Medicine and Health Sciences Commons^™

The Struggles Black Women Face In Federally Qualified Community Health Centers In South Carolina: A Phenomenological Exploration Of Women In Leadership Positions, Sharon Black

Dissertations

This qualitative interpretive phenomenological study examined the professional lived experiences of Black women who hold leadership positions within Federally Qualified Community Health Centers (FQHCs) in South Carolina. The researcher examined their experiences through the lens of Belenky’s (1986) Ways of Knowing framework, focusing on self-expression, voice, and how the participants processed their leadership experiences. In addition, the study draws on Crenshaw’s Intersectionality and Black Feminist Post-structuralist theories. The study explores the difficulties, successes, and strategies these women use, focusing on stereotypes, challenges in leadership roles, diversity of experiences, and the importance of voice themes.

The study provides practical suggestions for …

Evaluation Of Communication Sciences And Disorders Graduate Student Attitudes Related To Trauma-Informed Client Interactions, Jenica Joseph

Dissertations

Problem

Communication sciences and disorders (CSD) graduate students may have trauma histories and may be ill-equipped to identify and manage trauma responses in clients. This mixed-methods study examined graduate student attitudes towards implementing trauma-informed educational practice (TIEP) methods and trauma-informed patient care.

Method

The Attitudes Related to Trauma-Informed Care (ARTIC) Scale (Baker et al., 2016) quantitatively measured pretest/posttest changes in CSD graduate student attitudes towards use of trauma-informed care with clients. Participants (n=43) were assigned to non-equivalent experimental and control groups. Groups received the pre/posttest and either an immediate (experimental) or delayed (control) trauma-informed educational session. Twenty-one participants completed focus …

Measuring The Effect Of An Intervention On Student Engagement And Reading Comprehension, Kaitlin Reichart

Dissertations

Students arrive at school each day with a great disparity in emotional and learning readiness. This is caused by a multitude of factors such as chronic stress, family separation, poverty, the COVID-19 pandemic, sexism, trauma, ACEs, racism, and lack of access to resources. Students need daily assistance in understanding and regulating their emotions. Schools have become the central place for supporting students' mental health, yet teachers are generally overworked and underprepared in the area of supporting mental health. The purpose of this dissertation was to determine the impact of a universal tier one self-regulation intervention on student engagement and reading …

Simulation Psychological Safety Ecosystem: A Grounded Theory Study Of Nurses’ Experience With Psychological Safety In Prelicensure Simulation, Susan Eller

Dissertations

Over the past couple of decades, the utilization of simulation-based education in prelicensure nursing expanded in both frequency and functionality. Learning through simulation requires psychological safety where participants feel comfortable engaging to their fullest extent and can speak up or ask questions without fear of embarrassment to themselves or others. Professional simulation organizations provide recommendations for creating psychological safety, yet anecdotal stories from nurses report variability in their experiences ranging from positive to negative. Research regarding psychological safety in nursing education revealed some consistent themes of anxiety due to being observed or unfamiliar with simulation environments or expectations. The evolving …

Relationships Among Perceptions Of Support, Experiences Of Gatekeeping, And Burnout In Counselor Educators And Supervisors, Alicia Lamar

Dissertations

Counselor educators and supervisors carry out the responsibility of ensuring that counselors in training are competent and fit for practice. Burnout can occur when stressors in the workplace are not addressed. Engagement in the role of gatekeeper and perceptions of support can be factors that impact burnout in counselor educators. The exploration of variables that may relate to counselor educator burnout would benefit the counseling community including counselor educators, counseling students, counseling clients, and the community at large. There has been a paucity of research exploring the relationships among faculty members’ perceptions of support, experiences of gatekeeping, and burnout in …

Twitter Sentiment Analysis: Applications In Healthcare And Finance, Jiali Wang

Dissertations

This research explores the influence of Twitter sentiment on healthcare and finance industries. It assesses how Twitter sentiment and culture measure influence COVID-19 statistics, and it investigates the impact of Twitter sentiment on S&P 1500 stock mispricing. Furthermore, it examines how tweet sentiment predicts major industry returns.

The first part examines how Hofstede’s Culture Dimensions (HCD) and Twitter economic uncertainty index (TEU) relate to COVID-19 infection rate and death rate. The results show certain aspects in HCD, such as power distance index (PDI) and masculinity (MAS) both are negatively and significantly associated with the infection rate, while indulgence (IVR) and …

Using The Social-Ecological Model To Better Understand Sexual Assertiveness Among Undergraduate Women At An Institution Of Higher Education In The Southeastern United States, Lisa Wright

Dissertations

This study examined sexual assertiveness among female undergraduate students at an institution of higher education in the southeastern United States from the context of the social-ecological model. An online survey instrument examined sexual assertiveness, sexual communication self-efficacy, campus climate, and sexual scripts. Structural equation modeling was used to examine the relationships between these variables and all variables significantly predicted sexual assertiveness individually, but when examining the relationships collectively, only sexual communication self-efficacy and campus climate remained significant predictors of sexual assertiveness.

Effects Of Resilience Coaching On Behavioral Health Nurse Burnout, Dalila Franklin

Dissertations

Abstract

Background: Inpatient, staff nurse burnout negatively impacts nurses’ mental and physical health, hospital nurse retention and turnover, and patient care. The Stress First Aid for Health Workers program attempts to bolster resilience and subsequently reduce burnout among mental health nurses in this project.

Method: This quality improvement (QI) project was an observational pre-post survey design and was conducted on a cohort sample of inpatient, behavioral health nurses at an urban, mid-sized, Midwestern hospital psychiatric unit to assess personal, work-related, client-related, and overall burnout utilizing the Copenhagen Burnout Inventory (CBI) tool to quantitatively measure burnout pre- and three months post-implementation …

The Host Mir-17-92 Cluster Negatively Regulates Mmtv Replication By Targeting Its Genomic Rna Via Mir-92a, Jasmin Baby

Dissertations

The mouse mammary tumor virus (MMTV) is a milk-borne infectious agent capable of inducing mammary tumors primarily and to some extent, T-cell leukemias/lymphomas in mice. While MMTV has typically been employed to investigate fundamental processes in breast cancer initiation and progression, very little is known about the virus-host interplay during this process. MicroRNAs (miRNAs) are renowned master regulators of the transcriptome that influence key cellular activities, including anti-viral pathways that combat incoming viral infections. A recent study from our group revealed that unlike some retroviruses like bovine leukemia virus (BLV), MMTV does not encode virally-encoded miRNAs (v-miRs); rather, it perturbs …

Preclinical Behavioral Assessments Of Mitraginyne, The Main Psychoactive Alkaloid In Kratom, Rachel Burroughs

Dissertations

Mitragyna speciosa (kratom) is a medicinal plant indigenous to Southeast Asia and Africa with a long history of use for a variety of ailments, including diarrhea, pain relief, cough suppression, and amelioration of opiate withdrawal symptoms. Despite its status as an herbal remedy, kratom is banned in some countries due to a myriad of negative health risks. Preclinical psychopharmacology studies of mitragynine (MG), the main alkaloid of kratom, indicate it has opioid-like effects at higher doses and psychostimulant-like effects at lower doses. The current study utilized three rodent behavioral paradigms to evaluate the putative psychostimulant effects of MG. The specific …

Pharmacogenomics Translation In A Community Medical Context Using A Diffusion Of Innovations Framework: Provider Perspectives And Evaluation Implications, Sabrina Ewald Holley

Dissertations

Translation, in the context of medical research, is a process that describes how knowledge and innovation move and change into real world applications and outcomes. This study explores the translation of a medical innovation, pharmacogenomics (PGx), from research into clinical practice using the perspectives of medical providers in a community setting. PGx is the influence of a person’s genetics on drug response. Despite being available for over a decade, PGx testing is not widely adopted. Prior research primarily examined PGx translation in large academic medical centers, but not much is known about it in community practice settings. A better understanding …

Lifestyle Choices Related To Food Consumption And Their Relationship To Depression, Steven L. Jennings Jr.

Dissertations

Dieting, or the act of restricting oneself to small amounts or particular kinds of foods on the basis of health, spirituality, lifestyle, and moral decisions, is a practice that dates to 1066 A.D. However, with social media being as influential as it is, one might believe dieting is a new obsession or at least an obsession to which popular culture is returning. Despite this, it is only in recent years that researchers have begun to focus on the health benefits of such behaviors. The present study was designed to take this focus a step further by exploring the potential risks …

Hiv And Early Life Stress On Neuroimaging And Risky Behavior, Paola Garcia Egan

Dissertations

This study examined the interactive effects of early life stress (ELS) and HIV on brain morphometry, diffusion-basis-spectrum-imaging (DBSI), risky decision-making, and sex-risk behavior. 122 people with HIV (PWH) and 113 people without HIV (PWoH), free of major psychiatric illness and neurological confounds, were stratified into high (≥ 3 events) vs. low (< 3 events) ELS [PWoH/low ELS (n = 57), PWoH/high ELS (n =56), PWH/low ELS (n = 43), PWH/high ELS (n = 79)] and underwent structural magnetic resonance imaging, DBSI, neuropsychological, and risky-behavior assessment; all PWH were virologically controlled. Compared to PWoH, PWH had smaller orbitofrontal cortex (OFC), parietal lobes, insula, caudate and anterior cingulate. No ELS effects were detected in volumetric measures. Significant interactions were found between HIV serostatus and ELS on the OFC and on cellularity of the inferior fronto-occipital fasciculus after multiple comparisons adjustment. Specifically, PWH/high ELS exhibited significantly smaller OFC and PWoH/high ELS show significantly larger OFC than the other groups. PWoH/high ELS exhibited higher DBSI cellularity (neuroinflammation proxy) of the inferior-occipital-fasciculus compared to PWoH/high ELS. Regardless of HIV status, executive function moderated the relationship between the OFC and sex-risk behavior such that individuals within the sample who performed above average on a measure of executive function and had a larger OFC reported fewer sex partners in past six months than individuals with smaller volumes. No interaction was found between HIV serostatus and ELS on risky behavior measures. Clustering analyses defined ELS subgroups in PWH that were determined by demographic characteristics, duration of infection, recent CD4+ T-cell count, nadir CD4+ T-cell count and high/low ELS.Even in PWH that are virologically controlled, without major current psychiatric comorbidities, there is evidence of a synergistic impact of ELS and HIV on OFC volumes. Higher volumes in the OFC were detrimental when associated with lower executive function scores or advantageous when associated with higher executive function. Findings suggest that ELS is associated with different brain signatures among PWoH and virally suppressed PWH. However, ELS was not directly associated with risky behaviors, and subgroups in PWH were characterized by demographic variables, past substance use and HIV clinical variables.

Family Media Use Plan Implementation For School-Age Children, Mandy Kelly

Dissertations

Abstract

Background: This paper poses to discuss and examine the concern of unmonitored and excessive internet use by school-age children, ages eight years to 11 years old, along with the importance of employing a Family Media Use Plan, which is recommended by the American Family of Pediatrics (AAP). This issue, although not often studied, is a common occurrence today and is associated with physical and mental health concerns for this vulnerable population.

Method: This quality improvement project was accomplished through educating and surveying the parent population of the Intermediate building of a rural, Southeast Missouri Public School District. The involved …

Palliative Care Services On An Adult Inpatient Oncology Unit, Heather E. Barger

Dissertations

Abstract

Problem: Palliative care (PC) services are widely underutilized for patients with cancer, partly due to the shortage of PC specialists. Additionally, many Americans have not filled out advance directive (AD) paperwork which is commonly addressed in PC. In the absence of an AD, cancer patients are at risk of receiving undesired aggressive treatments in the event they are unable to make decisions independently.

Methods: This quality improvement pilot initiative utilized a descriptive observational design to evaluate the number of ADs documented in the electronic health record (EHR) on an inpatient oncology unit. A retrospective EHR review was used to …

Fall Prevention Among Older Adult Behavioral Health Patients, Jodie Shipley

Dissertations

Abstract

Problem: Inpatient falls are a major patient safety issue. Behavioral health units experience higher rates of falls among elderly patients with between 13.1 to 25 falls per 1,000 occupied bed days (OBD). The risk of falls for the aged population is increased on a psychiatric unit due to a myriad of issues including psychotropic medications, over-activity on the unit, and confusion (Wong & Pang, 2019).

Methods: This QI project is an observational descriptive pilot intervention evaluation of a redesigned fall prevention program with the aim to reduce falls on a midsized suburban Midwestern inpatient geriatric behavior health …

Parent Perceptions Of Adolescent Technology Use: Implications For The Parent-Child Relationship, Tiffany Somerville

Dissertations

Technology and social media use are now more popular than ever with adolescents. Problematic technology use has often been associated with decreased mental health and relationship quality. Researchers have typically identified problematic technology use by time spent on a device rather than in an interpersonal context. Phubbing and technoference are two constructs that describe how technology use can potentially be disruptive to in-person interactions. Little research has investigated technology use in the context of the parent-child relationship despite reports from parents that technology use is a frequent source of conflict. Through the theoretical frameworks of Bronfenbrenner’s neo-ecological model and structural …

Gestational Diabetes Mellitus Screening, Diagnosis And Knowledge In The United Arab Emirates, Maryam Mohammed Bashir

Dissertations

Gestational diabetes mellitus (GDM) is a significant public health problem with short- and long-term consequences. If undiagnosed and untreated, it is associated with multiple adverse perinatal outcomes and future risk of developing type 2 diabetes mellitus (DM) and other cardiovascular diseases in affected mothers and children. In the United Arab Emirates (UAE), up to 1 in 4 pregnancies are affected by GDM. This PhD dissertation explores GDM screening, diagnosis, guideline use, and knowledge to provide a basis for primordial, primary, secondary, and tertiary levels of prevention in GDM care in the UAE. Three studies were conducted to achieve the PhD …

Infertility Characterization, Factors Associated With Primary Infertility, And Seroprevalence Of Genital Infections: A Cross-Sectional Survey In Abu Dhabi, United Arab Emirates, Noor Motea Abdo

Dissertations

Worldwide, infertility affects 8%–10% of couples and it could be primary or secondary. In the United Arab Emirates (UAE), one in every six couples are facing difficulties in conceiving. However, there is a noticeable lack of epidemiological studies and empirical data characterizing populations seeking infertility treatment in the UAE. Therefore, to inform health policy planning, evidence-based data is required to understand the most common type of infertility and the burden of exposure to genital pathogens. To characterize fertility-treatment-seeking patients, investigate factors associated with primary infertility, and to estimate the seroprevalence of six pathogens known to be transmitted genitally and associated …

Investigations Of The Potential Use Of Macrophages In Gastric Stem Cell Activation/Differentiation And Ulcer Healing, Subi Sugathan

Dissertations

Stomach erosions and ulcerations are common health problems, and their therapy requires tissue regeneration. While current therapy for these disorders focuses on targeting parietal cells to inhibit acid secretion, the role of stem cells in the regeneration process is neglected. In this study, the aim is to investigate the potential use of macrophages to activate gastric stem cells in co-culture experiments and in a mouse model of gastric ulcer. Bone marrow-derived macrophages were prepared and cultured in the presence of lipopolysaccharides and interleukin-4 to, respectively, induce their differentiation into pro-inflammatory (M1) and anti-inflammatory (M2) macrophages. Polarization of these phenotypes was …

Exploring The Dynamics Of Primary Epsteinbarr Virus Infection Using A Novel Rabbit, Narendran Reguraman

Dissertations

Epstein-Barr virus (EBV) is a common herpesvirus asymptomatically carried by over 90% of the world population. However, in certain circumstances, the virus can lead to life-threatening diseases. Although the virus was isolated over 55 years ago, several fundamental aspects of the biology of EBV and the mechanism by which this virus induces pathology remain unknown. One major obstacle has been the lack of a suitable small animal model for EBV infection. We have recently shown that healthy rabbits are susceptible to EBV infection, and the virus establishes long-term latent infection typically seen in humans. The main objective of this dissertation …

Risk Factors Of Cyberbullying Victimization: The Impact Of Developmental Trauma, Yuliya Mykytyn

Dissertations

Trauma has been considered as one of the significant causes of psychological distress, especially if the traumatic event occurred in the childhood. At the same time, due to wide popularity of social media as a source of communication, cyberbullying emerged as a new way to harass someone, with specific focus on adults and young adults. The area of focus of this research project is to investigate whether experienced trauma, specifically developmental trauma might serve as a risk factor for cyberbullying victimization. Additional focus was on the differences in traumatic experiences and their impact for people with diverse cultural and ethnic …

Burnout, Collective Efficacy, And The Social Network Of A Unit, Amy Kiefer

Dissertations

Burnout, Collective Efficacy, Social Network, Social Network Analysis

Assessing Nursing Student Engagement In Clinical And Simulation Experiences, Karrie Osborne

Dissertations

clinical education, nursing education, student engagement

Effectiveness Of A Virtual Learning Environment On Pediatric Students’ Knowledge, Self-Confidence And Satisfaction With Learning Growth And Development Concepts, Laura Marie Robbins-Frank

Dissertations

growth and development, knowledge, pediatric nursing students, satisfaction, self-confidence, virtual learning environments

Characterization Of The Long Non-Coding Rna Proins In Human Pancreatic Β-Cell, Shareena Saeed Lootah

Dissertations

It is well established that the genome is pervasively transcribed. Only 2% of those transcripts are translated into proteins, and the remaining 98% are non-translated, generating the non-coding RNAs (ncRNAs) species. A close observation of these transcripts directed the scientific community to their increasing potential functional roles in the cells. Indeed, the literature exponentially unveils this notion, with many ncRNAs showing substantial and variable biological functions. The field is in its infancy; however, efforts are accelerating to discover and define this ocean of new species.

Long non-coding RNAs (lncRNAs) are sub-species of ncRNAs with an arbitrary size of more than …

The Molecular Basis Of Diabetic Cardiomyopath, Ahmed Salaheldin Mustafa Ali Sultan

Dissertations

Diabetes mellitus (DM) is a major and worsening global health problem. Type 2 diabetes mellitus (T2DM) accounts for more than 90% of DM and the global epidemic of obesity largely explains the dramatic increase in the incidence and prevalence of T2DM over the past 20 years. Cardiovascular complications are the major cause of morbidity and mortality in diabetic patients. The electrocardiogram (ECG) of diabetic and obese patients is frequently disturbed. The aim of this project was to characterize and clarify the molecular basis of electro-mechanical dysfunction in the hearts of type 2 diabetic and type 2 diabetic/obese rats. Experiments were …

Patient Perception Of Intensive Care Unit Discomfort, Essa Hakamy

Dissertations

Background: Discomfort has a significant effect on patient health and well-being; however, the symptoms are often difficult to address in ICU. Most patients in ICU are unable to communicate, making it difficult for physicians and nurses to distinguish between pain and discomfort. For example, artificial airways and assisted ventilation prevent patients from communicating. Patients may also have difficulty communicating due to delirium, fatigue, sedation, or neurological disease. Rationale: Discomfort has a considerable influence on patient health outcomes and well-being if not identified and addressed. Researchers have not explicitly explored discomfort apart from pain, which underscores the importance of studying the …

Adults With Preexisting Diagnosis Of Heart Failure In The Environment Of Coronavirus Disease 2019, Ronald Phillips

Dissertations

Background: Heart disease continues to be the leading cause of death among adults in the United States and other industrialized countries. Heart failure (HF) is a form of heart disease and has become an epidemic with complications and medical care costs increasing at an alarming rate. HF affects more than 5.7 million adults in the United States with an incidence between 550,000 to 670,000 annually, primarily affecting females, African Americans, and adults aged 55 years and older. HF is also associated with a high rate of mortality, estimated to increase, with a risk rate of 13%, 32%, and 64% among …

A Delphi Study Of The Skills Necessary For A Speech-Language Pathologist Or Occupational Therapist To Be Successful In A Leadership Position, Jessica Miller

Dissertations

Purpose: The purpose of this Delphi study was to identify the skills necessary for a speech-language pathologist or occupational therapist to be successful in a leadership position using an expert panel. In addition, the purpose was to rate the identified skills based on importance and lastly to determine the activities experts recommend to acquire the top-rated skills. Methodology: This study used a three-round Delphi method to collect data from expert leaders in speech-language pathology and occupational therapy. In Round 1, the expert panel was asked to identify the skills necessary to transition from a speech-language pathologist or occupational therapist to …