Medicine and Health Sciences Commons^™

Advanced Practice Providers: How Do We Improve Their Organizational Engagement?, Molly Condit, Paula Hafeman

College of Nursing Faculty Research and Publications

Advanced practice providers (APPs) are integral members of the multidisciplinary health care team, providing access to high quality and cost-effective patient care. Despite the consistent increase in demand for APPs, these practitioners often lack role clarity, frequently resulting in poor job satisfaction and retention. Establishing an advanced practice provider council within organizations is a positive step in providing APPs with a platform for increasing their visibility, peer support, and decision-making power, thereby improving their engagement within the organization.

Efficacy Of Natural Family Planning Methods, Richard J. Fehring

College of Nursing Faculty Research and Publications

No abstract provided.

Effects Of Women’S Weight Changes On Adverse Outcomes In A Second Pregnancy, Marianne E. Weiss, Olga Yakusheva, Kandice A. Kapinos

College of Nursing Faculty Research and Publications

Objective

To estimate the effects of women’s weight changes in four sequential perinatal periods across first and second pregnancies (pregravid, first gestation, interpregnancy, second gestation) on adverse maternal and neonatal outcomes in the second pregnancy while accounting for interdependencies in weight across the four periods (Aim 1) and to test the influence of the sequential path of weight changes through the four perinatal periods of risk on maternal and neonatal outcomes in the second pregnancy (Aim 2).

Design

Secondary data analysis.

Setting

Thirty-one Wisconsin hospitals.

Sample

Women with 24,795 linked records from first and second births from 2006 through 2013. …

The Relationship Between Biofilm Production And Human Respiratory Cell Attachment And Invasion By Acinetobacter Baumannii, Rachel A. Pearson

Theses and Dissertations

Acinetobacter baumannii is an opportunistic gram-negative bacterial pathogen that causes many nosocomial infections in immunocompromised individuals. Common infections include catheter-associated urinary tract infections, ventilator-associated pneumonia, skin and soft tissue infections, and bloodstream infections that often lead to septicemia. Increasing multidrug resistance (MDR) in A. baumannii warrants new approaches to understanding its virulence mechanisms and pathogenicity. As a first step in infection, A. baumannii can attach to host cells, providing a surface for the bacteria to grow and perhaps facilitating biofilm formation and subsequent tissue invasion. In this study, we evaluated antibiotic resistance and characterized biofilm formation, attachment, invasion, and surface …

Coordination Of Airway Protective Behaviors And Swallow: Effects Of Afferent Feedback And Sex., Alyssa D. Huff

Electronic Theses and Dissertations

This dissertation represents a series of studies describing mechanisms related to breathing, upper airway behaviors and their coordination in man and animal. Chapter two transformed the cough swallow aspiration protocol from the cat (previous work) to the human introducing a new strategy, volume targeting, in swallow breathing coordination. Chapter three evaluated swallow breathing coordination at increasing altitudes. As respiratory drive altered due to hypoxia and hypocapnia, swallow breathing coordination shifted toward inspiration occurring during the transition from inspiration and expiration. The collection of the two previous studies led to development of an animal model to evaluate volume targeting and …

Exploring Normalization Of Deviance And Examining Factors That Predict Culture Of Safety In The Operating Room., M. Imelda Wright

Electronic Theses and Dissertations

Patient safety in the operating room is a prodigious responsibility of OR nurses as the OR environment is complex and laden with risk, which increases surgical patients’ risk for adverse events. The dissertation presents the topic of patient safety in the operating room (OR), the concept of normalization of deviance, and a mixed-methods study with an exploratory sequential design that involved three phases. The dissertation comprises of five chapters. Chapter One presents an introductory overview of the salience of patient safety as well as its relevance to the unique environment of the OR. Chapter Two presents a concept analysis of …

Electrospun Fibers And Nanoparticles For The Prevention Of Sexually Transmitted Infections., Kevin Michael Tyo

Electronic Theses and Dissertations

Human immunodeficiency virus-1 (HIV-1) and herpes simplex virus 2 (HSV-2) affect hundreds of millions of people worldwide, with women disproportionately impacted by these infections. Currently, only oral pre-exposure prophylaxis (PrEP) is approved specifically for the prevention of HIV-1, but is challenged with adverse side effects associated with long-term use. Topical delivery platforms, such as gels and films, deliver agents directly to the female reproductive tract, but are limited in providing transient-release. The technology of polymeric electrospun fibers may serve as alternative topical delivery platform to the female reproductive tract. In these studies, we fabricated electrospun fibers comprised of different polymers …

Factors Influencing Consumers’ Choices Of Oral Hygiene Products: A Cross-Sectional Study, Faiza Awais, Hazik Bin Shahzad, Kiran Naheed, Ayyaz Ali Khan

Makara Journal of Health Research

Background: Environment, peer-groups, and salespersons influence consumers’ purchasing decisions regarding oral hygiene products. Other influences include various cultural, social, demographic, and socioeconomic factors. This study was designed to determine factors motivating and influencing consumers while choosing oral hygiene aids. Methods: 410 patients (age, 10–70 years), who visited the outpatient department of Sheikh Zayed Medical Complex, Lahore, Pakistan, were subjected to a close-ended questionnaire survey. Factors investigated included cost, packaging, media advertisement, perceptions, and previous experiences. Results: The cost of oral-hygiene products (82%) were the biggest influence. Advertisements influenced 55% of consumers in their purchase decisions regarding oral …

Correlation Between Carotid Intima-Media Thickness And Serum Tnf-Alpha Levels In Female With Rheumatoid Arthritis Of Different Ethnicities: A Single-Centre Experience In Malaysia, Kek Xin Yi, Asrul A. Wahab, Mohamad Norazrin Mohd Abas, Siti Amira Kamarul Abdul Wahid, Faridah Hanun Othman, Mohd. Shahrir Mohamed Said

Makara Journal of Health Research

Background: Rheumatoid arthritis (RA) is a destructive chronic inflammatory disease with intra- and extra-articular manifestations. It is associated with accelerated formation of arteriosclerosis. The aim of this study was to ascertain the correlation between endothelial dysfunction using carotid intima–media thickness (cIMT) and tumor necrosis factor-alpha (TNF-α) levels among the three main ethnic groups in Malaysia: Malay, Chinese, and Indian. Methods: This cross-sectional study included 23 females with RA belonging to three different ethnic groups who were free from cardiovascular risk factors. Blood sample was taken from each patient to measure serum TNF-α level, C-reactive protein (CRP), and erythrocyte …

Dimensions Of Stress In Parents Of Children With Autistic Spectrum Disorder, Amirah Hazwani Binti Bakri, Noor Aishah Binti Rosli, Zarinah Binti Mohd Kasirun, Mohd Hairul Nizam Bin Md Nasir, Fazidah Binti Othman, Tengku Sarina Aini Binti Tengku Kasim

Makara Journal of Health Research

Background: Parents of children with Autistic Spectrum Disorder (ASD) are at an increased risk for stress and other mental health problems. While treatment is mainly focused on the child, somehow parents’ stress is exacerbated. Accordingly, the purpose of this study was to identify the sources of stress in the parents of children with ASD. Methods: The 52 parents of children with ASD who participated in the study completed the child domain (CD) and parent domain (PD) subscales of the Parenting Stress Index Fourth Edition (PSI-4). Subsequently, the scores of the PSI-4 subscales were analyzed and compared. Results: …

The Effects Of A Maternal Personality, Children’S Behavioral Characteristics, And Parenting Styles On The Dental Anxiety Of 3- To 6-Year-Old Children, Sevgin Ibis, Mustafa Erhan Sari, Lemak Tomak, Zehra Babadagi, Koray Mehmet Zeynel Karabekiroglu

Makara Journal of Health Research

Background: Many individual and environmental factors cause dental anxiety in children. The aim of this study was to examine the effects of a maternal personality, children’s behavioral characteristics, and parenting styles on the dental anxiety of three- to six-year-old children. Methods: The parents of 230 children who applied to the Department of Pediatric Dentistry, Faculty of Ondokuz, Mayıs University were involved in this study. The “Temperament and Character Inventory”, “Child Behavior List”, and “Parenting Attitude Scale” were applied to the volunteer parents. All data were statistically analyzed (p < 0.05). Results: From the results of determining the …

Factors Influencing Pre-Marital Sexual Intercourse Among Unmarried Young Individuals In Cambodia, Vanthy Mai, Sirinan Kittisuksathit

Makara Journal of Health Research

Background: Sexual behavior of young individual are recognized as one of the main health priority in society. In Cambodia, young individual who hasten to involve in sexual intercourse, contributes to their high risk of various health issues, particularly those related to sexual reproductive health. This research will identify specific characteristics that have strong relationships with pre-marital sexual intercourse among unmarried young individuals in Cambodia. Methods: A binary logistic regression in a multivariate analysis of secondary data was applied from the 2014 cambodian demographic and health survey. the data about pre-marital sexual intercourse were assessed with the CDHS questionnaire …

Does Healthy Lifestyle Contribute To Physical And Mental Health Among University Students?, Dian Caesaria Widyasari, Sherly Saragih Turnip

Makara Journal of Health Research

Background: Little is known of how a healthy lifestyle and its health outcomes are related in university students in Indonesia. This study examined the association between healthy lifestyle markers (diet, sleeping hours, physical exercise, smoking, alcohol intake) and health outcomes (perceived physical fitness, psychological distress) among undergraduate students at university in Indonesia. We also examined gender-related patterns. Methods: A total of 616 undergraduate students participated in two cross-sectional studies carried out between 2011 and 2013. Six close-ended questions were used to measure health behaviors and perceived physical fitness. The Hopkin Symptoms Checklist-25 was used to measure psychological distress. …

An Experimental Model Of Chemically-Induced Ulceration Of The Buccal Mucosa Of Mus Musculus, Erik Idrus, Pratiwi Dwi Hartanti, Dewi Fatma Suniarti, Sri Redjeki Prasetyo, Yuniardini Septorini Wimardhani, Ajiravudh Subarnbhesaj

Makara Journal of Health Research

Background: Ulceration caused by chemical agents used in dental practice for in-office or home-used is a common event, resulting in discomfort and pain. Treatments for such conditions are still being developed, requiring extensive experiments both in vitro and in vivo studies. At present, a standardized experimental mouse model for mucosal ulceration caused by a chemical inducer to study the pathogenesis of ulceration and to develop medications for treatment of ulceration is still not available. The aim of this study was to create a chemically induced model of ulceration of the buccal mucosa of mice. Methods: An in vivo …

Veterans Using Mindfulness Practice To Cope With Trauma & Operational Stress Injuries, T'Challa Azhar Stuckey

All Theses And Dissertations

Psychological distress due to military operations is impacting returning veterans mentally and physically. The purpose of exploring literature relating to veterans is to determine if mindfulness-based interventions (MBI) are beneficial in managing the symptoms of posttraumatic stress disorder (PTSD). Data generated by the research question “What are the therapeutic benefits of mindfulness-based interventions, if any, in managing the symptoms of PTSD among veterans?” were explored to determine the effectiveness of using mindfulness-based coping skills to manage symptoms such as hyperarousal, intrusive recollections, and avoidance. The studies that were analyzed reported on veterans who have served in the U.S. Armed Forces …

Corticostriatal Functional Connectivity Of Bothersome Tinnitus In Single-Sided Deafness, Jennifer Henderson-Sabes, Yingying Shang, Philip L. Perez, Jolie L. Chang, Seth E. Pross, Anne M. Findlay, Danielle Mizuiri, Leighton B. Hinkley, Srikantan S. Nagarajan, Steven W. Cheung

All Faculty Scholarship

Subjective tinnitus is an auditory phantom perceptual disorder without an objective biomarker. Bothersome tinnitus in single-sided deafness (SSD) is particularly challenging to treat because the deaf ear can no longer be stimulated by acoustic means. We contrasted an SSD cohort with bothersome tinnitus (TIN; N = 15) against an SSD cohort with no or non-bothersome tinnitus (NO TIN; N = 15) using resting-state functional magnetic resonance imaging (fMRI). All study participants had normal hearing in one ear and severe or profound hearing loss in the other. We evaluated corticostriatal functional connectivity differences by placing seeds in the caudate nucleus and …

Feasibility And Acceptability Of A Self-Report Activity Diary In Families Of Children With And Without Special Needs, Bethany Forseth, Paula E. Papanek, Linda Bandini, Dale A. Schoeller, Andrea Moosreiner, Kathleen J. Sawing, Kimberley Zvara, Michael Fendrich, Michele Polfuss

Exercise Science Faculty Research and Publications

This study was conducted to examine the feasibility and acceptability of a self-report activity diary completed by parents and older children to assess the child's daily activity in children with and without special needs. The study included 36 child/parent dyads stratified by child age and diagnosis. Parents (n = 36) and children ≥13 years (n = 12) were asked to report on the child's daily activity using an activity diary. Feasibility was determined based on successfully returned diaries and acceptability via post-study interview. Activity diaries were submitted by 94% of the parents and 100% of the children, with 83% and …

Distal Splenorenal Shunt (Dsrs) In Children With Extrahepatic Portal Hypertension, Zia Ur Rehman, Zafar Nazir

Department of Surgery Docs

Portal hypertension (PH) is infrequent in children as compared to adults. Currently, repetitive endoscopic ablation of varices is standard treatment. However, endoscopic facilities are not readily available in resource-limited settings. We reviewed the indications, operative morbidity, mortality, shunt patency and re-bleeding episodes in nine patients (age range 6-16 years, M:F 6:3) who had DSRS for recurrent GI bleeding not responding to endoscopic treatment and hypersplenism. DSRS is a safe and effective treatment alternative in resource limiting setting for preventing bleeding and improving hypersplenism in children with extrahepatic portal hypertension.

Maternal Digital Media Use During Infant Feeding And The Quality Of Feeding Interactions, Alison K. Ventura, Jordyn Levy, Sierra Sheeper

Kinesiology and Public Health

Experimental research with parents of older children suggests parents’ engagement with technological devices (e.g., television, mobile devices) in the presence of their children decreases the quality of parent-child interactions. Many mothers report frequent use of technological devices during infant feeding but, to date, few studies have explored the potential association between maternal technological device use during feeding and the quality of infant feeding interactions. To this end, mothers (n = 25) and their infants (mean age = 19.3 ± 6.4 weeks) participated in a within-subject, experimental study to explore associations between maternal digital media use and feeding interaction quality …

Reducing Emergency Department Length-Of-Stay And Overcrowding Through Team Triage, Kirsten Gisela Sizemore

Doctoral Dissertations and Projects

Emergency department (ED) overcrowding is an internationally studied phenomenon linked to adverse patient outcomes, including death. Early medical screening exams (MSE) may prevent morbidity and mortality. Yet, EDs struggle to evaluate, treat, and discharge patients within recommended and nationally monitored benchmark times. This evidence-based scholarly project explored if stationing an advanced practice provider (APP) in triage would improve door-provider-times, length-of-stay (LOS), and the left without being seen (LWBS) rate at a medical center ED in the southeastern United States. A pre- and post-intervention design compared benchmark times after a provider triaged alongside the registered nurse (RN) during times of high …

The Lived Experience Of Practical Nursing Faculty Who Have Transitioned To A Concept-Based Curriculum As Required By The North Carolina Nursing Curriculum Revision Project, Lora Poole Bartlett

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological qualitative study was to understand the lived experience of practical nursing (PN) faculty who have transitioned from a systems-based curriculum to a concept-based curriculum (CBC) as required by the North Carolina nursing revision project. In recent years, nursing education transformation has been a topic of interest among government organizations, the healthcare system, nursing leaders and organizations, and faculty of nursing programs. However, literature specifically on how faculty perceive and transition into these new innovative methods of teaching is minimal. The participants in the study were PN faculty employed by North Carolina community colleges and …

Increasing Asymptomatic Chlamydia Screening In The Ed, Mikyung Kim

Doctoral Dissertations and Projects

The Centers for Disease Control and Prevention (CDC) recommends chlamydia screening in young women and others who are at risk based on scientific evidence related to the effectiveness of screening to prevent chlamydial infection. Female patients may visit the emergency department (ED) with symptoms such as urethritis, abdominal pain, or vaginal spotting. For men, most complaints are urinary problems, discharge from the penis, and testicular pain. However, most infected patients are never symptomatic and have no abnormal physical findings. Therefore, the question that spurred this project was, “Why aren’t asymptomatic patients screened more often?” Furthermore, “Why are the CDC screening …

The Use Of Patient Diaries In The Cvicu To Prevent Post-Intensive Care Syndrome And Improve Family Satisfaction With Care, Denise M. Goodberlet

Doctoral Dissertations and Projects

Patients in the ICU are at risk for adverse physiological and psychological symptoms including anxiety, depression and confusion common with post intensive care syndrome. The presence of these symptoms is correlated with poor satisfaction with care and decreased quality of life. This creates stress for patients as well as the families of these patients. This evidence-based practice (EBP) project sought to answer the clinical question: For patients and families in the cardiovascular intensive care unit (CVICU), can participating in an intensive care diary program, when compared to standard of care, decrease the symptoms and incidence of post-intensive care syndrome in …

Teachback: The Implementation Of The Teach-Back Method To Improve Patient Satisfaction With Care Transitions, Elizabeth M. Breton

Doctoral Dissertations and Projects

Patient education at discharge from the hospital is an essential element to continuation of care and management of chronic health issues. While many elements may contribute to patient satisfaction with discharge education, use of the teach-back method has been found to improve retention of discharge instruction, as well as increase patient confidence in chronic disease management and self-care at the time of discharge. Patient satisfaction with discharge education is a notable component of hospital reimbursement by national standards, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) results. Following education of nursing staff participating in …

Uncovering The Zeb1 Interactome To Identify Novel Regulators Of Metastatic Non-Small Cell Lung Cancer, Roxsan Manshouri

Dissertations and Theses (Open Access)

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death in the United States, due in part to the robust affinity of lung cancer cells to metastasize. Understanding the processes that contribute to metastasis provides promise for the discovery of novel therapeutic targets. Epithelial-tomesenchymal transition (EMT) is a proposed model for the initiation of metastasis. During EMT cell adhesion and polarity is reduced, allowing epithelial cancer cells to dissociate from the primary tumor and invade distant organs. The transcription factor zinc finger E-box-binding homeobox 1 (ZEB1) has been reported to uniquely correlate with NSCLC disease progression and to …

The Effect Of Traumatic Brain Injury On Tau Pathology By A Potential Seeding Mechanism, George Edwards Iii

Dissertations and Theses (Open Access)

The misfolding, aggregation and accumulation of specific proteins is the overarching concept in protein misfolding disorders (PMDs). The microtubule associated protein tau is known to form insoluble filaments known as neurofibrillary tangles (NFTs) composed of hyperphosphorylated tau (pTau) found in a subset of PMDs called tauopathies, such as Alzheimer’s disease (AD) and chronic traumatic encephalopathy (CTE), among others. Misfolded tau engenders a structurally alternative intermediate conformation that is prone to aggregate having amyloidogenic properties. Formation of amyloids, such as tau aggregates, is proposed to follow a nucleation-polymerization model where misfolded, soluble oligomeric seeds can trigger native proteins to misfold and …

The Role Of Membrane Domains In Protein And Lipid Sorting During Endocytic Traffic, Blanca B. Diaz-Rohrer

Dissertations and Theses (Open Access)

The lipid and protein composition of the plasma membrane (PM) must be tightly controlled to maintain cellular functionality, despite constant, rapid endocytosis. Because de novo synthesis of proteins and lipids is energetically costly, the cell depends on active recycling to return endocytosed membrane components back to the PM. For most proteins, the mechanisms and pathways of their PM retention remain unknown. The work presented here shows that association with ordered membrane microdomains is fully sufficient for PM recycling and that abrogation of raft partitioning leads to their degradation in lysosomes. These findings support a model wherein ordered membrane domains mediate …

Determination Of Thymic Epithelial Cell Composition And Proliferation During The Perinatal To Adult Transition, Scott Casey

Dissertations and Theses (Open Access)

T-cells develop in the thymus based on signaling from multiple stromal cell types, particularly thymic epithelial cells (TECs). The thymus develops rapidly during the perinatal time period (birth – 10 days in mice) before reaching a period of homeostasis (10 days – 6 weeks). The mechanisms that initially promote and subsequently limit expansion of the TEC compartment are not known. However, previous reports from our lab suggest that the Cyclin D1-RB-E2F pathway plays a key role in regulating the perinatal to adult transition. We have previously shown that inactivation in TEC of retinoblastoma (RB) family members through deletion of RB …

Identification And Molecular Analysis Of Dna In Exosomes, Jena Tavormina

Dissertations and Theses (Open Access)

Exosomes are heterogeneous nanoparticles 50-150nm in diameter. Exosomes contain many functional cargo components, such as protein, DNA, and RNA. While protein and RNA exosome content has been extensively studied, very little work has been done to characterize exosomal DNA. Here, we demonstrate that exosomal DNA is heterogeneous and its packaging into exosomes is dependent on the cell of origin. Furthermore, through a rigorous assessment of various isolation methods, we identify Size Exclusion Chromatography (SEC) as the best method for the isolation of exosomal DNA for downstream applications. Additionally, we evaluate the methylation status of exosomal DNA and demonstrate that exosomal …

A Signature Enrichment Design With Bayesian Adaptive Randomization For Cancer Clinical Trials, Fang Xia

Dissertations and Theses (Open Access)

Clinical trials in the era of precision medicine demand more flexible and efficient trial designs. Adaptive clinical trial designs allow pre-specified modifications of an on-going clinical trial and could shorten the trial duration. We reviewed five common types of adaptive clinical trials based on adaptation methods. In particular, outcome-randomization becomes more popular as it can assign more patients to the promising treatments based on the accumulated trial data. This data-driven allocation allows more patients to benefit from the trial, which is especially important for cancer patients. We compared different Bayesian outcome-adaptive randomization methods and discussed them from both methodological and …