Medicine and Health Sciences Commons^™

The Role Of Msa In The Global Regulation Of Virulence In Staphylococcus Aureus, Vijayaraj Nagarajan

Dissertations

Staphylococcus aureus is an important pathogen causing life threatening diseases in humans. Previously we showed that msa modulates the activity of sarA (Staphylococcal accessory regulator), which is one of a major global regulator of virulence in S. aureus. The objective of this study is to characterize the role of msa (Modulator of SarA) in the global regulation of virulence in S. aureus. Structure and function predictions were done using several computational tools and approaches to understand the nature of msa. A novel S. aureus microarray meta-database (SAMMD) was designed and developed to compare and contrast other transcriptomes with msa transcriptome. …

Knowledge Of Pain Management In Older Adults As A Content Area For Continuing Professional Education For Licensed Nurses, Wanda Cleveland Dubuisson

Dissertations

The research of the last 30 years has revealed the inadequacy of pain management in the older adult. Although evidenced-based clinical practice guidelines exist to direct the management of pain in the older adult, health care providers are either unaware or lack the proper understanding of the guidelines. This study investigated the differences in knowledge of pain management in older adults when examining licensed acute care nurses and extended care nurses. It sampled 118 acute care nurses working in two hospitals in Mississippi and 78 extended care nurses working in six extended care facilities (ECF) in Mississippi.

Based upon the …

Sense Of Humor, Stress And Coping, And Outcomes In Children's Lives, Lambertha Okhuizen-Stier Phd, Mph, Rn

Dissertations

Children are confronted with many stressors in their environment which may bring about symptoms such as anxiety, sadness, worry, aggressiveness, hyperactivity, restlessness, or low self esteem (Sharrer & Ryan-Wenger, 2002). To prevent the short and long term effects of stress, children may use coping strategies to manage or alter stressful life events (Lazarus & Folkman, 1984). This study explores the relationships between stress and sense of humor among school-age children. A sample of 106 students (and parents/guardians) in the San Diego Unified School District (SDUSD) returned self-report instruments packets containing the Multidimensional Sense of Humor Scale for Children, and the …

Female Collegiate Gymnasts And Experiences In Sport Retirement Due To Injury, Coleen Harrington Barry

Dissertations

There has been very limited research on sport retirement concerning the experiences that female collegiate athletes face when retiring from a sport due to injury. The purpose of this qualitative study was to explore, understand, and describe experiences that former NCAA Division I female gymnasts had when they retired from gymnastics, part-way through college, due to injury. The main objective of the study was to attempt to understand female collegiate gymnasts' sport retirement experiences and the impact these experiences may have had on their identity development and college experience. The study also considered female collegiate gymnasts' perceived needs and coping …

Radiographic And Functional Analysis Of Movement Allowed By Four Wrist Immobilization Devices, Timothy M. Mullen

Dissertations

Immobilization of the wrist is a common practice throughout the healthcare industry. The main forms of wrist immobilization are short-arm casts, prefabricated wrist splints, custom volar wrist splints, and custom circumferential wrist splints. It is generally accepted, by the medical community, that each form of immobilization allows for some movement. The amount each device allows is unknown. Establishing data that accurately describe the amount of mobility in each immobilization device will allow clinicians to make an evidence-based decision each time they are confronted with the need to order an orthosis.

The purpose of this study was to identify the specific …

An Educational Initiative To Promote Evidence-Based Practice, Laurel Ann Ecoff Phd, Ms, Rn, Nea-Bc

Dissertations

Evidence-based practice (EBP), recognized as essential in providing quality patient care and achieving optimal outcomes, is the integration of the best research evidence, patient preference, and clinician expertise. Healthcare providers must attain expertise in integrating EBP into the clinical setting. Fellowships are one strategy reported in the literature to assist nurses in acquiring needed knowledge and skills for evidence-based care. The purpose of the study was to evaluate the effectiveness of an educational intervention, the Evidence-Based Practice Institute (EPBI), to teach nurses the process of EBP for project implementation to improve nursing and patient outcomes. This descriptive study used a …

The Use Of Healing Touch In Adults With Hepatitis C Virus Receiving Interferon And Ribavirin: A Pilot Study, Margaret Ann Taylor Phd, Msn, Cns, Htcp/I

Dissertations

In the United States, an estimated 3.2 million individuals are infected with hepatitis C virus (HCV) the nation's most common chronic blood-borne viral infection. The number of deaths from HCV was predicted to triple within the next two decades. The most effective treatment for HCV is a combination of interferon and ribavirin; however, as many as 92% of patients experienced fatigue as a side effect. The severity of this symptom caused some patients to skip dosages or even stop the required medication regimen before it was completed. The primary purpose of this pilot study was to test the feasibility of …

The Contemporary Perspective Of Wellness Through The Voices Of The Kūpuna, Anne P. Odell Phd

Dissertations

Few studies successfully explain the decline of Hawaiian health, nor provide enough insight to the cultural determinants that affect Hawaiian wellness. For over two hundred years, Hawaiians have been influenced by a changing landscape mostly imposed upon Hawaiians and Hawaiian lands as a consequence of being conquered by powerful Western cultures. This grounded theory study utilized video elicitation and focus group methodologies to examine the perspective of wellness in a group of Hawaiian elders known as kūpuna. Following the viewing of a documentary film designed to elicit culturally based memories, a series of interview questions were asked to foster group …

An Exploration Of The Relationship Between Stress Physiological Signals And Stress Behaviors In Preterm Infants During Periods Of Environmental Stress In The Intensive Care Unit., Niang-Huei Peng

Dissertations

The purpose of this descriptive study was to examine relationships between stress physiological signals and stress behaviors in preterm infants during periods of environmental stress. The study used a repeated-measures design to examine the relationships between environmental stressors, sleep-wake states, and both stress physiological signals and stress behavioral responses in one group of preterm infants. Measurements of these variables for each preterm infant were recorded every two minutes during four 60-minute observation periods (two in the morning and two in the afternoon) conducted over two days (one morning and one afternoon observation each day). The sample was 37 preterm infants …

Combined Cognitive Behavioral Treatment Plus Caregiver Sessions For Childhood Depression, Dikla Eckshtain

Dissertations

Childhood depression is intimately related to the family context and caregiver-child relations, but only a limited number of treatment outcome studies for depressed youth have formally included members of the family in the intervention. To address this discrepancy the present study evaluated the efficacy of adding caregiver sessions to individual cognitive behavioral therapy (CBT) for the treatment of depressed youth. The treatment included 16 individual sessions and 7 caregiver sessions administered in the child's school to promote accessibility. Fifteen children (10 females and 5 males ranging in age from 8-13), who met inclusion criteria based on self-report and interview measures …

Intergenerational Communication: Its Effect On Early Screening Activities In African-American Adult Daughters Of Mothers With Breast Cancer, Rita R. Callahan Phd, Ma, Bsn, Rn

Dissertations

Health communication at numerous levels is vital to sustainability of healthy individuals. The notion of African-American mothers and adult daughters sharing breast health and breast cancer knowledge openly and honestly could be the initial step in addressing the high morbidity and mortality that continues to affect this population. Communication is a variable that has yet to be studied between African-American mothers diagnosed with breast cancer and their adult daughters. This study first examined whether this relationship existed, and secondly if it was strong enough in supporting and encouraging one another towards consistent breast health and breast cancer screening activities. The …

Perceptions Of Quality Of Life Of Latinos With Diabetes Living In The U.S.: Variations By Geographic Region Of Origin, Janice M. Long

Dissertations

The Latino population, the largest ethnic minority in the United States, is a diverse group originating from numerous geographic regions of Latin America. Latinos vary in the risk for type 2 diabetes, a condition that exacts a costly burden on those who suffer with it. With the Latino population diversity, diverse strategies are needed. One strategy is to improve outcomes of life quality by improving knowledge of those who deliver health services to Latinos with type 2 diabetes. Through measurement of quality of life (QOL), the more precious aspects of living, how one feels about living with diabetes, can be …

Spirituality And Symptom Self Management Of Osteoarthritis, Lois M. Kannan Phd

Dissertations

Healthcare providers need to identify holistic self-care techniques that are endorsed by patients as effective strategies for symptom management of osteoarthritis, which is the single most common cause of disability in older adults. Research in this area may direct the development of interventions to ensure that older adults are afforded every opportunity to remain active and productive, with an improved health related quality of life, despite age related musculoskeletal conditions. The purpose of this study was to describe the relationships among symptom experience, symptom management, and symptom outcome based on spiritual well-being. A quantitative, descriptive, correlational, and noninterventional study design, …

Transformations With Tai Chi: The Experience Of Community-Dwelling Tai Chi Practitioners, Sunny Yim Alperson Phd

Dissertations

While Tai Chi practice has dramatically increased across the U.S., its mechanism is unknown, and overall understanding of the phenomenon is lacking. The purpose of this study was to explore the experience of community-dwelling Tai Chi practitioners through a qualitative study, detailing its social and personal appeal, the reasons for their continued involvement, its symbolic meanings, and its impact on their lives. Utilizing the grounded theory method and dimensional analysis, in-depth interview data from 23 practitioners, aged 49-82 were audio-recorded, transcribed, coded and analyzed to derive a grounded theory. A theoretical model, transformation with moving meditation was developed, reflecting the …

The Impact Of Telemonitoring On Self-Efficacy, Emotional Well-Being, And Clinical Outcomes In Patients With Chronic Obstructive Pulmonary Disease Or Heart Failure, Jaclyn West-Frasier

Dissertations

Telemonitoring is the remote monitoring of patients' health status using telecommunications and information processing technologies. This pilot study analyzed data collected through a parent study that randomized 46 home health patients to either standard care (SC) or standard care with the addition of telemonitoring (TM). The telemonitoring device used in this study provided daily transmission of physiologic data and patients responses to questions about their disease and symptom management. Data analysis was completed to address the question whether telemonitoring, as part of standard home care for patients with chronic obstructive pulmonary disease (COPD) and patients with heart failure (HF), has …

Essential Novice Nurse Educator Role Competencies And Qualifications To Teach Ina Pre-Licensure Registered Nurse Education Program, Kathleen A. Poindexter

Dissertations

Expert nurse clinicians who are transitioning into academic positions after successful clinical careers often find they are unprepared to assume their new educator roles. While nursing clinical expertise may be a necessary expectation, the knowledge is not sufficient to assume a nurse educator position. Novice nurse educators prepared with the essential qualifications and competencies associated with the specialty role of a nurse educator will be better able to transition into their new academic roles. This study identified essential entry-level nurse educators' competencies and qualifications as reported by nursing administrators of accredited pre-licensure nursing programs across the United States.

This study …

Online Teaching Self-Efficacy Of Nurse Faculty Teaching In Public, Accredited Nursing Programs In The State Of Michigan, Kristi Adair Robinia

Dissertations

Nurse educators are being challenged to adapt to rapidly changing educational and health care environments. Higher education is under pressure to facilitate more web-based learning courses to reach wider markets of students. Nurse faculties are also being pressured to incorporate more technology into theory courses as a possible solution to a looming nation-wide nurse and nurse faculty shortage. Some faculty have enthusiastically embraced the new technology behind online teaching, while others remain concerned about online teaching effectiveness and course quality.

The purpose of this study was to examine variables that affect nurse faculty self-efficacy levels and participation in online teaching. …

A Study To Determine Factors That Inhibit Compliance With Engaging In Recommended Papanicoaou Smear Screenings In African American Women, Valecia Gail Carter-Vaughn

Dissertations

Papanicolaou (Pap) smear screenings help to detect abnormal cervical cells in the cervix. African American women are usually diagnosed in the later stages of cervical cancer. The purpose of this study was to determine factors that inhibit compliance with Pap smear screening in African American women.

Ninety-three African American women ages 18 or older, attending an urban health clinic participated in this descriptive design study to answer three research questions: 1) What factors inhibit compliance with recommended Pap smear screening in African American women age 18 or older? 2) Is there a difference between participants who attended the mobile clinic …

Use Of Monoclonal ∆-9-Tetrahydrocannabinol Antibodies Chemically Bound To A Polystyrene Surface Using Glutaraldehyde For The Purpose Of Extracting ∆-9-Tetrahydrocannabinol And ∆-9-Tetrahydrocannabinol Carboxylic Acid From Postmortem Whole Blood Samples For Analysis By Gas Chromatography Mass Spectrometry, Thomas Sidney Pittman

Dissertations

Quantitations of drugs and their respective metabolites in postmortem blood samples using gas chromatographic instrumentation is a primary analytical practice used to determine if drugs played a role in or were the cause of a victim's death. Postmortem blood samples often prove difficult to work with due to interfering substances formed during the putrefaction process. Attempts to eliminate interfering substances with present day extraction methods can be time-consuming, costly and often ineffective when dealing with drugs that exhibit toxicity or impairment at very low concentrations. This study was conducted using monoclonal antibodies chemically bound to a polystyrene surface to extract …

An Ethnography Study Of Hiv Positive Midlife Black Women, Charlotte Stoudmire Phd

Dissertations

Black women, ages 45 and older, are disproportionately affected by the HIV/AIDS epidemic. In 2001, Black women comprised 11% of all older women in the United States; however, they accounted for more than 50% of AIDS cases and more than 65% of HIV cases (Winningham et al., 2004). The literature review reflected little research specifically looking at the reason(s) for the increase in HIV in Black women, ages 45 to 60. Furthermore, few research studies focused on HIV patient health beliefs and their experiences in living with HIV. This study was conducted with an ethnography research method coupled with the …

The Rhetorical Strategies Of Pregnancy Support Centers Including The Visual Rhetoric Of Fetal Ultrasound Technology, Raymond Kyle Jones

Dissertations

This study examined the rhetorical strategies, including verbal and visual rhetoric, of pregnancy support centers that provide clients with fetal ultrasounds to persuade those who may be considering abortion as a means of resolving their unplanned pregnancy to carry to term. Qualitative data were gathered from 12 interviews of directors and ultrasound personnel from 7 states as well as from television advertisements and printed material. Eighteen research questions investigating the rhetorical transactions between centers and clients were answered. Rhetorical analyses were performed on the verbal and visual messages used in client interactions.

The grounded theory approach of inquiry resulted in …

The Effects Of Flaxseed Sdg On Perimenopausal Women With Mild Hyperlipidemia, Bonnie Marblestone Phd

Dissertations

In 2001, the National Cholesterol Education Program (NCEP) expanded their guidelines for evaluation and treatment of hyperlipidemia which includes not only a low cholesterol diet and exercise, but also the use of plant stanols such as Flaxseed and Soluble fiber. According to the NCEP III guidelines, women with mild hyperlipidemia and low risk cardiac factors would not qualify for drug therapy to control their cholesterol. However, the use of plant stanols could be used as an alternative. As there are limited studies involving postmenopausal women in regards to treatment of heart disease, there is virtually no information or research on …

Mortality Prognostication In Long-Term Care Residents: The Mds-Chess Scale, Caroline Etland Phd, Msn, Cns

Dissertations

Quality end of life (EOL) care for the elderly continues to be a challenge, in part due to late referral for palliative and/or hospice services. The purpose of this study was to determine the accuracy of the MDS-CHESS scale (Hirdes, Frijters & Teare, 2003) in predicting 6-month mortality in a stable American nursing home (NH) population. A secondary aim was to determine any differences in mortality between the 2 sites. A sample of 191 residents of two NHs was analyzed in a retrospective, correlational cohort study, using data collected from the federal MDS database. Correlational statistics and logistic regression were …

Predictors Of Re-Hospitalization For Home Healthcare Patients, Brenda Fischer Phd, Msn, Mba, Rn, Cphq

Dissertations

The overall purpose of this study was to examine the predictive capability of OASIS admission data for acute care re-hospitalization of home healthcare patients. Secondary data analysis using logistic regression was conducted on retrospective data from OASIS collected during the time period of July 1, 2006 to June 30, 2007. This study was conducted in a Medicare certified Home Health organization that is part of the largest public health system in California. The sample of 1802 patients with complete episodes of care was derived from a data set of 5,523 patients. All patients were included in the analysis and logistic …

Dyspnea: Effect Of Auricular Acupressure In End Stage Lung Cancer Patients, A Pilot Feasibility Study, Roger Alan Strong Phd

Dissertations

Introduction: Dyspnea is a debilitating symptom, common in advanced lung cancer patients, and poorly controlled. The National Institutes of Health has promoted the need for research regarding end of life care symptom control. Purpose: Conduct a feasibility study evaluating auricular acupressure effects on dyspnea in hospice lung cancer patients. Theoretical framework: The UCSF School of Nursing Symptom Management Faculty Group's Model for Symptom Management was used for the conceptual framework. The model includes three dimensions: symptom experience, symptom management strategies, and symptom outcomes. The Human Energy Field Theory provided context for using auricular acupressure. Aim: Conduct a pilot study evaluating …

A Quantitative And Qualitative Inquiry Into Moral Distress, Compassion Fatigue, Medication Error, And Critical Care Nursing, Jeanne Maiden Phd, Ms, Rn, Cns

Dissertations

A correlational embedded mixed method design was used for this study. A purposive sample of 205 critical care nurses (CCNs) provided quantitative data for the study. A focus group interview of five CCNs provided the qualitative data. The Moral Distress Scale (MDS), Professional Quality of Life Scale (ProQOL), and Medication Administration Error (MAE) Scale and demographics form were used to measure quantitative data. Quantitative findings included the majority of participants were female (91.7%); mean age 47 (SD = 7.91) years; mean years worked as a nurse was 23 (SD = 8.48); mean years worked on respective unit was 13.6 (SD …

Obesity Risk Knowledge, Self-Efficacy, And Physical Activity In Families Of Adolescents, Elaine M. Rutkowski Phd, Msn, Rn, Cns

Dissertations

There were no significant relationships found between parental obesity risk knowledge and physical activity in their children. nor between parent's self efficacy and their children's physical activity. In addition there was no significant relationship between the adolescents' obesity risk knowledge and their physical activity. There was, however, a statistically significant relationship between adolescent's self efficacy and physical activity. The result of the correlation between parent's self-efficacy and their level of physical activity was not significant but approached significance (p = .07) and may be identified as a trend. There was a statistically significant negative correlation between parents who describe their …

A Comparison Of Perinatal Care Providers' Use Of The National Institute Of Child Health And Human Development Standardized Terminology In Documentation Of Intrapartal Fetal Heart Rate Patterns, Faye M. Sigman

Dissertations

The purpose of this study was to determine if perinatal team members; nurses (RN) and primary care providers (PCP), were using the NICHD standardized terminology to document Fetal Heart Rate patterns during labor. Agreement in documentation of FHR and agreement in concept between the RN and PCP was also studied. A descriptive, comparative research design was used. Cohen?s Kappa statistics measured agreement in documentation of FHR patterns and Chi square measured agreement in concept, p< 0.05 for each. A retrospective medical records chart review was performed on 400 charts, meeting inclusion criteria, from three community hospitals. There were three data collection points and four criteria reviewed. This study found the use of NICHD terminology to document FHR alarmingly low (RN=51%; PCP=13%). It was used most often for decelerations (81%) RN, (22%) PCP, and least often for variability (19%) RN, (3%) PCP. Incomplete documentation was extremely high for the PCP (69%) and 81 charts (20%) had no FHR documentation. Agreement in documentation varied between the RN and PCP. They agreed most often on accelerations (81.4%) and least often on baseline rate (41.5%). When looking at all there points in time the RN and PCP agreed in documentation 59% but agreed in concept 78%. There were four areas where the RN and PCP agreed in their use of NICHD terminology: Accelerations on admission n=151, Kappa=0.091, p=0.007; variability during labor n=68, Kappa=0.27, p=0.015; variability prior to delivery n=33 Kappa=0.33, p=0.010, and decelerations during labor n=103, Kappa=0.16, p=0.018. Data from this study supports expanding this research, to identifying barriers to documentation. It also appears that education in use of NICHD terminology is needed.

Understanding The Relationship Between The Diligence Inventory-Higher Education Edition And The Myers-Briggs Type Indicator In The Admission Of College Students To An Orthopaedics-Based Honors Program, Michael A. Harstine

Dissertations

Problem. The Orthopaedic Scholar Institute (OSI) Team realized its need for a more objective selection and admission process that, as much as possible, quantified the characteristics desired in OSI students rather than relying solely on referral perception, intuition, and an interview, but it did not have a clear method or approach to do so. Administering standardized inventories that highlighted these desired characteristics and aided in the selection and admission process seemed to be an objective approach to obtain more quantifiable data. The problem for my study was, therefore, whether the Myers- Briggs Type Inventory (MBTI) alone could measure a student’s …