Medicine and Health Sciences Commons^™

Interprofessional Patient Simulation Training Compared To Online Training For Learning To Use In-Line Speaking Valves, Kristi A. Moore

Electronic Theses and Dissertations

Restoring speech in persons who are tracheostomy and ventilator dependent, through the use of a Passy-Muir Speaking Valve (PMSV), requires specific training. Methods of training interprofessional team members to assess in-line PMSVs are unclear. This study used a pretest/ post-test design to compare effects of online training and online training plus simulation training on knowledge acquisition, skills performance, and comfort levels when working with persons who are tracheostomy and ventilator dependent. Twenty-six students studying either respiratory therapy (N=13) or speech-language pathology (N=13) were assigned to the control group or experimental group. Results revealed that online training proved beneficial for increasing …

Comparison Of In Vivo Simulation Training Compared To Video Simulation Training For Identifying Clinical Markers Of Distress When Feeding Preterm Infants, Emily M. Wagner

Electronic Theses and Dissertations

Preterm infants have multiple health complications due to their underdeveloped neurological systems. Bottle-feeding difficulties are one complication that leads to pulmonary illness secondary to aspiration. Preterm infants exhibit clinical markers when experiencing distress during bottle-feeding. Training caregivers to identify clinical markers reduces the risk for aspiration. Simulation training provides a safe learning environment without harming patients. Twenty-two speech-language pathology and pre-requisite students divided into two simulation groups, video-simulation (N=12) and in-vivo simulation (N=10), were trained to document clinical markers of distress exhibited by preterm infants and make clinical judgments about bottle-feeding. Students rated their levels of anxiety during simulation training. …

Oregon's Death With Dignity Act: Socially Constructing A Good Death, Erin E. Mauck

Electronic Theses and Dissertations

As aid-in-dying legislation expands across the United States, this study examines the dynamics influencing participation in Oregon’s Death with Dignity Act. In addition to data from secondary sources, this thesis analyzes field research data collected in Oregon, including 14 in-depth interviews with volunteers and employees of two advocacy organizations at the center of legalized physician-assisted death. Themes emerged including the conditions that motivate participation, the importance of both personal and professional autonomy, the significance of a good death, and the growth of open dialogues about end of life choices. This thesis concludes with a discussion of the impact Death with …

Deciphering The Role Of Glycine134 In The Human Acidic Growth Factor-1’S Binding To Heparin, Adam W. Burroughs

Chemistry & Biochemistry Undergraduate Honors Theses

Human acidic fibroblast growth factor 1 (FGF-1) is a potent modulator of cell survival and exhibits a universal role in various physiological processes. Though potent, FGF-1 unbound to heparin is known to show a poor thermal stability and a relatively short in vivo half-life. Much is known about the structure and relation of FGF-1 with heparin yet there is still unknown information regarding the exact role of heparin in stabilizing FGF-1. Thus, the aim of this study is to mutate glycine at position 134 to glutamic acid in wild type FGF1. G134 is located in the heparin binding pocket, thus …

An Approach To Collect Non-Standard Microdialysis Compounds, Allison M. Schneider

Chemistry & Biochemistry Undergraduate Honors Theses

Microdialysis is a sampling technique that is used to collect analytes through a semipermeable membrane. The collection occurs via the microdialysis probe where analytes can diffuse through the membrane and be collected by use of the outlet. Microdialysis is typically utilized with solutes that are hydrophilic and have a low molecular weight. It is unusual for hydrophobic solutes to be used, but pentane, a hydrophobic analyte, was studied in this research to see if non-standard microdialysis compounds can be collected. This is important because the pentane resembles hydrophobic signaling molecules in the brain, such as prostaglandins and leukotrienes and can …

Nursing Students' Interest In And Perceived Barriers To International Clinical Experience, Bethany Rowell

Undergraduate Honors Theses

East Tennessee State University has a variety of international travel opportunities for general education within its undergraduate study abroad program. Some opportunities even exist within specific degree programs. Despite the literature purporting the benefits acquired from clinical experience abroad, the College of Nursing has yet to incorporate an international component to its BSN curriculum. This study explores College of Nursing students' interest in participating in international clinical experiences and the perceived barriers for students who are willing to travel.

Comparing The Utilization Of The Peds And Psc-17 Screeners In A Pediatric Primary Care Clinic, Halie L. Dyer

Undergraduate Honors Theses

Behavioral problems exhibited in early childhood can predict continued behavioral difficulties into adolescence and adulthood and can result in poor social functioning and health outcomes. Early identification of these concerns is necessary in order to connect families with appropriate interventions that thwart a negative trajectory. In pediatric offices, developmental screeners and pediatric surveillance are efficient and reliable methods of assessing behavioral concerns, which can help to quickly connect families with services. This study examines two methods of screening for behavioral concerns and the impact on on-site behavioral health referrals for children 4 and 5 years of age at a local …

An Epidemiological Look At Injuries Among High School Athletes Participating In A Variety Of Sports For Both Sexes, Emily H. Wills

Undergraduate Honors Theses

Physical activity is part of a healthy lifestyle, but participating in athletic activities like team sports can lead to injury. This study was designed to find the differences in types of high school sports injuries and how frequently these injuries occur among different sports and between males and females. A survey was given to members of the football, boys’ basketball, girls’ basketball, baseball, softball, and volleyball teams of a central Appalachian high school. The highest rate of injury was found in girls’ basketball at 86.7%, followed by football at 85.2%, boys’ basketball at 70.6%, softball and volleyball each at 69.2%, …

In Vitro Investigation Of The Effect Of Exogenous Ubiquitin On Processes Associated With Atherosclerosis, Chase W. Mussard

Undergraduate Honors Theses

Atherosclerosis, characterized by the build-up of cholesterol, immune cells and cellular debris within arterial walls, is accelerated following myocardial infarction by poorly understood mechanisms. Ubiquitin, a small, well-studied intracellular protein involved in protein turnover via the proteasome pathway, has recently been shown to exert extracellular effects on cardiac myocytes, in vitro, and in mice undergoing myocardial remodeling. This study investigates the potential role of extracellular ubiquitin in atherosclerosis by determining its effects on two critical atherosclerotic processes: the migration of vascular smooth muscles cells and the uptake of modified LDL by monocyte/macrophages in foam cell formation. In the presence …

Patients’ Perceptions Of Nurses As Role Models Of Healthy Behaviors, Sarah C. Baker

Undergraduate Honors Theses

Nurses are caregivers who are instrumental in improving patient outcomes through providing hands-on care and health education. In addition to performing prescribed interventions and providing instruction to patients, nurses can also have a positive impact by modeling healthy behaviors for their patients (Blake & Harrison, 2012). Nurses educate patients on the importance of maintaining healthy habits such as eating well, getting enough sleep and exercise, and avoiding alcohol and drug use; however, studies demonstrate that nurses have similar difficulty maintaining healthy lifestyles as the general population’s and in some cases are even more prone to develop problems with unhealthy habits. …

Investigation Into The Barbell Backsquat Comparing Weightlifting Shoes To Barefoot Conditions, Alex W. Pilkinton

Undergraduate Honors Theses

This present study was intended to investigate muscle activation patterns throughout the barbell back squat and determine if there are any differences found in EMG responses among individuals wearing weightlifting shoes and barefooted individuals. The hypothesis was that weightlifting shoes would generate significantly greater muscle activation patterns throughout the barbell back squat due to the rigid structure and raised heal in the shoe design. EMG patterns from six superficial lower extremity muscles were recorded from 12 subjects (means: 22.67 ± 2.39 age, 172,28 ± 14.04 cm height, 74.88 ± 16.11 kg mass), each meeting a specific inclusion criteria. Data collection …

Development Of A Simple Handheld Biosensor For Waterborne Pathogens, Bryce C. Jones

Chemical Engineering Undergraduate Honors Theses

Current methods of detecting waterborne pathogens involve testing strips which take 24-48 hours to yield results, or require expensive equipment in order to function. In minimalist environments, these two technologies are not always applicable to test water quality. With the emergence of a new method of PCR, named LAMP PCR, it is possible to quickly and accurately detect pathogen DNA in a water sample. In order to scale this technique into a simple device, the aspects of the reaction must be accommodated, and a visual detection method chosen. A handheld device which keeps the isothermal LAMP PCR stable for the …

An Evaluation Of Factors Which Can Affect The Implementation Of A Health Promotion Programme Under The Schools For Health In Europe Framework, Annemarie Bennett, Cara Cunningham, Charlotte Johnston Molloy

Articles

The Health Promoting Schools concept helps schools to promote health in a sustainable and long-term fashion. However, developing the capacity to promote health in this way can be challenging when a busy teaching curriculum must be fulfilled. This study aimed to identify factors which affect the acceptability of health promotion programmes to the everyday school environment.

Semi-structured qualitative interviews were audio-taped with primary school teachers in one Irish county and transcribed verbatim. The resulting transcripts were analysed using content analysis.

Thirty-one teachers were interviewed. The factors which may adversely affect the acceptability of health promotion programmes include the: attitude of …

Barriers And Facilitators Of Adolescent Health In Rural Kenya, Molly Secor-Turner, Brandy A. Randall, Courage Chikomborero Mudzongo

Faculty Publications - Doctor of Psychology (PsyD) Program

The purpose of this research was to identify perceived barriers and facilitators of health from the perspective of rural Kenyan adolescents and to characterize the cultural context that shapes these barriers and facilitators. Design: Following a semistructured interview guide, qualitative focus group interviews were conducted at day schools with 64 upper-primary and secondary students in rural central Kenya. Participants provided written parental consent and individual assent for study participation. Results: Findings were organized into seven categories (individual, family, peer, school, community, institutional, and cultural) according to a social–ecological framework to highlight the multiple social and environmental contexts that shape health …

Identifying Learning Acquired During Debriefing, Shelly J. Reed

UNLV Theses, Dissertations, Professional Papers, and Capstones

Debriefing, the reflective activity following an experiential learning exercise, has been identified as the most important part of simulation learning and is also important for learning in other activities utilized in nursing education. There is general agreement that debriefing provides learning and improves performance. However, there is little specific evidence about the phenomenon of learning acquired during debriefing, including how it occurs, how it is defined and identified, and how it is evaluated by debriefing facilitators. In addition, there are no instruments or tools specifically measuring learning acquired during debriefing. Without practical and theoretically grounded tools, simulation activities will continue …

Chronic Bronchitis And Chronic Obstructive Pulmonary Disease (Copd) Among Textile Workers In Karachi, Pakistan, Asaad Ahmed Nafees, Zafar Fatmi, Muhammad Masood Kadir, Nalini Sathiakumar

Community Health Sciences

Objective: To determine the frequency and predictors of chronic bronchitis and COPD among textile workers in Karachi, Pakistan.
Study design: Cross-sectional survey.
Place and duration of study: Karachi, Pakistan, from October to December 2009.
Methodology: Male textile workers from 15 mills of Karachi were inducted. Data was collected using American Thoracic Society respiratory questionnaire (ATS-DLD-78-a) and spirometry.
Results: Out of 372 participants, 29 (7.8%) workers had chronic bronchitis (4, 9.1% aged ≥40 years) and 25 (6.7%) had COPD (12, 27.2% aged ≥40 years). Workers with chronic bronchitis had significantly decreased lung function compared to the healthy workers. Those reporting severe …

Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy

Doctoral Projects

This descriptive study examined undiagnosed depression in the elderly and how it affects the elderly from retaining healthcare education. It is estimated by 2029, 20% of the United States population will be age 65 and older (Colby & Ortman, 2014). Depression in the elderly who have chronic diseases, is estimated to be undiagnosed up to 40% (Chaoyang et al., 2009). A hallmark symptom of depression is the inability to concentrate. It is unknown if undiagnosed depression will affect the older adult from retaining pertinent healthcare education. The 30 point Geriatric Depression Scale (GDS) was administered to a class of elderly …

Nursing Input During Interprofessional Rounds In The Intensive Care Unit, Kathrine A. Winnie

Doctoral Projects

Interprofessional rounding has become a standard in intensive care units. Healthcare organizations such as The Joint Commission (2013) and the Institute of Medicine (2010) promote interprofessional teamwork with the goal of improving patient safety and outcomes. The 2010 IOM report, The Future of Nursing – Leading Change, Advancing Health discusses the need for all nurses to work as part of an interprofessional team to improve healthcare. Interprofessional rounding offers a venue for nurses to demonstrate their role as an equal member of the healthcare team. At the hospital of focus, there has been no previous formal attempt to measure the …

Teaching And Evaluation Of Suicidal Assessment, Five-Step Evaluation And Triage (Safe-T) In The Emergency Department, Evangeline Rico

Doctoral Projects

Suicide remains to be a global and a national problem, and it continues to be one of the leading causes of death in the United States (U.S.) The Emergency Department (ED), being the gateway to the hospital can provide a great opportunity to assess each patient for suicidal ideation, and evaluate if patients present with risk factors for suicide. The competency of the ED staff plays a critical role in early recognition of patients who are at risk, and in implementing a plan of care for those with positive screens. However, researchers showed that knowledge deficit and lack of education …

The Impact Of Intensive Case Management On Hospice Utilization, Debra Lowry Hummel

Doctoral Projects

Objective: The purpose of this study is to examine if patients enrolled in multi-disciplinary intensive case management program (ImPACT) alter the patient’s end-of-life path or setting of death.

Methods: The quality improvement project is a quantitative retrospective study that compared patients receiving standard primary care vs intensive case management (ImPACT) during 2/2013-1/2014. It is a secondary analysis of a larger study of a quality improvement evaluation that took place at the Veterans Administration facility in Palo Alto, Ca.

Results: Among the 82 patients who died, 19 were enrolled in ImPACT for approximately 249 days compared to 63 who received standard …

Therapeutic Listening Communication In Children With Autism And Hyperacusis, Jennifer Margaret Hughes

Doctoral Projects

Hyperacusis, or auditory hypersensitivity, is defined as abnormally sensitive hearing and in some cases an extreme sensitivity, where normally tolerated sounds are perceived as excessively, even painfully loud. This is a debilitating condition for children with autism, causing activity limitations and participation restrictions, also leading to peer isolation and habitual sound avoidance behaviors.

This research explores a means of modifying the auditory environment of a child with hyperacusis in a safe, effective way for the purpose of improving attention span and facilitating learning. The small pilot study (n=4) was a single-subject, multiple-baseline design, conducted with school-aged children in the special …

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention in …

How To Start A Nurse Practitioner Faculty Managed Clinic: Missing Components?, Johnna Edmunds

Doctoral Projects

A serious need exists for improved access to primary care for vulnerable populations. Nurse Practitioner Faculty Managed Clinics (NPFMC) can help to alleviate this problem. The purpose of this qualitative, descriptive study was to identify and examine the beginning components necessary for implementing this inter-professional collaboration. A comprehensive literature review identified the absence of these components, which were then revealed through the interviews with founders of NPFMCs. Prior to the interviews two manuals were reviewed about the process of starting a free clinic. Questions were explored relating to the participants’ experiences in starting a NPFMC. Review of the manuals was …

Assessing Adult Tobacco Smoking Cessation In Low-And-Middle Income Countries: Analysis Of The Global Adult Tobacco Survey Data, 2009 – 2012, Daniel Owusu

Electronic Theses and Dissertations

Smoking cessation can reduce health risk and prevent millions of tobacco-related deaths. However, cessation rates are low in low-and-middle income countries (LMICs), with only a small proportion of smokers intending to quit. Given the paucity of literature to support tobacco cessation programs in LMICs, this study aimed to: 1) identify factors associated with intention to quit smoking, 2) assess the relationship between health care provider quit advice/tobacco screening and utilization of cessation assistance, and 3) examine the relationship between home smoking rule and smoking intensity across three stages of smoking cessation (precontemplation, contemplation and preparation) in LMICs. Data were obtained …

Risk Estimation Toward A Natural History Model For Low Grade Glioma Patients, Anh Thi Hoang Pham

Graduate Theses and Dissertations

Glioma is a common type of primary brain tumor that represents 28% of all brain tumors and 80% of malignant tumors. According to a recent study by the Centers for Disease Control and Prevention (CDC), gliomas account for 53%, 35% and 29% of all brain tumors (68%, 74% and 81% of malignant brain tumors) among children (aged 0-14), teenagers (aged 15-19) and young adults, respectively. Gliomas are often diagnosed through radiological imaging and histopathology. There are two main groups of gliomas following World Health Organization’s classification: Low grade gliomas (LGG), or grade I and II gliomas; and high grade gliomas …

Evaluation Of The Effects Of Radiation On The Positioning Of Histones And Other Proteins, Ashley Elizabeth Foster

School of Biological Sciences: Dissertations, Theses, and Student Research

Nucleosomes and the secondary structure of DNA play an important role in many cellular processes that are contingent on DNA accessibility, such as replication, transcriptional regulation, and DNA repair. Recently, there is also growing evidence that the association of histones and DNA to form a nucleosome offers protection from DNA degradation. Specifically, that the inherent structural properties of DNA organization can help protect DNA from exogenous damage such as radiation. In this study, we sought to evaluate the effects of radiation on the positioning of histones and other proteins.

In this experiment, we optimized established protein protocols in Saccharomyces cerevisiae. …

Thermoluminescence Study Of Mn Doped Lithium Tetraborate Powder And Pellet Samples Synthesized By Solution Combustion Synthesis, A. Özdemir, Zehra Yeǧingil, Necmettin Nur, Kasim Kurt, Tunç Tüken, Tolga Depçi, Gözde Tansuǧ, V. Altunal, V. Güçkan, Gökmen Sığırcık, Yan Yu, Muhammet Karataşlı, Y. Dolek

Department of Radiation Oncology Faculty Papers

In this paper, the thermoluminescence (TL) dosimetric characteristics under beta-ray, x-ray and gamma-ray excitations of powder and pellet Mn-doped lithium tetraborates (LTB) which were produced by solution combustion synthesis technique were investigated, and the results were compared with that of TLD-100 chips. The chemical composition and morphologies of the obtained LTB and Mn-doped LTB (LTB:Mn) were confirmed by X-ray diffraction (XRD), Fourier Transform Infrared (FTIR) and scanning electron microscopy (SEM) with EDX. LTB:Mn was studied using luminescence spectroscopy. In addition, the effects of sintering and annealing temperatures and times on the thermoluminescence (TL) properties of LTB:Mn were investigated. The glow …

Clearing The Smoke: The Ethics Of Multistate Legal Practice For Recreational Marijuana Dispensaries, Eric Mitchell Schumann

St. Mary's Journal on Legal Malpractice & Ethics

With many firms practicing in multiple states, a lawyer could represent a marijuana dispensary in a legalized state while practicing in a state, like Texas, which continues to criminalize the drug. This raises a question of whether Texas attorneys who make the bold attempt to assist a company that sells marijuana violate the rules of professional responsibility.

In Section II, this Comment examines the background of the criminalization of marijuana and looks into the movement to liberalize the laws surrounding it. Section III analyzes the rules of professional conduct in Texas and in Colorado to determine what a lawyer in …

Clinical And Demographic Variables Associated With Cognitive Deficits, Symptom Severity, And Duration After Concussive Injury In Adolescents: A Retrospective Study, Seema S. Aggarwal

Dissertations and Theses (Open Access)

Background: Concussions in adolescents are a public health concern with the growing popularity of high school sports. Recent legislation mandates that athletes who are suspected of a concussion be cleared to return-to-play by a clinician. More research is needed to develop a concussion predictive model to identify populations at risk for more severe and prolonged symptoms and long-term neurologic deficits.

Aims: The aims of this study were to (1) examine the effect of race and gender on neurocognitive and symptom scores and (2) determine which clinical (e.g., number of concussions, migraine history, learning disabilities/ attention deficit disorders) and demographic factors …

Becoming Baby Friendly: Rooming-In For Patient Centered Care In The Maternal Setting, Liana Macdonald

Honors College Theses

This thesis paper discusses the concept of rooming in on the maternity unit while pertaining to the QSEN nursing competency of patient centered care. Through an extensive review of the literature, the following question will be addressed: On the post-partum unit, does having the newborn rooming in with his or her mother improve patient-centered care compared to rooming in the nursery? After an introduction of the problem and its significance to patient-centered care, research that was conducted will be reviewed that discusses the importance of rooming in. A case example of a maternal-newborn couplet is provided, demonstrating the relevance of …