abstract: Late preterm infants (LPIs), born between 34 and 37 weeks gestation, are at risk for a myriad of health conditions related to neuro-muscular and physiologic immaturity. However, relative stability allow many of these infants to avoid care in specialty nurseries and discharge home with their mothers after birth. Due to underlying immaturity, feeding difficulty is the most common issue LPIs experience, resulting in early breastfeeding cessation, increased risk for secondary diagnoses, and hospital readmission. The purpose of this study was to assess early breastfeeding behavior of LPIs, including testing inter-rater reliability of an assessment tool and the feeding patterns of infants over time. An extensive review of breastfeeding assessment tools resulted in the selection of the Premature Infant Breastfeeding Behavior Scale (PIBBS) based on its reliability and validity in the preterm infant population. A convenience sample of LPI dyads was recruited and used to conduct inter-rater reliability testing of PIBBS. A longitudinal one-group non-experimental study was used for observational follow-up. A strong statistical agreement of PIBBS scores occurred between mothers and a healthcare professional (Cohen’s kappa values of items ranged from .776 to 1.000, p = <.001). Participants continued using the PIBBS tool after hospital discharge until their infants expected due dates (40 weeks adjusted age). T-test analyses were conducted to examine changes in scores over time indicating increase in item scores (p = .003 - .193). PIBBS appears to be a valid and reliable tool to assess breastfeeding among LPI dyads. Incorporation of PIBBS into a comprehensive plan of care could better support and protect breastfeeding among the LPI population. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2018

Book Summary: Florence in the Early Modern World offers new perspectives on this important city by exploring the broader global context of the fifteenth and sixteenth centuries, within which the experience of Florence remains unique. By exploring the city's relationship to its close and distant neighbours, the interdisciplinary chapters reveal the transnational history of Florence. The chapters orient the lenses of the most recent historiographical turns perfected in studies on Venice, Rome, Bologna, Naples, and elsewhere towards Florence. New techniques, such as digital mapping, alongside new comparisons of Architectural Theory and merchants in Eurasia, provide the latest perspectives about Florence’s cultural and political importance before, during and after the Renaissance. From Florentine merchants in Egypt and India, through actual and idealised military ambitions in the sixteenth-century Mediterranean, to Tuscan humanists in late medieval England, the contributors to this interdisciplinary volume reveal the connections Florence held to early modern cities across the globe. Steering away from the historical narrative of an insular Renaissance Europe and instead identifying the significance of other global influences, this volume is essential reading for students and scholars of early modern cities and the Renaissance.

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Archaeological investigations at Edwards Air Force Base (AFB) have been ongoing for more than 40 years. Yet the findings from the vast majority of those efforts are available only as grey literature that is known only to a relative few. The primary purpose of this thesis was to investigate a late Holocene decline in obsidian frequency reported by researchers working in the Bissell Basin and Rosamond Dry Lake region of Edwards AFB near the turn of the 21st century. A secondary purpose of this thesis was to shine a light on an area of the western Mojave Desert that is not widely known despite more than four decades of research. In order to explore the reported decline in obsidian frequency, I created an obsidian database using data gleaned from nearly 50 cultural resources management reports and supplemented those data with sourcing and hydration information for 39 additional obsidian artifacts. Those data were organized into tables, charts, and histograms to look for patterns that would support or refute the claim that obsidian use decreased significantly after the Gypsum time period (4000 to 1500 Before Present [B.P.]). Two patterns emerged from my analysis. The first was one where the overall abundance of obsidian at Edwards AFB did not decrease during the late Holocene, thus contradicting the conclusions made in the previous research. The second was one where the obsidian abundance shifted among the various regions of the installation. Yet these shifts are nowhere near as significant as the previously reported decline. Therefore, while the total amount of obsidian that entered the archaeological record at Edwards remained relatively stable from 1500 to 100 B.P., the amount of obsidian decreased in certain regions and increased in others. Although not within the scope of my original intent, my research also identified two areas for future research. The first involves an apparent pattern where the number of archaeological sites from which obsidian was recovered gradually decreases during the middle-Holocene even as the overall quantity of obsidian remains essentially unchanged. The second relates to the lack of a well-established hydration rate formula for obsidian recovered from archaeological sites on Edwards AFB. Ultimately, I concluded that the previous findings that obsidian declined during the late Holocene were affected by sampling bias and faulty data organization. Most archaeologists understand that poorly implemented sampling can lead to poorly derived findings and conclusions. What may not be as well understood is that a perfectly appropriate sample where the data are not organized well can also lead to flawed results and conclusions. It is hoped that this thesis will inform archaeologists not only about how the manner in which they organize their data can affect their interpretation of past human behavior, but also about additional research opportunities at Edwards AFB.

This study explores the relationship between Adult Protective Service (APS) referrals and the link between dementia type behaviors. The question is does self-neglect, due to dementia precipitate multiple APS referrals? A quantitative-study was conducted based upon a random selection of fifty client files from the years 2014 and 2015. The information collected was based upon data provided to the APS hotline and what was determined by the APS investigators. SPSS software was used to determine the values of the data. Table 1 displays the results of demographics with 37% males and 63% females. Results of this study are inconsistent with the existing literature.

Breast cancer is the 2nd leading cause of death among women. While a significant amount of research has been done to understand the different disparities related to this disease, there is still more to learn about the relationship between a person's nationality and the staging of breast cancer. Using the Surveillance, Epidemiology, and End Results Program as the data source, this retrospective cohort study was aimed at assessing late-stage breast cancer among Caribbean immigrants, specifically comparing Haitian women with Americans and other immigrant populations in the United States. The research questions addressed the link between nationality and the likelihood of late-stage breast cancer diagnosis as well as the risk factors associated with an advanced stage of breast cancer. Findings from logistic regression analyses indicated no statistically significant difference in Stage IV diagnosis between women born in Haiti and U.S.-born women, while the converse was true for women born in other foreign countries. The results also suggested that race, Hispanic ethnicity, marital status, insurance coverage, being unemployed, and language isolation were significant predictors of late-stage breast cancer diagnosis (p < 0.05). When stratifying the analyses by nationality, marital status and poverty were the common predictors of advanced breast cancer diagnosis among Haitian, foreign-born, and U.S.-born women. The observed disparities confirm the need for additional efforts that seek to improve screening rates among underserved groups and ultimately reduce the burden of late-stage breast cancer.

In both the narratives of their reigns and as objects of allusion in accounts of later periods of Roman history, the seven kings of Rome (r. 753-509 BCE, traditionally) frequently feature in historiographical and biographical works written after the death of Livy (17 CE) with meaningful nuance despite the relative crystallization of Rome's founding and regal legends during the age of Augustus (r. 31 BCE-14 CE). I demonstrate how 12 authors writing over a period of four centuries, from late in the reign of Tiberius (r. 14-37 CE) to shortly after the death of Theodosius I (r. 378-395), refashion the kings as creative reflections of, or reactions to, the Roman emperors in both their narratives and the time of writing those narratives. These writers are, in Latin, Velleius Paterculus, Tacitus, Suetonius, Florus, Justin, Aurelius Victor, Eutropius, Ammianus Marcellinus, and the anonymous authors of the Historia Augusta and Epitome de Caesaribus; in Greek, Appian and Cassius Dio. Through close, contextual readings I examine how and explain why certain authors present the kings as exemplary monarchs whose conduct should be imitated or avoided, especially in contexts where those kings are by a variety of rhetorical tactics compared or contrasted with figures in narratives of later history. I then place those readings along a chronological spectrum to reveal common elements of continuity and evolution of the kings among these 12 authors at various points in imperial history. It can be shown that the idealization of the kings is roughly a function of the author's audience and social class (i.e. Roman senators are less favorable to them than equestrians and provincials). Moreover, the kings evolve over time, beginning as blood ancestors of emperors in the early Principate, expanding to products and benefactors of a diverse, Mediterranean cosmopolis during the High Empire, then restricting to symbols of traditional political, cultural, and religious notions tied to the physical city of Rome in Late Antiquity, when the political, spatial, and spiritual transformation of the imperial office made the kings obsolete as persuasive models of imperial rulership. More broadly, this project adds to our understanding that at any point, societies tend to not only reinvent their histories as reflections of their own time, but also credit "Great Men" both as explanatory devices for major events and as embodiments of national identity.

This dissertation examines the innovative subjectivity of feminine voices constructed in poetry by three women writers from seventeenth- and early nineteenth-century China: Li Yin, Wang Duanshu, and Wang Duan. Drawing primarily on their individual collections, I argue that the writers fashion poetic selves that deviate from literati representations of feminine subjectivity through the writers' intertextual dialogues with mainstream literary and cultural traditions and also their poetic exchanges with contemporary women writers. I explore specific methods employed by the three writers to create distinctive voices of their own and specify modes that distinguish the alternative feminine voices in their writings, contextualizing my reading of poems from their collected works and of mise-en-scenes in the case of exchange poetry. My close reading of the three late imperial Chinese writers' poetry reveals that subject positions in their collected works, different from those of feminine voices constructed in literati poetry, are the result of the gendered writing self seeking voices to express lived experiences, deeply felt emotions, desires, anxieties, and pleasures. These positions in turn allow the writing self to have serious intellectual exchanges with their contemporary writers, create self-definitions beyond the normative roles as prescribed by the Confucian gender system and the literati poetic tradition, and realize personal transformation in poetry.

This research employs a sample of archaeological sites from three ecological zones to investigate the mobility strategies of hunter-gatherer groups in Late Archaic southwestern Idaho. The sample sites are organized into site types based on an independent evaluation of site components and existing site records. Ceramic assemblages at each site were analyzed to quantify the investment in ceramic technology, as a proxy for mobility. These measures were then compared to expectations generated from three proposed mobility patterns for hunter-gatherer groups in southwestern Idaho. Some of the predictions were met and these data allude to an archaeological record with a multitude of settlement patterns that may have changed over the course of seasons, years, and even decades.

The research reported in this thesis focuses on Late Cretaceous and Cenozoic fossil brachiopods of Western Australia. Although the work is primarily taxonomic, it also includes biodiversity, distribution and some aspects of ecology of the brachiopods described.The most recent information on the anatomy, physiology and ecology of brachiopods is summarised at the beginning of the thesis.Identification of brachiopods is determined primarily on internal morphological features as brachiopods tend to be homomorphic, many species looking externally the same. The morphological features used in the identification of the brachiopods described within the thesis are defined.The fossil material studied has come from four sedimentary basins in Western Australia. The Carnarvon Basin contains Late Cretaceous and Cenozoic fossil material. The Perth Basin also has Late Cretaceous and late Cenozoic brachiopods The Bremer and Eucla Basin have Cenozoic deposits. The stratigraphy of the deposits containing the brachiopods is described.Until this study commenced, eight species had been described from Western Australia. This thesis describes fifty eight species including thirty new species, one new family and two new genera.In preparing descriptions of the new species it become evident that many of the species from the Southern Hemisphere were quite different to those found in the Northern Hemisphere. Their closest affiliation was with genera and species described from the Antarctic Peninsula. Four genera and one species from the Late Cretaceous deposits of Western Australia are common to the Late Cretaceous deposits of the Antarctic Peninsula. In the examination of the Tertiary material from the Carnarvon Basin, it also became clear that there was a strong correlation with Tertiary material from the Antarctic Peninsula. At least four genera are common to both deposits. Six brachiopod ++ / genera from the Middle Miocene deposits of the South Shetland Islands Antarctica are common to New Zealand. Nine genera, identified from the La Meseta Formation, Seymour Island, Antarctic Peninsula, are also common to New Zealand. These genera are also found in Australia. This evidence has led to the proposal that in the Late Cretaceous there was a common shelf environment from the Antarctic Peninsula to the north-west coast of Western Australia. In this area, which formed the high latitude southern circum-Indo-Atlantic faunal province, brachiopods evolved different genera and species than those in the northern hemisphere. Many then dispersed into northern areas of the Indian, Atlantic and finally Pacific Oceans.When the material from the Middle to Late Eocene of the Bremer and Eucla Basin was examined, five genera were found to be common to the Early Tertiary of the Carnarvon Basin. When comparing the species from the south-western basins and those from the south- east it was evident that similar species occur in the Middle to Late Eocene of the Bremer, Eucla, St Vincent and Murray Basins. There are some fifteen species in common. Many of these species then occur in the Late Oligocene south-eastern basins near Victoria and Tasmania as the gap between the Australia mainland and Tasmania began to open. One species that occurs in the Late Eocene of Western Australia is also described from the Late Oligocene of New Zealand.In considering the distribution of the Cenozoic brachiopods, genera first appear in the north-west of Western Australia and they then appear in chronological order in the south-western basins and south-eastern basins of South Australia, then the south-eastern basins of Victoria and Tasmania and then New Zealand. By the Late Eocene, there was a shallow marine connection between the Bight and the Tasman Sea. By the Late Oligocene this had widened and ++ / Australia was finally totally separated from Antarctica.The Proto-Leeuwin Current was responsible for the distribution of the brachiopods from the north-west of Western Australia to the southern coast. Possible mechanisms for the distribution of genera to New Zealand include rafting and an extended larval stage.It has been suggested that brachiopods in Australia are distributed according to the substrate on which they settle rather than any other factor. Using the information on the distribution of brachiopods in Western Australia throughout the Cenozoic this hypothesis is examined. It is suggested that avoidance of light in the photic zone and food availability with competition with bivalves are more important factors than substrate conditions.