Medicine and Health Sciences Commons^™

Utilization Of A Concurrent Query Form To Improve Clinical Documentation In A Va Facility For Patients With Stroke Or Tia, Lisa A. Keefner

Electronic Theses and Dissertations

Caring for stroke patients diagnosed with acute ischemic stroke (AIS) and transient ischemic attack (TIA) at Veterans Health Administration (VHA) acute care hospitals is a very complex process that centers on accurate documentation. Inaccurate or missing documentation leads to patient safety issues, lower quality care, and inaccurate Veteran Equitable Resource Allocation (VERA) classification for reimbursement. This pilot project’s 3 problems of interest include improving provider response to clinical queries about documentation, capturing national metrics collected by the VHA, and accurately representing veterans in VERA classification. Based on a review of the literature available on patient treatment file (PTF) accuracy and …

Increasing Healthy Lifestyle Behaviors In Cargo Drivers, Ronda L. Bell

Electronic Theses and Dissertations

The purpose of this project was to examine the extent to which lifestyle behaviors of transportation drivers in North Texas can be improved with health education. This research study was conducted to examine the health behaviors of transportation drivers as a result of an educational partnership between nursing and the transportation industry. The goal was to improve healthy lifestyles through education to decrease chronic illness and comorbid conditions of a significantly at-risk occupational population. The impact of this education was immediate and verified with quantitative measurement and statistical analysis. Results demonstrated that after nurse-led health education, transportation drivers reported significant …

How Do Nurse-To-Patient Ratios In The Emergency Department Impact Patient Experience?, Jessica L. Marcoux

Electronic Theses and Dissertations

There is a lack of consensus about the staffing matrix across nursing and especially in emergency

nursing, where variations in arrival patterns, acuity, social determinants of health, and length of stay all impact the workload of emergency nurses. The objective of this paper was to determine if government-mandated staffing ratios had a greater impact on patient experience at hospitals in California than staffing based on hours per patient visit at hospitals in Massachusetts. Seven hospitals from the state of California with government-mandated nurse-to-patient ratios were compared to 7 hospitals from Massachusetts that did not have mandated staffing ratios to determine …

The Impact Of Education On The Attitudes Of Staff Of A Rehabilitation Hospital, Kathryn Voreis, Kathryn G. Voreis

Electronic Theses and Dissertations

Stroke, also known as CVA or cerebrovascular accident, is a major chronic disease worldwide. In the United States, it is the leading cause of disability, costing a billion dollars each year (CDC, 2017). Typically, Western medicine is used for the treatment of stroke in the United States. An approach that has potential to improve general health outcomes, movement, mobility, aphasia, and quality of life includes acupuncture along with the standard therapies. The purpose of this quantitative research was to determine if the staff of a rehabilitation hospital would have a change in attitude after an educational program on acupuncture. The …

The Effect Of Heart Score Risk Stratification Tool On Length Of Stay, Kelly Huffman

Electronic Theses and Dissertations

Abstract

With increasing national health care expenditures, different methods of reducing health care costs, along with supportive evidence-based research, are essential. This research will lead to changes in clinical practice standards including the utilization of tools by emergency room and hospitalist providers to reduce costs by decreasing the length of stay for acute chest pain admissions. The researcher utilized a retrospective review of charts for participants admitted into the acute care setting with the primary diagnosis of acute chest pain, with a focus on determining whether an initial calculation of a HEART Score risk stratification variable was completed and if …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

A Phenomenological Study Of The Experiences Of Military Families, Who Have Children With Disabilities And Maladaptive Behavior, With School-Based Mental Health Personnel, Londi J. Segler

Electronic Theses and Dissertations

This qualitative study used a phenomenological approach to capture the lived experiences of military families who have children with disabilities and maladaptive behavior to note risk and protective factors that might impede the mental health development of that population of student. Through interviews with at-home-caregivers, I explored their experiences with public school staff, outside mental health services, and school psychologists. Study findings revealed that participants felt they were going to battle with school staff who were not willing to incorporate culturally responsive practices when working with their children. School staff who implemented regular bi-directional communication were more likely to gain …

The Colored Pill: A History Film Performance Exposing Race Based Medicines, Wanda Lakota

Electronic Theses and Dissertations

Of the 32 pharmaceuticals approved by the FDA in 2005, one medicine stood out. That medicine, BiDil®, was a heart failure medication that set a precedent for being the first approved race based drug for African Americans. Though BiDil®, was the first race specific medicine, racialized bodies have been used all throughout history to advance medical knowledge. The framework for race, history, and racialized drugs was so multi-tiered; it could not be conceptualized from a single perspective. For this reason, this study examines racialized medicine through performance, history, and discourse analysis.

The focus of this work aimed …

The Experiences Of Ncaa Student-Athletes With An Eating Disorder Or Disordered Eating, Rachel E. Taylor

Electronic Theses and Dissertations

The purpose of this study was to explore the experiences of student-athletes who had an eating disorder or disordered eating (ED/DE) while competing for the National Collegiate Athletic Association (NCAA). Integrating criticism and connoisseurship and critical evocative portraiture, four post-collegiate women who participated in cross country and track, who were either clinically diagnosed with an ED/DE or who self-diagnosed, participated in two interviews to describe their experiences with and the impact of ED/DE on their athletic pursuits, academic pursuits, as well as their relationships with coaches, teammates, and family. The analysis of these interviews showed the complexity of this topic. …

Human Genetics, Psychotropic Drugs, And Acts Of Violence, Selma Jolanda Eikelenboom-Schieveld

Electronic Theses and Dissertations

From the start of the use of psychoactive prescription medications in the 1950s, physicians reported paradoxical adverse reactions, ranging from newly developing depressions to an increase in existing mood disorders, and extremely violent and bizarre acts of suicide and homicide. In this research, it is hypothesized that the pharmacological properties of the prescribed drugs or the interaction between the drugs and the enzymes that are primarily responsible for their metabolism (cytochrome P450s) could cause these reactions. Given that acts of violence could be medication-induced, the role of the rate of drug metabolism is discussed. Genetic testing of certain CYP450s could …

Fostering Trauma-Informed Schools By Considering The Experiences Of Teachers In Working With Trauma-Exposed Students, Allison A. Stiles

Electronic Theses and Dissertations

High rates of trauma exposure among youth in the United States and the detrimental effects of trauma on students’ psychosocial and academic outcomes are well-established. Such findings have engendered the emergence of trauma-informed schools across the nation. While research regarding trauma-informed schools has understandably focused on the needs of students, shockingly little is known about teachers’ experiences in working with trauma-exposed students. In particular, very few studies have examined the relationship between teachers’ indirect exposure to student trauma and related symptoms of secondary traumatic stress (STS), as well as factors that may predict STS levels or explain variation in the …

How 6-12th Grade Staff Support Students With Depression: A Pilot Study To Develop Measures Of Implicit Associations, Explicit Attitudes And Helping Behavior, Paul M. Thompson

Electronic Theses and Dissertations

Students with emotional disabilities are disproportionately suspended and expelled in K-12 schools. Attribution theory suggests individuals are less likely to provide assistance to others if they believe the individuals are responsible for their own difficulties. To test attribution theory, this study created new measures of explicit attitudes and implicit associations of licensed 6-12th grade staff regarding students with depression as well as a helping behavior measure of staff toward students with depression. The survey was distributed within a single school district in the western United States. A majority of the sample (N = 52) held a mental health license (60%), …

Investigating Post-Concussion Neurocognitive Deficits Using The Immediate Post-Concussion Assessment And Cognitive Testing Tool, Megan Ekern

Electronic Theses and Dissertations

Concussions represent a serious public health concern due to their severe short and long-term consequences. Many adolescents participate in sports that involve the chance of injuries such as concussions. Concussive injuries can be difficult to describe because most symptoms involve non-physical indicators such as impaired cognition, altered behavior, or sleep disturbances. Symptoms can also be influenced by age, gender, and previous history of concussions. Current best practice is to remove the athlete from activity and perform several tests to critically evaluate and assess the injury. ImPACT is a type of neuropsychological testing that includes patient information, baseline tests, postinjury assessments, …

Assessing The Relationship Between Principal Priorities, Written Wellness Policies, And School Wellness Policy Implementation, Courtney Trapp

Electronic Theses and Dissertations

Purpose: The purpose of this study is to assess the relationship between principal priorities, written wellness policies, and school wellness policy implementation. Methods: Principal priorities of nutrition and physical activity, written wellness policy quality and degree of policy implementation were assessed in 95 schools from eight states using the principal priorities questionnaire, the Wellness School Assessment Tool (WellSAT) version 2.0, and the Wellness School Assessment Tool for Implementation (WellSAT-I), respectively. Data is analyzed using Stata Statistical Software: Release 15. All data is presented as means ± standard error Statistical significant was set at p≤0.05.
Results: There was not a significant …

Profiling Transcription And Retrotransposition Of Mouse L1 Subfamilies, Lingqi Kong

Electronic Theses and Dissertations

Transposable elements, also called jumping genes, comprise almost 45% of the human genome. In contrast, only 1% of the human genome is protein-coding sequences. The function and advantages of maintaining such massive copies of transposable elements in the human genome are still unclear. Long interspersed element 1 (L1), the most substantial group and the only active autonomous transposable element in the human genome, has revealed its unique roles in many diseases. The insertional mutagenesis induced by L1 retrotransposition events could threaten human genomic stability and generate unexpected mutations. L1 overexpression has been documented in both somatic and germline cells and, …

Description Of Mental Health Responses On An Electronic Ppe At A Ncaa Division I Institution: A Pilot Study, Megan Blomberg

Electronic Theses and Dissertations

The purpose of this study was to improve the effectiveness of mental health screening forms that are used during the preparticipation physical exam, or PPE, process and to help start a discuss about the need for further mental health resources. This study aimed to look at the prevalence of mental illness being reported at a Division I Institution and whether we are receiving consistent answers across various forms. We pulled the data from all 750 student-athletes that competed during the 2017-18 academic year at South Dakota State University (SDSU) and looked specifically at their answers on the PHQ-9, GAD-7, and …

Impact Of Coaching By Extension Professionals On Rural Wellness Coalition Success, Taylor Willhite

Electronic Theses and Dissertations

Objective: To quantitatively assess coaches perceived confidence in coaching rural wellness coalitions and to qualitatively determine barriers and facilitators to success in coaching rural wellness coalitions.
Design: A mixed methods design was utilized with quantitative (scorecard) and qualitative (key informant interviews) methodologies.
Setting: Six rural South Dakota wellness coalitions.
Participants: Extension wellness coalition coaches (n=7), one previous and six current.
Intervention: A component of the broader SDSU Extension 1416 Centers for Disease Control (CDC) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) intervention.
Analysis: STATA was utilized for the quantitative scorecard data by running paired ttests. NVivo was utilized in the …

Early Adolescent Social Isolation, Hope, And Well-Being During A Pandemic, Alicen Hauck

Electronic Theses and Dissertations

Social isolation is often divided into two subcategories of objective and subjective. The COVID-19 pandemic has led to an increase in objective social isolation in the form of social distancing and fewer social events. Research delineating the relationship between social isolation and adolescent well-being utilize measures of subjective social isolation. Whereas, measures of objective social isolation are more commonly used with geriatric populations. Therefore, there is a lack of information specific to the impact of objective social isolation on adolescent well-being, particularly during a pandemic. The effects of social isolation due to COVID-19 will not be short lived. Deciphering the …

Examining Instructional Methods In End-Of-Life Nursing Education: Lecture Vs. Simulation, Jonathan M. Benson

Electronic Theses and Dissertations

Undergraduate nursing programs have historically glossed over end-of-life care, if their curricula addressed it at all. This lack of instruction can leave practicing nurses feeling poorly prepared to deliver this specialized care. Feeling incompetent and lacking confidence may lead to poorer attitudes regarding this nursing specialty. Thus, effective continuing education activities are paramount in equipping nurses to provide this care and improve attitudes towards caring for terminally ill patients and their families. The purpose of this study was to examine how registered nurse attitudes towards end-of-life care are impacted using a simulation-based learning experience compared to a traditional face-to-face lecture …

Educational Interventions For Women And Their Support Persons On Breastfeeding Outcomes, Alexandra Cordell

Electronic Theses and Dissertations

n the United States breastfeeding duration and exclusivity rates are not at ideal levels, therefore there is a need to examine existing interventions. The purpose of this systematic review was to examine the effects of education and support interventions during the third trimester, immediate postpartum, and the first six months of life on breastfeeding duration and exclusivity from six weeks to six months. Inclusion criteria were (a) randomized controlled trials or controlled clinical trials, (b) pregnant and/or postpartum women, (c) lactation education and support interventions, (d) measurement of breastfeeding outcomes from six weeks to six months, and (e) published between …

The Impact Of Anterior Cruciate Ligament Ruptures On Subchondral Bone Density In Collegiate Populations, Zach Harbaugh

Electronic Theses and Dissertations

The purpose of this study was to determine whether anterior cruciate ligament (ACL) rupture and reconstruction would lead to any significant changes in subchondral bone at the proximal tibia within 1 to 5 years post-surgical repair. Fifteen individuals (3 male, 12 female), aged 18 to 29 years old, who had sustained an ACL rupture and subsequent repair within the last 5 years were recruited for this study. An age and sexmatched control was recruited to match each participant. Subchondral volumetric bone mineral density (vBMD) of the proximal tibia was measured using peripheral quantitative computed tomography (pQCT). Additionally, jump force and …

The Relationship Between Food Rules And Childhood Obesity In Rural And Non-Rural Families, Anna Venjohn

Electronic Theses and Dissertations

Background: Childhood obesity is continuing to rise, leading to long-term health consequences. Research shows that rural populations have higher rates of childhood obesity. There is a lack of research on how the home environment may affect this health disparity. Parents often enforce food rules to control their child’s eating habits, but the difference between the rural and non-rural populations in enforcing these rules is unknown.
Purpose: The purpose of the present study was to determine if there is a significant difference in food rules between rural and non-rural school-aged children, and if these differences correlate to BMI categories.
Methods: Secondary …

Follow-Up Nurse Telephone Calls For Heart Failure Patients: A Case Study, Danielle M. Schievelbein

Electronic Theses and Dissertations

Follow-up care is essential when trying to avoid readmissions for patients who have recently been discharged from a healthcare facility. As evidenced by the literature, multiple strategies have been implemented to help manage the care of heart failure patients; however, readmissions continue to be higher than desired, which implies the current strategies utilized should be reviewed and revised. It is important to evaluate the effectiveness of methods when providing follow-up care that prevents readmissions and is also beneficial and convenient for the patient. The qualitative case study explored a heart failure follow-up protocol completed by a registered nurse using the …

Giving Voice To Adults Living With Cystic Fibrosis: A Phenomenological Study, Brandon M. Varilek

Electronic Theses and Dissertations

Cystic fibrosis is one of the most difficult chronic diseases to manage long-term because of the numerous challenges faced on a day-to-day basis. Historically, these challenges have primarily been studied using quantitative methods given the desire to prolong life. However, simply increasing the quantity of life does not mean that quality of life will improve. It is entirely possible that new treatments may worsen perceived quality of life. What is missing from the current research is the person’s voice regarding the experience of living with cystic fibrosis, especially as they continue to age. The primary purpose of this study was …

Parenting Styles, Parenting Practices, And Dietary Intakes Of Preschoolers And Their Parents, Biyi Chen

Electronic Theses and Dissertations

Emerging research efforts have focused on the role of parents in the development of dietary behaviors of their children. Parental influences play a particularly important role in determining the children’s weight and shaping children’s dietary behaviors, especially during early childhood. Parent-related determinants can be classified as two types—general parenting (parenting style) and specific parenting practices (e.g, food parenting practices). Examining the interactions between parental influences and preschoolers’ and their parental dietary behaviors and may reveal important insights into how parents influence children’s dietary behaviors. Therefore, the goal of this research is to examine the associations between parenting styles, food parenting …

Reducing Gaps In Knowledge About Electroconvulsive Therapy Among Mental Health Nurses, Janice L. Edmonson

Electronic Theses and Dissertations

This DNP study was conducted to identify knowledge gaps about electroconvulsive therapy (ECT) among mental health nurses and to determine the effectiveness of an educational intervention on the knowledge and attitude of mental health nurses about the use of ECT at a psychiatric hospital. In this study, the researcher sought to build upon an existing knowledge base using principles of adult learning theory to enhance the therapeutic relationship of the nursing staff when caring for ECT patients. A sample of three-quarters (N = 119) of the mental health nursing staff employed by the psychiatric hospital consented to participate in …

Improving Low Health Literacy In Poststroke Patients By Educating The Health Care Staff, Marthilde Brzycki

Electronic Theses and Dissertations

Abstract

Lack of health literacy in the poststroke patient population is a serious issue; with the addition of the homeless population to that group, the result may be devastating. According to the American Heart Association and American Stroke Association (AHA/ASA, 2016), stroke is considered the primary cause of death and one of the chief reasons for disability in the United States, and nearly75% of strokes occur in those who are 65 years of age or older. Nurse practitioners are vital, providing necessary training and stroke education to the nursing and other health care staff. This DNP project was initiated to …

Person-Centered Care Education For Caregivers Of Patients With Dementia In Long-Term Care Settings, Dawn Buckmire

Electronic Theses and Dissertations

Person-centered care (PCC) guidelines are being used as a care model to improve health outcomes for residents with impaired cognition. The researcher utilized PCC guidelines to educate caregivers in residential homes to provide care based on the residents’ individualized needs and choices to reduce worsening health conditions and potentially avoidable hospitalizations. The researcher created an educational tool to improve prompt management of health conditions for residents with cognitive impairment and set up a control group (n = 4) and an intervention group (n = 4) to conduct this project. The intervention group received the PCC education guidelines, whereas …

Design, Synthesis, & Biological Evaluation Of Novel Het-Aromatic/Aromatic Analogs For The Treatment Of Hiv, Cancer, & Cognitive Dysfunctions, Mohit Gupta

Electronic Theses and Dissertations

Cyclophilin A are a class of peptidyl-prolyl isomerases that catalyzes isomerization of the proline residue within a protein. Cyclophilin A plays an instrumental role in the pathogenesis of HIV and HCV virus. Using structure-based drug we designed and synthesized small molecule inhibitors of cyclophilin A. These inhibitors were biologically evaluated for their ability to inhibit WT HIV-1 inhibition.

Mitogen-Activated Protein Kinase signaling cascades plays a critical role in cancer cell survival, metastasis, and chemo-resistance. The MEK5/ERK5 pathway, which is a member of MAPK signaling cascade, is involved in cell survival, anti-apoptotic signaling, angiogenesis, and cell motility. It is found to …

Patient Satisfaction With Substance Use Disorder Rehabilitation Services, Trupti Dhumal

Electronic Theses and Dissertations

Background: Patient satisfaction is considered as an important indicator in the evaluation of healthcare quality across an array of treatments and services. It is deemed vital especially in the field of substance use disorder (SUD) research due to an increased emphasis on understanding patients’ perceptions regarding their treatment and the attributes that drive their progress towards recovery. Despite the potential value, gaps have been recognized in the exploration of these satisfaction-related assessments among patients undergoing SUD treatment in residential rehabilitative settings. Thus, there is a need for understanding the dimensions contributing to satisfaction which would facilitate the development of …