Medicine and Health Sciences Commons^™

Development Of Tongan Materials For Determining Speech Recognition Thresholds, Lisa Dawn Bunker

Theses and Dissertations

Speech recognition threshold (SRT) is an important clinical measure that validates the pure-tone average (PTA), assists in diagnosis and prognosis of hearing and hearing impairment, and helps identify non-organic hearing impairment. Few published, recorded, and standardized materials exist in languages other than English, which results in audiologists testing individuals using materials developed in a non-native language. Research shows that this is problematic, as certain criterion for SRT testing are not met. Thus, performance may reflect test-language deficiency rather than hearing impairment. Currently, there are no known published materials for use in measuring the SRT in individuals whose native language is …

The Effects Of Task Preference On Speech And Motor Performance Under Divided Attention Conditions, Amy Sue Leiter

Theses and Dissertations

Dual task performance and the interaction of tasks has been the subject of much research. When tasks are performed together they affect each other to varying degrees depending upon such factors as the similarity of the tasks, their difficulty, and whether one task is given preference over another. In this study, task preference was investigated under divided attention conditions in order to determine what effect preference had on task performance. Twenty young adults took part in this study and were randomly assigned into two groups. Each group was experimentally motivated to favor one of the two tasks – either speaking …

Closing The Research Gap: Enhancing Cambodian Participation In Clinical Research, Elsa C. Carlson

Theses and Graduate Projects

Obtaining proper sampling of a heterogeneous population remains a concern in research studies. Many studies have examined the low numbers of African-Americans recruited to clinical trials. Other studies have also focused on Latino-Hispanic disparity in research. However, there remains paucity in research involving Asian participation. This project aims to develop a nursing model of cultural immersion in the Cambodian community's culture that will foster deeper understanding, acceptance, and trust. In so doing, a research-friendly milieu of collaboration by the Cambodian community and the research community will be established. Madeleine Leininger's Theory of Culture Care Diversity and Universality is the theoretical …

Beyond Florence Nightingale: Celebrating Nursing At Augsburg Central Nursing Center, Lori J. Keith

Theses and Graduate Projects

The face of healthcare and our society are changing. People have difficulty accessing or paying for health services. One approach to meeting the needs of the under served is the utilization of nursing centers. The Augsburg College Department, in collaboration with Central Lutheran Church, maintains a no fee nurse managed center. Many nursing centers face continual difficulties in remaining viable or have closed because of funding issues. This project was developed to garner support for the Augsburg Central Nursing Center from Evangelical Lutheran Churches in America (ELCA) churches in the area. Fostering this relationship can provide necessary items and monies …

Bringing Down The Barriers Of Maggot Debridement Therapy, Kristine L. Gillard

Theses and Graduate Projects

The purpose of this paper is to describe the rationale for Maggot Debridement Therapy (MDT) and the development of a practice model. Chronic wounds are a growing problem in health care. Debridement of a wound is an essential component of wound healing as the presence of devitalized tissue can impede the healing process. Even with today's high-tech medicine there are still times we need to resort back to the basic and simple principles from nature that may help combat medical problems. The use of maggot larvae for wound debridement has made resurgence into wound management in the last 15 years. …

Bed Assignment: A Nurse's Call, Sandra L. Prince

Theses and Graduate Projects

The purpose of this Integrated Thesis Project is to develop a nursing unit based bed assignment procedural guideline. Currently general care patients admitted to the hospital are assigned to a bed through a centralized bed assignment process that does not involve nursing input. The nursing unit based bed assignment process is developed using the assumption that nurses will select the right bed for the right patient the first time with consideration given to patient's individual needs and staffing on the unit. A nursing unit based bed assignment process is anticipated to increase satisfaction for patient, family and nurse. Jean Watson's …

Becoming A Mother Across Cultures: Challenges Nurses Experience Teaching Prenatal Care To Recent Immigrant Sudanese Women, Cathy E. Miller

Theses and Graduate Projects

The purpose of this project is to provide an overview of Maternal Role Attainment (MRA) theory as discussed in nursing literature and explore how separation from culture may affect the transition to becoming a mother. Nursing issues related to teaching and supporting recent immigrant Sudanese women will also be identified. MRA is a complex developmental and transitional experience for women. In the United States, many women take on this role with the support of their culture, family, friends and community. However, over the past few years, the local public health agency has served a small number of immigrant pregnant Sudanese …

Synthesis Of Data To Develop Cultural Competency Training For Telehealth Nurses Providing Outbound Disease Management Programs To Hispanic Patients., Barbara L. Kreinbring

Theses and Graduate Projects

Telehealth nurses deliver disease management programs to culturally diverse populations, including Hispanic patients. Disease management programs focus on chronic conditions such as diabetes, which are increasing in prevalence. The CDC predicts that the number of Hispanic people with diabetes will rise nearly six-fold by 2050. The nurses who deliver these programs via the telephone need training focused on culturally competent care. The purpose of this project is to review and synthesize information in order to develop cultural competence training for telehealth nurses providing disease management programs to Hispanic patients.

The Lived Experience Of A Patient While Receiving Treatment On An Orthopedic Unit After A Hip Fracture: Integrating Research And Theory To Improve Patient Care, Margaret A. Kaser

Theses and Graduate Projects

A hip fracture is a devastating injury for an older person, often resulting in long-term or permanent loss of mobility and independence. Although research has been conducted on various aspects of hip fractures, little research has described the experience of a patient with a hip fracture. This phenomenological study explored the lived experience of a patient receiving treatment on an orthopedic unit after a hip fracture. A purposeful sample of two participants who were hospitalized at Saint Mary's Hospital following a hip fracture were interviewed after surgical repair of the fracture. The interviews were analyzed using Giorgi's descriptive phenomenology. The …

Giving Voice To Lived Experience Of Children Affected By Hiv/Aids In Namibia, Annie Retter

Theses and Graduate Projects

Namibia is one of the top five countries where HIV/AIDS is at epidemic proportions and thousands of Namibian children have become innocent victims of the disease. Research on children's lived experience of HIV/AIDS in Namibia is needed in nursing literature. The purpose of this project is to answer the question: What is it like to grow up in a society where AIDS is the leading cause of death and HIV infection rates are at epidemic proportions? Madeleine Leininger's Culture Care Theory will guide the research. An ethnonursing methodology that incorporates hermeneutic phenomenology will be used to answer the research question …

Oral Retelling As A Measure Of Reading Comprehension: The Generalizability Of Ratings Of Elementary School Students Reading Expository Texts, Rachel Clinger Burton

Theses and Dissertations

The purpose of this study was to refine a rating procedure used to assess intermediate elementary school students' ability to orally retell what they had read from two expository passages. Oral retellings from 28 fourth grade students were tape-recorded and rated on two different occasions by each of 4 raters. A four-facet (passage, day of test administration, rater, and rating occasion) generalizability study was conducted using a partially nested design. The six largest sources of variability identified in the G-study included (a) students, (b) the student-by-day interaction, (c) the interaction of passage with rater (nested within student and day), (d) …

The Role Of Extracellular Matrix And Matrix-Degrading Proteases In Neonatal Hypoxic-Ischemic Injury, Christopher C. Leonardo

USF Tampa Graduate Theses and Dissertations

Improvements in medical care over recent decades have increased the number of premature and low birth weight infants that survive hypoxic-ischemic (H-I) insults. Because there is a rising incidence in diseases associated with these events, it is critical to develop effective therapies to treat the various resulting neuropathies. Extracellular matrix constitutes the majority of brain parenchyma. Lecticans and matrix-degrading proteases including ADAMTSs (a disintegrin and metalloproteinase with thrombospondin repeats) and matrix metalloproteinases (MMPs) exert effects on cell viability and may be associated with either protective or destructive processes after H-I. Both ADAMTSs (Cross et al. 2006; Tian et al. 2007) …

The Development Of Word Recognition Materials For Native Speakers Of Tongan, Lara Cahoon Seaver

Theses and Dissertations

The purpose of this study was to develop, digitally record, evaluate, and psychometrically equate a set of Tongan bisyllabic word lists for use in measurement of word recognition testing. Commonly used bisyllabic words were digitally recorded by male and female native talkers of Tongan. The psychometric performance of the words was measured at ten intensity levels (- 5 to 40 dB HL) in 5 dB increments by 20 listeners with normal hearing acuity. The 200 words with the highest rate of listener identification were included in four relatively psychometrically equivalent word lists of 50 words each and eight half-lists of …

Essential Novice Nurse Educator Role Competencies And Qualifications To Teach Ina Pre-Licensure Registered Nurse Education Program, Kathleen A. Poindexter

Dissertations

Expert nurse clinicians who are transitioning into academic positions after successful clinical careers often find they are unprepared to assume their new educator roles. While nursing clinical expertise may be a necessary expectation, the knowledge is not sufficient to assume a nurse educator position. Novice nurse educators prepared with the essential qualifications and competencies associated with the specialty role of a nurse educator will be better able to transition into their new academic roles. This study identified essential entry-level nurse educators' competencies and qualifications as reported by nursing administrators of accredited pre-licensure nursing programs across the United States.

This study …

The Impact Of Telemonitoring On Self-Efficacy, Emotional Well-Being, And Clinical Outcomes In Patients With Chronic Obstructive Pulmonary Disease Or Heart Failure, Jaclyn West-Frasier

Dissertations

Telemonitoring is the remote monitoring of patients' health status using telecommunications and information processing technologies. This pilot study analyzed data collected through a parent study that randomized 46 home health patients to either standard care (SC) or standard care with the addition of telemonitoring (TM). The telemonitoring device used in this study provided daily transmission of physiologic data and patients responses to questions about their disease and symptom management. Data analysis was completed to address the question whether telemonitoring, as part of standard home care for patients with chronic obstructive pulmonary disease (COPD) and patients with heart failure (HF), has …

A Randomised Comparative Clinical Trial Of Prokinetic Agents And Proton Pump Inhibitors In H. Pylori Negative Non-Ulcer Dyspepsia, Mzee Ngunga

Master of Medicine in Internal Medicine

Aim: To compare the efficacy of prokinetic agents and proton pump inhibitors in symptom relief of patients with non-ulcer dyspepsia. Design: Comparative prospective single blind clinical trial. Patients and setting: Fifty four cases of non-ulcer dyspepsia in whom H. pylori has been eradicated were seen in the specialist gastroenterology clinic of a tertiary care hospital. Methodology: Patients with dyspepsia and negative endoscopy for peptic ulcer disease, gastro-oesophageal reflux disease, hiatus hernia and upper gastrointestinal malignancy in whom H pylori has been eradicated but still had dyspepsia were assessed and scored using the modified Glasgow dyspepsia severity score (GDSS) at baseline. …

Triple Test Assessment And A Scoring System To Predict The Presence Of Breast Cancer At Aga Khan University Hospital, Nairobi, Aideed A. Kahie

Master of Medicine in General Surgery

Background: Breast cancer is an emerging health concern in Africa. It is the most common female cancer in Kenya. The accuracy of the diagnostic modalities in our institution has not been previously assessed, especially in cases where components of the Triple Test (TT) are non-concordant. Objectives: To retrospectively evaluate the accuracy of TT, its components and its modification; the Triple Test Score when the components are nonconcordant at Aga Khan University Hospital, Nairobi. Methods: Using ICD9 611.72 we identified patients with breast lump or mass in the period between January 2000 and July 2007. One hundred and thirty nine patients …

Child Sexual Trauma: Testing The Robustness Of Browne & Finkelhor's Theory, Jose Mauricio Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Trauma has received great attention in the last three decades and a major societal issue today is child sexual abuse. Twelve percent of victims of maltreatment every year are victims of child sexual abuse (CSA). Several studies have suggested that the prevalence of CSA in women is in the range of 6% to 62% depending on how the data was collected (e.g., interviews, surveys) and the nature of the population sampled (e.g., general population, clinical population). Because of CSA, victims are impacted by the experience and encounter a change in the way they perceive the world on both the way …

Immediate Provisionalization Of Single 3.0 Mm Diameter Implant In Maxillary And Mandibular Anterior Region, Kotaro Oyama

Loma Linda University Electronic Theses, Dissertations & Projects

Immediate provisionalization of single implants with standard (3.75 - 4.5 mm) and wide diameter (> 4.5 mm) has been well documented. When the space is limited, small diameter implants (3.0 mm) must be used. Although high success rates have been reported, they were limited to healed site and were placed as staged procedures. The purpose of this prospective study was to evaluate the success rate and peri-implant tissue response of small diameter (3.0 mm) implants undergoing immediate provisionalization in the esthetic area.

Eleven patients who had missing maxillary lateral incisor(s) and/or mandibular incisor(s) participated in this study. Thirteen 3.0 mm …

Oxidative Stress-Mediated Anticancer Activity Of Novel Ahr Modulators Af & 5f203, Lancelot S. Mclean

Loma Linda University Electronic Theses, Dissertations & Projects

Estrogen receptor positive (ER+) breast cancer tends to respond to anti-estrogen agents such as Tamoxifen. Approximately 40% of ER+ breast cancer is resistant to these agents and those that initially respond often acquire resistance. Estrogen receptor negative (ER-) breast cancer remains largely unresponsive to these agents. It is therefore vital to discover drugs that are potent in both forms of breast cancer. Aminoflavone, (5-amino-2, 3-fluorophenyl)-6,8-difluoro-7-methyl-4H-l-benzopyran-4-one; AF; NSC 686288) and 5F203, (2-[-Amino-3-methy phenyl]-5-flurobenzothiazole) are novel anticancer candidate agents that display potent in vitro and in vivo anti-proliferative activity against select human tumor cells with a unique anticancer activity profile in the …

Effect Of Gutta Percha On The Retention Of A Post Using Different Cements, Saeda H. Basta

Loma Linda University Electronic Theses, Dissertations & Projects

This study evaluated the effect of residual gutta percha on the retention strength of prefabricated post cemented with four different cements. Forty intact mandibular single canal canines or premolars were selected for standardized size and quality, endodontically treated, and decoronated to the cementoenamel junction. A post space was prepared to accommodate Para post XP size 4 (Coltene, Whaledent Inc., Cuy Falls, Ohio) to a depth of 8 mm. The Obtura heated gutta percha system was used to inject a very thin line of gutta percha along one lateral wall to the depth of the future post. Forty obturated teeth were …

Response Of Endothelial Cells To Stressors: The Impact Of Aging And Diabetes, Katie Mclellan

Loma Linda University Electronic Theses, Dissertations & Projects

Preliminary research indicates there is some impairment of the endothelial cells to respond to single stressors such as local heat, shear stress, and global heat in older people and people who have diabetes. The response of the skin blood flow to local heat is an indicator of the endothelial cells ability to cope with stress. In addition, factors such as thicker subcutaneous fat and skin moisture may impair the skin’s ability to dissipate heat. For older people and people with diabetes, this endothelial dysfunction may cause an even more diminished response to multiple stressors. However, no studies have examined the …

A Geospatial Approach For New Perspectives On Satisfaction With Health Services In Malawi, Gideon Mazinga

Loma Linda University Electronic Theses, Dissertations & Projects

This dissertation explored the spatial pattern of user satisfaction with health services and factors, including policies that potentially explain the variation in the district-level of user satisfaction with health services. Nationwide secondary data was extracted from the 2002 Core Social Welfare Indicators Survey and the National Health Services Statistics databases obtained from National Statistics of Malawi. The National Health Facilities inventory obtained from the Malawi diffusion project was also geocoded to display the distribution of health care facilities in the country. Spatial autocorrelation and regression modeling techniques were applied on the national representative data set.

The spatial autocorrelation test revealed …

Factors That Affect Performance On Executive Functioning After Coronary Artery Bypass Grafting, Sapna Mahesh Patel

Loma Linda University Electronic Theses, Dissertations & Projects

Research suggests that individuals who undergo coronary artery bypass grafting (CABG) experience declines in neuropsychological functioning post-operatively. This decline has been observed in up to 80% of patients early after surgery, and in up to 30% of patients after six months. Many studies have examined the potential effects of CABG on neuropsychological functioning in general, and numerous studies have found that executive functions are impaired in particular. However, none have examined what factors contribute to observed executive dysfunction after CABG. This study investigated the role of memory functions on executive functions in a selected sample of patients undergoing CABG. This …

Novel Binding Domains Mediate Binding Of Hpv 16 E6 To Fadd And Procaspase 8, Sandy S. Tungteakkhun

Loma Linda University Electronic Theses, Dissertations & Projects

To evade the host response to infection, viruses have developed means to survive and propagate. HPV 16, a causative agent of cervical cancer and of some cases of oropharyngeal cancers, is one example. We have reported that the early viral protein E6 binds to proteins necessary for propagation of the apoptotic signal following receptor/ligand interactions, such as those mediated by FADD DED and procaspase 8 DED. E6 expression leads to the dose-dependent accelerated degradation of FADD and the protection of E6-expressing cells from Fas-induced apoptosis. Surprisingly, the splice isoforms of E6, E6_large and E6*, affect the stability of procaspase …

The Psychophysiology Of Information Processing Differences In Eating Disorders, Kathryn Grace Truitt

Loma Linda University Electronic Theses, Dissertations & Projects

Maladaptive or dysfunctional cognitive factors are believed to be significant contributors to pathology in eating disorders. The emotional Stroop task was used to examine [the] these dysfunctional cognitive factors. A sample of 31 women (14 nonclinical controls, 13 BN, 4 AN) participated in this investigation, after exclusion for ocular and movement artifacts and equipment problems the remaining sample contained 4 women diagnosed with BN, 4 women diagnosed with AN, and 9 matched non-clinical control subjects. Participants completed an Emotional Stroop task comprised of 8 blocks of words. On each trial, a word was presented in one of four colors (black, …

Mechanisms Of T Helper Cell Modulation In A Simulated Space Radiation Environment, Asma Rizvi

Loma Linda University Electronic Theses, Dissertations & Projects

Exposure to solar particle events (SPEs) poses the most serious threat to astronaut health. Due to this radiation environment, exploration of the solar system beyond Earth’s orbit entails many risks for the crew on these deep space missions. Depression or dysfunction of the immune system is a major concern due to its high radio-sensitivity; potential consequences include overwhelming infection, development of cancer, fibrosis, and poor wound healing. Astronauts are also exposed to low dose/low dose rate (LDR) radiation. A three month stay at the international space station exposes them to ~ 0.05 Gy of radiation.

C57BL/6 mice received LDR gamma-radiation …

Relative Timing Of Speech Motor Events At Utterance Invitation In Persons Who Do And Do Not Stutter, Bryan Thomas Brown

Masters Theses

Speech production is a highly complex speech motor activity that presumably requires a high degree of coordination between articulatory, respiratory and phonatory subsystems. Stuttering may be caused by breakdowns in speech motor coordination. The current study attempted to evaluate timing relationship between these systems at speech initiation in the perceptually fluent speech of people who do and do not stutter. To study this, tongue blade speed histories, respiratory transitions from inspiratory to expiratory gestures, and acoustic events at the initiation of perceptually fluent speech in persons who stutter and normally fluent speakers were analyzed in relative time. To identify the …

Predicting Long-Term Memory In Adult Brain Injury Patients Using Mr Spectroscopy, Herminia De La Rosa-Trujillo

Loma Linda University Electronic Theses, Dissertations & Projects

Accurate outcome prediction has proven to be somewhat elusive for patients with traumatic brain injury (TBI). The difficulty is due to the sometimes inaccurate methods of prediction currently available. Despite the advances seen in radiological technology, the traditional methods of x-rays, CT scans and MRIs are not always accurately able to predict patient functional outcome. These radiological methods are adequate in determining gross structural anatomical disturbances, however, they unable to detect more diffuse cellular damage believed to be responsible for the functional impairments evidenced in patients sustaining TBI. Magnetic Resonance Spectroscopy (MRS) is an imaging technique which measures brain metabolites …

Hiv Risk Among Nursing Students In Rwanda : Self-Efficacy, Knowledge And Attitudes, Jacqueline Wosinski

Loma Linda University Electronic Theses, Dissertations & Projects

Acquired immune deficiency syndrome (AIDS) is the leading cause of death in sub-Saharan Africa. With a prevalence rate of 3.1% in 2006, Rwanda is one of the hardest hit countries. Nurses are often the leading health professionals in rural communities and at the forefront of the fight against the HIV pandemic. Little has been written on how nurses are prepared to intervene successfully along the continuum of HIV prevention and care. A mixed-methods sequential exploratory approach was used to explore this question.

In the first phase, cognitive, socio-psychological, and environmental factors of nursing education in Rwanda in regard to HIV …