Medicine and Health Sciences Commons^™

Receptor Of Advanced Glycation Endproducts (Rage) Is Positively Correlated With Tumor Necrosis Factor-Α In Adolescents With Obesity, Tasnim Rahman, Daniel H. Conrad, Anshu Gupta

Undergraduate Research Posters

Introduction: Obesity in childhood is associated with an increased prevalence of diabetes and other traditional cardiometabolic risk factors, suggesting an epidemic of premature cardiovascular disease among today’s youth. Glycotoxins, known as advanced glycationend products (AGE’s), activating via the membrane-bound receptors (mRAGE), have been implicated in the pathophysiology of inflammation, (increased tumor necrosis factor-α [TNF-α ]), insulin resistance and vascular dysfunction in adults, but the role of RAGE in the early stages of metabolic disorders is unknown. In this study, we assessed relationship of cardiometabolicrisk factors, mRNA expression of TNF-α and RAGE in peripheral monocytes in adolescents with obesity.

Methods: Thirty …

The Sociocultural Basis Of Epidemiology Of Hypertension Among Residents Of Ogun State, Vernon E. Norman

Walden Dissertations and Doctoral Studies

There is a high prevalence of hypertension in Nigeria. Limited knowledge of hypertension, how to prevent it, its outcomes, rapid urbanization, and the adoption of Western eating habits are implicated. Hypertension is an important issue because chronic disease places economic, social, and disease burdens on society. The purpose of this mixed-methods study was to investigate lifestyle practices, knowledge, and attitudes on risks and prevention of hypertension among residents of Ogun State, Nigeria (N = 79). The conceptual framework for this study focused on how knowledge, attitudes, and practices influence the dietary habits, behaviors, and ultimately blood pressure . The PEN-3 …

Diffusion Of Social Network Technology And Overuse Among Health Industry Knowledge Workers, Abdel Rahman Toure

Walden Dissertations and Doctoral Studies

Many organizations now realize the important role of social network technology (SNT) in building social capital and hence broadening their customer base. However, observations have indicated that, while working, many knowledge workers use SNT to engage in non-job related activities, potentially leading to a decrease in productivity. The purpose of this study was to examine the relationship between the usage of SNT and productivity in the health sector. The theoretical foundation of this study emanated from Rogers's theory of diffusion of innovations and Campbell, Rodney, Scott, and Christopher's theory of performance. Collection of data involved a self-administered survey designed with …

Factors Influencing U.S Army Personnel Meeting Body Mass Index Standards, Salma Theus

Walden Dissertations and Doctoral Studies

Factors Influencing U.S. Army Personnel Meeting Body Mass Index Standards

by

Salma Theus

MS, California State University, Dominguez Hills, 2008

BA, La Sierra University, 2005

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Psychology

Walden University

September 2014

U.S. Army Regulations require soldiers to be fit, as excessive weight negatively impacts their readiness, health, and morale. A quantitative study examined if personal, behavioral, and/or environmental factors predict a soldier's self-efficacy and body mass index. Data were obtained from 117 soldiers on 6 scales: the Armed Services Vocational Aptitude Battery, the Army Physical Fitness …

African American Women's Perceptions Of Personal Risks For Heart Disease, Fecelia Laurice Holt

Walden Dissertations and Doctoral Studies

Heart disease has been the primary cause of death among both men and women in the United States. More African American women are developing and dying from heart disease than any other ethnic group; yet, they are less likely than European American women to know that they have the major risk factors for heart disease. The purpose of this study was to determine the overall knowledge and health beliefs about heart disease among African American women. Five health belief model constructs of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action were applied as the theoretical framework …

Family, Faith/Religion, And African Americans' Decisions To Seek Lung Cancer Treatment, Carla Demetrius Williams

Walden Dissertations and Doctoral Studies

Lung cancer is the leading cause of cancer mortality in the United States, especially among African Americans, who have the lowest survival rate from this disease among all racial/ethnic groups. The aim of this qualitative study was to investigate how family support and religion/faith influence patients' decisions about seeking treatment for lung cancer. This study was guided by the medical decision-making model and used a phenomenological approach. Data were collected from male and female lung cancer patients (n = 15) who were being treated in a thoracic and cardiovascular surgery clinic in Greensboro, North Carolina using semi-structured interviews. All participants …

The Effect Of Exercise Intensity On Physiological And Psychological Outcomes In Breast And Prostate Cancer Survivors: A Controlled Study, Eric Martin

Theses

Introduction

Research has identified a need to explore the components of exercise prescription for cancer survivors, particularly the most effective exercise intensity. The main purpose of this research was to examine whether exercise intensity modulates a range of physiological and psychological outcomes for breast and prostate cancer survivors. The primary outcomes were related to peak oxygen consumption (VO2peak) and quality of life (QOL). VO2peak is a highly sensitive measure that indicates overall health. QOL references the general wellbeing of individuals, and is an outcome of great importance in cancer rehabilitation research.

Pilot Study

A pilot study involving breast cancer survivors …

The "Globesity" Trend: Exploring The Ethical Concerns Of Registered Nurses Caring For Bariatric Surgery Patients, Casey L. Lowden-Crook

Theses

Obesity is a major global health problem. The comorbidities associated with obesity (for example: diabetes mellitus type 2 and cardiovascular disease) are multisystem and require continual medical management which places a great strain on the healthcare system. Australia is ranked the 5th most obese population in the world and deaths associated with obesity and obesity related illnesses are estimated at 7,200 per year (Medibank, 2010). This lifestyle disease is now the leading cause of premature death in Australia. The obesity epidemic is blamed on changes in the social, economic and physical environment (obesogenic environments) which have influenced people to over-consume …

Assessing Pediatric Nurses' Knowledge And Comfort Level With Recognition And Reporting Of Child Abuse, Andrea Sebastian

DNP Projects

Child abuse is a serious, yet preventable problem in the United States. Child abuse is defined in The Child Abuse Prevention and Treatment Act as “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation or an act or failure to act, which presents an imminent risk of serious harm” (United States Department of Health and Human Services [USDHHS], Children’s Bureau, Child Maltreatment 2009, 2010).

In 2010, there were an estimated 3.3 million referrals to Child Protective Services for the suspected abuse …

Implementation Of A Depression Screening Protocol Specific To Implantable Cardioverter Defibrillator Patients; A Quality Improvement Project, Kendra M. Kratzwald

DNP Projects

Background: Depression in patients with implantable cardioverter defibrillators (ICD) is a problem that has not been well addressed by providers. In 2012 the American Heart Association (AHA) released a scientific statement that recommended structured and routine depression screening of these patients. The AHA statement also recommended further research on depression screening instruments and their use with this population. Aims: 1.) To develop and implement an evidenced based depression screening protocol appropriate for patients with an ICD seen in an outpatient setting. 2.) Evaluate provider knowledge about depression screening (? Is this what you mean) and depression screening practices before and …

Emergency Nurses' Knowledge Of Pediatric Complaints, Kari J. Blackburn

DNP Projects

Each year there are more than 25 million pediatric emergency department (ED) visits, with 37-60% of the complaints being non-urgent (Brosseau, Hoffman, Nattinger, Flores, Zhang and Gorelick, 2007). Injury is the number one reason children present to the ED and is strongly associated with a complaint of pain (AHRQ, 2013). While pain is a high volume reason for visiting the ED, there are other presentation causes that may pose a high risk to pediatric patients. Nausea and vomiting is not typically viewed as a high risk complaint, yet there are some high risk etiologies resulting in nausea and vomiting that …

Assessing Prevalence Of Known Risk Factors In A Regional Central Kentucky Medical Center Heart Failure Population As An Approach To Assessment Of Needs For Development Of A Program To Provide Targeted Services To Reduce 30 Day Readmissions, Christeen Ivy Broaddus

DNP Projects

Abstract

Objectives:

1. Determine demographic, physiologic, and laboratory characteristics at time of admission of the heart failure (HF) population in a regional acute care facility in Central Kentucky through review of patient electronic medical records.
2. Determine which HF population characteristics are significantly associated with readmissions to the hospital.
3. Provide identification of the statistically significant common characteristics of the HF population to this facility so that they may work towards development of an electronic risk for readmission predictive instrument.

Design: Retrospective chart review.

Setting: Regional acute care facility in Central Kentucky.

Participants: All patients (n = 175) with a diagnosis or history …

Final Dnp Capstone Report: Improving Adolescent Hpv Vaccination Rates, Jessica L. Murray

DNP Projects

Background: Human papillomavirus (HPV) vaccines have been shown to be effective against HPV types that are linked to cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers. Despite Advisory Committee on Immunization Practices (ACIP) recommendations that all 11-12 year old males and females in the U.S. should be vaccinated with the three-dose HPV vaccine series, vaccination rates remain low. In 2012, only 34.9% of adolescent females and 6.8% of adolescent males completed the series. Efforts to increase vaccination rates are needed, and healthcare providers have been shown to be an important part of the solution.

Purpose: This investigation was conducted to …

Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani

DNP Projects

Purpose: To evaluate provider adherence to JNC 7 by assessing documentation of blood pressure control and interventions in the absence of control in order to assist providers in reaching Healthy People 2020 goal of blood pressure control.

Methods: A retrospective chart review was conducted for patients with essential hypertension. Data collected included blood pressure, use of a home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three visits. A provider survey regarding provider barriers to blood pressure control was also completed.

Results: All surveyed providers were aware and …

Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser

DNP Projects

CAPSTONE INTRODUCTION

Childhood overweight/obesity is a critical public health problem with devastating consequences. Many factors have combined to create the epidemic, and primary care providers can play an important role in addressing the problem by identifying overweight/obese children and encouraging them to engage in healthy behaviors. However, providers face a number of competing priorities making it difficult for them to provide these services effectively without outside support.

Obesity has reached an epidemic proportion in the nation’s youth. The Data Resource Center for Child and Adolescent Health (2011) found that 35.7% of children age 10 – 17 in Kentucky are overweight …

Delivery Of Evidence-Based Tobacco Use Interventions In Primary Care, Amber Silberman

DNP Projects

This capstone report presents three manuscripts which focus on tobacco use interventions in the primary care setting. The first manuscript presents a critical analysis of the Public Health Service guideline on Treating Tobacco Use and Dependence. The second manuscript presents a literature review pertaining to interventions that increase primary care provider compliance with guideline recommendations. The literature obtained from these first two manuscripts led to a descriptive study, which examined the documentation and implementation of specific guideline recommendations in a primary care clinic. The third and final manuscript details this study, and presents some practical implications for improving documentation …

Evidence-Based Blood Conservation Education For Icu Nurses: A Pre And Post-Test Evaluation Of Nursing Knowledge, Stefanie M. Bull

DNP Projects

Purpose: The purpose of this evidence-based education project was (i) to evaluate baseline nursing knowledge of anemia, blood conservation and transfusion medicine, (ii) to identify current blood conservation practice and the nurse’s prior exposure to blood conservation education (iii) to determine the potential impact of evidence-based education on nursing knowledge, and (iv) to determine the impact of education on the nurse’s attitudes towards future implementation of blood conservation practices based on the nurse’s self report.

Setting: The project was implemented in the Cardiovascular and Thoracic ICU (CVICU) at an 875-bed level-1 Trauma and Multi-Organ Transplant Center located in central Kentucky. …

Tobacco Treatment In College Students, Teresa H. Huber

DNP Projects

This study was conducted in a southeastern University to determine tobacco use status in a population of university students, student intention to quit, treatment options, use of student health service, and student’s degree of support of a tobacco-free policy. A major implication for practice is the need for college health providers to screen all students utilizing the USPHS Guidelines, as even light smokers may be vulnerable to nicotine addiction. However, the study found that a high proportion of the smokers were nondaily smokers who do not consider themselves as smokers and the vast majority of those were undergraduates. Thus, college …

Assessing Provider Knowledge And Attitude Towards Animal-Assisted Therapy As A Complementary Treatment For Children, Shannon Leigh Million

DNP Projects

Objective: The purpose of this project was to determine knowledge and attitudes of pediatric primary care providers working in a university outpatient clinic settings towards the use of animal-assisted therapy as a complementary treatment for children. This report also includes an integrative review of animal-assisted therapy in pediatric populations and a clinical practice guideline analysis regarding the use of equine facilitated learning with high risk children and adolescents in residential psychiatric treatment.

Methods: A survey tool was administered to the Department of Pediatrics at UK Healthcare.

Results: There were 41 respondents to the survey, 36 of which …

Trauma Resuscitation Team Program Evaluation, Lisa J. Fryman

DNP Projects

To evaluate the effectiveness of a newly implemented charge nurse-led trauma resuscitation team approach in the Trauma Intensive Care Unit (TICU). The approach was developed to improve patient throughput efficiency at a Level 1 Trauma Center. Measures of effectiveness include patient throughput efficiency, patient clinical outcomes, and financial impact. The implementation of the charge nurse-led trauma resuscitation team showed an improvement in efficiency of patient throughput without adversely affecting patient outcomes, and opening up critical resources for the next patient that arrives.

Screening For Sepsis: A Key Strategy For Early Identification And Management Of Septic Patients, Amy P. Fisher

DNP Projects

Background: Sepsis, defined as a systemic inflammatory response to infection, is a life-threatening medical condition that rapidly progresses from severe sepsis (characterized by signs of organ dysfunction) to septic shock with fluid-refractory hypotension. Adherence to the Surviving Sepsis Campaign guidelines for the management of severe sepsis and septic shock have been associated with improved delivery of care and reduced mortality. Delays in recognition of sepsis has been identified as a barrier to achieving early goal-directed therapy targets.

Purpose: To determine if a sepsis screening protocol could facilitate earlier identification of patients with sepsis

Methods: A retrospective medical record review was …

The Association Of Primary Care Physician Supply To The Prevalence Of Diabetes, Obesity, Smoking, And Hypertension In Georgia, Dennis L. White

MUSC Theses and Dissertations

The primary focus of this study was to compare primary care physician supply throughout Georgia to the prevalence of diabetes, obesity, smoking, and hypertension county by county, identifying potential issues related to primary care physician supply. This research identified the distribution of the primary care physician workforce across Georgia; county by county, and in urban and rural areas, and across public health districts. Then, the research identifies whether the current supply of Georgia primary care physicians is sufficient to meet the growing need for population healthcare. Studying the area of primary care physician supply in correlation to the prevalence of …

Effect Of Laser-Cut Slow-Flow Nipples On Preterm Feeding Performance, Katlyn Elizabeth Mcgrattan

MUSC Theses and Dissertations

Background: Dysphagia of prematurity is a highly prevalent condition that carries negative developmental, social, and financial implications. Although the modification of bottle nipple properties is a widely used treatment for dysphagia of prematurity, there have been a paucity of investigations examining the effect of this intervention on refined measures of feeding performance. Methods: Healthy preterm infants were evaluated for measures of milk ingestion and respiratory performance during oral intake on a laser-cut slow-flow and standard-flow nipple. Time to achieve hospital discharge milestones was recorded. Results: Few differences were observed in feeding performance between slow-flow and standard-flow nipples. Characteristics of respiration …

Physician As Teacher: Promoting Health And Wellness Among Elementary School Students, Jill E. Stefaniak, Victoria C. Lucia

STEMPS Faculty Publications

BACKGROUND: Every day, physicians engage in teaching during their patient encounters. It may be that medical students who are introduced to the principles of teaching and learning are more likely to become good communicators and learners. Service-learning may be an effective way for medical students to practice skills in teaching and communication in a real-world setting, while also filling a need within the community. The purpose of this study was to identify common themes within medical students' reflections on what they learned through participating in a teaching exercise with local elementary school children.

METHODS: As a required component of a …

Does The Sequence Of Instruction Matter During Simulation?, Jill E. Stefaniak, Carman L. Turkelson

STEMPS Faculty Publications

Introduction: Instructional strategies must be balanced when subjecting students to full-immersion simulation so as not to discourage learning and increase cognitive overload. The purpose of this study was to determine if participating in a simulation exercise before lecture yielded better performance outcomes among novice learners.

Methods: Twenty-nine participants were divided into 2 groups as follows: group 1 participated in simulation exercises followed by a didactic lecture and group 2 participated in the same learning activities presented in the opposite order. Participants were administered a multiple-choice cognitive assessment upon completion of a workshop.

Results: Learners who participated in the simulated exercises …

Parkinson's Diagnosis From The Caregiver's Perspective, Helen Maree Bradley

Theses : Honours

Parkinson’s disease (Parkinson’s) is a progressive neurodegenerative disorder. The irreversible and accumulating disability experienced means that people with Parkinson’s progressively lose their autonomy, eventually requiring complete care. Consequently, Parkinson’s significantly impacts sufferers and the people who care for them. Informal care, predominantly provided by female spouses becomes exceptionally demanding over time, and caregivers experience significant morbidity. Stress manifests across all stages of the caregiving trajectory, with diagnosis reported as a particularly stressful period for caregivers; however, few attempts have been made to understand what makes it stressful. The current study explored female spousal caregivers’ subjective experience of the Parkinson’s diagnosis, …

Enablers And Barriers Experienced By Grandparents Who Become Primary Caregivers Of Grandchildren: An Occupational Perspective, Janice Du Preez

Theses : Honours

Aim: The aim of this review was to identify current issues affecting grandparents who are raising their grandchildren in Australia.

Method: The study systematically reviewed twelve studies that evaluated supports for grandparents. The Checklist Analysis of Research for Systematic Review and the Quantitative and Qualitative Checklist were used to evaluate the studies.

Findings: Five support issues affecting grandparent-headed families were evidenced in the literature as being of priority. These include stress, intergenerational conflict, community support, legal and financial aspects, policies and service frameworks.

Conclusions: The paucity of research implies that further funding for large-scale research is required. Implications for informal …

Assessing Visual Perception Using Letters And Numbers, Janet Richmond

ECU Posters

To create a new visual perceptual test using letters and numbers in isolation and in context. Producing a linear scale to measure the ability of primary school children to visually discriminate upper and lower case letters in readiness for learning to read and perform mathematical calculations.

Idiots Savants, Retarded Savants, Talented Aments, Mono-Savants, Autistic Savants, Just Plain Savants, People With Savant Syndrome, And Autistic People Who Are Good At Things: A View From Disability Studies, Joseph N. Straus

Publications and Research

People identified as idiot savants have long comprised an identifiable group (a high level of skill in the context of perceived mental deficiency) whose story has mostly been told by psychiatrists and psychologists within a medicalized model of disability that assumes deficiency and seeks remediation and normalization. More recently, people identified as savants have become common figures of literary and cinematic representation. Both of these narrative frames have enfreaked them as alien Others, whose gifts and disabilities place them outside the normal run of human intelligence and creativity. With a focus on music, this article tries to see through these …

Health Status Within The Workplace, Kristina Bonham, Brooke April Tomlin

Phi Kappa Phi Research Symposium (Archived)

The purpose of this study was to assess health status in the workplace and determine if diagnosis of a major illness impacted work. The research design used was a quantitative, descriptive, non-experimental, one-shot study in which the 19-question survey measured the health behaviors of a variety of employers (n=50) along with 4-variable questions assessing fear. Chronic diseases such as heart disease, stroke, cancer, diabetes, and arthritis are among the most common, costly, and preventable of all health problems in the U.S. and 7 out of 10 deaths among Americans each year are from chronic diseases (Community Health Charities, 2012). Poor …