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Creating A Structural Empowerment Culture: A Professional Development Module For The Novice Nurse Leader, Beth A. Hock

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nursing leadership shoulders the responsibility for the performance of their nurses (McNeeseSmith, 1992). When a nurse leader creates a culture of structural empowerment, the work environment is more likely to produce higher quality patient outcomes and highly satisfied healthcare consumers. Novice nurse leaders are often ill-equipped early in their careers to forge a structural empowerment culture. Unfortunately, education programs to address the developmental needs related to structural empowerment do not seem to exist. Incorporating the theoretical underpinnings from Kanter theory (1977, 1993) and the Donabedian model (1966) to create an educational tool for the novice nurse leader in learning how …

Treatment Option Decision Making For Low-Grade Prostate Cancer, Janene Caldwell Witherite

Physician Assistant Scholarly Project Papers

Prostate cancer (PCa) is the second most common cancer, behind skin cancer, among men, in the United States (Centers for Disease Control and Prevention [CDC], 2019.). PCa is defined as low-grade or low risk if the neoplasm grows slowly or not at all. According to the Institute for Quality and Efficiency in Health Care, (2020), to make the conclusion that a PCa is low-grade, several tests are performed including a prostate specific antigen (PSA) level, a Gleason score, and a TNM score, which refers to tumor size, lymph node involvement, and metastasis outside the prostate. Low-grade PCa is further defined …

The Effects Of Language Barriers With Hispanic Patients In The Nashville, Rachel Poston

Honors Scholars Collaborative Projects

The existence of language barriers in the health care setting is a vital topic of study. This study assesses language barriers from the perspective of nurse-patient relationships, focusing on the Hispanic patient population in the Nashville, Tennessee area. A survey was designed using the Theory of Bureaucratic Caring by Marilyn Ray (2006) to investigate the current success, according to nursing perspectives, of healthcare facilities support of Hispanic patients to ensure quality outcomes and comprehension of care. The research design for this study was a non-experimental, descriptive study using a cross-sectional survey. The researcher used themes from the Theory of Bureaucratic …

Effectiveness Of An Aquatic Exercise Program For Reducing Weight, Body Fat And Chronic Low Back And Joint Pain, Terilyn Darley

Doctor of Nursing Practice Scholarly Projects

According to the World Health Organization (WHO), obesity has risen at an alarming rate and has reached epidemic proportions throughout the world (WHO, 2017). In the U. S., approximately 93.3 million U.S. adults are obese with an overall prevalence of 39.8 %. Chronic pain is another public health issue in the U.S, affecting almost 100 million people and is associated with significant annual healthcare costs and lost productivity (National Center for Complementary and Integrative Health [NCCIH], 2017). Exercise is considered one of the most effective prevention strategies for reducing obesity and has been documented to decrease chronic pain. The purpose …

Spatial Patterns In Socio-Economic Factors And Rapid Repeat Pregnancies In Kalamazoo County, Mi, Dennis Donkor

Masters Theses

Rapid repeat pregnancy (RRP) refers to a pregnancy that occurs less than 24 months after a live birth. In the United States, several studies have focused on factors that influence women to rapidly repeat pregnancies at the national and state level. As a result, this study explores spatial patterns in RRP in Kalamazoo County at the block group local level using birth records of moms in the county from 2008 to 2014. The study further investigates individual and neighborhood factors influencing RRP. Results from the hotspot (Getis Ord G*) revealed that block groups in eastside Kalamazoo township are significant hotspots …

Prospects For Finding The Mechanisms Of Sex Differences In Addiction With Human And Model Organism Genetic Analysis., Udita Datta, Sarah E Schoenrock, Jason A. Bubier, Molly A. Bogue, James D Jentsch, Ryan W Logan, Lisa M Tarantino, Elissa J Chesler

Faculty Research 2020

Despite substantial evidence for sex differences in addiction epidemiology, addiction-relevant behaviors and associated neurobiological phenomena, the mechanisms and implications of these differences remain unknown. Genetic analysis in model organism is a potentially powerful and effective means of discovering the mechanisms that underlie sex differences in addiction. Human genetic studies are beginning to show precise risk variants that influence the mechanisms of addiction but typically lack sufficient power or neurobiological mechanistic access, particularly for the discovery of the mechanisms that underlie sex differences. Our thesis in this review is that genetic variation in model organisms are a promising approach that can …

Identification Of A Novel Disorder With Cholestasis, Liver Fibrosis And Congenital Diarrhea Due To Organic Solute Transporter Alpha Deficiency, Emily Gao

Yale Medicine Thesis Digital Library

BACKGROUND: Much of our understanding of normal liver pathophysiology comes from studying patients with liver disease who remain undiagnosed after a comprehensive workup. Searching for diagnoses among such cohorts has benefits both for the underserved patients with idiopathic liver disease, but also for science as a whole. Unbiased genomic analysis of patients with undiagnosed disease has yielded remarkable results, including clinically actionable diagnoses in children and adults, as well as the discovery of novel genetic diseases. Thus, we posit that among pediatric patients with undiagnosed liver disease, there may be previously unrecognized Mendelian causes.

METHODS: We report a 2.5 year …

An Evaluation Of The Advance Directives-Live Action Simulation Training (Ad-Last) Program, Alexandra Rosa Spinelli

Theses and Dissertations

Advance Care Planning (ACP) is a process that captures a patient’s wishes in the case of future circumstances in which they are unable to express them. Studies show that less than one third of the general population has completed some type of formal Advance Directive (AD). There are barriers to completing ADs, and these barriers operate on multiple levels, including, patient, provider and institutional. To improve providers’ capacity to help patients complete ACP, and overcome these barriers, a provider-focused intervention was conducted. The current study is an analysis of archival data collected from the Advance Directives-Live Action Simulation Training (AD-LAST) …

Correlations To Financial Performance In The Pharmaceutical Industry, Fred Mcclellan

Walden Dissertations and Doctoral Studies

There exist conflicting priorities for leaders when considering ethical leadership behaviors and organizational financial performance. The purpose of this quantitative study was to examine correlations between top manager ethical leadership levels and organizational financial performance, within the pharmaceutical industry. The Ethical leadership theory was used to frame the study. Relationships between top managers’ perceived ethics levels and organizational financial performance were studied, as well as, whether top managers’ practices, purposes, and virtues acted as mediators. A goal of 184 participants were recruited from 338 pharmaceutical companies. Five top managers and 17 of their direct report team members took part in …

Factors Affecting Adherence To Diabetes Management Recommendations Among Afro-Caribbean Farm Workers, Aretha Meritian Townsend

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) is a global epidemic, impacting the economy and quality of life of affected individuals. The treatment and management of the disease often rely heavily on self-efficacy and provider guidance. Adherence to provider treatment regimens can help to prevent T2DM-related complications. However, non-adherence to T2DM regimens is a growing concern among minority populations, where T2DM is highly prevalent. Limited research is available for the Afro-Caribbean migrant farmworker (ACMF) with high rates of diabetes and an alarmingly high rate of non-adherence to treatment recommendations which is further complicated by low literacy, common cultural practices, and poor diets. …

Examining The Impact Of Baldrige On Hospital Performance, Jennifer O. Strahan

All ETDs from UAB

The national Baldrige program has supported performance excellence within healthcare for over twenty years, yet it has seen recent declines in the number of applications despite Baldrige award recipients claiming noteworthy improvements across operational, clinical, and financial outcomes. Previous studies have compared Baldrige hospital recipients to non-recipients, but no studies have empirically investigated the value of pursuing the Baldrige award, regardless of award recognition or not. Furthermore, it is unclear if specific categories of the Baldrige Excellence Framework (BEF) are associated with standardized industry performance outcomes. This study used propensity score matching with linear and quantile regression techniques to understand …

Health Outcomes Associated With Gulf War Illness, Shannon K. Barth

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background:

Nearlythirty years after the 1990-1991 Persian Gulf War a definitive case definition for Gulf War Illness (GWI) is lacking. The objective is to explore health outcomes associated with GWI using currently accepted classifications in order to better understand GWI by examining pre-war medical conditions as predictors of probable GWI, mortality outcomes of veterans with probable GWI, and female-specific medical conditions among women with probable GWI. Additionally, we utilize an alternative GWI case definition.

Methods:

Data come from theDepartment of Veterans Affairs (VA)1995-1997 National Health Survey of Persian Gulf War Era Veterans, a population-based survey of deployed …

Historic And Contemporary Use Of Catfish Aquaculture By Piscivorous Birds In The Mississippi Delta, Paul C. Burr, Jimmy L. Avery, Garrett M. Street, Bronson K. Strickland, Brian S. Dorr

United States Department of Agriculture Wildlife Services: Staff Publications

Piscivorous birds are the primary source of catfish (Ictalurus spp.) depredation at aquaculture facilities in northwestern Mississippi. Of particular concern is the Double-crested Cormorant (Phalacrocorax auritus), which can cost aquaculture producers millions of dollars annually through the depredation of cultured fish. Historical research conducted in the early 2000s estimated cormorant use of aquaculture ponds in the region, but aquaculture area has decreased by more than 70% since those estimates were made. With less aquaculture available, we predicted cormorant densities on aquaculture would be greater today than historically. Applying a similar methodology as in historical studies, we used …

Population Pharmacokinetics Of Ribavirin In Lung Transplant Recipients And Examination Of Current And Alternative Dosing Regimens, Eliza Milliken

Theses

Ribavirin is used in the treatment of respiratory paramyxovirus infection in lung transplant recipients; however, its pharmacokinetic profile in the transplant population is unknown despite the potential for alterations due to underlying pathology. Furthermore, the ability of current regimens to meet exposure targets has not been established. This study examined the pharmacokinetics of ribavirin in a lung transplant population from which current and alternate dosing regimens were assessed. Population pharmacokinetic modelling was conducted in NONMEM using concentrationtime data from 24 lung transplant recipients and 6 healthy volunteers. Monte Carlo simulation was used to assess the ability of dosing regimens to …

The Impact Of Faculty Bullying On Associate Degree Nursing Students, Angela M. Vitale

Walden Dissertations and Doctoral Studies

Bullying is prevalent in the profession of nursing, impacting the quality of health care and health care costs. The foundation of bullying, in the profession of nursing, may be attributed to bullying behaviors in nursing academia among nursing faculty and nursing students. Using Bandura’s social learning theory, the purpose of this study was to determine the relationship between bullying behaviors of nursing faculty and bullying behaviors of nursing students in associate degree nursing programs. Seventy-one randomly selected registered nurses who graduated from associate degree nursing programs in the past 5 years completed an online Incivility in Nursing Education-Revised survey. Spearman’s …

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Eftilagimod Alpha, A Soluble Lymphocyte Activation Gene-3 (Lag-3) Protein Plus Pembrolizumab In Patients With Metastatic Melanoma, Victoria Atkinson, Adnan Khattak, Andrew Haydon, Melissa Eastgate, Amitesh Roy, Prashanth Prithviraj, Christian Mueller, Chrystelle Brignone, Frederic Triebel

Research outputs 2014 to 2021

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. BACKGROUND: To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of eftilagimod alpha (efti), a soluble lymphocyte activation gene-3 protein, in combination with the programmed cell death-1 (PD-1) antagonist pembrolizumab. METHODS: The study was divided into two parts; parts A and B, where part A was the dose escalation part and part B was an extension part of the study. Patients with metastatic melanoma were treated with efti plus the standard dose of pembrolizumab. Blood samples were assayed to determine …

Attrition And Psychotherapy, Jesse Barrington Homan

Dissertations and Theses

Attrition in psychotherapy, also known as dropout, is a problem that affects clients who terminate, their families, therapists, mental health systems, and the overall community. Research on attrition is vast. However, the majority of this research has been done post hoc, relied on quantitative methods, and looked primarily at client demographic variables as the predictors of attrition. This has resulted in inconsistent findings, offers little to no useful information about attrition, and appears to blame clients for failed therapy. There has been little research on attrition from the perspective of clients who terminate. This study was designed to answer the …

Noninvasive Ventilation Protocol Development, Janise Pierce Tinsman

Doctoral Dissertations and Projects

Endotracheal intubation results in many serious complications including regurgitation, vocal cord paralysis, and death. Noninvasive ventilation using bi-level positive airway pressure has been shown to provide the necessary support without intubation and is also associated with better outcomes if trialed prior to endotracheal intubation. A noninvasive ventilation protocol was applied in a rural acute care facility. Results: The average length of stay for acute respiratory failure decreased from 5.32 to 4.44 days, while intubations fell from 41.9% to zero, and mortality fell from 9.7% to zero during the pilot period. Five cases met criteria for noninvasive ventilation, and three received …

Apples To Apples? Neural Correlates Of Emotion Regulation Differences Between High- And Low-Risk Adolescents, Michael T Perino, João F Guassi Moreira, Ethan M Mccormick, Eva H Telzer

2010-2019 OA Pubs

Adolescence has been noted as a period of increased risk taking. The literature on normative neurodevelopment implicates aberrant activation of affective and regulatory regions as key to inhibitory failures. However, many of these studies have not included adolescents engaging in high rates of risky behavior, making generalizations to the most at-risk populations potentially problematic. We conducted a comparative study of nondelinquent community (n = 24, mean age = 15.8 years, 12 female) and delinquent adolescents (n = 24, mean age = 16.2 years, 12 female) who completed a cognitive control task during functional magnetic resonance imaging, where behavioral inhibition was …

A Preliminary Historical Report On Embracing Online Education In Occupational Therapy, Janel Anne Belarmino, Angela Bahle-Lampe

The Open Journal of Occupational Therapy

The relevance and popularity of online occupational therapy education have been increasingly recognized. This paper describes the historical development of online occupational therapy education. Findings revealed three shifts in occupational therapy education, namely shifts in perception, in mode of instruction, and in the roles of teachers and students. The inception of online education in occupational therapy was a product of technological advancement and the demand for improved access to occupational therapy online education. The early phase of occupational therapy online education was confronted with challenges related to hesitance in the development and implementation of online programs and to negative perceptions …

Homelessness And Hospitality On The Ground, A Methodological Proposal For Catholic Social Teaching, Daniel Pilario

Journal of Vincentian Social Action

What resources, perspectives and experiences can we draw from formal Catholic Social Teaching and broader Catholic social thought to help us understand and interpret street homelessness in a global context? This article is intended to be an invitation to share narratives of hospitality on the ground vis-à-vis the problem of homelessness in the global world. Unlike top-down approaches, there are no clear principles to be applied; only concrete stories with all their frictions, ambiguities and difficulties hoping that God’s inspiration can reveal itself on the rough grounds where people walk in fidelity to the Gospel.

Improving Patient Education On Spinal Anesthesia: An Assessment Of A Patient Educational Program, Nicholas Raburn

Doctor of Nursing Practice Projects

Abstract

Spinal Anesthesia (SA) is a common type of anesthesia that is frequently used for surgeries of the lower abdomen, lower extremities, and perineal area. Spinal anesthesia offers fewer side effects and risks than General Anesthesia (GA). Patients usually recover their senses much faster with SA (MedlinePlus, 2017). Some patients often refuse SA due to fears and misconceptions. These misconceptions are related to a lack of education and resources available to patients. It is crucial that anesthesia providers learn to adequately educate patients preoperatively on the use of SA. Anesthesia providers in a community hospital in southern Illinois educated patients …

Living As A Dying Child: A Gadamerian Analysis Of The Poetry Of Mattie J. T. Stepanek, Corinne Ann Settecase-Wu

Dissertations, Theses, and Capstone Projects

Yearly, approximately 500,000 children live with life-limiting conditions in the United States; 50,000 die. Yet, details regarding children’s days of living as dying are unknown. The aim of this qualitative hermeneutic study is to gain understanding of the phenomenon of living as a dying child. A Gadamerian-inspired approach was implemented to underpin the study, and to analyze poetic text to address the research question: What is it to be living as a dying child? The text sample included 499 poems written by Mattie J. T. Stepanek, a dying child. The Settecase-Wu Conceptual Guide was developed and implemented to ensure accuracy …

Physician Stress: Is The Electronic Health Record To Blame?, Zack Ward

Dissertations

The purpose of this study was to explore the potential relationship between Family Medicine physician burnout and the electronic health record. To do so, this study utilized the Copenhagen Burnout Inventory to assess burnout among physicians, along with specific questions regarding usage of the electronic health record and measurement of physician perceptions of the electronic health record. Members of the Kentucky Academy of Family Physicians were sent two separate invitations to participate in the study twice over a one-month period via email.

The study yielded no significant differences in Family Medicine physician demographics and their degree of burnout, or the …

The Oculocardiac Reflex And Depth Of Anesthesia Measured By Brain Wave., Robert W Arnold, Aleah N Bond, Melissa Mccall, Leif Lunoe

Articles, Abstracts, and Reports

BACKGROUND: The oculocardiac reflex (OCR), bradycardia that occurs during strabismus surgery is a type of trigemino-cardiac reflex (TCR) is blocked by anticholinergics and enhanced by opioids and dexmedetomidine. Two recent studies suggest that deeper inhalational anesthesia monitored by BIS protects against OCR; we wondered if our data correlated similarly.

METHODS: In an ongoing, prospective study of OCR/TCR elicited by 10-s, 200 g square-wave traction on extraocular muscles (EOM) from 2009 to 2013, anesthetic depth was estimated in cohorts using either BIS or Narcotrend monitors. The depth of anesthesia was deliberately varied between first and second EOM tested.

RESULTS: From 1992 …

A Staff Training Plan On Screening African Americans For Prediabetes, Valerie Kershaw-Berry

Walden Dissertations and Doctoral Studies

African American adults have higher risks of undiagnosed Type 2 diabetes, uncontrolled Type 2 diabetes, and complications from Type 2 diabetes than members of other racial groups. Health care providers in rural Tennessee lack staff training plans for prediabetes screening of older African American adults. In addition, few rural Tennessee health care providers have programs in place to train staff in prediabetes screening, screening instrument use, and interventions for Type 2 diabetes prevention. The focus of this DNP project was on developing an evidence-based staff training program designed to improve knowledge regarding prediabetes screening in older African American adults. Concepts …

Preconception Health And Preterm Birth Differences Among U.S.-Born And Foreign-Born Black Women, Sheree Holmes Keitt

Walden Dissertations and Doctoral Studies

Foreign-born Black women giving birth in the United States have superior preterm birth outcomes compared to their U.S-born Black peers. Many studies have focused on tobacco use and medical risk factors, but few have focused solely on preconception health. The purpose of this study was to examine preconception health and preterm birth differences among U.S.-born and foreign-born Black women. Three theoretical frameworks guided this study: the life course theory, healthy migrant theory/immigrant paradox, and weathering theory. Primary research questions assessed (a) if there were an association between chronic preconception risk factors, prepregnancy obesity, diabetes, and hypertension, in U.S.-born and foreign-born …

Demographic, Behavioral, And Cultural Factors On Chlamydia Trachomatis Infection, Philis Grace Palmer

Walden Dissertations and Doctoral Studies

Chlamydia trachomatis is a sexually transmitted disease, and its incidence has been increasing in recent years in the U.S. population. Certain demographic factors have been identified as posing an increased risk to acquire this disease. The purpose of this mixed-methods research was to examine how population demographics (quantitative section) and cultural and behavioral factors (qualitative section) affect risk for contracting chlamydia trachomatis in the Miami-Dade, Florida area. The theory of reasoned behavior was the theoretical framework of the study. The quantitative component used secondary data from Jackson Health System (2012- 2018) pertaining to 333 Miami-Dade young adult individuals with incidents …

Gaps In Mental Healthcare Use And Perceived Quality Between Privately Insured Lgb And Heterosexual Individuals In The United States, Yuki Hayashi

Public Health Theses

Previous research has identified significantly heightened levels of mental health issues and psychological distress among lesbian, gay, and bisexual (LGB) individuals in the U.S., as well as greater mental health service utilization among this population. Using a nationally representative sample of privately insured adults in the U.S., we investigate differences in mental healthcare utilization, characteristics of mental healthcare received, and perceived quality of care between LGB and heterosexual individuals. Key results find that privately insured LGB men and women are significantly more likely than their heterosexual counterparts to have used outpatient mental healthcare as well as out-of-network (OON) outpatient mental …