Dissertation Defense Announcements

Candidate Name: Tyler Coker
Title: You are on Mute, an Empirical Study on Identity Threat and Resilience on Voice Patterns with the Moderating Effect of Supervisor Incivility
 March 29, 2024  9:00 AM
Location: Zoom Link: https://charlotte-edu.zoom.us/j/99161019264

This dissertation explores employee voice behaviors, specifically promotive voice and prohibitive voice. Literature acknowledges that employee voice behaviors are primarily measured at the individual level. However, there is a need for more research on employees' experiences or the potential influence that supervisors have on employees' voices (promotive and prohibitive) through actions such as supervisor incivility. Drawing from Conservation of Resource theory and the resource of Psychological Safety as the theoretical framework. This study reviews the interaction of experiences such as employee resiliency, threats to employee identity, and employee voice behaviors with moderating effects of supervisor incivility. A sample size of employees (N= 294) provides support for the relationship between employee resiliency and promotive voice behaviors. In addition, the study provides insights on practical implementation and future research in academia.

Candidate Name: Xu Cao
Title: Design and Analysis for Two-Phase Studies with Survival Data
 April 01, 2024  10:00 AM
Location: Fretwell 315

Large cohort studies under simple random sampling could be prohibitive to conduct with a limited budget for epidemiological studies seeking to relate a failure time to some exposure variables that are expensive to obtain. In this case, two-phase studies are desirable. Failure-time-dependent sampling (FDS) is a commonly used cost-effective sampling strategy in such studies. To enhance study efficiency upon FDS, counting the auxiliary information of the expensive variables into both sampling design and statistical analysis is necessary.

In survival analysis, it's commonly assumed that all subjects in a study will eventually experience the event of interest. However, this assumption may not hold in various scenarios. For example, when studying the time until a patient progresses or relapses from a disease, those who are cured will never experience the event. These subjects are often labeled as ``long-term survivors'' or ``cured'', and their survival time is treated as infinite. When survival data include a fraction of long-term survivors, censored observations encompass both uncured individuals, for whom the event wasn't observed, and cured individuals who won't experience the event. Consequently, the cure status is unknown, and survival data comprise a mixture of cured and uncured individuals that can't be distinguished beforehand. Cure models are survival models designed to address this characteristic.

Chapter~2 discusses the semiparametric inference for a two-phase failure-time-auxiliary-dependent sampling (FADS) design that allows the probability of obtaining the expensive exposures to depend on both the failure time and cheaply available auxiliary variables. Chapter~3 considers the generalized case-cohort design for studies with a cure fraction. A few directions for future research are discussed in Chapter~4.

Candidate Name: Randell Nairn
 April 09, 2024  9:00 AM
Location: https://charlotte-edu.zoom.us/j/94272321078

Scholars are particularly interested in understanding effective strategies to turn around business performance as businesses experience periods of decline. As the COVID-19 pandemic has revived the importance of better understanding effective turnaround strategies within organizations, additional research is needed to support businesses as they work to recapture or exceed pre-decline performance. This dissertation's research model suggests that operational and strategic turnaround responses have a relationship with firm performance. It is empirically tested using data collected from 98 top management team members across the United States regarding the operational and strategic turnaround responses implemented to combat the decline caused by COVID-19. The results show that strategic turnaround responses positively impacted firm performance. These findings have practical as well as theoretical implications that suggest the type of turnaround response needed in times of future global phenomena.

Candidate Name: Brendalynn Lieberman
Title: The Effects of Safe Sex Practice Education on Knowledge and Attitudes Among College Students
 March 27, 2024  9:00 AM
Location: CHHS 102

The effects of safe sex practice education on knowledge and attitudes among college students. (Under the direction of DR. KATHLEEN JORDAN)

Introduction: Sexual health education is crucial in reducing the burden of STIs among young adults. Comprehensive sexuality education can lead to positive risk reduction outcomes, such as delayed initiation of sex, a decreased number of sexual partners and frequency of sex, and increased use of contraceptives. The purpose of this study was to evaluate the effectiveness of an educational program focused on sexually transmitted infections (STIs) and safe sex practices among college students who are Greek life members. The intervention aimed to enhance the knowledge and attitudes of these students regarding sexual health and promote healthier sexual behaviors. This project is significant as it endeavors to fill the gap in existing literature concerning the effectiveness of sexual health education in college populations who are at heightened risk for STIs.
Design/Methods: The study utilized a pre-post intervention quantitative design. A convenience sample of 23 sorority and fraternity members aged 18-24 participated in the study. The intervention included an educational session focusing on aspects of sexual health, including transmission, screening, prevention of STIs, as well as safe sex practices. Participants were surveyed before and after the educational intervention using the STD Knowledge Questionnaire (STD-KQ).
Results: Of the 55 Greek life members who completed the pre-test, 23 completed the post-test. A paired-sample t-test showed that there was a statistically significant difference in STD-KQ scores pre- and post-intervention, t(22) = 4.51, p < .001, 95%CI [3.36, 9.08]. The average STD-KQ scores significantly increased from 8.65 ± 5.69 pre-intervention to 14.87 ± 5.69 post-intervention, indicating a significant improvement in STI knowledge and attitudes among the participants after the educational program. Additionally, most respondents reported an increased likelihood of using condoms during sexual activity post-intervention. Additionally, the respondents also reported an increased awareness of STDs and safe sex practices.
The findings highlighted the positive impact of targeted sexual health education in a university setting, especially within the Greek life community. These results underscored the need for universities and health educators to prioritize and integrate sexual health education within the curriculum. Lastly, the study also supports adopting a structured, informative approach to improve students’ awareness and practices regarding STI prevention.

Candidate Name: Christine Sisk
Title: Effectiveness of Cardiac ERAS Multimodal Analgesia on Perioperative Pain in Adult Cardiac Surgery Patients
 March 27, 2024  1:00 PM
Location: College of Health and Human Sciences: Room 102


CHRISTINE SISK. Effectiveness of Cardiac ERAS Multimodal Analgesia on Perioperative Pain in Adult Cardiac Surgery Patients. (Under the direction of Dr. KATHLEEN JORDAN)

Cardiac surgeries often rely on opioid analgesics, which can lead to adverse effects. The implementation of the multimodal analgesic approach, as a part of the ERAS protocol, has the potential to optimize intra- and postoperative pain management, leading to reduced opioid-related complications and improved patient outcomes. The purpose of this study was to evaluate the efficacy of multimodal analgesia within a Cardiac Enhanced Recovery After Surgery (ERAS) program in reducing postoperative pain and opioid consumption in adult cardiac surgery patients. This study compared the effects of cardiac ERAS multimodal analgesia against traditional opioid-based analgesia on postoperative pain and opioid consumption during the operation and the initial 24 hours postoperative.
The study was conducted at a level-one trauma center that had recently implemented the ERAS protocol on all cardiac surgical patients. Data was collected retrospectively from patients undergoing cardiac surgeries before and after the protocol’s implementation. The pre-ERAS group received traditional opioid-based analgesia, while the ERAS group received the ERAS multimodal analgesia protocol.
Data analysis revealed significantly lower intraoperative opioid consumption in the post-ERAS group compared to the pre-ERAS group (U = 1496.00, p = .026, z = -2.30). However, no statistically significant differences were observed in opioid consumption between the groups at 6 hours and 24 hours postoperatively. These findings suggest the ERAS protocol’s effectiveness in reducing intraoperative opioid requirements but limited impact on postoperative opioid consumption within the first 24 hours.
The study demonstrates that cardiac ERAS multimodal analgesia can effectively reduce intraoperative opioid consumption, highlighting its potential as a valuable component of perioperative pain management in cardiac surgery. While the findings did not show a significant reduction in postoperative opioid use, implementing such protocols can still offer benefits for patient care. This includes reducing opioid-related adverse effects and potentially improving patients’ overall recovery. Further research is needed to explore the longer-term impacts of multimodal analgesia on postoperative opioid consumption and patient outcomes in cardiac surgery.

Candidate Name: Jaime Moore
Title: The Impact of Evidence-Based Sepsis Education on the Recognition of Clinical Deterioration and Reducing Sepsis Mortality Among Inpatient Medical-Surgical Units
 April 04, 2024  9:00 AM
Location: CHHS 131

Sepsis is one of the leading causes of intensive care unit (ICU) transfers and mortality in the inpatient setting due to delayed recognition and untimely management of sepsis symptoms on non-ICU medical-surgical floors. Educating nurses on units with the highest rates of sepsis mortality and ICU transfers is important to increase confidence and knowledge to promote early recognition of sepsis and implementation of initial management guidelines. There is growing evidence of the effectiveness of escape rooms, however, most studies have been completed with students in academic settings. Additionally, sepsis education is traditionally targeted to the ICU and emergency department (ED) settings, not medical-surgical floors. The purpose of this project was to implement interactive escape room education with evidence-based sepsis content to prepare nurses to identify early warning signs of sepsis and clinical deterioration in medical-surgical patients. A two-group pre-/post-test quality improvement project was conducted with a sample of 17 nurses in the non-ICU medical-surgical units within the medicine service line at the project site. After the interactive escape room educational event, a statistically significant improvement in confidence and increased knowledge was demonstrated. Mean knowledge scores increased from 77.4 (SD=13.7) pre-intervention to 82.4 (SD=14.3) post-intervention. Significant improvements were seen in self-reported knowledge and confidence in identifying sepsis patients (z=2.33, p=.02), knowing how and what to monitor in sepsis patients (z=2.714, p=.007), and knowing initial management of patients with sepsis (z=2.646, p=.008). Mean ICU transfers decreased from 13 (SD=1.0) pre-intervention to 8.67 (SD=3.51) post-intervention indicating the project units performed better than the comparison units. Implementing an innovative escape room education intervention for non-ICU medical-surgical nurses is recommended to improve nurse knowledge and confidence in managing sepsis patients. By increasing nurse knowledge and confidence, earlier recognition of clinical signs of deterioration may assist with reducing ICU transfers related to clinical deterioration due to infections and sepsis.

Candidate Name: Lane K. Griffith
Title: Factors Related to Infusion of Trauma Education Among Counselor Educators at CACREP-Accredited Programs
 March 25, 2024  2:00 PM
Location: COED 246

Research has demonstrated the prevalence and cumulative nature of trauma and its lifelong adverse effects on physical, cognitive, emotional, and social wellness (Felitti et al., 1998; Merrick et al., 2019). Thus, counselor educators must prepare their students to work with clients with trauma effectively and ethically. A single study investigated trauma education and found that not all programs offer a trauma course (Montague et al., 2020). Thus, the CACREP (2015) trauma standards may be infused into other courses. The purpose of this study was to explore how trauma history, attitudes related to trauma-informed care, and prior trauma training were related to the infusion of trauma education into non-trauma-specific core courses by counselor educators working full-time for CACREP-accredited programs. It also investigated to what degree the trauma standards were infused. Multiple regression was used to analyze the data collected from 261 participants. Results indicated that moderate and substantial training were positive significant predictors of the degree of infusion (p <.001). The variables accounted for 14.1% of the variance. Although most counselor educators (91%) reported infusing the trauma standards into core courses, the standards were not infused equally. Results highlighted a high incidence of ACEs among counselor educators, with 62% reporting two or more and 33% four or more. Implications, limitations, and recommendations for future research are discussed.

Candidate Name: Jennifer Nicole Johnson
 April 03, 2024  1:00 PM
Location: 1. Login into Dr. Lewis' Zoom Video Conference Room 2. Use the following Meeting ID: 859-415-6604 3. Meeting Password: 54125

This qualitative study explores the lack of African American students enrolled in AP Calculus courses in North Carolina public high schools. It considered the perception of student-counselor relationships, academic advising practices, and sense of identity of high school counselor participants. In-depth interviews were conducted with three, African American, female high school counselors with five to twenty-four years of experience in high school counseling. The data yielded five domains: characteristics of a school counselor, expected duties of a school counselor, criteria to become an AP Calculus student, student-counselor relationships, and academic advising practices and the outcomes. From the domains, twenty-seven themes were generated: empathetic, open-minded, organized, flexible, creative, knowledgeable, serving the holistic needs of students, classroom guidance activities, non-counselor duties, resource, enrollments, interventions, advocacy, completion of prerequisite courses, exceptions to the rule, teacher recommendation, AP agreement, importance, trust, connections, race, alternatives, methods, encouragement, benefits, awareness, and partnership. Recommendations include universal access to Math I for African American students in 8th grade, update all stakeholders of the role and purpose of school counselors, professional development for school counselors, and an integrated curriculum for school counselors and administrators.

Candidate Name: Katherine Judge
 March 20, 2024  1:00 PM
Location: CHHS 131

To impact survival rates by 30%, emergency department (ED) workers should follow the Advanced Cardiovascular Life Support (ACLS) guideline of relying on end-tidal carbon dioxide (ETCO2) monitoring to ensure cardiopulmonary resuscitation (CPR) is high-quality. In a large tertiary care hospital-based ED, ETCO2 monitoring was not consistently utilized, despite workers having ACLS training and access to ETCO2 monitoring devices. The purpose of this project was to determine if high-fidelity ACLS simulation and ETCO2 monitoring training affected ED staff’s resuscitation self-efficacy and ETCO2 device application during clinical resuscitations. Twenty-eight interprofessional ED healthcare workers participated in high-fidelity adult cardiac arrest simulation scenarios. Paired-samples t-test results showed a significant pre-post simulation survey total average resuscitation self-efficacy improvement from 3.99 to 4.52 (t= 6.83, p < .001). Ten ED adult cardiac arrest events prior to simulation and twenty events post simulation were retrospectively analyzed for device utilization. Two-tailed paired-samples t-test results showed a non-significant improvement in device utilization (t= -1.96, p= .081), however utilization more than doubled from 20% to 45%. Overall, results indicated high-fidelity simulation can have a significant improvement in resuscitative confidence of ED workers, which in future studies may translate to higher survival rates for adults in cardiac arrest.

Candidate Name: V. Paige Stinson
Title: Micro-Opto-Mechanical Structures for the Infrared Spectral Range Fabricated by Two-Photon Polymerization
 March 27, 2024  9:30 AM
Location: Grigg Hall, Room 131, 9320 Robert D. Snyder Rd., Charlotte, NC 28262, USA

Since initial applications in the latter twentieth century, the field of micro-optics has greatly expanded. Micro-optics now encompasses research in areas such as integrated optics, micro-electromechanical systems (MEMS), quantum technology, sensing, energy harvesting, and metamaterials. In its current stage, dynamically tunable micro-optics are crucial to providing additional processing power without increasing volume. Micro-structured optics comprise a subsection of micro-optics where the optical response is manipulated by some sub-wavelength or wavelength scale structure. One challenge in developing micro-structured optics are restrictions in terms of geometric freedom and extensive development times. As a solution to some of these challenges, rapid prototyping techniques such as two-photon polymerization (TPP) have been employed in the development of complex two- and three-dimensional optics. TPP provides nano-scale feature sizes, resolutions which surpass the diffraction limit of the light source. In search of ways to add additional degrees of tuning in micro-optics, the unique properties of TPP compatible resins can be exploited. In this study, dynamically tunable micro-structured optics are developed by TPP. Being a polymer, the fabricated structures have unique mechanical properties when compared with conventional glass and metal optics. The structures are designed such that their optical response is sensitive to induced mechanical stress or strain. Both sub-wavelength and wavelength-scale micro-structured arrays were investigated for this mechanical tuning. In each case, changes in the structure's geometry due to mechanical stimuli resulted in a change in the optical response. In combination with a MEMS device, the investigated structures could have applications in integrated optics, mechanical sensing and beamsplitting, and tunable bandgap filtering.