Medicine and Health Sciences Commons^™

Exploring Unintended Pregnancy In The United States Military: A Phenomenological Approach, Mary Kathryn Phillips

Dissertations

Nearly half of the 6.7 million pregnancies in the United States each year are unintended. The U.S. unintended pregnancy rate is significantly higher than the rate in many other developed countries. By age 45, more than half of all American women will have experienced an unintended pregnancy, and three in ten will have had an abortion. Previous empirical research aimed to fix the rate of unintended pregnancy before it was adequately explored. The rationale for this study emanated from the belief that interventions intended to reduce the rate of unintended pregnancy will be more successful if the essence of unintended …

Integrated Dual Disorder Treatment: Co-Occurring Evidence-Based Practice Implementation, Alteration, And Fidelity Over Time, Jennifer Harrison

Dissertations

Individuals with co-occurring illnesses are at risk for poor outcomes related to criminal justice, hospitalization, housing, and employment. High fidelity evidence-based practice models, including Integrated Dual Disorder Treatment (IDDT), are associated with significant improvements in outcomes. Although IDDT has been well-researched in small scale clinical trials, the implementation, alteration, and sustainability in real world applications over time has not been well-researched or understood. Initially, a descriptive analysis of a secondary dataset including the full population of 68 IDDT fidelity teams from 2006–2012 evaluated by the Michigan Fidelity and Assessment Team (MiFAST) in one state was completed. IDDT fidelity significantly improved …

Effects Of Expected Service Life Exposures On The Functional Properties And Impact Performance Of An American Football Helmet Outer Shell Material, David E. Krzeminski

Dissertations

The purpose of this dissertation is to gain a greater scientific understanding of the changes in functional material properties and impact performance of an American football helmet outer shell material under expected service life exposures. The research goals are to (i) quantify chemical, physical, thermal, and mechanical degradation of an American football outer shell material under expected environmental conditions and (ii) develop a linear drop test impact protocol to employ expected on-field impact conditions to American football helmet components and a plaque-foam (i.e., shell-liner) surrogate. Overall, a step-wise progression of analysis was demonstrated to concurrently quantify and understand changes in …

Olfactory Enrichment In California Sea Lions (Zalophus Californianus), Mystera M. Samuelson

Dissertations

In the wild, California sea lions (Zalophus californianus) are exposed to a wide array of sensory information at all times. However, it is impossible for captive environments to provide this level of complexity. Therefore unique procedures and practices are necessary for the maintenance of physiological and psychological health in captive animals (Wells, 2009). This project aims to explore the behavioral effect of scent added to the environment, with the goal of improving the welfare of captive sea lions by introducing two scent types: 1.) Natural scents, found in their native environment, and 2.) Non-natural scents, not found in …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Outcomes Of Prediabetes And Diabetes Education Programs Tailored For Vulnerable Popuations, Diana Al Sayed Hassan

Dissertations

Diabetes is a debilitating disease and if not managed properly it can lead to multiple complications and even premature death. Diabetes continues to disproportionately affect vulnerable populations. The purpose of this three-paper method dissertation was to examine the implementation of a prediabetes and diabetes programs in a community setting to serve vulnerable populations in addition to understanding future diabetes-related educational needs.

The first paper is an evaluation of a shortened five-week diabetes prevention program for older adults with prediabetes or at a high risk for developing type 2 diabetes mellitus (T2DM). Chang in nutrition knowledge, eating and physical activity behaviors, …

Flow Experiences Among Individuals With Aphasia, Thomas W. Sather

Dissertations

Flow has been described as positive experiences of intense concentration, distorted time passage, and loss of self-consciousness. While flow has been reported for multiple populations in various settings, it has not been studied among individuals with aphasia. The purpose of this three paper dissertation is to examine flow experiences among individuals with mild aphasia, including environmental and personal factors associated with flow. Advocates of life participation approaches to aphasia stress the importance of interventions that support full engagement in life. Research on flow experiences and related environmental and personal factors may foster improved service delivery and outcomes for this population. …

Factors Associated With High Risk Infant Follow-Up Attendance, Martha Grant Fuller

Dissertations

Prematurity is a significant public health problem and preterm infants face well described risks of adverse neurodevelopmental outcomes. Bronfenbrenner’s bioecological theory of development describes interactions between biological and environmental factors and explains how these interactions can impact development. Systematic follow-up of preterm, high-risk infants is recommended for early identification of problems and provision of interventions and support services. Most research on follow-up attendance has involved small, single sites. A retrospective analysis of population based data available in the California Children’s Services High Risk Infant Follow-up Quality of Care Initiative (HRIF-QCI) data system was performed to examine factors associated with attendance …

Kentucky Middle School General Education Teachers: Perceptions On Sensory Integration Of Students On The Autism Spectrum, Lynda C. Harrison

Dissertations

This study examines the perceptions of general education teachers in Kentucky middle schools regarding their knowledge concerning Autism Spectrum Disorder (ASD), Sensory Processing Disorder (SPD), and their abilities to implement strategies designed to accommodate students on the spectrum. Participants included both general and special education teachers though the original targeted sampling included general education teachers only. Data were collected using a demographic questionnaire and a Likert scale survey created by the researcher and distributed through a web based program. Demographic characteristics collected included number of graduate credit hours, age, years of teaching experience, credited hours of training on ASD at …

Screening The Commercial Motor Vehicle Driver For Sleep Apnea, Dianna Ohlman

Dissertations

Abstract The transportation industry has the third highest occupational risk for death and disability (BLS, 2010) with 7% of Commercial Motor Vehicle Drivers (CMVD) falling asleep while driving (NHTSA, 2006). One contributing factor may be undiagnosed Obstructive Sleep Apnea (OSA) (Tregear et al, 2009). In 2006, a Joint Task Force (JTF) published screening recommendations for OSA, which led to a change in the Department of Transportation screening practices within a local Occupational Medicine clinic. The purpose of this study was to: (a) determine what percentage of drivers having had a positive clinical screening examination (met two of three objective measures) …

Public Relations In Government-Based Public Health: Testing Contingency Theory During H1n1 Response, 2009-2010, Terri Lea Sasser

Dissertations

The primary purpose of this study is to describe public relations programs in state and local government-based health departments nationwide. Using the H1N1 communications and public relations activities as a frame, or basis of comparison, this study will further seek to identify if Contingency Theory of public relations may be an apt descriptor of public relations activities during this particular response effort. This study uses Contingency Theory as a theoretical perspective to explain the strategic management of the organization-public relationships and add to the body of knowledge about Contingency Theory of public relations in the field of health communications. Contingency …

Overcoming The Loss Of Nonverbal Cues Encountered By The Adventitiously Blind: Reconstructing Relationships And Identity, Vernon Floyd Humphrey

Dissertations

In this study, couples shared their experiences adjusting to one of the members loss of sight. Through interviews, their narratives expressed their values, actions, inactions, successes, failures, needs, obstacles, and feelings. Participants explained their standpoint/perspective about vision loss, when it happened, how it affected them, how they reacted and responded, through hindsight how they thought they should have responded, and how they reconstructed a shared interpersonal relationship. Narratives about situations and events after the loss of sight revealed descriptions of their relationships and interactions with each other and other people in their circle. Through constant comparative analysis the individual narratives …

Co-Construction Of Personal Narratives In Supporting Identity And Communication In Adults With Aphasia: The ‘My Story’ Project, Katie A. Strong

Dissertations

Stroke and subsequent aphasia can impact a person’s identity negatively, interfering with quality of life. Co-constructing personal narratives about stroke and other aspects of a person’s life is a promising intervention for addressing identity issues. This series of three dissertation studies explored key aspects related to identity, personal narratives, and the perceived impact of telling one’s story.

Study 1 involved a survey examining whether speech-language pathologists view themselves as having a role in supporting the reconstruction of self-identity in adults with aphasia through the use of personal narratives. Results revealed that, whereas the majority of respondents viewed themselves as having …

Saliva Cotinine As A Measure Of Abstinence In A Lottery-Based Contingency Management Treatment For Smoking Cessation, Catherine M. Gayman

Dissertations

Contingency management decreases smoking by delivering monetary incentives contingent upon objective verification of abstinence. The present study investigated the effectiveness of monitoring saliva cotinine twice weekly in a contingency-management treatment for cigarette smoking using a cash prize-based payment system. Participants were randomly assigned to either a contingent reinforcement group or a non-contingent reinforcement group. The study began with five consecutive Baseline days during which participants smoked as usual, and was followed by four consecutive Shaping days, during which participants were asked to gradually decrease smoking. During the subsequent three-week Abstinence phase, participants submitted saliva cotinine and breath carbon monoxide samples …

Identifying The Molecular Mechanisms Of Early Cachexia Using Whole Transcriptome Sequencing In Muscle And Fat Biopsies From Cancer Patients, Amal Hussain Al Hadad

Dissertations

Cancer cachexia is responsible for one third of cancer–related deaths and contributes to the death of many others. More than 80% of cancer patients are cachectic towards the end of life. Despite intensive research, the mechanisms of cancer cachexia are still poorly understood. It is our hypothesis that identification of early changes in gene expression in cachexia will lead to an improved understanding of the mechanism that trigger this important problem in cancer patients. Thus, to shed light on the mechanisms involved in the major cachexia target tissues, we investigated the entire transcriptome in muscle and fat to identify altered …

Effects Of Exercise And Pharmacological Intervention On Electromechanical Function Of The Heart In The Goto-Kakizaki Type 2 Diabetic Rat, Khawla Abdulla Al-Ali

Dissertations

Type 2 diabetes mellitus accounts for more than 90% of cases of diabetes mellitus. Cardiovascular diseases are the major causes of morbidity and mortality in diabetic patients. A variety of diastolic and systolic dysfunctions have been reported. The severity of the abnormalities depends on the patients’ age and diabetes duration. The aim of the study was to investigate the age-dependent, exercise and pharmacological intervention on electromechanical function of the heart in the Goto-Kakizaki (GK) type 2 diabetic rat. mRNA expression was assessed in ventricular muscle with real-time RTPCR. Ventricular myocytes shortening, intracellular Ca2+ transport and L-type Ca2+ current were measured …

Characterization Of Carbapenemase Producer Enterobacteriaceae Isolated In The United Arab Emirates, Amna Eisa Al Baloushi

Dissertations

The efficient control of the spread of carbapenemase producer Enterobacteriaceae, a major public health treat world-wide, requires knowledge on the molecular epidemiology and genetic background of the emerging carbapenemase genes.

Our aim was to investigate the genetic support of New Delhi metallo-beta-lactamase and OXA-48-type carbapenemase genes in carbapenem resistant Enterobacteriaceae isolated in the United Arab Emirates. Since these isolates are extremely drug resistant, leaving few treatment options, the efficacy of alternative antimicrobials was also assessed.

Seven NDM-producer Enterobacteriaceae, collected during 2009-2011, and subsequently five NDM and OXA-48-type carbapenemase co-producer Klebsiella pneumoniae isolated during 2011-2013 in three hospitals of the …

The Effects Of Schedule Density Of Reinforcement For Alternative Behavior On Resurgence, Kathryn M. Kestner

Dissertations

Resurgence is the reemergence of a previously extinguished response when an alternative response no longer produces reinforcement. Although returning to previously successful methods for obtaining reinforcement is likely advantageous, resurgence also occurs in the form of treatment relapse. An individual may return to problematic behavior (e.g., aggression, self-injury, drug use) when an alternative behavior (e.g., communication response, coping skill, social behavior, etc.) is no longer successful at producing a reinforcer. Behavior analysts rely on treatments based on differential reinforcement of alternative behavior, and resurgence has been demonstrated following changes to reinforcement schedules due to errors in treatment integrity or intentional …

Functional Analysis Of Gambling, Mack S. Costello

Dissertations

Given high rates of gambling and the growing population of disordered gamblers, there is a need to develop assessment strategies with improved treatment validity. More specifically, assessment strategies are needed that identify the controlling variables for disordered gambling and, thus, provide guidance in the selection of treatment and prevention strategies. This study sought to develop a functional analysis for gambling by utilizing a simulated gambling environment in which contextual variables hypothesized to be causally linked to disordered gambling could be systematically manipulated. Seven experienced gamblers participated in the multi-element, single-subject experimental study. Participants who endorsed at least some problems from …

A Comparison Of The Effects Of A Web-Based Education Program About The Icu Environment And A Standard Education Program On Anxiety, Depression, And Acute Stress Experienced Among Family Members Of Icu Patients, Chrystal Leigh Lewis

Dissertations

Family members of ICU patients may experience anxiety, depression, and acute stress disorder symptoms. A need identified by the multi-society task for critical care research was to study the usefulness of interventions to quantify and treat anxiety, depression, and stress symptoms experienced by family members of ICU patients (Deutschman et al., 2012). This task force encouraged investigating using technology to address this need. (Deutschman et al.). The purpose of this prospective, quasi-experimental nonequivalent control group (pretest/posttest) design study was to compare the effect of standard ICU education and a web-based education program about the ICU environment on the level of …

Transitioning Teens With Diabetes To Adult Healthcare, Rebecca Ann Meyer

Dissertations

Adolescents must enter adult health care services at age 18, yet most are not ready and have not mastered daily self management of their type 1 diabetes. The purpose of this study was to determine the feasibility of a transition planning intervention, focused on educating adolescent/parent dyads about diabetes self management in preparation for the transition from pediatric to adult health care, using a newly developed transition plan and framework. The setting was a diabetes endocrinology clinic where 95% of young type 1 diabetics in the metropolitan area are seen. The intervention included supporting the parent in the relinquishing of …

Perceptions Of Incivility In Nursing Education: A Survey Of Associate And Baccalaureate Program Nursing Students, Kim Elaine Young Vickous

Dissertations

This study explored differences of nursing students’ perceptions of student and faculty incivility, measured using the Incivility in Nursing Education survey, across semesters and between Associate and Baccalaureate of Science nursing students. A sample of 262 Associate and Baccalaureate of Science nursing program students enrolled in second, third, and fourth semesters from a state university located in the mid-south participated in the study. Descriptive statistics, Analysis of Variance, and Independent t-tests were conducted to examine the research questions. These questions explored what student and faculty behaviors were perceived as uncivil and most frequently occurring (disruptive and threatening) uncivil behavior in …

An Evaluation Of The Attitudes, Beliefs, And Mental Health Literacy Of Young African American College Graduates, Marshae Antoinette Mcneal

Dissertations

The aim of this study was to examine the relationships between the attitudes, beliefs, and mental health literacy of young college-educated African Americans as compared to their Caucasian counterparts. Previous research indicates these two populations differ when receiving services for mental illness. The goal of this study was to see if this difference is due to their mental health literacy level, attitudes toward seeking help, as well as their attitudes and beliefs toward mental illness. A quantitative analysis was conducted using elements of the MacArthur Mental Health Module and the Attitudes toward Seeking Professional Psychological Help Scale-Short Form (ATSPPHS-SF) to …

Patients' Perception Of Feeling Known By Their Nurses And The Nurse Practice Environment, Deene' L. Mollon

Dissertations

Healthcare leaders have a responsibility to understand the connection between healthy practice environments and patients’ perceptions of care. The purpose of this research was to explore the relationship between the nurses’ perception of the practice environment and the patients’ perception of feeling known by their nurses.

This descriptive, correlational study used quantitative and qualitative methodology. A convenience sample of 123 patients, on six patient care units, completed the Patients’ Perception of Feeling Known by their Nurses Scale and a supplemental survey designed to determine the content validity of the Patients’ Perception of Feeling Known by their Nurses Scale. To …

Leadership Practices Among Undergraduate Nursing Instructors, Melissa Martin Bryant

Dissertations

The purpose of this study is to identify leadership practices of nursing instructors in the southern U.S.; and to determine if instructor leadership practices differ from the ‘norm’ leadership practices reported by the LPI instrument (Posner 2008), or from the practices observed by their matched students (observer version). Further, the purpose is to determine the relationship between instructors self-reported leadership practices (self-version) and student observed practices based on institution type, and instructor education level. The consisted of a group of instructors and students that were primarily Caucasian and female. The demographics for the instructors and students were similar to the …

Use Of Dietary And Herbal Supplements In Older Adults With Osteoarthritis, Sharon Denise Mcdonald

Dissertations

Over the past several decades, older adults with Osteoarthritis (OA) have increasingly used more natural products in an effort to manage chronic pain. The theoretical framework for this study was the Lazarus and Folkman transactional theory of stress and coping. This framework was chosen based on the belief that older adults with OA are taking natural products as an active problem solving coping strategy to manage the pain, disability, and alterations they experience in their health related quality life including functional status, physical symptoms, emotional health, and social functioning. Older adults also take prescription medications for Osteoarthritis and a variety …

Efficacy Of Behavioral Interventions In African-Americans With Type Ii Diabetes: A Comparative Effectiveness Analysis, Tangela Nicole Hales

Dissertations

Context: The efficiency and effectiveness of the healthcare system are prime foci for nursing research.

Objective:The purpose of this study was to review and critically appraise the current state of the evidence in the treatment of African American adults with type II diabetes. To address this objective, a systematic review was undertaken that investigated the comparative effectiveness of behavioral interventions in improving glycemic control.

Methods: Robust methodological approaches to comparative effectiveness research (CER) serve to improve the transparency, consistency, and scientific rigor of the research. The methods for this systematic review of literature followed those recommended in the Agency …

A Measure Of Soft Skill Gains Acquisition With Engagement In Baccalaureate Nursing Programs, Wendy J. Williams-Buenzli

Dissertations

This dissertation examined soft skill acquisition from engagement in baccalaureate nursing programs. Baccalaureate nursing programs prepare nurses to be the future leaders of nursing practice. Soft skills include critical thinking, interpersonal communications, and ethical decision-making. To explore the acquisition of soft skills, this research study analyzed data from the National Survey of Student Engagement to explore for gains in critical thinking, ethical decision-making, and critical thinking. After gains scores were identified, then correlations were run to identify key engagement indicators. The findings of the study found gains in soft skill behaviors from freshman year to senior year of baccalaureate education. …

Establishment Of A 3d Culture Model Of Gastric Stem Cells Supporting Their Differentiation Into Mucous Cells Using Microfibrous Polycaprolactone Scaffold, Sunitha Pulikkot

Dissertations

In the stomach, epithelial stem cells are responsible for glandular homeostasis and continuous production of four main cell lineages secreting mucus, acid, pepsinogen and hormones. While alteration in the proliferation and differentiation program of these stem cells is linked to the origin of gastric cancer, they represent an effective target for chemotherapy and a source for cell therapy or tissue engineering in cases of gastric mucosal damage or loss. The aims of this study were 1) to manufacture various forms of scaffolds using a biodegradable polymer (polycaprolactone), 2) to test the suitability of these scaffolds for growth of mouse gastric …

Preferences For Evidence-Based Depression Treatments: An Emphasis On Patient-Focused Care, Lauren A. Frye

Dissertations

Research indicates most depressed patients in the general U.S. adult population seek depression treatment in primary care settings where the prevailing method of treatment is antidepressant medication. Although primary care physicians regard this approach as a preferable first line method of depression treatment, studies indicate many patients do not. Several studies have found depressed patients in these settings prefer psychotherapy or counseling over anti-depressant medication. Many advocate patient preferences should be integral to the treatment decision making process. There is a demonstrated propensity towards psychotherapy or counseling over antidepressant medication among depression patients. However, it is unclear which psychological depression …