Dissertations / Theses on the topic 'CDM register'

Complementary and alternative medicine (CAM) has become very popular with populations internationally and in the United States. CAM is defined as “a group of diverse medical and health systems, practices and products that are not generally considered as part of conventional medicine”. CAM is described as having five specific divisions: whole medical systems, mind-body medicine, biologically-based practices, manipulative- or body-based practices, and energy medicine. Recent studies have shown that CAM use is increasing. In the US 33% of the population reported using CAM in 1990, but 1997 usage rates increased to over 41%. The popularity of CAM is one of the reasons for the creation of the National Center for Complementary and Alternative Medicine (NCCAM) by the National Institutes of Health the Federal Government's lead agency for scientific research on the diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine”. NCCAM information was the foundation for this project. The goals of this project are to evaluate the interest of dietitians in Georgia in CAM and introduce participants of this project to a segment of CAM treatments. The primary research question is: Are dietitians in the state of Georgia interested in using CAM as part of their practice? There were three distinct portions to this project; the initial survey of the dietitian participants, the development and use of the introductory CAM lesson, and the evaluation of this lesson and final survey. The data from both the first and second surveys as well as the post test does support a positive answer to the research question, “Are registered dietitians in the state of Georgia interested in CAM? The results clearly indicate an interest from both the survey 1 and survey 2/ post test group. Some may ask, “Is this really of any importance to the dietetics profession?” The answer to this can be found in the nutrition literature. Conducting a topic search of “Complementary and alternative medicine” in three predominant nutrition journals: the American Journal of Clinical Nutrition, The Journal of Nutrition and The Journal of the American Dietetic Association, revealed more than 17,000 articles. These articles range for original research to review of original research to commentary articles evaluating the use of CAM to the dietetics practice. A number of articles addressed the importance of CAM in dietetics education as well as its importance to the practice and reimbursement for services.

The Emergency Department (ED) as a workplace for the Registered Nurse (RN) is a stressful environment. Reasons are thought to include interactions with other members of the interdisciplinary team as well as the situations associated with the environment of the ED such as trauma, death, sadness, joy and the general unpredictability of each moment. Studies have documented general health care workplace stress and its influence on staff, but a very limited number of studies have concentrated on the ED. No widely published studies have identified stressors from the perspective of the ED RN. This dissertation is an interpretive phenomenological study that seeks to understand the experience of being an ED RN through the exploration of the perceptions of stress as lived by individuals who practice their art and science in this unique setting. Materials for evaluation and thematic identification were obtained through personal interviews of practicing nurses. The stories told by the participants communicated what each individual found to be negatively stressful as well as what each found to be positively stressful. Conclusions based on the findings of this work suggest a need for the ED RN to be able to depend on the presence of several factors in order to be able to function with as little distress as possible. The optimal ED environment for the RN is posited to be supportive of the individual goals of the RN, provide adequate resources and foster a communicative interdisciplinary environment. Recommendations are made to improve resource management and interdisciplinary relations.
ID: 031001340; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Adviser: Diane Wink.; Co-adviser: Diane Andrews.; Title from PDF title page (viewed April 15, 2013).; Thesis (Ph.D.)--University of Central Florida, 2012.; Includes bibliographical references (p. 130-135).
Ph.D.
Doctorate
Nursing
Nursing
Nursing

Background: Human papillomavirus (HPV) infections are the most common sexually transmitted infections in the world today. HPV has been identified as the cause of both cancer and genital warts. A vaccine to prevent select types of HPV infection was developed and approved for males and females ages 9 to 26. This vaccine has not been universally accepted by healthcare providers, parents, or the public and has lower vaccination coverage rates than other recommended vaccines for the same age group. Multiple studies addressing the knowledge, perceptions, and beliefs of providers and parents regarding the vaccine have taken place. Only a few studies with the nursing profession are found in the literature and they do not look at the vaccine in regards to males. Nurses are seen as one of the most trustworthy of professions. What nurses know, perceive and believe can impact both patients and those they come in contact with on an informal basis. Objective: The purpose of this study is to determine knowledge, beliefs, and perceptions of registered nurses about the human papillomavirus and associated vaccination for males. Methodology: This study took place in February of 2013 and used a descriptive correlational design with a cross-sectional survey. The survey was administered online to alumni of the University of Central Florida (UCF) College of Nursing, members of the Theta Epsilon chapter of Sigma Theta Tau International Honor Society, and current graduate nursing students and faculty of UCF College of Nursing. There were one hundred and twelve Registered Nurses that participated in the study. Findings: Knowledge of HPV varied among respondents. The vast majority knew that HPV was a common sexually transmitted infection however less were knowledgeable on specific iii information about the vaccine. Less than eighty percent of study participants knew that the vaccine was available for both males and females. Close to ninety percent of respondents agreed that vaccinating males would be important to protect their future partners from complications associated with HPV, such as genital warts and cervical cancer, and to protect themselves from future complications, such as genital warts and cancers. Participants with doctoral degrees possessed a significantly more favorable attitude (p<0.001) towards vaccine use in males than those with a bachelors degree. Conclusions: Nurses in this study were knowledgeable about specific HPV information but were less knowledgeable about the extent of infection seen in males or the availability of the vaccine for males. This study found inaccuracies and lack of knowledge among Registered Nurses that demonstrates the need for education about HPV and the associated vaccine. While the attitudes of the respondents reflect favorably toward the vaccine, there is still a need for education among this population.
B.S.N.
Bachelors
Nursing
Nursing

Front-line registered nurses (RNs) make up the workforce that directly affect the care of patients in a variety of different healthcare settings. RN job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The strongest predictors have been difficult to determine because workplaces differ, numerous tools to measure satisfaction exist, the workforce is diversified by generations and work positions, and ongoing policy changes directly impact the work of the front-line RN. The strength and stability of the workforce depends on an accurate understanding of the predictors of job satisfaction for the front-line RN. The purpose of this study was to comprehensively, quantitatively examine predictors of front-line RN job satisfaction from 1980-2009 to provide overarching conclusions based on empirical evidence. Of interest was: the (1) estimation of large, moderate, and small predictor summary effect sizes; (2) assessment of predictor differences among decades (i.e., 1980s, 1990s, and 2000s); (3) identification of causes for predictor differences among studies (i.e., moderators); and (4) investigation of predictor differences between generations (i.e., Baby Boomers, Generation X, and Millennials). A non-a priori meta-analysis approach was guided by inclusion and exclusion criteria to review published and unpublished studies from 1980–2009. The search process identified 48 published and 14 unpublished studies used for analysis. Within the studies that met inclusion criteria, 27 job satisfaction predictors met inclusion for analysis. Studies were coded for Study Characteristics (e.g., Year of Publication, Country of Study) that were needed for moderator analysis. Predictors were coded for data that were necessary to calculate predictor summary effect sizes (i.e., r, n). Coding quality was maximized with a coding reliability scheme that included the primary investigator (PI) and secondary coder. A random-effects model was used to guide the calculation of summary effect sizes for each job satisfaction predictor. Publication bias was examined using funnel plots and Rosenthal's Fail-safe N. An analysis of variance (ANOVA) was used to evaluate predictor differences among decades (i.e., 1980s, 1990s, and 2000s). Heterogeneity among studies was calculated (i.e., Q-statistic, I-squared, and Tau-squared) to guide the need for moderator analysis. Moderator analyses were conducted to evaluate Study Characteristics as sources of predictor differences among studies, and to investigate the influence of Age (i.e., generation) on predictor effect sizes. The largest effect sizes were found for three predictors: Task Significance (r=.61), Empowerment (r=.55), and Control (r=.52). Moderate effect sizes were found for 10 predictors (e.g., Autonomy: r=.44; Stress: r=-.43), and small effect sizes were found for nine predictors (e.g., Wages: r=.23; Staffing Adequacy: r=.19). Significant heterogeneity between studies was present in all of the 27 predictor analyses. Effect size differences were not found between decades or generations. Moderator analysis found that the sources of the difference between studies remain unexplained indicating that unknown moderators are present. Findings from this study indicate that the largest predictors of job satisfaction for the front-line RN may be different than previously thought. Heterogeneity between studies and unidentified moderators indicate that there are significant differences among studies and more research is needed to identify the source(s) of these differences. The findings from this study can be used at the organizational, state, and national level to guide leaders to focus efforts of workplace improvements that are based on predictors that are most meaningful to front-line RNs (i.e., Task Requirements, Empowerment, and Control). Future research is needed to determine contemporary predictors of job satisfaction for the front-line RN, and the causes of heterogeneity between studies. The findings from the current study provide the critical synthesis needed to guide educational and practice recommendations aimed at supporting job satisfaction of front-line RNs, thereby, maintaining this integral component of the healthcare workforce.
Ph.D.
Doctorate
Nursing
Nursing
Nursing

Over the last few decades our society has moved towards restricting where sexual offenders can live, work, and overall congregate. This issue has been the focus of great public attention due to the media's role in bringing these offenders to the light. Whether it is through the news, movies, TV series, books, talk shows, newspapers articles, etc., these offenders are constantly being talked about. Every body of government in the United States has moved towards implementing restrictions that are aimed at keeping sex offenders away from places where they are considered a potential danger. However, what it is not talked about is that in efforts to limit where sex offenders can live and work to ensure the safety of our society; we are isolating these offenders and hindering their reintegration into our society. By isolating sexual offenders from our society we are doing more harm than good because we are discriminating and not working to fit the needs of each individual offender. One size does not fit all. The intent of this thesis is to explore sexual offender legal restrictions, treatment, case law, constitutionality of these laws and to compare Florida's approach towards restriction of sexual offenders with other states. Through the analysis of case law and statutes, recidivism rates, and treatment options this thesis will evaluate what different approaches should be taken towards aiding the reintegration of sexual offenders into our society. This thesis will provide background information on sexual offenders, compare legal restrictions among states, give an analysis of sexual offender websites, and provide recommendations to a better approach in treating sexual offenders. By raising awareness to the unfairness of treatment of sexual offenders, this thesis aims to open a new gateway to determine more successful ways to rehabilitate sexual offenders.
B.A. and B.S.
Bachelors
Health and Public Affairs
Legal Studies

Over the past several years, increasing public emphasis on preventing child maltreatment has resulted in substantial changes to Florida's child abuse and neglect central registry. Many of these recent changes, aimed at preventing child maltreatment, have resulted in over one million false, unsubstantiated, and inconclusive reports of child abuse and neglect within the last decade. While the information held in reports may be useful for identifying and preventing potential child abuse or neglect, due process concerns have been raised with regards to the process of placing a person's name in a report without providing a hearing for challenging or removing inaccurate information. Focusing on Florida law, this research concentrates on: 1) the child maltreatment reporting process, 2) the procedures for maintaining reports, and 3) the accessibility of these reports in order to determine whether due process constitutional rights are protected under Florida's child abuse and neglect reporting laws. The intent of this thesis is to analyze the occurrence of unsubstantiated cases of child maltreatment, incidences of false reporting, and legal remedies available for those wrongfully accused of abusing or neglecting a child. Through the analysis of case law, federal and state statutes, available statistics, child abuse resources, and personal interviews with members of the Florida Legislature, evidence shows that due process constitutional rights are not protected under Florida's child abuse and neglect reporting laws. By raising awareness of the areas of child protection that require legal re-evaluation, this thesis aims to discover the balance between protecting children from harm and protecting adults from the severe ramifications resulting from false and improper allegations of child abuse and neglect.
B.S.
Bachelors
Health and Public Affairs
Legal Studies

The purpose of this research was to determine the effect work environment has on occupational commitment and intent to leave the profession for bedside registered nurses. Subscales of autonomy, control over the practice setting, nurse-physician relationship, and organizational support were incorporated into the analysis to determine which aspect of work environment most directly effects occupational commitment and intent to leave the profession. The research was undertaken in order to help administrators determine the ways in which work environment can be improved upon in order to retain bedside registered nurses in the profession. An explanatory cross sectional survey was distributed to 259 direct care bedside registered nurses employed at a rural, system affiliated hospital in Central Florida. Human subject protection was assured through the University of Central Florida Institutional Review Board. A 77 item questionnaire containing 9 demographic questions, 57 questions from the Nursing Work Index- Revised (NWI-R), 8 questions from Blau's occupational commitment scale, and 3 questions from Blau's intent to leave scale was distributed to all direct care nurses. Subjects were also given the opportunity to complete 3 short answer questions. A 32.8 percent response rate was achieved for a total of 85 complete and usable surveys. Data analysis showed that the work environment is positively related to occupational commitment and negatively related to intent to leave. In addition each of the four subscales (autonomy, control over the practice setting, relationship with physicians, and organizational support) were also positively related to occupational commitment and negatively related to intent to leave the profession. Implications for organizations, public policy and future research are discussed.
Ph.D.
Department of Health Professions
Health and Public Affairs
Public Affairs PhD

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Bachelors
Health and Public Affairs
Nursing

This investigation studied the impact of registered therapy dogs assigned to students in order to improve reading skills. The purpose of this study was to determine if children assigned to registered therapy dogs improve significantly in reading achievement and related school performance such as attendance and discipline when compared to students of similar characteristics not assigned to registered therapy dogs. Specifically, the study used data to ascertain whether students assigned to registered therapy dogs improved their reading skills and if these students demonstrated more or less growth than students of similar characteristics not assigned to registered therapy dogs. This study analyzed data from the Canine Assisted Reading Education (C.A.R.E. to Read) program, data collected from the teacher responses to the C.A.R.E. to Read Teacher Questionnaire, and data provided by Brevard Public School District. Repeated measures analyses and descriptive statistics clearly revealed that students assigned to registered therapy dogs demonstrated more reading growth than their peers who were not assigned to registered therapy dogs. Additionally, students assigned to the registered therapy dogs had a more positive attitude toward schoolwork, were more willing to participate in classroom activities, were more successful with higher level thinking skills, and were more self-confident after being assigned to the registered therapy dogs. Recommendations were made to address teacher training concerning classroom environment, higher level thinking skills, and identifying hesitant and resistant learners. Recommendations also were made for additional research on other uses for registered therapy dogs in the educational setting.
Ed.D.
Department of Educational Research, Technology and Leadership
Education
Educational Leadership EdD

Discrimination and inequality encountered by gays and lesbians in the United States is profuse. A cornerstone of the gay rights movement, equality in the workplace has been a pivotal struggle for gays and lesbians. This study examined the attitudes and opinions of registered nurses (RNs) regarding homosexuals in general and the protection of homosexuals in the workplace through a nondiscrimination policy. The author measured overall homophobic and discriminatory beliefs of the sample using the Attitudes Toward Lesbian and Gay Men (ATLG) Scale; the demographic questionnaire was infused with questions regarding a protective workplace policy. Using T-tests, one-way analysis of variance (ANOVA) and structural equation modeling (SEM), correlations between independent variables (gender, age, religious association, belief in the "free choice" model of homosexuality, education level, exposure to homosexuals through friends and/or family associations, race/ethnicity, and support or non-support of a workplace nondiscrimination policy protective of gay men and lesbians) with the dependent variable of homophobia were explored.
Ph.D.
Other
Health and Public Affairs
Public Affairs: Ph.D.

ABSTRACT The purpose of this study was to determine the extent to which enrollment management models have been successfully implemented within the 28 Florida community colleges. The study also sought to determine when enrollment management structures began and whether expected benefits were achieved. Analysis of the data collected in this study indicated the following five major findings. First, enrollment management concepts and practices have been implemented at some level within the 23 Florida community colleges surveyed. This was evident by the use of the word "enrollment" in the organizational titles as well as in the titles of the individuals who were responsible for the models. Second, enrollment management models reported were determined to be relatively new in comparison to four-year institutions. The literature on enrollment management demonstrated that four-year colleges began enrollment management practices in the early-to-mid 1970s. Much of the existing literature on enrollment management has been based on the experiences at four-year institutions. Third, some enrollment management divisions appeared to have key enrollment offices displaced. The key enrollment offices selected in this study were supported throughout the literature. Those offices represented were as follows: Admissions, Records and Registration, Financial aid, Orientation, and Advising. Fourth, increasing enrollment was the strongest reason for implementing the enrollment structure and subsequently was the strongest benefit realized. The anticipated decline in high school graduates, and the expectation of subsequent declining college enrollments during the 1970s, provided the impetus for the adoption of models of enrollment management. The fifth finding was that moving key enrollment offices such as financial aid into the enrollment management organizations would be an improvement to existing models. As enrollment management concepts are implemented into practice, the realignment of related offices may be necessary to effectively accomplish goals.
Ed.D.
Department of Educational Research, Technology and Leadership
Education
Educational Leadership

Little is known about how nurses learn and use coping and adaptation skills in the workplace. Quantitative studies have identified the factors, nature, and outcomes of nursing stress. However, qualitative studies describing the human experience associated with workplace stress are lacking. The phenomenon of interest for this study using focused ethnographic method is the self-described experience of coping and adaptation associated with workplace stress of registered nurses working 12-hour shifts employed in acute care hospital facilities in east central and central Florida. Three aspects of the phenomena were examined: the self-described experiences of stress, the manner in which coping skills are acquired, and the manner in which adaptation strategies are developed by experienced bedside nursing working 12-hour shifts in acute care hospital facilities. The purposive sample included nine female bedside nurses with five or more years' experience, working 12 hour shifts in acute care hospital facilities on bedside units, with patient ratios of 4:1 or greater. Data were collected using semi-structured, digitally recorded interviews at mutually convenient locations. The qualitative data were analyzed using inductive, constant, comparative process of coding, sorting, generalizing, and memoing to guide exploration and identify emergent themes and patterns. The predominant theme of stress emerged as the overwhelming sense of duty to the patient. Additional themes of coping and adaptation were noted. Recommendations for research, education, practice and policy are offered to support a healthy and sustainable nursing workforce.
Ph.D.
Doctorate
Nursing
Nursing
Nursing

School Psychology
Ph.D.
Kidney transplant recipients must take immunosuppressive medications to prevent the rejection of their transplanted kidney. If female transplant recipients become pregnant, however, very limited data are available about the effects of these medications on their exposed offspring. This study specifically reviews two of the most commonly used immunosuppressive medications prescribed to transplant recipients, cyclosporine and tacrolimus, and evaluates physical and cognitive development of the recipients' children who were exposed to these medications in utero. Participants in this study (n = 71) were female kidney transplant recipients who (a) voluntarily consented to be part of the National Transplantation Pregnancy Registry, (b) took cyclosporine or tacrolimus while pregnant, (c) had a child who is under the age of 6 years at the time of the study, and (d) were reachable via phone. Participants were asked standardized assessment questions related to their child's cognition and physical abilities from the Development Assessment of Young Children (DAYC). Standard scores from the assessment were recorded and analyzed to show that children exposed to cyclosporine or tacrolimus showed higher cognitive scores on the DAYC compared to the normative population. Children exposed to cyclosporine also showed higher physical scores compared to the normative population. Children exposed to tacrolimus did not show significant differences in physical development from the normative population. When cyclosporine or tacrolimus are required during pregnancy, these results help provide reassurance to parents and medical care providers about the cognitive and physical development of their offspring. Practical implications for school psychologists, limitations of this research, and directions for future research were discussed.
Temple University--Theses

Every year, millions of medical errors are committed, costing not only patient health and satisfaction, but thousands of lives and billions of dollars. Errors occur in many areas of the healthcare environment, including the profession of nursing. Nurses provide and delegate patient care and consequently, standard nursing responsibilities such as medication administration, charting, patient education, and basic life support protocol may be incorrect, inadequate, or omitted. Although there is much literature about errors among the general nurse population and there is indication that new nurses commit more errors than experienced nurses, not much literature asks the following question: What are the factors contributing to the commission of errors, including the omission of standard nursing care, among new nurses? Ten studies (quantitative, qualitative, and mixed-mode) were examined to identify these factors. From the 10 studies, the researcher identified the three themes of lack of experience, stressful working conditions, and interpersonal and intrapersonal factors. New nurses may not have had enough clinical time, may develop poor habits, may not turn to more experienced nurses and other professionals, may be fatigued from working too many hours with not enough staffing, may not be able to concentrate at work, and may not give or receive adequate communication. Based on these findings and discussion, suggested implications for nursing practice include extended clinical experience, skills practice, adherence to the nursing process, adherence to medications standards such as the five rights and independent double verification, shorter working hours, adequate staffing, no-interruption and no-phone zones, creating a culture of support, electronically entered orders, translation phones, read-backs, and standardized handoff reports.
B.S.N.
Bachelors
Nursing
Nursing

Background. The mounting burden of chronic disease associated with population ageing creates a challenge for health systems. Healthcare organisations are addressing this challenge by exploring new ways to improve patient health outcomes, including through the use of information technologies. Aim. This research aimed to identify key design features of a chronic disease management (CDM) register for the public sector health services provided in the Australian Capital Territory. Methods and setting. ACT Health, a government agency, is the largest health service provider in the ACT. An organisational analysis of ACT Health was conducted using qualitative, quantitative, and participant observation methods. Three index conditions- Chronic Heart Failure, Chronic Obstructive Pulmonary Disease, and Diabetes Mellitus Type 2 defined information according to the 'International Statistical Classification of Diseases and Health Related Problems: lOth Revision, Australian Modification' (ICD-10-AM)­ were chosen for data collection and analysis. Results. ACT Health policies support evidence-based CDM interventions, but their implementation has been slow and disjointed. This research found that support for CDM in ACT Health is within the 'basic support' range as measured by the MacColl Institute's Assessment of Chronic Illness Care (ACIC) survey. The survey revealed continuity of care as a concern. On the positive side, factor analysis of the survey results identified a novel 'patient empowerment' factor that was strength within ACT Health. This patient empowerment factor is somewhat more than a concept; it is one of the powerful predictors of positive outcomes for CDM interventions, and has policy importance in this particular regional health system for working toward CDM goals. In the participant observation aspect of this research, these findings were taken up to enrich the design features for an effective CDM register by incorporating the views of health professionals, patients and their carers. This research identified five data categories and associated variables required to support a CDM register. These five data categories are patient details, medical details, provider details, prevention details, and case coordination details. The prevention detail category is the centre of a CDM register intervention and consists of diagnostic, therapeutic and behavioural sub-categories. However, the research identified challenges regarding availability and completeness of these data in all five categories. Combining the survey and participant observation suggests that electronically incorporating standardised clinical information into a CDM register should enhance multidisciplinary communication, care planning and coordinated service delivery. A clinical data repository with data extraction and filtration systems compliant with the Health Level Seven International (HL7) metadata standard would enable the organisation to populate a CDM register's data fields from multiple sources. Conclusion. A health service specific CDM register based on established data standards can actively support effective CDM interventions within the service. Further expansion toward a population-based CDM register would depend on implementation of local and national e-Health initiatives to standardise clinical information for automatic extraction into CDM registers. The research provides policy and design recommendations to further strengthen chronic care processes to benefit patients with chronic diseases, their carers and health service providers.

Tese de doutoramento (Registo), Univ. de Lisboa, nº 28, 2009, (Immunologie), Université René Descartes - Paris V, 2009
Following antigenic challenge, naïve CD8+ T lymphocytes undergo severalchanges, including the expression of cell-surface molecules. In humans, theassociation of CCR7, CD45RA, CD27 and CD28 is widely used to discriminate areproducible set of functionally different subpopulations of CD8+ T cells. However,the prevailing data concerning the description of these subsets remainsfragmentary, since a multitude of studies used a different and limited set of surfacemarkers. Hence, some CD8+ T-cell subsets are still not clearly established,especially within the CCR7 CD45RA+ and CCR7 CD45R0+ compartments, andthe correspondent differential roles and lineage relationships remain undisclosed.The present study aims to define a predictable and precise correlationbetween particular cell surface markers and CD8+ T-cell functional properties. Weassociated CCR7, CD45RA, CD27 and CD28 expression levels to subdivide CD8+T cells into fourteen different cell types. These populations were further isolatedand gene expression of 18 genes was assessed, simultaneously, in single-cells bya novel multiplex RT-PCR method we developed. Our results demonstrate that thedifferent subpopulations display distinct and characteristic gene co-expressionpatterns, reproducible between donors. CD45RA expression is required to definethe naïve subset, but does not discriminate functionally different populations ofprimed cells. In contrast, gene expression profiles of CCR7-CD8+ T cells correlatesignificantly to CD27 expression levels and CD27/CD28 co-expression, and ahierarchy of activation stages could be established as follows: naïve < CD27high