EXAMINING ATTITUDES, PERCEPTIONS, AND OBSERVATIONS OF TOBACCO USE AND COMPLIANCE AT A SMALL PRIVATE LIBERAL ARTS COLLEGE IN KENTUCKY WITH A DESIGNATED AREA TOBACCO POLICY

A multitude of higher education institutions have adopted comprehensive smoke- and tobacco-free policies to minimize tobacco use, increase quit attempts, and reduce exposure to secondhand smoke on campus. However, the majority of campuses across the U.S. still have non-comprehensive policies and/or designated tobacco use areas. Given the limited research in this area, the purpose of this dissertation was to assess the attitudes, perceptions, tobacco use behaviors, and actual observational compliance of students, faculty, and staff on a college campus that possesses a designated area tobacco policy. This two-phased cross-sectional study included both direct observations and online survey data collection. For Phase I, to assess on-campus tobacco use behaviors and compliance with a designated tobacco area policy, during the Fall semester 2018 direct observations were made in 10-minute intervals throughout the typical work/class day during Mondays, Wednesdays, and Fridays for two consecutive weeks in the designated tobacco use areas on campus. Data were summarized using descriptive statistics and chi-squared tests for independence. For Phase II, a 36-item online survey was emailed to all staff, faculty, and students to assess their overall attitudes and perceptions regarding a designated tobacco area policy. Data were analyzed using descriptive statistics and individual chi-squared assessments for each item. Items were also combined to create relevant subscales; ANOVA was used for comparison purposes between demographic factors. Phase I: A total of 239 tobacco observations were made on campus during the two-week period. Significant relationships were discovered between sex and location (p \u3c 0.01), sex and compliance (p \u3c 0.01), time and location (p \u3c 0.01), as well as time and compliance (p \u3c 0.05). Males were more likely to be found using tobacco in general, either in compliance with the designated tobacco area policy or in violation of the policy. Phase II: A total of 185 staff, 88 faculty, and 332 students completed the online survey. Response rate was 33% for employees and 20% for students. Significant differences emerged when looking at the appeal of the designated areas on campus when comparing staff, faculty, or student status (p = 0.00) as well as tobacco use status (p = 0.00). Social influences yielded significance when comparing campus status (staff, faculty, or student; p = 0.00) as well as when comparing tobacco-users to non-users (p = 0.001). A significant difference was also found when comparing perceptions of designated tobacco areas (gazebos) and tobacco use between tobacco-users and non-users (p = 0.03). Findings provide quantitative evidence that tobacco is being used on campus, in both designated and non-designated areas. Male students were observed more frequently, regardless of compliant status. In addition, there was a strong correlation with observations and certain times of day as well as the location of observations, reinforcing the need for compliance efforts and availability of tobacco treatment. Additional research on college campuses with designated tobacco areas is necessary in order to better understand the overall impact that such policies have on college campuses, including whether designated policies may make it difficult for individuals on campus to either quit using tobacco or to stay quit. In addition, given the number of individuals using tobacco on campus, it would be beneficial to collect air quality data on campuses with designated areas, in comparison to campuses with comprehensive tobacco-free policies

THE EFFECTS OF DEBRIEFING ON DIAGNOSTIC REASONING DEVELOPMENT IN FAMILY NURSING PRACTITIONER STUDENTS

This dissertation explores the effect of simulation and the debriefing method of Debriefing for Meaningful Learning (DML) on diagnostic reasoning development in family nurse practitioner students (FNP-s) as measured by the diagnostic thinking inventory (DTI). A total of 13 FNP-s participated in this exploratory descriptive pilot study. All students completed both the pre-DTI survey prior to the start of the study, and the post DTI survey at the study conclusion followed by the Debriefing Assessment for Simulation in Healthcare-Student Version (DASH-SV) survey. Students participated in three urgent care simulations followed by the debriefing method of DML. The results of this study used mean comparisons in a repeated measure analysis given the small sample size. Dependent groups t tests revealed significant gains on the knowledge subscale but not on the flexibility items of the DTI, suggesting that the improvement in diagnostic thinking skills evidenced in this sample was due to the increase in knowledge gained from participation in the simulations and associated DML debriefings but not to any significant changes in the flexibility subscales. The effect of the simulations followed by DML method was also evaluated on reaction time (RT) indices. Although the total DTI scores did not show evidence of a significant improvement in time related to the RT to the diagnostic questions, the knowledge subscale of the DTI showed evidence of a significant improvement in RT. The observation that these FNP-s responded to the knowledge subscale of the DTI significantly faster after the intervention than before, provides additional evidence that suggests that the diagnostic knowledge of these FNP-s was improved by this intervention. Knowledge (non-analytic reasoning) was improved by participation in the simulations followed by DML as evidenced by improvement in knowledge decision efficiency (shorter RTs) in this subscale, however, there was not a similar improvement in the RTs in the overall total DTI scores or in the flexibility subscale. Overall scores on this debriefing method using the DASH-SV were positive. Simulation with the debriefing method of DML was found to significantly increase knowledge structure in this small sample of FNP-s

The Issue Of Sovereignty in an Ever-Closer Union

This paper aims to answer the following question: what is the understanding of the principle of sovereignty in the EU today, and how should this knowledge inform our actions tomorrow? It is demonstrated that from both doctrinal and practical points of view, it is impossible to determine conclusively what sovereignty or its preservation entails in the present European legal setting. The only point of clarity regarding the contemporary interpretation of sovereignty is that the principle should no longer be conceived in traditional and absolute terms – since this would be incompatible with the current European legal and political reality. Yet, while there seems to be an agreement on what sovereignty is not, there is no agreement, in either legal doctrine or practice, on what this principle actually is. It is argued that such a deeply contested nature of sovereignty puts in question not only the role and strength of this principle, but also the adequacy of its use as a legal parameter for determining the boundaries of the European integration process. It is thus concluded that in legal debates concerning the future of the EU, arguments relying on sovereignty should not be taken at face value. Rather, they should be approached with a critical eye and with full awareness of the disputed nature of the principle they rest upon

Evidentiary Privileges and the Exclusion of Derivative Evidence: Commentary and Analysis

Invocation of an evidentiary privilege traditionally meant that the confidential communications of a holder were protected from disclosure during judicial, administrative, or legislative proceedings. This model of evidentiary privilege law does not take into account information gathered from unauthorized preproceeding disclosures of otherwise privileged communications. A minority of courts seem willing to exclude this derivative evidence with little or no explanation. These courts may unwittingly base their decision on privacy concepts recently proposed as one of the modern justifications for the existence of evidentiary privilege in law. Courts confronted with this issue analyze it in confusingly, and often contrastingly, different manners

The Issue Of Sovereignty in an Ever-Closer Union

This paper aims to answer the following question: what is the understanding of the principle of sovereignty in the EU today, and how should this knowledge inform our actions tomorrow? It is demonstrated that from both doctrinal and practical points of view, it is impossible to determine conclusively what sovereignty or its preservation entails in the present European legal setting. The only point of clarity regarding the contemporary interpretation of sovereignty is that the principle should no longer be conceived in traditional and absolute terms – since this would be incompatible with the current European legal and political reality. Yet, while there seems to be an agreement on what sovereignty is not, there is no agreement, in either legal doctrine or practice, on what this principle actually is. It is argued that such a deeply contested nature of sovereignty puts in question not only the role and strength of this principle, but also the adequacy of its use as a legal parameter for determining the boundaries of the European integration process. It is thus concluded that in legal debates concerning the future of the EU, arguments relying on sovereignty should not be taken at face value. Rather, they should be approached with a critical eye and with full awareness of the disputed nature of the principle they rest upon

Say the Magic Words: Establishing a Historically Informed Standard to Prevent Partisanship from Shielding Racial Gerrymanders from Federal Judicial Review

In its 2019 decision in Rucho v. Common Cause, the Supreme Court closed the doors of the federal courts to litigants claiming a violation of their constitutional rights based on partisan gerrymandering. In Rucho, the Court held that partisan gerrymandering presents a political question that falls outside the jurisdiction of the federal courts. However, the Supreme Court did not address an insidious consequence of this ruling: namely, that map-drawers may use partisan rationales to obscure what is otherwise an unconstitutional racial gerrymander. This Note uses North Carolina as an example of a state with a long history of gerrymandering—both racial and partisan. Over the course of the last quarter century, the Supreme Court has repeatedly struck down North Carolina’s redistricting efforts as the product of racial gerrymandering. Nonetheless, when the State changed its strategy, arguing that it based its redistricting efforts on partisan goals, the Supreme Court in Rucho ultimately declined to review the constitutionality of the map, allowing it to stand. This leaves voters potentially unable to challenge redistricting where, as is the case in North Carolina, race and political behavior are closely aligned and the map-drawers claim that the map was designed to secure partisan advantage, even if racial demographics were central to their considerations. In effect, Rucho creates a “magic words” test that incentivizes map-drawers to sanitize the legislative record of references to race, in favor of references to partisanship, in order to insulate redistricting plans from federal judicial review. This Note suggests that the Supreme Court adopt a test to distinguish between racial and partisan gerrymandering using the approach the Court took in Flowers v. Mississippi—another 2019 decision. In Flowers, the Court placed great emphasis on Mississippi’s history of racial discrimination in jury selection in finding that the State had again violated the Equal Protection Clause in the case before it. Applying that logic to the issue of gerrymandering, this Note proposes a test that would presume that a challenged map from a state with a history of racial gerrymandering was a product of racial gerrymandering. The State would then face a high burden to rebut that presumption before the reviewing court could decide whether the case presents a political question under Rucho. The test this Note proposes would safeguard the right to vote, especially for Black and minority voters in states with histories of voter suppression and in so doing, ensure that the fundamentals of the democratic process are not subject to further erosion