Medicine and Health Sciences Commons^™

Quality And Safety Education In Newly Hired Rns And Rns In Staff Leadership Roles, Dennis Alan Bertch

Doctoral Dissertations

The intent of this project was to examine the potential knowledge, skills, and attitudes (KSA) gap of practicing bedside registered nurse (RN) care providers regarding the quality and safety education for nurses (QSEN) core competencies. Based on this perceived gap two key questions were explored: (a) do newly hired RNs and RNs in staff leadership roles demonstrate an understanding of the KSAs of the QSEN core competencies?; and (b) was there a difference in the understanding of the KSAs of the QSEN core competencies related to RN educational preparation, years of RN experience, and/or previous quality improvement training within and …

The Estimation Of Caloric Expenditure Using Three Triaxial Accelerometers, Tyrone Gene Ceaser

Doctoral Dissertations

Accelerometer-based activity monitors are commonly used to measure physical activity energy expenditure (PAEE). Newly designed wrist and hip-worn triaxial accelerometers claim to accurately predict PAEE across a range of activities. Purpose: To determine if the Nike FuelBand (NFB), Fitbit (FB) and ActiGraph GT3X+ (AG) estimate PAEE in various activities. Methods: 21 healthy, college-aged adults wore a NFB on the right wrist, a FB on the left hip, and AG on the right hip, while performing 17 activities. AG data were analyzed using Freedson’s kcal regression equation. PAEE was measured using the Cosmed K4b² (K4). Repeated measures ANOVAs were used …

The Psychosocial Effects Of Beryllium Sensitization And Chronic Beryllium Disease, Jeffrey Robert Miller

Doctoral Dissertations

The purpose of this study was to develop and validate a theoretical model that explains the psychosocial effects of beryllium sensitization (BeS) and chronic beryllium disease (CBD). Sequential, mixed research methods were used. The study population was current and former workers from Department of Energy laboratories and manufacturing facilities who have either BeS or CBD. A theoretical model based on uncertainty in illness and psychosocial adjustment to illness theories was developed. It was hypothesized that uncertainty had a negative effect on health quality of life unless mediated by the ability to make psychosocial adjustments to illness. Qualitative study results supported …

“I’Ve Accomplished Something Here” The Lived Experience Of Employed Breastfeeding Mothers: A Phenomenological Analysis, Jennifer Diane Stewart-Glenn

Doctoral Dissertations

Abstract

The purpose of this study was to describe the experience of employed breastfeeding mothers. Using a phenomenological approach based on the works of Merleau-Ponty, the researcher completed 13 interviews in which mothers with experience working full-time while breastfeeding were asked to describe their experiences. The interviews were transcribed verbatim and analyzed using a hermeneutical approach developed by Pollio and applied to nursing research by Thomas. Each interview was examined within the context of all the interviews to identify themes found throughout.

While participants’ experiences were grounded in the unsupportive world of the workplace, aspects of their experience became figural …

How Do Psychiatric Healthcare Workers Prevent The Use Of Restraint And Seclusion?, Kelly A. Carlson

Doctoral Dissertations

The purpose of this grounded theory method study was to understand the complex, interactive, and interrelated processes that psychiatric healthcare workers engage in to prevent the use of restraint and seclusion. Without supporting evidence of therapeutic validity, restraint and seclusion are commonly used by psychiatric healthcare workers to control disruptive patients. The Substance Abuse and Mental Health Services Administration issued a call for the elimination of restraint and seclusion use in psychiatric care settings in 2003. Workplace violence, another major public health concern, is both a cause and effect of the restraint and seclusion use. Individuals continue to be needlessly …

Development Of A Novel Technique For Predicting Tumor Response In Adaptive Radiation Therapy, Rebecca Marie Seibert

Doctoral Dissertations

This dissertation concentrates on the introduction of Predictive Adaptive Radiation Therapy (PART) as a potential method to improve cancer treatment. PART is a novel technique that utilizes volumetric image-guided radiation therapy treatment (IGRT) data to actively predict the tumor response to therapy and estimate clinical outcomes during the course of treatment. To implement PART, a patient database containing IGRT image data for 40 lesions obtained from patients who were imaged and treated with helical tomotherapy was constructed. The data was then modeled using locally weighted regression. This model predicts future tumor volumes and masses and the associated confidence intervals based …

Central Line-Associated Bloodstream Infection Prevention In The Long-Term Acute Care Setting, Mary Lisbeth Dougherty Msn Rn Aocna

Doctoral Dissertations

Sustained reduction of central line-associated bloodstream infections remains elusive in many institutions, including the long-term acute care hospital (LTACH), despite a focus on improving patient outcomes. A clinical practice survey was distributed electronically to nurses working in the LTACH setting. The survey provided for an anonymous assessment of knowledge related to policy/procedure, fidelity to practice as well as site-specific barriers to adherence to clinical practice guidelines. Results revealed opportunities for education related to clinical practice guidelines and basic central line-associated bloodstream infection strategies as well as perceived barriers to adherence to policy/procedure. Strategies aimed at mitigating gaps and barriers are …

Real-Time Analysis Of Brain Tumor Cell Dynamics: Novel Thermoelectric Detection Of L-Glutamate And Cell Metabolism Using Microfluidics, Siva Mahesh Tangutooru

Doctoral Dissertations

This study describes the design, fabrication and applications of a novel thermoelectric microfluidic bio-sensor. The bio-sensor is used for real time detection of the L-glutamate (L-glu) dynamics and metabolism for brain tumor cells immobilized in a microfluidic device. The microfluidic device is fabricated using a polymer/glass laminating technique (Xurography). An antimony-bismuth thin-film thermopile (primary sensing element) is integrated to the microfluidic device. The brain tumor cells are immobilized over the thermopile covering measuring and reference junctions of the thermopile using a poly-l-lysine coating layer. L-glutamate oxidase (L-GLOD) is immobilized over the measuring junctions of the thermopile prior to the immobilization …

It Transforms All Of You: Lived Experiences Of Partners Of Iraq Combat Veterans With Traumatic Brain Injuries, Laurel Sue Cassidy

Doctoral Dissertations

Just over two million service men and women have been deployed to the wars in Iraq and Afghanistan over the past ten years. Conservative estimates suggest that nearly one fifth of those deployed sustain a blast induced mild traumatic brain injury (TBI). Nearly half of those in the service are married, meaning a large number of spouses unexpectedly find themselves navigating a “new normal” after their partner returns from combat with ongoing sequelae from a TBI.

Ultimately, a sizeable number of spouses of Iraq combat veterans with TBIs have found themselves in the role of caregiver. The large majority of …

Effects Of A Home-Based Exercise Program On Perception Of Illness And Adaptation In Heart Failure Patients, Robin Faust Harris

Doctoral Dissertations

Patients experience decreased functional capacity from chronic symptoms associated with heart failure. Exercise increases activity tolerance and quality of life in heart failure patients. Physiologic responses to exercise in heart failure patients have been well-documented. In contrast, the effects of exercise on an individual’s perception of degree of disability due to chronic illness and their adaptive responses to heart failure have not been studied. The purpose of this randomized controlled trial was to examine the effects of a 12-week home-based combined aerobic and resistance training exercise intervention on an individual’s perception of degree of disability and adaptive responses to chronic …

Growth Regulation Of Pancreatic Cancer Cells And Their Normal Cells Of Origin By Nicotinic Acetylcholine Receptors, Mohammed Hussein Al-Wadei

Doctoral Dissertations

Pancreatic cancer is the fourth leading cause of cancer mortality with a five-year survival rate of less than 5 %. It shows no symptoms until it has reached an advanced stage upon which it has metastasized to distant organs limiting therapeutic options. Several studies have identified smoking, alcohol, diabetes and pancreatitis as risk factors for pancreatic cancer. While smoking is a well-documented risk factor for this malignancy, there still remains a controversy on whether alcohol can act as a risk factor itself or cooperatively enhances the effects of other risk factors.

Previous reports provide evidence that nicotinic acetylcholine receptors (nAChRs) …

Adaptations Of Yoga: Christian Interpretations, Eleanor Freyhan Odenheimer

Doctoral Dissertations

The yogic phenomenon in the West is multi-dimensional and threads through areas of history (DeMichelis, 2008), market trends, fitness and exercise, medicine (Guarracino, Lazo, Savino, & Edelstein, 2006); religion and spirituality (DeMichelis, 2008); and health and wellness (Iyengar, 1989). Coakley (2004) called for “more information about the connections among various religious beliefs around the world, ideas of the body, and participation in physical activities and sports” (p. 543). A dearth of literature exists concerning the connections between how Christian beliefs, the dominant religion in the United States (Pew Research Center, 2008), related to the body and physical activity participation inform …

End-Of-Life Culture Care Expressions, Meanings, Patterns, And Practices Among Yup'ik Eskimo, Pamela J. Embler

Doctoral Dissertations

The need for end-of-life care research is exemplified by the fact that the National Institutes of Health has made this topic a research priority. End-of-life care is multifaceted and concepts become complex when cultural perspectives are considered. The purpose of this qualitative ethnonursing study was to discover culture care expressions, meanings, patterns, and practices at end-of-life among Yup’ik Eskimo in community settings. Data was obtained from Yup’ik Eskimo of the Yukon-Kuskokwim Delta, Alaska. The Culture Care Diversity and Universality Theory and the ethnonursing research method directed this study. Key and general informants were interviewed. Interviews and observations were analyzed. The …

Population Genetics And Immune Response To Staphylococcus Pseudintermedius, Samar Mohammed Mansour Solyman

Doctoral Dissertations

Staphylococcus pseudintermedius is an opportunistic bacterium affecting canines that has recently developed a high prevalence of methicillin resistance and corresponding multi-drug resistance. Developments of alternatives to antibiotics such as vaccines are important strategies for control of this organism.Multilocus sequence typing is based on the sequence variations of slowly evolving genes and usually uses a minimum of seven genes. Population genetic studies of S. pseudintermedius have been based on sequencing four genes (MLST-4). Forty-five genes were selected from available genomic data and tested as MLST candidates. Four genes were amplified from all isolates and showed the highest number of alleles. By …

Nutritional Adequacy And Performance Of Raw Food Diets In Kittens, Beth Alair Hamper

Doctoral Dissertations

Feeding raw food diets to domestic cats is controversial. The objective of this study was to determine if raw feline diets were nutritionally adequate for kittens and whether they enhance immune function, reduce oxidative stress and improve digestibility. Twenty-four 9-week-old kittens underwent a 10-week growth feeding trial with two raw diet groups and one control group (commercial heat-processed canned diet) of eight kittens each. Anthropomorphic measurements, feed efficiency, oxidative stress, and blood biomarkers for innate and humoral immune function were evaluated. Additionally, 6 kittens and 4 adults participated in a 14 day digestibility trial using a 3 x 3 latin …

Effects Of Gender Composition Of Target And Sender Dyads On The Tendency To Infer Lies, Byron J. Simoneaux

Doctoral Dissertations

Lying is so common in human behavior that some have labeled it a social skill. Despite the ubiquity of lies, humans have consistently been found to be poor lie detectors. Attempts have been made to improve the accuracy of human lie detection. Unfortunately, the most successful training only improves accuracy slightly above the level of chance. Because of its importance to society, considerable effort has been aimed at developing methods to help determine when people are lying. Researching how and why humans infer that another person is lying has the potential to advance the understanding of lie detection. Researchers have …

The Relationship Of Basic Conditioning Factors, Knowledge, Self-Care Agency, Self-Care Behavior, And Urinary Sodium Excretion Of Hypertensive Older Adults: Testing Orem’S Self-Care Theory, Pratsani Srikan

Doctoral Dissertations

Understanding the powerful factors of sodium reduction benefits older adults by leading to reduce many health risks, lower the health care cost and diminished economic and social burden. This study had two aims: 1) to explore to what degree four factors--selected basic conditioning factors, knowledge of sodium reduction, sodium reduction self-care agency, and sodium reduction self-care behavior predict urinary sodium excretion in hypertensive seniors, 2) to test whether these variables related to sodium reduction were congruent with Orem’s Self-Care Theory.

Based on this theory, internal and external conditioning factors were proposed as either positively or negatively influencing an individual’s knowledge …

Evidence Based Practice Implementation: Perceptions And Expectations Of Master Of Social Work Students, Mholi Kent Vimba

Doctoral Dissertations

Abstract

Efforts to develop sustainable Evidence-Based Practice (EBP) implementation strategies in work settings have been generally unsuccessful. Scholars have focused on perceptions of workers already in work settings to identify implementation barriers and facilitators. None have focused on perceptions of social workers in training. This nationwide non-probability correlational study assessed Master of Social Work (MSW) students’ perceptions of EBP using a self-administered online survey. A total of 212 (57%) completed this survey with 164 (43%) timed out.

Perceptions were assessed using three sets of questions corresponding to the independent variables: EBP knowledge, attitude toward EBP and EBP self-efficacy. A …

Pulmonary Pharmacokinetics Of Tulatuthromycin In Mice And Pigs, Nicolas Francisco Villarino

Doctoral Dissertations

Tulathromycin is an antimicrobial approved for use in the treatment and control of bovine respiratory disease and treatment of swine respiratory disease in United States and European Union. This macrolide is a unique drug which has an extraordinary capacity to accumulate in lung tissue and shows distinctive pharmacokinetic features in animals. The pulmonary pharmacokinetics of tulathromycin in mice and pigs were evaluated in this dissertation. In mice, the pulmonary pharmacokinetics of tulathromycin was evaluated in healthy animals and animals challenged with lipopolysaccharide of Escherichia coli (LPS-Ec). A group of challenged animals were also rendered neutropenic. In pigs, the …

Career Development And Employment Concerns Of Employment-Seeking Students With Psychiatric Disabilities, Sarah Charlotte Helm

Doctoral Dissertations

Although some literature chronicles the career development of college students with other types of disabilities, students with psychiatric disabilities have been practically invisible in research focused on this topic. Yet evidence suggests that the number of students with documented psychiatric disabilities attending institutions of higher education is on the rise. Thus, the purpose of the study was to describe the career development and employment concerns of employment-seeking students with psychiatric disabilities.

A qualitative research design was used to gain in-depth information from the perspective of students with psychiatric disabilities, specifically case study. The participants were seven undergraduate students from three …

Prescription Stimulant Use By Graduate Students, Matthew Donald Varga

Doctoral Dissertations

The purpose of this study was to measure graduate student prescription stimulant use by assessing the extent of use, reasons for use, and poly-substance use. Graduate students (n = 1,015) enrolled at a large Southeastern university completed the Student Life Survey. The data were analyzed using a variety of analytical techniques including descriptive statistics, frequencies, and a stepwise logistic regression in order to answer the research questions guiding this study:

1. What is the extent of prescription stimulant abuse among graduate students on college campuses?
2. What are the reasons for graduate students’ illicit use of prescription stimulants?
3. Are graduate students …

Influenza Immunization Status Among African Americans: Factors Influencing Vaccine Decisions, Chandra Russell Story

Doctoral Dissertations

A disproportionate number of African American adults are susceptible to influenza- related morbidity due to chronic health conditions. The purpose of this study was to examine factors influencing influenza vaccination decisions among African American adults ages 18 and older in Blount County, Tennessee. Factors included constructs of social influence, access, vaccine safety, doctor recommendations, and sources of knowledge regarding the flu vaccine. Research questions were formulated to specifically address factors influencing one’s decision to be immunized for influenza. The theory of planned behavior served as the framework for developing the study.

A survey based on national phone surveys was modified …

Safety Climate Perceptions Of Contingent And Permanent Employees Associated With The Manufacturing Of Office Products, Anthony Jeffery Depietro

Doctoral Dissertations

The purpose of this study was to investigate if there were differences in the perceived safety climate experienced by contingent employees as compared to the perceptions of permanent workers’ safety climate. Knowledge of these differences will help safety professionals provide better safety training and working conditions for contingent workers. Safety climate is defined as employees’ perceptions of safety polices, procedures, and practices (Kath, Marks, & Ranney, 2010). The population for the study included employees who work for a manufacturer of office products located in Tennessee. A total of 813 employees participated in the study with a response rate of 87% …

A Description Of The Movement Of The Canine Pelvic Limb In Three Dimensions Using An Inverse Dynamics Method, And A Comparison Of Two Techniques To Surgically Repair A Cranial Cruciate Ligament Deficient Stifle, Jason Headrick

Doctoral Dissertations

The purposes of the dissertation were: 1) to describe three-dimensional (3D) motion of the canine pelvic limb using an inverse dynamics method, and 2) to compare these motion patterns between normal, healthy dogs and those that have had their stifles stabilized by one of two surgical methods approximately five years earlier.

Twenty-five dogs were allocated to three groups; healthy control dogs, dogs that had received the tibial plateau leveling osteotomy (TPLO), and dogs that had received the lateral fabellar suture (LFS) stabilization technique. Both surgical techniques were performed approximately five years prior on stifles with surgically induced cranial cruciate ligament …

A Consideration Of The Potential Side Effects Of Health Insurance Coverage, Melanie Jane Cozad

Doctoral Dissertations

The Patient Protection and Affordable Care Act (ACA) is federal health care reform legislation that represents the most significant health insurance expansion since Medicare and Medicaid were created in 1965. In this dissertation, I focus on how health insurance expansion affects the supply side of health care markets as well as health expenditures. While health insurance expansion potentially increases the demand for care, it also creates uncertainty, thereby impacting health care utilization, delivery, and input decisions. In my first chapter, I examine whether changes in health insurance coverage rates impact state-level health care delivery efficiency. Health care providers may vary …

The Operationalization And Validation Of Isomorphism In Supervision, Robert Eric Heidel

Doctoral Dissertations

This dissertation study is focused on operationalizing and validating the construct of isomorphism in supervision. Liddle and Saba (1983) defined isomorphism as the “recursive replication of processes and content between counseling and supervision. The construct has not been validated in the literature (Bernard & Goodyear, 2004), occurs in supervision at an unconscious level (Williams, 1997), is not understood by supervisees (Raichelson, Herron, Primavera, & Ramirez, 1997), and yet plays an integral and foundational role in how supervision is facilitated and structured (Gentry, 1986; Liddle, Breunline, Schwartz, & Constantine, 1984; Liddle & Saba, 1983; White & Russell, 1997).

In order to …

In Vitro Alterations Of A Putative Phospholipid Translocase, Atp10c, And Its Role In Glucose Metabolism, Sarah Elizabeth Hurst

Doctoral Dissertations

Atp10c/ATP10C is a putative aminophospholipid translocase or “flippase” that encodes for a type 4 P-type ATPase. Based on previous research, we hypothesize that Atp10c/ATP10C due to its flippase nature plays a role in diet-induced obesity and type 2 diabetes as Atp10c heterozygous mice display this phenotype. For purposes of this dissertation, Atp10c/ATP10C was characterized both generally and biologically to gleam information about its molecular weight, cellular location and possible biological roles and/or functions. Multiple experiments, both in vitro and in vivo, were performed in order to accomplish these characterizations and are discussed at length. Essential results …

A Factor Analysis Of The Health, Safety, And Welfare In The Built Environment Toward Interior Design As Perceived By Building Industry Professionals, Dana Marie Moody

Doctoral Dissertations

This research study created, piloted, and field tested a new instrument designed to collect perceptions toward an interior designer’s impact on the health, safety, and welfare of the public. It also established an initial profile of perceptions within building industry professionals, identified the salient factors within those perceptions, and determined the level of these factors through a factor analysis. The Health, Safety, & Welfare in the Built Environment instrument was developed using a Table of Specifications based on the subject content that interior designers must be familiar with in regards to protecting the health, safety, and welfare of the public …

Effects Of Increased Step Width On Knee Joint Biomechanics In Healthy And Knee Osteoarthritis Older Adults During Stair Descent, Maxime Robert Paquette

Doctoral Dissertations

Stair negotiation is one of the most challenging tasks for older adults especially for those suffering from knee osteoarthritis (OA). To date, no studies have investigated the effects of increased step width (SW) on knee joint biomechanics. The purpose of Study One was to investigate the effects of increased SW on peak internal knee abduction moment and other lower extremity variables during stair descent in healthy older adults. The purpose of Study Two was to investigate the effects of increased SW on peak internal knee abduction moment, knee pain and other lower extremity variables during stair descent in medial compartment …

“It Was Fight Or Flight...And Flight Was Not An Option”: An Existential Phenomenological Investigation Of Military Service Members’ Experience Of Hand-To-Hand Combat, Peter Richard Jensen

Doctoral Dissertations

Hand-to-hand combat is one of the more psychologically challenging performance environments for those in the military (Grossman, 1995). Even with the technological advances of modern warfare military leaders still believe hand-to-hand combat is an important and relevant challenge for service members (Blanton, 2007; Clark, 2009; Collins, 2007; Wojdakowski, 2007; Wood & Micaelson, 2000). Despite its importance, the hand-to-hand combat experience has, to date, attracted very little research attention. Therefore, the purpose of this study was to explore military service members’ experiences of hand-to-hand combat. To accomplish this objective, phenomenological interviews were conducted with 17 male military service members. Each participant …