Digital Commons Network^™

Effectiveness Of A University Employee Assistance Program Using The Workplace Outcome Suite And Client Satisfaction Survey, Josephine Jackson Banks

All ETDs from UAB

Background: Gallup (2013) reported that 30% of the U.S. workforce was not engaged in their work which means they were not reaching their full potential or productivity level. For organizations, lost productivity due to absenteeism or less than ideal performance at work impacts company performance and bottom line. Employee assistance programs are a resource to help increase employee health, productivity, and satisfaction through counseling interventions. Methods: Data were collected by a large urban university EAP over a 20-month period. The analysis was limited to EAP clients over the age of 18. A total of 866 subjects participated in this study, …

Predictors Of Subjective And Objective Everyday Functioning In Middle-Aged And Older Adults With Hiv, Alexandra Elaine Jacob

All ETDs from UAB

People with HIV (PWH) are at an increased risk for everyday functionalimpairment, especially as they age. The purpose of this study was: (1) to identify factors associated with subjective and objective instrumental activities of daily living (IADL) difficulty in PWH and (2) to identify factors associated with awareness of functional capacity. This cross-sectional study included 261 PWH. Participants completed a comprehensive neurobehavioral assessment, including self-report and performance-based measures of everyday functioning. Hierarchical multiple regressions were performed to identify health, psychological, and cognitive factors that contribute to subjective and objective evaluation of everyday functioning. We also examined factors that predicted a …

Characterization Of The Metabolic And Cognitive Features Of A Novel Alzheimer’S Disease Rat Model Along With Investigation Of Its Gut Microbiota Change Over Time, Akash Nagarajan

All ETDs from UAB

Alzheimer’s disease (AD) is currently the fifth highest cause of death in the United States and affects primarily individuals of very old age (>80 yrs.). Aging is known to be the biggest risk factor of AD. Recent studies have shown that AD patients have an altered gut microbiota composition. To investigate whether the Alzheimer’s disease pathology in the brain could drive gut microbiota changes during the adult and late life stage of the rat, we performed 16S ribosomal RNA sequencing on the fecal samples of the animals at 14 months and 20 months of age. We found a distinctive …

Pengaruh Jam Kerja Orang Tua Terhadap Kognitif Anak Di Indonesia, Pradini Ajeng Gemellia, Turro S. Wongkaren

Jurnal Ekonomi dan Pembangunan Indonesia

The current phenomenon shows an increasing work activities by both fathers and mothers to fulfil household needs. This social change is feared to give children imbalance time, causing children’s development to be not optimal. This study aims to see the influence of parental working hour on children’s cognitive scores in Indonesia. This study used data from IFLS Survey in 2007 and 2014 with a unit of analysis of children aged 7 to 14 used an OLS estimation method. The results of this study indicate that parental working hours had negative influence on children’s cognitive scores.

A Fuzzy Expert System For Predicting The Mortality Of Covid'19, Monika Mangla, Nonita Sharma, Poonam Mittal

Turkish Journal of Electrical Engineering and Computer Sciences

The COVID-19 pandemic has had a widespread impact on health and economy across the globe. It is leading to a huge number of deaths per day. Few researchers have been attracted to analyzing the mortality rate of COVID-19 from various perspectives. During the research, it has become evident that these fatalities are not only caused by COVID19, but they are also affected by some other factors. The authors of this paper aim to encompass three important types of factors viz. risk factors, clinical factors, and miscellaneous factors that influence the mortality of COVID-19. This manuscript presents a rule-based model under …

The Institute For Storytelling & Healthcare Design Research, Ruth E.P. Deibler

Theses and Dissertations

STORYTELLING, HEALTHCARE, INTERIOR DESIGN EDUCATION & GROUNDED THEORY RESEARCH:

THE TRIFECTA OF TRANSFORMATIONAL CHANGE IN HEALTHCARE DESIGN

Clinical Applications And Feasibility Of Proton Ct And Proton Radiography, Christina Marie Sarosiek

Graduate Research Theses & Dissertations

Proton therapy is a form of radiation treatment for cancer that utilizes the Bragg peak to create conformal high dose regions around the tumor volume. However, the use of x-ray computed tomography (CT) and x-ray radiography for treatment planning and pre-treatment quality assurance procedures improves the achievable effectiveness of proton treatment plans (using proton CT) and the pretreatment verification (using proton radiography). Errors in the conversion from x-ray Hounsfield units (HU) to proton relative stopping powers (RSP) leads to errors in the predicted proton range. To account for the errors, 3.5% margins are included in the treatment plan. This means …

Why End-Of-Life Discussion Matters: A Systematic Literature Review, Emily Grandson

All Graduate Theses, Dissertations, and Other Capstone Projects

End-of-life (EOL) discussions are a challenging yet vital topic of conversation in intensive care units (ICU) between healthcare providers, patients, and their families. There is great disparity in where, when, and how EOL discussions take place, but the consequences of neglecting their importance can be devastating physically, psychologically, and financially for all parties involved. Multiple inadequacies in the EOL discussion process have not only contributed to a personal and societal financial burden but an unacceptable quality of death for many ICU patients. A literature review was performed to determine what practice and policy changes could be made to improve EOL …

Impact Of Telemedicine On Heart Failure Readmissions And Mortality: A Literature Review, Stephanie R. Ledvina

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: Heart failure is a chronic condition that commonly results in frequent hospitalizations and increases risk of mortality (Kotb et al., 2015; Ong et al., 2016; Pekmezaris et al., 2018). In addition, heart failure places a significant burden on healthcare costs and utilization of resources (Hale et al., 2016; Kotb et al., 2015; Ong et al., 2016). Measures to reduce heart failure readmissions, mortality, and overall costs are needed. Telemedicine interventions may be beneficial in the management of heart failure; however, the current research provides unclear and inconclusive findings in regard to the effectiveness of telemedicine interventions on heart failure …

Reducing Polypharmacy In Older Adults At End Of Life: The Outcome On Quality Of Life, Melissa Jenson

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: Older adults at the end of life are commonly prescribed multiple medications which can lead to polypharmacy. Research has shown that optimizing medications through targeted deprescribing reduces inappropriate medications, reduces adverse effects and improves select outcomes. However, the impact of deprescribing remains uncertain--specifically whether this intervention improves quality of life (QOL). Objective: Explore polypharmacy in older adults at the end of life examining outcomes of deprescribing on the QOL. Methods: A systematic literature search using Academic Search Premier, CINAHL, Medline, JSTOR and Nursing and Allied Health Database was conducted between October 2020 to November 2020. Select articles …

Reconceptionalizing The Knowledge Base Of Social Work: The Imperative For Critical Theories And Perspectives In Social Work Education, Kristie L. Seelman, Elizabeth L. Beck, Shane R. Brady, Karimah Dillard, William Lane

The Journal of Sociology & Social Welfare

As the U.S. continues to grapple with the need for a racial reckoning, and with a growth of progressive voices and movements—especially those lead by Black, Indigenous, and People of Color—now is an important time to re-examine social work’s knowledge base. Students, researchers, and practitioners need the tools to challenge hegemony, inequity, injustice, and White supremacy from a structural position. Critical theory is an important tool for such work, yet it is not well integrated into social work textbooks, and many students still have limited exposure to it. In this paper, we explore critical theory’s roots and evolution and discuss …

Addressing The Needs Of African American Grandparents: An Intersectionality Perspective, Dorothy Smith-Ruiz, Kendra Jason

The Journal of Sociology & Social Welfare

This study seeks to demonstrate the intersecting structural and compounding challenges African American custodial grandparents experience collectively, rather than as separate non-competing factors, which has been modeled in prior studies. Using a mixed-method research design, the study explored the challenges faced by African American and white custodial grandparents. These challenges included difficulties attaining different types of support, respite care, and programs for teens and special needs grandchildren. Results showed that caregiving challenges among African Americans were more pervasive than their White counterparts. These findings have significant implications for the development of intervention programs for custodial African American grandmothers and their …

Journal Of Sociology And Social Welfare Vol. 48, No. 4

The Journal of Sociology & Social Welfare

No abstract provided.

Improving Fall Risk Knowledge Through Staff Education In An Assisted Living Facility, Assumpta Egowure Ike

Walden Dissertations and Doctoral Studies

AbstractPatient safety and fall prevention are crucial for nurses and healthcare workers especially in assisted living facilities considering the age and health status of the patients. Low staff knowledge of fall risk measures in an assisted living facility may have contributed to an increase in the number of falls recorded in the facility by 20% in the last 2 years. This project addressed the questions of whether an education project could increase staff’s level of knowledge on fall risk measures, and whether any improved knowledge would coincide with the number of falls per patient day in the assisted living facility? …

Coping Strategies Of Dual-Role Informal Caregivers, Lorilee Maldonado

Walden Dissertations and Doctoral Studies

There are nearly 43.5 million informal caregivers (ICGs) in the United States, and this number will nearly double by 2030. Trying to fulfill the needs of an aging family member and commitments to work, home, and other relationships create a constant state of stress that may result in either leaving the workforce or placing the care recipient in a facility. Finding strategies that support both roles is economically and socially critical. This study explored the strategies that some ICGs have acquired that enable them to cope with these pressures. Work-family conflict theory, focusing on the conflict between work and family …

Social Workers' Perspectives Of Depression In Baby Boomers Born Between 1946 And 1955, Karen Cohen

Walden Dissertations and Doctoral Studies

AbstractAs the leading-edge baby boomer (L-E boomer) cohort continues to age, demands of mental health services in treating diagnosed depression in this cohort are increasing. Licensed clinical social workers (LCSWs) are the most likely social workers to provide services to L-E boomers diagnosed with depression. LCSWs were the chosen participants for this generic qualitative study to gain knowledge of their perspectives of working with L-E boomers diagnosed with depression. Grounded in generational theory, this study used a generic qualitative approach allowing for nonrestrictive measures for capturing the data. NVIVO assisted in coding the data and identification of common themes, words, …

Adult Day Care Staff Education To Improve Communication And Behavioral Management Skills, Kathy Davis

Walden Dissertations and Doctoral Studies

AbstractIneffective communication and behavioral management skills are quality and safety issues that were identified at a local adult day care facility in the Southwest United States. Administrators at the facility identified a knowledge gap in communication and behavior management techniques for patients with cognitive impairment. An educational program, with a PowerPoint presentation and verbal feedback as key components, was developed and used to address the identified gap in practice related to individuals with cognitive impairments at the facility. The adult learning theory and the plan-do-study-act model provided supportive frameworks for program development and staff education. The project question explored whether …

Primary Care Physicians’ Attitudes, Beliefs, And Actions Toward Geriatric Treatment, Andrea Renee Holzner

Walden Dissertations and Doctoral Studies

AbstractIn the United States, an estimated 49.2 million older adults seek specialized geriatric medical treatment from a primary care physician (PCP). Due to a nationwide geriatrician deficit resulting from significant aging population growth, PCPs now manage specialized geriatric issues, such as Alzheimer’s disease, cognitive assessments, and physiological impairments, such as Parkinson’s, due to non-normative aging. Although PCPs may take geriatric courses, geriatric specialization is beyond a normative primary care medical practice. The purpose of this generic qualitative study was to explore primary care physician attitudes, beliefs, and actions, toward geriatrics and to expand the understanding of primary care physicians’ geriatric …

Homeowners’ Lived Experience In Developing And Using Accessory Dwelling Units In Ireland, Geraldine Mary Hurley

Walden Dissertations and Doctoral Studies

Researchers have explored the role of accessory dwelling units (ADUs) as a form of housing since at least the 1970s. Such exploration has taken place across a number of different disciplines, including gerontology, housing affordability, and urban planning. The literature tends to focus on specific policies, however, rather than on the lived experience of the homeowners impacted by those policies. Ireland’s national and local governments have yet to acknowledge the potential use of ADUs as a contributing solution to ongoing problems with housing supply, housing affordability, and homelessness, despite a government-declared national housing crisis. Formal research on ADUs in the …

Reducing Fall Rates At A Long-Term-Care Facility, Francis Ortego

Walden Dissertations and Doctoral Studies

In the United States, older adults often experience fall events that may result in physical, mental, and financial hardship. Since the project site was experiencing a significant number of patient falls, a fall-prevention quality improvement (QI) program was implemented. Guided by the diffusion of innovation theory and the plan-do-study-act (PDSA) model, the purpose of this doctoral project was to evaluate the effectiveness of that program to determine if the monthly fall rate in the facility would decrease during the next 6 months. The project site provided deidentified data in the form of monthly fall-rate totals as collected from the long-term-care …

Nursing Staff Education Fall Prevention Program At A Skilled Nursing Facility, Solomon Lomo

Walden Dissertations and Doctoral Studies

Falls have negative effects on the confidence, function, and quality of life in older adults and are major cause of injury and death among this population. The quality assurance report in a long-term care facility identified an average of 10 falls per week in the last quarter of 2017. The facility has a person-centered policy, which creates fall prevention challenges when usual fall protective practices are prohibited. The purpose of this education program was to educate staff nurses working with patients in a long-term care facility on additional evidenced based practices to prevent falls and injuries without compromising the person-centered …

The Systemic Experiences Of Social Workers In An Inpatient, State Psychiatric Hospital, Kesia Gwaltney

Walden Dissertations and Doctoral Studies

The National Alliance on Mental Illness surmised that 1 in 25 (9.8 million) adults in the United States are diagnosed with a serious mental illness annually. Of the 9.8 million people diagnosed, approximately 63% of them are psychiatrically hospitalized with repeat hospitalizations within 1 year of discharge. Social workers play a vital role in the treatment modalities of the patients they serve in the psychiatric hospital; however, there is no research that examined the professional systemic experiences of social workers in state, inpatient psychiatric hospitals and how these experiences may affect treatment outcomes of patients as it relates to frequent …

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …

How Does Direct Volunteering Affect The Onset Of Alzheimer’S Dementia In Elderly Patients With Preexisting Cardiac Comorbidities?, Sneha R. Gade

UROP Posters

Alzheimer's Dementia is a disease that affects memory, thinking, and behavior. The Alzheimer's Association reported Alzheimer's as the sixth-leading cause of death in the United States, and a cure does not exist. Donepezil, a cholinesterase inhibitor drug, is frequently prescribed to treat Alzheimer's disease. Still, patients must continuously take the medication for years to receive any measurable improvement in quality of life after developing Alzheimer's Dementia. Further, research shows prolonged use of Donepezil can lead to other health problems, such as QTc prolongation, for cardiac disease patients. Therefore, the effectiveness of non-drug interventions, such as volunteering to prevent the disease's …

Time Travellers And Storytellers: Representations Of Dementia In Children's Fantasy Literature, Tracey Guiry

School of Law, Humanities and Social Sciences Theses

This creative writing research-based thesis asks how dementia can be represented to primary-aged children through a fantasy fiction novel and offers an original fantasy fiction novel, The Battle for Spanoak (Guiry, 2020), written for children between the ages of 7 and 12-years-old as an original contribution to the corpus of dementia writing for children. The critical component to this thesis explores how generic fantasy devices and structures impact on the representation of dementia through ‘storytelling’ and ‘memory’ and describes the particular relevance of ‘time’ as a narrative device in dementia fantasy narratives. I have also contributed a corpus of dementia …

Apathy, Cognitive Impairment, And Social Support Contribute To Participation In Cognitively Demanding Activities Poststroke, Amy Ho, Marjorie L. Nicholas, Chaitali Dagli, Lisa Tabor Connor

Open Access Publications

No abstract provided.

The Global Alzheimer's Association Round Robin Study On Plasma Amyloid Β Methods, Josef Pannee, Kwasi G Mawuenyega, Vitaliy Ovod, James Bollinger, Randall J Bateman, Yan Li, Et Al

Open Access Publications

Introduction: Blood-based assays to measure brain amyloid beta (Aβ) deposition are an attractive alternative to the cerebrospinal fluid (CSF)-based assays currently used in clinical settings. In this study, we examined different blood-based assays to measure Aβ and how they compare among centers and assays.

Methods: Aliquots from 81 plasma samples were distributed to 10 participating centers. Seven immunological assays and four mass-spectrometric methods were used to measure plasma Aβ concentrations.

Results: Correlations were weak for Aβ42 while Aβ40 correlations were stronger. The ratio Aβ42/Aβ40 did not improve the correlations and showed weak correlations.

Discussion: The poor correlations for Aβ42 in …

Pleiotropic Effects Between Cardiovascular Disease Risk Factors And Measures Of Cognitive And Physical Function In Long‑Lived Adults, Julia J. Yudkovicz, Ryan L. Minster, Emma Barinas-Mitchell, Kaare Christensen, Mary Feitosa, Megan S. Barker, Anne B. Newman, Allison L. Kuipers

Open Access Publications

No abstract provided.

Racial Disparities In The Sofa Score Among Patients Hospitalized With Covid-19, Benjamin Tolchin, Carol Oladele, Deron Galusha, Nitu Kashyap, Mary Showstark, Jennifer Bonito, Michelle C. Salazar, Jennifer L. Herbst, Steve Martino, Nancy Kim, Katherine A. Nash, Max Jordan Nguemeni Tiako, Shireen Roy, Rebeca Vergara Greeno, Karen Jubanyik

Open Access Publications

BACKGROUND: Sequential Organ Failure Assessment (SOFA) score predicts probability of in-hospital mortality. Many crisis standards of care suggest the use of SOFA scores to allocate medical resources during the COVID-19 pandemic.

RESEARCH QUESTION: Are SOFA scores elevated among Non-Hispanic Black and Hispanic patients hospitalized with COVID-19, compared to Non-Hispanic White patients?

STUDY DESIGN AND METHODS: Retrospective cohort study conducted in Yale New Haven Health System, including 5 hospitals with total of 2681 beds. Study population drawn from consecutive patients aged ≥18 admitted with COVID-19 from March 29th to August 1st, 2020. Patients excluded from the analysis if not their first …

Nanoparticulate Matter Exposure Results In White Matter Damage And An Inflammatory Microglial Response In An Experimental Murine Model, Michelle Connor, Krista Lamorie-Foote, Qinghai Liu, Kristina Shkirkova, Hans Baertsch, Constantinos Sioutas, Todd E. Morgan, Caleb E. Finch, William J. Mack

Open Access Publications

Exposure to ambient air pollution has been associated with white matter damage and neurocognitive decline. However, the mechanisms of this injury are not well understood and remain largely uncharacterized in experimental models. Prior studies have shown that exposure to particulate matter (PM), a sub-fraction of air pollution, results in neuroinflammation, specifically the upregulation of inflammatory microglia. This study examines white matter and axonal injury, and characterizes microglial reactivity in the corpus callosum of mice exposed to 10 weeks (150 hours) of PM. Nanoscale particulate matter (nPM, aerodynamic diameter ≤200 nm) consisting primarily of traffic-related emissions was collected from an urban …