Medicine and Health Sciences Commons^™

Instituting An Oral Health Preventive Service Program, Including Fluoride Varnish, For Preschool Children Birth To Five Years In A Rural Health Clinic: A Clinical Scholarship Project, Carol Ann Berger

Dissertations

Abstract This project was designed to institute an oral health preventive program in a rural health clinic, in a dental provider shortage area, promoting oral health in preschool children birth to five years by: (a) instituting a program that supports the Missouri preventive service program in oral health, (b) promoting oral screenings and fluoride varnish twice yearly, (c) assessing the risk of caries, (d) referring to appropriate dental services and (e) educating parents or guardian about the importance of oral health and how to maintain oral health at home with children birth to five years. This project sought to answer …

Development Of An Advanced Practice Registered Nurse Primary Care Telephone Clinic, Linda G. Kaiser

Dissertations

Abstract Development of an Advanced Practice Registered Nurse Primary Care Telephone Clinic This pilot project developed and implemented a telephone clinic based on established Veterans Affairs telephone policy and procedures and determined patient acceptability of this new visit type as an alternative to face to face visits. The review of the literature produced research that indicates telephone clinics are a viable visit option for patients. Telephone visits provide access to the primary care provider while being convenient and economical for patients. Research studies demonstrate that patients are satisfied with this visit option. The pilot project was successfully implemented in a …

Oncology Nurses' Cultural Competence, Knowledge, And Attitudes Toward Cancer Pain, Ayman Alnems Phd, Msn, Rn

Dissertations

Effective pain management requires appropriate knowledge, attitudes, and assessment skills. The purposes of this study were to obtain information about the knowledge and attitudes of oncology nurses related to cancer pain and its management, to evaluate oncology nurses' cultural competence, and to investigate relationships between oncology nurses' cultural competence and their pain management knowledge and attitudes. Ferrell and McCaffery's (2008) Nurses' Knowledge and Attitude Survey Regarding Pain (NKASRP), the Cultural Competence Assessment Survey (CCA) (Doorenbos, Schim, Benkert, & Borse, 2005; Schim, Doorenbos, Miller, & Benkert, 2003), and a demographic questionnaire were used to measure oncology registered nurses' cultural competence and …

California School Nurses' Knowledge, Attitude, And Intention To Participate In Sexuality Education, Maria G. Matza Phd, Msn, Rnc

Dissertations

A critical need exists to provide adolescents with sexual health education as demonstrated by our nation's position in having the highest adolescent pregnancy rates among all the developed nations. The critical need is further pronounced by California's changing demographic profile of young Latinos who are projected to be the majority in 2042 and continue to demonstrate higher pregnancy and birth rates than other racial and ethnic groups. Currently, there is limited evidence to confirm if California's students are receiving sexual and reproductive health as required by law, nor is there evidence to link school nurses as teachers or consultants in …

Factors And Health Promoting Behaviors That Influence Maternal And Infant Outcomes In Older Pregnant Thai Women, Supawadee Thaewpia Phd, Msn, Rn

Dissertations

This dissertation summarizes research conducted in partial fulfillment of the program requirements for the Doctor of Philosophy in Nursing degree from the Hahn school of Nursing and Health Sciences, University of San Diego. The results of the dissertation research are organized as three discrete papers. Article one is entitled; "Reliability and Validity of Thai Translations of Instruments Measuring Psychosocial Factors and Health Promoting Behaviors among Older Pregnant Thai Women." This article describes the dissertation research study in which the selected instruments were piloted at an antenatal clinic in Thailand. The article determines the instruments' ability to examine perceived benefits, perceived …

In Their Own Words: The Lived Experiences Of Unemployed African American Men, Kenlana R. Ferguson

Dissertations

Due to staggering unemployment rates, African American men's experience with work in the U.S. has historically received widespread attention in the media and social science literature. Terms such as black male unemployment crisis, puzzle, epidemic and catastrophe have been used to describe the unemployment woes of black. Attempts at explaining why African American men are experiencing such difficulty in the world of work has been undertaken across the disciplines, however much of this work has amounted to nothing more than acknowledgement that isolating independent factors as causes does not suffice and that a more interdisciplinary framework is needed if we …

Teaching Language To Children With Developmental Disabilities Using Combined Direct Reinforcement And Stimulus-Stimulus Pairing, Brighid Helene Fronapfel-Sonderegger

Dissertations

Several researchers have used stimulus-stimulus pairing (the pairing of speech sounds with established reinforcers) to increase the frequency of specific vocalizations in children with disabilities. However, only a few addressed the utility of stimulus-stimulus pairing to increase functional language, and none combined stimulus-stimulus pairing and direct reinforcement. The present study combined stimulus-stimulus pairing and direct reinforcement to successfully teach 2 to 10 functional mands in 21–49 7-minute sessions with four children with developmental disabilities with low verbal repertoires. Following mand training, two children were taught 10 tacts for pictures using the combined direct reinforcement and stimulus-stimulus pairing procedure in a …

The Impact Of Guided Imagery On Sleep Quality In Mothers Of Preterm Infants, Linda M. Schaffer Phd, Mn, Rn

Dissertations

Background: Mothers who have given birth to preterm infants are at an increased risk for impaired sleep. Evidence based interventions are needed to assist mothers in improving their sleep quality as few are available. Purpose: Guided by the transactional framework of Lazarus and Folkman (1984), the purpose of this study was to: describe maternal and infant factors which influence sleep quality, examine the relationships between depression, anxiety, stress, social support, to sleep quality, and describe the influence of a R-GI intervention on sleep quality among a sample of mothers whose preterm babies were admitted to NICU. Methods: This prospective, descriptive, …

Enzyme Therapy In Oncology Care: A Clinical Scholarship Project, Julie Penick

Dissertations

Studies worldwide indicate that oral enzyme therapy (OET) can prevent or reduce the side effects associated with standard oncology care. Yet use of OET is not common in the United States. The ultimate aim of the proposed project is to improve the quality of life of women with breast cancer who are on standard chemotherapy protocols. Achieving this goal can be facilitated by implementation of the proposed feasibility project designed to: (a) enhance the knowledge of oncology care providers and women with breast cancer on use of OET in conjunction with standard oncology care, (b) assess the attitudes of oncology …

Analytical Strategies For Drug Residues In Various Matrices In A Regulatory Laboratory., Geraldine Dowling

Dissertations

Abstract

Today, in modern farming practices veterinary drugs are given to food-producing animals. The generic term “veterinary drugs” covers a broad variety of classes of chemical compounds and the list of drugs is enormous and it is a significant analytical challenge in regulatory control to provide monitoring programmes. The major concerns in veterinary drug usage are the presence of harmful residues that may be introduced into the human food chain. The aim of this research is the development of analytical methods capable of screening and confirming increased numbers of these residues in target matrices by Gas Chromatography Tandem Mass Spectrometry …

In Search Of Resilience And Positive Health Outcomes In Low-Income Adolescents With Asthma, Darla Kim Dewolff

Dissertations

Asthma is a chronic lung disease of epidemic proportions affecting 24.6 million Americans, including 7.0 million children. In particular, 22% of high school students indicated a doctor or a nurse had told them that they had asthma, with 10.8% with current asthma. The disease disproportionately afflicts minority children from low-income areas. Adolescents with asthma, who live in such areas, are at particular risk for increased morbidity and mortality. The purpose of this study was to examine the degree to which the phenomenon of resilience, observed in other physical health and psycho-social contexts, may be found in adolescents with asthma exposed …

Coping Mechanisms Among Lebanese First-Time College Students, Rita Doumit

Dissertations

No abstract provided.

Statin-Mediated Attenuation Of Chemokine Expression In Peripheral Nerve Vascular Endothelial Cells, Kelly Ann Langert

Dissertations

Pro-inflammatory cytokines, including tumor necrosis factor-α (TNF-α), play a pivotal role in the pathogenesis of Guillain-Barré Syndrome (GBS), a debilitating autoimmune disorder that affects the peripheral nervous system. By up-regulating endothelial expression of chemokines and cell adhesion molecules (CAMs), TNF-α facilitates the recruitment and trafficking of autoreactive leukocytes across the blood-nerve barrier and into peripheral nerves, an early pathological hallmark of GBS. Literature indicates that TNF-α, monocyte chemoattractant protein-1 (MCP-1), and intercellular adhesion molecule-1 (ICAM-1) are locally increased in patients with GBS, correlating with disease severity. Similar findings have been demonstrated in an animal model of GBS, experimental autoimmune neuritis …

The Effects Of Smooth Muscle Cells On Engineered Microvasculatures In Fibrin Hydrogels, Areck A. Ucuzian

Dissertations

Capillaries are comprised of two cell types: the endothelial cells (ECs) which line the lumen of the capillary, and the supporting pericytes which are closely apposed to the abluminal surface of the capillary wall (sometimes called mural cells). These pericytes are phenotypic derivations of mesenchymal organ stromal cells (from smooth muscle cells and fibroblasts in blood vessels, for example), are recruited and incorporate into the neocapillaries, and are known to mediate reciprocal interactions with ECs during angiogenesis. The overall purpose of this project is to determine how smooth muscle cells (SMCs) affect angiogenesis during microvascular development in fibrin hydrogels using …

Forebrain Noradrenergic Alterations And Anxiety After Myocardial Infarction, Jaimee Glasgow

Dissertations

Thirty to 45% of patients who suffer a myocardial infarction (MI) develop anxiety disorders and/or depression, and the development of mood and anxiety disorders following MI is a major risk factor for cardiovascular morbidity and mortality. Depressed post-MI patients have an increased risk of fatal arrhythmias, which are often precipitated by emotional stressors. However, the central nervous system mechanisms that contribute to post-MI anxiety and arrhythmia susceptibility are unknown. Therefore, the studies reported in this dissertation were designed to test the hypothesis that alterations in noradrenergic transmission in the forebrain contribute to the development of anxiety disorders and arrhythmia susceptibility …

The Emotional Intelligence Profiles And Cognitive Measures Of Nurse Anesthesia Students In The Southeastern United States, Shawn Bryant Collins

Dissertations

Problem. The purpose of this cross-sectional correlational study was to explore the relationship between emotional intelligence and personal and academic factors of nurse anesthesia students at three points in a program: matriculation, at one year of study, and in the last semester of study and the relationship of these to clinical scores and national certification examination (NCE) scores.

Method. An ex-post-facto cross-sectional study design was used to gather data at three critical times in nurse anesthesia (NA) programs to explore the relationships between emotional intelligence scores, preadmission demographics, clinical scores, and NCE scores.

Results. Data from 216 nurse anesthesia students …

Acute-To-Home Care Nursing Handoffs: Distributed Cognition Across Patterns Of Knowledge, Rosemary Kennedy

Dissertations

Timely, explicit, and effective communication of patient information during care transitions is fundamental to safe care. Studies show that handoffs or transfers of patient care from one provider to another are susceptible to communication failures (Riesenberg et al., 2009a). Most studies on communication failures focus on communication between providers within the same setting of care. Few studies, if any, focus on communication between care settings in different locations. However, research has identified gaps in care during critical transitions and identified poor communication and incomplete transfer of information as the root cause (Naylor et al., 2004). This qualitative dissertation consists of …

Shades Of Grey: An Exploration Of The Student Learning Experience In Diagnostic Radiology Education, Kathleen Linda Linaker

Dissertations

Diagnostic radiology education is a specialty within healthcare education and encompasses education at both the undergraduate and resident level. There is little research regarding what constitutes effective radiology education. The broad purpose of this study was to investigate through the student perspective how chiropractic students learned diagnostic radiology within their curriculum and what contributed to this learning. This interview-based, qualitative research explored the learning experiences of 12 fourth-year chiropractic students at two colleges. Specifically this study investigated a) the learning strategies students believe both worked and didn't work in learning radiology, b) student perceptions of the effectiveness of instructional methods …

Risk Perception, Psychological Well-Being, And Health-Promoting Behaviors In Persons Informed Of A Coronary Artery Calcium Score, Jennie Elizabeth Johnson

Dissertations

Background: Cardiovascular disease (CVD) remains the leading cause of adult deaths because individuals continue to engage in behaviors that exacerbate CVD. New technologies such as coronary artery calcium (CAC) screening detect atherosclerosis before clinical disease is manifested. Awareness of an abnormal finding should enhance motivation for change.

Objective: To examine how awareness of a CAC score affects risk perception and health-promoting behaviors in persons at high risk for CVD.

Methods: This study used a descriptive prospective design with 174 high risk adults (3 or more major risk factors) recruited at a radiology center offering CAC scans in a Chicago suburb. …

The Development Of Trust In The Nurse-Patient Relationship With Hospitalized Mexican American Patients, Sharon M. Jones

Dissertations

The Hispanic population in the United States is growing and this population experiences health care disparities compared to non-Hispanic Whites. Mexican Americans are the largest sub-group of Hispanics and providing nursing care that is patient-centered and culturally competent is important when caring for this population. Trust is an important component of patient-centered care and culturally competent care as well as a major element , (confianza) in the Hispanic culture. Although nursing researchers have identified the need for trust in culturally competent care with Mexican American patients, none have explored how trust develops between the nurse and the Mexican American patient. …

Role Of Myosin Light Chain Kinase In Binge Ethanol And Burn Injury-Induced Intestinal Barrier Dysfunction, Anita Zahs

Dissertations

Ethanol is a common factor in traumatic injury, including burn injury. Previous studies from our laboratory indicate that ethanol increases both pulmonary and gastrointestinal inflammation as well as susceptibility to infection in burn-injured mice; however, the mechanisms of these responses are not entirely known. Moreover, after burn injury, bacteria and their products leak out of the intestinal lumen and into the bloodstream. These bacteria can disperse throughout the body leading to pulmonary damage, acute lung injury, sepsis, and death. Ethanol in combination with burn injury has been shown to decrease intestinal barrier function greater than either insult alone. Long (210 …

Impact Of Multiple Children On Parental Supervision Practices, Parental Developmental Competence, And Unintentional Injury Risk, Jennifer L. Taylor

Dissertations

Unintentional injury is the leading cause of childhood mortality and morbidity in the United States. The effects of injury on children, families and society encompass physical, mental, emotional, and financial consequences. The highest injury rates are among preschool age children, especially preschool children who have siblings. Child injury prevention strategies can reduce the rates of childhood unintentional injuries and minimize the burdens to children, families, and society created by these injuries. To design and implement effective child injury prevention strategies, further investigation is needed to understand the relationship between the variables influencing the occurrence of child injuries. The specific aim …

Chest Tube Dressings: A Comparison Of Different Methods, Susan Kathleen Blackburn Jones

Dissertations

This study is an experimental design with randomization comparing the use of standard gauze dressings (SGD) to transparent adhesive dressings (TAD) to cover chest tube insertion sites in post-operative patients who have undergone cardio-thoracic surgery. The study was conducted in a 400 bed, tertiary non-academic teaching hospital in the Midwestern United States. Seventy-nine patients were enrolled in the study; 39 received TAD and 40 received SGD. The non-inferiority margin was set at 15% in keeping with current recommendations (Kaul & Diamond, 2006). The TAD was found to be not inferior to the SGD with regards to the proportional differences in …

Caring, Interaction, And Active Teaching Strategies: Factors That Contribute To The Success Of The Associate Degree Nursing Student, Penelope Sue Logsdon

Dissertations

This exploratory study examined successful associate degree nursing students’ perceptions regarding the importance of caring by the nursing faculty, nursing faculty/student interaction, and faculty use of active teaching strategies. Participants completed a researcher developed survey instrument that measured both the importance and frequency of the caring, interaction, and active teaching strategies. The survey instrument measured six demographic factors and 30 statements regarding caring, interaction, and active teaching. Participants rated the statements for both importance and frequency on a four-point Likert scale. Five community and technical college associate degree nursing programs participated in the research with a total of 270 successful …

Nursing Students' Lived Experiences Surrounding Medication Administration, Sally Nan Morgan Phd

Dissertations

Medication errors are abounding and the complexity of medication administration creates an environment where health care providers are at risk for making errors. This environment includes nursing students learning medication administration. Coupled with a rigid, protocol-driven pedagogy, nursing students may be placed in a learning experience counterproductive to accuracy. Previous studies have focused on causes and perceptions of medication errors looking for the delineation between safe and unsafe practice. In doing so, past research may have narrowed the path of discovery needed to diminish medication errors. In addition, research regarding the lived experience of nursing students while they are learning …

Call-Shift Fatigue And Use Of Countermeasures And Strategies By Certified Registered Nurse Anesthetists, Ramona M. Domen Phd, Crna

Dissertations

Purpose: The purpose of this study was to examine whether Certified Registered Nurse Anesthetists (CRNAs) experience fatigue during call and to assess their use of fatigue avoidance strategies (practices that prevent fatigue) and fatigue countermeasures (practices that decrease fatigue) to mitigate its effects. Method: Using a cross sectional descriptive survey design, data were collected from a randomly selected sample of 323 practicing CRNAs who worked call shifts. Data analysis: Data were analyzed using descriptive and multivariate statistics. Results: The sample was fairly evenly distributed with slightly more female respondents, 55% (n = 179). Fifty four percent worked a weekday call …

Development Of An Instrument Measuring The Perceived Attributes Of Using A Healthy Diet Innovation, Holly Ann Federico Huye

Dissertations

The Lower Mississippi Delta (LMD) is a rural region that is rich in agricultural resources but is one of the most impoverished areas in the US. Prior research has indicated LMD adults as having higher rates of obesity and diet-related chronic diseases as compared to US adults. While the need for dietary intervention in the LMD is evident, the first step in designing effective interventions is the assessment of one’s perceptions of dietary behaviors. The purpose of this research was to develop a valid and reliable instrument to assess individuals’ perceived attributes of using a healthy diet. Using the Diffusion …

Women's Cognitive Appraisals Of Their Birth Experience As Predictive And Maintaining Factors Of Postpartum Posttraumatic Stress Symptom Severity, Lauren Carr Spooner

Dissertations

Empirical support has accumulated for evidence of posttraumatic stress symptoms following approximately 30% of childbirth experiences (Olde, van der Hart, Kleber, & van Son, 2006). Researchers have suggested that there is a complex relationship among predisposing, precipitating, and maintaining factors that impact postpartum PTSD (Slade, 2006). Anxiety, perception of support, and negative cognitions are such factors that have been shown to significantly correlate with PTSD symptoms (Foa & Rothbaum, 1998; Olde et al., 2006; Soet, Brack, & Dilorio, 2003), but have not been studied together in relation to PTSD associated with traumatic birth. The current study controlled for trait anxiety …

The Effect Of Six Weeks Of Oral Echinacea Supplementation On Erythropoiesis, Nitric Oxide Production, And Exercise Performance, Tyler David Martin

Dissertations

The purpose of the present study was to investigate the effect of six weeks of oral Echinacea supplementation on serum erythropoietin (EPO) and erythropoietic status, plasma nitric oxide [NO], submaximal endurance exercise performance, and maximal oxygen uptake (V˙O_2max). Twenty-four males (mean ± SE): age = 25.2 ± 1.4 yr, height = 178.1 ± 1.4 cm, mass = 78.1 ± 1.6 kg, percent body fat = 12.7 ± 0.9 %, V˙O_max = 52.9 ± 0.9 mL·kg^-1·min^-1 were randomly grouped using a matched-pair, double-blind design and self-administered 8,000 mg·d^-1(5 × 400 mg × 4 …

Health Literacy And Health Promotion Behaviors Among Samoans, Katherine Tong Phd, Msn, Cfnp, Phn

Dissertations

Limited health literacy is associated with failure to engage in health promotion behaviors. Few studies examine this relationship among Samoans. This study used a cross-sectional correlational design to determine health literacy levels and their relationship to health promoting behaviors in a southern California Samoan population. Health literacy (Short form Test of Functional Health Literacy in Adults) and health promotion behaviors (Health Promotion Lifestyle Profile II) were measured in a convenience sample of 87 Samoans in southern California. Data analysis employed chi-square, t-test, and one- way ANOVA. Significant associations were found for health literacy and demographic characteristics of employment and marital …