Medicine and Health Sciences Commons^™

Application Of A Theory-Based Educational Intervention To Increase The Frequency Of Performing Oral Health Assessments On Children Among Advanced Practice Registered Nurses And Nurses, Denise Michelle Claiborne

Community & Environmental Health Theses & Dissertations

The purpose of this study was to determine if the use of a theory-based educational intervention would increase the frequency of performing oralhealth assessments (OHAs) during well-child visits among nurses. A randomized experimental design was conducted to determine if the educationalintervention would improve frequency of performing OHAs, in addition to, knowledge, confidence in performing OHAs, and advising parents. Using a non-probability sampling frame, “snowball technique,” a total of 46 participants were recruited. After exclusion criteria, 33 advanced practice registered nurses(APRNs), registered nurses (RNs), and licensed practical nurses (LPNs); were randomized into a control or experimental group. Data collection occurred over …

Environmental Justice And The Role Of Social Capital In An Underserved Urban Community, Lorraine Ann Dillon

Community & Environmental Health Theses & Dissertations

The purpose of this qualitative study was to evaluate a community's beliefs, attitudes, and experiences regarding their neighborhood's environmental health issues and the ways in which individuals utilize social capital (the degree to which a community collaborates and cooperates) to improve their environmental health. Research correlating social capital with health status shows that the higher the level of social capital in a community, the better the health. An understanding of why some groups exhibit more social capital than others is important in improving the public health system. The study was accomplished by comparing a convenience sample of two specific groups …

Survey Of Camera Phone Awareness In Outpatient Community Behavioral Health Facilities, Tara Lynn Overton

Community & Environmental Health Theses & Dissertations

The purpose of this study was to determine the level of camera phone awareness in outpatient community behavioral health facilities in a medium sized Mid-Atlantic state. Camera phones have been shown to have a detrimental effect on the protection of privacy in areas such as corporations, gym locker rooms, and court houses, but privacy issues have not yet been addressed in behavioral health. Privacy is an important issue in healthcare as shown through the implementation of the Health Insurance Portability and Accountability Act (HIPAA). This study used Rogers' (1995) Diftbsion of Innovations Theory as a framework for determining the stage …

Pressure Ulcer Development And Prevention In Long-Term Care Facilities In Virginia: A Descriptive Survey, Audrey D. Arthur

Community & Environmental Health Theses & Dissertations

The development of pressure ulcers is a common occurrence among older persons who may be temporarily immobilized or confined to a bed. An estimated 60,000 deaths annually can be attributed to complications from pressure ulcers. Guidelines recommended by the Agency for Health Care Policy and Research have been disseminated nationally and continue to be recommended as the standard of care for pressure ulcer prevention. In spite of the use of the recommended guidelines, pressure ulcer rates persist, suggesting there are other factors contributing to pressure ulcer development in long-term care facilities.

A survey was conducted to investigate which provider related …

Sibling Death In Childhood: An Evaluation Of The Literature Regarding Inclusion Of Minority Cultures, 1990–2002, Joyce Kay L. Cherry

Community & Environmental Health Theses & Dissertations

This evaluation seeks to determine the extent to which the professional literature concerning bereaved children in the United States includes African American, Hispanic American, and Asian American children whose siblings have died in childhood.

A literature search identifies 58 articles, published between 1990 and 2002, concerning children under age 19 living in the United States whose siblings have died. Articles are sorted by time frame and classified by type. There are 31 descriptive articles consisting of five literature reviews, five commentaries, five case studies, and 16 narratives; there are 27 research articles. Analysis determines the extent to which race, culture, …

The Hand Center: Considerations Related To The Design, Planning, Staffing, And Marketing, Marcia L. Miller

Community & Environmental Health Theses & Dissertations

A therapist intent on planning a hand therapy center has no resources that are specific to this specialty area of practice. There are contributions utilized to plan occupational and physical therapy departments that can be synthesized to a degree in the planning of a hand therapy center. The practice of hand therapy incorporates a high degree of physical interaction, with close proximity to the patient and handling by the therapist. This paper explores the unique requirements of a hand therapy department. In order to determine hand therapists' preferences for equipment and space utilization a survey was developed and distributed to …

Validation Of Passive Air Sampling Monitors Onboard United States Navy Submarines, Larry A. Mcfarland

Community & Environmental Health Theses & Dissertations

An operating submarine creates a unique air quality mixture of compounds that result from a combination of human metabolism, construction materials, materials brought onboard and compounds created through the interaction of ship systems. A comprehensive study of submarine atmospheres is ongoing during deployments of U.S. Navy nuclear submarines. As part of the overall effort, a paired air sampling comparison field validation was conducted to compare the air sampling effectiveness of passive diffusive monitors compared to more traditional active air sampling methods when sampling for acrolein, formaldehyde and ozone in the enclosed submarine atmosphere. Acrolein monitors containing 2-hydroxymethylpiperidine (HMP) impregnated glass …

The Accuracy Of Nitrous Oxide Passive Dosimeters As Compared With An Infra-Red Spectrographic Reference Method, Susan Allen

Community & Environmental Health Theses & Dissertations

Nitrous oxide is a gas often used in dental, surgical and veterinary operations as an anesthetic agent. Employees stationed in proximity of fugitive gas emissions may potentially suffer adverse health effects from chronic exposure to this agent. Passive dosimeters can be worn in the breathing zone of potentially affected personnel during exposure periods, then later analyzed to quantify nitrous oxide exposure. This study sought to establish the accuracy of several commercially available passive monitoring devices for nitrous oxide by comparison against an infra-red spectrophotometric reference method.

Devolpment Of A Scale To Assess Home Health Care Aides' Ability To Recognize Depression In Older Adults, Tina M. Nerney

Community & Environmental Health Theses & Dissertations

Depression afflicts 20% to 40% of people 65 and older. Depression in older adults is frequent and chronic. The challenge of a hospital stay and the knowledge of having a long term disability may increase the risk for a depressive episode. In today's health care environment older adults are being released from hospitals after a short length of stay and are frequently dependent on home health services for assistance with activities of daily living. Home health care aides are given the responsibility of providing these services to the older adult in the home environment and need to be aware of …

Human Immunodeficiency Virus (Hiv)/Hepatitis B Virus (Hbv) Risk Perception Related To Needlestick Injuries At A Medical School In Norfolk, Virginia, Ronald B. Hartman

Community & Environmental Health Theses & Dissertations

A limited number of studies have been conducted to assess the perceptions of risk of medical students and residents for acquiring Human Immunodeficiency Virus (HIV) or Hepatitis B Virus (HBV) via percutaneous (needlestick) injuries while performing clinical training. The purpose of this study is to investigate these perceptions of risk, and to determine whether there is an association between a high perception of risk and a low incidence of needlestick injury. The method of investigation was a four-page survey questionnaire. The instrument was investigated for reliability by use of a pilot study with a small group of medical students and …

Telemedicine: Discovering And Overcoming The Barriers, Dennis Mcclain-Furmanski

Community & Environmental Health Theses & Dissertations

Telemedicine is the use of teleconmrunications for medical diagnosis and patient care from a distance. This multimedia computer based medium serves as an aid to decision making, a means of transmission of care-related data and as a channel for collaborative care management between a provider and a patient. It is of greatest utility in remote areas, or in other cases where transportation of either provider or patient would be problematic or economically less feasible than the telemedicine alternative.

This study examined the current capabilities of the computer hardware and software necessary to implement a telemedicine system. It found that current …

A Test Of An Alternate Calibration Matrix For Niosh Method 7300, Robert T. Vitek

Community & Environmental Health Theses & Dissertations

The purpose of this study was to determine if the analytical results (when determining cadmium, lead, and zinc concentrations) for air sample filters prepared and analyzed according to N:OSH Method 7300, differ significantly, from those obtained when the instrument is calibrated using EPA Method 200.7 acid matrix standards. The null hypothesis was that no statistically significant difference, measured at the 95% confidence level, would exist between results obtained from the two calibration standards. Careful standard and sample preparation, the use of an internal standard, and the application of working standard and working internal standard correction factors served to isolate the …

The Effects Of Risk Management Program Implementation On Worker Safety Knowledge, John C. Donnelly

Community & Environmental Health Theses & Dissertations

This study examined the effect of the implementation of a risk management program tool on worker safety knowledge in a composite building material fabrication facility whose workers suffered from an increasingly high injury (incidence) rate in recent years. Risk assessment codes (RACs) and job safety analyses (JSAs) were the primary tools used to introduce workers to the concept of risk. Because employee involvement is a crucial element in JSA development. employee input was frequently solicited throughout JSA development.

The study instrument consisted of a pre-test and post-test survey, to which an experimental and control group were subjected. The instrument was …

Patient Satisfaction Among Users Of The After Hours Program, Helen L. Larocco

Community & Environmental Health Theses & Dissertations

The problem of increasing health care costs and decreasing access to health care services is a major crisis in the U.S. today. One factor contributing to the rising cost of health care is the inappropriate use of emergency rooms, (ERs). In response to escalating costs a local health care corporation implemented a telephone triage program called the After Hours Program, (AHP). The goal of the program was to reduce inappropriate utilization of emergency rooms, and to educate patients to recognize and treat specific health problems independently, i.e., home treatment.

A program evaluation was completed in which different dimensions of patient …

The Pollution Effects Of Pleasure/Work Boat Sewage Discharges On Fecal Contamination Levels Of Waters In And Around Marinas And Other Places Where Boats Are Moored On The Eastern Shore Of Virginia, George H. Bangs

Community & Environmental Health Theses & Dissertations

Contamination of seafood harvested from and recreational areas of the Chesapeake Bay, its tributaries and the Atlantic coast inshore waters may cause health problems for people consuming the seafood or coming in contact with the waters by swimming, water skiing, or other water sports. These health problems include, but not limited to, dysentery, typhoid and hepatitis (Natchez, 1990). This is a preliminary study into the level of fecal pollution generated by sewage discharges from boats in marinas and other places where boats are moored on the Eastern Shore of Virginia. Sites selected for the study included; (I) marinas and other …

An Assessment Of Four-Hour Sample Durations Used To Determine Full-Shift Noise Exposures In A Foundry, Vince Marlo Fleming

Community & Environmental Health Theses & Dissertations

Full-shift sampling, usually eight hours, is traditionally performed to assess daily occupational noise exposure. This sampling approach is inefficient, and costly for repeated, long-term exposure evaluations. This study assessed the use of four-hour sample durations and subsequent data analysis to determine daily occupational noise exposures in a foundry. The four-hour sample durations were extracted from full-shift samples and analyzed on their ability to provide valid data for estimating mean daily noise exposure levels without significantly affecting sampling precision or accuracy. Results of this study indicate four-hour sample durations can be used successfully to estimate full-shift noise exposures provided certain criteria …

The Identification And Magnitude Estimation Of Occupational Stressors In The Industrial Hygiene Profession, Judith Hinch

Community & Environmental Health Theses & Dissertations

The industrial hygiene professional is responsible for the evaluation and control of hazards in the workplace. Job stress has been identified as a factor affecting the health, safety and productivity of workers and can be considered a workplace hazard.

This study involved the development of an instrument to identify and quantify sources of stress within a give profession. The industrial hygiene profession was chosen, though the method can be, and has been, used to evaluate stress in other groups of individuals. The method involved the identification of the most significant sources of stress by surveying a small number of the …

A Comparison Of Four Muscle Relaxant Techniques And Their Incidence Of Postoperative Myalgia In Ambulatory Patients, William James Garske Jr.

Community & Environmental Health Theses & Dissertations

Postoperative myalgia was measured 24 and 72 hours following the administration of four different anesthetic regimens to 36 patients undergoing outpatient or 23-hour admission procedures. Each patient, ASA class I or II, was to undergo procedures of limited duration, 30 to 90 minutes, and surgical stimulation, including procedures such as knee arthroscopy, hernia repair, and breast biopsy. Anesthesia was induced with propofol 1.5 mg/kg, fentanyl 50 mcg, and maintained with O₂ , N₂O, and isoflurane. Group I (n=20), the control, received no muscle relaxant and was maintained with mask ventilation. Group II (n=5) received succinylcholine 1.5 mg/kg …

Validation Of A Bag Sampling Method For 1,3-Butadiene, Lori Eckenrode

Community & Environmental Health Theses & Dissertations

At this time there is no NIOSH approved means for bag sampling 1,3-butadiene. An attempt was made to use the application of cold (0°F) to inhibit the reactivity of the gas prior to analysis. The State of California Air Resources Board has an approved method for the gas chromatographic analysis of 1,3-butadiene from stationary sources. The method was utilized in the application of industrial hygiene monitoring of affected workers. The application of cold was found to be ineffective at inhibiting the highly reactive nature of 1,3-butadiene. Analyte losses were too great to classify the method as an accurate measure of …

The Degree Of Exposure To Anesthetic Nitrous Oxide Waste Gas In The Operating Room During Various Surgical Procedures, Kathryn Ann Longworth

Community & Environmental Health Theses & Dissertations

Halsey (1991) summarized the underlying reasons for continuing concern about the problem of waste anesthetic gases. Careful and systematic monitoring studies indicate that individual trends in anesthetic pollution levels are not as low as was confidently predicted 10 years ago, when scavenging devices became commonplace. Second, there are now clear legal requirements for assessment of the situation. It is estimated that each year more than 200,000 health professionals are occupationally at risk of illness as a consequence of chronic exposure to low doses of waste anesthetic gases (Rogers, 1986).

These contaminants are suspected pf being ~eratogenic, carcinogenic, mutagenic, and embryo-lethal. …

A Cipp Evaluation Of The Administrative Associate Training Program Through Sentara, Patricia A. Criswell

Community & Environmental Health Theses & Dissertations

Hospitals are facing change in today's environment. In order to meet these growing challenges, they are responding by providing value added services. Value added services have been defined as reducing inefficiencies and improving quality and service. Operational restructuring in the form of a new concept called patient-focused care has become the paradigm shift and structural revamping at several hospitals across the nation. Sentara Hospitals have adopted this program to improve the clinical and service quality delivered to the patient. An integral component of this new approach is the multiskilling of staff to reduce duplication, inefficiencies, and improve the quality provided …

Attitudes Of Virginia Dental Hygienists Towards Issues Relevant To The Independent Practice Of Dental Hygiene, Linda Hawkins Mccain

Community & Environmental Health Theses & Dissertations

Adequate studies have not been conducted to assess the attitudes of dental hygienists toward independent practice of dental hygiene. The purpose of this study was to investigate these attitudes. The method of investigation was a survey questionnaire designed by the principle investigator. The research results indicated weak support for the independent practice of dental hygiene. The support for general supervision of hygienists in Virginia and the desire to be allowed to practice in nontraditional settings was stronger. There was reported a very strong opposition to preceptorship in dental hygiene. The majority of Virginia dental hygienists agreed that they were educationally …

The Identification And Magnitude Estimation Of Stressors In A Selected Military Population At One Training Command, Susan W. Miller

Community & Environmental Health Theses & Dissertations

The purpose of this study was to identify the most stressful aspects of being a student at a military training command. ·Forty students listed the significant stressors that they encounter at the training command. This list was reviewed and consolidated into a stressor rating questionnaire with 16 stressors. A convenience sample of 86 students rated the stressors. In the second part of the study, the students rated the stressors on a scale of "0 to 1000". The study revealed that the most significant stressors for students were absence of family and friends, uncertainty about their future, dealing with instructor's attitudes, …

Awareness Of And Rights Related To The Patient Self-Determination Act Of 1990 By Selected Post-Adolescent College Students, Toni M. Vargas

Community & Environmental Health Theses & Dissertations

The purpose of this study was to determine if the Patient Self-Determination Act was effective in providing information to young adults and will young adults not only have an accurate understanding of their health care rights but sufficient opportunity to exercise those rights. From a sample of convenience, 83 college students were randomly selected to complete a questionnaire. The questionnaire contained 71 questions devised to reflect various aspects of the Patient Self-Determination Act. Five additional questions were asked to determine a generalized profile of the students. Data analysis of the responses identified 5 significant legal misunderstandings and 5 significant medical …

An Assessment Of Food Sanitation Knowledge And Practice Of Restaurant Workers In Taichung City, Taiwan, Shiow-Fu Sheu

Community & Environmental Health Theses & Dissertations

Taichung city is located in the western middle part of Taiwan, with a population of nearly 800,000. The total number of food service establishments in Taichung City is more than 10,000. Among these, nearly 2000 of the food establishments are considered restaurants. For such a large number of restaurants, the total number of food sanitation inspectors is 16. In order to overcome the shortage of the food inspector manpower problem, Taichung City Health Department has set up a "Food Sanitation Self-inspection Program", in an effort to encourage the restaurants to direct more attention to food sanitation problems. In the meantime, …

A Descriptive Study Of Commitment Practices In A Selected Jurisdiction, Louis A. Pesnicak

Community & Environmental Health Theses & Dissertations

This study examines the application of commitment procedures in one urban community in Virginia. The study investigated: the concordance rates of clinical recommendation for treatment and the outcome of the commitment hearing. the time lapse between detention of an individual and the hearing outcome. the presenting symptomatology and outcome. and the pre-detention compliance to treatment and outcome. The study's findings showed a concordance rate of 64% between clinical recommendation and outcome. It provided no significant differences in symptomatology/outcome, compliance/outcome, and time lapse/outcome. The lack of any significant findings seems to suggest that application of commitment laws might benefit from institution …

An Analysis Of Quality Assessment Efforts In Health Care, Margaret M. Curran

Community & Environmental Health Theses & Dissertations

The purpose of this research was to determine whether consensus could be reached by experts in the field of quality assurance on the most important indicators of health care quality and to determine whether cause and effect relationship could be attributed to the process and outcome indicators suggested in our survey. We invited participation by a representative sample of experts in a Delphi Panel to address these issues. There were 49 respondants to our Round One Questionnaire and they evaluated the relative importance of 50 process and 50 outcome indicators. Panelists were asked to establish cause and effect relationships between …

Identification And Ranking Of Stressors Specific To The Acute Head Care Nurse, Joan A. Breen

Community & Environmental Health Theses & Dissertations

No abstract provided.

A Comparative Analysis Of Pediatric And General Hospital Nurse Recruitment Practices, Rebecca Parsons Scott

Community & Environmental Health Theses & Dissertations

The focus of this study is a comparison of the National Association of Health Care Recruiter's annual recruitment survey with a duplicate survey that was sent to pediatriconly acute care hospitals. The goal was to determine differences between the recruitment and retention statistics found in all hospitals compared to those found in pediatriconly hospitals. Also, a major consideration was to find correlations among the variables in nurse recruitment and retention that might lead to a better understanding of what influences the recruitment budgeting process and how recruitment dollars might be spent most efficiently.

There was no significant difference found between …

Effects Of Applied Soil Repellent Finish On Pesticide Residues In Work Clothing, Sandra L. Prior

Community & Environmental Health Theses & Dissertations

This study explores the feasibility of using an applied soil repellent finish, Scotchgard, on 100% cotton denim fabric in order to enhance the removal of atrazine and alachlor residue during the laundering process. The experimental findings provided no statistically significant evidence that Scotchgard fabric protector reduced pesticide residuals on the 100% cotton denim fabric either before or after laundering. A significant finding secondary to the study involved the possible interaction of Scotchgard with the pesticide alachlor, leaving greater amounts of residual on the fabric after laundering than those found with no fabric treatment. This suggests that agricultural workers be cautioned …