Medicine and Health Sciences Commons^™

Improving Workplace Incivility By Educating Frontline Nurse Leaders: The Charge Nurse, Temika Ford

Doctor of Nursing Practice Projects

The term workplace incivility is often replaced interchangeably with workplace bullying, horizontal/lateral violence, psychosocial harassment, intimidating behavior, and/or aggression (micro/macro). Workplace incivility in nursing has lasting effects on the profession through worsening the nursing shortage, contributing to low morale, negative working environments, safety issues for staff and patients, stress-related health problems, absenteeism, and decreased quality of patient care. Incivility can be from a variety of sources including: Nurse managers, clinical team leads, unit coordinators, physicians, patients, and other healthcare professionals. Buy-in by nursing executive leadership and evidence-based education for nurses is mandatory to address organizational incivility.

The purpose of this …

Implementation Of A Dose Response To Wood Smoke Pm: A Potential Method To Further Explain Cvd In Wildland Firefighters., Dylan Richmond, John Quindry, Christopher T. Migliaccio, Brent Ruby

Graduate Student Theses, Dissertations, & Professional Papers

The presentation of cardiovascular disease (CVD) and comorbidities in aging and retired wildland firefighters (WLFF) continues to be one of the top health priorities to address by The United States Forest Service. In the past 20 years, experts at multiple meetings and conferences have confronted this growing concern as a formal call to action to investigation the individual components related to working in the wildland fire setting. The inhalation of wood smoke particulate matter (PM) shows evidence of altering homeostasis in WLLF’s in the areas of oxidative stress, inflammation, and arterial stiffness, all of which contribute to the development of …

Preliminary Investigation Of An Aphasia-Friendly Version Of The Patient Health Questionnaire – 8 (Phq-8) Compared To Other Patient And Proxy Reported Outcome Measures Of Depression, Kaylee Marie Walter

Graduate Student Theses, Dissertations, & Professional Papers

Persons with aphasia (PWA) experience post-stroke depression more frequently than stroke survivors who do not have aphasia. Currently, no patient reported outcome measures that screen for depression have been created specifically for PWA or modified to be aphasia friendly for PWA. The purpose of this preliminary study is to modify the Patient Health Questionnaire- 8 (PHQ-8) to an aphasia friendly format and to assess the feasibility of administering the modified assessment compared to other patient-reported and proxy-reported outcome measures used to screen depression. This retrospective analysis examined pre- and post-treatment outcome measures of depression for seven stroke-survivors with aphasia. The …

Linking Health Behavior Theory And Interventions To Increase Human Papillomavirus Vaccine Uptake, Gretchen Elizabeth Neal

Graduate Student Theses, Dissertations, & Professional Papers

Human papillomavirus (HPV) is the most common sexually transmitted disease in adults in the United States (US). Persistent HPV infection can cause several cancers, including cervical, oropharyngeal, and anal cancer. To prevent these cancers, the U.S. Advisory Committee on Immunization Practices recommends that all adolescents start the HPV vaccine series at ages 11-12 years. Despite the safety and efficacy of available HPV vaccines, vaccine uptake rates remain lower than public health goals. In the US, only 51.1% of eligible adolescents have completed the vaccine series, a rate lower than the Healthy People 2020 goal of 80% coverage for series completion. …

Programmatic Desensitization Of The Cough Reflex In Patients With Refractory Chronic Cough, Emma Bozarth Dailey

Graduate Student Theses, Dissertations, & Professional Papers

Aim: The purpose of this blinded, randomized, placebo-controlled pilot clinical trial was to determine the potential of treating refractory chronic cough (RCC) using a progressive desensitization model paired with behavioral cough suppression.

Methods: Twelve adults with chronic cough who had failed behavioral cough treatment enrolled in and completed the study. Participants were randomly assigned to a treatment (n=8) or placebo group (n=4). The study consisted of three phases. During Phase I, participants completed baseline testing, including cough sensitivity testing with capsaicin, the Leicester Cough Questionnaire (LCQ), urge-to-cough-testing, and 24-hour cough frequency testing. During Phase II, participants practiced behavioral cough suppression …

College Athletes And Alcohol Use: The Need For Effective Prevention/Intervention Programs, Paige M. Craig

Graduate Student Theses, Dissertations, & Professional Papers

The literature review investigates the relationship between alcohol and college athletes. College athletes are a high-risk drinking group; alcohol use amongst collegiate athletes is a major concern due to the consequences associated with use. It is important to review student-athlete behavior and influences that contribute to alcohol use in order to design a program that effectively prevents use and intervenes use when it occurs. Results from original articles were used to support the need for effective prevention/intervention programs for this population based on the severity and frequency of use, negative effects of alcohol, and lack of effective prevention/intervention programs. Coaches, …

Binegative Minority Stress, Psychological Processes, And Disordered Alcohol Use: Disparities Among Sexual Minority Womxn, Kinsie Jean Dunham

Graduate Student Theses, Dissertations, & Professional Papers

Sexual minority womxn (i.e., woman-identified persons) tend to report more harmful alcohol use and more negative alcohol use outcomes than heterosexual women—a pattern not consistently observed in man-identified populations. Further, bisexually-oriented, hereafter called nonexclusively-oriented, womxn (NOW) report more negative alcohol use outcomes and meet criteria for alcohol use disorder at higher rates than both lesbians and heterosexual women (or exclusively-oriented womxn; EOW). These disparities require further investigation to explicate the antecedents and mechanisms impacting alcohol use for this at-risk population. This project examines the incremental negative effects of binegativity as a specific minority stressor and antecedent of disordered alcohol use. …

Comparison Of Low Carbohydrate Diets On Renal And Glucose Function In Subjects With Type 2 Diabetes: A Systematic Review And Meta-Analysis, Garrett A. Couch

Honors Undergraduate Theses

Background - Type 2 Diabetes Mellitus (T2DM) is a growing crisis that can lead to more problems if left untreated. One of these problems includes diabetic nephropathy or Chronic Kidney Disease (CKD). While there have been many advances in the field of treating CKD with medication, there are currently no medications with the capability of stopping the progression of or reversing diabetic nephropathy; however, recent studies have shown that diabetic nephropathy can be stopped and even reversed through dietary interventions. One of these studies went through the effects of a low protein diet on diabetic nephropathy and found very promising …

Investigating Aggression In Huntington Disease, Chloe E. Larochelle

Honors Undergraduate Theses

Huntington Disease (HD) is a neurodegenerative disorder that is caused by a CAG trinucleotide repeat expansion in the huntingtin gene. The onset of the disease is defined by the presence of motor deficits, such as chorea. However, cognitive and psychiatric symptoms often develop before motor onset and typically have a larger impact on patient quality of life. Psychiatric symptoms include depression, anxiety, and OCD, but also aggression and irritability, which have been comparatively understudied due to stigma. Currently, treatments to modify these behaviors in premanifest HD patients are not consistently effective and often have side effects, creating a need for …

Trophic Enteral Feeds In Mechanically Ventilated Adult Patients With Acute Respiratory Distress Syndrome/Acute Lung Injury And Associated Clinical Outcomes, Kiersten Ann Tidwell

Honors Undergraduate Theses

Enteral nutrition (EN) is often delayed in critically ill patients despite strong evidence to support that early enteral nutrition feeding is beneficial in this population. Adverse outcomes in critically ill patients in which nutrition is delayed include a longer length of stay and time on the ventilator, and a higher incidence of pneumonia and hospital mortality. The purpose of this literature review was to evaluate the current evidence regarding trophic enteral feeds in mechanically ventilated adult patients with acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) and associated clinical outcomes. A retrospective literature review was performed to identify articles published …

Exploring The Effects Service Dogs Have On Veterans With Ptsd, Shelby E. Reeves

Honors Undergraduate Theses

Post-Traumatic Stress Disorder (PTSD) is a mental illness resulting from exposure to a traumatic event. Symptoms of PTSD vary, but those affected commonly experience nightmares, flashbacks, hypervigilance, and trouble sleeping; they may also avoid people or situations that trigger traumatic memories. It is estimated that PTSD affects about 10-30% of all United States veterans. Additionally, traditional treatment methods have an average dropout rate of 25% among military personnel. Inadequate PTSD symptom management may lead to depression, anxiety, suicidality, isolation, unstable relationships, and substance misuse. The purpose of this review is to examine the current research concerning the use of service …

Left Ventricular Strains During Late Filling In A Preclinical Model, Saar Peles

Honors Undergraduate Theses

Understanding the mechanisms governing left ventricular function and dysfunction is critical to analyze cardiovascular disorders and gaining insights into possible therapies. Left ventricular function can be evaluated using Magnetic Resonance Imaging (MRI). Cardiac displacements and corresponding strains are then computed from the imaging data. In measuring and assessing the left ventricle’s motion, images are taken either in the short axis (top-down) or long axis (side) views. In this project, we will use DENSE MRI data, which measures the displacements of individual tissue voxels during the cardiac cycle.

After extracting the myocardial tissue by segmenting the MR images, strains are computed …

Systematic Literature Review Of Cognitive Behavioral Treatments For Patients With Classical, Secondary, And Idiopathic Trigeminal Neuralgia, Linnea B. Herzog

Honors Undergraduate Theses

Trigeminal neuralgia is a painful neuralgia with a complicated pathology that is not clearly understood. Due to the ambiguity of the condition, patients often have to search for medical providers that specialize in trigeminal neuralgia, and even with the guidance of a specialist, some patients do not respond well to treatment.¹ Despite the uncertainty surrounding the specifics of the disease, there are treatments available that can provide some level of pain relief for patients suffering from this disorder. When a patient does not respond well to medical therapy, surgery can be the next appropriate step in patient care management. …

Understanding Reasons For Electing Gap Years Between Undergraduate Education And Medical School And The Impact Of Gap Years On The Student Experience Of Medical Education, Haroon Rashid

Honors Undergraduate Theses

Gap years have grown in popularity among many students attempting to go to medical school in recent years. According to the Association of American Medical Colleges (AAMC), more than half of matriculated students now have taken time off between their undergraduate studies and medical school. While many claim benefits to taking gap years, research on the impacts of these experiences on medical students is largely nonexistent. This study aims to qualitatively analyze the gap year phenomena and its impacts on medical students through semi-structured interviews conducted at the University of Central Florida College of Medicine. Through these interviews, the researchers …

The Role Of Igf-1 In Geriatric Skin, Amber Castellanos

Browse all Theses and Dissertations

Keratinocytes are cells that largely occupy the epidermis layer of our skin and function to protect against DNA damage induced by ultraviolet radiation. Keratinocytes rely on the activation of the IGF-1 receptor in order to carry out an appropriate response to UV-B radiation. Keratinocytes themselves do not express the IGF-1 ligand; IGF-1 is produced by fibroblasts found in the dermis layer of the skin. With age, fibroblasts become senescent and this interferes with their ability to produce IGF-1 for the epidermal IGF-1R. This occurrence may aid in understanding why geriatric individuals are at greatest risk for developing nonmelanoma skin cancers, …

Impact Of Passive Range Of Motion Exercises And Stretching In Knee Osteoarthritis Pain During Walking, Dominique Marchelle Ottonello

Browse all Theses and Dissertations

Knee osteoarthritis (KOA), is globally prevalent source of disability for the elderly. This degenerative malady progresses with age and has no cure. It manifests in gait changes and affects overall quality of life. Exercise therapy has been shown to improve knee joint range of motion, stiffness and pain due to KOA. This improvement is due in part to the direct relationship between muscle strength and joint stability. The purpose of this study is to examine how a passive range of motion (ROM) exercises and stretching regimens affect gait-alterations and associated pain from KOA experienced during walking. Nine KOA subjects were …

Smoke Inhalation, Lung Function, And Heart Rate In Wildland Firefighters, Jordan E. Nelson

All ETDs from UAB

Given the close proximity to the fire front and limited use of respiratory protection, wildland firefighters are exposed to elevated levels of biomass smoke during regular occupational shifts. Due to the complex composition of biomass smoke, the relationships relating biomass smoke exposure to health outcomes has yet to be elucidated. In addition to occupational exposures, increasing intensity of wildfire events may place communities within close proximity to wildfires at risk of biomass smoke exposure. This study aimed to assess exposures to biomass smoke particles and quantify respiratory and cardiovascular health responses during active fire events using novel monitoring techniques. Personal …

Rna Polymerase I Elongation Kinetics: A Biochemical And Global Study Of A Cancer Therapeutic Target, Catherine Elizabeth Scull

All ETDs from UAB

My graduate research has focused on understanding the elongation kinetics of RNA polymerase I (Pol I), the enzyme responsible for synthesizing ribosomal RNA (rRNA), and defining how inhibition of ribosome biogenesis may be used as a cancer therapeutic strategy. Here, I have defined key biophysical features of Pol I and I have expanded the field’s understanding of Pol I elongation by: 1) characterizing the enzymatic properties of Pol I by mutational analysis of the polymerase itself, and by 2) elucidating the role of DNA sequence on Pol I arrest and nucleolytic cleavage activity. In recent years, Pol I has become …

Electrospinning Piezoelectric Fibers For Biocompatible Devices, Bahareh Azimi, Mario Milazzo, Andrea Lazzeri, Stefano Berrettini, M. Jasim Uddin, Zhao Qin, Markus J. Buehler, Serena Danti

Chemistry Faculty Publications and Presentations

The field of nanotechnology has been gaining great success due to its potential in developing new generations of nanoscale materials with unprecedented properties and enhanced biological responses. This is particularly exciting using nanofibers, as their mechanical and topographic characteristics can approach those found in naturally occurring biological materials. Electrospinning is a key technique to manufacture ultrafine fibers and fiber meshes with multifunctional features, such as piezoelectricity, to be available on a smaller length scale, thus comparable to subcellular scale, which makes their use increasingly appealing for biomedical applications. These include biocompatible fiber-based devices as smart scaffolds, biosensors, energy harvesters, and …

Peace. Love. Youth. (In) Yoga: Development Of A Mental Health Program Among Adolescents Living In The Inner City, Sherilyn Jonnell Garner

All ETDs from UAB

Adolescence is a unique developmental stage during which physical, cognitive, social, and emotional changes occur simultaneously and the traumatic effects of adverse childhood experiences (ACEs) can be particularly salient for the emotional and cognitive development of adolescents as they navigate and adjust to the social environment (Blakemore & Mills, 2014). Seventy-seven percent of Black adolescents have unmet mental health needs, and only 13% of those adolescents receive services compared to 31% of White adolescents. Meeting mental health needs of Black adolescents is imperative as their mental health needs continue to grow and resources become increasingly scarce. Innovative, culturally acceptable, accessible …

Developing An Indicator System For A Healthy City: Taking An Urban Area As A Pilot, Tingting Li, Yong Fang, Dewei Zeng, Zumin Shi, Manoj Sharma, Huan Zeng, Yong Zhao

Walden Faculty and Staff Publications

Purpose: The Healthy Cities Project is an important strategy for global health. This study aimed to develop a scientific and appropriate indicator system for the evaluation of a Healthy City in Chongqing, China. Methods: Data were collected via a review of government documents, focus group discussions, and in-depth interviews. A total of 34 government documents were reviewed to build the indicator database based on our previous studies. The first round of focus group discussions, which involved eight health-related experts, was conducted to form the indicator system framework. In-depth interviews with 15 experts from government departments were conducted to design …

What Influences Trainee Decisions To Practise In Rural And Regional Australia?, Alexa Seal, Catherine Harding, Joe Mcgirr

Medical Papers and Journal Articles

Although international medical graduates (IMGs) make up a substantial part of the Australian rural general practice workforce, most research on factors associated with rural practice has focused on Australian medical graduates (AMGs). This study aimed to determine whether there were differences between IMGs and AMGs in terms of these factors. Registrars in training and recent fellows (Fellowship of the Royal Australian College of General Practitioners/ Fellowship of the Australian College of Rural and Remote Medicine) who participated in training in rural and regional Australia were surveyed about practice models and rural practice. Almost two-thirds of participants were practicing or intending …

Agency, Autonomy And Euthanasia, George Mendz, David Kissane

Medical Papers and Journal Articles

Agency is the human capacity to freely choose one’s thoughts, motivations and actions without undue internal or external influences; it is distinguished from decisional capacity. Four well-known conditions that can deeply affect agency are depression, demoralization, existential distress, and family dysfunction. The study reviews how they may diminish agency in persons whose circumstances may lead them to consider or request euthanasia or assisted suicide. Since agency has been a relatively neglected dimension of autonomous choice at the end of life, it is argued that to respect the autonomy of individuals, it is essential to establish their agency.

Maternal Mortality Among African American Women In The State Of Georgia, Causes, Policy, And Ethical Considerations, Zahra Shahin, Isabella M. Hardwick, Nancy Jeffery, Jalisa Jordan, William Mase

Department of Health Policy and Community Health Faculty Publications

Background

The U.S. is currently one of thirteen countries where maternal mortality rates (MMR) is worse now than it was fifteen years ago. Reducing maternal mortality is one of the significant challenges facing the health system in the United States, especially in the State of Georgia, which has one of the highest MMR in the nation. The purpose of this review is to explore the causes, policy, and ethical contextual factors contributing to increased maternal mortality rates among African American women in the State of Georgia. Also, identifying and addressing weaknesses and gaps that exist in the healthcare system and …

Nasa Dugo (‘It’S In The Blood’): Lay Conceptions Of Hypertension In The Philippines, Gideon Lasco, Jhaki Mendoza, Alicia Renedo, Maureen L. Seguin, Benjamin Palafox, Lia M. Palileo-Villanueva, Arianna Maever L. Amit, Antonio L. Dans, Dina Balabanova, Martin Mckee

Development Studies Faculty Publications

Introduction: Understanding explanatory models is important for hypertension, a leading risk factor for cardiovascular disease and stroke. This article aims to determine what adult patients with hypertension in the Philippines attribute their condition to, how these views might be explained and what the implications are for hypertension management. Methods: This is a qualitative study drawing on 71 semistructured interviews (40 initial and 31 follow-up) and four focus group discussions with patients diagnosed with hypertension. The setting was urban and rural low-income communities in the Philippines. Results: Four prominent perceived causes were identified—genetics, heat, stress and diet—for what patients refer to …

Self-Report Motor Competence In Adolescents Aged 12-18 Years In Regional And Rural Victoria (Australia), Mandy S. Plumb, Beth Hands, Fleur Mcintyre, Amanda Timler

IHR Papers and Journal Articles

Background: Poor motor skills are an increasing issue for adolescents in our local communities. In regional Victoria, almost 20% of children starting school in 2018 were considered at risk or developmentally vulnerable in the domain of physical health and wellbeing.

Purpose: The aim of the current study was to examine factors (how adolescents perceive their fine and gross motor skills, activities of daily living, comparison to peers) of motor competence that may be important to adolescents in regional Victoria, Australia, using the Adolescent Motor Competence Questionnaire (AMCQ).

Methods: A sample of 183 Australian adolescents ([138 females ( …

Detection Of Low-Level Egfr C.2369 C>T (P.Thr790met) Resistance Mutation In Pre-Treatment Non-Small Cell Lung Carcinomas Harboring Activating Egfr Mutations And Correlation With Clinical Outcomes, Linda Ye, Nima Mesbah Ardakani, Carla Thomas, Katrina Spilsbury, Connull Leslie, Benhur Amanuel, Michael Millward

IHR Papers and Journal Articles

Increasing evidence points to the presence of low-level de novo T790M mutations in patients with non-small cell lung carcinoma (NSCLC) harboring activating EGFR mutations. We utilized digital PCR (dPCR), a highly sensitive gene mutation detection method, to detect pre-treatment T790M mutations in NSCLC tumor samples and correlated the T790M status with clinical features and patient outcomes. DNA extracted from pre-treatment NSCLC tumor tissue with known activating EGFR mutations, diagnosed between October 2010 and May 2017 at PathWest laboratory, was used to perform targeted dPCR for quantitative detection of T790M mutations. T790M was detected in 42 of 109 pre-treatment samples (38.5%). …

Fatherhood Too Soon. Anxiety, Depression And Quality Of Life In Fathers Of Preterm And Term Babies: A Longitudinal Study, Ingrid Beatrice Petersen, Julie Anne Quinlivan

IHR Papers and Journal Articles

Introduction: Fathers are increasingly recognized as playing a critical role in the family unit and emotional development of children. The birth of a preterm baby can be confronting, yet there is limited research that explores how preterm birth might impact on father’s emotional wellbeing and quality of life. The aim of the study was to monitor quality of life and psychological wellbeing in a group of fathers to explore if a preterm birth altered outcomes in these two domains.

Methods: Institutional ethics committee approval was obtained. Australian men (N = 1000) were recruited in the antenatal period via their …

Association Between Pelvic Inflammatory Disease, Infertility, Ectopic Pregnancy And The Development Of Ovarian Serous Borderline Tumor, Mucinous Borderline Tumor And Low-Grade Serous Carcinoma, Louise Stewart, C J.R Stewart, Katrina Spilsbury, P A. Cohen, S Jordan

IHR Papers and Journal Articles

Objective: Risk factors for ovarian borderline tumors and low-grade serous carcinoma (LGSC) are poorly understood. The aim of this study was to examine the association between infertility, pelvic inflammatory disease (PID), endometriosis, ectopic pregnancy, hysterectomy, tubal ligation and parity and the risk of serous borderline tumor (SBT), mucinous borderline tumor (MBT) and LGSC.

Methods: This was a population-based cohort study using linked administrative and hospital data. Participants were 441,382 women born between 1945 and 1975 who had been admitted to hospital in Western Australia between 1 January 1980 and 30 June 2014. We used Cox regression to estimate hazard ratios …

Perceptions Of Surgeons On Surgical Antibiotic Prophylaxis Use At Aga Khan Hospital, Dar Es Salaam., Elizabeth Elibariki Mmari

Theses & Dissertations

Introduction: Surgical site infections are a major cause of morbidity and mortality among operated patients. The use of antibiotic prophylaxis in prevention and reduction of incidence of surgical site infection is widespread. In spite of the accessibility of universal and national guidelines for surgical prophylaxis, recent studies surveying the present routine of prophylaxis have demonstrated overutilization of a wide range antibacterial medications for a single patient. Few studies have shown qualitatively factors influencing this, and perceptions of surgeons on surgical antibiotic prophylaxis use. Unfortunately, none of these studies have been done in Tanzania.

Objective: To describe the perceptions of surgeons …