Digital Commons Network^™

Assessment Of Organizational Readiness: Parent Advisory Councils In A Children's Hospital Within A Hospital, Suzanne R. Springate

DNP Projects

Background: A children’s hospital within a hospital (CHWH) in the Midwest region of the United States established a strategic goal to become the preferred provider for children in the region. Outcomes in patient and family experience had fallen short of established organizational expectations. Recognizing that parent advisors are an essential component of patient and family centered care, the strategic plan called for integrating parents into formal, advisory roles.

Purpose: The purpose of this practice improvement project was to perform an assessment of organizational readiness to incorporate parents into formal advisory roles at this CHWH.

Methods: A cross-sectional survey design was …

Examining The Effectiveness Of An Intervention To Increase Provider Assessment Of Overweight And Obesity In The Primary Care Setting, Kristena R. Lea

DNP Projects

Obesity is an epidemic among adults in the United States, leading to a multitude of co-morbidities and billions of dollars in annual healthcare expenditures. Although primary care is the ideal setting for identification and treatment of overweight/obesity, it is often overlooked by providers. This capstone project was formed by three manuscripts, which were written to explore the lack of overweight/obesity identification and treatment in the primary care setting. Emphasis was made throughout the three manuscripts on the importance of providers using body mass index (BMI) as an objective means to discuss overweight/obesity with patients. The first manuscript is an integrative …

Implementing A Hospital-Acquired Pressure Ulcer Prevention Program, Maryann L. Lancaster

DNP Projects

Objective: To implement a Hospital-Acquired Pressure Ulcers (HAPU) prevention program utilizing an assessment tool to identify patients at risk, and intervene with a sacral Mepilex® dressing. Our aims are to determine if a change in nursing knowledge and change in nursing behavior after implementing our program.

Background: HAPUs are a significant problem in patient care and healthcare organizations must implement prevention protocols to reduce HAPU prevalence. Guidelines for implementing HAPU prevention programs suggest use of a validate risk assessment tool and initiating preventive interventions. One intervention found in the literature is the adjunctive use of prophylactic Mepilex® dressings to sacral …

Dnp Practice Inquiry Project Report: Depression Screening In Primary Care, Mary Kathleen Stafford

DNP Projects

Depression affects many people worldwide and is a leading cause of disability. National guidelines and recommendations have been created that support screening for depression in the primary care setting, however due to many barriers depression screening is often not performed or documented. This capstone project consists of three manuscripts, which evaluate the lack of depression screening in the primary care setting. The first manuscript is an integrative review of the literature to support depression screening in primary care and to address barriers to depression screening. The second manuscript is a guideline analysis of a national guideline published by the Institute …

Measuring Providers’ Adherence To The American Diabetes Association Screening Recommendation For Prevention Of Diabetic Nephropathy, Whitney R. Munroe

DNP Projects

Purpose: The purpose of this study was to evaluate provider adherence to the ADA’s recommendation for an annual screening urinary albumin excretion level to check for the presence of microalbuminuria. A secondary objective was to assess for adequate treatment (i.e. ACE inhibitor or ARB prescription) in those patients with microalbuminuria present.

Methods: A retrospective chart review was conducted on 60 randomly selected patients seen within a primary care practice in an urban university setting between January 1^st, 2014 and December 31^st, 2014. Inclusion criteria included age ≥ 18 years and an active diagnosis of type 2 …

Are Type 2 Diabetes Patients Receiving Diabetes Self-Management Education In The Primary Care Setting?, Erica Mahone

DNP Projects

Diabetes is a growing health concern in the United States, with approximately 1.7 million new cases diagnosed yearly. A management option to help patients gain glycemic control is the participation in diabetes self-management education (DSME). DSME aims to teach patients how and why they need to perform self-care, and not solely rely on medications to manage diabetes. A literature review of 10 studies between 2007 and 2014 was conducted and found favorable health outcomes for participants of DSME. Patients who participated in DSME had improved glycemic control, achieved blood pressure and cholesterol goals, and lost weight. An analysis of the …

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

Childhood Nutrition And Lifestyle In Owensboro, Kentucky, Mckenzie J. Mattingly

DNP Projects

According to the CDC, childhood obesity is now one of the leading health problems in the United States. Thirty-five percent of adults in the United States are obese. Kentucky is the 12th most obese state for adults. and the 7th most obese state for children. The State of Obesity: Better Policies for a Healthier America, states that Kentucky’s adult obesity rate is currently 31.6 percent. This is up from 21.7 percent in 2000 and 12.7 percent in 1990. Primary care providers must work to help prevent these numbers from continuing to climb. Since our population of children who are overweight …

Improving Nutritional Status In The Hematologic Oncology Population, Mary A. Malone

DNP Projects

Background: Patients undergoing treatment for both solid tumor and hematologic malignancies experience numerous symptoms that greatly affect their nutritional status. Malnutrition can have a negative impact on oncology patient outcomes. There is a reduced response to treatment, reduced survival and quality of life. Early and consistent interventions have proven beneficial in the oncology population.

Most hematologic cancer patients have good nutritional health. However, as their treatments intensify, side effects compared to their solid tumor counterparts can adversely affect nutrition. Interventions, consisting of total parenteral or enteral nutrition are initiated but only after oral intake has been impeded for 2-3 days. …

Examining The Relationship Between Type And Extent Of After-School Care Use And High Bmi In Children Ages 5-17, Morgan E.B. Chojnacki

DNP Projects

Objectives: The purpose of this study was to examine the relationship between body mass index (BMI) and after-school care use in school age children and adolescents in Kentucky. The specific aims of this study were to examine differences in BMI groups (high versus normal/low) by: a) type and b) extent of after-school care use.

Methods: Parents of children age 5-17 years were administered a 21-item survey which assessed the amount of time their children spent in specific types of after-school care. BMI of the child/adolescent participants were obtained at the time of the survey. High BMI was defined …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

The Influence Of Production Practices, Tillage, And Endophytic Bacteria On Bell Pepper Productivity And Physiology Under Different Irrigation Regimes, Zheng Wang

Theses and Dissertations--Plant and Soil Sciences

To evaluate the strip tillage in organic bell pepper (Capsicum annuum L.) production as an integrated system for sustainable vegetable cropping two-years of field trials were conducted in 2011 and 2012. The field trials were conducted to determine the viability of strip tillage in conventional and organic bell pepper production systems by comparing plant growth, water status, and fruit yield to plastic mulch grown plants application under different irrigation regimes. The two-year field data demonstrated that organic pepper with strip tillage application was a viable combination that produced comparable yield to conventional plastic mulch system and utilized water more …

Soil Management And Nitrogen Dynamics In Burley Tobacco Rotations, Congming Zou

Theses and Dissertations--Plant and Soil Sciences

Agronomic practices, including tillage, crop rotation and N fertilization, have been developed to efficiently manage soil N dynamics and crop N nutrition. These practices can affect soil organic carbon (SOC) and soil total nitrogen (STN) sequestration, and consequently influence soil nitrogen mineralization (SNM) and crop N nutrition. However, little research has been systematically and simultaneously conducted to examine the effect of agronomic management on (1) SOC and STN stocks; (2) SNM; and (3) crop N nutrition. Burley tobacco (Nicotiana tobacum L.) is a N demanding crop and subject to inefficiency in N fertilization. Moreover, conservation tillage and rotation have been …

Urea Formulations On The Productivity Of Bermudagrass And Bermudagrass-White Clover Pastures, Caitlin Timberlake

Theses and Dissertations--Plant and Soil Sciences

Bermudagrass (Cynodon dactylon L.) is a perennial warm-season grass that is very responsive to nitrogen (N) fertilization. Excessive N applications have negative environmental consequences and make maintaining mixed swards difficult. This study determined the effects of enhanced efficiency (EE) N fertilizers and fertilizer rate on bermudagrass yields, nutritive values, and white clover persistence. Nitrogen sources included urea, urea formulated with Agrotain^® (U+A), urea with Agrotain^® and dicyandiamide (SuperU), a polymer-coated urea (ESN), ESN+urea (75% ESN, 25% urea), and methylene urea (MU). In the urea formulation trial, SuperU and U+A maximized forage yields at lower N rates. The …

Draft Provincial/Territorial Legislation To Implement A Regulatory Framework For Medically-Assisted Dying Consistent With Carter V. Canada (Attorney General) 2015 Scc 5 And The Final Report Of The Provincial-Territorial Expert Advisory Group On Physician-Assisted Dying, Jocelyn Downie

Reports & Public Policy Documents

On February 6, 2015, the Supreme Court of Canada unanimously declared that the Criminal Code prohibitions on physician-assisted dying (both assisted suicide and voluntary euthanasia) violate the Canadian Charter of Rights and Freedoms. They immediately suspended the declaration for 12 months thus allowing the government time to craft new legislation. This paper is a contribution to the project of meeting that deadline -- it presents draft provincial/territorial legislation. This draft legislation is based on: 1) a thorough review of existing legislation in all permissive regimes throughout the world (reviewed through a "lessons learned" lens); 2) the requirements for constitutional validity …

A Zooarchaeological Analysis Of The Monashka Bay Site (Kod-026) Kodiak Island, Alaska, Ayla Aymond

All Master's Theses

This thesis involved the initial analysis of fauna recovered in 1989 by Christopher Donta at the Monashka Bay site on Kodiak Island. Analysis included all vertebrate remains (n = 36,273) larger than 1/8” from bulk samples collected in Area 3, a midden dating AD 1550-1670 during the site’s Koniag occupation. Results indicated a focus on cod (68% of fish identified to order), with modest amounts of sculpin, and small amounts of flatfish, salmon, herring, bird, and sea mammal. The predominance of cod is likewise seen at other Koniag-era sites in the vicinity, though the lack of salmon, which composed 2% …

Loyalty Cards And The Problem Of Captcha: 2nd Tier Security And Usability Issues For Senior Citizens, David M. Cook, Apoorv Kumar, Charwina Unmar-Satiah

Australian Information Security Management Conference

Information Security often works in antipathy to access and useability in communities of older citizens. Whilst security features are required to prevent the disclosure of information, some security tools have a deleterious effect upon users, resulting in insecure practices. Security becomes unfit for purpose where users prefer to abandon applications and online benefits in favour of non-digital authentication and verification requirements. For some, the ability to read letters and symbols from a distorted image is a decidedly more difficult task than for others, and the resulting level of security from CAPTCHA tests is not consistent from person to person. This …

Proceedings Of The 2015 Wa Chapter Of Msa Symposium On Music Performance And Analysis, Jonathan R. Paget, Victoria Rogers, Nicholas Bannan, Paul Hopwood, Krista Low, Adrian Yeo, Alix Hamilton, Lindsay Vickery, Stuart James, Carol Williams, Stewart Smith, Robin Ryan, Emma Jayakumar, Cat Hope, Lucas O'Brien

ECU Books

This publication, entitled Proceedings of the 2015 WA Chapter MSA Symposium on Music Performance and Analysis, is a double-blind peer-reviewed conference proceedings published by the Western Australian Chapter of the Musicological Society of Australia, in conjunction with the Western Australian Academy of Performing Arts, Edith Cowan University, edited by Jonathan Paget, Victoria Rogers, and Nicholas Bannan. The original symposium was held at the University of Western Australia, School of Music, on 12 December 2015.

With the advent of performer-scholars within Australian Universities, the intersections between analytical knowledge and performance are constantly being re-evaluated and reinvented. This collection of papers presents …

Amla Enhances Autophagy And Modulates Beta Amyloid Metabolism In An In Vitro Model Of Alzheimer’S Disease, Elham Teimouri, Prashant Bharadwaj, Stephanie R. Rainey-Smith, Paul Fraser, Giuseppe Verdile, Ralph N. Martins

ECU Posters

Alzheimer’s disease (AD) is a progressive, fatal neurodegenerative disease characterized by extensive neuronal loss associated with increased accumulation of the beta amyloid (Aβ) protein. Reducing production, preventing aggregation and improving clearance of Aβare areas of active research in the development of therapeutic agents to ameliorate neurodegeneration in AD. The Indian plant amla (Emblicaofficinalis), commonly known as Indian gooseberry, has widely been utilized in traditional Ayurvedic medicine preparations in the treatment of a variety of disease conditions including cardiovascular disease and diabetes: accumulating evidence also suggests that amla may be beneficial in AD. Amla exhibits antioxidant, anti-inflammatory, and anti-apoptotic mechanisms and …

A Conceptual Framework For Estimating The Impact Of Climatic Uncertainty And Shocks On Land Use, Food Production, And Poverty In The Philippines, Caesar Cororaton, Arlene Inocencio, Anna Bella Siriban-Manalang, Marites Tiongco

DLSU Business & Economics Review

Wide variations in climatic conditions from prolonged dry season to frequent occurrence of super typhoons have significant impact on the Philippines, especially on rural poor households which depend heavily on agriculture and food production for subsistence and income. This paper provides a research framework that can be used to understand the dynamics between climate change and agriculture. The framework incorporates the effects of climate change on agricultural productivity, as well as the effects of agricultural activities and land use on climate change through the emission of greenhouse gasses. The framework uses three simulation models to analyse the impact of climate …

Breastfeeding In The Philippine Workplace: What’S Wrong With The Right?, Emily Sanchez Salcedo

DLSU Business & Economics Review

There are four main differences between the Philippine and American statutes that promote breastfeeding. First, the Philippine law provides that lactation breaks should be compensated while the American law explicitly stated that employers are under no such obligation. Second, the Philippine law provides for “culturally appropriate lactation care and services” whereas majority of American states exempt breastfeeding from public indecency laws. Third, the Philippine law makes a conclusive statement that breastfeeding “enhances mother-infant relationship”. The American law wisely left such matter to individual realization. Fourth, the Philippine law puts the right of a mother to breastfeed on equal footing with …

Dine In Or Out: Understanding The Budgeting And Eating Out Behavior Of De La Salle University Students, Ma. Luisa C. Delayco, Hazel T. Biana

DLSU Business & Economics Review

The preparation and consumption of one’s food is governed by choices, attitudes, behavior, and beliefs. In De La Salle University, a school surrounded by a variety of restaurants, students make these food choices every day. Understanding how these food decisions are made is noteworthy, as this paper seeks to comprehend the students’ budgeting and eating out behavior through the use of Fishbein and Ajzen’s Theory of Reasoned Action. The underlying variables of the budgeting and eating out behavior of students are used to explain the pattern of correlations within a set of observed variables. Through an administered survey and data …

Evaluating The Impact Of Preventative Health Services On Improving General Well-Being, Mallory Lucille Madden

Public Health Theses

Individuals in the United States suffer from an unnecessarily high rate of preventable chronic disease. One reason for this may be the nation's focus on tertiary care rather than preventive care. Health is multi-dimensional and should therefore be approached in an integrative manner. The current study proposes an integrative and preventative approach to health care services that utilizes Rath and Harter's (2010) five dimensions of well-being. We measured the impact of preventative health services in addition to tertiary care services on the general well-being of individuals over a two-month period of time. We found that those receiving preventative care in …

Protein Intake And Hookworm Infection Susceptibility In Rural Ghanaian School- Age Children: A Mixed-Methods Study, Luis Enrique Maldonado-Vásquez

Public Health Theses

Background: Because human and animal cross-sectional studies cannot assess temporality, a longitudinal study is needed to assess the association between protein intake and hookworm infection susceptibility. Cultural preferences and belief systems have been noted to affect the intake of food in some African societies but extensive research has not been conducted to characterize them.

Methods: Children (n=274) 7-13 years of age who attended school in the Kintampo North Municipality of Ghana were screened for participation in a longitudinal study assessing the relationship between protein intake and hookworm infection susceptibility. Protein intake was calculated by 24-hour recalls. A qualitative sub-study recruited …

Impact Of Maternal Demographics On Infant Feeding Habits In American Samoa, Renu Nadkarni

Public Health Theses

Obesity and overweight prevalence in American Samoan adults are among the highest in the world, and levels are also high and increasing in children and infants. Obesity levels are believed to be due ultimately to the dramatic changes in lifestyle and diet over the past half century. A shift away from breastfeeding and to early introduction of formula and solid foods feeding is a dietary habit effected in this change, and can potentially influence a child's future body size and other health outcomes. As decisions about infant feeding are associated with certain maternal demographics in other populations, this study specifically …

Determinants Of Early Feeding Practices Among Hiv+ Mothers In Sub- Saharan Africa: A Realist Review, Camille Adrianne Pottinger

Public Health Theses

INTRODUCTION: Exclusive breastfeeding has been shown to provide many benefits that can be life saving for the infant and mother in low resource settings7. Although the potential effects of breastfeeding appear large, exclusive breastfeeding rates remain low in this area of the world, and are even lower among the HIV population8-10. It is important to understand what influences HIV + mothers to exclusively breastfeed, as well as formula feed and adhere to ARV (antiretroviral) medication while breast feeding in order to make comprehensive policy recommendations that are as culturally sensitive and practical as possible. The objective of this review is …

Contribution Of Income To Self-Management And Health Outcomes In Pediatric Type 1 Diabetes, Kaitlyn Rechenberg

Public Health Theses

Low income has been established as a risk factor for poorer outcomes in

youth with type 1 diabetes; however, the effect of moderate income has not

been studied. The purpose of this secondary analysis of baseline data from a multi-site study was to compare glycemic control, self-management, and

psychosocial outcomes [depression, stress, and quality of life (QOL)] at

different income levels in adolescents with type 1 diabetes. Youth (n=320,

mean age=12.3+1.1, 55% female, 64% white, mean A1C=8.3±1.4)

completed established self-management and psychosocial measures. A1C

levels were collected from medical records. Caregivers reported annual family income, categorized as high (>$80K), …

Factors Associated With Type 2 Diabetes Management In Santa Elena, Ecuador, Suhana Sarkar

Public Health Theses

Background: There has been a growing prevalence of diabetes in rural populations in low and middle income countries. Over a third of Ecuador’s population lives in rural areas, which tend to experience poorer health outcomes than urban areas. Therefore, the objective of this study was to examine potential risk factors associated with diabetes management in this region.

Methods: A sample of 150 diabetes patients from the Futuro Valdivia clinic in Santa Elena, Ecuador were surveyed and tested for HbA1c. The interview collected data on a variety of risk factors including diet, exercise, eating habits, food insecurity, medication usage, medication adherence, …

Cigarette Smoking And Thyroid Cancer Risk: A Population-Based Case-Control Study, Qian Wang

Public Health Theses

Abstract

Objective: Thyroid cancer incidence has increased substantially in the United States. Previous studies of the relationship between cigarette smoking and thyroid cancer have yielded conflicting results.

Methods: In order further clarify the association between cigarette smoking and risk of thyroid cancer, we analyzed data from a population-based case-control study in Connecticut in 2010-2011 including 462 histologically confirmed incident thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression models were used to estimate the associations between cigarette smoking and risk of thyroid cancer adjusting for potential confounders.

Results: Our data showed a decreased risk of well-differentiated thyroid carcinoma …