Veteran Specific Risk Factors For Delirium, Allison Perkins

Dissertations

Purpose/Aims: This study explored the relationships between military characteristics such as combat experience, mental health issues such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), depression, anxiety and substance use disorder (SUD), physical comorbidities such as coronary artery disease (CAD), other risk factors, and delirium diagnosis among hospitalized veterans.

Background: Delirium is a common disorder experienced by 25% of all hospitalized adults 65 years and older. No published studies to date have examined whether combat, TBI and PTSD are associated with the incidence of delirium in the hospitalized veteran.

Methods: A retrospective cross-sectional cohort design with a sample size …

Frailty And Post-Operative Outcomes In Adult Hip Fracture Patients, Melissa Yager

Dissertations

Abstract

Background/ Purpose: The majority of adult hip fracture patients never return to their pre-fracture functional level and have a poor quality of life (Kistler, Nicholas, Kates, & Friedman, 2015; Pioli et al., 2016; Sheehan et al., 2018). The prevalence of frailty in adult hip fracture patients is estimated at 51%. Frail patients with hip fractures are twice as likely to have a complication (Kistler et al., 2015). Extant studies have examined frailty and hip fractures independently, nonetheless, a gap in the literature exists with few investigations of the connection between frailty and post-operative outcomes after hip fracture. The purpose …

The Effect Of The Rapid Assessment For Adolescent Preventive Services (Raaps) In Improving The Style Of The Exchange Of Information And Balance Of Power During A Health Care Visit In A Pediatric Primary Care Setting, Brandi Snyder

Dissertations

It is estimated that more than 70% of illnesses, disabilities, and deaths among the adolescent population are related to adolescent high-risk behaviors. Adolescent high-risk behaviors include those that contribute to unintentional injuries and violence, sexual behaviors related to unintended pregnancies and sexually transmitted infections, alcohol and other drug use, tobacco use, unhealthy dietary behavior, and inadequate physical activity. Despite national recommendations, many providers remain reluctant to implement standardized screening tools that have been created to prevent and identify these behaviors. Studies have shown that a comprehensive preventative risk assessment, such as the Rapid Assessment of Adolescent Preventive Services (RAAPS) used …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Jean Nichols

Dissertations

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

La Maestra’S Circle Of Care: Studying The Impact Of An Integrated Service Model On The Health And Well-Being Of Vulnerable Populations, Zara Marselian

Dissertations

ABSTRACT

There is an urgent need to reform the health care delivery system in the United States, as recognized through current bipartisan efforts. Society’s vulnerable populations especially need health care reform as health care outcomes are the poorest among disadvantaged populations. Moreover, vulnerable populations are twice as likely to develop chronic diseases than the general population and they remain ill due to other contextual, societal factors affecting their ability to achieve health and well-being. This population is subjected to adverse life events that suggest a more comprehensive approach to health and well-being is called for.

The Circle of Care is …

The Lived Experience Of Adolescent Females With Diabetes: A Phenomenological Approach, Jane K. Dickinson

Dissertations

The purpose of this study was to gain a better understanding of what it means for adolescent females to live with type 1 diabetes. The following research question was investigated: What is it like for adolescent females to live with type 1 diabetes?

The Biopsychosocial Model Of Metabolic Syndrome Among U.S. Adults, Jennifer L. Saylor

Dissertations

The Metabolic Syndrome (MetS) is a cluster of medical disorders (obesity, hypertension, dyslipidemia, and insulin/resistance/glucose intolerance) that characteristically occur together in individuals. The prevalence of MetS continues to increase in the U.S. and increases the risk of type 2 diabetes, cardiovascular disease (CVD), and mortality. Little research uses a theoretical model to identify direct or indirect contributions to MetS and predictors to MetS. Identifying the factors that influence MetS in a national sample is necessary to understand targets for intervention to prevent the MetS and its sequelae.

This study tested a hypothesized conceptual model of the biopsychosocial factors associated with …

The Knowledge, Attitudes, And Self-Reported Behaviors Of Psychiatric Nurses Towards Obese Psychiatric Patients On Atypical Anti-Psychotropic Medications, Marcia D. Williams-Hailey

Dissertations

Obesity has continued to increase over the years with increase in morbidity and mortality. The advancement of psychiatric treatment has resulted in a higher prevalence of obesity among the psychiatric population related to the side-effects of the newer atypical anti-psychotics. This study address nurses' attitude towards obesity and people who are obese, focusing on psychiatric patients. Negative attitudes and low knowledge about psychiatric patients on atypical anti-psychotics can interfere with psychiatric nurses' therapeutic potential to support patients with health promotion behaviors. The purpose of this study is to develop an instrument to measure the knowledge, attitudes, and self-reported behavior of …

Perceived Risk For Cardiovascular Disease Among Japanese Adults, Satomi Hayashi

Dissertations

Cardiovascular disease (CVD) including coronary artery disease and stroke is a significant health problem in Japan regardless of well established health care and insurance system and various public campaigns and exhibitions in the contemporary Japanese society. Higher and increasing prevalence and incidence of well-known risk factor of CVD may contribute to increasing mortality and morbidity of CVD in the future. However, limited knowledge was available for understanding perceptions of risk for CVD among Japanese adults. This grounded theory study aimed to explore social psychological process in perception of risk for CVD among Japanese adults.

A View From Above: Alternative Perspectives On Smallholder Livelihoods And Agrobiodiversity Conservation In Northern Ecuador, Chris Hair

Dissertations

Food security and deintensification of agriculture are serious concerns in Latin America. Agriculture, especially at small-scale subsistence levels, is hard work, and comes with some economic and physical risk. Transitions from traditional multi-cropping to mono-cropping systems introduce two particular risks that are new to most smallholders: (1) the loss of agricultural diversity and (2) the potential for widespread failure when focusing on the cultivation of a single crop. This research explores how Small Unmanned Aerial Systems (sUAS), or drones, can be used for rapid inventories of crop diversity and to enhance crop management techniques on small-scale farms. In the community …

The Psychological Foundations Of Corporate Social Responsibility In Recreational Sport Organizations: An Investigation Of Employee Functioning, Rammi Hazzaa

Dissertations

The importance of corporate social responsibility (CSR) has been well documented in the mainstream management literature (e.g., Aguinis & Glavas, 2012; Turker, 2009). While CSR has been investigated in the sport management literature, it has been done almost exclusively from the macro-level perspective aiming to address questions about the implications of CSR for organizations and society (Babiak, 2010; Smith & Westerbeek, 2007). However, there has been little CSR-related research undertaken with regards to sport employees and the individual level of analysis (microlevel). As such, this study is guided by the general notion of the psychological foundations of CSR that explain …

Self-Care Domains, Benefits Of Self-Care In Graduate-Level Training Programs, And Ways To Incorporate Self-Care Education And Practices In Graduate-Level Training Programs, Krystel Segovia

Dissertations

A literature review was conducted to examine the concept of self-care as a proactive means to manage the stressors of life, enhance professional competency, and live a well-balanced lifestyle, particularly for graduate-level psychology students. Different levels of distress, including stress, compassion fatigue, and burnout, were researched and discussed. The various domains of self-care were discussed as were the benefits of engaging in regular self-care practices. Finally, various ways to incorporate self-care into already established graduate-level training programs at universities and practicum training sites were discussed to enhance the training experience as well as mitigate burnout in the novel clinician.

Adapting To Obstacles: Inhibition And Creative Potential In A Sample Of Successfully Aging Older Adults, Cassandra Dinius

Dissertations

Studying older adults who are aging ‘successfully’ (i.e., avoiding disease/disability; maintaining high cognitive and physical functioning; engaging in meaningful interpersonal/social engagement) may offer insight into variables that contribute to cognitive change throughout the lifespan. Successful aging is related to levels of engagement, which may be promoted by the problem solving and reevaluation encouraged by the creative process (Fisher & Specht, 1999). Creative thinking requires the consideration of diverse concepts and strategies (e.g., generating many solutions), as well as the regulated filtering of these possibilities (e.g., neither too permissive nor too narrow when eliminating ideas; Baas, De Dreu, & Nijstad, 2011). …

Design, Development And, Psychometric Assessment Of An Inventory On Concepts Pertinent To Developing Proficiency In Organic Reaction Mechanisms, Sachin Nedungadi

Dissertations

This three-phase study was conducted to design, develop, and psychometrically analyze the Reaction Mechanisms Concept Proficiency Inventory (RMCPI). In the first phase, open-ended interviews were conducted with organic chemistry instructors (N=11) to obtain their opinion on concepts pertinent to developing proficiency in organic reaction mechanisms. The results yielded 11 pertinent concepts. Additionally, participants believed that organic reaction mechanisms are essential for mastering organic chemistry and students have difficulty with understanding the meaning and utility of the curved-arrows. The difficulties that students have with reaction mechanisms could be due to a lack of understanding of fundamental general chemistry and organic chemistry …

Implementing Digital Media As A Pedagogical Tool In University Physical Activity Courses, Dannon G. Cox

Dissertations

Technological advancements have influenced the way we teach, learn, and communicate in education. Higher educational institutions must continually adapt to emerging technologies by implementing a variety of technologies such as photographs, audio, video, and an endless array of online platforms. Specifically, university physical activity programs, which have existed in higher educational institutions for over a century, are encouraged to incorporate digital media as a means to effectively and efficiently communicate a variety of content areas (Cardinal, 2017; Casey, Goodyear, & Armour, 2017; Tiernan, 2015). The purpose of this case study was to explore the implementation of digital media as a …

Health Care Access And Utilization By U.S. Farmworkers, Genesis Bojorquez

Dissertations

Background: Agriculture industry has the highest fatality rate among all United States industries. Farmworkers experience high rates of occupational injury, illness, and mortality, yet have limited access to health care. Implementation of the Patient Protection and Affordable Care Act (ACA) of 2010 increased health care accessibility and broadened farmworker eligibility for health insurance, yet no study has measured the impact of the ACA upon U.S. farmworkers.

Purpose: The purpose of this research was to examine health care access and health care services utilization among U.S. farmworkers following the implementation of the ACA in 2010.

Specific Aims:

1. Apply the …

Increasing Patient Adherence To Gestational Weight Gain Goals In Pregnancy, Annie Vining

Dissertations

Abstract

Problem: The inability to maintain healthy weight gain during pregnancy may contribute to multiple pregnancy-related complications. Nutritional education and support may improve nutrition and vitamin consumption, and recommendations for healthy gestational weight gains have been published. However, pregnant women have reported minimal advice regarding healthy weight gain during pregnancy. A personalized, nutritional counseling program was initiated in a Midwestern, suburban OB-GYN private practice.

Methods: A quality improvement descriptive, correlational design was used. A cohort of pregnant women first trimester through six-weeks postpartum received individual counseling and face-to-face interaction at an office visit each trimester.

Results: Twenty ( …

Congruency Between Parents' Actual And Desired Participation In The Care Of Their Hospitalized Child, Daria Katherine Romaniuk

Dissertations

Parents' participation in the care of their hospitalized child is an integral part of pediatric nursing practice and is considered to be beneficial for children and parents. However, parents may not discuss their participation with nurses and instead base their activities on their perceptions of nurses' assumptions and expectations regarding parents' participation in care. Nurses may assume a gate keeping role regarding parents' participation, deciding what parents will do and then monitoring these activities. Nurses' heavy workloads may preclude the teaching necessary for parents to participate in certain aspects of care. As a result, parents' actual participation in care may …

Quality Of Life Of Parental Caregivers Of Children (1-36 Months) With A Tracheostomy, Rachel Abraham Joseph

Dissertations

Children's health and well-being are invariably related to the health and well-being of their parents or caregivers. Many parents undertake home care of children with a tracheostomy who require highly complex and technology driven care that would have been formerly assumed by health care providers. Parents accept multiple responsibilities- that of an advocate, case manager, parent, nurse, and much more. A cross sectional descriptive study using survey method was conducted to gather data on stress, coping and quality of life in parents of children with a tracheostomy aged one month to 36 months.

Program Evaluation Of A District’S Elementary School Wellness Curriculum To Improve Undergraduate Training, Katie Boyer

Dissertations

This doctoral research project examined elementary teachers’ preparation to teach health content (Emotional, Relationships, Growth and Development, Nutrition, Physical Activity, Hygiene, Safety, Substance Use/Misuse, Diseases, Environmental/Consumer/Community Health) within the framework for a state’s certification and qualifications. The study used a mixed-methods approach in a Midwest school district to discover components of undergraduate certifications, current teaching methods, and potential modifications to the curriculum. While all surveyed elementary teachers were licensed to teach the health content, many were not formally qualified to teach the material due to content gaps in their teacher preparation programs. The study concluded that undergraduate institutions preparing teachers …

An Exploration Of Preschool Choice With Low-Income Families: The Critical Role Of Positive Attitudes, Behavioral Norms And Control Beliefs, Laurel E. Schmitt

Dissertations

Since the 1960s preschool has been seen as a potential equalizer for children of poverty as they enter kindergarten and long term studies of state and federal preschools have documented positive impacts, especially for low-income students. What has yet to be deeply explored is guardians’ decision-making processes to explain the lack of enrollment even when the stated barriers are eliminated (Obi, 2011; Payne, 1994; Swartz, 1996).

The purpose of this qualitative study was to describe and interpret, through a phenomenological lens, how low income parents and guardians made decisions to enroll their child or dependent in a preschool program. I …

The Epidemiology And Burden Of Cardiometabolic Risk Factors In A Young Emirati Population, Fatima Abobakr Hussein Mezhal

Dissertations

The United Arab Emirates (UAE) has experienced rapid economic growth that was paralleled by a drastic rise in non-communicable diseases (NCDs); primarily cardiovascular diseases (CVDs), which account for 40% of mortality in UAE. CVDs have complex etiology, interplay, and accumulation of many risk factors. Understanding the clustering and interrelationships between common risk factors like obesity, deglycation, dyslipidemia, hypertension and central obesity, and the associations with social and lifestyle determinants are warranted. The study aimed to estimate the burden of cardiometabolic risk factors (CRFs), their interrelationship, and their associations with other social and lifestyle determinants in a young Emirati population. Data …

Activated Carbon Nanofibers From Renewable (Lignin) And Waste Resources (Recycled Pet) And Their Adsorption Capacity Of Refractory Sulfur Compounds From Fossil Fuels, Efstratios Svinterikos

Dissertations

Dementia is a condition in which higher mental functions are disrupted. It currently affects an estimated 57 million people throughout the world. Dementia diagnosis is difficult since neither anatomical indicator nor functional testing are currently sufficiently sensitive or specific. There remains a long list of outstanding issues that must be addressed. First, multimodal diagnosis has yet to be introduced into the early stages of dementia screening. Second, there is no accurate instrument for predicting the progression of pre-dementia. Third, non-invasive testing cannot be used to provide differential diagnoses. By creating ML models of normal and accelerated brain aging, we intend …

Implementing A Standardized Nutrition Protocol To Enhance The Nutritional Health Of Pediatric Oncology Patients In The Ambulatory Care Setting, Jacqueline N. Arrison

Dissertations

It is estimated that 11,060 children in the United States, under the age of 15, will be diagnosed with cancer in 2019 (American Cancer Society, 2019). Malnutrition, a common consequence of the disease and its treatment, has shown to increase the risk of morbidity, mortality, early relapse, and a number of complications throughout cancer treatment.

The Impact Support Staff Has On School Climate At Comprehensive High Schools From The Perspective Of Principals, Melissa Bako

Dissertations

Purpose: The purpose of this phenomenological study was to identify and describe how high school principals perceive the actions of support staff impact school climate in the areas of safety, teaching and learning, interpersonal relationships, and the institutional environment in comprehensive public high schools in Riverside County, California.

Methodology: The researcher identified comprehensive public high schools within the state of California. Of this target population, purposeful sampling was applied to identify participants that were rich with information and that met specific criteria, and 12 principals were identified. The researcher collected and coded data from in-depth interviews; interview protocol directly …

Psychometric Evaluation Of A New Pressure Ulcer Skin Risk Assessment Scale For The Pediatric Burn Patient, Mary D. Gordon

Dissertations

Prevention of pressure ulcers is a primary goal in nursing practice, and achievement implies excellence in clinical care. One component of prevention is to understand the risk for pressure ulcer development. The benefit of knowing risk is to initiate pressure ulcer preventive interventions. Pressure ulcers are a significant problem in the pediatric burn patient population. Unfortunately, no skin risk assessment scale exist that capture the unique risk indices of the burn injury, thus the Pressure Ulcer Skin Risk Assessment Scale (PrUSRAS) was developed. The purpose of this study was to evaluate the validity, reliability and predictability of scores from the …

Factors Influencing End-Of-Life Decisions Regarding The Living Will And Durable Power Of Attorney: An Application Of Roy's Adaptation Model, Weihua Zhang

Dissertations

Modern technology offers extraordinary life-saving opportunities that were not imaginable in old times. However, it also takes us to a new frontier where the challenge of life-saving becomes death-prolonging. More than a decade after the Patient Self-Determination Act which guarantees the individual's legal right to decide the end-of-life care, the utilization of this right has seen no significant increase. The purpose of this quantitative study was to identify the variables that influence the decision-making responses related to Advance Directives (ADs). A path model applying Roy's Adaptation Model was developed for the study. Publicly accessible data collected for the Longitudinal Study …

The Lived Experience Of Non-Degreed Learners From A Time Modified Traditional Baccalaureate In Nursing Program, Stephanie S. Deboor

Dissertations

The purpose of this phenomenological inquiry was to describe, interpret, and gain a deeper understanding of how non-degreed, traditional baccalaureate nursing students experience education in a Time Modified Traditional Program of study.

The Relationship Among School Playground Design And Conditions And Physical Activity Levels In Children, Ipuna Estavillo Black

Dissertations

Almost 20% of children aged 6 to 11 years are obese in the United States, tripling over the last ten years. The rise in childhood obesity challenges nurses in their efforts to improve community health and sustainability. A decrease in physical activity (PA) levels has been associated with an increase in obesity. Schools have been identified as a primary setting to provide children adequate amounts of daily PA, and nurses working in the area of child health promotion can work with schools to provide opportunities for children to increase PA levels. The playground is one environment where children can increase …

Variables That May Affect Physical Activity Levels In African American Females With Type 2 Diabetes, Melanie K. Samardzija

Dissertations

Type 2 diabetes continues to pose a significant health challenge for the United States. The incidence and prevalence rates for type 2 diabetes are higher for certain at risk populations such as African American females. Personal behaviors including high-fat, high-caloric diets and physical inactivity result in obesity and insulin resistance that are associated with type 2 diabetes. Physical inactivity is particularly common in African American females, and this places them at an increased risk for the development of type 2 diabetes. Certain variables have been shown to influence physical activity. The purpose of this study was to examine how selected …