Medicine and Health Sciences Commons^™

Posthurricane Environment's Impact On Childhood Cancer Rates In Louisiana, 2004-2010, Lenora M. Robinson

Walden Dissertations and Doctoral Studies

Childhood cancer is the second leading cause of death in children aged 0-19 years. Research efforts to identify factors associated with or influencing this growing health problem are limited. The purpose of this research study was to examine, in reference to Louisiana during the period 2004-2010, the annual number of children diagnosed with cancer; the types of cancers; the possible effects of the environmental aftermath resulting from Hurricanes Katrina, Rita, and Gustav; and any correlation between environmental contaminants following these hurricanes with the number of children diagnosed with cancer. This study employed correlational quantitative methodology using archival data from the …

Retention Of The Experienced Nurse, Tina Melissa Brinegar

Walden Dissertations and Doctoral Studies

The nursing profession is facing a potentially devastating shortage of nurses by the year 2020. Contributing to the shortage is the retirement of experienced nurses who are over the age of 45, and an aging baby boomer population. The loss will place a considerable strain on the overloaded health systems. As a result, it is important to identify successful strategies for addressing the problem of experienced nurse retention. Therefore, the purpose of this project was to conduct a systematic review of literature to answer the question of what retention strategies have been used to prevent the loss of the experienced …

Improving Staff Knowledge Of Hypertension In Psychiatric, Homeless Patients, Maureen Ojose

Walden Dissertations and Doctoral Studies

Hypertension is a serious health problem in the United States. Clinical nurses may serve as facilitators in the screening, diagnosis, and treatment of hypertension. The purpose of this project was to evaluate the effectiveness of an education program on hypertension screening guidelines for nurses working in an outpatient psychiatric clinic. The project was supported by the health promotion model. The project used a pre- and post survey designed by the DNP student to collect data on nurses' knowledge, attitudes, and willingness to screen psychiatric patients for hypertension. Surveys consisted of 10 questions using a 5-point Likert-type scale. The results of …

Teamwork Perceptions Of Nurses And Nursing Assistants In A Community Hospital, Iwona Halina Enzinger

Walden Dissertations and Doctoral Studies

Teamwork in healthcare is recognized as a significant factor in achieving patient safety and impacting patient outcomes. Despite the general focus on teamwork in healthcare, there has been little research on teamwork among nurses and nursing assistants working on patient care units. The purpose of this doctoral project was to identify, compare, and analyze perceptions of teamwork in a group of nurses and nursing assistants in a community hospital setting where the TeamSTEPPS program has been implemented. The framework of this project was the concept of shared mental model and Imogene King's conceptual system and middle-range theory of goal attainment. …

Access To Care: Assessment Of Barriers In Two Rural Iowa Communities, Jean M. Osgood

Walden Dissertations and Doctoral Studies

The ability to access primary care services within the local community has a direct impact on the health and wellness of the community. Individuals living in rural settings face multiple challenges when attempting to access care. The purpose of this retrospective project was to identify barriers in 2 rural, underserved communities and make recommendations for process changes that could reduce these barriers. Data were gathered from 2 critical access hospitals and 2 rural health clinics located in rural, underserved areas in Iowa. Both hospitals identified access to health services as an issue within their communities. Administrative data were gathered on …

Strategies To Improve Job Satisfaction And Reduce Voluntary Employee Turnover Of Nurses, Stewart Proctor

Walden Dissertations and Doctoral Studies

Job satisfaction and employee turnover affect the health care industry in the form of overworked staff, inadequate health care, and loss of profits. In 2015, the United States health care industry had a shortage of over 923,000 registered nurses. Health care organizations lose an estimated $1.4 to $2.1 billion each year because of registered nurse (RN) turnover. These factors indicate that some managers lack the strategies to increase job satisfaction and reduce RN turnover. The purpose of this single case study was to use the Herzberg 2-factor theory to explore strategies 5 health care leaders use to improve nurses' job …

Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and …

Clinicians' Perceptions Of Trauma Treatment For People With Intellectual Disabilities, Katherine Elaine Schoech

Walden Dissertations and Doctoral Studies

People with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in the Denver, Colorado area. Four participants had experience working with people with ID, and 4 participants did not have this experience. Participants sat for semi structured open-ended recorded interviews, which …

Length Of Stay And Reimbursement Rates For Medicare Patients, Wandella Ezell

Walden Dissertations and Doctoral Studies

Medicare reimbursement rates across the United States have varied by as much as 49-130% across healthcare facilities. Geographic adjustments and severity of medical diagnoses attribute to some dissimilarity; however, the source of longer hospitalization and higher re-admission rates among Medicare patients requires financial consistency. The research encompassed (N = 3000) patients with hypertension as the focus for the study because this is a critical group of Medicare patients with a chronic disease that has been identified as a silent killer. The principal goal that drove this research study was to explain the variations in length of stay for Medicare patients …

Modulation Of H-Reflex Depression With Paired-Pulse Stimulation In Healthy Active Humans, Preeti Deshpande Oza, Shauna Dudley-Javoroski, Richard K. Shields

School of Pharmacy Faculty Articles

Depression of the Hoffman reflex (H-reflex) is used to examine spinal control mechanisms during exercise, fatigue, and vibration and in response to training. H-reflex depression protocols frequently use trains of stimuli; this is time-consuming and prevents instantaneous assessment of motor neuronal excitability. The purpose of this study was to determine if paired-pulse H-reflex depression is reproducible and whether paired-pulse stimulation adequately estimates the depression induced by the more traditional ten-pulse train. H-reflexes were elicited via ten-pulse trains at 0.1, 0.2, 1, 2, and 5 Hz in ten neurologically intact individuals on two separate days. We measured the depression elicited by …

Study Of Molecular Interactions Of Glycosaminoglycans And Glycosaminoglycan Mimetics With Their Protein Targets, Daniel K. Afosah

Theses and Dissertations

Glycosaminoglycans (GAGs) are complex linear chain carbohydrate molecules found on virtually all animal cell surfaces. Owing to their negatively charged nature, GAGs interact with a number of different proteins. Thus, although they have great potential as therapeutic agents, their apparent promiscuous interactions increase their side effect risk. GAG mimetics, including GAG oligosaccharides and non-saccharide GAG mimetics (NSGMs) are viable approaches to address this. This work discusses sulfated benzofuran thrombin inhibitors with submaximal protease inhibition, sulfated diflavonoid inhibitors of plasmin and GAG oligosaccharides with selectivity for human neutrophil elastase (HNE).

Anticoagulants are very important for the treatment of thrombotic diseases. The …

Analysis Of Stretch Reflex Responses In Mice Lacking Munc18-1 In Proprioceptors, Amr Mohi

Browse all Theses and Dissertations

The monosynaptic stretch reflex circuit is one of the simplest circuits of the central nervous system. We studied the connection between Ia proprioceptive afferents and motor neurons that comprise the circuit, by stimulating the dorsal root and recording from the ventral root of the fourth lumbar spinal nerve. In our study, we analyzed the status of neurotransmission in the stretch reflex circuit in postnatal PV-cre; munc18-1 lox/lox conditional mutant mice. Munc18-1 is responsible for synaptic vesicular release in neurons. In the PV-cre; Munc18-1 lox/lox mutants we use, Munc18-1 is only knocked out in proprioceptive afferents and A-beta somatosensory afferents, both …

Antimicrobial Activity Of Fractionated Borohydride-Capped And Electrochemical Colloidal Silver, Marjorie M. Markopoulos

Browse all Theses and Dissertations

Silver nanoparticles (AgNPs) and ionic silver (Ag+) are known to be broad-spectrum antimicrobial agents. Recent studies show these agents may be an alternative to the most widely used drinking water disinfectant, chlorine. Chlorine is a toxic industrial chemical with a lethal concentration of 430 ppm after 30 minutes. Additionally, chlorine can react with naturally occurring materials to produce a number of disinfection byproducts such as chloroform and trihalomethanes. Some of these byproducts pose cancer risks in addition to other negative impacts to human health. These would be eliminated with the use of Ag+ or AgNPs. The main goal of this …

The Scoop, Vol. 3 Issue 10, January 2017, Health Sciences Library

Volume 3

Latest news and events from the Health Sciences Library in our monthly newsletter for January 2017.

Behavioral Activation For Smoking Cessation And Mood Management Following A Cardiac Event: Results Of A Pilot Randomized Controlled Trial, Andrew M. Busch, Erin M. Tooley, Shira Dunsiger

Arts & Sciences Faculty Publications

Background: Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC).

Methods: Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or …

Characteristics Of Cigarette Smoking In Individuals In Smoking Concordant And Smoking Discordant Couples, Erin M. Tooley, Belinda Borrelli

Arts & Sciences Faculty Publications

Partner smoking status may impact smoking cessation outcomes. The purpose of this study is to compare smokers in smoking concordant couples (both partners smoke) to smokers in smoking discordant couples (one partner smokes) on variables that are important for quitting smoking. Participants were 123 cigarette smokers with cohabitating romantic partners (smoking discordant: n = 60, smoking concordant: n = 63, 63.9% females). We used one-way MANCOVA, controlling for age and number of cigarettes smoked per day, to examine differences between groups on smoking outcome expectancies, motivation to quit smoking, and dyadic efficacy to quit smoking. We examined smoking behavior in …

Silver Diamine Fluoride And Oral Health-Related Quality Of Life, Nazafarin Javdan

Theses and Dissertations

Purpose: The purpose of this study was to study the association between Silver Diamine Fluoride (SDF) and Oral Health-Related Quality of Life as assessed by “The Early Childhood Oral Health Impact Scale” questionnaire. Methods: Parents of healthy children (ASA I and II) ages 1-5 with early childhood caries with reversible pulpitis who had application of SDF filled out a questionnaire at baseline and again after one month. The questionnaire was designed to evaluate the child’s behavior, physical abilities, pain, temperament, and how well the child gets along with others. Results: Wilcoxon Signed Rank Test was used to …

Amixicile Inhibits Anaerobic Bacteria Within An Oral Microbiome Derived From Patients With Chronic Periodontitis, Kane Ramsey

Theses and Dissertations

Periodontitis is a chronic inflammatory disease caused by pathogenic bacteria residing in a complex biofilm within a susceptible host. Amixicile is a non-toxic, readily bioavailable novel antimicrobial that targets strict anaerobes through inhibition of the activity of Pyruvate Ferredoxin Oxidoreductase (PFOR), a major enzyme mediating oxidative decarboxylation of pyruvate. Our study aimed to evaluate the efficacy of amixicile, when compared to metronidazole, in inhibiting the growth of bacteria present in a microbiome harvested from patients with chronic periodontitis.

Plaque samples were harvested from patients with severe chronic periodontitis and cultured under anaerobic conditions. The microbiomes were grown in the presence …

Po2 Dependence Of Oxygen Consumption In Skeletal Muscle Of Hypertensive And Normotensive Rats, Habiba Shah

Theses and Dissertations

Human essential hypertension affects over 75 million people in the United States, and can lead to death due to its several serious health complications such as hypertension-related cardiovascular disease. The purpose of this research was to understand how hypertension could cause physiological changes to the microcirculation, specifically the PO₂ dependence of oxygen consumption (VO₂) in skeletal muscle of normotensive and hypertensive rats. The Spontaneously Hypertensive Rat (SHR) strain was used as the diseased model, and Wistar-Kyoto (WKY) rats were used as controls to conduct this study. The SHR strain develops hypertension between 5-6 weeks after birth with …

Burnout Or Depression: Both Individual And Social Issue, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In view of the profound problems attached to the construct of burnout, we recommended that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. Epstein and Privitera (April 8, 1398) rejected our recommendation on the grounds that burnout is not a “purely individual syndrome”. Problematically, Epstein and Privitera attributed to us an idea that is not ours. In these authors’ view, equating burnout with depression is synonymous with mistakenly individualising a social problem. For two reasons, the argument that depression cannot replace burnout because burnout is a social problem whereas depression is an individual …

Vital Exhaustion, Burnout, And Other Avatars Of Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In our view, there is a worrying tendency in psychology and medicine to let proliferate “depression-like” constructs—a transgression of the scientific canon of parsimony. The problem is not limited to vital exhaustion (VE). Burnout, a condition akin to VE, has been shown to problematically overlap with depression. Compassion fatigue, a condition that shows particularly blurred definitional contours, is also uncomfortably close to depressive symptomatology. The construct of neurasthenia may be part of this confusing trend as well, although neurasthenia has been elevated to the status of nosological category in the ICD. Construct proliferation jeopardizes knowledge growth by undermining theory building …

Biological Research On Burnout-Depression Overlap: Long-Standing Limitations And On-Going Reflections, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this commentary, we discuss seldom-noticed methodological problems affecting biological research on burnout and depression and make recommendations to overcome the limitations of past studies conducted in this area. First, we suggest that identified subtypes of depression (e.g., depression with melancholic features and depression with atypical features) should be taken into account in future biological research on burnout and depression, given that different subtypes of depression have been associated with distinct autonomic and neuroendocrine profiles. Second, we underline that research on burnout-depression overlap is made difficult by the absence of a consensual conceptualization and operationalization of burnout. In order to …

‘Burnout Syndrome’: From Nosological Indeterminacy To Epidemiological Nonsense, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, Imo’s review is undermined by the very research it relies on. We recommend that researchers interested in burnout begin at the beginning, that is to say, by establishing a reasoned, clinically-founded (differential) diagnosis for their entity of interest. As long as investigators do not complete the required groundwork for establishing a diagnosis and remain unable to distinguish a case of burnout from either a noncase or an existing disorder, conclusions regarding the prevalence of burnout will be nonsense. To close this comment, we note that an immediately available solution for effectively monitoring and protecting physicians’ occupational health …

Critically Appraised Paper For “Effect Of Physical Exercise-Movement Strategies Programme On Mobility, Falls, And Quality Of Life In Parkinson's Disease”, April Perez, Morganne Peterson, Raechel Jacala, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

A research team conducted a Level III prospective, longitudinal study to examine the effect of a standardized rehabilitation program, consisting of regular exercise and movement strategies, on fall risk, mobility, hospitalization, and quality of life for individuals with idiopathic Parkinson’s disease (PD). Over 2 years, 15 participants attended weekly rehabilitation sessions during Year 1 and biweekly sessions during Year 2. The rehabilitation program was designed to improve cardiovascular fitness, strength, flexibility, balance, posture, and gait pattern. Using a pre- and posttest study design, the research team assessed participants at baseline and at Year 1 and Year 2 follow-up evaluations. Using …

Critically Appraised Paper For “Efficacy Of Occupational Therapy For Patients With Parkinson's Disease: A Randomized Controlled Trial”, Amber Zadravecz, Hannah Tashjian, Emily White, Stephanie Pawek, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

Parkinson’s disease is a disabling, progressive condition that hinders occupational performance in daily activities and social participation. Occupational therapy supports engagement in activities that are meaningful to the patient. The purpose of this study was to explore the benefits of occupational therapy in addition to standard care for patients with Parkinson's disease.

An Innovative Behavioral Interview For Pre-Admission Selection Of Occupational Therapy Students, Kitsum Li, Julia L. Wilbarger, Shad St. Louis

Collected Faculty Scholarship

The goal for pre-admission interview is to identify students who will be successful both academically and professionally. The traditional structured pre-admission interview has not been shown to be effective in predicting students’ success in academic and fieldwork performance. This article describes an innovative behavioral interview process during which applicants interviewed simulated clients as part of the preadmission selection process. The goals of the pre-admission behavioral interview were to observe applicants’ behavior as team players, and to assess their interpersonal communication skills, capability to be reflective, and professionalism. During the behavioral interview, faculty interviewers assessed the applicants’ performance in the planning …

Exploration Of The Use Of Sensory Diets In Occupational Therapy, Allison Hunt, Morganne Peterson, Emily White

Student Research Posters

The purpose of this study was to fill the gap in literature and further examine the use of sensory diets in the field of occupational therapy. This study investigated the use of sensory diets among California occupational therapy practitioners. A mixed-methods design was used to collect data through a SurveyMonkey survey. The survey was sent out to members of the Occupational Therapy Association of California (OTAC) and received 98 respondents within one month. Participants worked among various clinical settings and implemented sensory diets with various client populations. Practitioners reported using terms such as “sensory strategies,” “sensory tools,” and “sensory supports” …

Living With Fragile X Syndrome: Occupations As An Outcome Measure In A Clinical Trial, Kaylee E. Gothelf, Ty Duong, Ana Baldinger, Theresa Chase

Student Research Posters

The purpose of this study was to evaluate the use of semi-structured interviews as an outcome measure in a clinical trial for children with fragile X syndrome (FXS) ages 2-6. This qualitative approach was used to analyze twenty-five interviews of parents with children in a double-blind medication trial - sertraline or placebo. The aim was to assess occupational improvements in their child that may not have been detected with the use quantitative outcome measures alone. Results showed greater improvements in the sertraline group in areas of behavior, social participation, sensory-related behaviors, receptive language, education, family impact and therapeutic strategies. Our …

Protective Factors And Resilience In Older Adults, Jessica Mcclain, Caroline Lee, Katelyn Gullatt

Student Research Posters

We sought to investigate whether three protective factors, (physical health, social support, and self-efficacy) predict resilience in Marin County older adults to promote successful aging in place. Fifty-eight Marin County participants aged 62 years and older participated in an exploratory cross-sectional quantitative study. Recruited from senior community programs and personal contacts, participants completed four self-report questionnaires. Descriptive and multivariate analyses using SPSS were conducted to investigate the relationship between the key variables. Of the three protective factors, self-efficacy is the most important predictor of resilience. Physical health and social support are important predictors of self-efficacy. In conclusion, three protective factors …

Therapeutic Listening® - Quickshifts Support For Pediatric Intervention, Bryant Luong, Ann Malloy, Shannon Preto

Student Research Posters

Few empirical studies have been conducted to provide evidence for the effectiveness of Therapeutic Listening - Quickshifts (TL-Q). Anecdotally, TL-Q has produced consistent positive results for therapists and clients as a pediatric intervention. Therefore, it is imperative to research TL-Q’s efficacy, which may lead to its broader implementation. In this study, the researchers examined the effectiveness of TL-Q intervention for children with sensory processing difficulties to improve participation and function in 1) school performance, (2) self-regulation and arousal, (3) activities of daily living (ADLs), (4) social/emotional skills, and (5) sensorimotor skills. Over the course of an 8 week prospective study, …