Medicine and Health Sciences Commons^™

Exploring The Factors Of Persistence For African American Senior Nursing Students, Yolanda Nelson

Theses and Dissertations

African American nursing students experience commonalities within their college experience. Often these students may be faced with challenges, barriers, and/or struggles that may place a hindrance on their success in meeting their educational goals. This qualitative study used a phenomenological approach to explore African American female nursing students perceptions of faculty-student relationships and its implications for persistence. Four African American female nursing students and two nursing faculty agreed to participate in this study. This research study offers an examination of past and present research regarding the history of African American nursing students, health disparity, social justice and diversity within the …

Community-Level Factors Associated With Health-Related Quality Of Life Among Older Adults, Yu-Hsiu Lin

Theses and Dissertations

Objective: Health-related quality of life (HRQOL) and well-being is a new topic area for Healthy People 2020 in the U.S. In a broad-based literature review, more research explored individual level factors of HRQOL, and few focused on older adults. Multilevel analysis was seldom adopted to investigate the relationship between area-level socioeconomic or social environment factors and HRQOL. In lieu of the traditional Chapter 4 (Results) and Chapter 5 (Conclusion), two manuscripts representing the two specific research aims are included. The main aim of first manuscript was to explore the association between area deprivation, area health resources and older adults’ HRQOL. …

Low-Intensity Physical Activity And Cardiometabolic Risk Factors Among Older Adults With Multiple Chronic Conditions, Yueyao Li

Theses and Dissertations

Introduction Cardiovascular disease (CVD) is the leading cause of death among older adults in the Unites States and is driven largely by cardiometabolic risk factors including elevated blood pressure and blood glucose. Studies have found the protective effect of moderate intensity physical activity (MIPA) and vigorous intensity physical activity (VIPA) on cardiometabolic risk factor; however, the association between light physical activity (LIPA) and cardiometabolic risk factor among older adults is not clear. Objectives 1). Examine the association between LIPA and cardiometabolic risk factors. 2). Examine whether the association between LIPA and cardiometabolic risk factor is moderated by multiple chronic conditions. …

Genetic And Epigenetic Variations In Asthma And Wheeze Illnesses, Todd M. Everson

Theses and Dissertations

Asthma, a chronic respiratory condition, is common worldwide with no cure and limited effective prevention strategies. It is well recognized that asthma has a multifaceted etiology, though many of the underlying mechanisms involved in asthma development, persistence and remission are still convoluted. Epigenetic mechanisms, such as DNA methylation, regulate gene-expression but are not related to changes in the actual DNA sequence. Recently, differential patterns of DNA methylation within many genes have been associated with asthma, particularly within genes involved in the differentiation of pro-inflammatory T-helper 2 (Th2) cells. DNA methylation patterns within less known biologic pathways undoubtedly are involved in …

A Qualitative Study Of The Massage Therapy Foundation's Best Practices Symposium: Clarifying Definitions And Creating A Framework For Practice, Ann Blair Kennedy

Theses and Dissertations

Large numbers of individuals seek massage therapy for wellness/disease prevention purposes and research supports consumer reported benefits including physical and psychological improvements. However, challenges within the profession may be hindering the advancement of the field. To better understand the process and outcomes and ultimately develop best practices for massage therapy as well as better inform education, policy and research, it is necessary to investigate how massage and/or massage therapy are defined and operationalized in practice. This study entailed qualitative analysis of cross-sectional data using a grounded theory approach to examine the data gathered from a two-day symposium held in 2010 …

Relationship Between Job Satisfaction Among Frontline Staff And Patient Satisfaction: Evidence From Community Health Centers In South Carolina, Ashley Lynn Barnes

Theses and Dissertations

The role of frontline staff (FLS) is vital to the success of health delivery organizations as they are often the main point of patient contact and the primary source of feedback regarding the patient experience and satisfaction. Anecdotal evidence suggests that FLS have among the highest turnover rates in health delivery organizations, resulting in high recruitment and training costs as well as disruptions in day-to-day operations. However, few studies have examined the role of FLS and the factors affecting job satisfaction among FLS. Researchers have also not examined the impact of FLS satisfaction on patient satisfaction. To address these research …

Dietary Patterns And Prostate Cancer Aggressiveness In African-American And European-American Men, Lara Ryan Schneider

Theses and Dissertations

Several foods and nutrients have been linked to prostate cancer risk, but the effect of overall diet on prostate cancer outcomes is not well understood. Previous research has primarily examined a posteriori dietary patterns in relation to prostate cancer; studies that have used a priori dietary patterns and their relationship with prostate cancer have been inconclusive. Furthermore, racial differences in prostate cancer incidence and aggressiveness are not well understood. Data from the case-only North Carolina-Louisiana Prostate Cancer Project (PCaP) was used to examine the association between overall dietary pattern, as measured by the Mediterranean Diet (MED) score and the Dietary …

Nurses Utilizing The V.O.I.C.E.S. Hiv Prevention Intervention In The Black Church Community, Jason Richard

Theses and Dissertations

The Human Immunodeficiency Virus (HIV) epidemic is a significant problem in the United States, especially in the “Bible Belt” Deep South where the epidemic is hitting this region the hardest. The HIV epidemic in the state of South Carolina is very real, significant, and quite alarming. In fact, the Center for Disease Control and Prevention (CDC) labels South Carolina as an HIV “hot spot.” All racial and ethnic groups are susceptible and impacted by HIV. However, evidence shows that African Americans – especially young adults 18-35, bear the brunt of the burden to the extent that the “new face” of …

Dental Insurance As A Mitigating Factor In Reducing The Risk Of Mortality Among Working-Age Adults With Dental Caries And Periodontitis, Naveed Sadiq

Theses and Dissertations

Background Poor oral health had been associated with increased risk of having systemic diseases and thus mortality. The purpose of this research was to find if dental coverage with health insurance could mitigate the risk of death due to untreated dental caries and periodontitis among working age U.S. adults. Methods Data were drawn from NHANES III (1988-1994) and linked to mortality updated till Dec. 31st, 2011. It was restricted to those in the age range of 20-64 years adults. Furthermore, it was restricted to those who had complete data collection on all measures. Unweighted propensity scores were calculated to control …

Physical Activity And Breast Cancer In South Carolina, Chisom Onyeuku

Theses and Dissertations

This study examined the relationship between breast cancer incidence and recreational physical activity. It was one of the first studies in the southeastern US to examine incident breast cancer and physical activity in an ethnically diverse cohort of women. In terms of physical activity, both lifetime and recent physical activity were analyzed. All physical activity data were from validated self-reported surveys. The study examined BMI, menopausal status and race as key confounders and effect modifiers. The study found evidence that for Black women, there was a positive relationship between the amount of lifetime physical activity and the odds of incident …

Metabotropic Receptor Modulation Of Kainate Receptors In The Hippocampus, C'Iana Patrice Cooper

Theses and Dissertations

Kainate receptors (KARs) are glutamate-gated ion channels that mediate synaptic transmission, modulate transmitter release, and mediate excitation in the brain. Potentiation in their function predisposes the hippocampus to hyperexcitability and seizures. These receptors are widely expressed throughout the central nervous system as tetramers composed of various combinations of GluK1-5 subunits. In the hippocampus (a brain region commonly associated with seizure initiation), GluK2-, GluK4-, and GluK5-containing receptors are highly expressed in the CA3 pyramidal cell layer, whereas GluK1 is barely detectable. The lack of pharmacological tools hinders identifying the functional contribution of each kainate receptor subtype in normal CA3 synaptic transmission. …

Unexpected And Interrupted Transitions Among Newly Licensed Registered Nurses: Perspectives Of Nurse Managers And Preceptors, Sheri S. Webster

Theses and Dissertations

Successful retention of newly licensed registered nurses (NLRNs) into practice is critical to ensure the nursing workforce required to meet current and future health care demands. NLRN turnover rates result in loss of revenue due to high orientation costs and further hinder the development of a stable workforce. For nurse educators and administrators to effectively address early attrition among NLRNs, they must have a clear understanding of the factors that contribute to NLRNs leaving employment. The aim of this qualitative descriptive research was to explore NLRN transition to professional practice from the experiences and perspectives of nurse managers and preceptors …

Individual- And Neighborhood-Level Determinants Of Emergency Department Utilization Among Patients With Diabetes In South Carolina, Charity B. Breneman

Theses and Dissertations

AIM: The primary aim of this study was to evaluate the geographic variation in emergency department (ED) use in South Carolina using geographical information systems (GIS) and to examine the effects of both individual- and neighborhood-level characteristics on frequent ED use among patients with diabetes. METHODS: ED discharge data for 2013 was geocoded based on patients’ residential ZIP code using GIS. Frequent ED use among patients with diabetes was defined as three or more ED visits between January 1, 2013 and December 31, 2013. The boundaries for each neighborhood were defined by the U.S. Census Bureau ZIP Code Tabulation Areas …

Framing Risk, Responsibility, And Resolution: A Mixed-Methods Study Exploring Traditional And Social Media Coverage Of The 2014 Elk River Chemical Spill, Tracey Thomas

Theses and Dissertations

Background: The 2014 Elk River Chemical Spill raised policy questions concerning chemical safety and revealed an immediate need for improved emergency communication. This two-phase study explored how media presented causes of and longterm solutions to the spill through an examination of media frames. The study also explored how health risks were communicated through traditional and social media. The specific aims of Phase I were to examine media coverage in the days following the spill and compare coverage across media channels. The specific aims of Phase II were to understand how public health stakeholders perceived coverage of the spill and how …

Support For Comprehensive Sexuality Education And Adolescent Access To Condoms And Contraceptions In South Carolina, Sarah H. Kershner

Theses and Dissertations

A statewide random-digit dialed telephone survey was administered to residents of a historically conservative southern state to 1) assess the level of support for comprehensive sexuality education (CSE) in public schools, 2) assess the support for availability to condoms and contraception as an effective strategy for reducing unintended pregnancies and sexually transmitted (STIs) among adolescents and 3) assess the perceived view of reproductive health as a moral or public health issue. Survey data were obtained from 841 South Carolina residents May through June 2013. Findings from the study revealed that the majority (90%) of South Carolina residents support CSE in …

Post-Fall Decision Making Among Older Women Living In Continuing Care Retirement Communities: A Mixed Methods Study, Caroline D. Bergeron

Theses and Dissertations

Introduction: One in every three adults over the age of 65 experiences a fall every year, with women experiencing more falls than men. Falls can affect how older women perceive themselves and their independence. The purpose of this study was to examine older women's health decision making after experiencing a fall. Methods: I conducted semi-structured interviews with 17 older women living independently in continuing care retirement communities (CCRCs) who had experienced a fall within the previous six months and 11 individuals the women identified as being involved in their post-fall decision making. I also conducted an exploratory survey on post-fall …

Refinement And Pilot Testing Social Networks For Encouraging Healthy Behaviors: The Social Pounds Off Digitally (Social Pod) Study, Sarah B. Hales

Theses and Dissertations

Currently about 71% of adults in the US are considered overweight or obese. Overweight and obesity are associated with higher risk of developing many chronic diseases; however, health risks associated with overweight and obesity can be reduced by as little as a 3% to 5% reduction in weight. Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, yet maintaining participant engagement over time has been a challenge. The purpose of this study was to develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction; revise the …

The Role Of Ovarian Function In The Progression Of Cachexia In The ApcMin/+ Mouse, Kimbell Louise Hetzler

Theses and Dissertations

Cachexia is a devastating a life-threatening condition that occurs secondary to underlying disease including cancer, AIDS, COPD and comprises severe loss of muscle and fat mass. Muscle mass atrophy and wasting with cachexia is especially dire, as skeletal muscle mass is associated with quality of life, functionality, and ability to respond to chemotherapeutics. While much investigation has been done in the male animal to elucidate the inflammatory pathways and muscle signaling underlying cachexia, very little work has occurred in the female. The overall purpose of this study is to determine if ovarian function can alter cachexia progression in the female …

Dental Hygienists' Cognitive Process In Periodontal Soft Tissue Charting, Kelsey M. Schwei

Theses and Dissertations

Introduction: Dental hygienists have not had the opportunity to be involved in the design and development of the periodontal soft tissue charts and the surrounding interface features that are used while examining dental patients in daily practice. In some cases, dentists are able to give their opinions, wants, and needs into the development of the health information systems that they use on a daily basis, but too often, the dental hygienist is forgotten about and no input is ever given to the developers from the dental hygienists. This project considers the impact of well-designed interfaces on effectiveness and workflow particularly …

The Effects Of Applied Grip Force, Frequency And Duration On Ratings Of Perceived Exertion, Jessica Lynne Gall

Theses and Dissertations

This study investigates the interactions of various combinations of frequency and duration that result in the same duty cycle at a given applied grip force (measured in % maximum voluntary contraction (MVC)) to determine their relative effect on perceived exertion. Eight female subjects (median age 20.5 years) performed 27 randomized trials containing combinations of dynamic grips, performing each combination twice. Each session contained three 25 minute trials, with a minimum of 12 minutes of rest between trials. The design used a 3x3x3 factorial protocol: i) 3 grip forces (10%, 25%, 40%) ii) 3 duty cycles (25%, 50%, 75%) iii) 3 …

Clinical Decision Making In Last Semester Senior Baccalaureate Nursing Students, Beth Cusatis Phillips

Theses and Dissertations

Clinical decision making (CDM) is an integral part of what nurses do (Muir, 2004; Ramezani-Badr, Nasrabadi, Yekta, & Taleghani, 2009). Yet, inspection of the nursing literature reveals concerns about the lack of preparation and readiness of new nursing graduates to engage in effective clinical decision making (Smith & Crawford, 2002, Duchscher, 2008, Gillespie & Paterson, 2009, Benner, Sutphen, Leonard & Day, 2010, Noohi, Karimi-Noghondar, & Haghdoost, 2012). This study was conducted to better understand the nature of students’ decision making and how they learn to make clinical decisions. Nursing students in their final semester of a baccalaureate program participated in …

Determining Accessibility For Ios Applications: Piloting A Checklist For Practitioners, Katelyn White

Theses and Dissertations

Background: Mobile technologies have infiltrated every part of daily life, including the school system. While these technologies are highly customizable, there are 6.4 million children with disabilities who may not be able to utilize these devices because of their lack of accessibility. The iOS Application Accessibility Checklist (iA2C) is a “first of its kind” tool, used to determine if an iOS app is accessible for users with a variety of disabilities.

Hypothesis: When using the iA2C, novice users with little experience in accessible design will determine apps to have a statistically similar number of accessibility features as experts, assessing the …

Place Experience Of Nursing Home Courtyards: A Holistic Approach To Understanding Institutional Outdoor Environments, Chia Jung Shih

Theses and Dissertations

This dissertation research investigates place experience of three nursing home courtyards. Based on systemic place theories, each nursing home courtyard is conceptualized as place or a system consisting of three major subsystems: physical settings, people and rules of place uses. Place experience as the center of conceptualization is the result of interactions between them. Place experience is thus characterized by objective, subjective and consensual qualities of people-environment relationships. The research design follows the premises of pragmatic case study methodology; a mixed research method is employed that includes archival research of floor plans, photo documentation, a physical setting checklist and instrumented …

Upper Extremity Kinematic And Kinetic Comparison Of Anterior Versus Posterior Walkers During Functional Activities In Children With Cerebral Palsy, Chris Burckardt

Theses and Dissertations

Introduction: Investigating the differences in upper extremity (UE) joint biomechanics between anterior and posterior walkers has been explored in limited contexts, even though research has shown that prolonged use of walking aids can lead to UE joint weakening or musculoskeletal injuries. Recent studies have investigated some of these differences in children with spastic diplegic cerebral palsy (CP) during gait; however, no research has been conducted that compare these UE joint biomechanical differences during functional activities or activities of daily living (ADLs). The aim of this study is to use motion analysis to compare kinematic and kinetic differences between anterior and …

From Data To Decision: An Implementation Model For The Use Of Evidence-Based Medicine, Data Analytics, And Education In Transfusion Medicine Practice, Nazanin Tabesh

Theses and Dissertations

Healthcare in the United States is underperforming despite record increases in spending. The causes are as myriad and complex as the suggested solutions. It is increasingly important to carefully assess the appropriateness and cost-effectiveness of treatments especially the most resource-consuming clinical interventions. Healthcare reimbursement models are evolving from fee-for-service to outcome-based payment. The Patient Protection and Affordable Care Act has added new incentives to address some of the cost, quality, and access issues related to healthcare, making the use of healthcare data and evidence-based decision-making essential strategies. However, despite the great promise of these strategies, the transition to data-driven, evidence-based …

Computational Analysis Of The Sir Mathematical Model For The Dengue Fever, Joseph Phillip Diaz

Theses and Dissertations

Dengue fever is a disease affecting people in more than 100 countries. Here we consider a host and vector model for the transmission of dengue fever. This SIR model consists of three compartments of susceptible, infective and removed for host (human) and two compartments of susceptible and infective for vector (dengue mosquitos). These five compartments yield five coupled nonlinear ordinary differential equations (ODEs). After non-dimensionalization, we have a system of three nonlinear ODEs. Reproductive number and two equilibrium points are calculated for various cases. Simulation is carried out for susceptible, infective and removed and the results are presented in graphical …

Activation Of Microglia In The Rotenone Lymnaea Stagnalis Model Of Parkinson's Disease, Xiomara Galvan

Theses and Dissertations

Parkinson’s disease (PD) is the most common irreversible neurodegenerative movement disorder affecting approximately ten million people worldwide. In the central nervous system (CNS), PD is known by the selective loss of Dopamine (DA) cells of the substantia nigra pars compacta. Although the disease has been very widely studied, the underlying mechanisms are not yet understood. Several hypotheses have arisen as result of injury of the mitochondria, some experiments include microglia activation, microtubule damage, and reactive oxidative species, which all result in the death of DA cells. The theory of microglia activation upon inflammation was explored in this study. Using the …

An Exploratory Investigation Of Tele-Counseling: Looking At The Power Of Therapeutic Alliance In Improving Wellness, Jorge Rostro

Theses and Dissertations

The present study explored the power of one tele-counseling session to elicit change within post wellness ratings scores and the relationship between clients’ perceptions of relationship, goals and topics, approach and method, and overall session with clients’ wellness ratings. Results indicated that the mean for post-session wellness was significantly greater than pre-test wellness ratings. The standardized effect size, d, was .43, indicative of a moderate effect size. No difference was found between client’s perceptions of predictor variables with post-wellness rating scores. This study adds support for the use of tele-counseling services as one session might have the power to elicit …

Incorporating A Robot In Intervention With Children With Asd: The Effect On Tantrum Behaviors, Tayler Bodon Whitmer

Theses and Dissertations

This study examined the effect of intervention involving a humanoid robot on challenging or tantrum behaviors of four children with low-functioning autism spectrum disorders (ASD). The current work was part of a larger study involving the effect of the robot on functional communication skills on a variety of different interactions with different communication partners. All participants took part in a single-subject, multiple-baseline design with various session types including baseline, traditional play-based treatment, treatment including the robot, and follow-up sessions. For the purpose of this study, only the sessions including treatment with the robot where the robot interaction occurred at the …

Functional And Phenotypic Analysis Of B- And T-Helper Cells In Rhesus Macaques And African Green Monkeys, Sahar Ali Alhakeem

Theses and Dissertations

Human immunodeficiency virus (HIV) is one of the most challenging infectious agents at the current time. To date, many vaccine trials have been conducted. However, there has not been a fully successful trial. This is due, in part, to the gap in knowledge of the protective immune response against HIV. African green monkeys (AGMs) serve as an interesting model to study immune protection in primate immunodeficiency virus infections due to their resistance to AIDS. Experimental SIV infection in rhesus macaques (RMs) resembles HIV infection in humans with chronic immune activation and progression to AIDS well characterized in both. Understanding the …