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The Relationship Between Narrative Informativeness And Psychosocial Outcomes In Chronic Stroke-Induced Aphasia, Eileen Armes, Jessica Richardson, Rick Arenas, Lori Nelson

Speech and Hearing Sciences ETDs

Currently there is a gap in the literature in understanding the relationship between the newly categorized primary outcome measure of discourse and secondary outcomes related to psychosocial impact, such as participation, psychological impact, social well-being, or mood. In a large sample of persons with stroke-induced aphasia (N=115), this study analyzed discourse samples using main concept analysis to determine how discourse performance correlates with the secondary outcome measures ALA, CCRSA, GDS, and CIQ. As a secondary research question, the differences in these relationships dependent on severity was also explored. Results showed statistically significant positive correlations between main concepts (MCs) and ALA …

Cold Storage Work And Cold Protective Gloves – A Review, Daena Charles

Theses

The rise of e-commerce and the increasing demand for online grocery shopping and delivery has prompted the growth of warehouse workers subjected to cold temperature working conditions. To ensure food safety and the preservation of inventory, majority of these e-grocery warehouses are cold storage with temperatures from 10°C to -23°C. Exposure to such cold working environments can have effects on the workers comfort, performance and health. As the demand for workers in cold temperature environments increases, it is important to understand how this environment affects the workers and the challenges it may present.

This review evaluates how working in cold …

Dexmedetomidine Use In The Pediatric Postoperative Patient With Emergence Agitation: A Systemic Review, Elizabeth Kittredge

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Emergence Agitation is a frequent complication in the pediatric postoperative population; with up to 80% incidence (Stamper, Hawks, Taicher, Bonta & Brandon, 2014). These patients will present with crying, overexcitement, thrashing, agitation and is seen within the first 30 minutes of emergence of general anesthesia (Mohkamkar, Farhoudie, Alam-Sahebpour, Mousavi, Khani & Shamomhammadi, 2014). Dexmedetomidine, a selective alpha 2 agonist, reduces norepinephrine output, initiates firing of inhibitory neurons such as the gama aminobutric acid system and reduces release of substance P and other catecholamines. These actions provide the patient with sedation, analgesia, and anesthesia (Nagelhout & Elisha, 2018). Due to the …

Deported Veterans: The Unintended Consequences Of “Good Moral Character”, Jonathan Deras

Master's Theses

The purpose of this research is to argue that U.S. immigration policy, specifically the 1996 IIRIRA (also known as IIRAIRA), needs to change regarding the legal treatment of immigrant U.S. military veteran deportees due to the following concepts. The first concept is to articulate how the criminalization of immigration, and how the military system intersects to facilitate the Deportation of U.S veterans. A key concept in this analysis is the standard of “good moral character” set by the U.S. government that enlistees need to meet to be accepted into the military; this standard is also used against immigrant veterans during …

Employee Wellness Pilot Program, Michelle Van Kirk

Nursing Doctoral

Background: Mental health professionals caring for the veteran population are at increased risk for compassion fatigue, burnout, and secondary traumatic stress based on the nature of their work. While mental health professionals may experience positive outcomes from providing compassionate care to veterans, compassion fatigue can lead to instability of the workforce. Methods: A pilot employee wellness program was implemented over a 9-week period, offering a different wellness module weekly during the employee lunch hour. Demographic data were collected pre-program, and mental health employees were surveyed pre- and post-program using an intent to stay scale and the Professional Quality of Life …

Charge Nurse Orientation, Angela Zafke

Nursing Capstones

Traditional undergraduate training focuses heavily on clinical skills with minimal emphasis on leadership. In practice, a nurse with clinical prowess is often promoted to the charge nurse position. Taking on the leadership role of a charge nurse can be a stressful experience without proper training and preparation that leads to burnout and turnover. With more experienced nurses facing retirement, now is the time to prepare future nursing leaders. This starts with adequately preparing a nurse to lead within the unit in the charge nurse role. A comprehensive literature review was conducted regarding charge nurse orientation. Charge nurse competencies were not …

Diversity: Lack Of African American Presence In Nursing Leadership, Dawn Carroll

DNP Qualifying Manuscripts

Aim. The purpose of this manuscript is to synthesize the literature on the paucity of African Americans in nursing leadership, the importance of inclusion, and the barriers to advancement.

Background. The nursing workforce does not reflect the population served. Minorities remain underrepresented in nursing and nursing leadership despite efforts to close the diversity gap.

Evaluation. The literature reviewed examined the lack of diversity in nursing and nursing leadership, perceived barriers to career advancement, and current efforts to diversify nursing leadership. Nine peer-reviewed, critically appraised studies are included.

Key Issues. Ensuring the nursing workforce represents the patient population served can …

The Reality For Minorities Exploring Nurse Executive Leadership Roles: An Integrated Review, Trarina Harris

DNP Qualifying Manuscripts

While nurses in direct patient care are serving a growing minority population, nurse executives are not racially representative of the patient population. This integrated review sought to understand the benefits of formal mentorship. Results included 2 themes: increasing diversity and self-efficacy through formal mentorship. The themes are explored in the literature. Implications for organizations and leaders will be discussed.

Language Concordance In Medicine And The Need For Medical Schools To Require Taking A Foreign Language As An Intervention Method To Minimize Language Barriers In The U.S., Mary K. Yousif

Honors College Theses

During medical school future student doctors are exposed to a multitude of patients, both natives and non-natives. However, there is no course offering (such as a foreign language or culture class) provided within the curriculum that prepares them for these future interactions. With communication being one of the primary skills used in healthcare, it is imperative to discuss the effects it can cause on a patient if not established. Overall, the goal of this research is to conduct a literary investigation regarding this matter and educate the medical community about the importance of providing effective communication in medicine. This begins …

Using Simulation For Oncology Nursing Competency Evaluation In Hospitals, Dana N. Littlepage

Doctor of Nursing Practice (DNP) Projects

Problem: Hospitals in an integrated health system, are experiencing low levels of oncologic admissions to their medical surgical units. This is creating a challenge for the organization to maintain nursing competencies for this subset of patients.

Context: In low volume, high risk acute care environments, where chemotherapy is to be provided, seasoned registered nurses grapple with maintaining their competencies, professional confidence and feeling safe enough to administer, monitor and care for this patient population (Muehlbauer, Parr, & Perkins, 2013). The purpose of this project was to ensure that both new and seasoned acute care oncology nurses have access …

Perioperative Advanced Directives, Derek Washer

Doctor of Nursing Practice Projects

Technology and surgical techniques continue to improve, resulting in more clients with advanced directives presenting to the operative suite for surgery or procedures requiring anesthesia. Anesthesia providers are in a critical position to discuss with the surgical patient or surrogate any alteration or reconsideration to their advanced directive. Unfortunately, patients and anesthesia provider discussions at a North Texas hospital were limited due to a knowledge deficit, an outdated hospital policy rescinding all directives perioperatively, and an inadequate consenting mechanism. The perioperative advanced directives project involved updating the hospital policy to current national guidelines and developing a “DNR Under Anesthesia” consenting …

Program Evaluation Of The Vapro Touch-Free Hydrophilic Intermittent Catheter In Hospitalized Patients Experiencing Urinary Retention, Dorothy Neufeld

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

A 319-bed hospital on the Florida Gulf coast revised their Bladder Care Bundle policy in September 2020. The document provided an algorithm to be followed to determine if intermittent urinary catheterization is warranted rather than an indwelling catheter to relieve urinary retention. Concurrently, this change included the introduction of a new product, Hollister’s VaPro Touch-Free Hydrophilic Intermittent Catheter which is considerably different from the traditional straight intermittent catheter previously utilized by the hospital. Its protective sheath and inducer tip are purported by the manufacturer to decrease the chance of contamination during insertion and thus reducing infection rates. A program …

Explicit Learning Of Auditory Categories In Preschoolers With And Without Developmental Language Disorder, Lauren Casey

University Honors Theses

This study a part of a broader study including Quam et al. (2020) and Yu (2020) with the aim of understanding how children with and without developmental language disorder learn language. With a better understanding of the underlying learning mechanisms affected in DLD, better interventions can be implemented. The current study investigates explicit language learning in preschoolers with and without developmental language disorder (DLD). This was done by observing sound discrimination and explicit sound-meaning mapping. One child with DLD and 29 children with typical language development (TLD) participated in this study. Inclusion in each group was determined by a hearing …

The Importance Of Nutrition Education As A Recovery Component For Individuals With Severe Mental Illnesses, Emily Martinez

Master's Projects and Capstones

In efforts to challenge the Western medicine’s determination of nutrition as a holistic approach, this paper represents the intent for mental health facilities in California to improve or implement nutrition education curriculum by enhancing interprofessional teams with dietitians as an important component of recovery for severe mental illness patients. There is concrete evidence proving that individuals who are in facilities recovering from mental illnesses have benefited from optimal nutrition consumption. Nutrition education has become a component among the toolbox of recovery options, but unfortunately it is not encouraged enough. Pharmaceutical companies advertise drug therapy as the most effective way to …

Imaging The Tumor Microenvironment Using 1,2-Dioxetane Chemiluminescence Agents, Lucas Ryan

Chemistry Theses and Dissertations

As complex organisms, animals and humans rely on a delicate interplay between many connected systems to maintain proper cellular and whole-body function. Oxygen regulation and homeostasis are vital for proper function in healthy cells, as are core components of aerobic metabolism and efficient ATP generation to supply our energy needs. Maintaining pH homeostasis is also of primary importance; cells maintain pH homeostasis through a host of active and passive transporters to maintain pH balance both inside and outside of the cell.

Events of uncontrolled cellular proliferation, also known as cancer, survive and thrive under conditions that perturb the delicate balance …

Implementation And Program Evaluation Pilot Study: Educating Health Care Providers About Protecting Population Health During Climate Change., Christine Fasching Maphis

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Recommendations regarding the need to prepare nurses and other health care providers (HCPs) for the health impacts of climate change (CC) have grown ubiquitous in the literature. Timely, efficient and sustainable strategies by the health care industry are necessary. Failure to act is predicted to result in catastrophic and lethal population health consequences. A growing body of research identifies related knowledge gaps and supports HCP competencies and best practice interventions to mitigate adverse population health impacts of CC. A social ecological framework and the PRECEDE-PROCEED approach were employed to develop and evaluate a series of online webinars designed to equip …

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …

What Methods Can The Health Care Industry Implement To Reduce Energy Consumption And Waste Production From Patient Care To Limit Greenhouse Gas Emissions?, Danielle H. S. Good

Senior Honors Projects, 2020-current

Purpose: Climate change is a growing issue all around the world and has negative impacts on the environment and human health. The health care industry is a significant contributor to greenhouse gas emissions amplifying climate change. Health care establishments are in place to improve health but are inadvertently harming it at the same time. Methods:A review of the literature was conducted to determine the impact the health care industry has on climate change and what can be done to limit the impacts on the environment. Resources were collected from trusted organizations databases such as Healthcare Without Harm, …

Opioid Free Anesthesia, Sarah Medina

Doctor of Nursing Practice Projects

Patients undergoing surgery are often given opioids intraoperatively. Administration of opioids is associated with untoward side effects that include nausea, respiratory depression, constipation, ileus, hyperalgesia, prolonged length of stay, and the potential for dependence (Garimella & Cellini, 2013). Emerging research on the topic of opioid-free anesthesia (OFA) is available and indicates several benefits of OFA, including reduction in postoperative pain, reduction in postoperative nausea and vomiting, reduction in postoperative shivering, and improved oxygen saturation levels (Mulier et al., 2018). This quality improvement project aimed to advance anesthesia providers' understanding of OFA by creating an OFA guideline and providing a learning …

Cultural Competency Training For U.S. Army Security Force Assistance Brigade (Sfab) Brigade Medical Teams, Jacob Blount

Doctor of Nursing Practice Projects

The United States Army began standing up Security Force Assistance Brigades (SFAB) in February 2018. The Brigade Medical Team (BMT) is an 11-person, interdisciplinary Army National Guard team. National Guard Soldiers only have one weekend per month and two weeks of annual training per year to develop/maintain cultural competence. The researcher investigated the efficacy of the Cross-Cultural Competence Trainer (3CT) V2 course to develop and maintain cultural competency in BMT personnel. Pre-test results were obtained from three military medical personnel and a post-test immediately after the course. Participants completed a longitudinal test 28-31 days after the post-test. There was a …

The Effects Of Maternal Delta-9-Tetrahydrocannabinol And Cannabidiol Exposure On Fetal Heart Development In Mice, Gregory Robinson

Electronic Thesis and Dissertation Repository

Up to 22.6% of pregnant women consume cannabis during pregnancy despite the uncertainty of teratogenicity of the main ingredients in cannabis, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). This study tested the hypothesis that gestational THC and CBD exposure leads to heart abnormalities. Daily, oral THC exposure induced heart abnormalities in 68% of offspring with three main phenotypes including thickened semilunar valves, ventricular myocardial hypertrophy and hypoplastic coronary arteries in fetuses, and postnatal cardiac dysfunction. Altered gene expression of key cardiogenic regulators, increased proliferation, and reduced epicardial epithelial-to-mesenchymal-transition were demonstrated implicating potential mechanisms responsible for these abnormalities. Also, maternal CBD exposure resulted …

Trust In The Nurse And Perceived Quality Nursing Care By Adult Oncology Patients With Implantable Vascular Access Port Devices: A Mixed Methods Study, Lois Rajcan

Electronic Theses and Dissertations

Objective: The purpose of this study was to obtain an understanding of nurse behaviors that promote trust and quality nursing care as perceived by oncology patients with totally implantable vascular access devices (TIVAD).

Methods: An explanatory sequential mixed-method design was used to answer the study questions. This design was comprised of two phases: 1) a quantitative online survey of oncology patients with TIVADs followed by; 2) qualitative interviews using purposively selected patients from the survey sample.

Results: Trust in the nurse and perceived quality of nursing care by patients with TIVADs were determined to be of average levels. Two qualitative …

Pharmacological Characterization Of Novel Serotonin Transporter Inhibitors Identified Through Computational Structure-Based Virtual Screening, Michael Wasko

Electronic Theses and Dissertations

Depression is a mental health disorder affecting greater than 350 million people worldwide with roughly 7% of the United States population diagnosed as of 2017. The selective serotonin reuptake inhibitors (SSRIs) have been the mainstay of pharmacotherapies for depression for the last 40 years. The SSRIs target the serotonin transporter (SERT), a monoamine transporter (MAT) responsible for terminating serotonergic neurotransmission. The SSRIs are not perfect therapeutics and suffer from delayed response times, inconsistent efficacy among patients, and often produce intolerable side effects. Therefore, a strong need exists to develop new antidepressants that are more efficacious and have fewer adverse effects. …

The Ethical Accountability Of Organizational Leadership To Communities Of Stakeholders In Healthcare, Lisa Martinelli

Electronic Theses and Dissertations

ABSTRACT

THE ETHICAL ACCOUNTABILITY OF ORGANIZATIONAL LEADERSHIP TO COMMUNITIES OF STAKEHOLDERS IN HEALTHCARE

By

Lisa A. Martinelli, JD, MA

October 2020

Dissertation supervised by Professor Gerard Magill

While much is written on organizational ethics in healthcare, this dissertation uniquely links organizational ethics and stakeholder theory to the ethical accountability of leadership to their distinct, vulnerable stakeholder communities. It does so by examining the healthcare organization’s moral agency in relation to stakeholder theory and applies those considerations to three major stakeholder categories: confidentiality and privacy of healthcare information, research and attention to specific pediatric populations, and ethics of care concerning the …

Examining The Intersectionality Of Religious Faith, Spirituality, And Healthcare Communication, Felix Okeke

Electronic Theses and Dissertations

This dissertation is my own contribution in responding to the concern raised by certain communication scholars. Their concern was that little research and few publications have been done in the communication field by communication scholars that trace the relationship among religious faith, spirituality, and healthcare communication. While Parrott (2004) describes this apparent neglect as “collective amnesia,” others label it “religion blindness.” Thus, in trying to trace this relationship, this project uses Christian, biblical, and bioethics backgrounds to establish the value, sacredness, and dignity of human life, since these concepts make healthcare and healthcare communication necessary in the first place. These …

Retrospective Cohort Study Of Patients With Chronic Low Back Pain In An Outpatient Pain Specialist Clinic, Gauri Desai

Electronic Theses and Dissertations

Background: Chronic low back pain (LBP) is a back pain that lasts for three or more than three months in the lumbar region of the spinal cord. A nerve injury or damage in the spinal cord region (neuropathic pain) requires multimodal treatment approach for pain reduction. With various treatment options utilized in the pain management of these patients, identifying demographical and clinical characteristics of patients with chronic LBP utilizing interventional procedures and pharmacologic treatments is imperative.

Objective: (i) To describe the demographics (age, gender, race, ethnicity, smoking status, alcohol consumption status, drug use status) and clinical characteristics (procedures, medications) …

Design And Synthesis Of Pyrimidine Based Fused Heterocyclics In The Potential Treatment Of Cancer And Opportunistic Infection, Farhana Islam

Electronic Theses and Dissertations

Dose-limiting toxicities of clinically used agents and development of resistance are two significant limitations in cancer chemotherapy. Microtubule targeting agents (MTAs) are a structurally diverse set of compounds that disrupt microtubule dynamics and exert their anticancer effect. Combination chemotherapy with antiangiogenic agents and microtubule targeting agents has shown an advantage against both these drawbacks. Single agents with dual antiangiogenic activity and cytotoxicity would afford a therapy that circumvents pharmacokinetic problems of multiple agents, avoid drug-drug interactions, lower the drug dose, decrease overlapping toxicities, and delay or prevent tumor cell resistance. The work in this dissertation reflects the progress of fused …

Facemasks For Source Control: Testing Influenza Transfer To Bedside Tables, Adriane M. Biggio

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The idea of using facemasks for source control is not new. The concept has been published since 1918 during the Spanish Flu. However, there is limited research testing human subjects on the effectiveness of facemasks in preventing influenza transfer or transmission. The objective of this study was to answer the question, “In influenza-positive Veterans, what is the effect of facemask wearing in comparison to not wearing a facemask on influenza transfer to bedside tables measured for two hours per condition over a ten-week time frame during the 2019/2020 influenza season?” A quasi-experimental evidence-based project pilot study design was used. …

Pulling Heart Strings: Quality Improvement Algorithm For Temporary Epicardial Pacing Wire Removal Post Cardiac Surgery, Jessica Norman

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The placement of temporary epicardial pacing wires (TEPW) is considered standard practice post cardiac surgery and is dependent on the patient’s cardiac function intra-operatively and their electrophysiologic profile after weaning from cardiopulmonary bypass (Reade, 2007; Elmistekawy et al, 2016). Complications associated with TEPW removal include myocardial damage, infection, perforation, tamponade, disruption of anastomoses, ventricular arrythmias, and death (Bojar, 2009; Carroll et al, 1998;Timothy & Rodeman, 2004). Currently there is no standard practice on the removal of TEPW and there is wide variation in removal practices involving patients who are routinely on medications such as dual antiplatelet therapies and systemic anticoagulation. …

Postpartum Depression: Educating The Provider And Staff About The Importance Of Screening, Referrals, Follow-Up And Adherence To The Maternal Mental Health Safety Bundle Toolkit, Natalie Regis

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Postpartum depression (PPD) affects approximately 10%-20% of women after childbirth. PPD is a disabling condition that can have serious health implications on mothers and their infants. Experts estimated that only 50% of women with PPD are diagnosed. Lack of education about screening practices can cause the disorder to go undiagnosed and untreated.

Purpose: The purposes of this quality improvement (QI) project were 1). To increase the provider and staff knowledge about the importance of screening with the implementation of a standardized screening tool 2). To increase PPD screening rates to 100% 3). To increase appropriate referrals to mental …