Medicine and Health Sciences Commons^™

Identification And Management Of Vertebral Column Fractures In Primary Care, Christopher Richard Hemmer

Dissertations

The purpose of this project is to perform a program evaluation of current treatment patterns of primary care providers for osteoporotic vertebral compression fractures (VCF). VCF’s result in significant morbidity and long term sequelae following a VCF is not uncommon. Additionally, there is controversy regarding the diagnosis and management of this disorder, especially as these relate to the clinical practice guidelines. This practice evaluation project included a pre and post-test survey and a continuing education offering. Thirty-nine physicians and nurse practitioners completed the survey instruments and attended the continuing education sessions. The educational session resulted in improvement of the provider’s …

Vertical Violence And The Student Nurse: Is This Toxic For Professional Identity Development?, Sherri Williams Cantey

Dissertations

This narrative inquiry centers on student nurses’ stories of vertical violence perpetuated by clinical registered nursing staff and the meaning that students associate with this phenomenon. Student nurses are the very young and potentially impressionable members of our profession; therefore, a concern of this study was if vertical violence affects professional identity development for the student nurse. Additionally through stories revealed by these participants, this study attempted to explore whether perceptions of violence are believed to be a rite of passage into the profession. Students are the future of our profession, and it is important that this phenomenon be understood …

Equine-Assisted Psychotherapy: A Descriptive Study, Erica Jex Gergely

Dissertations

The current study seeks to examine the program operations and treatment practices of individuals and organizations providing equine-assisted therapy services nationwide. Currently, there are several hundred programs across the United States that utilize equine-assisted therapy to treat common mental health problems in children, adolescents, and adults. Not all equine therapy programs function under the same theoretical model and therefore do not deliver treatment services using equivalent principles or techniques. In addition, program policies, procedures, and ethical guidelines of each provider vary. To date, there exists a paucity of research regarding equine-assisted therapy including both qualitative and quantitative data.

The present …

An Evaluation Of Social Capital's Effect On Depression Among Adolescents, Ezechukwu Awgu

Dissertations

Mental illness has been described as a “global burden of disease,” and depression accounts for a large part of the burden (Aslund, Starrin, Nilsson, 2010). In 2009, 35.7 percent of the adolescent population in the United States who reported past-year symptoms of a major depressive episode, for example, feelings of sadness, discouragement, loss of feelings of self-worth, and loss of interest in social activities, also used illicit drugs including marijuana, inhalants, hallucinogens, cocaine, heroin, and prescription-type psychotherapeutics for non-medical purposes (SAMHSA, 2009, APA, 1994). Additionally, substance abuse due to alcoholism was among the major causes of death for adolescents aged …

Using Box-Jenkins Modeling Techniques To Forecast Future Disease Burden And Identify Disease Aberrations In Public Health Surveillance Report, Larry C. Garrett

Dissertations

The analysis of public health surveillance data to identify departures from historical patterns of disease is required to facilitate the timely identification of potential outbreaks. Using the Box-Jenkins forecasting model, this study examines the potential to predict future disease burden based upon the historical record within local public health jurisdictions. Box-Jenkins forecasting was developed as a direct result of forecast problems in the business, economic, and control-engineering applications, yet it has not been systematically examined for use with public heath surveillance data.

Box-Jenkins forecast models are constructed by stratifying 84,029 disease reports from the State of Utah by year (n …

Health Literacy, Cognitive Impairment, And Medication Adherence In Veterans With Heart Failure, Lee Ann Hawkins Phd

Dissertations

Background: Heart failure (HF) affects 5.8 million people in the United States, costly in terms of patient mortality and morbidity as well as healthcare dollars. One important manifestation of poor HF outcomes is the excessive admission-readmission cycle. Non-adherence to medication is responsible for the majority of HF readmissions. Identification and intervention for key factors contributing to poor medication adherence is critical to improving outcomes. Two such factors prevalent in persons with HF are cognitive impairment (CI) and poor health literacy (HL). There is a paucity of tested interventions designed to improve medication adherence by addressing underlying CI or HL. A …

Public Health Nurse Decisions Regarding At-Risk Postpartum Case Closure, Denise K. Thompson Phd

Dissertations

During the late 19th century, public health nursing emerged in the United States as an autonomous nursing specialty providing maternal-child health (MCH) home visitation services. Present day MCH public health nurses (PHNs), guided by their predecessors, focus on health promotion and disease prevention in at-risk maternal-child populations. Health policies, funding streams, and local public health nursing protocols are examples of extrinsic factors that may affect length of home visitation services for at-risk women and their children. The purpose of this study was to better understand the factors related to variations in PHN decisions to terminate home visitation services for at-risk …

Temporal Characteristics Of Monoptic, Dichoptic And Half-Binocular Collinear Lateral Masking Of Contrast Detection, Wesley Tod Kinerk

Dissertations

Purpose: The temporal characteristics of dichoptic contrast integration across space in primary visual cortex are relatively unknown. This study investigated the effect of varying interstimulus interval (ISI) and flank duration on contrast detection threshold (CDT) of a sinusoid target under monoptic, dichoptic and half-binocular viewing. Methods: Eleven subjects with normal vision participated for a mean of 25 hours each. In the main experiment, target and flanks were 3 cpd vertical sinusoids with 6 lambda (sigma = 1.5 lambda) center-to-center vertical separation. Flank contrast was normalized to 3X flank CDT. Flanks were presented at 4 durations (67-500ms) and ISIs were presented …

Does Psychopathy Predict Future Risky Sexual Behavior?, Jessica Jade Fulton

Dissertations

Risky sexual behavior (RSB), such as having sex with an unknown partner, is associated with a variety of negative consequences including sexually transmitted diseases and unplanned pregnancy. Previous research (e.g., Fulton, Marcus, & Payne, 2010) suggests that psychopathic personality traits as assessed by the Psychopathic Personality Inventory (Lilienfeld & Andrews, 1996) are associated with RSB. Self-Centered Impulsivity (SCI), which is characterized by impulsivity, irresponsibility, and reckless behavior, was positively associated with RSB among men and women. In contrast, Fearless Dominance (FD), which is characterized by fearlessness, manipulativeness, and social dominance, was positively associated with RSB among men but not women. …

The Use Of Humor For Emotion Management On The Job: An Exploration Of 911 Communication Centers, Jennifer Dell Mclaughlin

Dissertations

This study sought to understand how humor affects a person’s ability to cope and manage their emotions in a high stress organizational environment. 911 communication centers are work environments where stress is commonplace, and the work environment can instantly become erratic and chaotic.

This study explored the role humor has in assisting organizational members with emotion management in a high stress job and the types of humor used by members to handle their job and cope with the stress.

The results suggest that humor is pervasive in 911 communication centers, and dispatchers use humor for personal coping, co-worker bonding, and …

The Development, Validation, And Application Of The Motivation Scale Of Disability Sport Consumption (Msdsc), Michael Paul Cottingham Ii

Dissertations

Consumer motivation, “the driving force within individuals that impels them to action” (Schiffman & Kanuk, 2004, p. 87), assists in identifying why consumers attend sporting events, and if they plan to repatriate or consume merchandise and media (Byon, Cottingham, & Carroll, 2010; Kim, Greenwell, Andrew, Lee, & Mahony, 2008). The Motivation Scale for Sport Consumption (MSSC) (Trail & James, 2001), consisting of factors that identify specific consumer motives (Trail & James, 2001; Wann, 1995), was tested in the context of disability sport (Byon, Carroll, Cottingham, Grady, & Allen, 2011; Byon et al., 2010) but did not take into account motives …

Exogenous Alpha-Synuclein Induces Cell Death Related Proteins In C6 Oligodendrocyte-Like Cells Corresponding To Protein Expression Observed In Multiple System Atrophy, Derrick Samuel Hilton

Dissertations

Multiple System Atrophy (MSA) consists of three disorders; Autonomic Dysfunction, Cerebellar Ataxia, and Parkinsonism. In MSA, the protein Alpha-Synuclein (SNCA) appears in the central nervous system as misfolded protein aggregates primarily in oligodendrocytes. This dissertation reports the results from studies examining the effect of exogenous SNCA has on a cell model: C6 oligodendrocyte-like cells. Treated cells were evaluated using western blot and DNA microarray. In addition the expression of proteins was evaluated using immunocytochemistry in MSA patient tissue.

C6 cells were shown to take up SNCA when added to the media. SNCA also underwent a truncation when taken up by …

Obstructive Sleep Apnea And The Effects Of Co-Existing Factors On Pacu Stay Time, Shari F. Jones Phd, Crna

Dissertations

Significance/Background: Obstructive Sleep Apnea (OSA) is the most common disturbance during sleep affecting 30% of the population. The occurrence of moderate/severe OSA is 11.4% in men and 4.7% in women. OSA is caused by repetitive partial or complete obstruction of the upper airway with apnea episodes. OSA is prevalent in western society, yet is frequently undiagnosed due to lack of knowledge of the disorder. This population presents a challenge during the peri-operative period due to increased risk for several complications. Of particular interest to Nurse Anesthetists, are respiratory complications that result in delayed emergence from anesthesia, delayed post-operative recovery, increased …

Case Study Of Parents Caring For A Child Having Type-1 Diabetes With Optimal Hga1c, Elizabeth Ciaccio Phd

Dissertations

Type 1 diabetes in school age children is a complex condition requiring continuous physical, nutritional, and therapeutic monitoring to prevent lifelong complications and maintain quality of life. In 2011, one in 400 children in the United States were affected by it. The purpose of this research study was to understand how parents achieve optimal HgA1c for their school age children with type-1 diabetes. Currently, there is very little research documenting how parents achieve this goal. Understanding this phenomenon more clearly can be used to inform future research, improve practice and provide information for development of effective health policy. Management of …

Assessing The Feasibility And Perceptions Of Health Services For Refugees Of Resettlement Organizations, Heidi Jean Worabo

Dissertations

Background: Since 1975 the U.S. has resettled 2.6 million refugees who had to flee from their home countries. Many refugee resettlement organizations have developed different models of innovation to promote a smooth transition between previous foreign refugee camps to U.S. communities so that refugees swiftly become economically and socially self-sufficient. Providing refugees with health benefits and resources has been foremost priority upon arrival as they try to overcome health care barriers. Yet there is a lack of literature examining the impact of these health services and how they are perceived by the program recipients. Purpose: This scholarly project aimed to …

Lesbian/Queer/Same-Gender-Loving Women Graduate Students In Mental Health Related Fields: A Grounded Theory Of Attitudes Toward Transgender Individuals, Bonnie M. Benson

Dissertations

Transgender (trans) issues are an emerging area of research within counseling psychology. As such, little is known about how individuals form their attitudes toward trans people. Despite evidence that lesbian women are one group that has held biased views of the trans population, the literature has not addressed the perceptions that lesbian women have of trans individuals. Furthermore, the campus climate literature has attended to how LGBT students experience campus discrimination, but this literature has not addressed within-group differences, that is, attitudes and interactions among LGBT members of a university community, such as those between lesbians and trans people. The …

The Rules Of Corporate Governance In Public Companies In The Uae, Salama Hmoud Hamad Ai Ameri

Dissertations

Due to the recent upheavals and deteriorating global economic outlook, a healthy reevaluation and attention is being focused on the role of corporate governance in global economic and legal debate among policy makers and experts. The urgency has been expedited by the global financial crisis of 2007-2008 ("Financial Crisis") which had negative impact on all corners of the globe. The United Arab Emirates ("UAE") was also affected by the Financial Crisis, albeit in a limited and manageable manner than many other countries around the world.

As a result of the Financial Crisis and its impact, UAE responded with measures to …

The Impact Of A Direct Care Training Program On The Self-Efficacy Of Newly Hired Direct Care Employees At State Mental Health Facilities, Marcus Wayne Lewis

Dissertations

Self-efficacy has been shown to be an important element in the success of individuals in a variety of different settings. This research examined the impact of a two week new employee orientation training program on the general and social self-efficacy of newly hired direct care employees at state mental health facilities. The research showed that the training program did not have a statistically significant impact on the social self-efficacy of the new employees after the training or after one month on the job. The research also showed that the two week new employee orientation program did not have a statistically …

Inpatient Glycemic Management: Glucose Control Relationship With Hospital Variables, Discharge Planning And Education, Crisamar Javellana-Anunciado Phd, Fnp-Bc, Rn

Dissertations

This dissertation study examined the relationship of glucose control with clinical outcomes, costs, discharge planning and education. Extant studies showed that hyperglycemia, in the presence or absence of a diabetes diagnosis, is prevalent in hospitalized patients. Hyperglycemia is found in one-third of all hospital admissions and is linked to poor clinical outcomes and increased healthcare costs. Furthermore, clinical evidence suggests that lack of discharge coordination associated with medical errors and readmission. This entire body of work contains three distinct sections: Two manuscripts and a grant proposal. The two manuscripts in this study were based on more current retrospective data at …

Nurse Manager Transformational Leadership Practices And Patient Outcomes Among Magnet And Non-Magnet Hospitals, Bridgett Byrd Sellars Phd, Msn, Ma, Rn

Dissertations

In 2004 the Institute Of Medicine called for healthcare leaders to embrace and adopt transformational leadership practices to promote quality of care and favorable patient outcomes. Nurse managers are accountable for 24-hour operations of their departments and influence patient outcomes. The purpose of this research was to examine the relationships among nurse manager transformational leadership practices, patient outcomes and hospital types (Magnet, On The Journey, and Non-Magnet). A correlational study examined relationships between self-reported transformational leadership practices of nurse managers and patient outcomes by hospital types. The study was conducted using a purposive sample of Association of California Nurse Leader …

A Qualitative Descriptive Study Of The Work Of Nurses In Interventional Radiology, Brenda Naef Boone Phd

Dissertations

This dissertation study explored the work of nurses in interventional radiology. Interventional radiology (IR) is an emerging field of practice in health care. More and more procedures that were historically done in the operating room are being performed in IR. This has led to higher acuity patients and an increased need for specialized nursing care. The work of nurses in this area of practice is not well described and as such can lead to a lack of understanding of nursing involved in high tech low touch areas. This qualitative descriptive research study was conducted to shed light on this under …

Breast Health And Mammography Screening In Older Women, Martha A. Ibarra Phd, Msn, Anp, Rn

Dissertations

Age-related health disparities in breast cancer screening are a public health concern. From 2002 to 2006, the median age for newly diagnosed cases of breast cancer was 61 years and the median age for breast cancer mortality was 68 years of age (Surveillance Epidemiology and End Results [SEER], 2009). Mammography is the best available screening tool for breast cancer detection (Susan G. Komen Foundation, 2008). The Centers for Medicare and Medicaid Services (CMS, 2006) reported that only about half of older women who are eligible for mammograms through Medicare obtain a mammogram every two years. The literature identifies psychosocial barriers, …

Relationship Between Delirium And Night-Time Interruptions In Icu, Amy R. Stuck Phd, Rn

Dissertations

Background: This dissertation examined the phenomenon of delirium in the intensive care unit (ICU) setting. Delirium is a form of cognitive disturbance with a physiologic etiology and complex, multifactorial mechanisms of causation and risk. Delirium in the ICU patient presents a significant risk for adverse outcomes including increased mortality, length of stay, falls, and restraint use. ICU delirium can lead to persistent cognitive impairment beyond discharge and frequent skilled nursing placement. Identifying delirium requires accurate diagnosis that is optimized when validated instruments are used. Sleep deprivation has been linked to adverse health consequences including delirium. Previous studies investigating the relationship …

Tobacco-Use Promotional Environment And Intrapersonal Environment: Predictors Of Smoking Intention Among Young Southern California Thai-American Adolescents, Arpakorn Magkunthod Phd, Msn, Rn

Dissertations

This study explores tobacco-use related environment, intrapersonal factors, and smoking initiation in Thai-American adolescents aged 10 to 16 living in Southern California. A purposive sample of 217 youth was recruited from seven Thai-community centers located in four counties of Southern California: The sample was fairly evenly distributed by gender with female (54.5%) and almost three quarters (70.9%) were born in the United States (70.9%). Age ranged from 10 to 16 years, with the mean age 12.71 years old (SD =1.835); 27% reported age of 11. Data were collected using the 97 item Teen Tobacco-Use Questionnaire. Findings indicated 12 participants (6.3%) …

Pain Management In Triage And Reducing Percentage Of Left Without Being Seen In An Overcrowded Ed, Christina Ballejos-Campos Phd

Dissertations

Although in most emergency rooms, the patient is seen first by a highly trained triage nurse, the ED physician is trained to determine if the patient can safely leave the ED prior to in-depth exam, treatment and diagnosis. The goal is to keep the left without being seen by a physician percentage low, since a high number would indicate poor quality, additionally patients who present with pain, and then leave the ED prior to being seen can pose a greater risk. This study examined the association of nurse-initiated triage pain protocol on the LWOBS percentage rate of patients who present …

Documentation: Delirium In The Hospitalized Older Adult, Jacqueline Fitzgerald Close Phd

Dissertations

Background: Delirium is a common, life threatening and preventable geriatric syndrome. Because this condition is frequently addressed by administering dangerous antipsychotic drugs, it is imperative that accurate systematic assessments are charted to determine the actual need for these medications. The purpose of the study was to describe medical record documentation of a systematic assessment of delirium in older adults who had been administered an antipsychotic medication. Methods: A descriptive correlational retrospective design was used for this medical record data based study. The setting was a 107 bed acute care community hospital located in southern California. Inclusion criteria were medical records …

Development Of An Advanced Practice Registered Nurse Primary Care Telephone Clinic, Linda G. Kaiser

Dissertations

Abstract Development of an Advanced Practice Registered Nurse Primary Care Telephone Clinic This pilot project developed and implemented a telephone clinic based on established Veterans Affairs telephone policy and procedures and determined patient acceptability of this new visit type as an alternative to face to face visits. The review of the literature produced research that indicates telephone clinics are a viable visit option for patients. Telephone visits provide access to the primary care provider while being convenient and economical for patients. Research studies demonstrate that patients are satisfied with this visit option. The pilot project was successfully implemented in a …

Instituting An Oral Health Preventive Service Program, Including Fluoride Varnish, For Preschool Children Birth To Five Years In A Rural Health Clinic: A Clinical Scholarship Project, Carol Ann Berger

Dissertations

Abstract This project was designed to institute an oral health preventive program in a rural health clinic, in a dental provider shortage area, promoting oral health in preschool children birth to five years by: (a) instituting a program that supports the Missouri preventive service program in oral health, (b) promoting oral screenings and fluoride varnish twice yearly, (c) assessing the risk of caries, (d) referring to appropriate dental services and (e) educating parents or guardian about the importance of oral health and how to maintain oral health at home with children birth to five years. This project sought to answer …

In Their Own Words: The Lived Experiences Of Unemployed African American Men, Kenlana R. Ferguson

Dissertations

Due to staggering unemployment rates, African American men's experience with work in the U.S. has historically received widespread attention in the media and social science literature. Terms such as black male unemployment crisis, puzzle, epidemic and catastrophe have been used to describe the unemployment woes of black. Attempts at explaining why African American men are experiencing such difficulty in the world of work has been undertaken across the disciplines, however much of this work has amounted to nothing more than acknowledgement that isolating independent factors as causes does not suffice and that a more interdisciplinary framework is needed if we …

Teaching Language To Children With Developmental Disabilities Using Combined Direct Reinforcement And Stimulus-Stimulus Pairing, Brighid Helene Fronapfel-Sonderegger

Dissertations

Several researchers have used stimulus-stimulus pairing (the pairing of speech sounds with established reinforcers) to increase the frequency of specific vocalizations in children with disabilities. However, only a few addressed the utility of stimulus-stimulus pairing to increase functional language, and none combined stimulus-stimulus pairing and direct reinforcement. The present study combined stimulus-stimulus pairing and direct reinforcement to successfully teach 2 to 10 functional mands in 21–49 7-minute sessions with four children with developmental disabilities with low verbal repertoires. Following mand training, two children were taught 10 tacts for pictures using the combined direct reinforcement and stimulus-stimulus pairing procedure in a …