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Using A Sexual & Gender Minority Health Disparities Framework To Examine Multi-level Influences On Bisexual College Women’s Sexual Health Communication About HIV
No full textPrior studies have consistently revealed that bisexual+ women are at an increased risk for numerous mental and sexual health disparities compared to individuals with differing sexual orientations, in part due to bierasure and binegativity-yet less is known about bisexual+ women's approaches to obtaining information about partner sexual health and HIV status. My dissertation employed a mixed-methods approach to investigate sexual health communication strategies (i.e., requesting partner sexual health history) as a means of HIV prevention, and the multi-level psychosocial factors that underlie sexual health communication related to HIV. Specifically, I assessed the individual, interpersonal, community, and societal factors-informed by the Sexual & Gender Minority (SGM) Health Disparities Research Framework and the Theory of Planned Behavior (TPB)-that guide sexual health communication in bisexual+ college women. A total of 258 bisexual+ college women completed an online survey that assessed for multi-level factors that affect HIV-related sexual health disparities and HIV prevention behaviors. Across levels of influence in the SGM ecological framework, community level influence in the form of LGBTQ community connectedness predicted bisexual women's individual level experience of sexual identity outness (i.e., more LGBTQ community connectedness predicted more sexual identity outness). Societal level influence in the form of bierasure predicted medical mistrust on the interpersonal level (i.e., less bierasure predicted less medical mistrust). When examining ecological influences on variables associated with the TPB, more LGBTQ community connectedness and less internalized heterosexism predicted more favorable attitudes around having a shared sexual conversation. More LGBTQ community connectedness also predicted more perceived social pressure around having a shared sexual conversation. Examining TPB variables more focally, the TPB intermediate variable of intention was not only influenced by upstream TPB variables (more attitudes, norms, and self-efficacy predicted greater intention) but also predictive of TPB outcome variables of sexual safety strategies and request for partner sexual health history. A qualitative analysis of HIV prevention behavior (request for partner sexual health history) yielded three themes across participants who reported requesting history: 1) Style, 2) Content, and 3) Timing, and one theme across participants who did not request history: 1) Barriers. The Barrier theme had seven subthemes: Discomfort, Unaware, Managing Partner Reactions, Perceived Minimal Risk, Partner Initiated, Social Norms, and Perceived Lack of Relevance. Qualitative responses provided context for upstream TPB variables and elucidated specific attitudes, norms, and efficacy factors that are involved in shared sexual health conversations. Future research should continue to take a multi-level approach in capturing the numerous factors that influence HIV-related sexual health outcomes for bisexual+ women. HIV prevention programs should consider how fostering positive attitudes, favorable social norms, and self-efficacy influences request for partner sexual health history
Higher Education Staff Retention: Decreasing Barriers, Increasing Supports, and Examining Congruence
No full textThe present study aimed to identify barriers and supports at a small private college and examine the impact of congruence, if any, on job satisfaction and turnover intention. Former staff of Moth College participated in a qualitative, phenomenological study that included a pilot survey, semi-structured interviews, and a hypothetical intervention. Prior to the study a literature review identified current studies, issues, and best practices related to the study questions and the study design. A theoretical framework utilizing Social Cognitive Career theory, Social Exchange theory, and Self- in role theory undergird the study. Participants of the study noted unrealistic/unreasonable expectations, poor work life balance, nepotism, and cronyism as barriers. Supports were identified as family atmosphere and colleagues. These concepts were used to create a hypothetical intervention that aimed to address and reduce barriers while utilizing identified supports. Participants were then asked to respond to feedback questions regarding the perceived effectiveness, if any, of the hypothetical intervention. A discussion of study results as well as recommendations and future study ideas are detailed in the final chapters
Examining Visual Processing Reaction Time As A Predictor For Driving Fitness
No full textRationale: As a complex IADL, driving is essential for social participation and quality of life. As such, it should be addressed by occupational therapy practitioners. Visual processing speed is a critical component of driving ability. Advanced age and medical conditions impact visual processing speed, therefore affecting driving risk. Although assessments of visual processing speed are limited, it can be isolated as a discrete ability when using a tool such as the Vision CoachTM. Purpose: This research examined visual processing speed reaction times between medically-at-risk drivers and healthy controls with the purpose of determining its relationship with the outcomes of a comprehensive driving evaluation. Three research questions were specifically targeted: (1) is there a statistically significant difference of reaction times on the Vision CoachTM between the age groups of the healthy controls, (2) is there a statistically significant difference in visual processing speed reaction times across age groups between the healthy controls and medically-at-risk, (3) does the Vision CoachTM demonstrate adequate sensitivity and specificity to predict driving fitness outcomes? Design: Data collection consisted of a comprehensive driving evaluation including an on-road component for medically-at-risk adults with a fitness to drive outcome designated as "pass" or "fail." The Vision CoachTM Full Field 60 task collected visual processing speed reaction times of the medically-at-risk adults as well as healthy controls to compare between the two groups, between age groups, and determine predictability between driving fitness outcome. Results: One-factor ANOVA showed a significant (p < .001) difference in visual processing speed reaction times between all age groups of the healthy controls. Two-factor ANOVA showed a significant (p < .001) difference between age groups of the healthy controls and medically-at-risk as well as between the two groups as whole. Using the default cut point of 0.5, a logistic regression model determined the Vision CoachTM accurately predicted 86.4 percent of the driving fitness outcomes. The AUC was significant (p = .001) at .905 for outstanding diagnostic performance. Conclusion: Results of this study show that medical risk for driving impacts visual processing speed reaction times, regardless of age. The Vision CoachTM is a reliable and valid tool to assess and improve this discrete ability and can be used by generalists and specialists to help determine driving fitness
Nursing Faculty Informatics Competency
No full textThe integration of technology in nursing education is essential for preparing future nurses to navigate the increasingly digital world of healthcare. This study explores the nursing informatics competency among faculty members at a large College of Nursing, aiming to assess proficiency levels and identify areas for improvement. Drawing on established frameworks such as the AACN essentials and NLN recommendations, the study employs a cross-sectional design to evaluate faculty competencies using the revised Self-Assessment of Nursing Informatics Competencies Scale (SANICS). Findings from the survey of 66 faculty members indicate a strong understanding of theoretical aspects but reveal a notable gap in practical computer skills, particularly in applied informatics tools. Recommendations include tailored training programs to address these deficiencies, ensuring faculty can effectively integrate informatics into nursing curricula and equip students with essential skills for modern healthcare practice. Closing this gap is vital for enhancing the quality of nursing education and preparing students to meet the evolving demands of patient care in the digital age
The Effect of Exercise Mode During Pregnancy on Maternal, Placental, and Cord Inflammatory Markers
No full textExcessive inflammation during pregnancy is associated with adverse pregnancy outcomes. Specifically, increased pro-inflammatory tumor necrosis factor alpha (TNF-[alpha]), interleukin 6 (IL-6), interleukin 1 beta (IL-1[Eszett]), interleukin-8 (IL-8), and c-reactive protein (CRP) have been associated with gestational diabetes, preeclampsia, intrauterine growth restriction, and preterm birth. Similarly, pathologies of the maternal-fetal interface, such as recurrent spontaneous abortion, are associated with high pro-inflammatory biomarkers. This also increases fetal exposure to high inflammation in utero, contributing to the increased risk of cardiometabolic and mental conditions later in life. In non-gravid adults, exercise is an effective method for reducing pro-inflammatory and increasing anti-inflammatory biomarkers, differing with exercise mode. Currently, no research has directly compared the effect of exercise modes during pregnancy on maternal, placental, and fetal inflammatory biomarkers. The purpose of this dissertation was to determine the effect of maternal aerobic, resistance, or combination (aerobic + resistance) exercise during pregnancy on maternal, placental, and cord inflammation. Samples from healthy pregnant women with singleton pregnancies that participated in a randomized control trial exercise intervention were obtained. The exercise intervention consisted of 150-minutes of moderate-intensity aerobic, resistance, or combination exercise per week from <16-wks gestation until delivery. First, we investigated the effect of exercise mode on inflammation in maternal plasma at enrollment (<16-wks) and 36-wks gestation. Second, we examined the concentration of inflammatory biomarkers in placental tissue. Third, cord blood was analyzed for inflammatory biomarkers. All studies utilized Luminex xMAP technology to quantify biomarker concentration. The second and third studies also identified protein and pathway differences with exercise using a label-free proteomics. Maternal, placental, and cord blood inflammatory biomarkers were similar between groups. However, these data revealed that other exercise metrics predicted inflammatory biomarker concentration. Specifically, increased weekly exercise duration predicted lower IL-6 and IL-8 and increased weekly exercise frequency predicted higher TNF-[alpha] in late pregnancy maternal plasma. Increased weekly exercise intensity predicted lower placental fibrinogen. Lastly, total exercise volume, exercise mode, and pre-pregnancy BMI predicted cord blood IL-6 and exercise mode and pre-pregnancy BMI predicted cord blood cortisol. Label-free proteomics revealed significantly different proteome landscapes in aerobic, resistance, and combination exercisers placental tissue and cord blood compared to controls. We identified multiple downregulated proteins in placentas of exercisers that related to inflammation and immunity. Similarly, there was a downregulation in cord blood pathways that related to innate and adaptive immunity, possibly indicating reduced downstream inflammatory biomarkers. Altogether the studies within this dissertation did not support our central hypothesis that exercise mode would differentially alter inflammatory biomarkers during pregnancy. However, our studies highlight the importance of monitoring all exercise metrics (e.g., frequency, intensity, time, type), as each related to changes in maternal, placental, and fetal inflammation. We were also able to identify other inflammatory proteins and pathways in placental tissue and cord blood, providing targets for future projects. Collectively, the studies within this dissertation support the safety of exercise during pregnancy, further emphasizing the possible benefits, regardless of exercise mode. The projects in this dissertation extend the knowledge on how antenatal exercise impacts inflammation during pregnancy, thus impacting maternal and infant health
The effect of ventilatory threshold in endurance and resistance training
No full textPURPOSE: With the growing rate of physical inactivity in the United States and around the world, the study of how to improve performance and increase the health benefits that come with exercise is increasing. There are many questions asked about the ventilatory threshold such as what point in time does the ventilatory threshold take place and how long is an individual able to exercise at a certain intensity before major fatigue happens? This brings me to my question, how is the ventilatory threshold affected when doing endurance or resistance exercise training? I looked at VO2 max stress test data to find where the ventilatory threshold occurs. I wanted to see if there is an increase in the ventilatory threshold of an individual through bouts of resistance and aerobic training. I am looking at the ventilatory threshold through different modes of exercise to see if it is an accurate indicator of one's cardiorespiratory fitness and what is the best method of calculating one's ventilatory threshold. This could also be vital knowledge during rehabilitation for a participant recovering from an injury or a participant wanting to improve their cardiorespiratory fitness level. The second purpose of this study was to determine whether there was a significant difference in the determination methods of finding the ventilatory threshold. METHODS: Three training groups: Sedentary, highly active Resistance Trained, and highly Active Endurance Trained performed a CPET on a cycle ergometer, and gas exchange was measured using a metabolic cart. Using the metabolic cart files, the ventilatory threshold was determined using the Ventilatory Equivalent method as the primary determinate with the secondary determinates being the V-Slope method, % VO2 max, and % maximal work rate (w). Once the VT was determined, four methods of determining VT were calculated in GraphPad Prism. The four determining methods that were calculated included the Ventilatory Equivalent, V-Slope, VE, and VCO2 methods. RESULTS: 59 participants participated in the CPET test and had their VT determined. There was a significant difference when comparing the Ventilatory Equivalent and VE methods for % VO2 max in the HART group. When comparing the group's % VO2 max, there was a significant difference using the Ventilatory equivalent method between all three groups. There was a significant difference between the Sedentary and HAET groups when doing a group comparison when looking at the % VO2 max using the VCO2. After comparing the groups using the % maximal work rate, there was a significant difference between all three groups for all four methods of determining the ventilatory threshold. CONCLUSION: The primary findings of the current study after observing the results of comparing the % VO2 max, the HART and HAET group had a higher % VO2 max. When comparing the % maximal work rate between the groups, the HAET group had a higher % maximal work rate compared to the sedentary and HART groups. When comparing what methods of determining VT, there was no significant difference between the methods. This states that any of the four methods could be a viable source to determine one's VT and participating in regular bouts of endurance or resistance training has improvements in VO2 max and CRF
From Comics to Community: How a Graphic Medicine Collection can Impact Library Services & User Experience
No full textObjective: The objective of this project was to develop a comprehensive graphic medicine collection in our library, aimed at providing diverse educational resources and enhancing student and faculty engagement.
Methods: We initiated the collection with a modest selection of 20 books in 2020, leveraging end-of-year funds for procurement. Our selection process included sourcing titles from GraphicMedicine.org, online reviews, and social media posts by experts like Matthew Noe and Alice Jaggers. A dedicated librarian created a Graphic Medicine Collection LibGuide as an online hub, featuring a subject directory, catalog links, reviews from faculty, staff, and students. Additionally, the Libguide contains the latest peer-reviewed literature on graphic medicine and shares ideas on the use of graphic medicine in the health sciences classroom. A team of two librarians and the user services coordinator are currently finalizing plans to teach a virtual graphic medicine class for the health sciences campus during the Fall 2024 semester. Finally, our student engagement coordinator promoted the collection via the library's social media channels and actively sought title suggestions from students.
Results: Through these efforts, the collection expanded to over 60 titles in four years, becoming one of the most circulated collections in our library. The LibGuide and social media promotion significantly increased visibility and accessibility, attracting a wide audience and fostering a community of engaged users.
Conclusions: The success of the graphic medicine collection highlights the importance of strategic collection development and active community engagement. By utilizing various platforms and engaging with students and experts, we have created a valuable resource that supports academic and personal growth. This project demonstrates the potential for similar initiatives to enhance library offerings and user engagement in other educational institutions.
References:
Bradley, S., Mclean, R., & Brewster, L. (2021). What can medical education learn from comics?. The clinical teacher, 18(6), 675–678. https://doi.org/10.1111/tct.1342
Dementia with Dignity
No full textPsychological and behavioral challenges are frequently exhibited by individuals living with dementia. Often the interaction between a caregiver and the individual is the precipitant for those behaviors. The leadership of a Continuing Care Retirement Community (CCRC) identified a knowledge and skills gap in staff preparedness to respond to behavioral challenges exhibited by individuals diagnosed with dementia. These behaviors complicate the delivery of adequate care and preservation of the individual’s dignity. They can also lead to caregiver fatigue, caregiver attrition, and emotional, verbal, or physical harm to the individual living with dementia. The primary objective of the Dementia with Dignity project was to enhance caregiver knowledge and confidence in their skills through targeted didactic and experiential educational sessions. Participants completed pre- and post-intervention surveys. Immediately post-intervention, participants showed significant increases in dementia knowledge and competence, suggesting an enhanced level of caregiver preparedness to engage individuals affected by dementia. Although an unmeasured objective, it was anticipated that these enhanced skills would contribute to the preservation of dignity and the enhancement of quality of life for those living with dementia.D.N.P
Teachers' Self-efficacy and Their Implementation of Instructional Best Practices
No full textBray-Clark and Bates (2003) asserted that teaching is a demanding job with unpredictable challenges which means that teachers' ability to be effective is partly dependent on their perceived self-efficacy. When teachers perceive their self-efficacy as waning, this may affect their commitment to their job and their willingness to implement instructional best practices. This poses a challenge for teachers' level of motivation and students' academic success as every student deserves quality instruction. The purpose of my study was to explore and alleviate a problem of practice regarding teachers' self-efficacy and their implementation of instructional best practices. The participants in my study were teachers who worked at a rural middle school in the North Central area of North Carolina. They volunteered to participate in my study after being given detailed information about the procedures and ethical considerations. I used a parallel convergent mixed methods research design which means I collected and analyzed both qualitative and quantitative data at the same time. As a trained mentor, I implemented a mentorship and support initiative where I worked with participants to improve their instructional best practices and by extension, their self-efficacy. I administered the Tschannen-Moran and Hoy (2001) Teacher Sense of Self-efficacy scale (TSES) to determine teachers' perception of their self-efficacy. While the data from the TSES were being analyzed, I conducted classroom observations over 2 weeks followed by post observation conferencing. I used the data from my classroom observations to inform my planning with participants for future lessons. Following my intervention, I made weekly visits to participants' classes to observe their implementation of instructional best practices then conducted post observation interviews to learn more about their self-efficacy. I used the results to determine that associations could be made between teachers' self-efficacy and their implementation of instructional best practices
DEFINING THE ABILITY OF SNAT NANOTHERAPEUTIC TO INHIBIT SARS-COV-2 INFECTION AND ALTER THE HOST MICRONOME TO INDUCE AN ANTIVIRAL CELLULAR ENVIRONMENT
No full textMicroRNAs (miRNAs) are regulatory elements that canonically bind to target mRNAs, reducing translation and protein output. They are non-coding strands of RNA, roughly 18-25 nucleotides long, and are found in plants, animals, and some viruses. During viral infection, they can be helpful or harmful to the host, affecting the cellular environment, immunity, and viral life cycle. Understanding miRNA interactions within the host and how they impact viral infections can inform therapeutic and diagnostic innovation. Nanomedicines have broad applications in the treatment of viral infections. They are less than 100 nm, and formulations include base materials such as metals, liposomes, or polymers. The nanoparticle alone may have therapeutic properties or be a carrier for therapeutic agents. Compared to traditional antivirals, nanodrugs are designed for greater bioavailability, specificity, stability, and safety. Smart Nano-enabled Antiviral Therapeutic (SNAT) is a nanodrug that alleviated SARS-CoV-2 pathology in a preclinical study using a hamster model. It is comprised of taxoid (Tx)-decorated amino (NH2)-functionalized near-atomic size positively charged silver nanoparticles (Tx--[NH2-AgNPs]) and is delivered in aerosolized form. Herein, the molecular mechanism by which SNAT exerts antiviral effects in hamsters is determined. Results from molecular biology and virology techniques suggest SNAT binds to the S2 subunit of the viral spike (S) protein of SARS-CoV-2 to interfere with viral infectivity. Next generation sequencing (NGS) and bioinformatics data reveal SNAT-induced changes in miRNA expression with antiviral implications in vivo. In addition, infected hamsters given SNAT treatment express interleukin-6 (IL-6), a cytokine upregulated during SARS-CoV-2 infection, at the same level as uninfected controls. These findings illustrate the potential use of next-generation sequencing in the evaluation of nanotherapeutics and provide valuable insights into the antiviral molecular mechanism of SNAT. The results demonstrate the two-pronged approach by which SNAT induces antiviral effects against SARS-CoV-2; directly binding SARS-CoV-2 and neutralizing viral infection, and indirectly orchestrating a cellular environment capable of thwarting viral infection. In conclusion, our findings suggest that SNAT may serve as a novel antiviral therapeutic against SARS-CoV-2 infection