Medicine and Health Sciences Commons^™

Critical Illness Survivors’ Perceptions Of Their Recovery: An Interpretive Phenomenological Inquiry, Kelly Calkins

Theses and Dissertations

Surviving critical illness with its physical, cognitive, and psychosocial morbidities is a growing clinical and research challenge and an important public health concern. Currently, there are few interventions for survivors of critical illness after hospital discharge. Potential interventions include rehabilitation services, Intensive Care Unit (ICU) diaries and ICU follow-up clinics, however, most survivors do not have access to these post-hospital interventions.

The purpose of this study is to gain a better understanding of how critical illness survivors experience their recovery, interventions they use, and what they perceive as facilitators and barriers to their recovery. A better understanding of these factors, …

The Impact Of Maternal Diabetes On Fetal And Infant Outcomes: A Secondary Analysis Of Peridata.Net® From 2013 To 2017, Christina Lynn Dzioba

Theses and Dissertations

ABSTRACT

THE IMPACT OF MATERNAL DIABETES ON FETAL AND INFANT OUTCOMES:

A SECONDARY ANALYSIS OF PERIDATA.NET® FROM 2013 TO 2017

Christina Dzioba, MS, ARNP, WHNP-BC, C-EFM

Background: Diabetes is a leading cause of morbidity and mortality for most of the developed world and is known to contribute to adverse maternal, fetal, and infant outcomes. The purpose of this study was to examine the relationship of maternal diabetes to fetal and infant outcomes for infants born in a small heterogeneous urban community with significant disparities in infant mortality using data in the PeriData.Net® database.

Methods: Women with diabetes were case matched …

Physical Activity During Pregnancy And Birth Outcomes In South Carolina 2009-2015, Andrew Tyler Broadway

Theses and Dissertations

Physical activity is known to be beneficial to adults in general, including pregnant women, but the literature on physical activity and neonatal outcomes has been inconsistent. Few studies have differentiated between physical activity prior to pregnancy and during pregnancy to see whether the typical beneficial effect is not due to having a more active lifestyle in general. The Pregnancy Risk Assessment Monitoring System (PRAMS) is a national cross-sectional surveillance system. Our data from SC PRAMS included 6391 respondents and was weighted to be representative of population of pregnant women that delivered in the state. We excluded births that were not …

The Association Of Hospital Practices To Breastfeeding Behaviors In South Carolina: Analysis Of 2013-2015 Pregnancy Risk Assessment Monitoring System (Prams) Data, Larisa Donnette Bruner

Theses and Dissertations

Objective: The purpose of this study was to determine whether hospital practices are associated with breastfeeding initiation and breastfeeding duration for ≥10 weeks.

Methods: We analyzed the 2013-2015 South Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) data. The population of interest was mothers who delivered a single live birth in the hospital. The infant was alive and living with the mother at the time of the survey. Chi-square and logistic regression were used to examine breastfeeding initiation and duration among all women who delivered in a hospital and those who stated that they initiated breastfeeding while in the …

Network Analysis Of Scientific Collaboration And Co-Authorship Of The Trifecta Of Malaria, Tuberculosis And Hiv/Aids In Benin., Gbedegnon Roseric Azondekon

Theses and Dissertations

Despite the international mobilization and increase in research funding, Malaria, Tuberculosis and HIV/AIDS are three infectious diseases that have claimed more lives in sub Saharan Africa than any other place in the World. Consortia, research network and research centers both in Africa and around the world team up in a multidisciplinary and transdisciplinary approach to boost efforts to curb these diseases. Despite the progress in research, very little is known about the dynamics of research collaboration in the fight of these Infectious Diseases in Africa resulting in a lack of information on the relationship between African research collaborators. This dissertation …

Survey Assessment Of Community Knowledge And Prevention Of Chagas Disease And Its Vector In Hidalgo And Cameron Counties, Adam Dennis Wiejaczka

Theses and Dissertations

Chagas disease, caused by the parasite Trypanosoma cruzi, kills thousands of people annually and is the dominant cause of infectious myocarditis worldwide. Kissing bugs are vectors that carry T. cruzi . and are found in the Lower Rio Grande Valley (LRGV). There is no vaccination nor cure for Chagas. The best mechanism of prevention is to control vector infestations. Little research is available regarding the level of understanding local communities have about Chagas.

Our goal was to test the knowledge of several communities in the LRGV on Chagas disease. Our hypothesis states that local communities do not have sufficient …

What's So Bad About Hooking Up? : Factors Predictive Of More Positive Perceptions Following A Hookup, Jade A. M. Spaulding

Theses and Dissertations

The purpose of the study was to examine factors predictive of a more positive perceptions following a hookup. The participants included 188 students from Illinois State University. Participants completed a demographics questionnaire, the Hookup Scale, the Rosenberg Self-Esteem Scale, the Sexual Self-Esteem Inventory, religiosity questions, attitudes toward hooking up questionnaire, emotional reactions to hooking up questionnaire, and the Social Academic, Romantic, and Sexual Hooking Up Reactions Scale. The current study found that participants who reported high global self-esteem, high sexual self-esteem, and positive attitudes toward hooking up reported less regret, more positive reactions, and fewer negative reactions following a hookup.

Markers Of Cardiometabolic Risk And Thyroid Dysfunction In U.S. Adolescents: Nhanes Iii, Jonathan Austin

Theses and Dissertations

The global prevalence of metabolic syndrome (MetS) and its associated components (high fasting glucose, waist circumference, blood pressure, triglycerides, and low HDL) have increased over the past few decades. In addition, abnormal thyroid hormone levels have been found to manifest in a cascade of metabolic dysfunction, which may be linked to MetS in youth. PURPOSE: The purpose of the study is to investigate the association between MetS, its components, and markers of thyroid function in a nationally-representative sample of adolescents. METHODS: The National Health and Nutrition Examination Survey III (1988-1994) collected data on the components of metabolic syndrome and thyroid …

The Effect Of Ammonia On The Germination And Outgrowth Of Bacillius Globigii, Joseph B. Kunicki

Theses and Dissertations

This research investigated the germination and outgrowth of Bacillus globigii in the presence of ammonia in laboratory scale experiments. Germination was measured by monitoring the release of dipicolinic acid, an organic compound present in bacterial spores, while outgrowth was measured using phase-bright microscopy and semi-automated counting procedures. The ammonia-N concentrations investigated generally did not cause statistically significant differences in the initial 1-hr germination rates or the average 3-hr outgrowth rates of Bacillus globigii spores in batch style experiments. The average 1-hr germination rates observed in the absence of ammonia-N was 0.0258 hr^-1 for the water and buffer controls and …

Radiological Decontamination In The Urban Environment Utilizing An Irreversible Wash-Aid Recovery System, Keith A. Sanders

Theses and Dissertations

The radioactive fallout from the Fukushima Daiichi nuclear reactors accident and the ongoing threat of nuclear or radioactive terrorism have forced the need for urban radiological decontamination into the forefront. Many of the established decontamination techniques are not ideally suited for the urban milieu. One of the keys to maximize the effectiveness of long-term remediation and recovery in the urban environment is immediate mitigation within a few days of the incident and before a rain event. The Integrated Wash-Aid, Treatment, and Emergency Reuse System (IWATERS) provides a potentially safe and effective method for early responders and remediation teams to perform …

Framed Text Messages As A Nutrition Education Intervention, Michael James O'Halloran

Theses and Dissertations

A youth’s college years is a critical period in health behavior formation, during which body mass index (BMI) and other health behaviors such as diet and physical activity are strong predictors of adult health status. Text messaging is prominent in the lives of most college-age adults. Despite this, relatively few studies have investigated the potential of utilizing a text message-based intervention to target fruit and vegetable consumption, a measure for weight management behaviors. Additionally, few studies utilizing a text message-based intervention have utilized a theory specific to the creation of behavior-motivating text messages. The gain-framed health behavior messages of Prospect …

Occupational Noise Dose Reduction Via Behavior Modification Using In-Ear Dosimetry Among Usaf Personnel Exposed To Continuous Impulse Noise, Jesse A. Trawick

Theses and Dissertations

The purpose of this research was to investigate the use of in-ear noise dosimetry and worker feedback to reduce noise exposures among combat arms instructors and heavy equipment operators in the Air Force. Specifically, this thesis sought to determine how effectively hearing protection devices (HPDs) are being utilized currently, and whether providing at-ear noise exposure data to workers results in reduced noise exposures or changes in worker attitude. These questions were addressed by performing a six-month field study using dosimeters to record worker noise exposures under HPDs. Subjects served as their own control, receiving feedback in only the latter half …

The Influence Of Clinically Meaningful Factors On The Performance Of The Recommended Annual Diabetic Foot Screening, Trisha A. Sando

Theses and Dissertations

Background: Diabetic foot ulcers are the result of multiple complications from hyperglycemia and lead to poor quality of life and high healthcare costs. The annual diabetes foot screening exam (ADFSE) and prevention interventions can reduce DFUs up to 75%. In 2015, 71% of the US population received the ADFSE.

Objectives: The main objectives of this dissertation were: 1) to determine the association between adherence to diabetes self-management behaviors and the ADFSE, 2) to determine the association between concordant and discordant comorbidities and the ADFSE and 3) to determine the association between the performance of diabetes preventive care processes, number of …

The Importance Of Person And Place In Predicting Prostate Cancer Incidence And Mortality Among United States Veterans Seeking Veterans Health Administration Care, Peter Georgantopoulos

Theses and Dissertations

T Introduction: There are several unique characteristics in the epidemiology of prostate cancer (PrCA) that make it an interesting and important cancer to study. The first is that while prostate cancer is the most common cancer that men develop, it is one of the least common cancers that men die from. This indolent nature of PrCA has led to the idiom among health scientists that “men are more likely to die with PrCA than due to PrCA”. Just like other cancers, several individual-level risk factors (e.g., family history of the disease, age, and race) are well established for both PrCA …

Adult Nursing Students’ Perceptions Of Social Presence In Facilitator-Created Subject- Specific Videos In An Online Nursing Course, Jamie Anne Marcus

Theses and Dissertations

The literature established that online instruction consists of cognitive, teaching, and social presence. Studies on the element of social presence linked text-based delivery of instruction with learners’ feelings of isolation and disengagement. This research findings prompted this facilitator creation of five-to-seven-minute companion videos that aligned and complemented weekly text-based learning modules to ascertain students’ perceptions of these videos as a medium for channeling social presence.

Post-video viewing surveys yielded responses to pragmatic and emotional questions. Pragmatic questions were aimed at the visual impact of professor’s delivery of information. Emotional questions gauged the students’ feelings of connectivity with the facilitator. Triangulated …

Motivators Impacting Employment After Disability Due To Injury Or Chronic Illness, Damion B. Jackson

Theses and Dissertations

Unemployment caused by the need to treat and recover from a disability due to injury or chronic illness is a common phenomenon. Research illustrates that absence from work damages organizational growth, employers, and employees. Employees often experience problems with their mental and physical health that affect their social identity and function. In the context of the recognized value of employment for human health and well being, policy-makers have implemented various programs and approaches to encourage re-employment of those unemployed due to required treatment and rehabilitation. Many of the approaches are driven by financial incentives to encourage individuals to rejoin the …

A Longitudinal Analysis Of Shiftwork And Self-Reported Depression In A Police Cohort, Meghan Holst

Theses and Dissertations

Background: Shiftwork is associated with many chronic diseases stemming from the disruption of circadian rhythms. Police officers have a high risk for many adverse conditions including depression. Abnormal bodily functions, such as increased stress and disturbed sleeping patterns, may play an important role in the development and severity of depression. This study was designed to assess the association between depressive symptoms and shiftwork in a police cohort from Buffalo, NY

Methods: This longitudinal analysis consists of 470 police officers from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study. Data were collected during visit 3 between 2004-2005 and visit …

The Effect Of Neighborhood Characteristics And Acculturation On Vegetable Intake Among U.S. Hispanics, Anna Victoria Mesa

Theses and Dissertations

The growing prevalence of chronic disease among the U.S. Hispanic population has drawn increasing attention to modifiable behaviors such as diet in an effort to curb the burden of disease among this population. While factors affecting dietary intake among U.S. Hispanics have been largely studied, this study broadens the scope of existing analyses from examining the role of individual-level factors, including acculturation, to also include environmental factors such as neighborhood ethnic composition. Multilevel mixed modeling was employed to test the interaction of individual acculturation with neighborhood ethnic composition to predict vegetable intake among a sample of U.S. Hispanics. Individuals who …

Comparative Effectiveness Of Conventional And Novel Sampling Methods For The Recruitment Of Sexual Minority Identified Women, Sarah M. Piperato

Theses and Dissertations

Sexual minority identified (SMI) women have an amplified risk for risky health behaviors and chronic health conditions. Current research on mechanisms related to health disparities in SMI women is limited. Research targeting SMI women has relied on small, convenience samples to address health disparities. Due to the nature of this population, probability sampling methods are ineffective and inefficient and cost prohibitive. The purpose of this dissertation was threefold. First, we examined the current state of literature to gain insight on prevalent sampling strategies used to access SMI women for health-related research. Second, we compared the efficacy of two sampling strategies, …

The Effects Of The Affordable Care Act On The Receipt Of Colonoscopies Among Insured Elderly, Min Jee Lee

Theses and Dissertations

Background: The Affordable Care Act (ACA) waived deductibles and eliminated coinsurance for colonoscopies for Medicare beneficiaries beginning on January 1, 2011. This study investigated the effect of the ACA’s removing of financial barriers on the receipt of colonoscopies among insured elderly, who are predominantly covered by Medicare. Moreover, this study examined how income-related disparities in colonoscopy use have changed over the past decade and attempted to quantify various contributions to income-related disparity in the use of colonoscopies among insured elderly. Methods: Five cycles (2008, 2010, 2012, 2014, and 2016) of the Behavioral Risk Factor Surveillance System (BRFSS) were utilized to …

Sleep, Shiftwork Adaptation, Autonomic Dysfunction, And Metabolic Syndrome, Torrance Torrance

Theses and Dissertations

Background: Sleep is considered a physiological necessity and its disruption is associated with a wide variety of adverse mental and physical health outcomes including increased incidence of obesity, cancer, hypertension, cardiovascular disease, type 2 diabetes mellitus, stroke, depression, post-traumatic stress disorder (PTSD), work-related and vehicle accidents, and aberration of the autonomic nervous system.

Methods: Three studies were conducted from three separate populations. The first study examined the latent trajectories of self-reported sleep quality in active duty Army soldiers over a 3-year period using data from the Global Assessment 2.0 survey and Repeated Measures Latent Class Analysis (RMCLA) procedures. Generalized Estimating …

How Do Health System Employees With Established Musculoskeletal Complaints Decide On Their Treatment Pathway? A Qualitative Approach, Noor Alshareef

Theses and Dissertations

Purpose: Non-pharmacologic treatment such as physical therapy (PT) are advocated for musculoskeletal pain for decreasing opioid use. Early access to PT has been shown to decrease costs and improve outcomes through direct access via self-referral. Although self-referral to PT is permitted in the majority of U.S states, health insurance coverage has been identified as a barrier preventing some patients with musculoskeletal complaints from using it. There are few studies examining patient factors related to early access to physical therapy via self-referral. The purpose of this study was to identify the factors outside of insurance that influence the choice to access …

Interpersonal Communication About Cigarette Warning Labels Among U.S. Smokers: Differences Between Latinos And Whites, Victoria Catherine Lambert

Theses and Dissertations

Pictorial health warning labels (HWLs) on cigarette packs are used worldwide to curb cigarette smoking, the leading preventable cause of death in the United States While individual-level mediators of HWLs’ effects on cessation have been thoroughly studied, interpersonal communication about HWLs has received less attention in HWL research. However, results from one study demonstrated the importance of interpersonal communication, finding that conversations about HWLs predicted quit attempts in Australia, Canada, and Mexico. That study also found that smokers in Mexico, where most smokers are Latino, reported more conversations than smokers in Australia and Canada, where most smokers are non-Latino White. …

The Impact Of The Medicaid Coverage Expansion And The Removal Of Cost-Sharing Under The Affordable Care Act On Mammography And Pap Tests, Abeer Alharbi

Theses and Dissertations

Background: The Affordable Care Act (ACA) aimed at making health care affordable and accessible including the use of preventive care services. To achieve these aims, the ACA expanded Medicaid coverage to population with income below 138% of FPL and removed cost-sharing when using preventive care services recommended by the USPSTF. This study tried to assess the impact of these provisions on the rate of mammography and Pap tests among women. Methods: Data was obtained from the Medical Expenditure Panel Survey - Household Component MEPS-HC. A difference-indifference design was used to determine the effect of Medicaid eligibility expansion on the outcomes …

Investigating Drug-Related Violence In Indian Country: The Lumbee Tribe Of North Carolina, Asa Alena Revels

Theses and Dissertations

Drug-related violence (DRV) impacts the over-all wellbeing of communities, with disparate health outcomes observable in many poor, minority communities. The purpose of this study was to better understand the multi-level social and environmental factors influencing elevated rates and prevention of DRV within the Lumbee, a southeastern American Indian Tribe. This was accomplished via in-depth, one-on-one interviews with 37 Lumbee Tribal Members and Key Leaders. The findings align with existing research, revealing the influence of such factors as poor socioeconomic conditions, coping strategies, broken family structures, and the influence of federal policy. Of interest was the substantial influence of the local …

Patient Characteristics, Discharge Disposition, And Hospital Factors Associated With All Cause 30-Day Hospital Readmission For Total Joint Arthroplasty In 2014, Hamad Yahya Alzamanan

Theses and Dissertations

Objective: Recent improvements in hospital care have come from a growing knowledge of factors that contribute to readmission. The objective of this work is to identify and describe the national readmission rate after Total Joint Arthroplasty, and to evaluate selected hospitals’ and patients’ factors for their association with the all-cause 30-day readmission rate after TJA in the United States in 2014. Method: Retrospective analysis of 938,504 TJA acute care hospital discharge records was performed, using a nationally representative database that is dedicated to the study of hospital readmissions, and accounts for 51% of total US hospitalizations. Logistic regression models were …

Factors Affecting Patient Satisfaction With Healthcare System Of Turkey, Serdar Aydin

Theses and Dissertations

The World Health Organization (WHO) defines health system as comprising of all the organizations, resources, and institutions dedicated to improving health. Health systems have a responsibility not just to improve the health of the population they serve but to provide financial protection against the costs of illness and to respond to people’s expectation with dignity. Besides, healthcare satisfaction and consumer satisfaction have become the latest trend in measuring quality to have a competitive advantage or best practice in the healthcare industry. Over the past 30 years, consumer satisfaction has gained widespread recognition as a measure of quality in many services …

Hiv In The United States: A Spatial Examination Of Testing And Outcomes, Sazid Shameem Khan

Theses and Dissertations

The main objectives of this dissertation were to provide a complete depiction of the prevalence of HIV across the United States and to assess HIV testing trends among various subpopulations. Additionally, we focused on measuring spatial access to HIV testing resources across the U.S. South, where HIV is rapidly becoming more burdensome and resources have historically been allocated disproportionately. We sought to identify disparate populations and locations that require further focus moving forward to stem the HIV epidemic. We utilized a variety of data sources such as the Behavioral Risk Factor Surveillance System (BRFSS) which was used to assess national …

The Impact Of False Positive Mammography Results On Breast Cancer Screening Intention Among Black Women, Deeonna E. Farr

Theses and Dissertations

Extensive research indicates that false-positive mammograms (FPM) have been associated with negative psychosocial and cancer-related beliefs, but only a handful of studies examine Black women’s reactions to this experience. Additionally, these studies do not investigate how organizational and provider-level factors in concert with individual patient characteristics shape Black women’s experiences and reactions to FPM results. The purpose of this study was to determine the impact of organizational, provider, and individual-level factors on the processes and outcomes associated with FPM results in Black women. This study had two specific aims:

1) To describe, using a mixed methods approach, the organizational and …

Introduction Of Innovative Medical Practices In Mayo Clinic: Effect Of The Interventions On Patient Outcomes, Duaa I. Aljabri

Theses and Dissertations

Purpose: Assessment of health technologies in medical practice is an ongoing process to provide clinicians and policymakers with information on the value of those applications. This dissertation aims to add to the existing body of literature and fill the gaps in prior studies by assessing two health technologies in Mayo Clinic Florida (MCF). The first paper provides an assessment of patient portal adoption and activity during hospitalization among cancer patients, and determines whether a portal application is associated with selected indices of patient safety, utilization and satisfaction. The second paper provides an assessment of a new approach in pain …