Medicine and Health Sciences Commons^™

Feasibility Study Among Military Personnel With Traumatic Amputation During Military Combat Or Training, Michele (Shelly) R. Burdette-Taylor Phd, Msn, Rn-Bc, Cwcn, Cfcn

Dissertations

Military operations have resulted in a significant number of mangled extremities leading to traumatic amputations. Extremity injuries predominate, representing 50% to 70% of all injuries treated (Melcer, 2010). The majority of injuries sustained in Operation Endearing Freedom/Operation Iraqi Freedom (OEF/OIF) are combined penetrating, burn and blast injuries, traumatic amputation, and infections from the multi-drug resistant organism, Acinetobacter (Melcer, 2010). The purpose of this study was to measure the quality of well-being and impact of events in a group of adults who served in the U.S. armed forces and sustained the loss of one or more limbs during any combat or …

Shrouded In Stigma: A Heuristic Study Of Living With Hiv, Neal Stacy Rosenburg

Dissertations

HIV-related stigma is a serious hindrance to addressing the recruitment, maintenance, and follow-up nursing care of HIV-infected persons. This study was anchored within the heuristic research model, which engaged both the researcher and participants in a dialogical and aesthetic manner to unveil the stigma of HIV. The close proximity of the researcher and study participants revealed the most visceral, emotional, and self-reflective nature of gathering data, while maintaining the integrity and rigor of a qualitative study. The purpose of this heuristic study was to examine the lived experiences of HIV-infected individuals relating to internalized stigma within an existential context. This …

The Cultivation And Practice Of Spiritual Care Expertise In An Inpatient Palliative Care Setting, Gail Elaine Pittroff

Dissertations

Caregivers involved in palliative care seek to understand problems and challenges at end of life through research to determine the best care for patients and their families. Spiritual care is a key component of quality end of life care, yet there is a paucity of research on spiritual care in inpatient settings at end of life in nursing literature. The purpose of this study was to examine the personhood and spiritual care practices of inpatient palliative nurse consultants. This study describes expert nurse’s experience of delivering spiritual care for patients and families at end of life in inpatient palliative care …

The Mother's Perspective: Understanding More About The Health Care Needs Of The Preschool Child With Autism, Margaret W. Bultas

Dissertations

Background Information: The prevalence of autism spectrum disorders (ASD) has dramatically risen over the last decades. It is known that children with ASD visit health care providers (HCP) more frequently than typically developing peers. Given behavioral and medical complexities of these children, mothers may experience barriers in this process. Purpose: The purpose of this study was to gain a better understanding of mothers’ experiences of taking their children to the HCP. Aims of this study were to reveal mothers’ concerns related to these experiences, examine resources and barriers affecting the quality of the visit, and discover more about the effect …

Spermatogenesis: Laser Microdissection Optimization, Deborah Ann Hansen

Dissertations

Studies link paternal environmental exposures to pesticides, herbicides, and radiation to adverse reproductive outcomes such as developmental delays, malignancies, and structural birth defects. To date, 900 children of Vietnam veterans with presumed Agent Orange exposure receive VA presumptive service connected benefits because these children have Spina Bifida. To date, there are limited data to explain the underlying causal mechanisms whereby paternal environmental exposures result in adverse reproductive events. Laser microdissection (LMD) is the only technology that allows the isolation of cell subpopulations from complex tissues such as the testes without disturbing the cell’s bimolecular signature. LMD is essential in the …

Direct Care Workers Perceptions And Practices Related To Quality Of Life In Long Term Care, Karen M. Kinyon

Dissertations

The focus of this case study was to discover how DCWs define success in their practice and what institutional and individual factors contribute to their successful practices. It describes how DCWs perceive quality of life for NH residents and how their practices reflect quality of life indicators. The conceptual model for which this research is based on was developed around the concepts that individual and institutional factors contribute to the successful practices of direct care workers; and, how these DCWs perceive quality of life influences how they practice to promote quality of life for nursing home residents. Using a case …

Ability Of Clinicians-In-Training To Recognize Vicarious Traumatization: A Multiple Case Study, Amy Cavanaugh

Dissertations

Clinicians repeated exposure to clients who have a history of traumatic experiences can lead to vicarious traumatization (VT), which is the potential for clinicians to experience negative consequences such as changes in their sense of self and worldview (McCann & Pearlman, 1990). Experiencing VT negatively impacts the clinician’s professional identity and counseling work with clients (Pearlman & Saakvitne, 1995a, 1995b; Saakvitne & Pearlman, 1996). Having an awareness of VT is a first step in protecting oneself from experiencing the potential consequences of counseling clients who have experienced trauma. Given this, it seems relevant to understand what clinicians-in-training know about VT. …

Neurochemical Effects Of Amyloid-Beta Oligomers In Rats, John J. Panos

Dissertations

Alzheimer’s disease is a progressive neurodegenerative disease characterized by memory loss and cognitive decline. Although the symptomology of Alzheimer’s disease is well defined, its precise etiology remains elusive. Animal models are invaluable for understanding the pathogenesis of this devastating disease. Knowledge of the neurochemical actions of amyloid-β oligomers in specific brain structures is essential for validating animal models of Alzheimer’s disease and for determining the most appropriate behavioral assays of memory. The specific aim of this project was to investigate the neurochemical effects of direct intracerebral infusion of amyloid-β oligomers in the rat. Experiment 1 investigated direct infusions of synthetic …

Student Persistence In Associate Degree Nursing Programs At Mississippi Community Colleges, Kathryn Lee Fleming

Dissertations

The purpose of this study was to examine factors of student persistence and attrition in addition to strategies that may help students persist in associate degree nursing programs at community colleges. Data were collected from nursing students enrolled in first-year associate degree nursing programs at participating Mississippi community colleges and analyzed using multiple regression and repeated measures ANOVAs. Tinto’s Classic Model and Bean & Metzner’s Nontraditional Model of Student Attrition were utilized in this study. This mixed methods convenience sample yielded 564 participants, and the results were as follows: environmental factors and demographic factors of student persistence were found to …

Lgb-Affirmative Therapists' Use Of Developmental Models Of Lgb-Identity In Therapy. A Phenomenological Investigation, Victoria E. Cane

Dissertations

Socially sanctioned hostility toward sexual minority persons continues to be a reality in the United States and worldwide. Therapists working with sexual minorities have responsibility to provide non-pathologizing, affirmative therapy to these clients. A central aspect of affirmative therapy is therapists' recognition and understanding of sexual orientation (SO) identity and developmental models of sexual minority identity have a played a vital role in promoting this understanding. Although such models have been central to the practice and training of affirmative therapy, therapists' applied use of the models has not been empirically investigated. For this phenomenological study, nine affirmative therapists were interviewed …

Tongueless: Representation Of The Mentally Disabled And The Novel, Brent Walter Cline

Dissertations

This study examines the representation of the mentally disabled in the novel for two related outcomes. The first is to prove that the representation of the mentally disabled is not merely a subset of the representation of the disabled in general. This is intended less as a political statement as it is a literary one. Acknowledging and building off the work of writers in disability studies such as David Mitchell, Sharon Snyder, and Tobin Siebers who concentrate on the body of the disabled, this study shows that attempts to represent the mentally disabled are fundamentally different than those who are …

Perceived Levels Of Nurse Educators' Attainment Of Nln Core Competencies, Julie Kinney Higbie

Dissertations

Nurse educators need to be well-prepared with essential competencies, to prepare nurses for their future in health care. Nurses who are recruited to teach, must meet at least minimal competencies and be provided appropriate resources to assume their roles in academia. The recently published National League for Nursing (NLN) Core Competencies for Nurse Educators (2005) identify the skills, knowledge and attitudes necessary for both novice and experienced faculty.

This research study explored faculty's perceived attainment of these competencies utilizing Benner's Novice to Expert theory as a framework. It examined several areas of interest related to nurse educator competency, years of …

The Relationship And Effects Of Mindfulness On Comfort, Work Satisfaction, And Burnout Among Nurses Who Provide Direct Patient Care, Pamela Lichtenberg Heard

Dissertations

This study proposed to examine the problem of burnout in the nursing profession and ways to ameliorate burnout. Many burnout studies in the past focused on the problem and possible solutions that managers and/or hospital administrators could incorporate into their organization. The focus of this study is to evaluate ways that nurses can decrease their own propensity to burnout through the use of mindfulness. Therefore, this study examined burnout in a non-traditional manner. It is not assumed that others must assist nurses with decreasing their levels of burnout. Mindfulness is a means by which nurses can empower themselves to combat …

Assessing Mississippians’ Preparedness For Disasters Using The Citizen Corps National Survey 2009, Carl Huston Mangum Ii

Dissertations

Disaster preparedness, a shared responsibility of all citizens and disaster agencies, is the most critical component in minimizing risk and damage from disaster. Mississippi has been affected by some of the most devastating disasters in American history, both in terms of physical destruction and human life. The purpose of this study was to assess Mississippians’ disaster preparedness by replicating The 2009 Citizen Corps National Survey (CCNS). The 65 question 2009 CCNS was slightly modified to survey 678 randomly selected Mississippians about the Citizen Corps Personal Disaster Preparedness Model: Demographics, Volunteering, Drills/Exercises, Community Plan, Household Plan, Disaster Supplies, Prevention, Self-efficacy, Reliance, …

Thai Patients' Experiences Of End-Stage Renal Disease: A Path Through An Unknown World, Chuleeporn Piyasut Phd

Dissertations

The purpose of the study was to explore how Thai end-stage renal disease (ESRD) patients manage the challenges of living with hemodialysis. The participants were Thai ESRD patients, who were receiving hemodialysis in one of the central provinces in Thailand. A grounded theory approach was employed in this study as it focuses on social processes grounded in individual experiences of participants in the study. The participants included 30 ESRD patients, aged 26-75, who had been undergoing hemodialysis from 6 months to 12 years. Individual in-depth interviews were audio-recorded and transcribed. Data were analyzed by using Atlas.ti. Data analysis revealed "a …

A Critical Reflection On Advanced Practice Nursing, Patricia Quinn Phd

Dissertations

Legitimation of the Nurse Practitioner (NP) and advanced practice nursing is explored using the framework of critical theory and the case study methodology of Yin. Three different cases are analyzed using classic themes of critical theory - oppression, alienation and ideology and false consciousness. Three publishable articles comprise this portfolio. First is "Looking for love (legitimation) in all the wrong places - A critique of Nurse Practitioner effectiveness literature". This article reviews the literature of NP effectiveness and offers an analysis of the failures and problems of these positivistic studies. Article two is "At least some of us are still …

Breastfeeding And Mothers With Chronic Health Conditions, Blanche Landis Phd

Dissertations

Breastfeeding and Mothers with Chronic Health Conditions Breastfeeding may be most beneficial for women with specific chronic illness and may decrease the risk or prevent those illnesses from developing in their children. This study examined the initiation and duration rates of mothers identified as having asthma, hypertension, and diabetes; differences between the three groups in their efforts to breastfeed, and associations between determinants/outcomes of breastfeeding and behavioral beliefs, normative beliefs, and perceived control of mothers using Ajzen's Theory of Planned Behavior (TPB). A retrospective quantitative methodology was used to compare rates of initiation and duration, the differences between the three …

Pharmaceutical Marketing: A Comparison Of Different Markets, Paul Sherlock

Dissertations

No abstract provided.

Grade Point Average As A Predictor Of Timely Graduation From Associate Degree Registered Nursing Programs, Delores J. Jackson

Dissertations

The purpose of this study was to determine if admission selection strategies that utilize cumulative and/or pre-requisite GPA are predictive of timely graduation for associate degree nursing (RN-AD) students. Data were obtained from de-identified records of 437 associate degree nursing students enrolled in three Midwest community colleges from 2003-2006. Of the total sample, only 44% of the students graduated on time (i.e., in four semesters or two years). Although a statistically significant difference was found for timely graduation rates between colleges (ranging from 29% in College B to 54% in College A), no relationship was found for cumulative GPA, pre-requisite …

The Abortion Attitudes Of Counselor, Social Worker, And Nursing Trainees, Mary J. Ball

Dissertations

This study examined the similarities and dissimilarities in abortion attitudes among counselors (CTs, n = 51), social workers (SWTs, n = 42), and nurses in training (NTs, n = 78), based on profession, age, race, gender, and religion. Data were analyzed using analysis of variance and standard multiple regression. It was predicted that profession, religion, age, gender, and race would predict the abortion attitudes of CTs, SWTs, and NTs in training. It was also predicted that the attitudes of CTs and SWTs would be most similar, and that both of these groups would hold more positive abortion attitudes than NTs. …

Experimental Analysis Of Gambling Using A Concurrent-Schedules Procedure, Andrew Ellis Brandt

Dissertations

Gambling has been experimentally investigated using various types of gambling simulations designed to mimic the contingencies found in real-world games of chance. Findings from past risky choice research suggest that certain procedures used in existing gambling simulations may systematically increase levels of gambling. Two of these characteristics, the use of a participant stake and the type of options available during gambling, were tested in four experiments in which participants had the opportunity to gamble using tokens exchangeable for entries into a $50 lottery. Experiments 1 and 2 tested persistence on a gamble option when either a single-option or a concurrent …

Evaluation Of Medication Effects On Academic Performance, Sleep, And Core Adhd Symptoms In Children, Tina K. Head

Dissertations

Idiosyncratic effects of Vyvanse™ (lisdexamfetamine dimesylate) and placebo were evaluated in a double-blind alternating treatments experimental design in this 4-week study. Direct, objective measures were combined with traditional behavior ratings to provide data sets to assess whether or not the prescribed stimulant medication showed detectable therapeutic effects for a child whose positive response to medication was not obvious via traditional subjective methods. Effects of medication on core ADHD symptoms, academic performance, and sleep in four children ages 10-12 with attention deficit/ hyperactivity disorder. Potential side effects were also measured. Daily measures included parent rating scales, side effects checklist, sleep journal …

The Effect Of Shapedown On Habits And Self-Esteem For Overweight And Obese Children, Susan Bonnell Phd

Dissertations

Obesity in children is increased in the United States and globally which creates both physical and psychological health risks and co-morbidities affecting the development of positive self-esteem (Sinton & Birch, 2005; Whetstone, Morrissey, & Cummings, 2007). The development of poor self-esteem in children increases the risk of problem behaviors such as aggression, crime, teenage pregnancy, drug and alcohol use, tobacco use, and eating disorders (Brook et al., 2007). Treatment of childhood obesity is multifaceted, requiring behavioral and lifestyle changes for both child and family to achieve a healthy weight (De-Santis-Moniaci & Altshuler, 2007; Plourde, 2006; Ritchie, Crawford, Hoelscher, & Sothern, …

Predictors Of Job Satisfaction And Burnout In Travel Nurses, Marcia Faller Phd, Msn, Rn

Dissertations

This study examined various individual and work environment characteristics and their influence as predictors of travel nurse job satisfaction and burnout. In addition it described travel nurses; a population of nurses that has not been previously studied. An explanatory sequential mixed methods design was used in order to take advantage of the exploratory nature of the qualitative portion in describing the attitudes and motivations of travel nurses in detail; and to further explain the findings from the quantitative portion of the study. The quantitative portion of the study used a descriptive correlational methodology with secondary data analysis of a cross-sectional …

The Impact Of A Clinical Mentor Program On Patient Outcomes, Cynthia M. Steckel Phd

Dissertations

The increasing complexity of patient care requires an expert nurse to navigate the hospital stay, yet today's workforce brings a declining supply of seasoned nurses, creating a patient need/nurse expertise gap. The clinical mentor role was developed to bridge this gap and create a safety net, using expert nurses, relieved of a patient assignment, to provide oversight for quality patient care. Results reported elsewhere showed improvements in failure to rescue and pressure ulcers six months before and after implementation. The purpose of this study was to examine the long-term impact of this new care model over the subsequent three years …

Battery And Abuse In The Elderly: A Forensic Analysis, Amy Y. Carney Phd, Mfs, Np

Dissertations

Elder abuse is a recognized social problem in the United States. First labeled as "granny battering" and originally studied under the umbrella of family violence, maltreatment of the elderly has received more funding and research in recent years. Multiple aspects of elder abuse have been examined in the literature including measures for detection, assessment, and documentation. Although studies have examined the circumstances surrounding abuse as well as theories of causation and characteristics of the abuser and the abused, studies of the relationship between the abuser and the abused are less well documented. The purpose of this research was to examine …

Application Of Systems Engineering Science To The Healthcare Environment, Jonathan Mack Phd, Msn, Anp, Rn

Dissertations

This Doctoral dissertation consists of a research portfolio examining the application of systems engineering techniques to the healthcare environment. The portfolio consists of three final publishable articles submitted to meet the program requirements for the, Doctor of Philosophy in Nursing degree from the University of San Diego, Hahn school of Nursing and Health Sciences. Article one is titled; "Use of a bed projection tool to predict ICU bed needs." This article describes the dissertation research study in which a bed projection tool was piloted on an ICU unit to determine the tool's ability to predict inpatient bed requirements. Article 2 …

Violence, Depression, Parental Stress, And Child Neglect Among High Risk Postpartum Women, Kristen D. Lambert Phd, Msn, Rn

Dissertations

The purpose of this study was to characterize a vulnerable population of postpartum women at risk for family violence and maladaptive outcomes and to determine the degree the identified attributes increase the risk of child neglect and psychological aggression. Lazarus' Appraisal Theory and Scaer's Traumatic Spectrum framework provided a conceptual basis to examine the interrelationships between intimate partner violence (IPV), depression, previous traumatic history, and child neglect. A descriptive correlation design using secondary analysis of longitudinal data collected for the Healthy Families San Diego Clinical Trial was used. Standardized measures including the CTS, CTS2, CTSPC, CES-D and PSI were administered …

Knowledge Transfer In Public School Food Service: Post-Implementation Of The Process Approach To Haccp Food Safety System, Lydia Rebecca Frass

Dissertations

Based on Havelock's (Havelock & University of Michigan. Center for Research on Utilization of Scientific Knowledge, 1969) Knowledge Transfer Model and using Kirkpatrick's Training Evaluation Model (1996a, 1996b) levels of Reaction, Behavior, and Learning, this study analyzed knowledge transfer between public school district managers, cafeteria managers, and line workers. These employees were trained through cascade training methods during the federally mandated implementation of the Process Approach to HACCP food safety system beginning in the 2005-2006 school year.

Measuring Behavior, an Observation Checklist (based on HACCP's 7 steps and 10 FDA food borne illness risk factors and interventions) was used to …

Shared Presence: Caring For A Dying Spouse, Lana Sue Mclouth Kanacki Phd, Ms, Rn

Dissertations

There is limited research on female spouses and their end-of-life experience with their dying husbands. The purpose of this study was to explore wives' perceptions of hospital and hospice care at their husbands' end-of-life. The grounded theory method was used for this study. Data were collected over thirteen months and then transcribed and coded for meaning. Participants were 25 elderly widows (62-103 years of age) with 19 husbands' deaths in a hospice setting and 6 in the hospital. They were widowed from 6 months to 10 years after the death of their spouses. They were good informants with excellent recollections …