Medicine and Health Sciences Commons^™

The Health Of Human Trafficking Victims In San Diego, California: A Retrospective Study, Noelle Lipkin Leveque

Dissertations

Background/Purposes/ Aims: Human trafficking (HT) is a threat to human rights globally. Studies indicate between 28% and 87% of HT victims encountered a health care professional during their trafficking period. Nonetheless, little is known about the health care needs of victims of HT. The purpose of this study was to examine the health care needs of a self-identified group of trafficked women in San Diego County, California.

Conceptual Basis: The Model of Human Trafficking and Health by Zimmerman et al. (2011) was used to identify multiple determinates of health following the trafficking period including demographic factors (age at assessment, age …

Exploring Factors Impacting Veterans' Hypertension Control, Jian Hua Liu

Dissertations

Exploring factors impacting veterans’ hypertension (HTN) control is essential in reducing the common cardiovascular disease event of stroke, heart attack, chronic kidney disease and mortality. The purpose of this study was to describe multidimensional factors impacting veterans’ HTN control. Utilizing a descriptive, exploratory, cross-sectional, retrospective, convenience sampling research design, 331 electronic medical records in a VA dashboard data set were reviewed for men and women veterans between the age 24 and 98 years (M=62, SD=13) in a Southern California Veterans Affair primary care clinic from October 17, 2014 through October 17, 2016. Data were analyzed by univariate, bivariate and multivariate …

The Lived Experience Of Intersectionality Among African American Women With Breast Cancer, Teri D. Armour Burton

Dissertations

African American women (AAW) continue to have breast cancer mortality rates that are 42% higher than White women (De Santis et al., 2015). Researchers suggest that an epistemological approach that integrates the biomedical and feminist models would be more effective in addressing health disparities. The concept of intersectionality, which grew out of the Black feminist movement, provides a lens in which to view the lived experiences of AAW with breast cancer. The intersectionality paradigm attempts to address the marginalized, oppressive, intersecting social existence of AAW through the examination of identity, social class, and power.

This qualitative study applied a descriptive …

Mexican-Born Immigrant Decision-Making About Self-Management Of Type 2 Diabetes, Virginia Lynn Hart-Kepler

Dissertations

Purpose: This study explored how English-speaking Mexican-born immigrants with diabetes 2 (T2D) made decisions about diabetes self-management (DSM).

Background: Little is known about the self-care decisions of Mexican-born adults living in America with T2D. This information is needed so that health care professionals (HCPs) might better support patients’ DSM. T2D is a serious, multi-system disease, effecting persons of Mexican heritage almost twice as often as non-Hispanic whites (NHW); with lower insulin sensitivity, rapid prediabetes/T2D onset, and severe outcomes. Ineffectively managed blood glucose (BG) risks serious complications, reduced life quality, and premature death. T2D is primarily self-managed; requiring BG control. HCPs …

Second-Generation Thai American Women's Perceptions On Cervical Cancer Screening, Essie Asawapornmongkol

Dissertations

Background: Cervical cancer is one of the most preventable diseases in the United States (US) (Center for Disease Control and Prevention, 2015a). Despite advances in early detection and a vaccine available, it continues to affect Southeast Asian American (SEAA) women in high numbers. Multiple barriers to cervical cancer screening are seen among SEAA women, which include acculturation, age, marital status, apprehension, financial burden, access to healthcare, and knowledge about cervical cancer, screening, and preventative health (Ho & Dinh, 2010). Studies on SEAA women and cervical cancer screening primarily involve women who were born in Southeast Asia. These studies have not …

Correlation Of The Boost Risk Stratification Tool As A Predictor Of Unplanned 30-Day Readmission In Elderly Patients, Carol K. Sieck

Dissertations

Carol K. Sieck

Loyola University Chicago

CORRELATION OF THE BOOST RISK STRATIFICATION TOOL AS A PREDICTOR OF UNPLANNED 30-DAY REAMDISSION IN ELDERLY PATIENTS

Risk stratification tools can identify patients at risk for 30-day readmission but available tools lack predictive strength. While physical, functional and social determinants of health have demonstrated an association with readmission, available risk stratification tools have been inconsistent in their use of variables to predict readmission. The Better Outcomes by Optimizing Safe Transitions (BOOST) 8 P's tool is a risk stratification tool developed by the Society of Hospital Medicine but has no published validation studies. The theoretical …

Unavoidable Pressure Ulcers: An Ethnonursing Study, Catherine M. Clarey-Sanford

Dissertations

Catherine M. Clarey-Sanford

Loyola University Chicago

UNAVOIDABLE PRESSURE ULCER: AN ETHNONURSING STUDY

In an effort to improve patient safety and the quality of care in the acute care setting, there has been an increased focus on the prevention of adverse events believed to be avoidable. Hospital-acquired pressure ulcers (HAPU) have been listed as one of those adverse events, and hospitals are no longer reimbursed for related costs. However, there are patient conditions and clinical situations in which a pressure ulcer can be deemed unavoidable. In acute care, unavoidable means that the patient developed a pressure ulcer even though the provider …

Investigating Novel Methods Of Interaction With Pharmaceutically Relevant Enzymes, Cory T. Reidl

Dissertations

Metalloproteins requiring one or more metal ions for normal function make up 30% of all known proteins, and many critical biological pathways contain at least one metallo-enzyme. Di-nuclear metallo-proteins constitute a large class of these proteins yet we currently lack effective methods of inhibiting these enzymes for the development of new medical therapies, particularly for the discovery of new antibiotics. Our work has focused on developing novel functionalities that selectively interact with di-nuclear catalytic centers, and we are targeting three separate di-zinc-metallo-enzymes that are unique to bacteria and play key roles in their growth and development. These enzymes are DapE, …

Simulation Using A Standardized Patient To Measure Perception And Congruency Of Spiritual Care For A Veteran From Three Perspectives To Inform Nursing Education And Practice, Mary E. Desmond

Dissertations

Spiritual care refers to a purposeful process of helping another find meaning and purpose

in life through a mutual connection. Providing spiritual care is a professional nursing mandate, yet nurses report barriers in education and practice. Veterans want spiritual care to promote quality of life, and to cope with military experiences and chronic conditions. Patients report receiving less than desired spiritual care and nurses report infrequent provision of spiritual care. It is also unclear how congruent patients and nurses are in their perceptions of spiritual care. A spiritual care simulation and performance checklist was developed using a review of the …

Elevated Hydrostatic Pressure Selectively Enhances Matricellular Gene Expression In Human Trabecular Meshwork Cells, Jonathan Lautz

Dissertations

Primary open-angle glaucoma (POAG) is a progressive optic neuropathy

characterized by loss of peripheral vision secondarily associated with elevated intraocular pressure (IOP). Transforming growth factor (TGF)-β2 is markedly elevated in the aqueous humor (AH) of patients with POAG. It has been previously shown that TGF-β2 increases IOP, in part, by inducing expression and release of endothelin-1 (ET-1) and connective tissue growth factor (CTGF) within the trabecular meshwork (TM). ET-1 and CTGF may ultimately lead to increases in IOP by enhancing TM cell contractility and extracellular matrix (ECM) deposition. Here we confirm that TGF-β2 enhances mRNA content of ET-1, CTGF, and …

What Is The Relationship Between Vitamin D Status, Pregnancy Symptoms And Quality Of Life?, Jennifer Woo

Dissertations

Purpose and Background/Significance: The main purpose of the study is to determine: (1) to determine if there is a relationship between vitamin D status, pregnancy symptoms, health promoting behaviors, and quality of life and (2) to determine if differences exist in pregnancy symptoms, health promoting behaviors and quality of life between African American and Hispanic women. There is evidence to show that vitamin D deficiency has been associated with numerous symptoms such as musculoskeletal pain, poor sleep, and depression. However, whether low levels of vitamin D is associated with these and other symptoms during pregnancy is unknown. What is known …

Identifying The Complexity Of Bipolar Disorder, Brandie Marie Stiles

Dissertations

Bipolar disorder is a complex illness that is difficult to correctly diagnosis and treat. Experts estimate that a correct diagnosis and treatment for bipolar disorder may be delayed for up to 7-10 years after symptoms become problematic. The primary purpose of this study was to identify the complexity of diagnosing bipolar disorder, including diagnostic patterns, recommended treatment, and patient response. A focused ethnography, including in-depth interviews and a retrospective chart review, were completed to answer the research questions: 1) What is the nature of the experience of receiving a diagnosis of bipolar disorder? 2) What are the diagnostic and treatment …

Implementation Of Sleep Assessment Questionnaire In College Health And Counseling Visits: A Quality Improvement Pilot, Sarah Ruth Jackson

Dissertations

Sleep deprivation or sub-optimal sleep hygiene in college students has profound implications. Decreased cognitive performance, increased depression or mood concerns, higher rates of usage of alcohol or marijuana to compensate for poor sleep are all interconnected. The American College Health Survey (2011) results indicated that students do not receive support or education on the importance of sleep habits from their schools or medical providers. This DNP project explored two areas of interest. The first was a change in patient interview protocol as a quality improvement project in UMSL University Health, Wellness, Counseling & Disability Access Services (UHWC&DAS). The second area …

A Comparison Of Multipath And Conventional Neuromuscular Electrical Stimulation, Cody Brian Bremner

Dissertations

Neuromuscular electrical stimulation (NMES) is the use of an electrical current for the purpose of eliciting a muscular response, and these treatments are most often used clinically for the specific purpose of increasing quadriceps strength. It is commonly accepted that the effectiveness of NMES for this purpose is primarily determined by the NMES training intensity. However, spatially limited motor unit recruitment, fatigue and discomfort negatively impact NMES-induced torque, which subsequently reduces NMES training intensities. Due to the importance of NMES training intensity, a substantial amount of research has focused on strategies designed to increase NMES-induced torque production, as well as …

Epidemiology Of White Spot Syndrome Virus In The Daggerblade Grass Shrimp (Palaemonetes Pugio) And The Gulf Sand Fiddler Crab (Uca Panacea), Muhammad

Dissertations

Ever since the first outbreaks of White spot syndrome virus (WSSV), which causes White Spot Disease (WSD), in Asia in the early 1990s, the pathogen has been a major constraint to the profitability of the shrimp aquaculture industry across the globe. WSSV has a broad host range and is routinely detected in wild decapod crustaceans. In the present study, two common species in the tidal salt marsh along the northern coast of the Gulf of Mexico, the daggerblade grass shrimp (Palaemonetes pugio) and the Gulf sand fiddler crab (Uca panacea), were investigated for their role as …

A Microbiomic Approach To The Characterization Of The Impacts And Influences Of Viral, Bacterial, And Harmful Algal Bloom Toxins On The Bottlenose Dolphin, Corey David Russo

Dissertations

As apex predators that display high site fidelity Tursiops truncatus (bottlenose dolphin) are indicators of marine ecosystem health. Bottlenose dolphins, additionally, display pathogenesis and immune response similar to that of humans. Humans and coastal bottlenose dolphins, in particular, are constantly exposed to the same industrial, agricultural and domestic toxins and pathogens, contaminants and pollutants. Thus, studies on the bottlenose dolphin are also valuable in bridging the gap between ocean and human health. Bottlenose dolphins are susceptible to viral bacterial and toxin infection. Infection in the bottlenose dolphin manifests itself in the form of mass stranding events, unusual mortality events, chronic …

Group Empowerment Capacity And Capability In Associate Degree Schools Of Nursing In The United States, Christy Lee Savell

Dissertations

The purpose of conducting this research was to determine the perception of group empowerment capacity (EC) and group empowerment capability (E) among faculty and administrators in associate degree nursing programs (ADN) in the United States (U.S.), whether there was a significant difference in the scores of EC and E between the two groups and if there was a significant relationship between the mediating variables and EC. The study was conducted online with administrators and faculty of ADN programs throughout the United States (U.S.). Information letters with questionnaire links were sent to all members of the Organization of Associate Degree Nurses …

Faculty-To-Faculty Incivility As Perceived By Nursing Faculty, Melinda Lofton Sills

Dissertations

The purpose of this research was to determine the perceived presence of workplace incivility among nursing faculty in associate, baccalaureate, and graduate nursing programs and whether there was a significant difference between workplace incivility behaviors, occurrence of incivility, extent of incivility, and engagement of incivility among the three groups. A convenience sample of faculty from nursing programs accredited by Accreditation Commission for Education in Nursing and Commission of Collegiate Nursing Education in Alabama, Arkansas, Florida, Louisiana, and Tennessee completed the Incivility in Nursing Education-Revised (INE-R) survey. The final sample included 169 nursing faculty.

Based on the results of the study …

A Mother's Spiritual Journey With Her Disabled Son: An Autoethnography, Margaret C. Higgins Edd

Dissertations

Abstract

This autoethnographic research delves into a mother’s experiences with her disabled son over thirty-five years. Beginning with a thick description of the crib accident that resulted in physical and cognitive disabilities that profoundly change the course of both mother and son’s life, this research chronicles the search for meaning, community, and healing as they negotiate the realms of medicine, education, career, family, and spirituality. Models of disability that seek to explain various ways in which society often views disability are examined, but none resonate with the researcher’s intimate experiences nor satisfies her deepest needs for insight and healing. Making …

Visual Impairment And Factors Associated With Difficulties With Daily Tasks, Anne T. Riddering

Dissertations

In the past 10 years, the number of American adults with visual impairments has increased from 1 million to 4 million and is expected to double to 8 million people by the year 2050 (The Eye Diseases Prevalence Research Group, 2004; National Eye Institute, 2013). Therapies to treat retinal diseases causing visual impairment, such as diabetic retinopathy and age-related macular degeneration (Massof, 2002; Mogk, 2011), have evolved in the past two decades (Gupta et al., 2013; Hooper & Guymer, 2003), but little research has examined recent population and difficulties with performing daily activities. Different types of professionals, including ophthalmologists, optometrists, …

Factors Affecting Community Participation In Young Adults With Intellectual And Developmental Disabilities, Molly Bathje

Dissertations

Young adults with intellectual and developmental disabilities (IDD) participate less frequently in communities than other disabled and non-disabled peers (Verdonschot, de Witte, Reichrath, Buntinx, & Curfs, 2009) even though they express a desire to participate (Kampert & Goreczny, 2007) and federal policy mandates community inclusion (Haertl, 2014). Participation in one’s community is linked to health and quality of life (World Health Organization, 2002). The broad goal of this three paper dissertation is to contribute to a deeper understanding of what facilitates and impedes community participation for young adults with IDD by (1) developing a new conceptual model, (2) evaluating a …

Private Sector Emiratization: Evaluating The Policies And Practices Designed To Achieve Abu Dhabi's Strategic Hrm Goal, Khaled Sultan Saeed Ai Kaabi

Dissertations

The purpose of this study is two-fold: firstly, to gauge the job satisfaction levels of UAE nationals employed in the private sector and secondly to consider the HRM policies and procedures most likely to attract and retain such individuals. The issue is of contemporary importance because the UAE has a fast-growing population, and already overstaffed public sector and, a labor nationalization program that has yet to have a significant impact on the ratio of nationals employed in the private sector visa- vis the classic public sector. Using a combination of employee survey and expert interview feedback this study provides a …

An Examination Of African Americans' Utilization Of Health Care, Brittany Powell

Dissertations

The study examined the relationship between perceptions of discrimination, social support, quality of health care received, and utilization of health care services among African Americans. Data was analyzed from 99 African American respondents that completed either an online or paper questionnaire. The responses demonstrated significant relationships existed between discrimination and quality of health care as well as social support and utilization of health care. Results concluded that the more discrimination one perceives, the lower quality of health care they are to expect, and therefore they are less likely to utilize services. However, the data also reflected that even in the …

Improving Veteran Access To Heart Failure Specialty Care: A Change Model Project, Mark Bird Whelchel

Dissertations

Background: Many Veterans Health Administration (VHA) facilities have cardiac services, but not all VHA centers offer heart failure care. Viable alternative models exist to traditional outpatient treatment by physicians, such as Tele-medicine consultations, the use of nurse practitioner run clinics, and the use of models such as Specialty Care Access Network-Extension for Community (SCAN-ECHO) and site specific contracted physician services models. These have the potential to improve Veteran access to care. Objective: The purpose of this change project was to conduct a needs assessment survey, in joint effort with the Hershey Medical Center Heart and Vascular Institute, to identify barriers …

The Coach Expectancy Cycle And The Impact Of A Coaching Education Intervention In Youth Soccer, Erica Ann Pasquini

Dissertations

The coach expectancy cycle is a four-stage model that explains coaches’ feedback behaviors (Horn, Lox, and Labrador, 1998). In the first stage coaches make judgments based off of previous sport experience and knowledge. In the second stage, these judgments influence coaches’ behaviors. Solomon (2008, 2012) has shown that coaches provide more instruction, praise, and corrective instruction to athletes they perceive to be higher expectancy. In the third stage, the unequal behaviors coaches exhibit affect athlete performance and satisfaction in sport. Research has shown that athletes perceptions of poor coaching behavior positively correlates with drop out (Gearity & Murray, 2011; Hollembeak …

Health Literacy As A Moderator In The Relationship Between Diabetes Knowledge And Diabetes Outcomes, Jameshyia Ballard Thompson

Dissertations

The purpose of this research was to determine if health literacy was a moderator in the relationship between diabetes knowledge and diabetes outcomes, and explore the relationship between diabetes knowledge and health literacy. The target population included adults living in Mississippi with a diagnosis of diabetes at any point in life. A pilot study was performed to determine if the Functional Communicative Critical Health Literacy scales (FCCHL) and the Spoken Knowledge in Low Literacy in Diabetes scale (SKILLD) were appropriate for use in a population of adults in Mississippi with a diagnosis of diabetes. Participants for the pilot study were …

The Associations Among Expressed Emotion, Relationship Satisfaction, Ptsd Symptoms, Alcohol Use, And Depression: A Longitudinal Investigation With A Military Sample, Laci Lee Zawilinski

Dissertations

PTSD in military personnel is highly prevalent and accompanied by elevated rates of additional issues such as depression, problematic alcohol use, and interpersonal relationship problems. Family members and spouses of military personnel have also been shown to be negatively impacted by PTSD symptoms. Previous research has indicated that family members and spouses’ expressed emotion regarding the PTSD patients’ symptoms negatively impacts treatment outcome in civilian populations. However, studies have yet to investigate the effect of expressed emotion on the course of PTSD symptoms and associated problems in military personnel. Therefore, the purpose of the present investigation was to examine the …

An Evaluation Of African American Fathers’ Perceptions And Influences On Child Food Choices And Physical Activity Behaviors, Valerie Annette Richardson

Dissertations

Child obesity is affecting children’s health nationwide. Rates are highest among African Americans (AA) in the South. Research has explored parents’ influence on child eating and activity, but most has reported on mothers’ influences. The purpose of this research was to investigate perceptions about AA fathers’ influences on their children’s eating and physical activity. Using a structured focus group questionnaire based on the parent layer constructs of Birch and Ventura’s Ecological Model for Child Overweight (2009), four focus groups were conducted with 28 AA fathers with children 6- to 11-years-old in a rural and an urban church setting in southeast …

Analysis Of The Intricacies Of Substrate Recognition Of High Mobility Group Proteins And Aminoacyl-Trna Synthetases Using Non-Cognate Substrates, Douglas Van Iverson Ii

Dissertations

The studies presented in section 1 (Chapters I-IV) focus on the design and development of nucleic acid four-way junctions (4WJs) to target a member of the high mobility group (HMG) proteins, the proinflammatory cytokine high mobility group box 1 protein (HMGB1). In the present study, hybrid PNA-DNA 4WJs based on a model DNA 4WJ were constructed to improve the thermal stability of 4WJs while maintaining strong binding affinity toward HMGB1. An electrophoretic mobility shift assay (EMSA) was used to examine the binding affinity of an isolated DNA binding domain of HMGB1, the HMGB1 b-box (HMGB1b), toward a set of PNA-DNA …

Three Essays On Informal Payments In The Health Care Sector In Russia, Alexandra Polovinka

Dissertations

Health care is one of the most corrupt sectors in Russia. In 2015 twenty percent of patients paid a bribe for the health care services once or twice, and thirteen percent more than twice (Russian Public Opinion Research Center, 2015). Using data on adults from over 5,000 households in Russia, this three-essay study analyzes out-of-pocket formal (official) and informal (unofficial, bribes) payments for the health care.

In the first essay, I study whether there is a difference in the amount of unofficial pay-ments across five types of health care services (ambulance, inpatient, outpatient, dental, and medical checkups) and two types …