The objective of this study was to uncover the critical success factors that have significant value-added impacts on corporate acquisitions in the lodging industry. Specifically, this study attempted to systematically discover evidence about the determinants of a successful pre-acquisition management process, and the determinants of successful post-acquisition integration, as well as to identify an appropriate evaluation criteria for determining the post-acquisition performance of an acquisition deal. In addition, this study tried to identify important acquisition objectives of hotel acquirers. This study employed an integrated and holistic viewpoint that includes the most critical corporate acquisition issues simultaneously and in a multi-dimensional framework. As a research methodology, a Delphi technique, which is a non-face-to-face communication method, was employed and proved its effectiveness throughout the study. The key question guiding this research is, what are the critical factors in the overall acquisition process that contribute to successful acquisitions? The findings of this study indicate that the most important acquisition objective for acquirers in the lodging industry is to accelerate the growth of their firms. Further, the most important critical success factor for hotel acquirers before the deal is completed is the identification of the trend of the target firm's cash flow from operations, and reliable and valid information about the target is the most significant dimension in the pre-acquisition management phase. The study results suggest that the most significant key success factor in the post-acquisition integration stage for the lodging industry is to plan and establish a post-acquisition strategy as early as possible, even before the deal is done, while the development of an effective post-acquisition transition strategy immediately after the deal is closed is the most crucial dimension in the post-acquisition integration phase. One of the most significant findings of this study was that hotel executives gave relatively higher importance to pre-acquisition management strategy than to the post-acquisition integration process. In terms of post-acquisition performance evaluation criteria, measures from a value-based management (VBM) approach received the highest rank in evaluating the economic gains of corporate acquisitions in the lodging industry. The study results can help to improve hospitality industry academics' and practitioners' understanding of important M&A phenomena leading to significant changes in the industry's competitive landscape. / Ph. D.

The purpose of this study was to identify counseling competencies considered important for audiologists to possess to provide effective counseling in practice.To achieve this, researchers and clinicians with expertise in audiologic counseling, were recruited to participate in a three-round consensus survey. These experts were asked to generate and rate a list of counseling competency items they believed were important for audiologists to possess. In the final round of the study, final consensus was met on 64 counseling competency items (16 knowledge, 35 skills, and 13 attitudinal items) deemed important for audiologists to possess. The results of this study revealed that current practice guidelines in the field lack the clarity and detail necessary for audiologists to provide effective counseling in practice. Items that met consensus can inform counseling competencies students can acquire during pre-professional training. Future research is proposed to explore what is needed to move these competencies forward into training/practice and to help improve audiologic patient/family outcomes.

The purpose of this study was to develop a consensus from a panel of experts composed of public school music teachers both based in instrumental methods and/or choral methods, higher education music professors from various backgrounds, public school administrators, philanthropists, authors, researchers, state music supervisors, and leaders in professional music organizations on regional and national levels. Through the use of the panel of experts from geographical regions across the United States and Canada, this study strove to build strategies that addressed the effects of reducing funding for music education. The vehicle used to build consensus was the Delphi Technique. Through this Delphi study, the 35 panelists suggested, refined, and prioritized strategies that could address music education funding issues. The Delphi panel members were asked to respond to 14 open-ended questions in the Round 1 questionnaire. During the Round 2 questionnaire, panelists were encouraged to make further recommendations or offer remarks to clarify the already presented strategies, which resulted in a final compilation of 12 questions with 67 subparts. The Round 3 questionnaire was divided into two sections. Section 1 asked panel members to rate the predetermined strategies on a Likert-type scale and Section 2 asked panel members to rank the same strategies in order of importance. The consensus of strategies by the Delphi panel members may be used to address funding issues on local, state, and national levels. The strategies listed in this study agreed upon by the panel of experts could be transferred into a mass produced handout or pamphlet and distributed to governmental leaders, conference attendees, or published in music education textbooks to educate future music teachers on methods that can be used to combat ever pressing funding issues that continually threaten the elimination and/or reduction of educationally based and publicly supported music programs.

The Open Educational Resources (OER) movement was started roughly ten years old (Wiley & Gurell, 2009). Since that time thousands of resources have been produced. Though these resources have been used both for classroom development and for the autodidact, the development of OER was not without problems. Incompatibility between Creative Commons licenses has made revising and remixing two resources difficult, if not impossible (Linksvayer, 2006). Tools to help educators find appropriate educational resources have been necessary but are still nascent. Educators' perceived quality issues have also hampered adoption (Wiley & Gurell, 2009). The result is that resources were only being minimally reused (Wiley, 2009). One possible reason observed for the limited reuse was the barrier of technology. Some resources were easier to view, revise and remix from a technical perspective than others. Hilton, Wiley, Stein, and Johnson (2010) created the ALMS analysis framework to assess the technical openness of an OER. Although the ALMS framework allowed for an assessment of OER, no pilot instrument was reported in the Hilton et al. (2010) article. The framework has not been tested because there is no known rubric with which measurement can occur. Consequently, Hilton et al.'s framework needed to be further developed and tested against a range of open educational resources. This dissertation examined the ALMS analysis, which was previously only a concept, in order to create a concrete framework with sufficient detail and documentation for comparisons to be made among OERs. The rubric was further refined through a Delphi study consisting of experts in the field of OER (n=5). A sample of OERs (n=27) rated by a small group (4) was conducted to determine inter-rater reliability. Intra-class correlation indicated moderate agreement (ICC(2,1) =.655, df=376, 95% CI [.609, .699]). Findings suggested that the degree of technical difficulty in reusing OERs can be measured in somewhat reliable manner. These findings may be insightful in developing policies and practices regarding OER development.

Purpose: The threefold purpose of this research is to identify the essential antecedents of cultural competence as identified by international nurse researchers, to compare the content of the extant cultural competence instruments to these antecedents and to potentially identify gaps in their conceptualization. A secondary aim of this research is to initiate validation of Harper's model of ethical multiculturalism. Conceptual Basis: The model of ethical multiculturalism depicts the attributes of ethical multiculturalism as the fulcrum of a balance between two ethical philosophies of fundamentalism and relativism. The attributes of moral reasoning, beneficence/nonmaleficence, respect for persons and communities, and cultural competence form the pyramidal fulcrum. The antecedents form the base of the pyramid and include cultural awareness, culture knowledge, cultural sensitivity, cultural encounters, cultural skill and understanding of ethical principles. Methodology: An on-line Delphi method was conducted with 35 international nurse researchers identified through published research, university directories, and professional organizations. Consensus was reached after two rounds. Following the Delphi rounds, sixteen members of the expert panel participated in an on-line focus group to validate results of the Delphi and discuss cultural competence in the international arena. Findings: Eighty antecedents of cultural competence were identified. Focus group discussion validated findings of the Delphi. Consensual thematic analysis of the focus group transcripts resulted in six themes: chimerical, contact, contextual, collaboration, connections, and considering impact. The Transcultural Self-Efficacy Tool (TSET) contained the most antecedents identified by the expert panel. Conclusions: Cultural competence is a process, not an outcome, and must be considered from the perspective of the recipient of care or research participant. Nurses must strive to deliver culturally acceptable care. The model of ethical multiculturalism is revised to include cultural desire as an antecedent. Nurses must understand the impact of globalization on individual health and care delivery. Implications for Nursing: Further testing of cultural competence instruments is needed to determine the correlation of self-efficacy with behavior, self-assessment with client assessment, and cultural competence with client outcomes. In education, research is needed to determine the most effective methods of teaching cultural competence. Increased recruitment of minorities into nursing programs is warranted. In practice, nurses must be prepared to provide language assistance as needed, recruitment and hiring of minorities must be increased, and minority thresholds must be used to determine cultural knowledge content for organizations.

Introduction Allodynia is a type of neuropathic pain defined as pain due to a stimulus which does not normally provoke pain. There is little research and conflicting advice. The purpose of this thesis is to provide a summary of the current state of hand therapy knowledge. To accomplish this, a review of the hand therapy literature related to allodynia was conducted, along with the collection of expert opinion utilizing the Delphi survey technique. Methods International hand therapy experts were invited to participate in a classical Delphi study. Mixed methods were used to summarize each round and inform any subsequent questioning. Thematic analysis was used to look for patterns of meaning within the written responses. A consensus level of 75% was decided upon a priori for all final recommendations. Results Forty-three hand therapists from 15 countries contributed to the fourth and final round. Through the consensus process definitions related to allodynia, and assessments and treatments for allodynia, were explored and recommendations generated. Two themes were identified 1) assessment and treatment decisions depend on the client’s presumed underlying mechanisms contributing to the allodynia as well as psychosocial and functional status, and 2) whether the area of allodynia should be touched or not. Discussion and conclusions The literature and our survey results are mixed on whether it is beneficial to touch an area of allodynia. Other aspects related to allodynia such as functional or psychosocial impact are rarely addressed in the literature but were highlighted in our survey. This thesis contributes to the knowledge by presenting: 1) a summary of the current literature, 2) a new consensus definition of hypersensitivity, 3) experts’ recommendations for assessment and treatment of allodynia of the hand and factors to consider when utilizing these, and 4) recommendations for future research, practice, and education. / Thesis / Master of Science Rehabilitation Science (MSc) / Allodynia is when pain is caused by something that would normally not be painful such as a light touch or mild temperatures. It occurs when nerves become overly sensitive, and if this happens in the hand, it can limit how people use their hand and cause distress. There is little research to guide therapists and conflicting advice in textbooks on how to treat this. To help fill this gap, we conducted four online surveys with hand therapy experts. We found that expert therapists recommended assessments and treatments that look at how the person with allodynia is functioning and managing the pain. However, they disagreed on whether the painful area should be touched or not. This is important as it influences the advice given to clients and how treatment is delivered. More research is needed to compare approaches and to figure out what factors may influence how people with allodynia may respond to different treatments.

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This is the report of a Delphi study designed to identify the characteristics, behaviors, and work environments of spiritual leaders. A panel of philosophers, writers, business leaders, non-profit leaders, religious leaders, educators, and politicians was purposefully recruited to participate in the study. Data gathered from the panel were analyzed with the Maykut and Morehouse (1994) constant comparative method and descriptive statistics to identify characteristics, behaviors, and work environments of spiritual leaders. The panel-identified characteristics and behaviors of spiritual leaders were grouped into three themes: interpersonal, intrapersonal, and religious. Work environments in which spiritual leaders can be effective were grouped into six themes: community-building, person-centered, product-oriented, principle-driven, religious, and mission/purpose-driven. The interpersonal descriptors are predominant in the findings, supporting the conclusion that spiritual leadership is interpersonal in nature in an enhanced way. Although writers have emphasized that spiritual leadership is separable from religion, the panelists accepted 13 descriptors in religious categories, indicating that they had difficulty separating spiritual religious leadership from a secular counterpart. The findings incorporate the concepts of meaning, community, and integrity presented in a theory of spiritual leadership created for this study, but the findings go well beyond the concepts in the theory. To be more reflective of reality, the theory must be expanded to emphasize the other-orientation of spiritual leaders. The expanded theory and the enriched concepts within it may have benefit to practitioners and future researchers interested in exploring the practice and study of spiritual leadership. Two tools were created from the findings. One tool is a self-assessment that leaders may use to compare their leadership style with that of spiritual leaders. The second tool may be used by leaders to assess whether their work environments promote the effectiveness of spiritual leaders. Researchers may find the tools useful as initial measures of the characteristics, behaviors, and environments of spiritual leaders. / Ph. D.