. To assess the rigor of existing evidence, we systematically reviewed randomized controlled trials evaluating VRx for treating and managing symptoms experienced by cancer patients and survivors. We analyzed research testing VRx as a home-based treatment for various health conditions, mapping the barriers, facilitators, and implementation frameworks. We evaluated clinician and user perspectives through two mixed-methods studies, identifying critical system requirements for VRx dissemination. Using human-centered design, we developed and tested an implementation package, including assistive materials, clinician training, and prescribing tools. We completed a three-arm randomized pilot, assessing acceptability, usability, and fidelity of the implementation package and prescribing VRx in a simulated clinician consultation. Technology acceptance significantly improved across all groups (p < 0.05); usability, acceptability, and fidelity were highest when clinician consultation was included. Findings highlight the critical role of clinicians and impact of structured implementation strategies on the widespread adoption of VRx. This study contributes to implementation science by providing a structured assessment of implementation strategies and outcomes, where empirical testing remains limited. The findings expand evidence on the adoption of DTx by providing a holistic understanding of factors driving implementation success and offering actionable insights for scaling VRx for at-home care. Ultimately, this work provides a framework for making DTx usable, useful, and scalable where patients need care most: at home.Doctor of Philosoph

    On Points in the Piedmont: A Study of Transitions in Functional Types and Lithic Traditions Associated with Projectile Weapon System Use in North Carolina

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    The transition between the spear thrower (atlatl) and bow in eastern North America (ENA) has long served as an important area of consideration for understanding processes of cultural change in the region, as the shift between these two technologies is theorized to have significantly impacted various aspects of the social organization of Native communities (e.g., hunting, warfare, and settlement patterns). Given poor preservation of perishable components of these tools, developing methods for determining the functional uses of their lithic projectile points has been a core focus of research on projectile weaponry. Using a sample of type specimens from the North Carolina Piedmont in the North Carolina Archaeological Collection, I evaluate both support for existing temporal models of the bow’s adoption and the methods used to create these models. The results of this study indicate a Late Woodland introduction for the bow in this area, while simultaneously refuting the traditional notion that small, triangular point forms are directly indicative of the first arrowheads.Master of Art

    Chasing the Rainbow and Boekie Woekie: The Artist's Book as a Medium Made of Motion

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    The “artist’s book” has been an expanding field of creative practice since the 1960s. Critical writing in the late 20th century attempted to define how the newly conceptualized practice was distinct from historical ways in which artists had been engaged with the book form. Now that the “artist’s book” is a firmly established idea, critical writing has moved toward interrogating its parameters and exploring methodologies tailored to the unique characteristics of the book as a medium.This thesis proposes movement as the defining distinctive characteristic of the artist’s book: movement on the page surface, movement through a book’s pages, and movement of the book among readers through distribution. Through detailed analysis of the bookwork Chasing the Rainbow, by Rúna Thorkelsdóttir, and of the artists’ bookstore Boekie Woekie, I explore what a methodology based in theories of movement, such as Henri Lefebvre’s rhythmanalysis, can bring to the study of artists’ books.Master of Art

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