Medicine and Health Sciences Commons^™

Factors Mediating Disruptive Behaviors In A Veterans Affairs Medical Center, Marylois Lacey

Dissertations

. Disruptive behaviors are often related to care giving situations in which the patient wants something that is not possible, refuses to participate in what is required, demands instant gratification, or demands immediate emotional support. In response to the patients’ demands and actions, health care providers use limit setting, activity demand, and denial of request. This study sought to answer the following questions: (a) Are code greens associated with symptoms of a medical and/or psychiatric diagnosis, denial of request, limit setting, and activity demand? (b) Are activity demand, denial of request, and limit setting more likely to be associated with …

Quality Of Life Among Southwest American Indians And Alaska Natives Living With The Hepatitis C Virus, Rydell Todicheeney-Mannes Phd, Rn, Acns-Bc

Dissertations

Background: Hepatitis C Virus is considered to be a global public health threat because seventy-five percent of infected persons have no symptoms and are unaware of their infection. It is significant to note that AI/ANs commonly contend with issues that prevent them from receiving or seeking medical care. Objectives: The purpose of this study was to: (a) Characterize the level of depression, alcohol consumption, stigma, and quality of life; (b) Examine the relationship among the variables of age, gender, residing on an AI/AN reservation, current partner status, depression, alcohol consumption, and stigma with quality of life in a sample of …

The Journey To Becoming-Authentic From The Voices Of Nursing Students Living With Attention Deficit Hyperactivity Disorder, Sheryl Lynn Allen

Dissertations

Research and literature on nursing students living with attention deficit hyperactivity disorder (ADHD) in higher education is deficient in supporting the needs of a growing population. The aim of this study sought to uncover the essence of nursing students’ experiences through a hermeneutic phenomenological approach and promote deeper understanding of the meaning of lifeworld experiences through the lens of critical social theory (CST). CST sustains freedom from ideological restraints to allow exploration into individual experiences. The voices of student participants provide the medium for articulating meaning. An integrative approach using van Manen’s (1990) and Munhall’s (2012) methods guided this study. …

Emotional Intelligence And Community Healthcare Productivity, Christopher Jacob Fox

Dissertations

Economic crisis is threatening state budgets. The strain on state budgets effects pensions and the healthcare benefits to communities. Rising healthcare costs and lagging insurance reimbursement rates are forcing healthcare organizations to sustain programs with fewer financial resources. Research studies indicate that payment increases from Medicare and Medicaid will not keep pace with the historical trend in hospital cost inflation (Kaufman, 2011). Of the healthcare facilities affected by federal budget constraints are community mental healthcare centers. The strain on state budgets has taken its toll on community mental healthcare facilities in particular struggling under the healthcare reform initiatives (Simpson, 1995). …

Group Empowerment Capacity And Capability In Schools Of Nursing, Mary Louanne Friend

Dissertations

Nursing education is experiencing rapid changes as nurses are expected to transform and lead health care delivery within the United States. The ability to produce graduates who can promote a culture of safety, and provide patient centered care in collaboration with others will require nursing administrators and faculty who are empowered and able to achieve goals. The Sieloff Theory of Group Empowerment within Organizations (Sieloff & Bularzik, 2011) provided the theoretical basis for this exploratory correlational study examining group empowerment capacity and empowerment in administrators and faculty within the United States. Empowerment was conceptualized as the ability of the group …

Quantifying Value In Public Health: Using Economic Methods To Analyze System Change, Theresa M. Green

Dissertations

In this time of economic downturn, it is becoming increasingly important for organizations, including those in public health, to “prove their worth,” to show the value in improvement strategies. Health agencies have learned to discuss impact in terms of health outcome and mortality/morbidity measures. However, it is critical that these impacts are also expressed in a way that shows cost-efficiency and economic benefit especially for promising, evidence-based public health interventions. Although several methods of economic evaluation including cost-effective analysis, cost-utility analysis, or cost-benefit analysis and return on investment (ROI) have been used in social sciences and health research, fewer examples …

Evaluation Of Modafinil In Preclinical Behavioral Assays Of Abuse Liability, Amanda J. Quisenberry

Dissertations

Modafinil is an FDA-approved drug for the treatment of narcolepsy with efficacy in the treatment of chronic fatigue syndrome, obstructive sleep apnea, and shift-work sleep disorder. Modafinil’s wake-promoting and cognitiveenhancing effects are reportedly similar to those of traditional psychostimulants, but without the side effects typically associated with these substances. Modafinil has also been investigated as an agonist replacement therapy for psychostimulant dependence, although results of clinical trials are equivocal. Few studies have examined its behavioral effects in combination with psychostimulants and the neuropharmacological actions of modafinil are not well understood. The primary aim of this study was to assess modafinil’s …

The Partial Characterization Of The 142r Protein Of Tanapox Virus, Krystal N. Seibert

Dissertations

Due to the complex nature of cancer, a variety of strategies are being employed to treat patients. Among these are oncolytic viruses that conditionally replicate in tumor cells with specific cellular landscapes. Several viruses including Herpesviruses, Adenoviruses, and Poxviruses, predominantly vaccinia virus (VV), have been explored for their oncolytic potential. Most of these viruses can productively infect a variety of cell types and it is one goal to create conditionally lethal viruses that can only replicate in tumor cells. Due to the prevalence of p53 inactivating mutations in cancers viruses that are restricted to p53 null cells are desirable and …

Grip Strength, Multimorbidity, And Disability, Amy M. Yorke

Dissertations

The presence of two or more chronic health conditions, also known as multimorbidity, is one of the most prevalent health disorders experienced by adults. Adults with multimorbidity and functional limitations represent clinical and financial challenges to the current health care system. The purpose of this three-paper dissertation is to examine the relationship between grip strength, multimorbidity, and the prediction of disability in adults. Data from the 2008 Health and Retirement Study (HRS), a nationally representative, longitudinal study completed on Americans age 50 years and over, are used for the dissertation.

The objective of the first paper is to investigate the …

Acupuncture For Sleep Disturbances In Veterans With Post Traumatic Stress Disorder, Heather C. King Phd

Dissertations

Post Traumatic Stress Disorder (PTSD) has emerged as a significant problem among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans. Disturbed sleep is one of the most frequently reported symptoms among OEF/OIF veterans with PTSD. PTSD itself is impairing, but the burden of this disorder is likely heightened when accompanied by sleep disturbances. Sleep disturbances have been associated with a 75-90% increased risk of co-morbid conditions, increased levels of depression and anxiety, daytime sleepiness and fatigue, reduced psychomotor performance, diminished work productivity, and decreased quality of life. These consequences of disturbed sleep emphasize the critical need for additional evidence based therapies …

Characterizing The Genetic Bases Of Autosomal Recessive Disorders, Nadia Awni Akawi

Dissertations

Autosomal recessive disorders have devastating effects on patients and their families. Elucidating the genetic bases of such disorders is essential to improve their clinical outcome and for implementing effective prevention programs. In this dissertation, the genetic bases of seven autosomal recessive disorders in consanguineous families were investigated using homozygosity mapping followed by candidate genes or whole-exome sequencing. Consequently, novel genomic loci and novel mutations have been revealed. The mutations underlying Silver-Russell syndrome in three families were found in OBSL1 and CUL7 genes, known to cause 3-M syndrome. In addition, the mutations identified in COL11A1 in two families were the first …

A Descriptive Exploratory Study Of The Experience Of Gay Partners Of Hiv-Positive Men, Jon Christensen Phd, Msn, Rn

Dissertations

HIV disease/AIDS has been the focus of much research since its introduction in 1981 and continues to have profound implications for those living with the disease and for those who are in close social relationships with them. One group that has received minimal attention in the HIV/AIDS literature is gay partners of HIV infected men. The aim of this study was to explore and describe the experiences of gay men living with a life partner who has HIV disease/AIDS who were not primary caregivers. A qualitative study using an interpretive descriptive approach was employed to study the experiences of ten …

Effects Of Acculturation On Mammography Utilization Among Korean American Women, Jungeun K. Kim Phd

Dissertations

The purpose of this study was to examine the relationship between acculturation and mammography utilization among Korean American (KA) women. The specific aims of this study were to determine the differences in demographic characteristics, perceived health beliefs, self-efficacy, and knowledge of breast cancer, and mammogram history among the four cultural groups (American identity, Bicultural, Korean identity, and Marginality) of KA women, and to examine the effects of the level of acculturation on the likelihood of getting a mammogram. Breast cancer remains the most commonly diagnosed cancer among KA women. However, KA women consistently have lower screening rates for breast cancer. …

Compassion Fatigue: Prevalence Among Nurses At A Midwest Pediatric Hospital, Branch Carole

Dissertations

Compassion fatigue is a term used to describe the unique stressors affecting people in care-giving professions (Joinson in 1992). For nurses, the impact of compassion fatigue may result in stress-related symptoms, job dissatisfaction, decreased productivity, patient satisfaction, safety issues, and job turnover. The purposes of this non-experimental descriptive survey using electronic distribution to collect data were to identify the prevalence of compassion fatigue composed of burnout and secondary traumatic stress and compassion satisfaction among nurses and nursing staff who deliver direct patient care at the hospital and the relationship between demographic variables (age, work category, level of education, work experience) …

A Pilot Project To Develop A Tool To Assess Gain In Knowledge In Third Graders Participating In A Science Based Drug Prevention Education Curriculum, Miriam Dawn Butler

Dissertations

Drug use and abuse presents a significant problem to individuals, families, and law enforcement in communities across the United States. Methamphetamine is a particular concern in one rural eastern Missouri county. Much work is being done in this county by multiple agencies to decrease methamphetamine production and use. Little attention, however, has been focused on prevention in the elementary schools. Substance use and experimentation may begin as early as 12 years old or even earlier. By initiating a proven drug prevention education curriculum before children begin to experiment with tobacco, alcohol and illicit drugs, drug use may be delayed or …

Examination Of The Pediatric Diabetes Routines Questionnaire In Adolescents: Development Of An Adolescent Self-Report Version And Confirmatory Factor Analysis, Jessica Sima Pierce

Dissertations

Previous literature suggests a positive relationship between general child routines and diabetes treatment adherence. However, research examining routines specific to the diabetes regimen is lacking. Recently, the Pediatric Diabetes Routines Questionnaire (PDRQ) was developed as a parent-report measure of diabetes-specific routines for children and adolescents with type 1 diabetes. Though the PDRQ has provided a means to measure routines specific to the diabetes regimen, limitations exist in regard to its use with adolescents. Thus, the goals of this study were to develop and evaluate a parallel adolescent self-report version (PDRQ: Adolescent; PDRQ:A) of the PDRQ and to examine the psychometric …

Role Of Msa In Immune Evasion, Persistence, And Protease Regulation In The Human Pathogenic Strains Of Staphylococcus Aureus, Maria Deepa Basco

Dissertations

Opportunistic pathogens like Staphylococcus aureus on entering the host can stay colonized at the foci of infection or evade the immune system to disseminate to other sites. In this study we investigated the regulatory influence of the modulator of sarA (msa) on immune evasion and host persistence, employing the hospital-acquired strain S. aureus UAMS-1 and community-acquired strain S. aureus USA300 LAC. In the murine sepsis model, mutation of the msa gene in LAC showed no change in dissemination of infection; however, in UAMS-1 a decrease in microbial load was observed in the lungs. Differential regulation by the msa gene was …

Biophysical Understanding Of Novel Synthetic Amyloid-Β (Aβ) Prions In Alzheimer's Disease, Amit Kumar

Dissertations

Oligomers of amyloid-β (Aβ) peptide are the primary toxic agents that play a pivotal role in the pathogenesis of Alzheimer’s disease (AD). Oligomers are the intermediates formed during the Aβ aggregation process leading up to insoluble fibrils. It is important to know that oligomers can also be formed via pathways that do not lead to fibril formation. Such ‘off-pathway’ oligomers would have significantly longer half-lives than the ‘on-pathway’ ones, which may result in prolonged toxicity to neuronal cells. Furthermore, neither the mechanism of neurotoxicity nor the potential mechanisms of propagation and proliferation to neighboring cells are well understood. Moreover, recent …

Discovery And Characterization Of A Tanapoxvirus Encoded Human Neuregulin Mimetic, David Jeng

Dissertations

Studies on large dsDNA viruses such as poxviruses have been helpful in identifying a number of viral and cellular growth factors that contribute to our broad understanding of virus-host interaction. Orthopoxviruses and leporipoxviruses are among the most studied viruses in this aspect. However, tanapoxvirus (TPV) a member of the genus Yatapoxvirus, still remains largely unexplored, as the only known hosts for this virus are humans and monkeys. Here, we describe the initial characterization of an EGF-like growth factor mimicking human neuregulin from TPV, expressed by the TPV-15L gene. Assays using a baculovirus expressed and tagged TPV-15L protein demonstrated the ability …

An Examination Of Executive Function, Mild Cognitive Impairment And Fall Risk In Community Dwelling Older Adults, Jennifer A. Blackwood

Dissertations

The aim of this three-paper dissertation was to examine the relationship between fall risk, executive function (EF) and mild cognitive impairment (MCI) in community dwelling older adults. Papers one and two describe how mild changes in cognition influence performance on four measures of fall risk, the Five Times Sit to Stand Test (FTSTS), usual gait speed, the Timed Up and Go (TUG) test, and the Activities Specific Balance Confidence Scale (ABC) in a group of community dwelling older adults. The third paper describes if participation in a progressively challenging domain specific computerized cognitive training intervention influenced performance on measures of …

A Prospective Examination Of Mindfulness Training On The Mitigation Of Postraumatic Stress Symptoms, Abby E. Blankenship

Dissertations

The current study investigated the ability of a one-session computerized mindfulness intervention to mitigate posttraumatic stress disorder (PTSD)-like symptoms in response to a trauma analogue. Ninety-two participants were randomly assigned to either mindfulness training or no treatment. Participants assigned to the mindfulness training completed a 1-hour computerized mindfulness training and practiced their skills for 1 week. All participants were exposed to an analogue for real-life trauma and were assessed at 1- and 2-week follow-up. Participants assigned to the mindfulness condition exhibited significantly lower levels of PTSD-like symptoms at 2-week follow-up in comparison to the no treatment condition. In addition, participants …

Motivational Interviewing Assessment And Behavior Therapy As A Stepped-Care Approach To The Treatment Of Adolescent Depression, Tanya N. Douleh

Dissertations

Depression is a significant public health concern with a lifetime prevalence of 24.01 for adolescents in grades 9-12 (Lewinsohn, Hops, Roberts, Seeley, & Andrews, 1993) and a point prevalence of 4-6% (Kessler, Avenevoli, & Ries, 2001). The risks associated with adolescent onset depression include comorbidity, depressive episodes continuing into adulthood, and suicidality. These risks make it imperative to develop effective treatments to address adolescent depression. Stepped care is an approach to treatment which involves treatment of illness using the least invasive measures first and moving toward more invasive treatment as indicated by ongoing assessment. Through a single-participant design, the current …

Impact Of Participating In A Short-Term Intervention Model Of Sports Education Camps For Children With Visual Impairments, John Michael Mcmahon

Dissertations

This three-paper format dissertation explores three topics relevant to participating in a short-term model Sports Education Camp for youth with vision impairments. The three papers are independent studies, yet build upon each other by first measuring physical performance in certain skills, then exploring their levels of self-perception, body mass index, and level of physical activity in their local communities, and finally describing the population of participants at various points over a 25-year period. Papers one and two examined differences in pre- and post-camp measures for first-time and repeat participants, with the first paper focusing on physical performance, and the second …

A Comparison Of Medication Managemnt Between Older And Younger Adults Living With Hiv, Judy A. Frain

Dissertations

The aims of this study were to examine whether there are differences in medication management between older and younger adults living with Human Immunodeficiency Virus and to explore the relationship between age and personal factors including cognitive ability, depression and self-efficacy on medication management. The research utilized a descriptive-correlational, cross-sectional design to compare medication management between older and younger adults living with HIV and to describe differences in predictive factors of cognition, depression, and self-efficacy on medication management ability between older and younger adults living with HIV. Results indicate both older and younger adults have high rates of mild cognitive …

Move Montana: An Exercise Program For Children, Adolescents, And Their Families, Deanna Lynn Babb

Dissertations

Despite advances in medical science, the prevalence of obesity in the US has more than doubled in the last three decades, to over 72 million people (CDC, 2009). The purpose of this project was to pilot an exercise program that would increase physical activity in a group of adolescents and one of their parents or guardians. A convenient sample of 10 adults and eight adolescents returned surveys and exercised through the entire eight weeks (N = 18). Ten of the 18 participants (56%), six parents and four adolescents, reported increased frequency of exercise each week throughout the eight week period. …

Implementation Of Mental Health Screening In An Adolescent Health Care Clinic, Lisa Colleen Isenberg

Dissertations

The purpose of this project was to increase the awareness of adolescent mental health issues and emphasize the importance of screening for depression and suicidal ideations, to provide clinicians mental health screening tools, and to determine the barriers and challenges involved in performing mental health screenings in practice. This project implemented mental health screenings in an adolescent, urban, walk in health clinic and evaluated the mental health screening and implementation process from the patient and the provider perspectives and determined the resources needed for follow up. This practice evaluation project included a mental health screening on consenting 18-24 year olds, …

Toward A Model For Predicting Depression Among Veterans, Nita Aurora Magee-Cornelius

Dissertations

Major depression, identified as a leading cause of disability in the United States, is often first diagnosed by primary care providers. This disability is associated with increased morbidity, mortality, and a lower quality of life. With approximately one in every three veteran diagnosed with depression and the rate of suicide increasing in the United States military (Department of Veterans Affairs, 2009), the Patient Health Questionnaire-2 items (PHQ-2) can be instrumental in identification and monitoring of depressive symptoms. The purposes of this retrospective study were to determine the prevalence of depression, as measured by the federally mandated PHQ-2 in the VA, …

Nursing Students' Attitudes Toward Science In The Nursing Curricula, Jill Deanne Maroo

Dissertations

The nursing profession combines the art of caregiving with scientific concepts. Nursing students need to learn science in order to start in a nursing program. However, previous research showed that students left the nursing program, stating it included too much science (Andrew et al., 2008). Research has shown a correlation between students’ attitudes and their performance in a subject (Osborne, Simon, & Collins, 2003). However, little research exists on the overall attitude of nursing students toward science. At the time of my study there existed no large scale quantitative study on my topic. The purpose of my study was to …

Perceptions Of Workplace Bullying Among Practicing Registered Nurses, Crystal Regina Threadgill

Dissertations

Workplace bullying (WPB) is a social and organizational problem. Within the health care arena, employees, particularly registered nurses, are at risk. WPB has several adverse effects and has been cited in the literature as closely associated with burnout and nurses leaving their positions. This quantitative study examined workplace bullying among practicing registered and its relationship with burnout and nurses’ intent to leave their current position.

The surveys utilized were the Negative Acts Questionnaires-Revised (NAQ-R), Maslach Burnout Inventory Survey, Intention to Turnover Scale and a demographic survey. Of the surveys distributed, a total of 185 were returned from one selected hospital …

The Impact Of Technology Attitudes And Skills Of Rural Health Clinic Nurses On The Level Of Adoption Of Electronic Health Records In Mississippi, Jennifer Lynn Styron

Dissertations

The evolution of health information technology continues to reform the delivery of efficient, safe, and equitable healthcare in the United States. One such example is the emergence of electronic health records (EHRs) and the discerning emphasis placed on using this technology in meaningful ways. While the integration of EHRs into daily practice impacts all healthcare professionals, nurses remain a prominent driver in the successful adoption and usage of these systems. It is therefore imperative to understand the impact of nurses’ technology attitudes and skills on the level of EHR adoption in Mississippi.

This quantitative study examined the technology attitudes and …