Medicine and Health Sciences Commons^™

The Implications Of Mild Traumatic Brain Injury And Malingering, Knowledge Base, And Opinions In Life Care Planning, Rigel Pinon, Irmo Marini, Tiffany Cantu, Iliana Escandon

School of Rehabilitation Services & Counseling Faculty Publications

The current study surveyed 86 rehabilitation educators from 27 universities spanning 17 states teaching graduate rehabilitation counseling students regarding to what extent, if any, they address the medical and psychosocial aspects of traumatic brain injury in their curriculum to students. Students of various disciplines who develop life care plans particularly with mild traumatic brain injury must be aware of the symptomatology and prognosis in relation to long-term medical and psychological care needs. Knowing how to distinguish and assess valid subjective complaints, neuropsychological testing, and diagnostic findings regarding traumatic brain injury is key to developing a methodologically reliable and valid plan. …

Improving Breastfeeding Education Among Hospital Nurses, Kara R. Connelly

Graduate Dissertations and Theses

Breastfeeding is well-documented as the most beneficial method of infant feeding worldwide. There are numerous national initiatives present to improve breastfeeding outcomes. Despite knowledge and health care organization efforts, the recommendations of exclusive breastfeeding through six months of life with continued breastfeeding through one year of age are not being met. The purpose of this DNP project is to determine if a structured self-study educational program on breastfeeding recommendations, the 4^th Edition of the Lactation Management Self-Study Modules created by Wellstart International™, provided to hospital nurses on a maternity unit in Central, New York with a Level One nursery, …

Advanced Clearing Methods And Imaging Techniques For Optimized Three- Dimensional Reconstruction Of Dense Tissues, Caleb A. Padgett

Theses and Dissertations

Advances in tissue clearing have allowed biological and biomedical researchers to image entire segments of tissue and generate three-dimensional reconstructions, allowing for a better understanding of the structural and morphological characteristics of large tissues. This study compared three commonly utilized clearing methods and analyzed their effectiveness in increasing imaging depth for three-dimensional reconstruction of large tissue segments. Mouse heart, mouse brain, mouse colon, and embryonic chick tissues were cut into thick sections, cleared and immunolabeled with an antibody specific to each tissue type, and imaged using a confocal microscope. The results of this study concluded that most tissues cleared by …

Understanding Barriers To Genetic Testing For Sickle Cell Trait: The African-American Male Perspective, Shandrea Foster

Theses and Dissertations

Research has shown a reluctance in African-American males to pursue testing for sickle cell trait. Few studies have tried to discern what barriers are contributing to this issue within the African-American male community. Research suggests a lack of knowledge may be the biggest contributing factor. This study hypothesized there would be a significant difference in knowledge of sickle cell trait based on educational level, age, and health beliefs. African-America male participants (N=116), ages 18 and over, completed a questionnaire assessing knowledge, risk perception, health beliefs, barriers, and motivating factors within the context of sickle cell trait. One-way and two-way analysis …

Body Mass Index Trajectories And The Relationship Between Stressful Life Changes And Nutrition-Related Health Outcomes Among United States Army Soldiers, Julianna Marie Jayne

Theses and Dissertations

Body mass index (BMI) has risen among members of the military, though to a lesser degree than in civilian populations. BMI as an anthropometric tool has been essential for population surveillance and documenting the obesity epidemic and its health consequences. One use for BMI in population surveillance is to model the BMI trajectories of a population over time. Many studies are available on the BMI trajectories and determinants of BMI in civilians, but few studies of this nature in military populations exist. Establishing the shape and determinants of BMI trajectories among Soldiers is critical given the importance of weight management …

A Qualitative Exploration Of Experiences And Motivations For Diabetes Self-Management In African American Men Between The Ages Of 40-85 With Type 2 Diabetes, Anthony Q. Walker

Theses and Dissertations

Diabetes is a devastating disease that can affect an individual’s health and quality of life, but if managed properly, individuals with diabetes can have a good quality of life. Diabetes strikes African American men at a high rate. This study used a qualitative design to explore African American men between the ages of 40-85 with type 2 diabetes (T2DM) and their definition of diabetes and motivation, their experience of living with diabetes, their self-management behaviors, their motivations for managing diabetes, and what they and healthcare providers believe motivates them to self-manage diabetes and to attend diabetes self-management education (DSME) programs. …

Sleep, Shiftwork Adaptation, Autonomic Dysfunction, And Metabolic Syndrome, Torrance Torrance

Theses and Dissertations

Background: Sleep is considered a physiological necessity and its disruption is associated with a wide variety of adverse mental and physical health outcomes including increased incidence of obesity, cancer, hypertension, cardiovascular disease, type 2 diabetes mellitus, stroke, depression, post-traumatic stress disorder (PTSD), work-related and vehicle accidents, and aberration of the autonomic nervous system.

Methods: Three studies were conducted from three separate populations. The first study examined the latent trajectories of self-reported sleep quality in active duty Army soldiers over a 3-year period using data from the Global Assessment 2.0 survey and Repeated Measures Latent Class Analysis (RMCLA) procedures. Generalized Estimating …

Healthy Motivations For Moms-To-Be (Healthy Mom2b) Study: A Mobile Health Intervention Targeting Gestational Weight Gain Among U.S. Women, Alicia Anne Dahl

Theses and Dissertations

INTRODUCTION: Almost one-half of all pregnant women in the U.S. exceed the Institute of Medicine’s (IOM) gestational weight gain (GWG) guidelines. Healthy GWG is critical for reducing adverse health outcomes associated with excessive GWG for the mother and infant. Electronic health (e-health) interventions delivered through mobile apps and websites hold potential as readily available resources for targeting health behaviors and monitoring GWG during pregnancy. The development of the Healthy Motivations for Moms-To-Be (HM2B) intervention was informed by health behavior theories, a systematic review of existing in-person and technology mediated interventions (Aim 1 of this dissertation), and results of an online …

The Impact Of The Medicaid Coverage Expansion And The Removal Of Cost-Sharing Under The Affordable Care Act On Mammography And Pap Tests, Abeer Alharbi

Theses and Dissertations

Background: The Affordable Care Act (ACA) aimed at making health care affordable and accessible including the use of preventive care services. To achieve these aims, the ACA expanded Medicaid coverage to population with income below 138% of FPL and removed cost-sharing when using preventive care services recommended by the USPSTF. This study tried to assess the impact of these provisions on the rate of mammography and Pap tests among women. Methods: Data was obtained from the Medical Expenditure Panel Survey - Household Component MEPS-HC. A difference-indifference design was used to determine the effect of Medicaid eligibility expansion on the outcomes …

Investigating Drug-Related Violence In Indian Country: The Lumbee Tribe Of North Carolina, Asa Alena Revels

Theses and Dissertations

Drug-related violence (DRV) impacts the over-all wellbeing of communities, with disparate health outcomes observable in many poor, minority communities. The purpose of this study was to better understand the multi-level social and environmental factors influencing elevated rates and prevention of DRV within the Lumbee, a southeastern American Indian Tribe. This was accomplished via in-depth, one-on-one interviews with 37 Lumbee Tribal Members and Key Leaders. The findings align with existing research, revealing the influence of such factors as poor socioeconomic conditions, coping strategies, broken family structures, and the influence of federal policy. Of interest was the substantial influence of the local …

Patient Characteristics, Discharge Disposition, And Hospital Factors Associated With All Cause 30-Day Hospital Readmission For Total Joint Arthroplasty In 2014, Hamad Yahya Alzamanan

Theses and Dissertations

Objective: Recent improvements in hospital care have come from a growing knowledge of factors that contribute to readmission. The objective of this work is to identify and describe the national readmission rate after Total Joint Arthroplasty, and to evaluate selected hospitals’ and patients’ factors for their association with the all-cause 30-day readmission rate after TJA in the United States in 2014. Method: Retrospective analysis of 938,504 TJA acute care hospital discharge records was performed, using a nationally representative database that is dedicated to the study of hospital readmissions, and accounts for 51% of total US hospitalizations. Logistic regression models were …

Chronic Conditions Profiles And Cardiometabolic Risk Factor Control Among A Diverse Sample Of Older Adults With Type 2 Diabetes Mellitus, Tsion Kidanie

Theses and Dissertations

Background: Multiple chronic condition is common in older adults with diabetes. Several prior studies have shown that having multiple chronic condition impact cardiometabolic risk factor controls (i.e., blood pressure, High-density lipoprotein (HDL) cholesterol level, and high glycated hemoglobin (HbA1c). However, it is not clear whether these results extend to a multiethnic sample of older adults.

Objectives: 1). Examine the association between Comorbidity profile and ABCs goals achievement. 2). Examine whether the association between comorbidity profile and ABCs goals achievement is moderated by race/ethnicity.

Methods: A sample of 3532 participants from Health and Retirement Study (HRS) years 2010 and 2012 and …

Initiating A Peer Support Program For Parents Of Children With Autism Spectrum Disorder In Richland And Lexington Counties, Danielle P. Simmons

Theses and Dissertations

Objective: To initiate a parenting support program for parents of children with Autism Spectrum Disorder (ASD) in Richland and Lexington Counties. Background: Parents of children with ASD have increased stress and a poorer sense of well-being relative to parents of children with typical development. This parent population in Richland and Lexington Counties identified lack of support as a major stressor. The parenting support model initiated (e.g. Parent to Parent program) is an evidence-based intervention used to provide peer support to parents of children with ASD. The training of veteran parents is essential in the development and initiation of a Parent …

The Nervous System And Cancers Of The Head And Neck, Christian A. Graves

Theses and Dissertations

The anatomy of the head and neck is closely associated with the nervous system which plays an important role in the prognosis of head and neck cancer (HNC). However, the molecular interactions between these compartments and HNC remain poorly understood. We present a novel big data approach utilizing clinical data, sequencing, and machine learning to identify and validate potential molecular pathways by which the nervous system affects the development and progression of HNC. Our studies demonstrate across multiple datasets that perineural invasion (PNI) frequently occurs in HPV+ HNC. Furthermore, we show novel activating and missense mutations and pathways that may …

Implementing A Surgical Pathway To Reduce Operating Room Cancellation Rates, Demerise Ott Minor

Theses and Dissertations

Improving operating room efficiency is a high priority as health care cost become more challenging. In order to reduce surgical cancellation rates, a process improvement plan was implemented using a preoperative surgical pathway to optimize a patient’s health prior to scheduling the surgical procedure. The surgical risk assessment tool risk stratifies the patient based on the urgency of the procedure, the type of procedure, and the patients overall medical disease state. The Surgical Risk Tool determines patients with surgical risk scores of 9 or greater require medical and/or cardiac clearance in addition to hemoglobin A1C of 8 or less and …

Food Acquisition And Shopping Patterns And Associations With Body Mass Index, Xiaonan Ma

Theses and Dissertations

Background: Obesity is a big public health concern in the US. Previous studies examined its association with food shopping practices measured by distance to the food store, shopping frequency, and type of store selected. However, not much is known about the actual food acquisition and shopping habits integrating multi-dimensional aspects. The purpose of this study was to identify distinct food acquisition and shopping patterns in populations primarily residing in food deserts in South Carolina (SC) and a general population in the US and characterize these patterns with respect to socioeconomic status (SES), nutritional knowledge, and perceptions and store selection …

Association Of Insurance And Provider Type With Patients’ Perceived Cost And Ease Of Access To Healthcare Services Among Medicare Beneficiaries Diagnosed With Diabetes, Metria Harris

Theses and Dissertations

Medicare beneficiaries diagnosed with diabetes are likely to have health complications or episodes associated with diabetes, resulting in higher health care utilization and costs. Andersen’s Health Care Utilization Behavior Model (HCBM) includes predisposing, enabling, and need factors, but it excludes perception. Ajzen’s Theory of Planned Behavior (TPB) shows that perception influences health service use. This study was performed using a real-world model integrating Andersen’s HCBM and Ajzen’s TPB to determine whether there was an association between insurance type (Medicare Part D versus non-Part D) and perceived ease of access or cost among Medicare beneficiaries with diabetes. The second objective was …

The Impact Of False Positive Mammography Results On Breast Cancer Screening Intention Among Black Women, Deeonna E. Farr

Theses and Dissertations

Extensive research indicates that false-positive mammograms (FPM) have been associated with negative psychosocial and cancer-related beliefs, but only a handful of studies examine Black women’s reactions to this experience. Additionally, these studies do not investigate how organizational and provider-level factors in concert with individual patient characteristics shape Black women’s experiences and reactions to FPM results. The purpose of this study was to determine the impact of organizational, provider, and individual-level factors on the processes and outcomes associated with FPM results in Black women. This study had two specific aims:

1) To describe, using a mixed methods approach, the organizational and …

Using Ultrasound Guided Peripheral Intravenous Catheters In Difficult Access Patients, Courtney Prince

Theses and Dissertations

The purpose of this quality improvement project is to compare the use of ultrasound to guide placement of peripheral intravenous (USGPIV) catheters versus standard techniques in difficult access patients, as measured by the number of attempts required to obtain venous access and total cost related to means of obtaining peripheral venous access between a nurse driven USGPIV and VAT team consults or physician assistance. The appraised evidence indicates USGPIV increases the number of successful PIV placements, prevents non-essential central lines and excessive needle sticks, and reduces patients and healthcare professionals frustrations (An et al., 2016, Au et al., 2012, Dargin, …

Operation Of The Leica Sp8 Multiphoton Confocal System Using Single Or Multiple Fluorochromes, Amy E. Rowley

Theses and Dissertations

The goal of this thesis is to systematically examine each decision made in obtaining images on the Leica SP8 Multiphoton Confocal Microscope and discuss the basic operating parameters in order to generate publication quality images. The capabilities of the LAS X software are discussed along with an in depth discussion of each icon in order, beginning with the Configuration icon, moving then to Acquire, and a brief overview of the possible imaging processing functions within the Process icon. At the conclusion of this thesis, the reader should feel comfortable with the operation of a confocal system and understand the tradeoffs …

Test-Retest Reliability Of The Short Form Survivor Unmet Needs Survey, Karen Taylor, Max Bulsara, Leanne Monterosso

Nursing Papers and Journal Articles

Objective: Reliable and valid needs assessment measures are important assessment tools in cancer survivorship care. A new 30‑item short‑form version of the Survivor Unmet Needs Survey (SF‑SUNS) was developed and validated with cancer survivors, including hematology cancer survivors; however, test–retest reliability has not been established. The objective of this study was to assess the test–retest reliability of the SF‑SUNS with a cohort of lymphoma survivors (n = 40).

Methods: Test–retest reliability of the SF‑SUNS was conducted at two time points: baseline (time 1) and 5 days later (time 2). Test–retest data were collected from lymphoma cancer survivors (n …

Qualitative Results From A Phase Ii Pilot Randomised Controlled Trial Of A Lymphoma Nurse-Led Model Of Survivorship Care, Karen Taylor, Leanne Monterosso, Caroline Bulsara

Nursing Papers and Journal Articles

Purpose: To explore and describe lymphoma survivors’ thoughts and perceptions of the components of a nurse led lymphoma survivorship clinic intervention.

Methods: An exploratory, qualitative descriptive study using interviews from 10 participants who had transitioned post-treatment into the survivorship phase via a nurse-led lymphoma survivorship clinic intervention.

Results: Thematic analysis revealed three major themes: Reassurance and individualised care; Information and support; and Empowerment. Participants described the reassurance they gained from having contact with a health professional post-treatment who individualised information and support. A survivorship care plan and treatment summary was developed for this study and was believed to be very …

General Practice Palliative Care: Patient And Carer Expectations, Advance Care Plans And Place Of Death-A Systematic Review, Claire E. Johnson, Peta Mcvey, Joel J. Rhee, Hugh Senior, Leanne Monterosso, Briony Williams, Julia Fallon-Ferguson, Matthew Grant, Harriet Nwachukwu, Michele Aubin, Patsy Yates, Geoffrey Mitchell

Nursing Papers and Journal Articles

Background: With an increasing ageing population in most countries, the role of general practitioners (GPs) and general practice nurses (GPNs) in providing optimal end of life (EoL) care is increasingly important.

Objective: To explore: (1) patient and carer expectations of the role of GPs and GPNs at EoL; (2) GPs’ and GPNs’ contribution to advance care planning (ACP) and (3) if primary care involvement allows people to die in the place of preference.

Method: Systematic literature review. Data sources: Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases.

Results: From 6209 journal …

Workplace Bullying: A Survey Of Virginia Dental Hygienists, Gayle B. Mccombs, S. Lynn Tolle, Tara L. Newcomb, Ann M. Bruhn, Amber W. Hunt, Lanah K. Stafford

Dental Hygiene Faculty Publications

Purpose: Workplace bullying in health care has been identified as a problem that negatively affects career satisfaction, career longevity and patient outcomes. The purpose of this pilot study was to determine the prevalence of workplace bullying in a convenience sample of dental hygienists in the state of Virginia.

Methods: Two hundred and forty Virginia dental hygienists attending a continuing education seminar were invited to participate. Using the Negative Acts Questionnaire-Revised (NAQ-R), respondents were asked to indicate how often they had experienced 22 negative acts or behaviors according to rate of occurrence (never, now and then or monthly, weekly or …

Tuned In: An Investigation Of The Use Of Group Amplification Systems For Students, Including Those On The Autism Spectrum, In First Grade Mainstream Classrooms, Emily Velichka

Senior Independent Study Theses

The purpose of this study was to determine the academic benefits and challenges, if any, of utilizing a group amplification system in first-grade mainstream classrooms. More specifically, this study measured the influence of a group amplification system throughout language-based tasks, such as spelling accuracy. A total of 33 first-grade students, including two students reportedly diagnosed with an Autism Spectrum Disorder (ASD), participated in the study, with 17 students in Classroom A and 16 students in Classroom B. This study’s experimental procedures included a spelling pretest, two intervention activities, and a spelling posttest, administered over the course of four days. The …

Working With Transnational Women From Latin American Countries From A Feminist Therapy Framework: A Guide For Mental Health Providers Working With This Population, Diana Hinojosa

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The experiences of transnational families in the United States have largely been examined as they relate to the impact that separation and migration have on the family system. In most recent years, women have assumed the experience of migration and have moved to countries like the United States to work and provide for their families back home. Transnational families are typically understood as family members who live separated from each other, often across national borders, but continue to maintain unity and connections with each other. The following literature review will examine the social factors impacting Latin American women’s decision to …

Examining Acoustic And Kinematic Measures Of Articulatory Working Space: Effects Of Speech Intensity, Christopher Dromey, Jason A. Whitfield, Panika Palmer

Faculty Publications

Purpose: The purpose of this study was to examine the effect of speech intensity on acoustic and kinematic vowel space measures and conduct a preliminary examination of the relationship between kinematic and acoustic vowel space metrics calculated from continuously sampled lingual marker and formant traces. Method: Young adult speakers produced 3 repetitions of 2 different sentences at 3 different loudness levels. Lingual kinematic and acoustic signals were collected and analyzed. Acoustic and kinematic variants of several vowel space metrics were calculated from the formant frequencies and the position of 2 lingual markers. Traditional metrics included triangular vowel space area and …

Development And Preliminary Assessment Of Interprofessional Education Focused On Vulnerable Populations, Celia Pechak, Connie Summers, Barbara Schoen, Margie Padilla, Patricia Lara, Joanna Velasco, Stephanie Capshaw

Faculty Publications

With the current state of the U.S. healthcare system, interprofessional collaborative practice (IPCP) has never been more important. Health professions educators are increasingly incorporating interprofessional education (IPE) in their curricula in order to prepare students for IPCP. The HealthFocused IPE Community of Practice (representing nursing, occupational therapy, pharmacy, physical therapy, rehabilitation counseling, social work, and speech-language pathology) at the University of Texas at El Paso has created a unique IPE model centered on vulnerable populations. The purposes of this paper are to describe the early development of this innovative IPE model and present findings from an evaluation of an IPE …

Vitamin E Status Is Inversely Associated With Risk Of Incident Tuberculosis Disease Among Household Contacts, Omowunmi Aibana, Molly F Franke, Chuan-Chin Huang, Jerome T Galea, Roger Calderon, Zibiao Zhang, Mercedes C Becerra, Emily R Smith, Carmen Contreras, Rosa Yataco, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression.

OBJECTIVE: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk.

METHODS: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on …

Modeling Safe Sleep Practices For The Newborn In The Hospital: Is It Happening?, Marietta Sperry, Kimberly Kohlieber

Books, Presentations, Posters, Etc.

Background: Nurses have been noted to model unsafe sleep practices for the newborn in the hospital, despite having been extensively trained. Parents report they repeat this behavior at home. There is a reluctance of nurses to comply, notwithstanding implementation of Back to Sleep programs and documentation of parents being taught safe sleep practices, causing a plateau in the reduction sudden infant death syndrome (SIDS).

Methods: Systematic review of literature from CINHAL, Indiana State University Library, Google Scholar, and PubMed from last five years.

Results: Nurses were found to agree with many guidelines. Personal bias, or habit influenced poor implementation. Although …