Social and Behavioral Sciences Commons^™

Rush To Judgment: The Sti-Treatment Trials And Hiv In Sub-Saharan Africa, Eileen Stillwaggon, Larry Sawers

Economics Faculty Publications

Introduction: The extraordinarily high incidence of HIV in sub-Saharan Africa led to the search for cofactor infections that could explain the high rates of transmission in the region. Genital inflammation and lesions caused by sexually transmitted infections (STIs) were a probable mechanism, and numerous observational studies indicated several STI cofactors. Nine out of the ten randomized controlled trials (RCTs), however, failed to demonstrate that treating STIs could lower HIV incidence. We evaluate all 10 trials to determine if their design permits the conclusion, widely believed, that STI treatment is ineffective in reducing HIV incidence.

Discussion: Examination of the …

Functional Capacity In Schizophrenia: Relationship Among Effort, Reinforcement Learning And Self-Beliefs, Sally J. Vogel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with schizophrenia exhibit a wide range of complex neurocognitive, psychiatric and behavioral impairments. Recent research suggests that this complex array of symptoms can be at least partially accounted for by dysfunction in more basic mechanisms, such as the ability to learn from positive and negative reinforcement, or the ability to exert adequate effort when completing simple tasks. Evidence also suggests that deficits in these basic mechanisms may contribute to more complex symptoms, such as functional impairment. Also, the relationship between neurocognitive deficits and functional impairment has been found to be mediated by defeatist performance beliefs. However, studies have not …

Comparing Functional Motor Control And Gait Parameters In Children With Autism To Those Of Age-Matched Peers Who Are Typically Developing, Patricia Stevenson, Samantha Novotny, Jillian May, Christopher Ancell

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare motor performance of children with Autism Spectrum Disorder (ASD) to that of age-matched peers who are typically developing (TD) on motor control tasks plus symmetry and variability of gait parameters across four walking conditions. A sample of convenience of children with ASD (n=6) and peers who are TD (n=6) were recruited. Motor control was assessed using initiation and completion times on the Timed Up and Go (TUG) test. Gait parameters were collected using a computerized walkway under four trial conditions: 1) walking at self-selected velocity (SSV); 2) walking during a tray-carrying task …

Pushing For New Options In Childbirth: A Case Study In Contemporary Integrative Midwifery, Kerie Ann Francis

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study, I investigate the concept of “integrative midwifery” in a major metropolitan area in the Southwest United States. Specifically, I look at a group of midwives, doulas, and other birthworkers who have organized into a collective business entity to provide services to pregnant and birthing women. Stemming from a perception that the medical model of maternity care is broken in this country, these practitioners seek to offer alternatives. I draw upon literature regarding complementary and alternative medicine (CAM) which shows that market conditions have created a situation in which alternatives to medical modes of care have become increasingly …

A Comparison Of The Effects Of Different Doses Of Gabab Receptor Ligands On Spatial Learning And Memory And Memory Flexibility, Chelcie Heaney

UNLV Theses, Dissertations, Professional Papers, and Capstones

The principal inhibitory neurotransmitter in the brain, gamma amino-butyric acid (GABA), mediates several types of learning and memory. Of the two main receptor subtypes for GABA, the in vivo role of GABAB receptor in learning and memory is less well characterized and the current data often conflict. Based on the current literature, it is unclear, for instance, whether enhancing GABAergic activity via the GABAB receptor could be beneficial for or detrimental to learning and memory. Hippocampally-dependent learning and memory tasks are of particular interest due to their clinical relevance to patients with schizophrenia or Alzheimer’s disease, who exhibit impaired performance …

Intraprofessional Nursing Communication And Collaboration: Apn-Rn-Patient Bedside Rounding, Rita M. Herm-Barabasz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Executive Summary

Leading advisory agencies have long advocated that health care must be safe and effective (Institute of Medicine [IOM], 2001). In order for health care to be safe and effective, good communication and collaboration are essential. Research has found that in health care, poor communication and teamwork failures are the major contributors to adverse events (Cornell, Townsend-Gervis, Vardaman, & Yates, 2014; The Joint Commission, 2011; O’Leary, 2012). Such communication-related adverse events can cause avoidable injury, loss of life, and financial devastation. In light of advanced practice nurses’ (APN) increasing contribution in care management, and in order to ensure delivery …

Survival Of The Fittest: The Role Of Linguistic Modification In Nursing Education, Brenda Strauch Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project’s long term goal was to improve English-as-a-Second-Language (ESL) nursing student retention. Improving the quality of multiple choice exams is a first crucial step. ESL students find multiple-choice exams to be one of the most challenging aspects of nursing school. One reason for this is the presence of linguistic errors in exam questions. Linguistic errors include: irrelevant question content, poor sentence structure, and culturally biased words or phrases. Non-ESL students are less affected because exams are written in their native language. Linguistic modification, as part of best practices in item writing, removes these types of errors. The U.S. Department …

Examining The Role Of Supportive Others In Substance Abuse Treatment And Child Welfare, Jessica Marie Urgelles

UNLV Theses, Dissertations, Professional Papers, and Capstones

Child neglect is a prevalent problem and often co-occurs with parental substance abuse. Mothers are most often the perpetrators of child neglect. The currently available treatment programs appear to be failing to meet the needs of these mothers. Most mothers are not completing treatment, putting them at risk of losing custody of their children. The literature suggests that women may have different risk factors associated with their substance use, as compared to men. Social networks appear to play a particularly important role in the maintenance of women’s substance abuse problems. The role of social networks may be distinct for different …

Children’S Human Figure Drawings And Racial Identity: A Mixed Methods Study, Sonya B. Jimerson

EVMS School of Health Professions Master's Level Capstones, Projects and Papers

This study explored characteristics of children’s Human Figure Drawings (HFD) to determine whether any relationship existed between drawing characteristics and the artists’ identified race. Three hundred nine children’s HFDs obtained from the Eastern Virginia Medical School (EVMS) art therapy database were used in the study. The drawings were completed by 34 Black American males, 61 Black American females, 105 White American males, and 149 White American females, the children were between the ages of 7 and 11, and attended public schools in Southeastern Virginia. A checklist was developed through content analysis that contained 11 items associated with each group. The …

Teacher Narratives And Student Engagement Testing Narrative Engagement Theory In Drug Prevention Education, Michelle Miller-Day, Michael L. Hecht, Janice L. Krieger, Jonathan Pettigrew, Young Ju Shin, John L. Graham

Communication Faculty Articles and Research

Testing narrative engagement theory, this study examines student engagement and teachers’ spontaneous narratives told in a narrative-based drug prevention curriculum. The study describes the extent to which teachers share their own narratives in a narrative-based curriculum, identifies dominant narrative elements, forms and functions, and assesses the relationships among teacher narratives, overall lesson narrative quality, and student engagement. One-hundred videotaped lessons of the keepin’ it REAL drug prevention curriculum were coded and the results supported the claim that increased narrative quality of a prevention lesson would be associated with increased student engagement. The quality of narrativity, however, varied widely. Implications of …

The Effect Of Balance-Based Torso-Weighting On Mobility, Gait, Balance, Postural Control, And Falls Efficacy In Mobility Limited Older Adults, Jennifer L. Vincenzo

Graduate Theses and Dissertations

Exercise is a known intervention to prevent fall risk among older adults; however, adherence is poor. Therefore, it is of interest to determine if other interventions improve function and decrease fall risk among older adults. Balance-Based Torso-Weighting (BBTW) is a non-exercise intervention that improves functional measures among adults with multiple sclerosis, yet the effectiveness of BBTW has not been assessed among older adults without progressive neurological disorders. We conducted a double-blind, randomized study to analyze the effect of BBTW on functional measures and falls efficacy among community-dwelling, mobility limited older adults after 5 days of wearing BalanceWear® for 4 hours …

Effect Of Sensory Cues On Hand Hygiene Habits Among A Diverse Workforce In Food Service, Robert Pellegrino

Graduate Theses and Dissertations

Poor hand hygiene is a leading cause of foodborne illnesses in the foodservice industry. A series of complex motivational interventions must be employed to permanently change the behavior of workers, to increase their compliance and sustain appropriate levels of proper hand hygiene. Unlike the healthcare industry, which uses large, costly multi-modal behavior modification strategies, the foodservice industry must deploy rapid, cost-efficient strategies that are focus on accommodating these goals with the constraints of high employee turnover rates and diverse demographics. This research was twofold, 1) examining differences in emotions and hand hygiene behavior among participants of two cultures when handling …

Failure To Launch? Understanding Variations In Emerging Adult Flight Patterns, Christina Ashley Williams

Graduate Theses and Dissertations

What does the transition to adulthood look like for emerging adults? This study proposes that popular cultural ideas like "failure to launch" imply an oversimplified dichotomy that does not account for the multiple "flight patterns" into adulthood. Focusing on the narratives of six interview cases selected from the larger sample of interviewees from Wave 4 of the National Study of Youth and Religion and drawing on the quantitative data from the broader survey sample, this mixed-methods approach examines in-depth, narrative experiences and the ways structural barriers vary between upper-middle, lower-middle, and working class emerging adults. We find that emerging adulthood …

The Role Of Stress: Low Birth Weight And Preterm Birth For African American Women, Tionna Latrice Jenkins

Graduate Theses and Dissertations

This population-based study evaluates the impact that psychoSocial stress has on adverse birth outcomes of low birth weight (LBW) and pre-term birth (PTB) among African American mothers in Arkansas. The relationship between adverse birth outcomes in African American women and stress in comparison to non-Hispanic Caucasian women data was evaluated from the Pregnancy Risk Assessment Monitoring System (PRAMS) quantitative survey. Data from 2005 through 2010 was reviewed to show the impact that psychoSocial stress has on adverse birth outcomes. The study sample was comprised of 14,196 participants.

Ethnic group status is the key maternal-level independent variable in this study. Of …

Reporting Practices, Knowledge And Opinion Of Policy Regarding Drivers With Dementia Among Arkansas Neurologists And Geriatricians, Erika Martin Gergerich

Graduate Theses and Dissertations

Background: States have various policies regarding a physician's ability or responsibility to report at-risk drivers with dementia to the Department of Motor Vehicles (DMV). Some states have mandatory reporting policies, others have optional reporting policies and some have no policy regarding this issue. Arkansas has no reporting policy regarding drivers with dementia to the DMV. Therefore, physicians in Arkansas face the risk of liability if they report a patient against their will to the DMV in good faith. Neurologists and geriatricians are often in a position to diagnose and treat individuals with dementia. Research Questions: The following three research questions …

Art Therapy For Anxiety And Depression During Military-Induced Separation: A Case Study, Christa L. Turpin

EVMS School of Health Professions Master's Level Capstones, Projects and Papers

The purpose of this case study was to gain a preliminary understanding of the effects of art therapy on anxious and depressive symptoms in a 32-year-old African American military wife experiencing military-induced separation from her active duty husband. The mixed methods study design included administration of the Beck Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI) before and after six sessions of individual art therapy and a semi-structured interview conducted at the conclusion of the study to gain insight into the participant’s experience of art therapy. Results of the BDI-II revealed no change in overall score pre to post-intervention, but …

The Call To Artmaking: Claiming And Reclaiming The Artist Therapist, Josephine M. Stromseth

EVMS School of Health Professions Master's Level Capstones, Projects and Papers

This heuristic qualitative study was completed with the intention of learning about myself as an Art Therapy student in a personal and professional perspective by way of incorporating the Expressive Therapies Continuum (ETC) with artmaking and reflective practice. Using the Moustakas method, this study was organized into the following stages: Initial Engagement, Immersion, Incubation, Illumination, Explication, creative synthesis, and the validation of heuristic research. The data was collected over a 6-week period artmaking once per week, and using ETC assessments to track the variety of change between the experiences of creating in a singular component each week. The findings were …

Use Of Social Media To Promote Continuous Learning: A Phased Strategy For Graduate Medical Education Fellowship Implementation, Jaswant Singh Basraon, Deborah Simpson, Anjan Gupta

Journal of Patient-Centered Research and Reviews

Purpose

Clinical developments continue to grow at an accelerated rate, challenging the existing paradigm of information access, dissemination and learning by trainees. The aim of this study was to deliver relevant, concise and newly emerging information on cardiovascular disease using Twitter, and assess its impact.

Methods

A Twitter account for our institution’s cardiovascular disease fellowship program was established. All fellows and faculty were encouraged to follow tweets for clinical developments. To assess Twitter use, participation rates and the number of tweets by topics and followers were tracked longitudinally. Impact on fellows was assessed through a brief evaluation survey and an …

An Education Saved My Life: Silver Wolf’S Path To Promise, David Patterson Silver Wolf (Adelv Unegv Waya)

Books and Monographs

In An Education Saved My Life, Professor David A. Patterson Silver Wolf (Adelv unegv Waya) narrates his path from a difficult early family life, his introduction to alcohol and drugs as an adolescent, and a directionless early adulthood overshadowed by chemical dependency, to a series of events and encounters that transformed his life. Dr. Patterson Silver Wolf attributes not only the substance abuse, but the many turns that led to it, to what he calls a “poor belief system.” As the title suggests, by contrast, he attributes much of the success he has experienced since then to his education, but …

Book Review: Being Mortal: Illness, Medicine And What Matters In The End, Sue Sutton

Patient Experience Journal

In her review of Being Mortal: Illness, Medicine and What Matters in the End written by Atul Gawande, MD, Sue Sutton shares both the insights of Dr. Gawande and their important perspectives for person-centered experience. She reinforces that in this day of increased focus on understanding patient’s expectations and patient-focused care, Dr. Gawande compels us to learn how to have the difficult conversations about what really matters. She closes the review with a compelling quote from the author, "I never expected that among the most meaningful experiences I’d have as a doctor— and, really, as a human being— would come …

Creating And Integrating A New Patient Experience Leadership Role: A Consultative Approach For Partnering With Executive And Clinical Leaders, Denise M. Kennedy

Patient Experience Journal

Many healthcare organizations are creating new leadership roles to add subject matter expertise and structure to their patient experience improvement efforts. The patient experience field is emerging, however, so there are many questions about this role’s function and how best to structure it in the organization for maximal effectiveness.

This article explores the benefits of a consultative approach for improving the patient experience. Previous research on management consulting and the integration of new roles in established organizations is briefly reviewed. Mayo Clinic Arizona’s (MCA) comprehensive, "7-prong" service model is revisited. Developed and implemented in 2008, the model is predicated on …

Health Information Technology: A Key Ingredient Of The Patient Experience, Matthew Werder

Patient Experience Journal

In this exploration to understand the linkages of health information technology (HIT) and patient experience, a comprehensive literature search was conducted using the key words, “information technology, HIT, patient experience, patient satisfaction, and technology”, on the MEDLINE, PubMed, and EMBASE databases resulting in over 1,000 citations. Eventually, 35 of the most relevant articles were reviewed and 11 identified as key references to include in beginning to explore the question, as the transformation of healthcare continues, how can technology enable a positive return on investment to a patients’ perception of their care in an organization and how can technology impact the …

Variations In The Patients’ Hospital Care Experience By States’ Strategy For Medicaid Expansion: 2009-2013, Edmund Becker, Kenton Johnston Phd, Jaeyong Bae, Jason M. Hockenberry Phd, Ariel C. Avgar, Sandra Liu, Ira Wilson, Arnold Milstein Md, Mph

Patient Experience Journal

Our investigation evaluates the extent of differences in the patient’s hospital experience due to variations among state strategies to adopt, or not adopt, their Medicaid plans to the 2010 ACA legislation. Using ten HCAHPS measures, we analyze patient hospital experience data for the 2009 - 2013 period for all 50 states and the District of Columbia grouped by those states that (1) did not expand, (2) expanded Medicaid through Section 1115 waivers, (3) expanders early, and (4) expanded Medicaid concurrent with the new ACA legislation.

Our findings reveal that those states that opted out of Medicaid expansion typically started with …

Cancer Patients’ Experiences Of Error And Consequences During Diagnosis And Treatment, Henriette Lipczak, Liv H. Dørflinger, Christine Enevoldsen, Mette M. Vinter, Jeanne L. Knudsen

Patient Experience Journal

The study objective was to investigate patient experienced error during diagnosis and treatment of cancer. The design included a nationwide patient survey on quality and safety in Danish cancer care. Responses regarding patient experienced error were separately analyzed, quantitative responses using descriptive statistics and qualitative responses using systematic text analysis. Study participants included 6,720 adult patients with a first time diagnosis of cancer registered between May 1st and August 31st 2010. The patients received a questionnaire concerning their experiences of care received by general practitioners, specialist practitioners and at the hospital. A response rate of 65% was achieved. 10 – …

Patient Complaints As Predictors Of Patient Safety Incidents, Helen L. Kroening, Bronwyn Kerr, James Bruce, Iain Yardley

Patient Experience Journal

Patients remain an underused resource in efforts to improve quality and safety in healthcare, despite evidence that they can provide valuable insights into the care they receive. This study aimed to establish whether high-level patient safety incidents (HLIs) were predictable from preceding complaints, enabling complaints to be used to prevent HLIs. For this study complaints received from November 2011 through June 2012 and HLI incident reports from April through September 2012 were examined. Complaints and HLIs were categorised according to location or specialty and the themes they included. Data were analysed to look for correlations between number of complaints and …

Weighting Patient Satisfaction Factors To Inform Health Care Providers Of The Patient Experience In The Age Of Social Media Consumer Sentiment, Blaine Parrish, Amita N. Vyas, Grace Douglass

Patient Experience Journal

The researchers explored the possibility that patients would go beyond simple ranking and could give weight to previously validated and reliable patient satisfaction factors, while also describing their online habits related to the patient experience and health seeking information in order to inform medical providers on what patients say matters most when evaluating satisfaction with their provider. One thousand one hundred and sixty-four adults completed a 13- item web-based quantitative survey, developed by public health researchers, to weight patient satisfaction factors and describe online health seeking habits of patients across the United States. Proportional weights for each of the patient …

Patient Satisfaction Reported By In-Visit And After-Visit Surveys, Rukiya Wongus, Nicholas H. Schluterman, Sharon Feinstein, Nihkolle Mcgirt, Deborah R. Greenberg, David B. Schwartz

Patient Experience Journal

Patient experience measurement has become a basic requirement for every healthcare provider organization. Yet, when the timing and mode of survey administration are considered, there is skepticism about the usefulness of ‘after- visit’ patient experience surveys to measure satisfaction and identify opportunities to improve service or health care quality. The aim of this observational study was to compare patient satisfaction among those who rated the patient experience at the conclusion of their outpatient appointment while still in the office, to that among those who rated the patient experience up to one month after their outpatient appointment via a mailed survey. …

Considering Shared Power And Responsibility: Diabetic Patients’ Experience With The Pcmh Care Model, Olena Mazurenko Md, Phd, Sheila Bock Phd, Catherine Prato, Margarita Bondarenko

Patient Experience Journal

The patient-centered medical home (PCMH), an innovative primary care model that fosters a stronger, more personal patient-doctor relationship than traditional health care models, should be particularly well suited for the treatment of chronic conditions such as diabetes that require ongoing management by both patients and providers. Despite growing research on the effectiveness of PCMHs in diabetes care, relatively little attention has been given to diabetic patients’ experiences. This qualitative study examines diabetic patients’ experiences at one PCMH setting, using in-depth interviews to understand patients’ perspectives of the shared power and responsibility between patient and provider in their diabetes care. Our …

The Children’S Hospital Of Philadelphia Family Partners Program: Promoting Child And Family-Centered Care In Pediatrics, Amy Kratchman, Ba, Darlene Barkman, Ma, Kathy Conaboy, Ba, Anna De La Motte, Msed, Rachel Biblow, Msw, Katherine Bevans, Phd

Patient Experience Journal

Involving Family Advisory Councils in decisions that impact pediatric healthcare demonstrates hospitals’ commitment to child- and family-centered care. Yet, reliance on advisors as the sole source of family input has several limitations: infrequent meetings impedes the council’s capacity to address emerging concerns in a timely manner; feedback obtained from a small number of highly-engaged family members may not represent the perspectives of “typical” patients and families; advisors provide feedback in a reactive manner and are generally not equitably involved in problem identification or the initial development of solutions. In recognition of the need to strengthen and advance family partnerships, the …

So Much More Than A “Pair Of Brown Shoes”: Triumphs Of Patient And Other Stakeholder Engagement In Patient-Centered Outcomes Research, Amanda Brodt, M.P.P., Christine K. Norton, M.A., Amy Kratchman

Patient Experience Journal

This piece illustrates the “real world” experiences of patients and other stakeholder partners in research to help inform and inspire future patient-centered outcomes research (PCOR) efforts. The Patient-Centered Outcomes Research Institute (PCORI) was created in 2010 to fund research that helps patients, clinicians, and other healthcare stakeholders make informed health decisions. The first 50 funded PCORI Pilot Projects engaged patients, caregivers, parents, patient advocates, clinicians, and other non-traditional research stakeholders to serve in advisory and leadership positions on their research teams, many for the first time. In interviews with seven patients and other stakeholders, several lessons learned emerged, including how …