Digital Commons Network^™

Text Messaging As Adjunct To Community Based Weight Management Program, Claudia Bouhaidar

Theses and Dissertations

Obesity ascending rates are still a public health priority. The primary aim of the study was to evaluate the effect of tailored text messages on body weight change in overweight and obese adults in a community based weight management program. A secondary aim was to detect behavioral changes in the same population. The study design was quasi-experimental with pre and posttest analysis, conducted over 12 weeks. A total of 28 participants were included in the analysis. Body weight, eating behaviors, exercise and nutrition self-efficacy, attitude toward mobile technology, social support and physical activity were assessed at baseline and at 12 …

The Economic Burden Of Opioid Poisoning In The United States And Determinants Of Increased Costs In Opioid Poisoning, Timothy Inocencio

Theses and Dissertations

Introduction: Opioid poisoning has been rapidly increasing in the past decade, and has been driven in large part due to increases in opioid prescribing. This has been accompanied by intervention efforts aimed at preventing and reversing opioid poisoning through naloxone prescription programs. Current literature have not quantified the economic burden of opioid poisoning. Understanding this information can help inform these efforts and bring light to this growing problem. In addition understanding various determinants of increased costs can help to identify the types of populations more likely to have greater costs. Main Objectives: The objectives are 1) to quantify the economic …

Listening To The Voices Of Emerging Adults: The Experience Of Living With Phiv, Constance D. Hill

Theses and Dissertations

The purpose of this descriptive study was to explore the research question: "As an emerging adult what is your everyday experience of living with PHIV?" The purposive sample consisted of six emerging adults living with perinatally acquired HIV (PHIV), who are 18-29 years of age, speak English, and live in the greater Chicago area.

This was an exploratory study using a participatory action approach of photovoice. Photovoice methodology combines photography and participatory action to provide images and the participants' interpretations of their everyday health realities. Five themes which describe the everyday experience of living with PHIV emerged from the thematic …

Childhood Obesity And The Relationship To Well-Child Visits, Nancee Croatt Wozney

Theses and Dissertations

Trends during the past 20 years have revealed a dramatic increase in childhood obesity in the United States. At present, approximately nine million children over 6 years of age are considered obese (Institute of Medicine [IOM], 2011). According to (American Academy of Pediatrics [AAP], 2009) the protocol for obesity care for youth is to monitor the body mass index (BMI) routinely (at least annually) and offer appropriate counseling and guidance to children and their families. A report in the literature indicated that the number of children attending yearly well-child visits that include measurement of BMI is well below the AAP …

Factors Associated With Bed-Sharing Within Racial Groups In A Sample Of Mothers And Young Infants In Wisconsin, Trina C. Salm Ward

Theses and Dissertations

Since 2005, the American Academy of Pediatrics has recommended a separate but proximate sleep surface for infants (AAP, 2005). However, racial differences in the prevalence of bed-sharing and infant mortality (especially as a result of SIDS or unsafe sleep) continue. Limited research has examined predictors of bed-sharing by racial group, especially the AAP's 2005 policy statement against it. The purpose of this study was to explore maternal-infant bed-sharing and infant sleep position for African-Americans and Whites in a sample of 2,530 respondents (822 African-American and 1,708 Whites) to the Wisconsin Pregnancy Risk Assessment and Monitoring System (PRAMS), a stratified sample …

An Anaylsis Of Patient-Physician Discourse: Comparing Physician Diagnostic Scripts To Patient Social Script Expectations, Denis Grimes

Theses and Dissertations

This study examines how participants interpret physicians' diagnostic discourse and physician interruptions during the patient's disclosure of problems and concerns. Using medical diagnostic scripts written for upper respiratory infections, participants' reactions to physician attentiveness and physician interruptions were measured. When physicians interrupt patients during the patient's disclosure of problems and concerns, interruptions violate patient's social script expectations and negatively affect patient satisfaction. Physicians' demonstrations of attentiveness and explanations of the purposes for the interruptions do not compensate for interruption's effects, and satisfaction with physician behavior is reduced.

Complexity And Uncertainty In Human And Ecological Risk Assessment, Matthew Jordan Dellinger

Theses and Dissertations

Multiple interacting stressors in the environment present increasingly complex risks to human health. Too often, however, the data required for traditional risk assessment are either lacking or unavailable at the necessary spatial or temporal scale. In addition, assessment practices and management policies need to move away from single factor approaches in order to accommodate the reality of complex chemical mixtures and environmental stressors. Recent literature suggests that a paradigm shift is under way. This points to a need for the development of new techniques both for rapid data collection and flexible risk assessment strategies that can adapt to make use …

Predictors Of Healthcare Cost In A Wisconsin Acute Leukemia Population: Utilization Of A State-Level All Payer Claims Database, Patricia Ann Steinert

Theses and Dissertations

Understanding cost predictors of low incidence high cost cancers is increasingly important as the U.S. attempts to control health care costs. Acute myeloid and acute lymphoblastic leukemia are hematologic cancers requiring high cost care.

Using Anderson's model of health care utilization this study explores the influence of patient and community factors on health care costs. Insurance claims cost data obtained from the Wisconsin Health Information Organization provided a sample of 837 acute leukemia patients from April, 2009 and June, 2011. Total, ancillary, inpatient, outpatient, pharmacy and professional services costs were analyzed using a GLM gamma log link regression model to …

The Relationship Among Maternal Parenting Stress, Coping, And Depressive Symptoms Across Time, Karen Foren Lake

Theses and Dissertations

This study was a secondary analysis in which the relationship among maternal parenting stress, coping, and depressive symptoms over time in 161 low-income mothers who participated in an Early Head Start Pathways Project were examined. Measurements were assessed longitudinally over a 12 year period of time. Direct and indirect relationships were proposed between maternal mastery, pre-existing depressive symptoms, relationship with significant other, child behavior, child temperament, maternal parenting stress, coping, and later depressive symptoms. Results from path analyses showed that when assessed earlier in the childbearing years, mastery, depressive symptoms, relationship with significant other, child temperament, child behavior, and maternal …

"Being Certain": Moral Distress In Critical Care Nurses, Marian Baxter

Theses and Dissertations

Published literature has focused on understanding moral distress from a descriptive standpoint. Missing from the literature is an exploration of the role a nurse can play in his/her/own moral distress.A qualitative study with an interpretive design incorporated Clandinin and Connelly' narrative methodology. Results highlighted assumptions were made by participants in the absence of resources, which led them to" know the right action to take" from their own perspective.

Costs And Use Of Oral Anti-Cancer Medications Among Senior Medicare Part D Beneficiaries, Nantana Kaisaeng

Theses and Dissertations

Oral cancer drugs are branded and expensive medications that generally do not have generics available. The restrictions of the Medicare Part D program, including the coverage gap and high cost-sharing, and the high cost of oral chemotherapy may lead to patients’ non-adherence to medication. Few studies have examined the cost and utilization of oral anti-cancer medications. This study will be the first to examine the costs associated with the use of oral anti-cancer medications and the impact of cost-sharing and type of prescription drug subsidy on medication discontinuation in the Medicare Part D elderly population. Objectives: To determine the usage …

Heart Failure Symptom Clusters And Functional Status, Janet Herr

Theses and Dissertations

Abstract HEART FAILURE SYMPTOM CLUSTERS AND FUNCTIONAL STATUS Janet Kay Herr Ph.D A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University 2012 Major Director: Dr. Jeanne Salyer, Ph.D., R.N., F.N.A.P Associate Professor, Adult Health & Nursing Systems Clinical assessment of heart failure includes symptom identification and the evaluation of the relationship of symptoms to functional status. Symptom clusters are groups of at least 2 or 3 co-occurring symptoms that are related but are independent of other groups of symptoms. The objectives of this study are to: …

Perceptual, Acoustic, And Kinematic Effects Of Sentence-Initial, Single-Phoneme Prolongation In People Who Do And Do Not Stutter, Darrell Sharp Matthews

Theses and Dissertations

This study examined a sentence-initial one-second sound prolongation as a possible fluency-inducing condition in people who stutter. The effects of this prolongation technique on the single sentence utterances of five people who stutter (PWS) and five age- and gender-matched controls were investigated. Variables tested included stuttering percentages, speaking rate, duration of phonated intervals, and correlation between upper lip and lower lip/jaw. Results showed a non-significant trend for less stuttering to occur when participants used the prolongation technique. Significant findings included longer durations of phonated intervals and more negatively correlated upper- and lower-lip movements during the prolongation condition. Rate of speech …

Understanding The Risky Sexual Behaviors Of Study Abroad Students, Ashley Schaffer

Theses and Dissertations

Using the Triandis Model of Interpersonal Behavior (TIB) this study examined the influence of environmental and individual characteristics on predicting risky sexual behaviors of study abroad students. This study utilized a two-stage, qualitative and quantitative methodological framework. First, focus groups with previous study abroad students were held in order to gather data that informed the development of assessment. Second, data was subsequently collected from 128 study abroad students. The TIB significantly predicted a participant's intentions to engage in risky sexual behavior with the construct labeled subjective social norms emerging as a significant predictor. The model also significantly predicted engaging in …

The Effect Of Physician Ownership On Quality Of Care For Outpatient Procedures, Xinliang Liu

Theses and Dissertations

Ambulatory surgery centers (ASCs) play an important role in providing surgical and diagnostic services in an outpatient setting. They can be owned by physicians who staff them. Previous studies focused on patient “cherry picking” and over-utilization of services due to physician ownership. Few studies examined the relationship between physician ownership and quality of care. Using a retrospective cohort of patients who underwent colonoscopy, this study examined the effect of physician ownership of ASCs on the occurrence of adverse events after outpatient colonoscopy. Agency theory is used to as a conceptual framework. Depending on the extent to which consumers are able …

On The Genetic And Environmental Associations Between Body Composition, Depression Symptoms And Smoking Behavior., Roseann Peterson

Theses and Dissertations

Obesity is a serious public health crisis and recent estimates of its incidence are the highest in United States history, with 35% and 17% of American adults and children affected, respectively. The clinical definition of adult obesity is operationalized as a body mass index (BMI) greater than 30 kg/m2. Although the prevalence of common obesity has increased dramatically over the past 30 years–largely thought to be due to changes in the environment, such as high calorie diets and sedentary lifestyles—twin and family studies have shown consistently that relative body weight is under considerable genetic influence in both children and adults, …

Interpersonal Control In Dating Relationships: How Is It Affected By Trust In One's Partner And Adult Attachment Style?, Melissa Franz

Theses and Dissertations

The U.S. spends billions of dollars each year treating victims of physical, sexual, and psychological abuse. A majority of college women (up to 75 percent) reported having experienced psychological or emotional abuse. These acts are intended to demean, criticize, and dominate one's partner. Control is one facet of psychological abuse and is intended to regulate one's partner. Control and psychological abuse are related to numerous negative outcomes in its victims. This study examines the influence of attachment style and trust on one's use of IPC in a relationship. One hundred forty seven participants were recruited (1) via a social networking …

The Impact Of Sexual Self-Esteem On Sexual Risk Detection In College Women, Lauren Lucente

Theses and Dissertations

Sexual assault victimization has been associated with poor risk recognition and low sexual self-esteem (Gidycz, McNamara, & Edwards, 2006; Schwartz & Shipiro, 1997). Evidence suggests that sexual self-esteem may precede risk recognition subsequently impacting victimization (Mayers, Heller, & Heller, 2003; Zeanah & Schwartz, 1996). The purpose of this study was to investigate the direct predictive impact of global and specific components of sexual self-esteem on risk recognition. Participants engaged a laboratory analog to measure risk detection and completed a series of questionnaires to measure sexual self-esteem. Results indicated that global sexual self-esteem is not predictive of risk recognition. In regard …

The Correlation Between Spectral Moment Measures And Electropalatometric Contact Patterns For /T/ And /K/, Janelle Barrett

Theses and Dissertations

Spectral moment analysis has helped further our understanding of the spectral properties of obstruent speech production; however, the physiologic correlates of these spectral measures are not well understood. The aim of the present study was to examine the possible correlations between the linguapalatal contact patterns used to produce the stops /t/ and /k/ and the resulting spectral characteristics. Using spectral moment analysis and electropalatography, the real-word productions of eight speakers of American English were investigated. The spectral measures for the stop consonant tokens in the present study were found to be similar to data reported in previous research with adult …

Schizotypy And The Role Of Coping Behaviors In The Experience Of Positive And Negative Affect, Jessica Hayes

Theses and Dissertations

The purpose of the current study was to examine whether (a) schizotypy is positively related to negative affect and negatively related to positive affect, (b) whether individuals with high levels of schizotypy use more maladaptive coping behaviors than those low in schizotypy, (c) that maladaptive coping behaviors will mediate the relationship between schizotypy and negative affect, and (d) that adaptive coping behaviors will mediate the relationship between schizotypy and positive affect. A sample of 435 undergraduate participants completed self-report measures including The Brief Cope, The Schizotypal Personality Questionnaire, and The Positive and Negative Affect Schedule. Bivariate correlations resulted in levels …

An Acoustic Analysis Of Elements Of Contrastive Stress Produced By 8 To 10-Year-Old Children, Nicole Michelle Clover

Theses and Dissertations

Contrastive stress is an aspect of communication that can be used to highlight information, de-accent redundant information, and create distinctions between new and previously-provided information. Previous research has documented that adult speakers use relative changes in their vocal intensity, fundamental frequency (F0), and duration to mark contrastive stress in a sentence. However, less is understood about how and when children mark contrastive stress in their communication, thus the current study aims to examine a number of acoustic elements of contrastive stress in 8 to 10-year-old children. Speech samples were elicited from 20 children and analyzed to determine if the acoustic …

Assessment Of The Role Of Solute Carrier Drug Transporters In The Systemic Disposition Of Fluoroquinolones: An In Vitro - In Vivo Comparison, Aditi Mulgaonkar

Theses and Dissertations

Fluoroquinolones (FQ) are broad-spectrum charged antimicrobials exhibiting excellent tissue/fluid permeation. Thus, FQ disposition depends essentially on active transport and facilitative diffusion. Although most early transporter studies investigating renal elimination of FQs have focused on apical efflux of FQs from renal proximal tubule cell (RPTC) into urine, their basolateral uptake mechanism(s) from blood into RPTC (i.e., first step to tubular secretion) has not yet been explored in detail. Renally expressed SLC22 members: organic anion (OATs) and cation (OCTs) transporters are known to transport such small organic ionic substrates (molecular weight ~400 Da). Hence it is of interest to explore the role …

Quality And Coordination Of Care For Persons With Brain Injury In The Community: Developing A Survey, Brian Philip Johnson

Theses and Dissertations

Background: Because of increasing demand on primary care physicians and a complex, fragmented, healthcare "system", people now must coordinate their own healthcare and services. In response, care coordination has become a clinical specialty, typically done by nurses or social workers. People with disabilities (PWD) also must coordinate their care, including health and disability-support services, knowing who to call, advocating for themselves, and scheduling appointments, among other things. Such demands can be particularly problematic after brain injury, which may impair abilities to prioritize, coordinate, manage, and schedule activities. Coordinating services requires participation of the PWD, and supportive significant others (SSO). At …

Effects Of Progressive Lens Eyeglasses On Gait Performance Factors Among Young And Middle-Aged Groups, Autumn Marie Milanowski

Theses and Dissertations

Background: It is estimated that over 85% of adults over the age of 45 develop a condition called presbyopia (Holden et al., 2008). Multifocal lenses (MfLs) are used to functionally adapt to this condition to allow for convenient near and distance vision. However, this causes vision distortion in the lower part of the visual field at ground level while walking. Since safe ambulation relies on the lower visual field to detect obstacles (Marigold et al., 2008), and vision acts as a moderating factor for increased fall rates as individuals age (Heasley et al., 2005), there is a need to investigate …

Understanding The Development Of Alphabet Knowledge In At-Risk Populations: The Influence Of Pre-Literacy Skills, Ashley Coursin

Theses and Dissertations

In the current research, alphabet knowledge has been confirmed as a critical component of children's developing emergent literacy proficiency. The assessment of pre-literacy skills, such as alphabet knowledge, plays an important role in the management of children at-risk for poor reading outcomes. This study aimed to better understand the influence of phonological awareness skills, print skills, and receptive vocabulary on the development of alphabet knowledge in at-risk preschool-age children. Statistical analyses revealed that a significant unique relationship was present between phonological awareness skills and the development of alphabet knowledge. Furthermore, this study identified three clusters of children based on the …

Using The Strain Index And Tlv For Hal To Predict Incidence Of Aggregate Distal Upper Extremity Disorders In A Prospective Cohort, Tiffany Amber Cash

Theses and Dissertations

Work-related distal upper extremity (DUE) musculoskeletal disorders (MSDs) are very prevalent and costly in the United States. It is important to recognize working conditions that lead to these disorders, in order to lessen the impact that they have on workers and their employers. Identifying jobs that are likely to cause DUE MSDs is difficult because there are many factors that are believed to contribute to DUE MSD development. The current study aims to determine if the Strain Index (SI) and the ACGIH TLV for HAL (two DUE job physical exposure assessment methods) predict increased risk of workers developing aggregate DUE …

Development Of A Methodology For The Quantification Of Physiological Load For Soccer Players, Robert W. Wilson

Theses and Dissertations

The overall aim of this research project was to devise valid mathematical models for quantifying the physiological load (PL) of practices and competitions for female and male NCAA Division I collegiate soccer players. Data from sub-maximal and maximal effort tests were used to construct these models. After development of the physiological load quantification (PLQ) models, the validity of them occurred by comparing them to the physiological gold standard of performed work, volume of oxygen consumed (V*O2). Last, comparisons of the scores from the PLQ models to the PL scores from the previous models occurred. In combination these three studies have …

Cell Death And Growth Arrest Pathways Mediating The Actions Of Stilbene 5c In Hct-116 Colon Cancer Cells, Moureq Alotaibi

Theses and Dissertations

Abstract The stilbene derivative, cis-3, 4’, 5-trimethoxy-3’-aminostilbene (stilbene 5c), is a potentially potent antitumor agent that acts via binding to the colchicine-binding pocket in microtubules. Earlier studies have shown that stilbene 5c induces cell death in ovarian cancer cells and leukemic cells. The present study was designed to investigate the effectiveness of this microtubule poison against the HCT-116 human colon cancer cell line and its mechanisms of action. Time course studies demonstrated that stilbene 5c produces a biphasic decrease in cell viability. The capacity of the cells to proliferate was not restored upon removal of the drug after 6 days …

Development Of Psychometrically Equivalent Speech Audiometry Materials For Measuring Speech Recognition Thresholds In Native Tagalog Speakers, Brandon Brian Taylor

Theses and Dissertations

In addition to the use of pure-tones for testing hearing, speech signals are highly valuable diagnostic tools for identifying and evaluating hearing impairment. Speech audiometry involves the implementation of such signals in the measurement of hearing acuity. One aspect of speech audiometry involves assessment of the speech recognition threshold (SRT) which evaluates an individual's ability to hear and understand speech. While live speech has been used in the past to assess SRT, recorded materials are preferred and have been shown to be advantageous over live speech. High-quality digitally recorded speech audiometry materials have been available in English for some time, …

Relationship Of Demographic Characteristics And Bmi With Health Literacy In Pacific Islander Care-Giving Adults, Sharla E. Morgan

Theses and Dissertations

Purpose: Health literacy and obesity are major global issues. Vulnerable populations, such as those with low health literacy, have the highest rates of obesity. Native Hawaiian and other Pacific Islander (NHOPI) nations have the highest prevalence of obesity in the world. This study describes the relationship between health literacy and demographic variables in a sample of NHOPI caregiving adults. Methods: We conducted a correlational study of 364 NHOPI adults. Each was a caregiver of at least one NHOPI child. Data were collected at grocery stores and a preschool in two Hawaiian Islands (n=209) and at NHOPI events in Utah (n=155). …