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Full-Text Articles in Medicine and Health Sciences

Social-Ecological And Protective Factor Approach To Managing Parental Incarceration, Jacquelyn Harris Jun 2020

Social-Ecological And Protective Factor Approach To Managing Parental Incarceration, Jacquelyn Harris

Dissertations

Mass imprisonment does not only impact the incarcerated individual; it also affects approximately five million children in the United States. Researchers identified and compare the impact of parental incarceration on child development. They acknowledged the protective factors across the lifecycle from a social-ecological perspective and specifically related to parental incarceration. The comprehensive literature review inspired an innovative model, the social-ecological and protective factor approach to managing parental incarceration. The primary goal of this model is to combat the detrimental effects of parental incarceration by identifying protective factors across the lifecycle and throughout the microsystem, mesosystem, and exosystem. This model is ...


Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar Jun 2020

Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar

Dissertations

The present study was designed to examine physicians’ mental health, attitudes, and behaviors toward self-care and the utilization of mental health services. As the medical field can be very demanding and exhausting, it is believed that many physicians suffer from mental illnesses such as anxiety and depression. However, it was theorized that many physicians do not engage in adequate self-care regimes or seek support and suppress their symptoms, which may further exacerbate their illnesses. A thorough literature review was performed to explore the following: possible barriers to physicians seeking mental health services to address high rates of mental illnesses, physicians ...


La Maestra’S Circle Of Care: Studying The Impact Of An Integrated Service Model On The Health And Well-Being Of Vulnerable Populations, Zara Marselian May 2020

La Maestra’S Circle Of Care: Studying The Impact Of An Integrated Service Model On The Health And Well-Being Of Vulnerable Populations, Zara Marselian

Dissertations

ABSTRACT

There is an urgent need to reform the health care delivery system in the United States, as recognized through current bipartisan efforts. Society’s vulnerable populations especially need health care reform as health care outcomes are the poorest among disadvantaged populations. Moreover, vulnerable populations are twice as likely to develop chronic diseases than the general population and they remain ill due to other contextual, societal factors affecting their ability to achieve health and well-being. This population is subjected to adverse life events that suggest a more comprehensive approach to health and well-being is called for.

The Circle of Care ...


Emotional Intelligence Methods Utilized By Successful Major League Baseball Closers To Perform Successfully In High Pressure Situations, Joshua Rosenthal Apr 2020

Emotional Intelligence Methods Utilized By Successful Major League Baseball Closers To Perform Successfully In High Pressure Situations, Joshua Rosenthal

Dissertations

Purpose: The purpose of this qualitative case study is to understand the similarities that exist in the descriptions of emotional intelligence methods utilized by retired successful Major League Baseball closers to appraise, express, regulate, and utilize their emotions to perform successfully in high pressure situations.

Methodology: The dissertation was a qualitative case study. Twelve of the top 50 retired save leaders in Major League Baseball were interviewed to understand the similarities in the descriptions of emotional intelligence methods used to perform successfully in high pressure situations. This study attempted to understand what exactly elite closers did to utilize emotional intelligence ...


Impulsivity As A Trait Predictor In Baccalaureate Nursing Students, Jennifer Bertucci Apr 2020

Impulsivity As A Trait Predictor In Baccalaureate Nursing Students, Jennifer Bertucci

Dissertations

Impulsive personality traits have been linked to pathological decision making in individuals who possess the trait. Impulsive pathological decision making may include acts of aggression, divergence, risky behavior, lack of self-care, etc. The purpose of this study was to examine impulsive personality traits among nursing students. Traditional students are defined by the following characteristics: earns a high school diploma, enrolls full time immediately after finishing high school, are financially dependent on parents, and either do not work during the school year or works part-time (the exception to the rule) (Choy, 2002). A non-traditional nursing student is defined as students who ...


Team Creation Methods In Practice: Understanding The Potential Effects Of Nonverbal Communication In The Leadership Of Team Formation, Troy Allen Robertson Apr 2020

Team Creation Methods In Practice: Understanding The Potential Effects Of Nonverbal Communication In The Leadership Of Team Formation, Troy Allen Robertson

Dissertations

Teams require leadership, even if they are self-managed. The group of individuals who make up a team must be gathered in some form or another. For self managed teams to function successfully, the first step is the process of creating the team. Many aspects may factor into the creation process. Often time is of the essence and methods to quickly assess and form teams show merit. First impressions in general are based largely on nonverbal communication. The focus of this mixed-methods concurrent embedded study is to analyze the potential effects of nonverbal communication on influencing team creation. A group of ...


A Meta-Synthesis Of The American And The European Standards For The Accreditation Of Counseling Training Programs, Natalia Zapolsky Mar 2020

A Meta-Synthesis Of The American And The European Standards For The Accreditation Of Counseling Training Programs, Natalia Zapolsky

Dissertations

The purpose of this qualitative study was to explore how the European Standards for the accreditation of counseling training programs compare to CACREP standards and to each other. The differences and commonalities between standards have been defined through a meta-synthesis of integrated findings from a large body of inter-related qualitative studies and reinterpretation of the synthesized data.

This qualitative meta-synthesis research was intended to contribute to the process of counseling globalization by exploring the unique cultural features and aspects of the European and the U.S. accrediting systems for counseling training programs. This research revealed 1) the commonly recognized areas ...


Patient-Specific Factors Associated With Surgical Delay In A Large Academic Hospital, Natalie Meyers Jan 2020

Patient-Specific Factors Associated With Surgical Delay In A Large Academic Hospital, Natalie Meyers

Dissertations

The high cost of healthcare is driving the search for more efficient practice, especially in high-stakes locations like the operating room. In addition to financial losses, patients suffer physical and emotional distress, including an increased risk of morbidity or mortality when surgical cases are delayed due to inefficiency. While patient-related causes of delay have been implicated, it is unclear which specific factors are most significant. This study aimed to identify specific patient factors correlated with surgical delay and develop a predictive risk algorithm that describes the relationship between patient-specific factors and surgical delay.

A retrospective review of 36,543 patients ...


A Correlational Model Of Burnout And Personality Among Clergy In The United States, Nathanael M. Stephens Jan 2020

A Correlational Model Of Burnout And Personality Among Clergy In The United States, Nathanael M. Stephens

Dissertations

Problem

This study explored the relationship between personality and burnout. The facets of personality detailed in the Factor Five Model served as the independent variables, with burnout as the dependent variable. Research exists on the relationship between personality and burnout for individuals in helping professions. However, there is little research on the interaction between burnout and personality factors among Protestant clergy members.

Method

A total of 602 participants who self-identified as living in the United States were recruited through an advertisement on Facebook. Participants all indicated they were Protestant members of the clergy and had been in the ministry for ...


Choice Of God/Higher Power, Perceptions Of God/Higher Power, Religious Beliefs And Behaviors, And Social Support As Predictors Of Length Of Sobriety, Satisfaction With Life, And Quality Of Life Among People Recovering From Alcohol Addictions In Three Midwestern States, Carlton Martin Jan 2020

Choice Of God/Higher Power, Perceptions Of God/Higher Power, Religious Beliefs And Behaviors, And Social Support As Predictors Of Length Of Sobriety, Satisfaction With Life, And Quality Of Life Among People Recovering From Alcohol Addictions In Three Midwestern States, Carlton Martin

Dissertations

Problem

An estimated 12.7% of the US population meet the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) (American Psychiatric Association, 1994) criteria for Alcohol Use Disorder (AUD). The annual cost to the society, including emergency room visits, lost days at work, and accidents on the road is in the billions. The impact of this disorder on the family, the community, and the individual is immeasurable. A growing body of literature supports an association between religious and spiritual beliefs and behaviors and recovery from alcohol addiction. This project is an investigation of this association. The goal is to offer ...


Perivascular Waste Metabolites Clearance In Central Nervous System (Cns), Yiming Cheng Dec 2019

Perivascular Waste Metabolites Clearance In Central Nervous System (Cns), Yiming Cheng

Dissertations

Efficient clearance of interstitial waste metabolites is essential for normal brain homeostasis. Such effective clearance is hampered by the lack of a lymphatic system in the brain, and the cerebrospinal fluid (CSF) is unable to clear large size waste metabolites in the brain. Here, a novel idea that brain arterial endothelium and smooth muscle cells reactivity regulates the clearance of these water-insoluble large size waste metabolites through the perivascular dynamic exchange, and that low dose ethanol promotes this perivascular clearance is proposed.

In Aim 1, the biodistribution of a large size waste metabolite (Amyloid-β protein mimic) in rat perivascular space ...


Exemplary Chief Nurse Executives Leading Through Storytelling, Tricia Kassab Dec 2019

Exemplary Chief Nurse Executives Leading Through Storytelling, Tricia Kassab

Dissertations

Purpose: The purpose of this phenomenological study was to understand and describe how exemplary human resources administrators use storytelling to lead organizations using Denning’s (2011) model. In addition, it was the purpose to understand how they use storytelling to create transformational change. Denning’s The Leader’s Guide to Storytelling highlights eight storytelling narrative patterns: to ignite action, to communicate who you are, to build your brand, to transmit values, to foster collaboration, to share knowledge, to tame the grapevine, and to share vision.

Methodology: This phenomenological qualitative study described the lived experiences of exemplary elementary chief nurse executives ...


Using Lifestyle Educational Intervention To Decrease Blood Pressure Reading Amongst African American Adults, Catherine Madu Dec 2019

Using Lifestyle Educational Intervention To Decrease Blood Pressure Reading Amongst African American Adults, Catherine Madu

Dissertations

Hypertension or high blood pressure is a global epidemic and a major public health challenge in the United States. Hypertension increases the risk of cardiovascular disease, stroke, and renal failure. The disease disproportionately affects African Americans (AAs) and is a leading cause of morbidity and mortality in this ethnic group. Effective management of hypertension decreases complications from the disease. The purpose of the clinical scholarly project (CSP) was to decrease blood pressure readings amongst AA adults, ages 18 to 65 years old using educational intervention on lifestyle modifications. A convenience sampling of 20 AA (n = 20) adult participants was drawn ...


The Usage And Impact Of Outpatient Commitment Orders On Suicide And Suicide Attempt Rates In Mississippi, Sam Mauldin Dec 2019

The Usage And Impact Of Outpatient Commitment Orders On Suicide And Suicide Attempt Rates In Mississippi, Sam Mauldin

Dissertations

Rates of self-harm and suicide in the United States have not decreased since 1980 and remained relatively constant through the start of the 21st Century. The most recent data indicate that suicide rates in the United States have risen by about 2% a year from 2006 through 2016, although suicide rates have decreased in other countries during the same timeframe. Finding a viable intervention to slow rates of self-harm and suicide is needed in the United States. The need for closer patient observation has been cited as an underutilized intervention for the reduction of attempts of self-harm and suicide ...


A Quality Improvement Study On Missed Appointment Management In Primary Care, Aunye' Dina Amos Nov 2019

A Quality Improvement Study On Missed Appointment Management In Primary Care, Aunye' Dina Amos

Dissertations

Abstract

Problem: Patients who miss appointments have poorer health outcomes and increase costs for medical care. The purpose of this quality improvement study was to evaluate the effects of missed appointments on patients’ outcomes for diabetes mellitus, and resulting financial losses to a private primary care practice.

Method: A quality improvement initiative with a retrospective review of patients over a six-month period in 2018 (before) and 2019 (after a missed appointment fee was implemented). All adult patients, aged 18-92 years, were included. For those with diabetes, a HbA1c for each patient who kept or missed their appointment was recorded.

Results ...


Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan Nov 2019

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 ...


Impact Of A Web-Based Instructional Module Of Alzheimer’S Disease Within Seven Content Knowledge Domains, Joyce Haynie Nov 2019

Impact Of A Web-Based Instructional Module Of Alzheimer’S Disease Within Seven Content Knowledge Domains, Joyce Haynie

Dissertations

Abstract

Alzheimer’s Disease (AD) has been classified as the most common form of dementia. Primary health care providers are usually the first clinicians to whom individuals present with symptoms of dementia. By 2050, it is expected that as many as 13.8 million Americans will be living with AD, and millions more will be placed in the challenging role of providing care for these individuals. However, studies continue to show that dementia is often underdiagnosed and under detected. The purpose of the study was to systematically inquire about the impact of AD education on level of knowledge about AD ...


Evaluating Controlled Substance Documentation In An Electronic Medical Record, Delora Brooks Nov 2019

Evaluating Controlled Substance Documentation In An Electronic Medical Record, Delora Brooks

Dissertations

The Centers for Disease Control and Prevention (CDC) directives issued in 2016 gave guidelines for safely prescribing opiates; however, primary source discussions about methods used for documenting opioid and controlled substance monitoring within an electronic medical record (EMR) are limited (Hussain, Nelson, Polston & Zheng, 2019). This leaves individual providers to determine the appropriate way to document. Inconsistent documentation may not protect providers or organizations from regulatory, civil or criminal liability. As stated by Raveesh, Nayak & Kumbar (2016), “The best way to handle medico-legal issues is by preventing them”. Even with the advent and widespread use of EMRs, documentation is still often limited to basics: diagnosis, medication, dosage, procedures, referrals, and follow up (Schneider, 2014). The purpose of this project was to implement a practice improvement change which included creation of a standardized template and a central location for documentation of controlled substance monitoring. This allowed providers to document, see the dates and results for urine drug screens (UDS) or pill counts, review any concurrent schedule II or III medications, and log prescription drug monitoring database (PDMD) checks. Data indicated an improvement in documentation frequency for UDS and PDMD checks at both 30 and 60 days; however, this increase was only statistically significant for UDS at 30 days with p = 0.004. The increase was not found to be statistically significant for either UDS or PDMD checks at 60 days.


Fathers' Experiences With Their Premature Infants Or Unhealthy Neonates, Lisa Cummings Nov 2019

Fathers' Experiences With Their Premature Infants Or Unhealthy Neonates, Lisa Cummings

Dissertations

Author: Lisa Cummings PhD RN

Fathers’ Experiences with Their Premature Infants or Unhealthy Neonates

Purpose and Background/Significance: Fifteen million babies worldwide are born prematurely each year, impacting a multitude of fathers. The importance of an early close father-infant relationship has been identified as central for the development of the child. Fathers influence on a child’s emotional and cognitive development and their physical well-being and health. Many times, the Neonatal Intensive Care Unit (NICU) is the initial contact environment between a father and his premature infant. Studies have shown that the NICU can be a stressful environment for parents ...


Developmental And Sex Modulated Neurological Alterations In Autism Spectrum Disorder, Azeezat Azeez Aug 2019

Developmental And Sex Modulated Neurological Alterations In Autism Spectrum Disorder, Azeezat Azeez

Dissertations

Autism Spectrum Disorder (ASD) was first described in 1943 by Dr. Leo Kranner in a case study published in The Nervous Child. It is a neurodevelopment disorder, with a range of clinical symptoms. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), used by clinicians to diagnose mental disorders, a child needs to have persistent social deficits, language impairments, and repetitive behaviors, that cannot be explained by neurological damage or intellectual disability. It is known that children diagnosed with ASD are often are developmentally delayed therefore alterations in the typical developmental trajectory should be a major factor in ...


Modelling In Vitro Dissolution And Release Of Sumatriptan Succinate From Polyvinylpyrrolidone-Based Microneedles Aided By Iontophoresis, James Paul Ronnander Aug 2019

Modelling In Vitro Dissolution And Release Of Sumatriptan Succinate From Polyvinylpyrrolidone-Based Microneedles Aided By Iontophoresis, James Paul Ronnander

Dissertations

A novel dissolving microneedle array system is developed to investigate permeation of a sumatriptan succinate formulations through the skin aided by iontophoresis. Three formulations consisting of hydrophilic, positively charged drug molecules encapsulated in a water-soluble biologically suitable polymer, polyvinylpyrrolidone (PVP), have been accepted by the U.S. Food and Drug Administration (FDA). The microneedle systems are fabricated with 600 pyramid-shaped needles, each 500 µm tall, on a 0.785-cm2 circular array. In vitro transdermal studies with minipig skin and vertical Franz diffusion cells show > 68% permeation of sumatriptan over a 24-hour period. A combination of microneedle and electrical current ...


The Diffusion Of Telehealth: System-Level Conditions For Successful Adoption, Danika Tynes Aug 2019

The Diffusion Of Telehealth: System-Level Conditions For Successful Adoption, Danika Tynes

Dissertations

Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory. System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using multiple logistic regression.

Analyses included data from 84 states leveraging data from the World Health Organization, World Bank, ICT Index ...


From The Boots On The Ground: A Comparison Of The Attitudes And Beliefs Of Military Members And Mental Health Professionals Regarding The Moral Injury Construct, Karis L. Callaway Aug 2019

From The Boots On The Ground: A Comparison Of The Attitudes And Beliefs Of Military Members And Mental Health Professionals Regarding The Moral Injury Construct, Karis L. Callaway

Dissertations

An increasing amount of research conducted in recent years indicates that, in addition to Posttraumatic Stress Disorder, moral injury is a key concept to recognize when considering the deployment experiences of service members. Although related to Posttraumatic Stress Disorder, which is a fear-based mental health diagnosis, moral injury is a distinct concept. It acknowledges the possible prolonged negative psychological, social, and spiritual consequences that may occur after experiences that challenge and transgress one’s deeply held moral beliefs. Events such as perpetration of harm, failing to protect or prevent harm, and witnessing or learning about distressing acts committed by influential ...


The Relationship Between Frequency Of Yoga And Meditation On Ptsd Symptoms In Individuals Who Have Experienced Intimate Partner Violence, Kimberly Polignani Aug 2019

The Relationship Between Frequency Of Yoga And Meditation On Ptsd Symptoms In Individuals Who Have Experienced Intimate Partner Violence, Kimberly Polignani

Dissertations

Intimate partner violence (IPV) has become a growing phenomenon in the United States,

affecting nearly 13% of the population. The adverse mental health outcomes from people who experience IPV are prevalent and more than half have a diagnosis of posttraumatic stress disorder (PTSD). Therefore, therapeutic techniques for PTSD appear to be feasible for IPV survivors and their mental health issues. Complementary and alternative medicine has become a widely accepted approach for PTSD. Being two complementary and alternative medicine techniques, yoga and meditation are effective forms of therapy in many diagnoses, including PTSD. This study utilized a not-for-profit organization called the ...


Comorbid Symptom Treatment In Parkinson’S Disease Using Neurofeedback, Joanne Mcfarland O'Rourke Aug 2019

Comorbid Symptom Treatment In Parkinson’S Disease Using Neurofeedback, Joanne Mcfarland O'Rourke

Dissertations

The purpose of this research was to determine the impact of neurofeedback (NFB) on Parkinson’s symptoms that patients identify as priorities. First, a focus group of patients helped identify priority symptoms, then a pilot study tested protocols resulting from the focus group, and finally, an intervention study using a single subject design was conducted.

In the focus group, tremor and activity planning were identified as issues affecting every group member. The pilot study was conducted with three mid-stage Parkinson’s patients, who received a sensory motor (SM) protocol to address tremor, a SM plus cognition protocol (SM+Cog) for ...


Same-Sex Sexual Coercion Among Women: The Impact Of Minority Stress On Perpetration And Victimization Experiences Of Women Of Diverse Sexual Identities, Allison Kirschbaum Jul 2019

Same-Sex Sexual Coercion Among Women: The Impact Of Minority Stress On Perpetration And Victimization Experiences Of Women Of Diverse Sexual Identities, Allison Kirschbaum

Dissertations

The purpose of the current study was to investigate women’s experiences with same-sex sexual coercion perpetration and victimization. Specifically, I sought to explore the role that the stress of living as a sexual minority plays in these experiences as well as to determine whether the psychological variables of perceived powerlessness, psychological distress, social support, and alcohol use mediate the relationship between minority stress and perpetration and victimization experiences. Data were collected online from self-identified women and individuals assigned female at birth who reported experiencing genital sexual contact with another woman (N=339). Of the cisgender women in the sample ...


A Survey Of Healthcare Workers On Safe Patient Handling And Mobility Resource Availability, Utilization, And Adherence, Kimberly Waltrip Jul 2019

A Survey Of Healthcare Workers On Safe Patient Handling And Mobility Resource Availability, Utilization, And Adherence, Kimberly Waltrip

Dissertations

The purpose of this study was to examine the current status of safe patient handling and mobility—specifically resource availability, utilization, and adherence to established safe patient handling and mobility standards—and measure any relationships among these factors. This study builds on the reliability and validity of the adapted American Nurses Association’s (2016) Safe Patient Handling and Mobility Self-Assessment Resource. Responses came from a one-shot survey of healthcare workers in direct patient care across several private and Veterans Health Administration healthcare organizations in the Midwestern United States. The risk of injury is higher in patient handling than in many ...


Management And Support Of Uninsured Patients With Diabetes Type Ii Within A Nurse Managed Clinic, Emma Spencer Jul 2019

Management And Support Of Uninsured Patients With Diabetes Type Ii Within A Nurse Managed Clinic, Emma Spencer

Dissertations

The purpose of the project was to improve the quality of care for the uninsured, Type II Diabetics residing in a Midwestern urban underserved community. Community Health in Partnership Services (CHIPS) was a nurse-managed clinic, located in that area, that sought to lessen the burden of being uninsured. An annual fee of $35.00 allowed an uninsured community member access to a variety of different health care providers including specialists. In order to utilize this health care team efficiently, it was necessary to implement nurse-led care coordination for patients diagnosed with Type II Diabetes. This quality improvement project followed the ...


Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff Jul 2019

Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff

Dissertations

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission ...


Barriers To Mental Health Treatment In Patients Referred By Primary Care, Rebecca Palmer Jul 2019

Barriers To Mental Health Treatment In Patients Referred By Primary Care, Rebecca Palmer

Dissertations

Problem: Limited access to mental health treatment is one of many potential barriers to treating mental illness in the United States. Where resources are readily available, reportedly high no-show rates for established mental health appointments suggests further investigation is necessary to identify frequent barriers within that population. This was a quality improvement project to identify common themes in patient-reported barriers to care.

Methods: A 4-question phone survey was offered to individuals that did not appear at their mental health appointment. Data was analyzed to identify the most commonly reported barriers to mental health treatment. Additional data collected includes reported history ...