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Medically unexplained symptoms (MUS), defined as symptoms lacking objective test findings or known biological causes, are highly prevalent and pose significant challenges for healthcare providers. Often associated with complex biopsychosocial origins, MUS can lead to diagnostic uncertainty. Consequently, providers may rely on patient characteristics, such as gender and mental health history, when making a diagnosis or determining appropriate treatments, which may introduce bias into their decision-making. This study investigated how these factors influence provider decision-making in diagnosing and treating MUS, focusing on two key research questions: (1) How does knowledge of a patient’s gender and mental health history affect diagnostic assessment? And (2) How does it impact treatment likelihood?
A sample of 152 primary care providers participated in the study, through an online survey, which implemented a 2x2 factorial between-subjects design. Participants were randomized into one of four conditions and reviewed clinical case vignettes, responding to questions regarding diagnostic and treatment considerations. The findings revealed a significant effect of patient gender and mental health history on treatment decisions. Providers were less likely to recommend medical follow-up for female patients with a history of depression and anxiety compared to male patients without a history of mental health concerns. For symptoms specifically involving generalized pain and fatigue, providers were more likely to attribute them to behavioral health factors than medical causes in female patients with histories of depression and anxiety compared to other groups. Conversely, for patients without a mental health history, providers favored medical follow-up over behavioral health interventions, regardless of patient gender. No significant differences emerged for diagnostic assessment or behavioral health treatment recommendations across groups.
These results suggest that patient gender and mental health history influence provider decision-making regarding the management of MUS, highlighting the need for strategies to reduce bias and improve equity in clinical decision-making. Additional research is warranted to explore these relationships further and better understand how various factors impact the assessment and treatment of ambiguous symptoms.
Transportation electrification is a critical global policy, and the effective integration of electric vehicles (EVs) is key to ensuring power grid reliability and resilience. This dissertation proposes solutions to address the integration of fleet EVs (FEVs) into distribution grids, using cloud-based and edge-based approaches.
First, a centralized, cloud-based optimization model is developed for the strategic placement of FEV charging stations, designed to enhance grid resilience during high-impact, low-probability events like hurricanes.
Second, a bilevel optimization framework is introduced to aggregate FEV charging with other distributed energy resources (DERs), enabling their participation in the ISO day-ahead energy and reserve markets. This approach models FEVs as part of a Distributed Energy Resource Aggregator (DERA), providing energy and ancillary services.
Third, a novel cloud-edge collaboration framework is proposed to enable decentralized control of FEV charging stations at the grid edge. This framework uses federated reinforcement learning, allowing individual FEVs to coordinate their actions locally while contributing to voltage regulation and grid stability.
These solutions offer a comprehensive approach for optimizing the deployment and control of FEV charging stations, addressing both operational efficiency and market integration in modern power grids.
Black women are underrepresented in secondary math education, but their presence is critical for young black girls who dream of STEM careers. Some researchers believe that the number of Black women pursuing secondary math licensure can be increased through improved recruitment strategies, while others focus on causes of leakage in the education pipeline. This study sought to discover types of capital that Black women, who are preservice Mathematics teachers (PSMTs), relied on to persist towards the completion of their teacher preparation programs.
Framed using Critical Race Feminism and Black Feminism, this study employed Counternarrative Inquiry to discover the capital that the five PSMTs credited for their ability to stay the course. The findings indicate that, while PSMTs might use the same capital, they use it in a variety of ways and for different purposes.
A key implication of the findings from this study is that, if undergraduate math educators can mitigate or eliminate the conditions within the math classroom that triggers the use of many of the capitals in this study, Black women who are PSMTs may be able to divert their energies to developing robust mathematical identities.
Increasing tensions in American society surrounding social equity issues and minority statuses like race and sexual orientation have prompted competing social narratives. Historically marginalized groups face disparate socioeconomic, housing, and educational opportunities. The existing body of research and governmental data contend that there are strong relationships between minority status(es) and housing instability. However, most of the presently available research does not examine these relationships within the school district’s economic context and local homelessness response efforts. This dissertation investigated the association of housing instability with minority status(es), school district, and homelessness response efforts. A descriptive quantitative case study was conducted of Black and White adolescents, between the ages of twelve and eighteen, identifying as heteronormative or LGBTQ+. Data used came from the Oakland Unified School District and the Los Angeles Unified School District. This study employed Critical Race Structuralism and Quantitative Critical Theory to guide the study’s analysis. Cross-sectional data from the 2017 Youth Risk Behavior Surveillance System (YRBSS) survey was used for secondary data analysis. The present study analyzed intersections between race, sexual orientation, school district, and housing instability.Opportunities for further data collection and exploration were identified and implications for policy and programming were discussed.
Keywords: race, sexual orientation, housing instability
As the demand for stabilized and fast-tuning laser sources continues to grow in metrology applications, there is a corresponding need for innovative laser sources that satisfies this need. This dissertation aims to create a novel stabilized and frequency-modulated (FM) laser source utilizing Volume Bragg Grating (VBG) as a wavelength selection method. In order to produce this source, six subsystem components need to be integrated. These include: 1) selecting the proper laser source, 2) implementing a PID control to maintain temperature and source current, 3) laser source fast and slow axis collimation, 4) optimizing the bonding between components of the mechanical frequency-based modulator, 5) opto-mechanical design of a fixture for the modulator to enhance adjustment, and 6) interferometric measurement of the modulation depth using a Michelson configuration.
The periodic refractive index written within the bulk VBG provides a feedback mechanism to act as a wavelength selective mirror as an external cavity to the laser diode. Two piezoelectric (PZT) actuators bonded at each end of the VBG generate the oscillatory force to create a mechanical modulation of the diffraction wavelength in traditional external cavity frequency modulation techniques. This novel approach requires bonding of the actuators. To minimize damping by adhesive layers, it is necessary to choose an appropriate adhesive. Among the adhesives studied, E60HP has proven to give the best result in terms of amplitude. A mechanism that provides 6 degrees-of-freedom adjustment of the oscillator to align VBG diffraction grating to the wavefront of the laser beam is developed and tested. The VBG alignment results gave a spectrometer limited linewidth of 0.27 nm. Modulation depth study still needs to be investigated. The final system is comprised of a 775 nm external cavity laser diode, a 3033-layer VBG at replay wavelength at 778.17 nm, and with frequency modulation at 530.7 kHz.
The number of low-performing schools has drastically increased since COVID-19. During the 2018-2019 school year, there were 488 low-performing schools (North Carolina Department of Public Instruction, 2024). The number increased to 736 schools during the 2023-2024 school year, a 50.8% increase (North Carolina Department of Public Instruction, 2024). Understanding factors related to climate in these schools is pertinent to making teachers’ jobs more rewarding while improving student outcomes (Rosenburg & Anderson, 2021). Though there is research on school climate and student achievement, more research is needed to examine school climate in low-performing elementary schools in North Carolina.
This quantitative study explored whether two school-level characteristics, namely, schools’ Education Value-Added Assessment System (EVAAS) growth status and school performance grade, impact teachers' confidence levels regarding principal leadership, teacher leadership, student discipline, and teacher retention. Thus, this quantitative study sought to answer the overarching research question: whether there are statistically significant differences in perceptions of principal leadership, teacher leadership, student discipline, and teacher retention based on their school’s EVAAS growth measure and performance grade.
This study’s participants were certified staff members from 293 low-performing public elementary schools ranging from pre-kindergarten to fifth grade in North Carolina during the 2021-2022 school year. The statistical analysis used was a 2 x 2 factorial MANOVA, which measured the dependent variables (principal leadership, teacher leadership, student discipline, and teacher retention). Additionally, the 2 x 2 factorial MANOVA examined the EVAAS growth measure (met or not met) and the school performance grade from each school (D or F) based on the certified staff perspectives of the dependent variables. Findings suggest that teachers’ perceptions of teacher leadership and teacher retention differ significantly based on the school’s EVAAS growth measure and performance grade in low-performing elementary schools in North Carolina. However, the results did not align with previous research on teachers’ perceptions of principal leadership and student discipline, as there was no statistically significant difference.
The decentralized systems take a significant role in the public and private sectors that serve different needs of the organizations. The heart of those systems in any system is the dissemination protocol. Hyperledger Fabric is a highly recommended option for production-ready distribution network systems. Though Hyperledger Fabric is intended to have any consensus protocol as a pluggable module, it does not provide technical guidance on how to plug a consensus module there. Furthermore, the first release of Fabric used Kafka as its consensus protocol and then switched to Raft as its consensus protocol. Both Kafka and Raft are Crash fault-tolerant (CFT) protocols that do not support Byzantine fault participants. This paper examines the required steps to plug a consensus protocol into Hyperledger Fabrics and, more importantly, integrates the Byzantine Fault Tolerant consensus protocol BDLS into Hyperledger Fabrics. The consensus protocol BDLS is among one of the most efficient and promising BFT protocols for blockchains. The paper presents detailed technical insights in integrating the BDLS protocol into Hyperledger Fabric, highlighting the intricacies and benefits of this integration. In the last part of the paper, we compare the performances
of Raft and BDLS based Hyperledger Fabrics.
The study shows that Hyperledger Fabric, employing BDLS fault tolerance protocols, matches the performance of the existing Raft-based Fabric. Our BDLS Fabric implementation, featuring BFT consensus, achieves a throughput of 2717 transactions per second (TPS), nearly on par with Raft-Fabric's 3083 TPS, despite Raft-Fabric lacking support for BFT consensus. All the codes are available in the GitHub repository: \url{https://github.com/BDLS-bft/fabric}.
Teachers at K-12 supplemental virtual programs may support Quality Matters™ peer reviews for organization-managed master courses. Although there are time, focus, and capacity concerns with this practice as teachers in supplemental programs may not have expertise designing courses or writing online content, the experience of serving as a Course Representative and applying the QM rubric throughout the process provides the potential for an enduring professional development opportunity for teachers that may enrich their commitment to virtual instruction and their understanding of the comprehensive virtual learning environment. This qualitative case study explored the experiences and perspectives of K-12 online teachers at a state-led supplemental school who teach online and have served as Course Representatives for organization-managed master course QM peer reviews. Document analysis and semi-structured interviews served as sources of data, and data was coded using deductive codes from Ali and Wright’s (2017) Online Faculty Professional Development model and inductive codes focused on participants’ experiences and perspectives. The study guides K-12 educators on the potential professional impact of serving as Course Representatives for organizational course reviews. It also provides recommendations for K-12 virtual programs considering quality assurance implementation at their organization. Further research, including cross-site studies, quantitative research, or mixed methods inquiry that explore virtual educators supporting a culture of quality at their respective institutions, may extend the study’s findings. Additionally, studies focused on K-12 teacher's perceptions of priorities in course design, online instructional practice, and virtual teacher leadership, could build upon themes and findings.
The purpose of this study was to better understand the living-learning community (LLC) experience and the residential-optional learning community (ROLC) experience, specifically the aspects that had the most influence on college transition and involvement according to students. The LLC model specifically has become common practice within higher education, but there is very limited research available for other learning community models that may more effectively meet student needs. Seven semi-structured interviews were conducted with students who participated in a living-learning community or residential-optional learning community during the 2021-2022 academic year at a large, PWI, urban research institute. Four major themes were identified: (1) Multiple Factors Affected the Decision-making Process related to Housing Choice, and It Emerged that Residential-Optional LCs Offered the Best Choice For Many Students, (2) Living the Unexpected: COVID-19 Had A Significant Impact On Learning Community Decision-Making and Institutional Operations, (3) The Importance of Finding Community: The Loss of Normalcy During COVID-19 Impacted Student Motivation To Find Connection In Learning Communities, and (4) Students Were Looking For Support and Growth Entering College and They Found Them Within the LC. The findings of this study indicated strong outcomes related to the ROLC experience and challenges related to the lack of housing flexibility in the LLC experience that provides additional considerations for higher education leaders who are seeking to provide high-impact practices that will support first-year students.
The purpose of this study was to investigate novice middle school teachers’ perceptions concerning classroom management. Classroom management is a crucial component of teaching. However, it has consistently been a difficult area for novice teachers or teachers having less than three years of teaching experience (Albright, 2017; Kelly et al., 2015; Rose & Sughrue, 2021; Weinstein & Everston, 2013). While it is evident that novice teachers struggle with classroom management, the way in which they conceptualize it needs further clarification. Determining precisely what specific aspects of classroom management with which novice teachers struggle also needs to be explored further. Using a phenomenological, qualitative design, data was collected using individual interviews. Interviews with eight novice, middle school teachers led to various notable findings. The findings included (a) novice middle school teachers’ conceptualizations of classroom management center on the importance of establishing and maintaining a healthy community for learning, as well as the use of repetitive structures and procedures to lead and facilitate classroom activities; (b) intervening in student misbehavior was found to be the most difficult aspect; (c) building relationships is essential for all teachers, and relationship building can bring about classroom management success; and (d) novice teachers need classroom management support with peer-led or real time learning opportunities. This study illustrates how novice middle school teachers define classroom management and explores what aspects of classroom management cause novice teachers the most struggle. Prior research has offered a broad, bird’s eye view of the problem of classroom management. These findings provide specific problems from the voices of teachers and suggests that providing novice teachers with peer-led or real-time classroom management support could greatly enhance their classroom management skills.
