Medicine and Health Sciences Commons^™

Navigating The Child Welfare System: An Exploratory Study Of Families' Experiences, Lianne Fuino Estefan

USF Tampa Graduate Theses and Dissertations

Growing up in a family environment that includes child maltreatment can result in an array of negative consequences for children, including health, behavioral, developmental, and social difficulties, and these consequences can persist over the lifetime. Families who have come to the attention of child welfare services for child maltreatment are at particularly high risk for experiencing multiple concurrent problems, including intimate partner violence, substance abuse, and mental health issues, as well as other family challenges. It is essential to intervene effectively with this population. However, there are few qualitative studies of parent experiences in the child welfare system through which …

A Pilot Study Of Small-Scale Variations In Outdoor Benzene Concentrations, Samantha Catherine Fridh

USF Tampa Graduate Theses and Dissertations

Benzene is an important toxic chemical in urban air and known human carcinogen released substantially by mobile sources. It's important to understand the spatial variation of benzene concentrations in order to understand exposures of susceptible sub-populations such as children and minority groups. Current monitoring networks use large and expensive air samplers that require electricity and restrict the location and number of samplers, not allowing for fine spatial resolution data.

The goals of this study are to develop and evaluate protocols for passive sampling and analysis of ambient benzene concentrations, and conduct a pilot study investigating small-scale variations over an area …

Actualizing Empowerment: Developing A Framework For Partnering With Families In System Level Service Planning And Delivery, Kathleen Ferreira

USF Tampa Graduate Theses and Dissertations

The engagement of families of children and adolescents with Serious Emotional Disturbance (SED) as full partners in individual treatment, organizational, and system level decision making has become an important focus for systems of care (SOCs) serving youth with emotional and behavioral challenges. SOCs typically include cross-agency partnerships with mental health, child welfare, juvenile justice, and education for the purpose of providing services and supports for youth with SED who have multi-agency needs. Implementation of a federal mandate requiring family driven care (FDC) within systems of care funded through the Children's Mental Health Initiative (CMHI) has revealed that most system of …

A Meta-Analysis Of Cultural Competence Education In Professional Nurses And Nursing Students, Ruth Wilmer Gallagher

USF Tampa Graduate Theses and Dissertations

Cultural competence learning interventions have been suggested to positively improve knowledge, attitudes, and behaviors in both professional nurses and nursing students. A meta-analysis was used to examine the effectiveness of learning interventions designed to increase the cultural competence in professional nurses and nursing students. This is the first known meta-analysis of studies on cultural competence learning interventions in professional nurses and nursing students.

The meta-analysis was done using 13 research studies on cultural competence educational interventions from 1999 to 2010 that were published peer-reviewed literature found in electronic databases. Analyses were computed using a fixed-effect model and effect size data …

The Role Of Hiv-1 Proteins In Alzheimer's Disease Pathology, Brian Nelson Giunta

USF Tampa Graduate Theses and Dissertations

Prevalence of HIV-associated cognitive impairment is rising, the worst form of which is HIV-associated dementia (HAD). The disease is fuiled by a chronic innate type pro-inflammatory response in the brain which is highly dependent upon the activation of microglia. We first created an in vitro model of HAD composed of cultured microglial cells synergistically activated by the addition of IFN-gamma and the HIV-1 coat glycoprotein, gp120. This activation, as measured by TNF-alpha and NO release, is synergistically attenuated through the alpha7nAChR and p44/42 MAPK system by pretreatment with nicotine, and the cholinesterase inhibitor, galantamine. As these medications have been FDA …

The Impact Of Managed Care On The Utilization And Distribution Of Inpatient Surgical Procedures With Demonstrated Volume And Outcome Endogeneity, Linda Stephens Gipson

USF Tampa Graduate Theses and Dissertations

Purpose

This study is designed to determine whether managed care has had an influence on the number and distribution of procedures with demonstrated volume and outcome endogeneity in Florida healthcare markets; in addition, methods are developed to determine which measures of managed care activity best predict the impact of managed care in health care markets.

Rationale

A retrospective population based cohort design is used capitalizing on the variability among Florida markets between 1995 and 1999, a period which captured the full business life cycle of managed care plans statistical areas and competing hospitals (market share) over time. Multiple regression models …

Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Heat Stress Levels, Brian Grace

USF Tampa Graduate Theses and Dissertations

Clothing can influence heat stress depending on the design and its ability to act as a barrier. The progressive heat stress protocol permitted the collection of data to empirically estimate the apparent total evaporative resistance (R_e,T,a). Five different clothing ensembles were evaluated, which included work clothes, cotton coveralls, and three limited-use protective clothing ensembles including a pthesis-barrier ensemble, (Tyvek^® 1424), water-barrier, vapor-permeable ensemble (NexGen^® LS 417), and a vapor-barrier ensemble (Tychem QC^®). The study design called for three metabolic level's: low, moderate, and high (L, M, & H) and three heat stages: compensable, transitional, …

The Mediating Role Of Social Support And Fulfillment Of Spiritual Needs In End Of Life Care, Kimberley A. Gryglewicz

USF Tampa Graduate Theses and Dissertations

End of life (EOL) caregiving can be a daunting and challenging endeavor as caregivers adjust to the ever-changing care demands associated with dying. Increased personal care, assisting with symptom and medication management, and attending to the emotional and spiritual needs of the dying person require caregivers to learn new tasks and to assume new roles such as social worker, nurse, and chaplain. As families continue to play an essential role in meeting the health care needs of their dying loved ones, it is imperative for social workers to understand the complexities of the end of life caregiving experience in order …

Relationship Between Cancer-Related Fatigue And Depression: A Pilot Study, Gloria Michelle Guess

USF Tampa Graduate Theses and Dissertations

Fatigue is one of the most bothersome symptoms reported by patients diagnosed with cancer, and research indicates that the majority of patients receiving chemotherapy report symptoms of fatigue. Fatigue can have an effect on quality of life; therefore, it is essential that healthcare providers gain a better understanding and recognition of fatigue.

Fatigue can also be a symptom of depression. Depression is another prominent symptom reported by patients diagnosed with cancer. Unfortunately, there are similarities between the symptoms of depression and fatigue making it difficult for health care providers to distinguish between the two. This study utilizes the subscale of …

A Comparison Of Oncology And Non-Oncology Nurses In Their Knowledge Of Cancer Pain Management, Nicole Houle

USF Tampa Graduate Theses and Dissertations

Approximately 1.5 million people are diagnosed with cancer each year. Most of these people will experience pain at some point during or after their treatment. Areas of knowledge that nurses have been shown to have deficits in include assessment and pharmacological management. These types of issues can affect the treatment given to their patients. The purpose of this study is to evaluate the level of knowledge of cancer pain management in oncology and non-oncology nurses and how they compare with each other.

To study these variables, two instruments, the Pain Management Knowledge Test and a demographic survey, were distributed to …

Friendship Networks, Perceived Reciprocity Of Support, And Depression, Ryan Francis Huff

USF Tampa Graduate Theses and Dissertations

Using social network analysis as a theoretical framework, the current study examined the associations between self-reported egocentric network characteristics and depression among a sample of United States college students. It is important to understand factors related to depression among this population due to the severity of its potential outcomes (e.g., suicide and interpersonal problems at school). Drawing inspiration from a recent study conducted by Christina Falci and Clea McNeely (2009), the current investigation used OLS regression to test for both linear and curvilinear relationships between egocentric network size and depression. Potential interactions between network size, density, and gender were also …

Case-Control Study Of Sunlight Exposure And Cutaneous Human Papillomavirus Seroreactivity In Basal Cell And Squamous Cell Carcinomas Of The Skin, Michelle R. Iannacone

USF Tampa Graduate Theses and Dissertations

Non-melanoma skin cancer (NMSC), comprised of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common cancer in Caucasians. Ultraviolet radiation (UVR) exposure is the most important environmental risk factor for both BCC and SCC development. However, the precise relationship between UVR and the risk of NMSC is complex, and the relationship may differ by skin cancer type. It has been hypothesized that intermittent patterns and childhood sunlight exposure are important for BCC while continuous (chronic) and lifelong (i.e. childhood and adulthood) sunlight exposure is important for SCC. Epidemiologic studies have demonstrated that cutaneous human papillomavirus (HPV) …

Evaluating Knowledge And Attitudes Of Graduate Nursing Students Regarding Pain, Eric Bartholomew Jackson

USF Tampa Graduate Theses and Dissertations

Insufficient pain management continues to be problematic for hospitalized patients throughout the country. It significantly interferes with a person's quality of life making it an issue of great concern to nurses in any setting. However, nurses do not do a good job of managing pain. The purpose of this evaluation was to assess graduate nursing students' knowledge and attitudes toward pain management.

Forty (n=40) graduate nursing students were asked to participate in the evaluation. All students agreed and completed the Demographic Data Form, Nurses Attitude Survey and the Pain Management and Principles Assessment. Thirty-eight females and two males participated in …

An Evaluation Of The Early Steps Referral Process In Hillsborough County To Detect Delays In Access To Early Intervention Services, Jessica Fry Johnson

USF Tampa Graduate Theses and Dissertations

Early intervention services are important in obtaining better outcomes for infants with a developmental delay or a condition that may result in a delay. In Florida, a primary resource for providing these services is the Early Steps Program. This study analyzed the Early Steps referral process to identify barriers to prompt access. The guiding hypothesis was if differences exist in key outcomes of the referral process, then these differences may reveal where improvements can be made. Improving access to early intervention should produce better outcomes and reduce the costs of services required later by addressing developmental concerns earlier.

The dataset …

Assessing The Relationship Of Monocytes With Primary And Secondary Dengue Infection Among Hospitalized Dengue Patients In Malaysia, 2010: A Cross-Sectional Study, Benjamin Glenn Klekamp

USF Tampa Graduate Theses and Dissertations

Dengue, a group of four similar viruses transmitted through the bite of a mosquito, is estimated to infect upwards of 100 million annually in over 100 nations throughout the global equatorial belt. Distribution of global dengue is highly skewed as Southeast Asian and Western Pacific regions endure 75% of the global dengue burden. Similar to other regional countries, Malaysia has been rapidly urbanizing, which has supported a hyperendemic dengue state.

The biological pathway by which dengue infection causes a wide range of clinical manifestations, spanning asymptomatic to life-threatening severe complications, is not comprehensively understood. Historically, severe dengue complications have primarily …

Associate Degrees In Health Related Occupations As Predictors Of Success In Physician Assistant Programs, David E. Kotun

USF Tampa Graduate Theses and Dissertations

The primary purpose of this study was to determine if applicants who had an associate degree in the health sciences prior to acceptance to a physician assistant program would do better than those applicants without an associate degree in the health sciences on three measures of success of physician assistant education. The three measures of success used were graduation rates, scores on the Physician Assistant Knowledge Rating and Assessment Tool (PACKRAT), and performance on the national certifying exam, the Physician Assistant National Certification Examination (PANCE). Data used for this dissertation were taken from original source documents and raw data sent …

Gender Differences In Lung Cancer Treatment And Survival, Margaret Anne Kowski

USF Tampa Graduate Theses and Dissertations

The objectives of this research were to test treatment and survival differences between women and men with lung cancer as there is minimal investigation in the literature. Three research questions were developed with statistical testing for gender differences based on similar cancer type, stage, treatment assignment and survival. Data for 44,863 primary lung cancer cases were collected from eight U.S. state-based cancer registries to investigate the research questions. The lung cancer incidence data included the morphological cell-types of adenocarcinoma (AC); squamous cell carcinoma (SCC); large cell carcinoma (LCC) and small cell carcinoma (SCC). Stage, grade, treatment type, as well as, …

Assessment Of The Dependence Of Ventilation Image Calculation From 4d-Ct On Deformation And Ventilation Algorithms, Kujtim Latifi

USF Tampa Graduate Theses and Dissertations

Ventilation imaging using 4D-CT is a convenient and cost effective functional imaging methodology which might be of value in radiotherapy treatment planning to spare functional lung volumes. To calculate ventilation imaging from 4D-CT we must use deformable image registration (DIR). This study validates the DIR methods and investigates the dependence of calculated ventilation on DIR methods and ventilation algorithms.

The first hypothesis is if ventilation algorithms are robust then they will be insensitive to the precise DIR used provided the DIR is accurate. The second hypothesis is that the change in Houndsfield Unit (HU) method is less dependent on the …

Bone Marrow Transplant Nurses' Attitudes About Caring For Patients Who Are Near The End Of Life: A Quality Improvement Project, Leslie Lauersdorf

USF Tampa Graduate Theses and Dissertations

In oncology setting, there is a range of emotions felt by patients and nurses alike such as helplessness, anger, sadness and anxiety; and this is especially the case as patients near the end of life. The literature shows there is an interest in nurses' attitudes toward caring for patients who are near the end of life. This project examines the overall attitude of Bone Marrow Transplant (BMT) nurses' attitudes toward caring for patients who are near the end of life using the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD) and a Demographic Data Sheet. This project investigated the …

Responding To Tobacco Craving: Acceptance Versus Suppression, Erika B. Litvin

USF Tampa Graduate Theses and Dissertations

Most treatments for substance use disorders (SUDs) are based on a model that craving is a primary cause of relapse, and therefore they emphasize skills for preventing and reducing craving. Acceptance and Commitment Therapy (ACT) provides a theoretical rationale for "acceptance" of drug-related thoughts and cravings, and proscribes suppression, a more intuitive and commonly used coping strategy. However, it remains largely unknown whether various coping strategies differentially affect craving intensity, drug use behavior, or other relevant outcomes during a craving episode. Using a randomized, between-subjects design (acceptance-based coping, suppression-based coping, or no coping instructions/control), the current study compared the effect …

Performance Assessment Of Predicted Heat Strain In High Heat Stress, Ronald Eugene Long

USF Tampa Graduate Theses and Dissertations

Heat stress is a common physical agent associated with many occupations. The most commonly used method of assessing heat stress exposure is an empirical method using the Wet Bulb Globe Temperature Index but his method is limited in its ability to parse out individual contributors to the heat stress. The International Organization for Standardization (ISO) published a rational model called Predicted Heat Strain (PHS) in 2004, and rational methods have the advantage of separating out the individual pathways for heat exchange. The objective of this research was a performance assessment of the current PHS model. This experimental design consisted of …

Transition Experiences Of Adolescent Survivors Of Childhood Cancer: A Qualitative Investigation, Alana Delores Lopez

USF Tampa Graduate Theses and Dissertations

Adolescent survivors of childhood cancer are a growing population with unique needs as they face a combination of challenges associated with normal development and returning to life after treatment completion (Wakefield et al., 2010). One specific need identified in the research literature includes the effective delivery of transitional care and planning (Hewitt, Greenfield, & Stovall, 2005). It has been suggested that the provision of transition care and planning can help facilitate the shift from one phase of care to another and promote positive transition experiences (National Cancer Institute, 2008). The shift from off-treatment to post-treatment and school reintegration have been …

Translation And Adaptation Of The Center For Epidemiologic Studies-Depression (Ces-D) Scale Into Tigrigna Language For Tigrigna Speaking Eritrean Immigrants In The United States, Mulubrhan Fisseha Mogos

USF Tampa Graduate Theses and Dissertations

Depression is one of the oldest known mental health conditions. It is acknowledged to be a global health problem that affects people from any culture or ethnic group. The prevalence of depression widely varied across countries and cultures. The cross-cultural relevance of the concept of depression, its screening or diagnosis, and cultural equivalence of items used to measure symptoms of depression has been area of research interest. Differences in prevalence rates in depression have been suggested as being due to research artifacts, such as use of instrument developed for one culture to another culture. With the current trend of globalization …

Nurse Manager Emotional Intelligence As A Predictor To Registered Nurse Job Satisfaction And Rn Perceptions Of The Practice Environment And The Relationship To Patient, Nursing And Hospital Outcomes, Jacqueline Cecilia Munro

USF Tampa Graduate Theses and Dissertations

The purpose of this study was to determine if the level of Nurse Manager (NM) emotional intelligence (EI) predicted registered nurse (RN) job satisfaction and RN perceptions of the practice environment. In addition, relationships to patient, nursing, and hospital outcomes were explored. Participants included RNs (N=659) and NMs (N=38) from 53 nursing units at eight hospitals located in the southeast region of the United States. A cross-sectional, correlational research design was used to test the hypotheses. Pearson product-moment correlation coefficients, simple linear and multiple regression statistics were conducted to analyze the data. Level of NM EI had a positive, not …

Visual Search For Smoking Stimuli: Detection And Distraction, Jason A. Oliver

USF Tampa Graduate Theses and Dissertations

Extensive research has shown that the attentional systems of addicted individuals are biased towards drug-related stimuli, but despite several decades of effort these results have frequently been inconsistent. Though commonly believed to result from addiction and dependence, cognitive research would suggest that frequent exposure to drug-related stimuli could affect the attentional processing of drug-related cues even if no actual drug use occurs. The present investigation examined attentional bias for smoking cues using a novel visual search paradigm amongst smokers currently in nicotine withdrawal and fully satiated smokers, as well as a non-smoker control group. Variables related to smoking behavior, as …

Does D-Cycloserine Augmentation Of Cbt Improve Therapeutic Homework Compliance For Pediatric Obsessive Compulsive Disorder?, Jennifer M. Park

USF Tampa Graduate Theses and Dissertations

D-cycloserine (DCS), a partial agonist that acts on the N-methyl-D-aspartate (NMDA) receptor of the glutamatergic receptor complex, may enhance fear extinction learning during exposure-based therapy. Clinical studies in adults with obsessive-compulsive disorder (OCD) and non-OCD anxiety disorders - and a recent trial in pediatric OCD - have shown that DCS can improve treatment response to exposure therapy relative to placebo and exposure therapy. Some have hypothesized that improved treatment response is a function of increased compliance and engagement in therapeutic homework tasks, a core component of behavioral treatment. The present study examined the relationship between DCS and homework compliance in …

Numeracy, Cancer Risk Perceptions, And Self-Protective Behaviors Among U.S. Adults, Teri Malo

USF Tampa Graduate Theses and Dissertations

Individuals have become more involved in health-related decisions, in part due to an unprecedented access to information that can be used to enhance both physical and mental health. Much of this health-related information is presented in a numerical format; unfortunately, research suggests many Americans may not possess the literacy skills necessary to comprehend numerical health-related information. More research needs to be conducted to examine numeracy and its role in cancer risk perceptions, and how those risk perceptions relate to cancer self-protective behaviors. The purpose of the current study was to: (a) examine socio-demographic variables associated with numeracy, (b) determine which …

Understanding The Psychosocial Aspects Of Waterpipe Smoking Among College Students, Mary Pautler Martinasek

USF Tampa Graduate Theses and Dissertations

Waterpipe tobacco smoking has migrated from being a custom of some cultures to becoming a staple around college campuses. The social nature and flavored tobacco encourage initiation in this tobacco naïve age group.

The study was a sequential mixed method design, employing primary data collection and analysis of a random sample of university students who live on campus at a single university. The study involved observations (N=6), intercept interviews with smokers and nonsmokers (N=63), three focus groups (N=31), and an online survey (N=288).

Findings were centered on the constructs of the Theory of Reasoned Action by Ajzen and Fishbein (1975), …

Repeated Binge Pattern Ethanol Administration During Adolescence Or Adulthood: Long-Term Changes In Voluntary Ethanol Intake And Mesolimbic Dopamine Functionality In Male Rats, Antoniette Michelle Maldonado-Devincci

USF Tampa Graduate Theses and Dissertations

Binge alcohol consumption is a rising concern in the United States, especially among adolescents as during this developmental period alcohol use is usually initiated and has been shown to cause detrimental effects on brain structure and function. These findings have been established through the use of binge models in animals, where animals are repeatedly administered high doses of ethanol typically over a period of three or four days. While such work has examined the effects of a four-day and repeated three-day binge, there has been almost no work conducted aimed at investigating the long-term behavioral and neurochemical and/or functional consequences …

Eating Disorder Metaphors: A Qualitative Meta-Synthesis Of Women's Experiences, Rachael Brooke Goren-Watts

Antioch University Dissertations & Theses

Eating disorders have reached epidemic levels in the United States and cause immense pain and suffering. Given the high fatality and relapse rates of eating disorders, as well as the numerous medical complications associated with them, it is useful to know more about how individuals view their eating disorder, and the meaning making during the recovery process in order to better understand the experience. Narrative theory, and specifically the metaphors women use to story their experience, enrich our understanding of eating disorders within a social constructionist lens. This qualitative meta-synthesis utilizes hermeneutics and identifies and describes the metaphors that women …