Medicine and Health Sciences Commons^™

Virtual Supervised Practice During The Covid-19 Pandemic. Does Virtual Learning Affect The Quality Of Preparation For The Rd Exam Or Beginning Dietetics Practice?, Shaynee M. Roper

UNF Graduate Theses and Dissertations

The Covid-19 pandemic has seemingly altered the practice of Dietetics, and its essential supervised practice component of the Dietetic Internship programs. Telehealth, in particular telenutrition, became a necessity of practice for the entire United States and many parts of the world. Medicare and many private insurance companies amended policies for the expansion, inclusion, and provision of MNT via telephone.¹ In addition, numerous Dietetic Interns were forced to complete the supervised practice (SPE) components of ACEND (Accreditation Council for Education in Nutrition and Dietetics) accredited programs virtually. The practice of telehealth is not a new concept. Indeed, this area of …

A Two-Day Virtual Workshop On The Micronutrient-Directed Nutrition-Focused Physical Exam For Ghanaian Nutrition Professionals: Examining Perceived Self-Efficacy And Innovation, Leah Anne Qubty

UNF Graduate Theses and Dissertations

Micronutrients are key components of various physiological processes. Therefore, in the setting of deficiency, poor health outcomes ensue. In Ghana, micronutrient deficiencies are common and medical resources are limited. The Ghanaian dietetics profession is growing, and this growth is propitiously timed to address micronutrient deficiencies. Biochemical markers of nutrition status are considered the gold standard to detect micronutrient deficiencies, but are costly and require specialized medical equipment. In the absence of available biochemical markers of nutrition status, the micronutrient-directed nutrition-focused physical exam is a viable tool. Nutrition professionals such as Registered Dietitians are qualified to conduct this exam, but feel …

The Potential Mediating Effects Of Social Support Network Size And Physical Activity On Cognitive Function And Mortality Risk, Madeline Zipperer

UNF Graduate Theses and Dissertations

BACKGROUND: Low cognitive function has been shown to be an independent predictor of all-cause and cardiovascular disease (CVD)-related mortality. Social support network size and total physical activity volume (TPAV) are two modifiable factors which have been shown to be independently associated with cognitive function and mortality risk. Therefore, the purpose of this study was to examine the potential mediating effects of social support network size and TPAV on cognitive function and all-cause and CVD-related mortality risk in a large, nationally representative sample of U.S. adults.

METHODS: Study sample (N =2,550) included older adult (≥ 60 years of age) participants …

Total Brachial Artery Reactivity And Incident Heart Failure And Heart Failure Sub-Types: Multi-Ethnic Study Of Atherosclerosis, Daniela Charry Segura

UNF Graduate Theses and Dissertations

Purpose: The aim of this study was to evaluate the association between total brachial artery reactivity (TBAR) and the cumulative risk of incident heart failure (HF), HF with reduced ejection fraction (HFrEF), and HF with preserved ejection fraction (HFpEF) in a community-based study. Methods: Sample included 5,499 participants (45-84 years of age) from the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease at baseline. Brachial artery ultrasound was performed after five minutes of cuff occlusion at the right forearm. TBAR was calculated as the difference between maximum and minimum brachial artery diameters following cuff release, divided by the …

Physician Knowledge, Attitudes, And Behaviors Towards Registered Dietitian Nutritionists, Amy Motley Jones

UNF Graduate Theses and Dissertations

Diet is increasingly linked with overall quality of life, and a healthy diet is now being considered one of the cornerstones of preventative care. Physicians rely on Registered Dietitian Nutritionists (RDNs) as most doctors lack the nutrition knowledge to properly treat their patients, especially during their residency. Little published information exists on the specific collaboration of RDNs and resident physicians. This study aimed to determine whether mentoring with an RDN increased physician nutrition knowledge, increased consults to RDNs, and whether physician attitudes improved regarding their understanding of the role of the RDN in healthcare. Knowledge or attitude alone are not …

The Effects Of Fermented Vegetable Consumption On The Composition Of The Intestinal Microflora And Levels Of Inflammatory Markers In Women: A Pilot And Feasibility Study, Amy Galena

UNF Graduate Theses and Dissertations

Background: The gut microbiome plays a key role in metabolic disease development. Diet is a modifiable factor that significantly influences gut microbial composition, and fermented foods are a reliable source of probiotic microorganisms that can contribute to gut homeostasis. The primary objective of this study was to explore the feasibility of fermented vegetable consumption for six weeks on markers of inflammation and gut microflora profiles in women.

Methods: Thirty-one women consumed 100 g/day of fermented vegetables (group A), non-fermented vegetables (group B), or no vegetables (group C) for six weeks. Dietary intake was assessed twice during the intervention by a …

Factors Associated With Overall Experience In Advanced-Practice Doctoral Programs, Kristi Chipman

UNF Graduate Theses and Dissertations

Advanced-Practice Doctoral (APD) students are working professionals who are often returning to school after several years of practice. Multiple areas and concerns may affect overall experience as well as retention rates in doctoral programs.

This mixed-methods research study utilized both qualitative (interview) and quantitative (survey) methods. Students from three different APD programs (Doctorate in Clinical Nutrition, Doctor of Education, and Doctor of Nursing) were asked to participate in a semi-structured interview. The interview was used to help guide the development of a survey. Students from the three groups (n=65) were asked to participate in a one-time, non-incentivized, survey. The survey …

Parents' Attitudes And Beliefs Towards Dietary Behaviors Of Children With Autism Aged 5-13 Years, Subashree Narayanan

UNF Graduate Theses and Dissertations

Autism is a neurodevelopmental disability that may affect nutritional management of children with autism. Parent’s attitudes and their behavior towards healthy eating reflects on the child’s eating habits and thus, their nutritional health. This study aimed to describe the diet quality of children with autism using the Healthy Eating Index (HEI) scores. It also aimed to assess the relationship between parent’s perceived barriers and self-efficacy and children’s dietary behavior and dietary intake (age 5-13 years). The relationship was assessed using 2 questionnaires, Nutrition and Health Awareness and BAMBI questionnaire for parent’s attitudes and beliefs and dietary behavior, respectively. Dietary intake …

Investigation Of The Multidimensional Determinants Of Nutritionally Risky Coping Strategies And Tradeoffs In Adults, Cheryl Marsland

UNF Graduate Theses and Dissertations

Multidimensional determinants influence use of negative nutrition coping strategies and tradeoffs in households accessing food relief. The objective of this study is to examine negative nutrition coping strategies and tradeoffs at different levels of food insecurity in households accessing food relief and investigate how these behaviors relate to experience-based food insecurity dimensions and populations at risk. This secondary data analysis is from the cross-sectional Sunshine State Hunger Survey (SSHS) conducted June 2018 to August 2018. Over 600 adults were surveyed capturing households of Floridians who accessed 18 direct service charities and community groups that provide food relief across the Tampa …

A Mixed Methods Study Examining The Barriers And Facilitators To Research Utilization And Evidence-Based Practice In Adult Weight Management, Kevin B. Metcalf

UNF Graduate Theses and Dissertations

Background

Obesity is a disease with many associated comorbidities and its prevalence in the U.S. continues to increase despite the majority of people with obesity attempting weight loss. Dietitians are responsible for using evidence-based practice to mitigate the effects of obesity, however, differences in practice philosophies, opinion leaders, misinformation, a sense of competence, and the complexity of nutrition research have been identified as barriers to implementing practice guidelines into daily practice. It is unclear how dietitians strike a balance between empirical evidence, anecdotal evidence, and patient-centered practice.

Aims

The primary aim of this mixed-methods study was to identify the barriers …

Validation Of An Evidence-Based Dietetic Practice Instrument And The Association Between Level Of Education And Use Of Evidence-Based Dietetic Practices Among Registered Dietitian Nutritionists, Leslie Thompson Van Horn

UNF Graduate Theses and Dissertations

Evidence-based practice (EBP) is associated with improved and consistent patient care and reduced healthcare costs. While dietetic didactic and practice requirements emphasize EBP, there is a lack of a valid and reliable instrument that measures both objective and subjective knowledge of EBP among registered dietitian nutritionists (RDNs). Content validity was conducted with 11 experts and resulted in a 38-item survey that included ten items assessing objective knowledge of EBP. Items were deemed clear and appropriate for the survey goals and intended audience based on a face validity review among 16 RDNs with varying backgrounds. A pilot evaluation (n = …

A Hopeless Illness Representation Style: Examining Chronic Illness And Depression With Coping As A Mediator, Dana Arnold

UNF Graduate Theses and Dissertations

The self-regulation theory of illness representations (Leventhal et al., 2003) and the hopelessness theory of depression (Abramson et al., 1989) were used to observe how hopeless illness representations, depression, and coping styles interact. 238 participants with a chronic illness lasting three months or more were observed through the VOICE (Verification of Illness and Coping Experience) survey. Mediation was used to analyze the relationship between hopeless illness representations and depression, with passive coping as the mediator. All regressions in the mediation analysis were significant, and partial mediation was found. Patients with hopeless illness representations were more likely to use passive coping …

Impacts Of Meals On Wings (Mow) Program On Volunteers' Perceptions And Motives, Juan Diego Salcedo

UNF Graduate Theses and Dissertations

INTRODUCTION: Food insecurity is a problem in the subpopulation of older adults and the elderly. The following study aimed to explore the perceptions and motives such as career benefits, impacts experienced through volunteering, skills in dietetics, comfort level with seniors, social responsibility, peer modeling, and empathy of student volunteers participating in a food recovery-meal delivery program known as Meals on Wings (MOW) on a college campus in the Southeast.

METHODOLOGY: The study was conducted during July 2021. Semi-structured interviews were administered over the video conference program Zoom to 10 (n=10) student volunteers who volunteered with MOW for at least one …

The Nutrition Care Process In Diabetes Medical Nutrition Therapy, Casey R. Colin

UNF Graduate Theses and Dissertations

The purpose of this study was to examine documentation quality and outcomes in a sample (n = 564 patient cases) of Diabetes Registry data from ANDHII, and to determine the validity and reliability of a revised NCP quality audit tool. RDNs have struggled to objectively demonstrate the value of MNT, which has limited MNT reimbursement and RDN recognition amongst allied healthcare providers. Development of a standardized process (the NCP), standardized language (the NCPT), and ANDHII have provided a means through which RDNs can improve MNT documentation and capture outcomes data, but gaps in adequate utilization exist. The most common …

An Examination Of The Impact Of The Covid-19 Health Threat, Stress, And Social Isolation On Lifestyle Habits As Analyzed Through The Protection Motivation Theory, Luciana Adib Soares

UNF Graduate Theses and Dissertations

The COVID-19 emerged in China in 2019 and quickly spread to other countries, leading to mandated lockdowns and social isolation. This cross-sectional study examined the impact of the COVID-19-generated stress, health threat, and social isolation on dietary, physical activity, and self-care habits of adults in Florida, utilizing the PMT as a framework. Participants (n = 478) completed online surveys about demographics, perceived stress, and changes in lifestyle habits. Significant positive changes were reported in cooking at home (p < .001) frequency, sweets (p < .001), and breakfast (p = .009) consumption, outdoors physical activity (p = .005), self-care (p < .001), relaxation (p < .001), and rest (p < .001) habits. Significant negative changes were reported in fast food (p = .004) and snack (p < .001) consumption. A significant relationship existed between self-reported stress, perceived threat, (r = .33, p < .001), and perceived efficacy, (r = -.15, p = .002). Perceived threat was the most important predictor of changes …

Safety Analysis Of Battery-Powered Adaptive Ride-On Toys For Children With Disabilities, Abbey Fraser

UNF Graduate Theses and Dissertations

Modified battery-powered ride-on toy cars, or adaptive ride-on toys, represent novel rehabilitation tools and developmental aids for children with disabilities. Studies have shown that children are benefiting socially and developmentally from their use. However, the use of these toys by children with disabilities potentially poses a risk of injury and it is vitally important to ensure the safe use of these toys, particularly for the benefit of those with developmental challenges.

Within this context, the purpose of the first study was to determine whether modifications to ride-on toys are sufficient to prevent common modes of injury such as falls, passenger …

Exploring The Impact Of A Nutrition Support Workshop For Ghanaian Nutrition Professionals, Sarah D. Zeola

UNF Graduate Theses and Dissertations

Ghana, a middle-income country in West Africa, has long experienced high rates of malnutrition and is increasingly struggling with nutritional challenges from non-communicable diseases including overweight, obesity, hypertension and stroke. There is an inadequate number of trained Ghanaian nutrition professionals to meet the demands of providing nutrition care for the citizens of Ghana and those professionals providing nutrition care have limited opportunities for continuing education. This quasi-experimental prospective, single cohort pre-test/post-test research was conducted in Accra, Ghana in September 2019 to determine if providing a nutrition support workshop to Ghanaian nutrition professionals (dietitians, dietetic interns, dietetic students and nutritionists) would …

The Self-Perceived Impact Of A Food Recovery-Meal Delivery Program On Homebound Seniors’ Food Security, Nutrition Health, And Well-Being, Alice Marie Sanchez

UNF Graduate Theses and Dissertations

For many senior citizens, meeting nutritional needs is essential to good health and daily function. Studies indicate that many American older adults are not meeting their nutrition needs and often suffer from food insecurity. Meals on Wings (MOW) is a food recovery-meal delivery program that attempts to decrease the influence of food insecurity among older adults. This study aims to explore the self-perceived impact of a food recovery-meal delivery program on homebound seniors’ nutrition health, food security, and well-being.

Semi-structured interviews were administered to adults age 55 and older on the waitlist for Meals on Wheels America in Duval County …

Biomarkers Of Inflammation In Heart Failure Patients With Reduced And Preserved Ejection Fractions: Multi-Ethnic Study Of Atherosclerosis, Michelle Lynne Stone

UNF Graduate Theses and Dissertations

Purpose Examine the relationships between high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and soluble tumor necrosis factor-α receptor-1 (sTNF-R1) and the cumulative risk of heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fractions in a diverse, population-based sample. Methods Study sample included 6,814 adult (45-84 years of age) men and women who participated in the Multi-Ethnic Study of Atherosclerosis and were free of cardiovascular disease at baseline. Cox regression was used to calculate the hazard ratios (HR) associated with elevated baseline hs-CRP (> 3-10 mg/L), IL-6 (> 75^th percentile) and sTNF-R1 (> 75^th percentile) and risk of overall …

Diabetes Risk Status And Physical Activity In Pregnant Women: U.S. Brfss 2011, 2013, 2015, 2017, Bethany Rand

UNF Graduate Theses and Dissertations

Objective: We sought to examine differences in aerobic activity (AA) and muscle-strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States.

Background: Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations.

Methods: The sample (n=9,597) included pregnant women ages 18-44, who participated in 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS were: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or …

Colors Of Fruits And Vegetables And Diabetes Risk In The United States Latino Population, Raymond Anthony Colon

UNF Graduate Theses and Dissertations

Objectives: Fruits and vegetables (FV) play an important role in people’s health. The current study aimed analyzed if specific colors of FV are associated with type 2 diabetes mellitus (DM) risk in the United States (US) Hispanic/Latino population.

Methods: This study used participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). It is a multi-center, prospective cohort study with 5,740 self-identified Hispanic/Latino individuals from 2008-2011. Data collected include anthropometrics, oral glucose tolerance test (OGTT), dietary intake, medical history, physical activity, and sociodemographic information. FV are categorized into five color groups: green, white, yellow/orange, red/purple, and uncategorized.

Results: A total …

Development And Validation Of A Mindful Food Parenting Instrument To Assess The Relationship Between Parent Food Practices And Children’S Dietary Outcomes, Su-Nui Escobar

UNF Graduate Theses and Dissertations

American children’s diets are commonly recorded as deficient in nutrient rich foods such as vegetables, fruits, and whole grains. Such diets often exceed amounts of unhealthy items such as added sugars and sweetened beverages. In addition, 23% of children are considered overweight or obese. Mindfulness techniques in parents have been correlated with improved dietary outcomes in children and a healthier family eating environment.

The primary aim of this study was to develop and validate an instrument that reflects the theoretical framework drawn from current models of mindful eating, mindful parenting and mindful food parenting. The instrument is a practical tool …

Person-Centered Physical Training Programs For Individuals With Intellectual Disabilities: Stimulating Motivation And Participation As Essential Components Of Program Development, Monica Bolaños-Boudreau

UNF Graduate Theses and Dissertations

This qualitative case study explored the perceptions of two individuals with intellectual disabilities who participated in a person-centered physical training program that identified factors of motivation and influences on self-determined physical choices. The findings of this study revealed five factors that seemed to motivate participants to exercise; (a) enjoyable activities, (b) personalized program, (c) exercises that promoted health and positive self-images, (d) exercise routines that were familiar and safe, and (e) an exercise partnership with the trainer. Considering these factors of motivation, community leaders, administrators, and practitioners may promote self-determination and ultimately, impact participation by individuals with intellectual disabilities. Additionally, …

Military Veteran Students Transition To Academic Life With Ptsd, Trauma, And Potential For Freezing Response., Alicia Marie Erchul

UNF Graduate Theses and Dissertations

The current study is the first known research to investigate the association of the freezing response with PTSD and traumatic stress in the military veteran student population. Current understanding of the freezing response are primarily based in comparative psychology, with some studies extending to human participants (Azevedo et al., 2005; Facchinetti et al., 2006; Hagenaars et al., 2012; Volchan et al., 2017). Models generally agree that the freezing response consists of reduced body sway with decreased heart rate (Porges, 2003, 2007; Hagenaars et al., 2014).

Thirty-eight military veteran students (n=38; 18 female; 20 male) with ages ranged from 19 to …

An Examination Of Social Connectedness On Ptsd And Freezing In A Student Military Population, Jessica Marie Ledwith

UNF Graduate Theses and Dissertations

This study investigates the impact of social connectedness (SC) and post-traumatic stress disorder (PTSD) in a military college population, and their relation to physiological measures such as body sway, heart rate (HR), and heat rate variability (HRV). According to previous research, people with PTSD are more likely to exhibit a freezing response to affective images. In the present study, we explore the potential freezing response for military personnel at the levels of PTSD symptom groups and social connectedness. We also investigate the possible buffering effect social connectedness has on the outcome of PTSD and freezing. There was a total of …

Fight, Flight, Or Freezing? Investigating The Immobility Response In Military Veterans, Paige Elizabeth King

UNF Graduate Theses and Dissertations

When the body is faced with threat to life or limb, the autonomic nervous system works to overcome the danger – by either fight, flight, or freezing. While immobility may not appear to be the most logical solution, theories exist that it allows for judgement of the situation and preparation for action. This study investigated the stress response that military veterans, with or without post-traumatic stress disorder (PTSD), demonstrate when shown unpleasant images. Researchers wanted to determine the extent to which veterans would show freezing or immobile responses when under an unpleasant image condition. It was hypothesized that veterans who …

Effect Of Case Presentation On Physical Therapy Students’ Clinical Reasoning, Nicholas Larosa

UNF Graduate Theses and Dissertations

This mixed-methods study investigated the effects of case method presentation on the clinical reasoning hypotheses generated, strategies implemented, and errors made by physical therapy students working through a musculoskeletal clinical problem. The study was framed by Marton and Säljö’s levels of processing, McCrudden’s et al. goal-focusing model, Cognitive Load Theory, and the Model of Domain Learning. Verbatim transcriptions for each problem-solving session was created and coded. Cohen’s kappa was κ = .75 indicating substantial inter-rater reliability for the finalized coding schemes. Quantitative analysis included mean and standard deviation calculations followed by Mann Whitney-U comparisons which detected several significant differences …

Risk Domains And Adolescent Depression, Nathan Kawczynski

UNF Graduate Theses and Dissertations

Adolescence and young adulthood are the periods of development associated with the highest amount of risk-taking. One theory, the Dual-Systems model, suggests that this could be due to an imbalance in the maturation of two brain systems: reward appraisal, which matures first, and cognitive control, which matures later. This imbalance may be the cause of adolescents’ tendency to favor immediate rewards, disregarding consequences. Depressed adolescents, however, behave differently. While it is not exactly clear whether they take more risks or fewer risks, depressed adolescents display different interactions and decision making with their peers than non-depressed adolescents. This study attempted to …

Educating For Engagement: The Influence Of Physical Therapist Education On Lifelong Learning And Professional Engagement, Raine Osborne

UNF Graduate Theses and Dissertations

Healthcare professions educational programs have a responsibility to develop professionally engaged lifelong learners. Knowledge of the factors important to the development of these desirable characteristics may inform educational leaders’ decisions about program and curriculum design. This study aimed to investigate the relation between level of education and an orientation towards lifelong learning and future professional engagement. In addition, the influence of learners’ type of motivation for continued learning, and learning goal orientation on this relation was also assessed.

A cross-sectional survey of learners from a single healthcare profession, physical therapy was conducted to investigate these relations. Physical therapist learners from …

Correlations Between Dietary Indicators And Cardiometabolic Profiles In Preschool Children., Kristin M. Berg

UNF Graduate Theses and Dissertations

ABSTRACT

Background: Recent literature suggests preschool children regardless of income, age, ethnicity, and gender are subject to future cardiometabolic risk. Dietary intake, when analyzed can indicate diversity and lack of meeting adequate nutrient standards. A combination of anthropometric and blood analysis with dietary intake assessment can provide practitioners the knowledge for adequate early nutrition intervention and education.

Objectives: This descriptive, cross-sectional study describes the relationship between dietary intake and cardiometabolic indicators in preschool children. There is also a comparison of mean subject values and referenced national standards.

Study Sample: Four hundred seventy-one preschool children, between the ages …