Nursing Commons^™

Repetitive, Pre-Anesthetic Fasting And Malnutrition In A Pediatric Oncology Population Undergoing Radiation Therapy, Laura P. Santibáñez

Dissertations and Theses (Open Access)

Background: Pediatric oncology patients often experience nutritional status changes, particularly malnutrition, which may adversely affect their outcomes. Although the consequences of malnutrition are elucidated, its causes remain unclear. A possible cause of malnutrition in pediatric oncology patients is repetitive, pre-anesthetic fasting prior to non-invasive procedures and treatments, such as anesthesia-assisted radiation therapy (AART). This exploratory study investigated the association between repetitive, pre-anesthetic fasting and non-fasting days and malnutrition in pediatric oncology patients receiving AART.

Procedure: A retrospective cohort of 138 pediatric oncology patients (£ 10 years of age) who received any type of radiation therapy (RT) with or without anesthesia …

Treatment Recidivism In Adolescents With Mental Illness: A Focused Applied Medical Ethnography, Chukwudi C. Ekwemalor

Dissertations and Theses (Open Access)

Background

Treatment recidivism, described as frequent unplanned relapse readmissions, is a national problem predominant in adolescents with mental illness with significant socioeconomic consequences. Adolescents living with mental illness are a sub-culture of adolescence, the critical growth period of developmental and social transition from childhood to adulthood. The main triggers of treatment recidivism in this population are not fully understood from previous studies.

Purpose

The study purpose was to explore treatment recidivism with the following aims:

1. To illuminate treatment recidivism from the perspectives of recidivist adolescents with mental illness.

2. To describe the main factors that contribute to treatment recidivism …

Experiences Of Stress And Coping Over Time By Caregivers Of Stroke Survivors: A Mixed-Methods Approach, Fang Ye

Dissertations and Theses (Open Access)

Background/ Objectives: Caregivers of stroke survivors often experience physical and mental stress, decreased physical and emotional well-being, high burden of care, social isolation, and neglecting self-care. The majority of previous research studies have identified caregiver experiences during the first one-to-two years post stroke. Little is known about caregiver experiences beyond the first two years of the post- stroke recovery trajectory, indicating a need for longitudinal study of their experiences over time. Therefore, the objectives of this study were to 1) investigate caregiver experiences of stress and coping over 5-7 years post stroke using quantitative methods, and 2) explore through …

Role Of Stress And Social Resources On Biomarkers And Fatigue In Staff Nurses: A Biobehavioral Approach, Mona Cockerham

Dissertations and Theses (Open Access)

Purpose

Consecutive 12-hr workdays can contribute to increased stress and fatigue and negative biological responses in nurses, potentially compromising quality of patient care and safety. The primary purpose of this study was to assess changes in stress, fatigue, and biological responses (salivary cortisol and alpha-amylase) over three consecutive 12-hr workdays in acute care nurses and how stress and social resources function in predicting fatigue and biological responses.

Methods

In a prospective study, 81 acute care nurses completed questionnaires and provided saliva samples four times: pre-shifts and post-shifts of day 1 and day 3.

Results

Although stress and biological responses did …

Influences On Self-Care In Women With Heart Failure: A Pilot Study, Joy Corcione

Dissertations and Theses (Open Access)

Background: Heart Failure self-care becomes exceedingly difficult to perform as the disease progresses; therefore social support becomes important in facilitating heart failure self-care. Woman with heart failure represent a significant and growing vulnerable population. Women tend to have lower self-confidence in providing self-care, experience greater negative emotions, decreased social support, experience more adverse psychosocial factors affecting self-care and experience greater psychosocial adversity than do men. Self-care is vital in managing heart failure and social support greatly facilitates self-care behaviors.

Purpose: The purpose of this pilot study was to gain a deeper understanding about the sources of perceived social support and …

Information Processing Speed Impairment After Stroke, A Descriptive Study, Susan Alderman

Dissertations and Theses (Open Access)

Background Information processing speed (IPS) is an elemental cognitive function impacting multiple other functions including memory, attention, and executive function, and academic skills like arithmetic, reading and writing. However, little research has been done on IPS impairment in acute stroke. This article compares the frequency and severity of IPS impairment in mild and moderate stroke and its impact on quality of life.

Methods The longitudinal study of patients with mild stroke (NIHSS

Results Using linear mixed model regression, similar frequency and severity of IPS and memory impairments were noted, regardless of stroke severity, in the sample of 30 patients (60% …

Psychometric Performance Of The Arabic Versions Of The Cancer Behavior Inventory‐Brief And The Functional Assessment Of Cancer Therapy‐Breast In Saudi Arabia, Maaidah M. Algamdi Msn

Dissertations and Theses (Open Access)

Background: Arabic is the mother tongue of 26 countries, including Saudi Arabia where cancer is the fourth leading cause of death. Cancer is a sensitive issue in the Arabic population and a clear understanding of patients’ perceptions of self-efficacy for coping with cancer and quality of life helps assess interventions designed to facilitate optimal patient outcomes. In preliminary studies, the Cancer Behavior Inventory-Brief (CBI-B) was translated and back translated between English and Arabic, and reviewed for translational validity by an expert panel. The Arabic version of the CBI-B (CBI-BA) had acceptable evidence of translational validity with an overall translational validity …

Clinical And Demographic Variables Associated With Cognitive Deficits, Symptom Severity, And Duration After Concussive Injury In Adolescents: A Retrospective Study, Seema S. Aggarwal

Dissertations and Theses (Open Access)

Background: Concussions in adolescents are a public health concern with the growing popularity of high school sports. Recent legislation mandates that athletes who are suspected of a concussion be cleared to return-to-play by a clinician. More research is needed to develop a concussion predictive model to identify populations at risk for more severe and prolonged symptoms and long-term neurologic deficits.

Aims: The aims of this study were to (1) examine the effect of race and gender on neurocognitive and symptom scores and (2) determine which clinical (e.g., number of concussions, migraine history, learning disabilities/ attention deficit disorders) and demographic factors …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

No abstract provided.

Nutritional Status And Tuberculosis Risk In Adult And Pediatric Household Contacts, Omowunmi Aibana, Xeno Acharya, Chuan-Chin Huang, Mercedes C Becerra, Jerome T Galea, Silvia S Chiang, Carmen Contreras, Roger Calderon, Rosa Yataco, Gustavo E Velásquez, Karen Tintaya, Judith Jimenez, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children.

METHODS AND FINDINGS: We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used …

Community-Based Participatory Research To Improve Early Detection And Treatment Of Hypertension In A Suburban Community In Thailand, Chuncharaporn Sinsiri

Dissertations and Theses (Open Access)

Communities have a significant role in working with health personnel to detect new and previously diagnosed cases of high blood pressure during community BP screening programs. In Thailand there are many people with elevated BP who do not access care. The purpose of this Community-Based Participatory Research (CBPR) was to build a community partnership following the CBPR approach to develop a health program to improve early detection and treatment of hypertension. Three specific aims were: Aim 1. Using CBPR principles, describe the process of building a community partnership to develop a community health program to improve early detection and treatment …

Prevalence Of Steroid-Induced Hyperglycemia In Patients With Mantle Cell Lymphoma Receiving High Dose Steroids, Veronica Brady

Dissertations and Theses (Open Access)

Background

Hyperglycemia as a result of glucocorticoid administration (steroid-induced hyperglycemia [SIH]) occurs in 32-37% of adult patients with cancer both with and without previous history of diabetes. Patients diagnosed with mantle cell lymphoma (MCL) are often treated with chemotherapy regimens that include high dose steroids as first line therapy. Little is known about the prevalence of steroid-induced hyperglycemia in patients with MCL receiving high dose steroids. Moreover it is not known if how the resulting hyperglycemia is managed impacts time to relapse or death.

Purpose

The primary aim of this study was to determine the prevalence of SIH in MCL …

Parent Perceptions Of Patient Safety Culture In The Neonatal Intensive Care Unit, Madelene J. Ottosen

Dissertations and Theses (Open Access)

Background: Understanding and promoting a positive culture of patient safety within neonatal intensive care units (NICU) has been to shown to decrease threats to patient safety. Parents are an integral part of the NICU culture, yet little is known about how they perceive patient safety and what role they would find meaningful and appropriate for engaging in safety promotion activities in the NICU. Therefore the purpose of this study was to determine how neonatal parents conceptualize patient safety and their role within the Neonatal Intensive Care Unit (NICU).

Methods: Using an ethnographic qualitative approach, semi-structured interviews and field observations of …

Work-Related Musculoskeletal Disorders: Psychological Factors In Licensed Nurses, Cynthia Pipkins

Dissertations and Theses (Open Access)

Background: Physical risk factors for work-related musculoskeletal disorders (WMSD) among licensed nurses have been well established. Rehabilitation following WMSD traditionally focuses on physical dimensions, but both physical and psychological factors may be useful during rehabilitation, as suggested by the Fear Avoidance Model of Chronic Pain (FAMCP) and the Pain Experience Psychological View model (PE).

Purpose: The purpose was to describe demographic characteristics of nurses with and without WMSD and relationships among related psychological factors of pain (intensity, severity, and interference), personality traits (extraversion and neuroticism), and coping strategies (catastrophizing, diversion, reinterpreting, cognitive coping, fear avoidance, and depression) as postulated in …

Activity-Rest And Skin Temperature Circadian Rhythms And Sleep Patterns In Community-Dwelling Women, Kristina L. Leyden

Dissertations and Theses (Open Access)

Purpose: The purpose of the study was to explore activity-rest and temperature circadian rhythms and sleep patterns in ambulatory women of reproductive, perimenopausal, and postmenopausal stages. Study aims were to (1) correlate the patterns of activity-rest with skin temperature and determine (2) lead-lag relation between activity-rest and circadian temperature rhythm, (3) stability of activity-rest patterns during work and non-work days, (4) duration of actigraphy sampling sufficient to reliably capture activity-rest patterns, and (5) sleep parameters in participating women across reproductive stages.

Design: Analysis of extant data sets.

Sample and Setting: Seven community-dwelling women, 27-to-54-years old

Methods: Participants wore an actigraph …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

No abstract provided.

Association Of Cardiorespiratory Fitness And Adiposity With Inflammatory Biomarkers In Young Adults, Eunduck Park

Dissertations and Theses (Open Access)

Background: Low grade systemic inflammation plays a key role in atherosclerosis, and C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor- alpha (TNF -a), markers of systemic inflammation, are associated with cardiovascular events and adiposity. Cardiorespiratory fitness has shown health benefits by reducing circulating levels of inflammatory markers. However, it remains uncertain whether the negative association between cardiorespiratory fitness and inflammatory biomarkers is due to cardiorespiratory fitness itself or results from lower levels of adiposity. Moreover, the evidence examining the interaction between cardiorespiratory fitness and adiposity in inflammation in young adults is lacking.

Purpose: The aims of this study were …

Factors Associated With Physical Activity In Kindergarten Children, Carol Hammonds

Dissertations and Theses (Open Access)

Background: Reversing obesity is an urgent public health need for children: worldwide, in 2011 more than 40 million children under the age of five were either overweight or obese. Increasing intensity and duration of physical activity is a strategy to aid in preventing and reducing obesity. A minimum of 60 minutes per day of moderate to vigorous physical activity is recommended for children. School settings, such as full-day kindergarten, where 74% of children in the United States are enrolled, provide opportunities for population-based interventions to increase physical activity, yet little objective data exist on current levels of physical activity in …

How Do Black Nulliparous Women Cognitively Construct Birth?, Marianne F. Moore

Dissertations and Theses (Open Access)

A focused ethnography was conducted to determine the cognitive constructions about birth described by nulliparous Black women in an urban area of the Southwestern US; also, during postpartum, how do these women reconcile expectations with the actual birth? Semi-structured interviews were conducted before birth and after birth.

Women, 16 or older, 17 - 33 weeks carrying a singleton fetus and without anomalies or problems like pre-gestational diabetes, NYHA Cardiac Class III/IV, cancer, renal failure, or sickle cell anemia that eliminated vaginal birth were sequentially recruited and sampled in an affiliated ultrasound clinic. Women scheduled for an anatomy scan were approached. …

Understanding The "Big Picture": End-Of-Life Decisions In The Picu, Amy J. Howells

Dissertations and Theses (Open Access)

Objective: Describe critical care providers' cognitive constructions or their interpretation of the process of decision-making that influences both the technique of conversations and the recommendations given to parents regarding limitation or withdrawal of life sustaining treatments from terminally ill children in the PICU. Design: Qualitative Medical Ethnography. Setting: Tertiary care children's hospital affiliated with a college of medicine. Participants: Eleven critical care providers in the department of pediatrics (attending physicians, critical care fellows, pediatric nurse practitioners, physician assistants). Interventions: In depth, semi-structured interviews designed to explore the experiences of providers in the participation of end-of-life care decision-making. Measurements and Main …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

No abstract provided.

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

• Greetings from Dean Patricia Stark
• Nursing faculty members receive endowment medals at dinner
• “AccPhD” program proves model for faculty growth
• Gifts topping $1.3 million support studies of future nursing educators
• Rozmus selected for 2013 Regents’ Outstanding Teaching Award
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• Partners 2013 Spring Luncheon: Cody Unser shares outlook with Partners
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• School celebrates 40th Anniversary
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• Armstrong inducted as 2013 FAAN, receives $2.4 million NINR grant
• TURN study aims …

Symptoms In Early And Long-Term Breast Cancer Survivors Who Have Completed Primary Therapy, Faith Strunk

Dissertations and Theses (Open Access)

Background

Many breast cancer survivors continue to have single or multiple symptoms after they have completed primary cancer therapy. The quantifiable, subjective experience of multiple symptoms and their impact is defined as symptom burden. Previous research has focused on symptoms during primary therapy or shortly after completion of treatment.

Objectives

Our study objectives were to determine whether symptom burden differed according to survivor status (early as opposed to long-term survival) and/or use of endocrine or hormonal adjuvant therapy. We hypothesized that there would be no difference in the symptoms expressed among early- and long-term survivors.

Methods

In this cross-sectional study, …

Cholera Vaccination Campaign Contributes To Improved Knowledge Regarding Cholera And Improved Practice Relevant To Waterborne Disease In Rural Haiti, Omowunmi Aibana, Molly F Franke, Jessica E Teng, Johanne Hilaire, Max Raymond, Louise C Ivers

Faculty, Staff and Student Publications

BACKGROUND: Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV) might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti.

METHODOLOGY/PRINCIPAL FINDINGS: We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811). An OCV campaign occurred from May-June 2012 after …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

• Greetings
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• UTHealth School of Nursing – By the Numbers
• 2012 PARTNERS Spring Luncheon – honored “Generations of Nurses” – guest speaker Naomi Judd
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• Giuseppe Colasurdo, M.D. – Appointed Sixth President in U THealth’s 40-Year History
• Dean Starck Named to UT Academy of Health Science Education, Marcus Honored by Regents for Outstanding Teaching
• Students Select Two for 2012 …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

• Greetings
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Maternal And Neonatal Outcomes By Labor Onset Type And Gestational Age, Jennifer L Bailit, Kimberly D Gregory, Uma M Reddy, Victor H Gonzalez-Quintero, Judith U Hibbard, Mildred M Ramirez, D Ware Branch, Ronald Burkman, Shoshana Haberman, Christos G Hatjis, Matthew K Hoffman, Michelle Kominiarek, Helain J Landy, Lee A Learman, James Troendle, Paul Van Veldhuisen, Isabelle Wilkins, Liping Sun, Jun Zhang

Faculty, Staff and Student Publications

OBJECTIVE: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age.

STUDY DESIGN: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age.

RESULTS: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor.

CONCLUSION: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

• Greeting
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Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

• Honoring a Leader
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• --Accelerated Ph.D. Campaign
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Aggressive Vs Conservative Phototherapy For Infants With Extremely Low Birth Weight, Brenda H Morris, William Oh, Jon E Tyson, David K Stevenson, Dale L Phelps, T Michael O'Shea, Georgia E Mcdavid, Rebecca L Perritt, Krisa P Van Meurs, Betty R Vohr, Cathy Grisby, Qing Yao, Claudia Pedroza, Abhik Das, W Kenneth Poole, Waldemar A Carlo, Shahnaz Duara, Abbot R Laptook, Walid A Salhab, Seetha Shankaran, Brenda B Poindexter, Avroy A Fanaroff, Michele C Walsh, Maynard R Rasmussen, Barbara J Stoll, C Michael Cotten, Edward F Donovan, Richard A Ehrenkranz, Ronnie Guillet, Rosemary D Higgins

Faculty, Staff and Student Publications

BACKGROUND: It is unclear whether aggressive phototherapy to prevent neurotoxic effects of bilirubin benefits or harms infants with extremely low birth weight (1000 g or less).

METHODS: We randomly assigned 1974 infants with extremely low birth weight at 12 to 36 hours of age to undergo either aggressive or conservative phototherapy. The primary outcome was a composite of death or neurodevelopmental impairment determined for 91% of the infants by investigators who were unaware of the treatment assignments.

RESULTS: Aggressive phototherapy, as compared with conservative phototherapy, significantly reduced the mean peak serum bilirubin level (7.0 vs. 9.8 mg per deciliter [120 …