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Articles 1 - 30 of 864
Full-Text Articles in Medicine and Health Sciences
Finding Hope In Chaos: The Development Of A Tool To Identify Key Factors That College Students Use To Effectively Deal With Adversity, Joetta Harlow Kelly
The purpose of this study is to identify techniques that could be developed into a resource for counselors and other professionals who assist college students in dealing effectively with adversity. In a series of four surveys, 200 people were asked to participate. These included professional counselors and ministers both on and off campus, as well as directors in Student Affairs, such as those in student support services and student life. To accomplish this, questionnaires were developed to identify and allow for tabulation of the counseling techniques most commonly used for students dealing with adversity by those working with college students ...
The Impact Of Emotional Intelligence And Affective Behavior On Paramedic Student Field Internship Success, Jim Lambert
Purpose: The purpose of this correlational study was to examine the relationship between emotional intelligence (EI) scores, as defined by Bradberry and Greaves (2009) and paramedic student success during the field internship phase of their education as determined by the California Paramedic Field Internship Major Evaluation (FE) Rating Criteria.
Methodology: This quantitative, nonexperimental, correlational study utilized data collected from the Emotional Intelligence Appraisal—Me Edition and the California Paramedic FE reports provided by paramedic preceptors in the field. Data were collected from 30 paramedic interns from 3 paramedic programs in Southern California and analyzed using the Pearson product moment correlation ...
Career Coaching: A Study Of Veterans Health Administration (Vha) Leaders', Jerelyn Dugas
Purpose: The purpose of this qualitative multiple case study was to explore and describe the impact of career coaching on the career performance growth and retention as perceived by healthcare’s emerging leaders who participated in selected coaching program institutes for a minimum of 1 year at VHA hospitals in Southern California.
Methodology: The researcher selected a qualitative multiple case study to explore and describe VHA leaders’ perceived impact of coaching on their career performance growth and retention. Further, the researcher conducted semi-structured, interviews with 15 participants to gain a better understanding of the lived experiences of the participants at ...
Primary Care Physician Delivered Brief Behavioral Intervention For Adult Obesity And Associated Health Conditions, Julia C. Huston
Obesity is a chronic health condition with prevalence rates that have continued to rise steadily over the past 30 years to the point that it has now been declared a global epidemic and a serious public health concern. Obesity is associated with significant physical and economic costs, primarily resulting from co-occurring health conditions that increase the risk of morbidity including type II diabetes, hypertension, dyslipidemia, stroke, coronary heart disease, and respiratory problems. Despite the dissemination of several obesity treatments, including pharmacotherapy, lifestyle modification, and bariatric surgery, the prevalence and severity of obesity continues to rise. Federal guidelines recommend the use ...
Beta-Testing Of An Interactive Multimedia Computer Program Of Exposure Therapy For Ptsd, Marie C. Barrett
Posttraumatic Stress Disorder (PTSD) results in significant impairment for the individual and substantial costs to society. Research indicates that cognitive behavioral psychotherapy (CBT) is the most effective treatment for PTSD and that among CBT treatments, exposure therapy is the treatment technique with the strongest evidence to recommend it for PTSD treatment. Computerized programs that deliver evidenced-based treatments offer a potential solution to barriers that prevent individuals from accessing and completing treatment. The present study evaluates the clinical and practical functionality of a computer-based program designed for the treatment of PTSD. Results indicate that completion of the program is associated with ...
Qualitative Analogue Study On Student Therapist’S Reactions To Client Suicidality, Cynthia A. Beevers
Suicidal clients are a reality for both professional and student therapists providing counseling (Chemtob et al., 1988; Dexter-Mazza & Freeman, 2003; Goodman, 1995; Howard, 2000; Jacobson, Ting, Sanders, & Harrington, 2004; Kleespies, Penk, & Forsyth, 1993; Kleespies, Smith, & Becker, 1990; Mackelprang, Karle, & Cash, 2014; McAdams & Foster, 2000). Previous research has investigated the experiences of professional therapists working with suicidal clients, but little is known about student therapists’ experiences with suicidal clients. Only two studies were found investigating the experiences of student therapists working with suicidal clients (Kleespies et al., 1993; Kleespies et al., 1990). However, in the two studies explicitly focusing on student therapists’ experiences with suicidal clients, participants were doctoral students from clinical or counseling psychology programs that were in their pre-doctoral internship. No information was found regarding the experiences of student therapists currently attending a master’s degree program. Further, both studies exploring the experiences of doctoral students working with suicidal clients used a retrospective design ...
Training Pediatric Primary Care Providers In Behavior Management Strategies, Kate Burger
Childhood mental health disorders are a significant public health concern in the United States. It is estimated that every year 13 to 20% of children living in the United States experience a mental health disorder (National Research Council and Institute of Medicine, 2009). Despite the clear need for mental health care, less than half (45.6%) of children with one or more emotional, behavioral, or developmental conditions receive treatment from a mental health professional (The National Survey of Children's Health, 2007). There is growing evidence that integrating mental health services into pediatric primary care can result in increased treatment ...
Demonstrating Functional Analytic Psychotherapy As An Independent Variable In Efficacy Research: A New Measure Of Treatment Fidelity, Lindsey E. Knott
Functional Analytic Psychotherapy (FAP) is a contextual behavior therapy that takes an in session, in vivo focus to improve client outcomes. This in vivo (IV) focus is distinctive of FAP and involves the therapist utilization of contingencies in session to decrease problematic response classes and increase more adaptive response classes (i.e., a differential reinforcement procedure). This contingent responding is proposed to be FAP’s mechanism of action leading to client change. FAP efficacy research mainly consists of small n single-case studies or group designs combing FAP with another CBT intervention. Maitland & Gaynor (2012) offered recommendations for increasing FAP efficacy research, including the development of a reliable measure to determine whether a therapist implemented the distinguishing features of FAP. Maitland and Gaynor (2016) developed a 10-item fidelity measure, called the FAP Adherence Form (FAP-AF), to assess for aspects of FAP across 5 items and distinguish it from supportive listening (SL) assessed over 4 items. The measure was used in two FAP outcome studies (Maitland & Gaynor, 2016; Maitland et al., 2016) and it distinguished FAP ...
Incidence Of Head Injury Among Synchronized Skaters: Rates, Risks, And Behaviors, Gretchen L. Mohney
Incidence Of Head Injury Among Synchronized Skaters: Rates, Risks, And Behaviors, Gretchen L. Mohney
Data regarding risk and rates for head injury and concussion specific to the sport of synchronized skating is absent from literature. This study investigated the rate and risk for head injury and concussion as a function of team level, identified behaviors to include education, neurocognitive baseline screening and protective equipment utilization, and the implementation of return to sport protocols.
An anonymous cross-sectional survey was implemented at the 2018 U.S. Synchronized Skating Championships. Participants were female members of a qualifying team, ages 13 and older, at the intermediate participation level and higher. The survey response rate was 42% (520/1232 ...
Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden
Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.
Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements ...
Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher
Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.
Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization ...
Implementing The Cdcs Core Elements Of Outpatient Antibiotic Stewardship Program Into The Urgent Care, Deanna Powelson
Purpose: The inappropriate use of antibiotics has led to the development of antimicrobial
resistance which is a severe threat to the public and an increasing global problem. The
Centers for Disease Control and Prevention (CDC) estimates at least two million illnesses
and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States (CDC,
2014). The purpose of this quality improvement (QI) project was to evaluate the
effectiveness of an antibiotic stewardship program (ASP) on urgent care providers'
prescribing on viral respiratory tract infections (RTIs) including the common cold,
pharyngitis, and bronchitis.
Methods: This QI project implemented the CDCs ...
An Exploration Of Nicu Nursing Staff Perspective On The Change From Pod To Private Room Patient Care, Julie Nickles
Neonatal Intensive Care Units (NICU) are designed to care for critically ill newborns who require constant care. The design of the NICU may have an impact on not only the patient and their family but also the nursing staff. Historically neonatal intensive care have employed a cohort model of care. In this model multiple infants are in the same room or pod. With success of single room maternity care, the increased need for changes in neonatal care became apparent. Today, new parents desire extended contact with their extremely preterm and often very sick infant. This trend has led a standard ...
Optimizing The Involvement Of Women With Opioid Use Disorder In The Care Of Their Infants Experiencing Neonatal Abstinence Syndrome, Rebecca Boedeker
The incidence of opioid use disorder (OUD) has grown to epidemic proportions. Infants exposed to opioids inutero are likely to experience withdrawal symptoms during the hours and days immediately following birth, known as Neonatal Abstinence Syndrome (NAS). Research indicates maximizing non-pharmacologic, supportive management decreases Neonatal Intensive Care Unit (NICU) admissions, the length of stay, and the severity of NAS. The purpose of this project is to evaluate the effects of an antepartum consult designed to prepare mothers with OUD to participate in this nonpharmacologic care. The Women and Infants Substance Help (WISH) Center delivers prenatal care for women with OUD ...
Assessment Of Nursing Knowledge Before And After Implementation Of Educational Intervention On Heart Failure, Sarah Scott
Purpose: The purpose of this study was to assess the knowledge of nursing staff on a cardiology unit before and after the implementation of heart failure specific education. Methods: Forty staff nurses on a cardiology unit at a single institution were given The Nurses Knowledge of Heart Failure Education Principles Survey (NKHFEP), a validated tool to assess nursing knowledge of heart failure. A series of four educational sessions were given to the same forty nurses. They were then given the NKHFEP survey a second time to assess change in knowledge post educational intervention. Results: The mean of Pre-education (M = 16 ...
Traumatic Brain Injuries: A Telehealth Alternative For Veterans, Jessica Dickman
Traumatic Brain Injuries: A Telehealth Alternative For Veterans, Jessica Dickman
Problem: Traumatic Brain Injuries (TBI) are known as the signature wound of veterans serving in Operation Enduring Freedom (OEF) and the Operation Iraqi Freedom (OIF). After the initial TBI diagnosis, outpatient TBI follow-up rates are reported to be approximately 9% less in the Veteran Healthcare Administration (VA) system when compared to the private sector. The purpose of this quality initiative was to decrease the rate of missed appointments among OEF/OIF veterans using a telehealth alternative.
Methods: The Plan-Do-Study-Act (PDSA) method was used to implement a consistent process for the telehealth visit option. A retrospective medical record review over the ...
Aligning With Patient-Centered Medical Home Standards: Depression Screening In Women's Health, Charity Galgani
Problem: The Patient Centered Medical Home (PCMH) model of care improves health care quality and patient experience of care, and decreases costs. Depression screening is a requirement for becoming a PCMH. The purpose of this quality initiative was to obtain baseline data to describe depression screening rates among female adult patients receiving women’s health care within a Midwestern public health department seeking PCMH recognition.
Methods: The study utilized a descriptive, observational design and was guided by the Plan-Do-Study-Act framework. A retrospective medical record review was used to assess the rate of depression screening utilizing the PHQ-2 and PHQ-9 tools ...
Assessing The Impact Of Practice Transition On Advance Practice Registered Nurse’S Job Stress And Job Satisfaction, Patricia E. Hendrickson
The impact of the transition to full practice authority (FPA) on job satisfaction and job stress has not been previously described in the literature.
Job satisfaction, job stress, and practice transition stress data was collected from a sample of 33 Advance Practice Registered Nurses (APRN) working at the VA St Louis Health Care System using Misener Nurse Practitioner Job Satisfaction Survey (MNPJSS), National Institute of Occupational Safety and Health Generic Job Stress Questionnaire (NIOSH-GJSQ), and student-developed practice transition stress questionnaire during the initial phase of FPA transition.
APRNs were minimally satisfied to satisfied. Job stress from work ...
Nurse-Led Triage Clinic In An Hiv Supportive Housing Apartment Community, Sally Breen
Problem: HIV-positive persons living in supportive housing who were otherwise homeless are reported to have better health outcomes than those who remain homeless. This was a quality improvement project to obtain baseline information regarding the implementation of onsite nursing services for individuals and their families residing in an HIV-positive supportive housing apartment community in an urban Midwestern city. Methods: A nurse triage clinic was implemented in partnership with the Doorways organization. Two registered nurses staffed the clinic two days per week. Data was collected on demographics and clinic utilization over a nine-week period. Results: Of the apartment residents, N=95 ...
Aligning With Patient-Centered Medical Home Standards: Depression Screening In Primary Care, Elizabeth Segura
Problem: The Patient Centered Medical Home (PCMH) is a model of care that improves the quality and experience of care and decreases cost. Use of a validated depression screening tool for adult patients is a PCMH certification requirement. The purpose of this quality initiative was to obtain baseline data when a depression screening tool was utilized among adult patients in an internal medicine clinic within a Midwestern public health department.
Methods: This was a quality improvement project utilizing a descriptive and observational design. A retrospective medical record review was used to assess the rate of depression screening utilizing the ...
Implementation Of National Pediatric Guidelines To Prevent Chemotherapy Induced Nausea And Vomiting In Children With Cancer, Taryn Sandheinrich
Purpose: The purpose of this study was to assess the use of supplemental, as needed (prn) pharmacologic interventions for uncontrolled acute chemotherapy induced nausea and vomiting (CINV) in children with cancer after implementation of new pediatric CINV prophylaxis guidelines. Description of Project: A retrospective chart review was completed on forty-three children admitted to the hospital for chemotherapy during a 3 month period in 2017 to document the use of medications given for acute breakthrough CINV. The pre-implementation group received anti-emetics based on the institutional standard of care. A second retrospective chart review was completed on thirty-three children admitted to the ...
Evaluation Of Educating Registered Nurses Prior To Implementing New Evidence-Based Protocol: Enhanced Recovery After Surgery (Eras), Lisa Brooks
Evidence-based protocols promote standardization of care and patient safety. The inclusion of major stakeholders is imperative to the success of implementation of a new protocol. The “Enhanced Recovery After Surgery” (ERAS) protocol was implemented at the Veterans Administration Medical Center – St. Louis prior to formal education of direct-care registered nurses (RNs), a major stakeholder group. Due to the lack of knowledge, the RNs who were expected to implement and adhere to the ERAS protocol were not prepared and displayed a lack of confidence. Subsequently, an educational training intervention was designed and executed with thirty-five RN participants. Prior to this training ...
Implementing A Caps Simulation To Increase Nursing Education Practice Students’ Self-Awareness Of Attitudes And Beliefs About Poverty, Melissa Ehmke
Problem. The purpose of this project is to determine if college students who are currently in nursing school, will benefit from the addition of a poverty simulation to positively influence their self-awareness and individual-level beliefs and attitudes towards poverty, therefore being able to serve those in poverty fully and guide them to appropriate resources.
Methods. Bachelor of Science in Nursing (BSN) and Doctoral Nursing Practice (DNP) students participated in a three-hour Community Action Poverty Simulation (CAPS). A twenty-one item Attitude Toward Poverty Scale short form (ATPS) survey was completed pre and post-simulation participation.
Results. Significant improvements resulted in three of ...
Measurements That Matter: Assessment & Management Of The Symptoms Of Chronic Illness Using The Integrated Palliative Outcome Scale (Ipos), Deborah Jeffery
Measurements that Matter: Assessment and Management of the Symptoms of Chronic Illness Using the Integrated Palliative Outcome Scale (IPOS)
Background: The mission of the Advanced Illness Management (AIM) program at the Visiting Nurse Association of Greater St. Louis (VNA) is to relieve the burden of serious illness by providing exceptional care to patients and families through symptom management. A validated symptom tool was needed for holistic assessment.
Purpose: This is a quality-improvement project aimed at enhancing symptom management in patients experiencing advanced illness in a community-based palliative care program. Provider use of the Integrated Palliative Outcome Scale (IPOS) as ...
Prophylactic Antibiotic Use In Female Patients With Pelvic Floor Reconstructive Surgery: A Retrospective Comparative Effectiveness Study, Courtney E. Turnbough
Problem: The purpose of this project was to determine the most effective prophylactic antibiotic to decrease the number of patients who have urinary tract infections (UTIs) after pelvic floor reconstructive surgery in a gynecological reconstructive surgery practice.
Methods: This was a retrospective chart review from 2015-2017 that included 732 subjects from a single practice. All patients underwent pelvic floor reconstructive surgery, with or without a midurethral sling placed. Patients also had a catheter and vaginal packing postoperatively. Patients who had a culture-proven UTI within the six-week postoperative period were noted.
Results: There were less UTIs (χ2 = 12.119, df = 1 ...
Alternatives In Magnesium Sulfate Treatment Courses: An Investigation Of Physician Prescribing Behaviors, Erin Williams
Problem: The gold standard for managing preeclampsia in the postpartum patient is 24- hours of magnesium sulfate as this is the time the patient is most susceptible to experiencing a seizure (American College of Obstetricians & Gynecologists, 2013). However, these patients are at an increased risk for experiencing adverse health outcomes, as well as interruptions in maternal-infant bonding due to the mother requiring a higher level of care. Methods: A one group pretest-posttest design was conducted to gain a better understanding of the current practice while also assessing the willingness of physicians to change prescribing behavior after receiving the research-based education ...
Indirect & Displaced Aggression: The Role Of Comparison Based Traits And Cognitive Vulnerabilities, Niki M. Knight
The present study explored the relationships of contingent self-esteem, dispositional envy, and two cognitive vulnerabilities (i.e., anger rumination and fear of negative evaluation) to indirect aggression (IA) and displaced aggression (DA) in a college student sample (N = 346). Despite the theoretical relevance of these personality and cognitive factors to aggression, there is little empirical evidence linking them to the perpetration of IA and DA. Bivariate correlations and hierarchical multiple regression were used to test the utility of these constructs in accounting for unique variance in IA and DA and to assess the potential role of participant gender. Participants high ...
"Understanding Lgbtq+ Intimate Partner Violence & Challenges In, Dr. Juanita Yates
"Understanding Lgbtq+ Intimate Partner Violence & Challenges In, Dr. Juanita Yates
This research project is a focus on Intimate Partner Violence (IPV) within LGBTQ+
community and the challenges associated with seeking family support. IPV is defined as a violent
or aggressive behavior within the home, typically involving the violent abuse of an intimate spouse
or partner. However, IPV can happen on the street, in one’s home or even in a public place. Those
exposed to IPV can be children, men and women. IPV is a prevalent issue in our society (Bright
2008). According to Ristock (2005), violence in LGBTQ+ relationships may be referred to as
partner violence, relationship violence, or ...
Hybrid Model - Statistical Features And Deep Neural Network For Brain Tumor Classification In Mri Images, Mustafa Rashid Ismael
A brain tumor is the most common disease that affects the central nervous system (CNS), the brain, and spinal cord. It can be diagnosed using the safest and most reliable imaging modality, the Magnetic Resonance Imaging (MRI), by radiologists who may use the assistance of computer-aided diagnosis (CAD) tools. Automated diagnosis is sought because it is essential to overcome the drawbacks of the manual diagnosis, such as time and the stress of viewing MRI images for long hours, and the human error potential. Image analysis and machine learning algorithms are tools that can be used to build an intelligent CAD ...
Examining The Relationships Between Ethnicity, Palliative Care And Readmissions In The Heart Failure Population, Deanna Johnston
Specific Aim: The aim of this dissertation is to analyze the relationships between ethnicity, palliative care consultation and readmissions in the heart failure population at a community hospital that serves a large diverse population.
Background: Hospitals struggle with preventing readmissions. There are many interventions that can be implemented to help prevent readmissions, and Palliative Care (PC) is one of those interventions. PC has many benefits including symptom management, improved communication through the healthcare continuum, understanding of illness and treatment options, and can be provided in conjunction with curative treatments. Heart failure is one of the most common readmission diagnoses. It ...