Medical Specialties Commons^™

Dancing Around Infertility: The Use Of Metaphors In A Complex Medical Situation, Angela L. Palmer-Wackerly, Janice L. Krieger

Department of Communication Studies: Faculty Publications

People use metaphors to cognitively frame their experiences as well as to explain those experiences to others, especially in complex medical situations. However, previous research has not fully explored the extent to which metaphors may be helpful or harmful to achieving well-being. This investigation fills this gap by identifying and explaining metaphor use in the context of infertility. Guided by self-determination theory, in-depth interviews were conducted with 22 women and men who had experienced an inability to conceive a child. Analysis of participant narratives yielded 10 prominent metaphors that reflect how participants’ need for competence, autonomy, and relatedness were (and …

Comprehension Of Randomization And Uncertainty In Cancer Clinical Trials Decision Making Among Rural, Appalachian Patients, Janice L. Krieger, Angela L. Palmer-Wackerly, Phokeng M. Dailey, Jessica L. Krok-Schoen, Nancy E. Schoenberg, Electra D. Paskett

Department of Communication Studies: Faculty Publications

Comprehension of randomization is a vital, but understudied, component of informed consent to participate incancer randomized clinical trials(RCTs). Thisstudy examines patient comprehension of the randomization process as well as sources of ongoing uncertainty that may inhibit a patient’s ability to provide informed consent to participate in RCTs. Cancer patients living in rural Appalachia who were offeredanopportunitytoparticipateinacancertreatmentRCT completed in-depth interviews and a brief survey. No systematic differences in randomization comprehension between patients who consented and those who declined participation in a cancer RCT were detected. Comprehension is conceptually distinct from uncertainty, with patients who had both high and low comprehension experiencing …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Foster Parents' Perceptions And Beliefs About Social Emotional Development In Infants And Toddlers, Susan R. Noel

DNP Projects

Infants and toddlers placed in foster care are at increased risk for social-emotional (SE) development dysregulation. Foster parents, as surrogate parents, play a critical role in a young child having the potential for healthy SE development. The transactional model supports the complex and intricate interplays and transactions of the child, the foster parent, and the environment that influences a healthy SE development. This qualitative descriptive study explored foster parent knowledge, behavioral cue recognitions, and role perception regarding a young child's SE development. Although the sample size was small, the study provides relevant information, from the on-going experiences of foster parents, …

An Analysis Of Cognitive Factors In School-Aged Children With Emotional Disturbance And Adhd Using The Wisc-Iv, Maria Fragnito Maddalo

PCOM Psychology Dissertations

Children with Emotional Disturbance and ADHD demonstrate social, emotional, and behavioral symptoms that present many challenges for School Psychologists because of differences between each student’s individual needs. A high level of comorbidity exists for these children with internalizing and externalizing symptoms. Little is known about neurocognitive factors as they relate to ED versus ADHD. The current study examined the cognitive profiles of a total of 58 children with ED versus ADHD, using the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). Index scores that were examined included Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed. The groups were compared …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

The Prospective Association Between Positive Psychological Well-Being And Diabetes, Julia K. Boehm, Claudia Trudel-Fitzgerald, Mika Kivimaki, Laura D. Kubzansky

Psychology Faculty Articles and Research

Objective: Positive psychological well-being has protective associations with cardiovascular outcomes, but no studies have considered its association with diabetes. This study investigated links between well-being and incident diabetes.

Methods: At study baseline (1991-1994), 7,800 middle-aged British men and women without diabetes indicated their life satisfaction, emotional vitality, and optimism. Diabetes status was determined by self-reported physician diagnosis and oral glucose tolerance test (screen detection) at baseline and through 2002-2004. Incident diabetes was defined by physician-diagnosed and screen-detected cases combined and separately. Logistic regression estimated the odds of developing diabetes controlling for relevant covariates (e.g., demographics, depressive symptoms). Models …

A Narrative Inquiry: Case Leaders' Perspectives On Resilience In Hospice Care, Gail Renee Ahern

Antioch University Dissertations & Theses

This study is a qualitative inquiry examining the perspective of team leaders within hospice organizations on resilience. The goal of this study was to examine how hospice leaders build resilience for themselves and within the interdisciplinary teams they lead. A framework of three key theories of leadership—servant, spiritual and authentic—was used to help in understanding the similarities and differences of the interviewed leaders and their key themes and practices. The eight leaders interviewed were from a range of hospices in diverse settings and all were directly responsible for leading interdisciplinary teams. In-depth phenomenological interviewing was undertaken until the study reached …

Analyzing The Effect Of Complaints, Investigation Of Allegations, And Deficiency Citations On The Quality Of Care In United States Nursing Homes (2007 – 2012), Kevin E. Hansen

USF Tampa Graduate Theses and Dissertations

The quality of care in nursing homes has been evaluated from many varying perspectives, but few studies have analyzed quality in light of complaints made to state survey agencies by residents, their family members, or other individuals interacting with the nursing home. This study analyzed complaints, investigation of complaint allegations, and complaint-related deficiency citations to determine their effect, if any, on the quality of care in nationwide nursing homes. Using the Online Survey Certification and Reporting (OSCAR) survey dataset for facility characteristics and the complaint investigation dataset for outcomes of complaint investigation, analyses conducted included descriptives, correlations, conceptual mapping for …

Saying ‘No’: A Biographical Analysis Of The Experiences Of Women With A Genetic Predisposition To Developing Breast/Ovarian Cancer Who Reject Risk Reducing Surgery, Doreen Molloy

Theses: Doctorates and Masters

Background: Genetic technologies have identified some of the genes implicated in cancer susceptibility. Women with mutations in breast/ovarian cancer-susceptibility genes (BRCA1 and 2) have a lifetime combined risk of breast/ovarian cancer of more than 80%. Risk reducing surgery (RRS) reduces cancer risk by as much as 90% in high risk populations. Despite this, some BRCA1/2 mutation-positive women say no to RRS.

Purpose: To illuminate an understanding of why women at high risk of developing breast/ovarian cancer say no to risk reducing surgery (RRS).

Design: Denzin’s (1989) interpretive biography was combined with Dolby-Stahl’s (1985) literary folkloristic methodology to provide a contextualised …

Sugihara Causality Analysis Of Scalp Eeg For Detection Of Early Alzheimer's Disease, Joseph C. Mcbride, Xiaopeng Zhao, Nancy B. Munro, Greg A. Jicha, Frederick A. Schmitt, Richard J. Kryscio, Charles D. Smith, Yang Jiang

Sanders-Brown Center on Aging Faculty Publications

Recently, Sugihara proposed an innovative causality concept, which, in contrast to statistical predictability in Granger sense, characterizes underlying deterministic causation of the system. This work exploits Sugihara causality analysis to develop novel EEG biomarkers for discriminating normal aging from mild cognitive impairment (MCI) and early Alzheimer's disease (AD). The hypothesis of this work is that scalp EEG based causality measurements have different distributions for different cognitive groups and hence the causality measurements can be used to distinguish between NC, MCI, and AD participants. The current results are based on 30-channel resting EEG records from 48 age-matched participants (mean age 75.7 …

Impact Of Improving Throughput In The Emergency Department, Katherine J. Edrington

Doctor of Nursing Practice (DNP) Projects

The purpose of this project was to evaluate the patient experience in the emergency department (ED) and in the inpatient setting while correlating increased throughput and patient outcomes at a suburban Acute Care facility in Ohio. The culture in the organization has lacked accountability and ownership of the patients. The ED admitted length of stay (ALOS) was 358 minutes in the beginning of 2013. For the first time in the organization’s history, the ED ALOS is now typically less than the recommended benchmark of 300 minutes. A report of findings among ED’s surveyed showed the ALOS best practice is 244 …

Developmental And Cultural Perspectives On Children’S Postoperative Pain Management At Home, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Outpatient surgery is extremely common in children, and approximately 4 million children experience significant pain after surgery in the USA each year. Management of children's postoperative pain in the home setting is suboptimal and is impacted by characteristics of children and parents, as well as the larger family and cultural context. In particular, developmental status of the child, parental beliefs regarding pain expression and analgesic use in children, cultural values and language barriers can affect management of children's postoperative pain. Targeting the myriad barriers to children's pain management by capitalizing upon the use of tailored interventions may help bridge the …

Evaluating The Effectivesness Of Information Sources Regarding Hiv Among Gold Miners In Quảng Nam, Noah Landesberg

Independent Study Project (ISP) Collection

Young migrant males in strenuous manual labor environments represent a high-­‐risk population for the transmission of HIV/AIDS. In Vietnam, gold miners are representative of this high-­‐risk population. Phước Sơn district, Quảng Nam province is home to much of Vietnam’s mining activity and has a comparatively high rate of HIV. Previous studies have been done on HIV/AIDS prevalence in Quảng Nam as well as related knowledge and practices. This analysis of a 2014 questionnaire examines the effects of varying information sources on HIV/AIDS knowledge. The sample of workers was mostly male and between 25 and 49 years old. Migrants made up …

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Adults With Intellectual Disability Or Autism Spectrum Disorder. Executive Summary, Kimberly I. Snow Mhsa, Ba, Stuart Bratesman Mpp, Taryn Bowe, Julie T. Fralich Mba

Disability & Aging

This chartbook describes Maine’s historical trends in meeting the needs of adults with ID/ASD through institutional and community based services in comparison to other states; a detailed analysis of the population’s utilization of different types of services and their costs in SFY 2010; the implementation of the Supports Intensity Scale (SIS) as a means of identifying the supports needs of the adults with ID/ASD; and the complement of providers serving this population in Maine.

Hiv Drug Resistance Among Infants And Children In South Africa: How Efficient Is Genotypic Testing?, Ellen Hendrix

Independent Study Project (ISP) Collection

Background: South Africa has the largest prevalence of HIV infection. This epidemic impacts adults as well as the pediatric population. The presence of drug-resistant mutations to antiretroviral therapies among infants and children is on the rise. Few studies have been conducted on this topic. Objective: The study aims to determine whether drug resistance testing in the form of genotypic testing is cost-effective when deciding whether to switch to a new HIV antiretroviral therapy following drug failure. Method: An interactive research approach is taken by collecting primary data from experts in this field. Secondary sources including guidelines from the World Health …

Effects Of Video Enhancement In A Stated-Choice Experiment On Medical Decision Making, Susanne Hoffmann, Joachim Winter, Francis G. Caro, Alison Gottlieb

Gerontology Institute Publications

Background. The internet can be useful in administering stated-choice experiments to understand medical decision making and refine the content of patient decision aids. In internet-based stated-choice experiments, video and audio files can be used to provide information to respondents. Quality of data may or may not be affected.

Objectives. In a methodological experiment concerned with administration of a stated-choice experiment on the internet concerned with knee-replacement surgery, we compared the data quality obtained with video-enhanced and conventional text formats.

Methods. Members of the RAND Corporation’s American Life Panel and 50 years of age or older (n=1616) were randomly assigned to …

Factor Structure Of The Cpt-Ii, Mary Vertinski

UNLV Theses, Dissertations, Professional Papers, and Capstones

The current study investigates the factor structure of the Conners' Continuous Performance Test-II (CPT-II) in four pediatric samples of participants: (a) patients with traumatic brain injury, (b) healthy controls, (c) patients with various clinical diagnoses, and (d) all of the previously mentioned subjects combined. Confirmatory factor analyses (CFA) were used to investigate a one-, three- and four-factor model fit of the data. None of the models examined were an adequate fit for the data; however, it appears that the four-factor model seemed to be the best fitting of the models examined. Failure to find reasonably adequate fit precluded further analyses.

Formulating Effective And Accessible Population-Based Colorectal Cancer Screening Programs, Danielle Luffman

Independent Study Project (ISP) Collection

Colorectal cancer, a type of carcinoma originating in cells of the colon or rectum, continues to rank as the third most prevalent cancer worldwide with 1.36 million cases and the fourth most fatal with 693,881 deaths during 2012. In an attempt to alleviate the burden of colorectal cancer throughout society, governments and non-governmental organizations continue to implement population-based cancer screening programs. These programs, typically designed by a federal authority, offer free screening tests to a given population for a certain type of cancer on a routine basis. National systematic screening programs have effectively reduced the incidence of and mortality from …

Designing A Mechanical Linkage Capable Of Decreasing Force Transfer From The Facemask To The Protective Helmet When Loading Occurs, Levi Hansen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction

Sports that involve extensive personal contact have a high incidence of injury. The introduction of regulations mandating the use of personal protective equipment in these sports is the most common injury control strategy (Marshall et al., 2002). Negligible attention has been paid to the mechanical linkage between the facemask and helmet as a means of reducing force transfer from the facemask, through the helmet, and to the head and or neck of the athlete.

Methods

A novel prototype mechanical linkage of reasonable simplicity that provides 360° of freedom in motion capable of decreasing force transfer from the facemask to …

Government Efforts And Personal Opinion Explain The Medicalization Of Pregnancy And Childbirth Through Time In Lower Mustang, Nepal, Ruth Baker

Independent Study Project (ISP) Collection

The way that women approach pregnancy and childbirth in rural Nepal has seen an amazing change in the past twenty to thirty years. The medicalization of this entire process, from pre-­‐ to post-­‐natal care, comes with government efforts for the increased education of women about family planning, nutrition, hygiene, and the proposed benefits of institutional versus in-­‐home delivery. In 9 villages of Lower Mustang, interviews conducted with Government Health Post workers, Female Health Volunteers, and women of different ages sought to discern personal experience and opinion about pregnancy and childbirth from the perspective of both local women and those with …

The End Of An Era: The Cancer Stem Cell Hypothesis And Its Therapeutic Implications, Emily Paton

Independent Study Project (ISP) Collection

Cancer, a leading cause of death in many developed countries, has become a global health burden. Much of the drain on healthcare systems has resulted from the high cost and ineffectiveness of conventional cancer treatments, which often lead to cancer relapse or metastasis. The failures of chemotherapy, radiation, and surgery have been elucidated by the cancer stem cell (CSC) hypothesis, which postulates that a small percentage of tumor cells drive tumorigenesis. These cells can sustain cancer through their capacity to self-renew and differentiate into specialized tumor cell types, similar to how healthy stem cells maintain healthy tissues. Conventional cancer treatments …

Longer Gestation Among Children Born Full Term Influences Cognitive And Motor Development, Emma V. Espel, Laura M. Glynn, Curt A. Sandman, Elyssia Poggi Davis

Psychology Faculty Articles and Research

Children born preterm show persisting impairments in cognitive functioning, school achievement, and brain development. Most research has focused on implications of birth prior to 37 gestational weeks; however, the fetal central nervous system continues to make fundamental changes throughout gestation. Longer gestation is associated with reduced morbidity and mortality even among infants born during the period clinically defined as full term (37–41 gestational weeks). The implications of shortened gestation among term infants for neurodevelopment are poorly understood. The present study prospectively evaluates 232 mothers and their full term infants (50.4% male infants) at three time points across the first postnatal …

Hearing The Patient Voice: Using Video Intervention/Prevention Assessment To Understand Teens With Cystic Fibrosis, Susan Horky Lscw, Laura E. Sherman Msw, Julie Polvinen, Michael Rich Md

Patient Experience Journal

This qualitative study asked two questions: 1) How do teens with cystic fibrosis (CF) feel about their treatments; and 2) What factors lead teens to adhere, or not adhere, to treatments. To answer these questions we used an innovative approach (Video Intervention/Prevention Assessment or VIA), to learn about the experiences of teens with CF. We loaned video camcorders to teens with CF and asked them to create visual narratives of their lives. Researchers logged and coded videotapes, identifying themes that arose from the material. A primary theme was “Doctors don’t understand.” Participants also highlighted the value of routines and parental …

Current Perspectives On Primary Care Workforce, Kathleen Klink

Health Workforce Speaker Series

No abstract provided.

Alzheimer's Therapeutics Targeting Amyloid Beta 1-42 Oligomers I: Abeta 42 Oligomer Binding To Specific Neuronal Receptors Is Displaced By Drug Candidates That Improve Cognitive Deficits, Nicholas J. Izzo, Agnes Staniszewski, Lillian To, Mauro Fa, Andrew F. Teich, Faisal Saeed, Harrison Wostein, Thomas Walko Iii, Anisha Vaswani, Meghan Wardius, Zanobia Syed, Jessica Ravenscroft, Kelsie Mozzoni, Colleen Silky, Courtney Rehak, Raymond Yurko, Patricia Finn, Gary Look, Gilbert Rishton, Hank Safferstein, Miles Miller, Conrad Johanson, Edward Stopa, Manfred Windisch, Birgit Hutter-Paier, Mehrdad Shamloo, Ottavio Arancio, Harry Levine Iii, Susan M. Catalano

Sanders-Brown Center on Aging Faculty Publications

Synaptic dysfunction and loss caused by age-dependent accumulation of synaptotoxic beta amyloid (Abeta) 1-42 oligomers is proposed to underlie cognitive decline in Alzheimer's disease (AD). Alterations in membrane trafficking induced by Abeta oligomers mediates reduction in neuronal surface receptor expression that is the basis for inhibition of electrophysiological measures of synaptic plasticity and thus learning and memory. We have utilized phenotypic screens in mature, in vitro cultures of rat brain cells to identify small molecules which block or prevent the binding and effects of Abeta oligomers. Synthetic Abeta oligomers bind saturably to a single site on neuronal synapses and induce …

Alzheimer's Therapeutics Targeting Amyloid Beta 1–42 Oligomers Ii: Sigma-2/Pgrmc1 Receptors Mediate Abeta 42 Oligomer Binding And Synaptotoxicity, Nicholas J. Izzo, Jinbin Xu, Chenbo Zeng, Molly J. Kirk, Kelsie Mozzoni, Colleen Silky, Courtney Rehak, Raymond Yurko, Gary Look, Gilbert Rishton, Hank Safferstein, Carlos Cruchaga, Alison Goate, Michael A. Cahill, Ottavio Arancio, Robert H. Mach, Rolf Craven, Elizabeth Head, Harry Levine Iii, Tara L. Spires-Jones, Susan M. Catalano

Sanders-Brown Center on Aging Faculty Publications

Amyloid beta (Abeta) 1-42 oligomers accumulate in brains of patients with Mild Cognitive Impairment (MCI) and disrupt synaptic plasticity processes that underlie memory formation. Synaptic binding of Abeta oligomers to several putative receptor proteins is reported to inhibit long-term potentiation, affect membrane trafficking and induce reversible spine loss in neurons, leading to impaired cognitive performance and ultimately to anterograde amnesia in the early stages of Alzheimer's disease (AD). We have identified a receptor not previously associated with AD that mediates the binding of Abeta oligomers to neurons, and describe novel therapeutic antagonists of this receptor capable of blocking Abeta toxic …

On Reporting The Onset Of The Intention To Move, Uri Maoz, Liad Mudrik, Ram Rivlin, Ian Ross, Adam Mamelak, Gideon Yaffe

Psychology Faculty Books and Book Chapters

"In 1965, Hans Kornhuber and Luder Deecke made a discovery that greatly influenced the study of voluntary action. Using electroencephalography (EEG), they showed that when aligning some tens of trials to movement onset and averaging, a slowly decreasing electrical potential emerges over central regions of the brain. It starts 1 second ( s) or so before the onset of the voluntary action1 and continues until shortly after the action begins. They termed this the Bereitschaftspotential, or readiness potential (RP; Kornhuber & Deecke, 1965).2 This became the first well-established neural marker of voluntary action. In that, the RP allowed for more …

Assessing Technologies For Information-Seeking On Prostate Cancer Screening By Low-Income Men, Susan W. Mcroy, Emily M. Cramer, Hayeon Song

Journal of Patient-Centered Research and Reviews

Purpose: This paper presents a multipart investigation of the benefits and challenges in deploying automated question-answering as an alternative to web-based searching to provide information about prostate cancer screening for low-income men age 40 years and older.

Methods: The study comprised: 1) a survey assessing current use of the Internet, mobile phones and texting; 2) a controlled observational study of both web-based searching and automated question-answering for information about prostate cancer; and 3) a formative field study in which subjects interacted with a health department nurse using text messages.

Results: Survey results suggest the target population has greater access to, …