Doctoral Dissertations
Permanent URI for this collection
Browse
Recent Submissions
1 - 5 of 923
-
ItemSpeech-Language Pathologists’ Ratings of Airway Protection Behaviors and Treatment Recommendations for Dysphagia(Middle Tennessee State University, 2024)ABSTRACT This study investigated speech-language pathologists’ (SLPs) ability to utilize a novel 5-point airway protection scale (APS) when reviewing FEES videos, the frequency of airway protection behaviors visualized during FEES, and SLP practice patterns regarding the recommendation of modified texture diets (MTDs) for the improvement of airway protection. Five SLPs—trained in the use of the APS—were recruited to determine if they could reliably analyze FEES videos with the APS. For both scoring sessions, inter-rater reliability was “almost perfect” (κ = .91; 95% CI, .881 to .939, p < .0005) and intra-rater reliability was “substantial” (κ = .80) for one rater and was “almost perfect” (κ = .95 - 1.0) for the remaining four raters. After determining that these five SLPs could reliably utilize the APS, a medical records review of their FEES reports was completed. Four hundred seventy-seven FEES reports, totaling 25% of all reports created from January 1, 2023 to January 1, 2024, were randomly sampled. There was a significant association between sex and APS scores (p < .001). Despite accounting for only 43.4% of the sample, females accounted for 53.8% (n = 769) of all scores of APS “2,” which indicates a functionally normal airway protection score. APS scores of “5” denote the most severe complication for airway protection behaviors, and males accounted for 62.8% (n = 201) of all APS “5” scores. SLPs who treat dysphagia recommend MTDs to prevent airway protection issues like laryngeal penetration and aspiration that can lead to severe pulmonary complications. A survey of clinical practice patterns indicated that over 90% of respondents recommend MTDs when needed. However, the use of the MTDs is not without risk. Indisputably, the use of MTDs can cause significant and systemic health risks. Hence, informed consent for the use of MTDs in healthcare settings is required. However, when surveyed about the negative health outcomes associated with consuming MTD, SLPs demonstrated poor understanding of hazards associated with MTDs—calling into question the ability of SLPs to fully inform their patients regarding the standard practice of recommending MTDs to prevent pulmonary complications.
-
Item“Death Is but the Next Great Adventure:” Harry Potter and the Art of Dying Well(Middle Tennessee State University, 2024)Since its publication in 1954, The Lord of the Rings has served as a foundational text of fantasy literature. Tolkien’s correspondence reveals that he regarded his novel as both a Christian text and a meditation on death and deathlessness. As such, the novel serves a similar function as an ars moriendi—a medieval guidebook on how to die well by emulating Christ’s model. Although Middle-Earth is a decidedly pre-Christian setting, The Lord of the Rings nonetheless espouses a Christian ideal that a good death is not a matter of how one dies but why one dies. Those who lay down their lives in defense of others or for the sake of a better tomorrow are posited as heroes, whereas those who live selfishly and ignore all chances of redemption die ignominious deaths. Tolkien, then, positions the quest for deathlessness as a rejection of what it means to be human and dramatizes this rejection by having those characters who gain immortality unnaturally become warped and twisted by the endeavor into grotesque caricatures of their former selves. J. K. Rowling has downplayed the influence of The Lord of the Rings on her Harry Potter series (1997-2007), yet while there are few cosmetic similarities to Tolkien’s novel beyond the broadest of strokes, the two works are remarkably similar thematically. Intentionally or not, Rowling’s Harry Potter novels are an even more overt example of a modern ars moriendi. Rowling foregrounds death and the pursuit of deathlessness from the very beginning of the series by having these ideas be not only thematic issues but also the primary drivers of the plot. Like Tolkien, Rowling’s view of death is shaped by an explicitly Christian perspective, and the various examples of good deaths that serve as lessons for both Harry and the reader reinforce the notion of selflessness and love as positive forces. Where Rowling differs from Tolkien is that she integrates her examination of an ignoble death with the quest for deathlessness into a single, salient example—Lord Voldemort—but still, she follows Tolkien’s model by having his quest for immortality bring about physical changes that leave him unrecognizable as a human being. Similarly, Harry himself serves as the most explicit example of a good death, for by the end of the series, he becomes a Christ-like figure, willingly going to what he believes will be his death for no other reason than because it will spare others from suffering and torment.
-
ItemThe Effects of Plyometric Training Volume and Surface Composition on Jump Performance(Middle Tennessee State University, 2024)Plyometric training (PT) is a popular method used to improve vertical and horizontal jump performance. However, the influence of training surface and volume on the effectiveness of PT remains unclear. The purpose of this dissertation was to examine the effects of training surface and volume following a 6-week PT program on jump performance in physically active individuals (PAI). For study 1, participants (N = 18) completed a 6-week PT program on either a soft (2-inch foam surface; n = 9) or hard (hardwood gymnasium floor; n = 9) surface. Vertical jump performance was assessed by squat jump (SJ), counter-movement jump (CMJ), and approach jump (AJ) before and after the PT program. For Study 2, participants (N = 12) completed a 6-week PT program with either moderate volume (1460 total foot contacts) or high volume (1850 total foot contacts).Jump performance was assessed using broad jump (BJ), SJ, CMJ, AJ. Participants for both studies were recruited through email at Middle Tennessee State University. The results of the first study indicated significant improvement in SJ, CMJ, and AJ regardless of training surface. The results of the second study similarly indicated significant improvement from pre- to post-testing for BJ, CMJ, and AJ, regardless of training volume. Notably, neither training group exhibited significant improvements in SJ performance. Considering the findings of these studies, practitioners looking to elicit improvements in vertical jump should align the PT training surface with individual needs, preferences, and resources. Additionally, improvements in vertical and horizontal jump performance can be elicited with programs as low as 1460 total foot contacts. With the two volumes utilized in this dissertation, there is no apparent benefit to the higher training volume based on the outcomes measured.
-
ItemThe Impact of Teacher Sensemaking and Attribution Theory on Instructional Decision-Making(Middle Tennessee State University, 2024)This dissertation discusses the relationship between teacher sensemaking, attributions, and instructional adjustments prompted in response to student performance data. Through this qualitative observation study, this paper explores the varying perspectives of teachers, including their level of assessment literacy, and the dynamics of their Professional Learning Community (PLC) teams, and how they impact the teachers’ perceptions of student performance data. Furthermore, this research examines how leaders in the field can leverage the insights gained from teachers’ sensemaking processes to better support them in the context of a PLC. This dissertation aims to contribute to the research surrounding teacher sensemaking and attribution theory to gain a deeper understanding of factors that influence instructional decision-making.
-
ItemCarving Out Communities: Black Institution Building in Rutherford County, Tennessee 1860-1890(Middle Tennessee State University, 2024)"Carving Out Communities: Black Institution Building in Rutherford County, Tennessee 1860-1890" explores a still neglected topic in public history and historic preservation: the significance of space in considering the significance of Black churches in community formation and institution building in the 19th century rural South. Historic preservationists in particular still neglect African American space making and Black institution building when they assess the cultural landscape or consider the significance of where and when Black churches were located. This study focuses on Black churches and cemeteries in Rutherford County, Tennessee. The county seat of Murfreesboro once briefly served as the state capital in the 1820s; during the Civil War, the U.S. Army occupied the county at two different times, and created a major military base in the county by 1863, after the Battle of Stones River had devastated adjacent farms and plantations. Using documentary evidence and the substantial material culture evidence left behind by the congregations as they formed and built their churches, the study investigates how Reconstruction-era Black congregations acquired land and created sacred safe havens within an increasingly hostile social and political environment of white supremacy, racial atrocity, and political disenfranchisement. The acquisition of space and construction of Black institutions were key points of resistance and allowed Black groups and neighborhoods to carve their own identity and protect their own community within a racially contested landscape.