Medicine and Health Sciences Commons^™

Transcending Microbial Source Tracking Techniques Across Geographic Borders: An Examination Of Human And Animal Microbiomes And The Integration Of Molecular Approaches In Pathogen Surveillance In Brazil And The United States, Amber Mae Koskey

Theses and Dissertations

Waterborne illnesses, attributed to the ingestion or contact with contaminated water, present a significant global health concern. Surface water sources can be impacted by wide array of pollution inputs, but fecal pollution generates the most significant and acute threat to human health. Therefore, the detection of fecal bacteria in surface water sources remains an important public health objective. Current surface water monitoring employs the use of fecal indicator bacteria (FIB) including E. coli and enterococci as proxies for pathogenic organisms carried in fecal pollution. These traditional indicators, detected by culture-based microbiological methods, do not discriminate fecal sources from another. New …

Integration And Impact Of Stress Management And Resiliency Training (Smart) In A Nurse Residency Program: A Feasibility Study, Sherry Chesak

Theses and Dissertations

Nursing is recognized widely as a highly stressful profession, and the time of orientation is identified as the most stressful time in a nurse's career. Innovative strategies are needed to assist new registered nurses in the management and prevention of stress as a result of transitioning into the complex and challenging healthcare environment. The purpose of this study was to assess the feasibility and impact of integrating a Stress Management and Resiliency Training (SMART) program within a nurse residency program for new nurses at an academic medical center. Additional aims were to assess the effects of the program on participants' …

Patient-Oriented Evidence-Based Treatment Decision Support System (Treatquest®) For Lung Cancer, Danqing Hu

Theses and Dissertations

Involving patients in healthcare decisions makes a significant and enduring difference to healthcare outcomes. One challenge for patients is the lack of evidence-based information and tools to support their decision making. Although patients have access to significant information through internet and other sources, it is not personalized for their specific situation. This dissertation attempts to help patients acquire evidence-based information relevant to their own situation, so they can make a more informed decision in co-operation with their physicians. Lung cancer has been selected as a focus for this study because lung cancer presents very complex decision making situation and is …

Representing And Retrieving Patients' Falls Risk Factors And Risk For Falls Among Adults In Acute Care Through The Electronic Health Record, Jann Pfaff

Theses and Dissertations

Defining fall risk factors and predicting fall risk status among patients in acute care has been a topic of research for decades. With increasing pressure on hospitals to provide quality care and prevent hospital-acquired conditions, the search for effective fall prevention interventions continues. Hundreds of risk factors for falls in acute care have been described in the literature. However, due to variations in the terms utilized to represent each fall risk factor, an effort to compare findings across settings and replicate research is hampered. As the expectations for the effective use of electronic health records increase, an opportunity exists to …

The Experiences Of Women Entering Methadone Treatment For Opioid Use: An Interpretive Phenomenological Inquiry, Melissa Mae Rubio

Theses and Dissertations

The United States is facing a momentous public health problem of prescription and illicit opioid use among women. Traditionally in health literature women have received less attention than men and this is especially true with regard to drug use. In terms of recovery from opioid use, treatment centers that use methadone as a pharmaceutical replacement for illicit opioids have been present in the US for decades, and women have been enrolling in treatment since its inception. However, there is little in the literature about the characteristics of these women, why they choose methadone treatment, and what their experiences are while …

Trends In Work-Related Injury Rates And The Associated Incurred Costs In Long-Term Care Centers, Darcie Lange Olson

Theses and Dissertations

Background. Nursing assistants, working in long-term care facilities, have consistently been among the top occupational groups experiencing work-related musculoskeletal injuries. These injuries have been attributed the physical demands of lifting and moving the individuals in their care. Great strides in research have identified successful risk reduction strategies such as the implementation safe patient handling and mobility programs. The benefits of these programs have been advocated over the last two decades, but the rate of injuries among nursing assistants continues to be more than double the national average for all other industries. The purpose of this study was to investigate the …

New Graduate Nurses' Experiences Of Transition During Orientation Into Critical Care, Mari Beth St Clair

Theses and Dissertations

The concept of new graduate nurses working in critical care for some healthcare systems remains a fairly new concept. Often new graduate nurses begin their orientation in critical care with minimal to no critical care experience. Orientation for the new graduate nurses can be challenging as for years new graduate nurses were not allowed to work in critical care until they had a minimum of one year of nursing experience. Currently new graduate nurses beginning employment in critical care are faced with revisiting basic nursing and learning critical care nursing at the same time. In order for critical care units …

Simulation Design Characteristics: Perspectives Held By Nurse Educators And Nursing Students, Jane Brekke Paige

Theses and Dissertations

Simulation based learning (SBL) is pedagogical method poised to innovate nursing educational approaches. Yet, despite a growing body of research into SBL, limited investigation exists regarding assumptions and beliefs that underpin SBL pedagogy. Even though key simulation design characteristics exist, the particular methods nurse educators use to operationalize simulation design characteristics and how these choices are viewed from the perspective of nursing students is unknown. Without understanding what motivates educators to design simulations as they do, it is difficult to interpret the evidence that exists to support chosen methods. Through the exploration of perspectives (points-of-view), underlying beliefs can be uncovered. …

Communication During Palliative Care And End Of Life: Perceptions Of Experienced Pediatric Oncology Nurses, Kathleen Montgomery

Theses and Dissertations

Advances in cancer and supportive therapy have led to improved outcomes for children with cancer. Despite progress, children still die from complications of cancer therapy or their disease. Communication during palliative care and end of life is essential to successful navigation through the end of life continuum. Nurse communication during palliative care and end of life is a phenomenon with limited research, and it is unclear how the level of nursing experience influences the perspectives of nurses communicating during end of life. The purpose of this dissertation study was to describe the commonalities of nurses' experiences of communicating palliative care …

Perceived Needs And Coping Resources Of Newly Hired Nurses In Transition, Catherine A. Schmitt

Theses and Dissertations

Newly hired nurses who do not transition well often leave their first nursing position or nursing prematurely, at great cost to themselves, the profession, the hiring organization and patients. The purpose of this secondary analysis study was to better understand the experience of new graduate nurses (NGNs) and experienced nurses as each group transitions to a new setting in nursing practice and the contribution the preceptor role plays in that transition. Schlossberg's Transition Theory was the framework that guided the study. The original data were collected from 118 newly hired nurses who were predominantly female and Caucasian with the majority …

Walk It Off!: The Relationship Between Physically Active And Passive Coping Style And Perseverative Cognition, Michelle Rosalie Di Paolo

Theses and Dissertations

ABSTRACT

WALK IT OFF!: THE RELATIONSHIP BETWEEN PHYSICALLY ACTIVE AND PASSIVE COPING STYLE AND PERSEVERATIVE COGNITION

by

Michelle R. Di Paolo

The University of Wisconsin-Milwaukee, 2013

Under the Supervision of Professor Marcellus Merritt

The main aim of the current study is to assess if a relationship exists between self-selected coping styles and levels of perseverative cognition (PC). Recent pilot studies have revealed a relative distinction between the coping styles people choose when coping with stress, i.e., those that are physically active (PAC) like going for a walk, jogging, or lifting weights, and those that are physically passive (PPC) like reading …

The Influence Of Position Type And Generational Grouping On Job Satisfaction Of Milwaukee County's Public Health Workforce, Jeanette L. Kowalik

Theses and Dissertations

Nationally, the public health workforce (PHW) consists of 155,000 staff (NACCHO, 2010). It is projected that half of the PHW will soon retire. Health departments must find ways to retain its diverse workforce.

Job Satisfaction is a critical variable that impacts a sustained PHW. Job Satisfaction assessments can promote sustainability of the workforce because the data assembled from the assessments can inform research, policy, and practice. Public health workers that report high Job Satisfaction are less likely to quit as well as delay retirement (RWJF, 2013).

The purpose of this study is to examine the influence of position type and …

Evaluation Of Vdr-Coactivator Inhibitors Using Biochemical And Cell-Based Assays, Athena Marie Baranowski

Theses and Dissertations

ABSTRACT

EVALUATION OF VDR–COACTIVATOR INHIBITORS USING BIOCHEMICAL AND CELL–BASED ASSAYS

by

Athena Baranowski

The University of Wisconsin–Milwaukee, 2013

Under the Supervision of Dr. Alexander Arnold

The vitamin D receptor (VDR) is a ligand–dependent transcription factor, which belongs to the nuclear receptor superfamily. VDR–mediated gene regulation is governed by coregulators (coactivators and corepressors). VDR coregulator binding inhibitors (CBIs), which were discovered using high throughput screening (HTS), were evaluated using cell–based assays and biochemical assays to determine their ability to inhibit the interaction between VDR and steroid receptor coactivator–2 (SRC–2). Determining their ability to inhibit the VDR–SRC–2 interaction can lead to the …

Effects On Volunteer Peer Leaders Participating In A Health Promotion Program For U.S. Veterans, Leslie A. Patterson

Theses and Dissertations

Health-focused peer-led interventions demonstrate success in reducing risk-related behaviors among participants with chronic illnesses, yet few researchers have explored the effects of such interventions on the health of volunteer peer leaders who participate in the interventions. Using data from the project entitled, An RCT of a Peer Support Intervention to Improve Hypertension, this study explored volunteer peer leaders' self-care behaviors that contribute to blood pressure control in two hypertension interventions for U.S. veterans. Inspection of the study's findings demonstrated that volunteer peer leaders improved their health habits and hypertension knowledge significantly more than the peer groups they served. Findings revealed …

Feasibility And Preliminary Outcomes From A Pilot Study Of The Smile Curriculum For Mother-Infant Co-Occupational Engagement And Maternal Self-Efficacy, Emily Whitlock

Theses and Dissertations

OBJECTIVE: To report on the feasibility and preliminary outcomes from a pilot study of the SMILE curriculum, a new educational program designed to enhance the mother-infant relationship by focusing on improvement of co-occupational engagement within daily routines.

METHOD: Six mothers, each with an infant diagnosed with special medical needs who received services in a local birth-to-three program, participated in an exploratory design study. Each mother was assigned to a SMILE curriculum intervention group or a waiting-list control group. Mothers were evaluated pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP-SE) Scale for measurement of maternal self-efficacy and the Center …

Potential Benefits And Withdrawal Effects Of Cranial Nerve Non-Invasive Neuromodulation On Functional Mobility For Individuals With Traumatic Brain Injury, Kati P. Liegl

Theses and Dissertations

Objective: Document and describe benefits and withdrawal effects of the Cranial Nerve Non-Invasive Neuromodulation (CN-NINM) intervention.

Background: Neuromodulation techniques can be used for the treatment of many diagnoses and conditions. Many current neuromodulation techniques have or can have negative consequences such as high cost, risk of surgical complications or infections, effects not lasting without the drug or stimulation presence, and need for medical experts' direct oversight. A new rehabilitation intervention called CN-NINM may eliminate these negative factors, making it a promising tool for clinicians and participants. CN-NINM combines targeted training activities with mild, portable, electrical stimulation of the tongue to …

Life After Adhesion: L-Selectin Throughout The T Cell Lifespan, Abner Garcia Fernandez

Theses and Dissertations

Lymphocytes require antigenic encounter to activate and proliferate, eventually clearing the source of antigenic challenge. The peripheral lymph nodes (PLN) are the primary sites of antigenic encounter and thus the ability of lymphocytes to migrate to this tissue is a requirement for mounting effective immune responses. The process of lymphocyte migration to the PLN is known as the "adhesion cascade". Specifically, lymphocytes are captured from the blood through the adhesion molecule, L-selectin, followed by CC chemokine receptor 7 (CCR7)-mediated integrin activation, which ultimately results in cell transmigration into the PLN. Because the PLN is the site where antigenic encounter is …

Modulation Of Interleukin-17 By Tumor Necrosis Factor Alpha During The Immune Response To Borrelia Burgdorferi, Velinka Medic

Theses and Dissertations

Arthritis is one of the main complications of late-stage Lyme borreliosis. Cytokines play an important role in the persistent inflammation that is elicited by the causative agent of disease, Borrelia burgdorferi. Tumor necrosis factor alpha (TNF-alpha) is a pro-inflammatory cytokine that is induced by B. burgdorferi and that has been implicated in development of arthritis. However, in a mouse model of Lyme arthritis, treatment with anti-TNF-alpha; antibodies increased the severity of disease. By contrast, injection of recombinant TNF-alpha; ameliorated arthritis in this model. These findings suggested that other factors might be involved during the development of Lyme arthritis. One possible …

Examining Mediators To Physical Activity As A Link To Interventional Efforts Aimed At Increasing Activity Levels And Improving Physical Functioning In Older Adults, Christopher Dondzila

Theses and Dissertations

The number of older adults living in the United States is growing at an increasingly rapid rate, and is host to a high prevalence of chronic diseases and physical impairments. Physical activity and exercise have been shown to be beneficial in impacting such conditions, yet the majority of older adults remain inactive. The purpose of this dissertation was to employ a sequence of studies to investigate mediators to physical activity, leading to an intervention to increase activity and promote health.

The purpose of Project VOICE was to examine whether awareness and utilization of community resources to promote physical activity and …

Parents' Treatment Of Their Children's Pain At Home: Pharmacological And Non-Pharmacological Approaches, Ayala Y. Gorodzinsky

Theses and Dissertations

During childhood, individuals often experience pain on a daily or nearly daily basis (American Academy of Pediatrics and American Pain Society, 2001). Pain can be treated using pharmacological or non-pharmacological techniques. This study will focus on the techniques provided by parents, since parents most often treat children's painful experiences at home (Finley, McGrath, Forward, McNeill & Fitzgerald, 1996). The processes involved in parental decision-making regarding which techniques to use include a combination demographic, availability and perceived need factors (Andersen, 1995). Seven hundred and fifty-six parents of children 6 to 17 years completed a survey regarding use and effectiveness of pharmacological …

Perceptual Correlates Of Acoustic Measures Of Vocal Variability, Bree Ann Cumbers

Theses and Dissertations

This study investigated relationships between acoustic measures of vocal variability (pitch sigma, SFF range) and perceptual ratings of vocal variability during a reading task. Fifteen male (19-30 years of age) and nineteen female speakers (20-30 years of age) who were recorded reading the Grandfather Passage provided the stimuli for the listening task. From these samples, 30 were selected as representing a continuum of degrees of vocal variability. Male (N = 15) and female (N = 15) samples were presented to listeners separately. Thirty graduate students in Communication Sciences and Disorders who had a course background in voice supplied the perceptual …

The Impact Of Cancer Caregiving On Cancer Caregivers: Stories Of Lives In Transition, Cynthia Marie Steinwedel

Theses and Dissertations

The purpose of the study was to examine the impact of cancer caregiving on primary caregivers, exploring their personal narratives looking back on the entire experience from diagnosis, through treatment, and beyond. Caregiving is associated with exacerbation of stress-related disorders such as hypertension and heart disease and may also be associated with increased mortality rates. Transitions theory served as the conceptual framework for the study. Eleven adult caregivers, pre-retirement age, each participated in two semi-structured interviews. Caregivers were recruited from a community cancer resource center and were purposively selected to achieve maximum variation in terms of outcome of cancer treatment. …

Reading Comprehension And Nursing Education: A Missing Variable Associated With Nursing Student Attrition?, Debra L. Lajoie

Theses and Dissertations

ABSTRACT

READING COMPREHENSION AND NURSING EDUCATION:

A MISSING VARIABLE ASSOCIATED WITH

STUDENT ATTRITION?

by

Debra L. Lajoie, MSN

The University of Wisconsin-Milwaukee

December, 2013

Under the Supervision of Susan Dean-Baar, PhD, RN, FAAN

The goals of nursing faculty and administrators are to select students most capable of completing the nursing program and to provide academic support needed for program completion. However, despite stronger entrance requirements, educators are still baffled by the persistent attrition from nursing education programs. The purpose of this study was to describe and compare the level of reading comprehension of two groups of students, a pre-nursing student …

Impact Of The Arthritis Foundation's Walk With Ease Program On Self-Efficacy, Quality Of Life And Pain Reduction In A Group Format, Kelly Nicole Reese

Theses and Dissertations

Objective: To evaluate the effectiveness of the Arthritis Foundation's Walk With Ease Program for individuals with self- or medically-diagnosed arthritis within a group format. The study also investigates the individuals' perceptions on self-efficacy, quality of life and pain reduction pre- and post- intervention.

Background: The prevalence of arthritis is increasing and this places a major burden on individuals, health systems and social care systems globally. Osteoarthritis, the most common arthritis condition, is a major cause of impaired mobility and disability for aging populations. Osteoarthritis affects millions of people around the world. Self-management programs like the Walk With Ease Program have …

The Effects Of Static Stretching Versus Dynamic Stretching On Lower Extremity Joint Range Of Motion, Static Balance, And Dynamic Balance, Wenqing Wang

Theses and Dissertations

The purpose of this study was to examine the effects of static stretching (SS) versus dynamic stretching (SS) on lower extremity joint range of motion (ROM), static balance, and dynamic balance. Fifteen active subjects with tight hamstring and calf muscles participated. Hip flexion and knee extension ROM angle was measured using a fluid inclinometer. A closed-chain method of measuring ankle dorsiflexion ROM was used. Static balance was assessed in single-leg stance on a force plate using the time-to-boundary (TTB) measurement. The Star Excursion Balance Test (SEBT) was used to assess dynamic balance in three directions. These measurements were assessed before …

Metformin-Induced Pedf Expression Regulates Cell Proliferation And Lipid Metabolism In Prostate Cancer Cells, Miguel Angel Tolentino

Theses and Dissertations

Prostate cancer (PCa) is one of the most common cancers in American males. A high fat diet and obesity accelerate PCa progression and increase the 1risk of death from disease. Epidemiological studies have indicated that PCa patients with type 2 diabetes have higher mortality rates than PCa patients without diabetes. Type 2 diabetics who are on metformin, a drug to control blood sugar levels, show a delay in PCa progression in comparison with PCa patients with type 2 diabetes who are not on metformin. It has been proposed that metformin inhibits proliferation via activation of AMP-activated protein kinase (AMPK) or …

The Effects Of Expiratory Muscle Strength Training On Swallowing And Voice Measures In Healthy Older Adults, Adam Follmer

Theses and Dissertations

This study investigated the effects of a four week expiratory muscle strength training (EMST) exercise program on healthy older adults (65-79 years). The investigators were interested in possible changes to the swallowing and voice production systems, both of which are in the scope of practice for a speech language pathologist. Specific voice variables included maximum phonation time, conversational intensity level, and upper and lower limits of available intensity range. Swallowing variables were related to tongue function and included maximum isometric pressure and mean swallowing pressure. Finally, maximum expiratory pressure was measured as a comparative value to other EMST studies. A …

Cepstral- And Spectral-Based Acoustic Measures Of Normal Voices, Rachel Garrett

Theses and Dissertations

A review of recent literature suggested that cepstral- and spectral-based acoustic measures showed good potential as objective measures of dysphonia for clinical application. However, the small numbers of normal subjects in previous research and wide age ranges prevent a good estimation of the performance of normal speakers of various ages on these measures. Therefore, the purpose of this study was to provide normative data for Long-Term Average spectral- and cepstral-based measures for both men and women in two different age groups to aid clinicians with assessing and treating voice disorders. Sixty participants consisting of fifteen males and fifteen females, ages …

Optimizing Hand Crank Configuration For Therapeutic Use Of Amtrykes® For Children With Upper Extremity Motor Deficits, Jennifer Hardy

Theses and Dissertations

Objective

The purpose of this research study was to create a model to assist therapists, that determines the optimal positioning of the hand cranks when fitting a child for an AmTryke® with a disability that limits upper body strength, such as a brachial plexus injury.

Method

A fitting model was developed by testing the amount of force required to start moving the hand cranks on the AmTryke® when various amounts of weight were applied to the seat of the device. The data collected inserted into a table. A questionnaire developed and emailed to a convenient sample of pediatric physical and …

Measuring Outcomes Of Rehabilitation Among Persons With Upper Extremity Traumatic Injuries, Jamie Carl Grede

Theses and Dissertations

Grip strength is frequently measured to determine outcomes of rehabilitation among people with upper extremity traumatic injuries (UETIs). UETIs also affect rate of force-production during an isometric grip. However, we do not have a reliable and valid measure for detecting these force changes. The purpose of this study was to determine the validity and responsiveness, i.e. ability to detect change, of the Force-Time Curve (F-T Curve) to determine rate of force production. Twenty people with UETIs undergoing rehabilitation were recruited to participate in this study. Using an electronic Jamar dynamometer, each participant performed three maximal isometric grips, each lasting 10 …