View All Items

Title: FACTORS RELATED TO STRESS IN NURSING STUDENTS.
Creator: Shultz, Marie, Covelli, Maureen, University of Central Florida
Abstract / Description: The purpose of this review of literature was to explore and critically analyze relevant literature regarding stress factors and the consequences of stress in nursing students. Findings from this review of literature aimed to provide a better understanding of stress factors and the physical and psychological impact of stress on nursing students. Information was collected from the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and MEDLINE- EBSCOhost databases to explore...
Show moreThe purpose of this review of literature was to explore and critically analyze relevant literature regarding stress factors and the consequences of stress in nursing students. Findings from this review of literature aimed to provide a better understanding of stress factors and the physical and psychological impact of stress on nursing students. Information was collected from the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and MEDLINE- EBSCOhost databases to explore what research has been conducted and to assess the current knowledge base. Analysis of the literature indicated that nursing students reported experiencing increased levels of stress during the academic year. Nursing students reported higher levels of stress in conjunction with elevated external stressors, including increased responsibilities and course requirements. Analysis of the findings suggested that factors related to stress in nursing students arose from clinical sources, academic sources, and personal sources. Further analysis indicated that experiencing elevated levels of stress had a negative impact on the student. Increased levels of stress, combined with poor coping mechanisms, may lead to poor academic performance and burn-out among nursing students. Future research may evaluate means to reduce stress levels and mitigate stress in nursing students through targeting specific causative factors. Findings from this review of literature aim to influence student management of stress.
Show less
Date Issued: 2011
Identifier: CFH0003825, ucf:44778
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0003825

Title: EFFECTS OF PROBIOTICS ON THE REDUCTION IN INCIDENCE OF NECROTIZING ENTEROCOLITIS IN PREMATURE ([less than]37 WEEKS GESTATION) NEONATES.
Creator: Cox, Makenzie, Covelli, Maureen, University of Central Florida
Abstract / Description: Problem: Necrotizing Enerocolitis (NEC) is one of the leading causes of morbidity and mortality in neonatal intensive care units (NICU), affecting 7% to 14% of premature neonates weighing less than 1500g (Lin et al., 2008). Healthcare costs for the treatment of NEC account for roughly 20% of the 5 billion dollars spent on infants in the NICU annually (Gephart, McGrath, Effken and Halpern, 2012). Nutritional supplements, such as probiotics, may be used prophylactically to prevent NEC in this...
Show moreProblem: Necrotizing Enerocolitis (NEC) is one of the leading causes of morbidity and mortality in neonatal intensive care units (NICU), affecting 7% to 14% of premature neonates weighing less than 1500g (Lin et al., 2008). Healthcare costs for the treatment of NEC account for roughly 20% of the 5 billion dollars spent on infants in the NICU annually (Gephart, McGrath, Effken and Halpern, 2012). Nutritional supplements, such as probiotics, may be used prophylactically to prevent NEC in this high-risk population. Objective: A literature review was performed to examine which strains of probiotics show the most potential in reducing the incidence of necrotizing enterocolitis. Method: A literature review was performed using CINAHL, Science Citation Index, Science Direct, Medline, Academic One file, PsychINFO, and PUBMED databases. Key words included enterocolitis, Necrotizing*/PC OR NEC* AND probiotics*. After applying exclusion criteria, 9 articles remained for this review. Results: A variety of probiotic strains used to reduce the incidence of NEC were identified, along with inconsistent times of initiation, number of colony forming units and length of treatment. The most commonly studied probiotic strains include Lactobacillus species, Bifidobacterium species, and Saccharomyces species. After detailed analysis, it appears that a combination of Bifidobacterium species and Lactobacillus species reduce the incidence of NEC from an 8% (Fern�ndez-Carrocera et. al, 2013) reduction up to 100% reduction in the incidence of NEC (Braga, Pontes da Silva, Cabral de Lira, and Lima, 2011). These two species, when combined, were more successful when compared to Saccharomyces species or Lactobacillus species alone. Conclusion: Although there is positive support for the proactive use of probiotics for the reduction of the incidence of NEC in premature neonates, the inconsistencies between studies are a barrier for determination of a specific treatment recommendation. Although the combination of Bifidobacterium species and Lactobacillus species has been shown to have an impact on the reduction of NEC incidence, the research inconsistencies provide a barrier to generalizations for treatment. Additional research that focus on Bifidobactrium species in combination with Lactobacillus species is needed. Furthermore, the use of probiotics as a preventative treatment for NEC has not been thoroughly researched in extremely premature infant populations (gestation). Therefore, although the results are promising, further research is needed before this can be determined as a safe preventative method. The current questions remaining include: when prophylactic treatment should be initiated, how long prophylactic treatment should last, the number of colony forming units to be administered, and what is the long-term impact of probiotic administration on the normal gut flora, if any.
Show less
Date Issued: 2016
Identifier: CFH2000055, ucf:45537
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000055

Title: THE USE OF WET-TO-DRY DRESSINGS FOR MECHANICAL DEBRIDEMENT.
Creator: Villa, Katherine, Covelli, Maureen, University of Central Florida
Abstract / Description: Clinical management of complex wounds is essential to promote wound healing. Prolonged healing time may lead to longer and more costly hospitalizations and poorer patient outcomes. The removal of nonviable, necrotic tissue via debridement is vital to the healing process. One of the most common debridement techniques, in the United States, is the use of wet-to-dry dressings. There are no defined guidelines or protocols for the timing of dressing changes and subsequent debridement. The purpose...
Show moreClinical management of complex wounds is essential to promote wound healing. Prolonged healing time may lead to longer and more costly hospitalizations and poorer patient outcomes. The removal of nonviable, necrotic tissue via debridement is vital to the healing process. One of the most common debridement techniques, in the United States, is the use of wet-to-dry dressings. There are no defined guidelines or protocols for the timing of dressing changes and subsequent debridement. The purpose of this study was to perform a review of literature to determine the rationale for the use of wet-to-dry dressings, explore alternative time sequences of treatment, and to identify the risks and benefits for this methodology of debridement in an adult population with acute traumas. Inclusion criteria consisted of peer reviewed, English Language, research articles published within the last 5 years (2007-2012), adults with acute wounds treated by wet-to-dry dressing debridement. This review of literature was conducted using CINAHL and MEDLINE databases using the following search terms: Wound debridement, wet-to-dry dressing*, timing, sequencing, schedul*, standard*, debridement, acute wound*, and mechanical debridement. The review of literature yielded zero results meeting the search criteria therefore, a second review of literature was performed using the same search criteria but expanded to include articles published within the past 15 years (1997 -2012). The second review of literature also yielded zero results that met the search criteria. A lack of evidence supporting the use of wet-to-dry dressings for the purpose of debridement suggests that healthcare providers are following tradition rather than evidence based practices. Nurses and healthcare providers need education on best practices in wound care to advocate for their patients to ensure the best possible outcome. Further research on wound care modalities that are clinically efficient is needed.
Show less
Date Issued: 2013
Identifier: CFH0004362, ucf:45003
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004362

Title: APPRECIATING THE GOLDEN HOUR: A COMPARATIVE INTERDISCIPLINARY STUDY.
Creator: Tachon, Taylor, Heglund, Stephen, Covelli, Maureen, University of Central Florida
Abstract / Description: Within the health care, many medical professionals know about the critical time restraints for provisions of care within their discipline, but do not know the term "The Golden Hour". The Golden Hour is a term indicating the universal time restraint found within every area of health care and more specifically, every area of nursing. The term and concept represented by it should be recognized to better the outcomes of our patients. Although the Golden Hour typically indicates a 60-minute period...
Show moreWithin the health care, many medical professionals know about the critical time restraints for provisions of care within their discipline, but do not know the term "The Golden Hour". The Golden Hour is a term indicating the universal time restraint found within every area of health care and more specifically, every area of nursing. The term and concept represented by it should be recognized to better the outcomes of our patients. Although the Golden Hour typically indicates a 60-minute period of time, various settings recognize shorter and longer periods during which specific actions must be taken to assure positive patient outcomes. To meet this aim, this thesis will review studies related to outcomes as associated with time critical interventions that could be categorized by "The Golden Hour". To meet the goal, a search of CINAHL, MEDLINE, PsychINFO, and ScienceDirect databases was conducted. Findings of the search revealed that while the term is not widely used, the concept of time sensitive care is found in many areas of Health Care and, specifically, within multiple sub-disciplines of nursing.
Show less
Date Issued: 2018
Identifier: CFH2000314, ucf:45846
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000314

Title: SECONDARY VICTIMIZATION OF YOUNG ADULT FEMALE SEXUAL ASSAULT VICTIMS.
Creator: Hunter, Kristin M, Covelli, Maureen, Ricci, Susan, University of Central Florida
Abstract / Description: The response of community members and public institutions to the crimes of rape and sexual assault have been, historically, disappointing. Victims have felt forced into silence, ashamed to speak out about their experiences. More recently, with the rise of social media use and the #me-too movement, attention and interest has been garnered for this unique class of crimes and victims. It has been discovered that victims of sexual assault who report their assault to community members, police...
Show moreThe response of community members and public institutions to the crimes of rape and sexual assault have been, historically, disappointing. Victims have felt forced into silence, ashamed to speak out about their experiences. More recently, with the rise of social media use and the #me-too movement, attention and interest has been garnered for this unique class of crimes and victims. It has been discovered that victims of sexual assault who report their assault to community members, police investigators, and health care workers are at risk of secondary victimization. This is a series of attitudes, behaviors, and practices that retraumatizes, shames, and blames victims of sexual assault. These behaviors contribute to increased levels of Post-Traumatic Stress Disorder (PTSD), depression, anxiety, shame, self-blame, lack of perpetrator prosecution, and more. The purpose of this thesis was to evaluate the causes and effects of secondary victimization, its extent and prevalence, specifically how young adult females were affected by this issue, and any potential programs or solutions that may reduce or limit secondary victimization. This aim was achieved by reviewing and synthesizing thirty-two research articles related to issues of women's health, secondary victimization, and sexual assault or rape. Several programs were found to show promise for reducing this phenomenon, including sexual assault nurse examiner programs, victim advocates, professional counseling, and improving the education of police investigators and others involved in interactions with sexual assault victims.
Show less
Date Issued: 2019
Identifier: CFH2000473, ucf:45902
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000473

Title: Infection Control and Health Care Associated Infection (HCAI) in the Nursing Home: A Study to Determine the Impact of an Educational Video and Pamphlet About Infection Control on Knowledge and Perception of Hand Hygiene in Certified Nurse Assistants.
Creator: Hypes, Kathe, Blackwell, Christopher, Covelli, Maureen, Winton, Mark, University of Central Florida
Abstract / Description: The impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO's Hand Hygiene Knowledge Questionnaire...
Show moreThe impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO's Hand Hygiene Knowledge Questionnaire and the WHO Perception Survey. Friedman's test and central tendencies showed no statistical relationship between the educational intervention and the overall knowledge scores of the sample. There also were no statistical differences in perception of hand hygiene in the CNA sample. Infection frequency was reduced with a percent change of -42%. While results of knowledge and perception surveys were not statistically significant, multiple conclusions were derived to suggest that educational opportunities may impact hand hygiene practice in CNAs and lead to a decrease in infection.
Show less
Date Issued: 2012
Identifier: CFE0004551, ucf:49239
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004551

Title: Perceptions Influencing School Nurse Practices to Prevent Childhood Obesity.
Creator: Quelly, Susan, Covelli, Maureen, Bushy, Angeline, Norris, Anne, Lieberman, Leslie, University of Central Florida
Abstract / Description: Approximately one-third of children in the United States are overweight or obese with increased risks for numerous physical and psychosocial comorbidities. Schools are ideal environments to address this serious health crisis and school nurses are uniquely positioned qualified healthcare providers to actively participate in childhood obesity prevention (COP). A review of the literature provided findings to identify a gap in the knowledge regarding the association between school nurse COP...
Show moreApproximately one-third of children in the United States are overweight or obese with increased risks for numerous physical and psychosocial comorbidities. Schools are ideal environments to address this serious health crisis and school nurses are uniquely positioned qualified healthcare providers to actively participate in childhood obesity prevention (COP). A review of the literature provided findings to identify a gap in the knowledge regarding the association between school nurse COP perceptions and practices. A modified theoretical framework based on Bandura's health promotion by social cognitive theory guided this study. The purpose of this study was to identify the key perceptions (self-efficacy, perceived benefits and perceived barriers) influencing school nurse participation in COP practices and determine associations between school nurse characteristics and COP perceptions and practices. Preliminary research was conducted to determine content validity for modified perception scales, clarity of instructions and questions, data collection and retrieval procedures, and refinement of recruitment strategies. Adequate reliability and validity was determined for modified scales measuring school nurse self-efficacy, perceived benefits, perceived barriers, and COP practices targeting individual children (child-level) and the entire school population (school-level). Florida RN school nurses (n = 171) completed self-administered anonymous questionnaires from an emailed weblink or a paper version offered at two Florida Association of School Nurses conferences. School nurses with characteristics reflecting more education engaged in more COP practices (p (<) .05) than those without education-related characteristics. School nurses with (>) 8 hours of COP education reported higher COP self-efficacy than those with none (p (<) .01). Linear regressions showed that a model comprised of self-efficacy, perceived benefits, and perceived barriers significantly explained 12.0% of the variance in child-level practices (p (<) .001) and 9.1% of school-level practices (p (<) .001). Self-efficacy explained the most variance of school nurse child-level and school-level practices (p (<) .001), and perceived barriers were inversely associated with child-level practices (p (<) .05). Four series of regressions showed that only perceived barriers partially mediated the influence of self-efficacy on child-level practices. Data analyses indicated self-efficacy and perceived barriers were key determinants of school nurse COP practices. Therefore, policy changes and educational interventions to increase self-efficacy and reduce perceived barriers may be effective in mobilizing school nurses to actively engage in COP practices.
Show less
Date Issued: 2012
Identifier: CFE0004585, ucf:49188
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004585

Title: Adherence Practices of Caucasian Women With Hypertension Residing in Rural Florida: An Exploratory Study.
Creator: Hopple, Jeanne, Bushy, Angeline, Sole, Mary, Covelli, Maureen, Oetjen, Dawn, University of Central Florida
Abstract / Description: Hypertension, or high blood pressure, is a major risk factor for heart disease and stroke. Elevated blood pressure is often a silent process affecting multiple organ systems. Risk for heart disease is associated with poorly treated or unrecognized hypertension that is more common among women than men. Non-adherence to prescribed treatment regimens has been identified as a major reason for inadequate hypertension management. This exploratory descriptive qualitative study using narrative...
Show moreHypertension, or high blood pressure, is a major risk factor for heart disease and stroke. Elevated blood pressure is often a silent process affecting multiple organ systems. Risk for heart disease is associated with poorly treated or unrecognized hypertension that is more common among women than men. Non-adherence to prescribed treatment regimens has been identified as a major reason for inadequate hypertension management. This exploratory descriptive qualitative study using narrative inquiry investigated adherence practices among Caucasian women with diagnoses of hypertension from a rural area of Florida. The purpose of this study was to gain an understanding from women who had been diagnosed with hypertension about the challenges of living with and managing this chronic condition in their daily lives. Participants included Caucasian women (n = 11) recruited from a Federally Qualified Rural Health Center in Florida. Semi-structured interviews were used to collect data. Content analysis procedures were used to analyze the interviews. Emergent themes included: work stress affecting health and leading to high blood pressure; silent (")sneaky, gradual(") onset of mild to moderate symptoms leading to high blood pressure; and strong influence of family members with high blood pressure and related complications that instilled fear in participants to adhere to their prescribed treatment plan in some, or in others to non-adherence. Social support from friends and coworkers was a repeated theme supporting adherence. Minor themes associated with non-adherence included fear of potential side effects of medications, challenges of daily living caring for family, fatigue from high blood pressure and medications affecting daily work, poor food choices due to finances and availability of high sodium and fatty foods at work and home, stress and time demands affecting ability to exercise to control high blood pressure, and focus on family forgetting self-needs. Limitations of the study included a small convenience sample with findings that may not be applicable to a population of hypertensive women from different rural settings. Future nursing studies in similar populations may contribute to improved adherence practices, leading to reduced complications from poorly controlled hypertension.
Show less
Date Issued: 2011
Identifier: CFE0004120, ucf:49100
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004120

Title: An Exploratory Study of Physiologic Responses to a Passive Exercise Intervention in Mechanically-ventilated Critically Ill Adults.
Creator: Amidei, Christina, Sole, Mary, Byers, Jacqueline, Covelli, Maureen, Smith, Gerald, University of Central Florida
Abstract / Description: Muscle weakness is the most common and persistent problem after a critical illness. Early mobilization of the critically ill patient, beginning with passive exercise and progressing to ambulation, may mitigate muscle effects of the critical illness. However, mobilization may produce adverse effects, especially early in the illness when risk for physiologic deterioration is common. If safe, introducing a mobility intervention early in the illness may facilitate ventilator weaning, shorten...
Show moreMuscle weakness is the most common and persistent problem after a critical illness. Early mobilization of the critically ill patient, beginning with passive exercise and progressing to ambulation, may mitigate muscle effects of the critical illness. However, mobilization may produce adverse effects, especially early in the illness when risk for physiologic deterioration is common. If safe, introducing a mobility intervention early in the illness may facilitate ventilator weaning, shorten intensive care unit and hospitals stays, and improve functional status and quality of life for mechanically ventilated critically ill patients. The aim of this study was assess the cardiopulmonary and inflammatory responses to an early standardized passive exercise protocol (PEP) in mechanically ventilated critically ill patients. Using a quasi-experimental within-subjects repeated measures design, mechanically ventilated critically ill adults who were physiologically stable received a single standardized PEP within 72 hours of intubation. The PEP consisted of 20 minutes of bilateral passive leg movement delivered by continuous passive motion machines at a rate of 20 repetitions per minute, from 5-75 degrees, to simulate very slow walking. Physiologic parameters evaluated included heart rate (HR), mean blood pressure (MBP), oxygen saturation, and cytokine levels (IL-6 and IL-10), obtained before, during, and after the intervention. The Behavioral Pain Scale (BPS), administered before, during and after the intervention was used as a measure of participant comfort. The study sample was comprised of 18 (60%) males and 12 (40%) females, with a mean age of 56.5 years (SD 16.9 years), who were primarily Caucasian (N=18, 64%). Mean APACHE II scores for the sample were 23.8 (SD 6.2) with a mean predicted death rate of 48.8 (SD 19.8), indicating moderate mortality risk related to illness severity. Number of comorbidities ranged from 1-10 (X=4). All participants completed the intervention with no adverse events. Using repeated measures analysis of variance (rmANOVA), no significant differences were found in HR, MBP, or oxygen saturation at any of the four time points in comparison to baseline. BPS scores were significantly reduced (F(2.43, 70.42)=4.08, p=.02) at 5 and 10 minutes after the PEP was started, and were sustained at 20 minutes and for one hour after the PEP was completed. IL-6 was significantly reduced (F(1.60, 43.1)=4.351, p=.03) at the end of the intervention but not at the end of the final rest period. IL-10 values were not significantly different at any of the three time points, but IL-6 to IL-10 ratios did decrease significantly (F(1.61, 43.38)=3.42, p=.05) at the end of the PEP and again after a 60 minute rest period. Passive leg exercise was well tolerated by study participants. HR, MBP, and oxygen saturation were maintained within order set-specified ranges during and for one hour after activity, and patient comfort improved during and after the intervention. A downward trend in HR was noted in participants, which is contrary to usual HR response during exercise, and may represent clinical improvement in this population related to reduction in pain. Reduction of mean IL-6 values at the end of the PEP, but not after the rest period, suggests that the PEP was responsible for the initial IL-6 improvement. Improvement of IL-6 to IL-10 ratios from the end of the PEP to the end of the final rest period suggests that IL-10, although non-significant, may have had some effect, indicating that IL-10 increases may occur later than the time period of study.Passive exercise can be used as an approach to facilitating mobilization in mechanically ventilated critically ill adults until they are ready to participate in more active exercise. It could be that more frequent and aggressive exercise, such as passive cycling at faster rates, four times daily, will be tolerated in this population. While the understanding of clinical significance of cytokine profiles in critically ill patients is still evolving, cytokine levels may be useful in explaining benefits of mobilization in this population. Further study is required to replicate the impact of passive exercise on pain, and it may represent a novel approach to pain management in critically ill patients.
Show less
Date Issued: 2012
Identifier: CFE0004350, ucf:49424
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004350

Title: Helping Mothers Defend their Decision to Breastfeed.
Creator: Natoli, Kandis, Aroian, Karen, Covelli, Maureen, Quelly, Susan, Uddin, Nizam, Miller, Ann, University of Central Florida
Abstract / Description: The United States has established breastfeeding as an important health indicator within the Healthy People agenda. Healthy People target goals for breastfeeding initiation, duration, and exclusivity remain unmet. The US Surgeon General's Office reports that lack of knowledge and widespread misinformation about breastfeeding are barriers to meeting Healthy People goals. Breastfeeding mothers are vulnerable to messages that cast doubt on their ability to breastfeed. Very little research has...
Show moreThe United States has established breastfeeding as an important health indicator within the Healthy People agenda. Healthy People target goals for breastfeeding initiation, duration, and exclusivity remain unmet. The US Surgeon General's Office reports that lack of knowledge and widespread misinformation about breastfeeding are barriers to meeting Healthy People goals. Breastfeeding mothers are vulnerable to messages that cast doubt on their ability to breastfeed. Very little research has examined specific approaches to help people resist negative messages about health beliefs and behaviors. The objective of this quasi-experimental study was to test an intervention designed to help mothers defend their breastfeeding decisions and resist influences that attempted to persuade them to give formula to their babies. Women attending prenatal breastfeeding classes were recruited and assigned to comparison and intervention groups. The intervention was a board game based on McGuire's inoculation theory of resistance to influence. Controlling for intention to breastfed, intervention and comparison groups were examined for differences in maternal self-efficacy to resist persuasion to give formula and breastfeeding rates for initiation, duration, and exclusivity. Data analyses consisted of analysis of covariance and logistic regression. There was no significant difference between comparison and intervention groups, both groups had high self-efficacy to resist giving formula to their babies; nor were there significant differences regarding breastfeeding initiation, duration and exclusivity. The lack of significant differences may have been influenced by ceiling effects in all of the breastfeeding variables, possibly due to the high socioeconomic level of the sample. The intervention may have worked better in women who were more prone to dissuasive influence, such as those with lower education.
Show less
Date Issued: 2015
Identifier: CFE0005981, ucf:50764
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005981

Title: An Evaluation of Anxiety Following Substance Abuse Withdrawal and Assessment of Somatic Treatments presently Available with a Focus on Cranial Electrotherapy Stimulation.
Creator: Hutchison, Janet, Neff, Donna, Weiss, Josie, Covelli, Maureen, Seikel Thomas, Stacy, University of Central Florida
Abstract / Description: Addictive disorders/substance use disorders (SUDS) affect almost everyone in the United States, either directly or indirectly. The cost of substance abuse to the social and economic structure in the United States is huge. Anxiety is one of the most frequently mentioned symptoms which lead to relapse during the early weeks of recovery due to neurohormonal changes in the limbic system as well as cortisol production which occur during this time. Present research in the treatment of anxiety in...
Show moreAddictive disorders/substance use disorders (SUDS) affect almost everyone in the United States, either directly or indirectly. The cost of substance abuse to the social and economic structure in the United States is huge. Anxiety is one of the most frequently mentioned symptoms which lead to relapse during the early weeks of recovery due to neurohormonal changes in the limbic system as well as cortisol production which occur during this time. Present research in the treatment of anxiety in substance abuse and long term recovery is focused on genetics and pharmaceuticals, however most pharmaceuticals produce sedation. Additional therapies in early recovery, which decrease the symptoms of anxiety while enhancing cognitive ability to learn and apply coping skills, are needed.Purpose: The purpose of this dissertation was to identify the natural degradation of anxiety symptoms occurring during the first few weeks following detox from alcohol or opiates. To identify non pharmacological methods in use to decrease anxiety symptoms during this period, and then examine whether treatment with Cranial Electrotherapy Stimulation (CES) would enhance the degradation of anxiety symptoms. Methods and Results: The initial prospective study of 53 men in residential treatment, measured anxiety on entry, 30 and 60 days. The results found that increased anxiety measured prior to a participant leaving against medical advice was more significant than increased anxiety measured on admission. The follow-on pilot study in the same residential program was a double-blind experimental study using CES with active and placebo CES units loaned from the manufacturer. The intervention was conducted during the first 3 weeks of opiate/alcohol abstinence; a period identified when anxiety peaks, and dropout rate is high. There were 29 men in the experimental group and 31 in the placebo group. Salivary cortisol and state anxiety were measured on the first and final day of CES treatment. Anxiety was also measured at study enrollment and at 30 days when study enrollment was terminated. The results were statistically inconclusive as both the placebo and CES (experimental) groups trended downward; however the trend was greater in the CES group. Discussion/Implications: Anxiety was identified as a significant factor in leaving treatment early. Cranial Electrotherapy Stimulation appears to decrease anxiety in non-substance abusing populations. However, these finding were not supported in this substance abusing population during the first month of recovery. Although CES appeared to be the most promising alternative therapy, more research is needed in the use of this and other emerging therapies for the treatment of anxiety symptoms during this early recovery period.
Show less
Date Issued: 2016
Identifier: CFE0006118, ucf:51169
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006118

Title: Ventilator-Associated Complications in the Mechanically Ventilated Veteran.
Creator: Grano, Joan, Sole, Mary, Covelli, Maureen, Talbert, Steven, McGuirt, Aron, University of Central Florida
Abstract / Description: Surveillance of ventilator-associated pneumonia (VAP) has been the common outcome measurement used for internal and external benchmarking for mechanically ventilated patients; and although not a clinical definition, it is commonly used as an outcome measurement for research studies. Criteria in the VAP definition include both subjective and objective components, leading to questions of validity. In addition, recent legislation has mandated the public reporting of healthcare-associated...
Show moreSurveillance of ventilator-associated pneumonia (VAP) has been the common outcome measurement used for internal and external benchmarking for mechanically ventilated patients; and although not a clinical definition, it is commonly used as an outcome measurement for research studies. Criteria in the VAP definition include both subjective and objective components, leading to questions of validity. In addition, recent legislation has mandated the public reporting of healthcare-associated infections, including VAP, in many states. Infectious disease experts have recently recommended monitoring a new outcome, ventilator-associated events (VAE), that contain specific objective criteria. The Centers for Disease Prevention and Control (CDC) have refined this definition and released a new VAE protocol and algorithm, replacing the VAP surveillance definition, as a result. The VAE protocol assesses for ventilator-associated conditions (VAC). The primary aims of this study were to determine the incidence of VAC; and to assess four predictors for VAC, including two VAP prevention strategies (use of the subglottic secretion drainage endotracheal-tube [SSD-ETT]), and daily sedation vacation); and two patient-related factors (alcohol withdrawal during mechanical ventilation, and history of COPD). In addition, the incidence for VAE, using a new national algorithm was determined. Using a retrospective study design, electronic medical records of 280 veterans were reviewed to identify cases of VAC using the VAE algorithm. The setting was two intensive care units (ICU) at a large Veterans Administration Healthcare System (VAHCS) from October 2009 to September 2011. In addition to demographic information, variables were collected to determine if cases met event criteria (VAC, infection-related ventilator-associated complication [IVAC], and possible or probable VAP). Incidence rates were calculated for VAC and IVAC. Comparative data between those with and without VAC were assessed with independent sample T-test or non-parametric equivalents. The study sample was predominantly male (97.1%), Caucasian (92.1%), non-Hispanic (90.7%); with a mean (SD) age of 67.2 (10.4) years. Twenty patients met the VAC definition resulting in a VAC incidence of 7.38 per 1000 ventilator days. There were no statistically significant differences in demographics or disease characteristics found between the two groups (patients with VAC and patients without VAC). Using logistic regression, the impact of the four predictors for VAC was assessed. None of the four explanatory variables were predictive of the occurrence of VAC. Secondary outcomes (e.g. mechanical ventilation days, ICU days, hospital days, and mortality) of veterans with VAC were compared to veterans without VAC. Results indicated that the VAC group was associated with a significantly longer duration of ICU stay, longer mechanical ventilation period, more likely to have a tracheostomy, and had a higher mortality during hospitalization. Expanding mechanical ventilation quality performance measures to include VAE/VAC provides a better representation of infectious and non-infectious ventilator-associated problems, and provides more accurate morbidity and mortality in this high-risk ICU population. Further research is necessary to explore patient characteristics and prevention strategies that impact the development of all VAC.
Show less
Date Issued: 2013
Identifier: CFE0004853, ucf:49706
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004853

Title: A Faith-Based Primary Diabetes Prevention Intervention for At-Risk Puerto Rican Adults: A Feasibility Study.
Creator: Torres-Thomas, Sylvia, Chase, Susan, Covelli, Maureen, Gonzalez, Laura, Yan, Xin, Miller, Ann, University of Central Florida
Abstract / Description: Diabetes is a serious health threat that disproportionately affects Hispanics of Puerto Rican heritage. Current evidence supports diabetes prevention programs to change health behaviors in people who are at risk and thus prevent the development of type 2 diabetes. However, few interventions exist for Hispanics, and even fewer have been designed for Puerto Rican adults. A literature review of community-based diabetes prevention programs involving at-risk Hispanics was conducted using a...
Show moreDiabetes is a serious health threat that disproportionately affects Hispanics of Puerto Rican heritage. Current evidence supports diabetes prevention programs to change health behaviors in people who are at risk and thus prevent the development of type 2 diabetes. However, few interventions exist for Hispanics, and even fewer have been designed for Puerto Rican adults. A literature review of community-based diabetes prevention programs involving at-risk Hispanics was conducted using a cultural sensitivity framework to determine the state of the science and identify gaps in knowledge regarding diabetes prevention for Puerto Ricans. An integrated theoretical framework was developed using constructs from the extended parallel process model (perceived severity and susceptibility) and social cognitive theory (self-efficacy) to design program components aimed to educate and motivate positive dietary behavior change in Puerto Rican adults. The two key components were a diabetes health threat message and dietary skill building exercises that incorporated spirituality and relevant faith practices, and were culturally-tailored for Puerto Ricans. A pretest-posttest, concurrent mixed methods design was used to test the impact and evaluate feasibility of a diabetes health threat message and skill-building exercises in a sample of Puerto Rican adults. A total of 24 participants enrolled in the study and attended six-weekly meetings that included baseline data collection, a health threat message, dietary skill building exercises, focus group interviews, posttest data collection, and an end-of-study potluck gathering. All of the study participants were Puerto Rican and a majority were female (70.8%), with a mean age of 55.5 years (SD 13.71). Most had a family history of diabetes (n = 21, 87.5%) and believed they were at-risk for the disease (n = 16, 66.7%). Using Wilcoxon matched-pairs signed rank test, significant increases or improvements were found in perceptions of diabetes severity (p (<) .01), dietary self-efficacy (p = .002), and dietary patterns (p = .02) at posttest in comparison to baseline. Spearman's rank correlations found moderate to strong relationships between the following variables: perceived severity and weight (rs = -.44, p = .03), dietary self-efficacy and dietary patterns (rs = .43, p = .04), dietary self-efficacy and fasting blood glucose levels (rs = - .45, p = .03), and American acculturation and weight (rs = .51, p = .02). The qualitative themes that emerged contributed to our understanding of participants' perspective relative to the health threat message, dietary skill building exercises, and the importance of cultural relevance and spirituality. The data support feasibility of this faith-based intervention that had an attendance rate of 58% and no loss of sample due to attrition. Diabetes prevention interventions for at-risk Puerto Ricans adults that incorporate a faith-based, culturally-tailored health threat message and dietary skill building exercises may help educate those who are at-risk and motivate lifestyle behavior change to prevent the development of diabetes. Further faith-based, culturally-tailored diabetes prevention research is indicated for Puerto Rican adults.
Show less
Date Issued: 2015
Identifier: CFE0005725, ucf:50124
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005725

60 minutes (1)	+ -
Addiction recovery (1)	+ -
Anxiety opiate alcohol detox (1)	+ -
Bificobactrium (1)	+ -
CES (1)	+ -

Caucasian rural women (1)	+ -
Childhood obesity prevention (1)	+ -
Cortisol in recovery (1)	+ -
Critical care (1)	+ -
Diabetes prevention (1)	+ -
Emergency (1)	+ -
Golden Hour (1)	+ -
Health care associated infections (1)	+ -
Lactobacillus (1)	+ -
Mechanical debridement (1)	+ -
NEC (1)	+ -
Perceptions (1)	+ -
Practices (1)	+ -
Puerto Ricans (1)	+ -
School nurse (1)	+ -
Time limitation (1)	+ -
adherence (1)	+ -
adherence practices (1)	+ -
breastfeeding (1)	+ -
certified nurse assistants (1)	+ -
controlled trial (1)	+ -
cytokines (1)	+ -
education (1)	+ -
exercise (1)	+ -
faith-based (1)	+ -

ETD Collection (8)	+ -
Honors Collection (5)	+ -

Covelli, Maureen (13)	+ -
University of Central Florida (13)	+ -
Sole, Mary (3)	+ -
Bushy, Angeline (2)	+ -
Miller, Ann (2)	+ -

Quelly, Susan (2)	+ -
Amidei, Christina (1)	+ -
Aroian, Karen (1)	+ -
Blackwell, Christopher (1)	+ -
Byers, Jacqueline (1)	+ -
Chase, Susan (1)	+ -
Cox, Makenzie (1)	+ -
Gonzalez, Laura (1)	+ -
Grano, Joan (1)	+ -
Heglund, Stephen (1)	+ -
Hopple, Jeanne (1)	+ -
Hunter, Kristin M (1)	+ -
Hutchison, Janet (1)	+ -
Hypes, Kathe (1)	+ -
Lieberman, Leslie (1)	+ -
McGuirt, Aron (1)	+ -
Natoli, Kandis (1)	+ -
Neff, Donna (1)	+ -
Norris, Anne (1)	+ -
Oetjen, Dawn (1)	+ -
Ricci, Susan (1)	+ -
Seikel Thomas, Stacy (1)	+ -
Shultz, Marie (1)	+ -
Smith, Gerald (1)	+ -
Tachon, Taylor (1)	+ -

Search In

Sort Results By:

Narrow results by:

Topical Subject

Collection

Type of Resource

Language

Creator

Format

Owner