Medicine and Health Sciences Commons^™

The Lived Experience Of Novice Senior Nurse Leaders During Organizational Role Transitions, Sharon Kauffman

Student Theses, Dissertations and Capstones

The qualitative interpretive phenomenological study investigates the lived experiences of novice senior nurse leaders, who have transitioned to new organizational roles within a single healthcare organization in the Southeast United States. Senior nurse leaders have complex responsibilities but may not have training adequate to lead masterfully at new organizational levels. This phenomenon is poorly understood. Senior nurse leaders who do not develop the appropriate interpersonal skills and systems thinking may experience a sense of role insufficiency. Yet, strong leadership among senior nurses is vital to the successful performance of healthcare organizations, given the current landscape of change and the rapidity …

Decreasing Nurses’ Stress In The Emergency Room Utilizing Mindfulness Meditation, Andrea L. Entus

Student Theses, Dissertations and Capstones

Background: Emergency Room (ER) nurses are challenged both physically and emotionally, and are repeatedly exposed to severe occupational stress (d'Ettorre & Greco, 2016; Duffy et al., 2015). For example, some stressors are demands from patients and physicians, long hours, complex diagnoses, and a fast pace (Hunsaker et al., 2015). A considerable number of nurses experience work-related interpersonal conflict, secondary traumatic stress, and other stress disorders, which negatively affects the quality of patient care they deliver (Westphal et al., 2015). Purpose: The purpose of this evidence-based practice project was to implement a mindfulness meditation intervention to decrease emergency room nurses’ stress. …

Enacting Narrative Pedagogy: The Lived Experience Of Prelicensure Baccalaureate Nursing Faculty, Suzanne Wurster

Student Theses, Dissertations and Capstones

Background. Prelicensure baccalaureate nursing faculty manage up to five generations in the classroom. Each generation has its own unique educational needs and learning styles, which present pedagogical challenges for nursing faculty. Students need to be prepared to provide care for complex patients in a changing healthcare environment. Research-based pedagogies, such as narrative pedagogy, enable faculty to use teaching and learning approaches in which students can translate knowledge acquired in the classroom to their clinical practice. Purpose. The purpose of this study was to understand the lived experience of prelicensure nursing faculty as they implemented narrative pedagogy in the classroom or …

Examining Factors Associated With Failure To Fail In The Clinical Setting, Dee A. Adkins

Student Theses, Dissertations and Capstones

Clinical nursing faculties struggle to assign failing grades to underperforming students in the clinical setting; this is known as failure to fail. Qualitative literature has revealed common factors for failure to fail; however, quantitative studies are required to determine the extent to which those factors affect the faculty’s decision-making process. The purpose of the study is to explore the relationship between face-implicating factors and the faculty’s likelihood of failing students in the clinical setting who do not meet the passing criteria. What is the relationship between face-implicating factors and the nursing faculty’s likelihood of passing students in the clinical setting …

The Lived Experiences Of Thriving Nursing Students, Nicole M. Mentag

Student Theses, Dissertations and Capstones

As the demand for qualified nurses increases, nursing education is responsible for preparing students for healthcare challenges. Nursing education focuses on academic success measures, including licensure examination passage, graduation rates, and grade point average. Though these outcomes are important, they fail to capture the complexities of student success. Thriving, the conceptual framework for this study, is a phenomenon within higher education that expands on the traditional measures of success and integrates cognitive and psychological aspects of the college experience. This study utilized interpretive phenomenology to understand the meanings of the lived experiences of thriving undergraduate nursing students. Semi-structured interviews were …

Comparison Of Pre-Licensure Bsn Student Outcomes Between Team-Based And Traditional Learning Methods, Tressa Jane Pedroff

Student Theses, Dissertations and Capstones

Background: The increased complexity of healthcare systems requires nurses to have a different skillset, largely not provided in today’s nursing curricula. Team-based learning is one possible teaching strategy believed to increase nurses’ critical thinking and teamwork self-efficacy. Currently, there is insufficient objective data available that demonstrates improved academic performance and perceptions of teamwork skills in pre-licensure Bachelor of Science in Nursing students. Purpose: The purpose of this study is to compare the effects of team-based learning and traditional lecture-format teaching strategies among pre-licensure Bachelor of Science in Nursing students in a Foundations of Nursing Practice course. Theoretical Framework: Vygotsky’s social …

Com Outlook_Winter_2020, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

The Effect Of Dental Probiotic Use On The Inhibition Of Streptococcus Mutans: A Clinical Study, Halah Thanoon

Student Theses, Dissertations and Capstones

Brief Background: Streptococcus mutans (S.mutans) is the pioneering pathogenic bacteria responsible for the initiation of dental caries. Controlling S.mutans activity using dental probiotics may have an impact on caries incidence and oral health in general. Objective: To evaluate the effects of commercially available dental probiotics (PRO-Dental, Hyperbiotics Inc.) usage for 60 days in a row on the cariogenic bacterium S.mutans in high caries risk patients with high or low S.mutans counts at baseline and 30 days after the discontinuation of use. Methodology: A total of 30 consenting adult patients with high caries risk (according to NSU CAMBRA protocol) without any …

Are Finger Width Palpation, Tape Measure, And Caliper Reliable, Valid, And Accurate To Diagnose Diastasis Recti Abdominis (Dra)?, Tamara L. Roehling

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: Diastasis recti abdominis (DRA) is a condition where the medial rectus bellies separate at the linea alba. A DRA can negatively impact posture, trunk and pelvic stability, pelvic floor muscular control, respiration, trunk movement, and abdominal viscera support. The purpose of this research is to determine whether tools used in the clinic effectively screen for DRA. Specifically, this study compared the reliability, validity, and diagnostic accuracy of finger width, tape measure, and calipermeasurements to the clinical best standard, ultrasound imaging. Additionally, the study investigates whether there is a correlation between DRA and low back pain and pelvic floor dysfunction. …

Impact Of Psychological Factors On Adolescents With Anterior Knee Pain, Mitchell Selhorst

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem and purpose: Psychological factors impact self-report measures of pain and function among adults with anteriorknee pain (AKP), but we do not know (1) if psychological factors also impact pain, self-reported function, and objective measures of function among adolescents with AKP and (2) if a psychological intervention would affect function. The purpose of this dissertation is to determine the impact of psychological factors on pain, self-reported function, and objective measures of function in adolescents with AKP.

Methods: This dissertation was prospective, with three separate studies. Two were cross-sectional observational studies, and the third was a randomized-controlled trial. Patient questionnaires were …

Development And Validation Of The Self-Management Assessment For The Residuum And Prosthesis (S.M.A.R.T.), Daniel Joseph Lee

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Self-management is the process of preventing complications through meticulous self-care and vigilant self-inspection. Persons with long-term impairments or diseases must follow an effective self-management routine as part of their care regimen to reduce the risk of injury. Assessment of knowledge as it relates to self-management is standard care forpersons with chronic disease and long-term impairments. Identifying knowledge gaps allows for patient-centered educational interventions to be targeted to the person’s area of deficit. Despite the importance of self-management in persons with limb loss, there is currently no valid and reliable way to objectively assess knowledge specific to this population.

Purposes: …

Impact Of Physical Therapist Attitudes And Beliefs On The Outcomes Of Patients With Low Back Pain, Adam P. Rufa

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction: Physical therapist attitudes and beliefs about low back pain (LBP) have been shown to influence patientbeliefs and affect clinician behavior. The purpose of this project was to investigate physical therapist attitudes and beliefsabout LBP, identify factors that influence those beliefs, and determine if attitudes and beliefs have an impact on patientoutcomes. Methods: This study was a retrospective cohort design that included a survey of physical therapists and thecollection of patient outcomes from Focus on Therapeutic Outcomes, Inc. (FOTO). Attitudes and beliefs were measured using the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain Attitudes and …

Impact Of Strength And Range Of Motion On Loss Of Ambulation And Functional Change Measures In Boys With Dmd, Tina Duong

Department of Physical Therapy Student Theses, Dissertations and Capstones

Duchenne muscular dystrophy (DMD) is an x-linked lethal progressive disorder affecting boys who are typically diagnosed due to motor delays or weakness. Key features include loss of motor function throughout the lifetime resulting in early mortality from cardiopulmonary complications in the late 2nd and 3rd decades of life. Rates of progression are variable yet sequential due to a typical pattern of motor weakness that occurs from proximal to distal muscle groups. Current standards of care include contracture management and Glucocorticosteroids (GC). Timed function tests have been used to understand and predict loss offunctional milestones such as walking, getting off the …

Effects Of Cueing On Sit To Stand Transfers In Parkinson Disease, Rebecca Ann Martin

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Individuals with Parkinson Disease (PD) often experience difficulty transferring from sit to stand (STS). Current evidence suggests cues which promote an external attentional focus improve gait and transfers for individuals with PD. However, this research utilizes cues which are difficult to replicate in clinical or natural environments making the findings difficult to generalize or implement. Purpose: The primary purpose of this study is to determine the effect of 3 different explicit cues on STS for individuals with PD. Additionally we sought to determine if, in this population, a relationship exists between latency of movement initiation and postural sway …

Financial Impact Associated With Implementation Of The Low Back Pain Clinical Practice Guideline In Outpatient Physical Therapist Practice, Heidi Kosakowski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Dysfunction and disability arising from low back pain (LBP) affects more people than any other condition globally, and results in changes to the quality of life for many individuals. The financial burden of managing low back pain is among the highest both in the United States and globally. Clinical practice guidelines (CPGs) provide recommendations on patient management strategies and have the potential to simultaneously improve patient outcomes and lower health care costs. Limited evidence exists on the impact of CPG implementation on downstream medical costs that are incurred after physical therapist care. A retrospective observational study was conducted that examined …

Neurophysiological Effects Of Dry Needling To The Thoracolumbar Junction Multifidi In Subjects With Low Back Pain And Decreased Hamstring Length, Nicole Ginette Clark

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: Dry needling is becoming increasingly popular in the treatment of neuromusculoskeletal conditions. The neurophysiological effect of treatment, specifically those related to the sympathetic nervous system (SNS) is considered a relevant physiological mechanism contributing to a patient’s rehabilitation. The primary purpose of this study was toinvestigate the neurophysiological effects of dry needling, as measured by sympathetic outflow and muscular flexibility. A secondary purpose of this study was to determine if changes in SNS activity correlate with clinically meaningful improvements in pain and disability. Design: This was a prospective, double-blind randomized clinical trial. Subjects: The study sample consisted of …

Correlation Of Trust And Outcomes Following Physical Therapy For Chronic Low Back Pain, Kory J. Zimney

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Trust is a key component for developing therapeutic alliance. Improvements in trust have been found to improve outcomes forpatients receiving psychiatric and medical physician care. Current trust measurement scales have not been utilized in a physical therapy setting and no studies have explored the relation of trust in provider to physical therapy outcomes.

Purpose: The primary goal was to explore the correlation of patient trust measured at various points within the therapeutic encounter to the change in outcome measurements after receiving physical therapy care.

Research Design and Methods: Non-experimental correlational quantitative analysis of patient trust in their physical therapist …

Does The Range Of Walking Speeds Produced By Community-Dwelling Older Adults Relate To Or Predict Function, Disability, And Community Mobility?, Michelle Germaine Criss

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Self-selected (SSWS) and maximum walking speeds (MWS) are frequently studied and related to multiple body systems, function, falls, and mortality. Walking at a slow speed voluntarily or measuring a range of walking speeds (WS), however, has rarely been investigated. Purpose: The aims ofthis project were to explore a proposed measure of WS adaptability called total walking speed range(TWSR), to assess the reliability and validity of slow walking speed (slowWS) as a component of TWSR, to assess if TWSR could predict function, disability or community mobility, and finally, to compare thepredictive ability of TWSR to single walking speeds. Methods: This …

Comprehensive Physical Function Measure For The Intensive Care Unit: The Use Of Rasch Analysis And Item Response Theory, Michelle Lynn Peterson

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction: This dissertation study provides an in-depth examination of current intensive care unit (ICU) physical function assessment measures and synthesizes these into one comprehensive measurement tool that addresses multiple areas of function.

Background: A recent systematic review identified 26 measures being used in ICU clinical research, although a subsequent systematic review revealed only 14 of those physical function assessment measures have psychometric properties evaluated specifically for the ICU setting. A robust physical function assessment measure for use in the ICU, allows for determination of efficacy of treatment, comparison of studies across settings, and broader interpretation of results.

Specific Aims: Aim …

Therapeutic Autoethnography: From Epiphany To Catharsis, Kelsey Railsback

Department of Family Therapy Dissertations and Applied Clinical Projects

A large percentage of the U.S. population has been directly or indirectly affected by sexual violence. The Rape, Abuse, and Incest National Network (2020b) reported 433,648 victims annually, and Dillinger (2018) reported 747,408 registered sex offenders living in the United States. As a victim-survivor of sexual violence, I have a unique narrative in that I chose to work therapeutically with sexual offenders. Reactions from my family, friends, and colleagues have varied from surprise to alarm, but I hope this dissertation inspires readers to take a second look. Readers who are mental health professionals may consequently be motivated to work with …

Perceptions And Understanding Of Research Situations As A Function Of Consent Form Characteristics And Experimenter Instructions, Jeremy D. Heider, Jessica L. Hartnett, Emmanuel J. Perez, John E. Edlund

Faculty Publications

Two studies examined how research methodology affected participant behaviors. Study 1 tested (a) consent form perspective (1st, 2nd, or 3rd person) and (b) information on participants’ right to sue upon perceptions of coercion, ability to recall consent information, and performance on experimental tasks. Unexpectedly, participants who received instructions without the right to sue information had significantly better recall of their research rights. Study 2 manipulated (a) consent form complexity (presence or absence of jargon) and (b) the detail of verbal instructions (simple, elaborate); participants who received a consent form with simpler language spent more time on a difficult task, and …

Simulating Medical Isolation: Communicatively Managing Patient And Medical Team Safety, Elizabeth Spradley, R. Tyler Spradley

Faculty Publications

Reducing hospital acquired or associated infections (HAIs) is a national public health priority. HAIs pose risks to patients, visitors, and medical personnel. To better understand how to communicatively manage safety in medical isolation, data was collected with nursing students simulating medical isolation in a high-fidelity simulation with a medical mannequin with C. difficile. Observations of nursing students and faculty revealed four distinct communication practices: social support, patient education, humor, and storytelling. Conclusions include recommendations to intentionally design these communication practices into high-fidelity medial isolation simulations and scale up these communication practices in routines of safety.

Can Athletes Be Tough Yet Compassionate To Themselves? Practical Implications For Ncaa Mental Health Best Practice No. 4, Andreas Stamatis, Paul J. Deal, Grant B. Morgan, Jeffrey S. Forsse, Zacharias Papadakis, Sarah Mckinley-Barnard, Eric M. Scudamore, Panagiotis Koutakis

Faculty Publications

Recent tragic events and data from official NCAA reports suggest student-athletes’ wellbeing is compromised by symptoms of mental health (MH) disorders. Self-compassion (SC) and mental toughness (MT) are two psychological constructs that have been shown effective against stressors associated with sports. The purpose of this study was to investigate SC, MT, and MH in a NCAA environment for the first time and provide practical suggestions for MH best practice No.4. In total, 542 student-athletes participated across Divisions (Mage = 19.84, SD = 1.7). Data were collected through Mental Toughness Index, Self-Compassion Scale, and Mental Health Continuum–Short Form. MT, SC (including …

A Novel Item-Allocation Procedure For The Three-Form Planned Missing Data Design, Kyle M. Lang, E. Whitney G. Moore, Elizabeth M. Grandfield

Kinesiology, Health and Sport Studies

We propose a new method of constructing questionnaire forms in the three-form planned missing data design (PMDD). The random item allocation (RIA) procedure that we propose promises to dramatically simplify the process of implementing three-form PMDDs without compromising statistical performance. Our method is a stochastic approximation to the currently recommended approach of deterministically spreading a scale's items across the X-, A-, B-, and C-blocks when allocating the items in a three-form design. Direct empirical support for the performance of our method is only available for scales containing at least 12 items, so we also propose a modified approach for use …

Identification Of A Novel Disorder With Cholestasis, Liver Fibrosis And Congenital Diarrhea Due To Organic Solute Transporter Alpha Deficiency, Emily Gao

Yale Medicine Thesis Digital Library

BACKGROUND: Much of our understanding of normal liver pathophysiology comes from studying patients with liver disease who remain undiagnosed after a comprehensive workup. Searching for diagnoses among such cohorts has benefits both for the underserved patients with idiopathic liver disease, but also for science as a whole. Unbiased genomic analysis of patients with undiagnosed disease has yielded remarkable results, including clinically actionable diagnoses in children and adults, as well as the discovery of novel genetic diseases. Thus, we posit that among pediatric patients with undiagnosed liver disease, there may be previously unrecognized Mendelian causes.

METHODS: We report a 2.5 year …

Sports And Talent Selection In Early Adolescence, Ahmet Uzun

Health Sciences

Early adolescence is the fastest development period between childhood and adulthood. It is understood that this situation is important in determining the differences between ages in terms of academic and sports studies in adolescence development. It should be remembered that differences in the motor power of individuals, especially in early adolescence (11-14 years), may affect athletes' athletic achievement and future athlete training levels.In this case, some physical fitness tests are required to better monitor the health and education levels of individuals in childhood and adolescence. It is seen that these tests are widely used especially in childhood and adolescence. In …

Combination Of Dasatinib With Chemotherapy In Previously Untreated Core Binding Factor Acute Myeloid Leukemia: Calgb 10801, G. Marcucci, S. Geyer, K. Laumann, W. Zhao, D. Bucci, G. L. Uy, W. Blum, A. K. Eisfeld, J. E. Kolitz, R. A. Larson, +7 Additional Authors

Journal Articles

© 2020 by The American Society of Hematology. Acutemyeloid leukemia (AML)witheither t(8;21)(q22;q22)or inv(16)(p13q22)/t(16;16)(p13;q22) is referred to as core binding factor (CBF) AML. Although categorized as favorable risk, long-term survival for these patients is only ∼50% to 60%. Mutated (mut) or overexpressed KIT, a gene encoding a receptor tyrosine kinase, has been found almost exclusively in CBF AML and may increase the risk of disease relapse. We tested the safety and clinical activity of dasatinib, a multi-kinase inhibitor, in combination with chemotherapy. Sixty-one adult patients with AML and CBF fusion transcripts (RUNX1/RUNX1T1 or CBFB/MYH11) were enrolled on Cancer and Leukemia Group …

Pulmonary Artery Aneurysm: A Review, M. Gupta, A. Agrawal, A. Iakovou, S. Cohen, R. Shah, A. Talwar

Journal Articles

No abstract provided.

The Impact Of United States Medical Licensing Exam (Usmle) Step 1 Cutoff Scores On Recruitment Of Underrepresented Minorities In Medicine: A Retrospective Cross-Sectional Study., M. Williams, E. J. Kim, K. Pappas, O. Uwemedimo, L. Marrast, R. Pekmezaris, J. Martinez

Journal Articles

Background and Aims:United States Medical Licensing Exam (USMLE) scores are the single, most objective criteria for admission into residency programs in the country. Underrepresented minorities in medicine (URiM) are found to have lower USMLE scores compared to their White counterparts. The objective of this study is to examine how USMLE step 1 cutoff scores may exclude self-reported URiM from the residency interview process across various specialties. Methods:This was a retrospective cross-sectional study of 10 541 applicants to different residency programs at Zucker School of Medicine at Hofstra/Northwell Health between May 2014 and May 2015. We identified Blacks and Hispanics as …

Mir193a Modulation And Podocyte Phenotype, A. Jha, S. Saha, K. Ayasolla, H. Vashistha, A. Malhotra, K. Skorecki, P. C. Singhal

Journal Articles

Apolipoprotein L1 (APOL1)-miR193a axis has been reported to play a role in the maintenance of podocyte homeostasis. In the present study, we analyzed transcription factors relevant to miR193a in human podocytes and their effects on podocytes' molecular phenotype. The motif scan of the miR193a gene provided information about transcription factors, including YY1, WT1, Sox2, and VDR-RXR heterodimer, which could potentially bind to the miR193a promoter region to regulate miR193a expression. All structure models of these transcription factors and the tertiary structures of the miR193a promoter region were generated and refined using computational tools. The DNA-protein complexes of the miR193a promoter …