Browsing by Author "Redican, Kerry J."

Now showing 1 - 20 of 123
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    Achievement Of Developmental Milestones Among Salvadorian Orphans
    Swartz, Katherine Lively (Virginia Tech, 2009-02-02)
    El Salvador has a large population of children living in orphanages where, as predictions from previous research indicate, many will not meet developmental milestones that could be remediated with research and development. The purpose of this study was to determine milestone achievement and environmental impact among Salvadorian orphans at selected sites, in order to make recommendations for appropriate training materials to allow for the mentoring of caregivers to advance milestone achievement among the orphans. The five objectives addressed in the research are in context of two investigator selected orphanages in El Salvador: 1. Determine the current level of development of orphans using the Battelle Developmental Inventory Screening Test. 2. Determine characteristics of caregivers who have frequent interactions with the orphans. 3. Determine areas of strength and deficiency among the orphans with respect to Personal-Social, Adaptive, Motor, Communications, and Cognition. 4. Determine the level of association between selected characteristics of orphans with developmental milestone achievement. 5. Develop a model caregiver-training program for implementation at the two selected orphanages based on investigator-derived characteristics and related findings. Screening Tool strengths and deficiencies were identified among the orphans with respect to Personal-Social, Adaptive, Motor, Communications, and Cognition. The Batelle Developmental Inventory Screening Tool in Spanish was completed on 34 qualifying children at Hogar Immaculado Corazon de Maria orphanage and an additional ten screening tools were completed on qualifying children at Casa de Mi Padre. Statistical analyses determined the level of association between selected characteristics of orphans with developmental milestone achievement. Using findings from this initial phase, a model caregiver-training program was developed and implemented at the two selected orphanages based on investigator-derived characteristics and related findings. Conclusions from the study and recommendations were developed from the findings. The level of achievement of developmental milestones among the selected orphans was below the expected level for their chronological age. The caregivers employed by the two orphanages were a diverse group of individuals from a variety of backgrounds. The majority of them described themselves as not having formal education in child development. The strong interest they demonstrated during the training program indicated an eagerness and willingness to learn. The areas of greatest deficiency were communication and cognitive scores. The areas of relative strength were Adaptive and Motor skills. There were few statistically significant relationships between the selected independent variables and the scores on the screening tool with the exception of association between motor scores and both the child?s nutritional status and the number of months they have spent in the orphanage. Months spent in the orphanage also show some evidence of association with communication scores, but not statistically significant. The model intervention program was successfully implemented and should be part of an on-going training program. Future research should replicate this study in similar setting and provide additional probes with a larger sample to substantiate these finding and more in depth understanding for enhancement of both theory and practice.
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    Adolescent Girls' Body-Narratives and Co-Constructed Critical Interpretations
    Oliver, Kimberly L. (Virginia Tech, 1996-06-05)
    Narrative analysis, a form of narrative inquiry, uses stories to frame and describe how people interpret and construct the meanings of their lives. Stories connect us with our past, help us to understand our present, and offer vision of possible futures. People live and create their lives through the stories they see, hear, tell, internalize, and hope for. The interpretation of narrative is not about certainties or standards, but rather about the multiplicity of perspectives and possibilities that can be constructed to make experience understandable. Critical interpretation of narrative can thus be a transformative process; a process being so crucial to the health of adolescent girls in Western culture. This study explores how four adolescent girls, and one researcher, together, interpreted and constructed the meanings of their bodies. The journey connects the researcher's struggle to find more democratic and empowering forms of inquiry, with the stories four eighth grade girls, diverse in race, social class, religion, and skin color, tell about how they experience and see their bodies in culture, in relation to others, and as them selves. All four girls are learning to create and desire an "image" of an ideal woman, and thus are beginning to objectify their bodies to be "looked at" by others. Image was a predominant interpretive frame for constructing meaning of the body for all four girls. Yet race, particularly visual racial representations, was also a predominant interpretive frame for the two African American, and one African American-Indian girls.
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    Alcohol consumption, wantedness, and support of pregnant adolescents
    Shortt, Sandra Small (Virginia Polytechnic Institute and State University, 1982)
    The purpose of this study was to explore relationships between pregnant teens' use of alcohol before and during pregnancy and several personal and social variables, including the wantedness of the pregnancy, support of the pregnancy by significant others, pregnant teens' reasons for drinking, the context of their drinking, and the use of alcohol by significant others. This information is needed to plan and evaluate effective prenatal education and intervention programs related to the use of alcohol during pregnancy. Such programs are important in light of increasing numbers of pregnant teens, the number of female adolescent drinkers, and findings about the effects of moderate and binge drinking on fetal development. Subjects consisted of 14 to 19 year old patients of the High-Risk Ob/Gyn Clinic at Roanoke Memorial Hospitals. These patients were predominantly low income urban and suburban teens, with some referrals from areas outside Roanoke City and County. Subjects responded anonymously to a written questionnaire. One-fourth of the subjects were classified as drinkers according to their binge drinking before and during pregnancy. Higher percentages of drinkers than abstainers were white, married, had been pregnant at least once in the past, and intended to become pregnant. Proportionately fewer drinkers indicated religious preferences or attended church services on a regular basis. Drinkers were more likely to smoke and smoked more than abstainers. Personal effects reasons for drinking, consumption in settings where adults were not present, and weekly consumption by peers and boyfriends/husbands were reported by significantly higher percentages of drinkers than nondrinkers. Wantedness and support of significant others were significantly related. Knowledge of the potential harm that all types of alcoholic beverages pose to fetal development was reported by over 70% of the sample. Key sources of knowledge about alcohol and fetal risk were subjects' mothers, pamphlets or books, school health class, the RMH Clinic and television. Boyfriends were also a key source of information for drinkers. Implications of these findings for clinical and educational practice are discussed.
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    An Analysis of National HIV/AIDS Education Efforts Among 15-39 Year Olds and Health Care Workers Applying the Health Belief Model (HBM) in Six Cities in Sonsonate, El Salvador
    Cates, Sarah Elizabeth (Virginia Tech, 2009-01-27)
    This descriptive research used the Health Belief Model (HBM) to assess HIV/AIDS knowledge, perceived severity, perceived susceptibility, and behavioral practices within the population throughout the State of Sonsonate, El Salvador. Geographic Information Systems (GIS) was also utilized to display the results of this population study. The study population was composed of 15-39 year olds consisting of a total sample size of 1,500 (250 participants from each of the six cities). The basis of this study was to evaluate where this population fit within the Health Belief Model (HBM) and also to practically represent the results pictorially. Also, this information was collected so that the government of El Salvador could see and understand where their educational deficits existed so that future programs could be established to alleviate these discrepancies. An instrument consisting of 65 items including demographics, knowledge, perceived severity, perceived susceptibility, and behavioral practices was used for the general population. The analysis of the data was two-fold using Geographic Information Systems (GIS) mapping and statistical analysis. GIS mapping was used to graphically pinpoint areas of knowledge deficit and misinformation about HIV/AIDS. Results were based on a general population of 1,454. Various indices were created to show the level of knowledge or frequency of safe behavioral practices. The Perceived Severity and Perceived Susceptibility sections were not aggregated into an index but rather treated as individual variables. An item analysis of the questionnaire found that on average the general population responded correctly to 78% of the knowledge questions. However, a total of 11 questions in the knowledge section had less 75% (n=385) of the general population answering correctly. Another 3 questions in the behavior section were also found to have less than 75% (n=385) indicating safe behavioral practices. Linear regression analyses were performed to explore correlations between the areas of demographics, knowledge level, perceived severity, and perceived susceptibility to safe behavior. GIS maps were created to pictorially show where this population's deficiencies were in regard to the HBM. This research helped to pinpoint where this population fits within the construct of the Health Belief Model so that future educational efforts can be targeted in geographic areas with the greatest need. This will help to move this sample toward behavioral change.
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    An analysis of player position group, height, weight, and relative body weight and their relationship to scores on the Functional Movement Screen(TM)
    Krackow, Michael Stuart (Virginia Tech, 2001-12-10)
    Sports medicine professionals are continuously attempting to keep the incidence of injuries down. One way to accomplish this is to employ preventive methods that identify athletes who are at a greater risk of becoming injured prior to the start of the athletic season. The Functional Movement Screen™ (FMS) is a screening method that attempts to identify those individuals at risk of sustaining injuries by determining deficits in athletes' mobility and stability. This is an area of great conflict because athletic injuries result from many factors, not only in mobility and stability weaknesses. Therefore, it must first be determined whether deficient scores on the FMS are the result of the proposed weakness, or rather other potential risk factors. Functional Movement Screen™ scores were collected from 136 collegiate Division 1-A football players from three athletic programs. The scores were separated into one of three groups based upon the position played by each subject: (1) skill group, (2) combo group, and (3) line-of-scrimmage group. Data were also collected on each subject's height, weight, and relative body weight (BMI). The results of the ANOVA and Tukey HSD showed that there was a significant difference p < 0.05 between the line-of-scrimmage group and the skill group, as well as between the line-of-scrimmage group and the combo group. No significant difference was demonstrated between the combo group and the skill group. The results of the Pearson Correlation demonstrated a significant negative relationship p < 0.05 between the height of an athlete and the score received on the FMS. Significant negative relationships p < 0.01 were shown between the weight of an athlete and the score received on the FMS, as well as the relative body weight (BMI) and the athletes' score on the FMS. The results suggest that the score an athlete receives on the FMS may not reflect mobility and stability deficiencies because other factors affect the outcome of the scores. Therefore, at the present time, the FMS may not be a reliable tool by itself for identifying athletes who are at a greater risk of sustaining non-contact types of injuries.
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    An Analysis of Student Assistance Program Characteristics and Activities in Selected Illinois Schools
    Wampler, James R. (Virginia Tech, 2010-03-30)
    The main purpose of this study was to survey the participants, directors, and the coordinators that are associated with the SAP. The survey was done in order to determine opinions concerning the factors, procedures, standards, and guidelines for this program. Whether they are adequate, in order, complete enough and properly fitting, are questions to be reviewed in this document. They hopefully will verify items that are proper, thorough, and complete. They may accentuate procedures and factors that are illuminative, that highlight the points of the programs that are successfully aiding students. The need and interest in continuing educational programs is pointed out. It is pleasing to find the large number of participants desiring continuing education. Notably, as the drug scene is constantly changing, mental health needs detection and help is another point that is continually evolving. This document is to review the Landscape Questionnaire and relate to its validity, and appropriateness; bearing in mind the strong point of strict confidentiality in respect of the students. The need for compensated education of the involved principles would further involvement, with perhaps more guidance counseling principles involved, as a lot of these basics are ingrained. The Questionnaire is divided into 6 general functional sections for purposes of simplification of discussion, and that pattern followed throughout.
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    An Analysis of Student Assistance Programs
    Hardwicke, Shannon Bragg (Virginia Tech, 2006-05-05)
    The purpose of this study was to examine a sample of students who participated in a student assistance program in Southwest Virginia. Using existing data from a school system in Southwest Virginia, this sample was observed to measure changes in student academic performance. The sample was also examined to determine the extent to which they instituted positive behaviors such as school attendance and reduction of disciplinary actions taken. In addition, this study assessed differences in demographic characteristics among student participants. Also studied was the extent to which gender differences related to academic performance and behavior. Significant changes in students’ academic performance, attendance and disciplinary measures were established in the present study. Negative associations were established for those participating in the student assistance program and grade point average. Positive associations were found for those participating in SAP and attendance and disciplinary measures. No significant differences were yielded in the comparison of gender to academic performance and behavior. SAP coordinators recorded that the majority of participants did improve since referral to program and most completed or currently remained in the student assistance program. However, a small percentage of students actually entered treatment programs following recommendations made to parents from the student assistance program committee. This research assessed only the demographic and individual characteristics: gender, gifted or special education status, ethnicity and age. Therefore, other demographics such as socio economic status may offer additional explanation into academic and behavior outcomes of students involved in student assistance programs.
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    An Analysis of the Components of Mental Toughness in Sport
    Creasy, John Wayne Jr. (Virginia Tech, 2005-11-14)
    Many coaches are becoming aware of the importance of developing mentally tough performers and are designing programs to develop it in their athletes. One of the most significant problems in designing these programs is the inconsistency in the definition and description of mental toughness. If programs are to be designed with the goal of developing mental toughness in athletes, the components of the construct must be identified. Based on the advantages that mental toughness can offer to the performer, this study was designed to develop an understanding of the components of mental toughness in sport. The purpose of this study was to identify the components of mental toughness as perceived by National Collegiate Athletic Association (NCAA) coaches and was guided by two fundamental questions: what are the essential components of mental toughness? and to what degree are these components teachable (trainable). Twenty-two NCAA coaches were selected to participate from a mix of Division I, II, and III male sports teams. The procedures for this study were divided into a two-phase approach. Phase One consisted of each participant completing a questionnaire for the purpose of evaluating the importance and teachability (trainability) of 20 separate components of mental toughness. Phase Two consisted of follow-up, semi-structured interviews that provided further insight into the perspectives of the participants. The results of this study indicated the essential components of mental toughness based on their importance to the construct. The results also indicated the degree of teachability (trainability) of each component. A unique relationship between teachability and trainability was also revealed in this study. These findings provide a better understanding of the components of mental toughness and support the need for its development in sport.
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    Analysis of the Stakeholder Derived Conceptual Models and Exploration of Lung Cancer Screening Barriers in a Medically Underserved Area
    Zarghami, Fatemeh (Virginia Tech, 2018-06-13)
    The number of new cases of lung and bronchus cancer was 55.8 per 100,000 men and women per year. The number of deaths was 44.7 per 100,000 men and women per year. These rates are age-adjusted and based on 2010-2014 cases and deaths. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. The knowledge that lung cancer can be successfully treated if caught early has driven a decades-long search to find an accurate and reliable screening test. National Cancer Institute's National Lung Screening Trial (NLST) found that annual screening with Low-Dose CT (LDCT) for asymptomatic patients aged 55 to 74, with a smoking history of at least 30 pack-years, and smokers who quit less than 15 years ago, had a 20% reduction in risk of death from lung cancer. Findings of this trial resulted in that LDCT becoming the gold standard of screening for lung cancer. The SEED method is a community-engaged research approach to develop conceptual models and generate patient-centered research questions. This method has been used to engage community stakeholders of Martinsville, Virginia to develop conceptual models of the factors contributing to lung cancer outcomes. In the first manuscript of this dissertation, these models which were produced by 3 different groups of stakeholders have been examined closely to explore the complexity, similarities, and differences. The models were used to produce a research agenda on the topic of factors impacting lung cancer outcomes for future researchers. A literature review was conducted by the study team on the final research agenda. The goal of this literature review was to avoid duplication of research and to focus future research on the identified gaps. The knowledge and attitudes of the health care providers and patients about lung cancer screening and the barriers in the uptake of LDCT were identified as a research gap. The design of the Martinsville lung cancer study described in the second manuscript of this dissertation responds to this identified research gap. These studies and their results shed light on the factors that impact lung cancer outcomes using a community based participatory approach.
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    Application and Evaluation of Teledermatology In An Underserved Area of Honduras
    Baze, Michael Ray (Virginia Tech, 2011-08-02)
    Since the 1800's, technological advances have extended the foundation on which telemedicine could build. With its evolution, telemedicine has proven to be a means of offering effective health care interventions, from a multitude of disciplines. Teledermatology, a specialty application of telemedicine, offers great potential in improving the standard of dermatologic care by bridging the gap between the expert opinion of dermatologists and those without access to basic dermatologic care, particularly in developing nations, where skin disease continues to be a major public health problem. In Honduras, the setting for this study, and other developing nations, technology to support telemedicine is available. Dermatologic disease is among the most common disease presentations in the developing world, which left untreated due to a lack of access to adequate medical care, can progress causing increased morbidity or even death. A potential but untested solution is teledermatology. Teledermatology offers great potential in improving the standard of dermatologic care by bridging the gap between the expert opinion of dermatologists and those without access to basic dermatologic care. The purpose of this study was to evaluate the prevalence and types of dermatologic conditions and the feasibility of a store-and-forward teledermatology system in an underserved area of Honduras, so as to potentially provide more timely diagnosis and treatment, implementation of preventative measures, and offer long term solutions.so as The justification and significance of this study was the potential of store-and-forward teledermatology to improve the standard of dermatologic care by improving access of populations in underserved areas to dermatology specialists through affordable technology. The methodology of this study was primarily case study descriptive. This study was conducted at a public primary care clinic (JMA Clinic) and satellite sites in underserved areas of Francisco Morazán, Honduras. During a four week period in Spring 2011, patients with dermatologic conditions were examined and photos taken of condition. The patient information was sent to 3 U.S. board certified dermatologists, who provided diagnosis and treatment within 24 hours, which allowed the clinic physician sufficient time to review recommendations before patient follow-up. Patients would receive follow-up within 48 hours of initial visit. Diagnostic agreement, image quality, and user satisfaction were evaluated. IRB forms were submitted and clearance given. The data was analyzed with SPSS using descriptive statistics. The primary findings were the types of dermatologic conditions, interobserver agreement, image quality, and patient and physician satisfaction. The findings of this study substantiate the need for dermatologic care, as approximately 1 out of every 5 patients of the JMA Clinic presented with a dermatologic condition. The majority of these patients were children or women in their late 20s and early 30s; many of whom had their condition for more than a year and most had not received prior therapy. The types of dermatologic conditions observed were typical of that seen at a dermatology clinic in the U.S., yet inclusive of tropical and regional differences. Dermatitis, infectious and pigmentary conditions were the most common presentations. The interobserver diagnostic agreement achieved was 78%, and improved when considering differential diagnoses. Image quality received high ratings. Patients and physicians recorded a high level of overall satisfaction. Physicians indicated improved knowledge of teledermatology. Because of the unique environment and circumstances, the results are limited to the setting in which the study occurs. This project was a pilot study limited to 4 weeks of data collection and will be limited in significance by its duration and small sample size with respect to the conclusions that can be drawn about the prevalence and types of dermatologic conditions. This study illustrates that teledermatology is a viable means of providing dermatologic care to those in an underserved area of Honduras, where a lack of or limited access to general healthcare or specialty dermatologic care exists. The data offers insights to draw conclusions and recommendations on the potential for similar models to be implemented in underserved areas throughout Honduras and other similar regions.
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    An Assessment for our Future: An Investigation of the Presence of External Ecological Assets within Three Counties and One City in Southwest Virginia 6th Grade Youth
    Neurauter, Viki Braud (Virginia Tech, 2011-03-25)
    Problem: Prevention Planning Teams are challenged with developing intervention programs designed to decrease youth risk behaviors. Literature indicates that by increasing the number of assets/protective factors within a child's external ecology it decreases the likelihood of the youth participating in risk behaviors. Information which explicitly focuses on the etiology (external ecology) of youth risk behaviors for Southwest Virginia Region (SWVAR) 6th grade youth had not been performed; therefore, this study investigated the reported external ecology present in the SWVAR 6th grade youth, whether there are differences in the reported external ecology by gender, and whether there are differences in the reported external ecology by race/ethnicity. Methods: The SWVAR 2009-2010 6th grade Youth Risk Behavior Surveys were analyzed and items extracted which pertained to the Search Institute Developmental Assets Framework. Twelve survey items were identified which fit into the External Asset Building Block areas of Support, Empowerment, and Boundaries and Expectations. Responses to these items by SWVAR 6th grade youth who participated in the 2009-2010 YRBS (n=2051) were analyzed via descriptive statistics for overall responses and Chi-Square in relation to gender and race/ethnicity. Results: Descriptive statistics and Chi-Square analysis indicated an overall positive external ecology. There were however statistically significant differences by gender and race/ethnicity in each of the represented External Asset Building Blocks. Conclusions: SWVAR 6th grade youth who participated in the 2009-2010 YRBS indicated an overall positive external ecology by overall responses, gender and race/ethnicity. There are however segments by gender and race/ethnicity which indicate a need for intervention and/or further investigation.
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    Assessment of the Prevalence of Smoke-Free Environment Policies Throughout the Commonwealth of Virginia at Worksites Employing Fifty or More Workers
    Housenick, Mitchell Alexander (Virginia Tech, 2001-04-05)
    The purpose of this study was to investigate the prevalence of smoke-free environment polices throughout the Commonwealth of Virginia at worksites employing fifty or more workers. Specifically, this study assessed policy prevalence, development, implementation, and enforcement. In addition, this study assessed smoke-free environment policy effectiveness. The population for this investigation consisted of telephone surveys of 374 worksites located throughout the Commonwealth of Virginia. Of these worksites, 340 (91%) completed the telephone survey. The population (n = 340) was spread throughout five health regions, Northern, Northwest, Central, Southwest, and East. Descriptive analysis and One-way Analysis of Variance (ANOVA) were applied to investigate differences between these five health regions. An alpha of .05 was selected for this study. Based on the findings, the following conclusions were drawn: (1) Fifty-percent of the worksites located throughout the Commonwealth of Virginia have some form of smoke-free environment policies; (2) The smoke-free environment policy constructs used in the telephone survey guide were statistically significant in identifying differences between the five health regions; (3) Smoke-free environment policies at the worksite are dependent upon health region; (4) Implementation of smoke-free environment policies is dependent upon health region; (5) Enforcement of smoke-free environment policies is dependent upon health region, and (6) Effectiveness of smoke-free environment policies is dependent upon health region. The following recommendations were suggested: (1) Further studies assessing smoke-free environment policy enforcement should be conducted annually; (2) Studies incorporating a qualitative research methodology regarding smoke-free environment policy prevalence should be conducted; (3) Studies involving common smoke-free environment policies at different states should be investigated, and (4) Additional in-depth surveys should be conducted to evaluate health outcomes associated with the implementation of smoke-free environment policies.
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    Behavioral assessment of interpersonal skill among Type A and B college students
    Watkins, Patti Lou (Virginia Polytechnic Institute and State University, 1986)
    The Type A behavior pattern (TABP) is a coronary-prone response style characterized by intense ambition, competition, preoccupation with deadlines, and time-urgency. Anger may be the most detrimental aspect of the overall behavior pattern, but few studies have examined how Type As display anger in daily interactions. This study assessed anger expression as well as general conversational skill among Type As and Bs in representative situations. Type As and Bs were also classified based on degree of self-reported anger with skill differences examined among these four groups as well. Behavioral assessment occurred during challenging and non challenging role play scenes and a deception period in which confederates interrupted subjects' progress on a task. Observers, confederates, and subjects rated anxiety, anger, assertiveness, general demeanor, overall social skill, and interest during these conditions. Type As expressed anger less appropriately than Bs in challenging scenes but had greater overall social skill and made more interesting partners across conditions. Type As and Bs with minimal anger received better ratings than those with greater anger. Discussion addresses clinical significance of the TABP and directions for future assessment/treatment of coronary-prone behavior.
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    Board of Certification Examination Success and Clinical Education
    Hickman, Katherine Marie (Virginia Tech, 2010-12-06)
    Athletic training education has evolved from a model with a strong experiential component and a weak educational curricular component to a standards based framework program. Throughout the development of Athletic Training Education Programs (ATEPs), starting in 1950's through today when the Commission on Accreditation of Athletic Training Education (CAATE) has tightened restrictions and standards for athletic training curriculum. Athletic training education is broken into two components. The first component includes a didactic education or classroom curriculum and the second component involves clinical experience, where hands on experience supplements classroom understanding and allows students to becomes competent with the concepts taught during classroom curriculum. In comparing allied health professions, entry-level athletic trainers perceive approximately 53% of their professional development comes from clinical experiences, while physical therapy clinical experience have been reported to be 23% - 30% of the professional development (Weidner & Henning, 2002). The purpose of the study was to examine if relationships exist between characteristics within ATEPs and athletic training students (ATSs) success on the Board of Certification (BOC) examination. Twenty-four graduates from six selected CAATE accredited NCAA Division I participating Institutions completed a 20 question survey regarding characteristics of clinical experiences within the ATEP as well as other demographic information that may identify relationships between those characteristics and success on the certification examination. BOC EXAMINATION SUCCESS AND CLINICAL EDUCATION Results of this study identified no significant relationships between characteristics within ATEPs, football experience, or student demographics and success on the BOC examination. The number of subjects was limited and, if a larger population were surveyed, results may differ. Although not statistically significant, GPA as a predictor of and first attempt success on the BOC examination approached a significant value. These findings show consistency with previous research. In conclusion, this study did not identify relationships that were significant but relationships that approached a level significance. No significant relationships were identified between ATEP characteristics, football experience, or student demographics and BOC examination success. Although fall football experience is not related to success on the BOC examination results show significant relationship between football experience and students' perception of observational role as well as hands on injury evaluation experience. Students who are placed within Division I football tend to hold roles strictly as observers versus those students who are placed within the high school football settings. Future research in the area of clinical experience and success on the BOC examination should continue. A larger sample size, from a variety of athletic conference's should be included in the survey population.
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    A Case Study of Freshmen Swimmers' College Transition Experiences
    Skinner, Ned Thomas (Virginia Tech, 2000-02-10)
    The transition from high school to college can be a difficult and stressful experience for a student-athlete. University athletic departments across the country, in conjunction with the office of student life, implement transition programs in an attempt to assist freshmen with their new environment. The purpose of this study was to determine a head coach's role in the transition process between high school and college of a freshman student-athlete. Furthermore, the study sought to address to what extent a student-athlete could benefit from evaluating the effectiveness of the transition process. Fifteen participants from a large NCAA Division I swim program took part in this study in the fall of 2003. Each participant was officially recruited to attend the institution and was entering college for the first time. A two phase approach was utilized to obtain data on the swimmers' first three weeks in college and also their first semester in college. Each swimmer was interviewed after his or her first three weeks in school in a semi-structured environment. Each participant was asked the same series of questions. Each participant was also interviewed near the conclusion of his or her first semester and was asked a series of follow up questions. The data was analyzed utilizing qualitative methods. The results of the study indicated that a head coach has a critical role in assisting freshmen student-athletes in their program with the transition from high school to college. Student-athletes look to their head coach as a mentor who can affect the new environment, and thus the head coach is a significant factor in their transition experience. Further, a head coach should know the components of the transition programs offered by both the university and athletic department, and develop his or her own transition model to increase the chances of a well adjusted freshman student-athlete. The results of the study also indicated that a student-athlete can benefit from evaluating the effectiveness of a transition program annually. Universities, athletic departments, and coaches should make needed changes each year to address the specific needs of freshmen student-athletes entering college for the first time.
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    The Certified Registered Nurse Anesthetist: Occupational Responsibilities, Perceived Stressors, Coping Strategies, and Work Relationships
    Perry, Tristan Roberts (Virginia Tech, 2002-11-06)
    A qualitative inquiry was launched to explore occupational stress among Certified Registered Nurse Anesthetists (CRNAs). Four research questions were posed: 1) What are the roles and responsibilities of the CRNAs as they see them? 2) What are the CRNAs perceived stressors encountered on the job? 3) What are their coping strategies related to the perceived stressors? 4) What is the relationship between CRNA job stress and interpersonal work connections? Twenty CRNAs, with varying anesthetic backgrounds, and 15 of their co-workers from North Carolina and Tennessee participated in the study. Semi-structured interviews, clinical observations, and artifact data (i.e., photographs) were employed to answer the research questions. The perceived occupational-related stressors that were recognized by the CRNAs pertain specifically to patient care, anesthesia work in general, interpersonal job relationships, inadequate surgical preparation, the operating room environment, and physical stressors. Staying focused upon the task at hand (i.e., patient care), the use of humor, verbalization and internalization of concerns, along with adopting personal hobbies were identified by the anesthetists as coping mechanisms to combat work-related stress. The participants take their professional duties to their patients and devotion to their fellow colleagues seriously - so much so that they rarely take vacation time or sick leave. After data analysis, six major themes surfaced: the role of being an attentive, reliable co-worker alleviates the antagonism found within OR relationships; maintaining open lines of communication is an effective way to address concerns and prevent staff conflict; among the CRNAs, occupational-related stressors create concern for patient safety; interpersonal work relations cause more stress than any of the other perceived job stressors; engaging in personal hobbies assists the CRNA in coping with work-related stress; and the nurse anesthetists' work lives are not as stressful as their personal lives. The answers to the research questions and the themes underscore the necessity that the shortage of Registered Nurses and anesthetists needs to be addressed in order to more effectively tackle the participants perceived stressors. In addition, employers can adopt concrete measures in assisting CRNAs with handling occupational stress, such as offering mandatory in-servicing and adequate time to attend in-servicing.
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    Changes in Skeletal Muscle Sarcoplasmic Reticulum Function in Adult and Aged Fisher 344 Brown x Norway Rats
    Rabon, Karma Melisa (Virginia Tech, 1997-06-16)
    The decline of physical ability that occurs with aging has been linked to reduced skeletal muscle function. It has been theorized that Ca2+ uptake and release by the sarcoplasmic reticulum (SR) is altered with aging. Data pertaining to the actual structural and functional changes of SR due to aging are limited; thus, this theory has not yet been fully proven. The purpose of this research was to determine if SR function is altered as a result of aging in the following muscles: soleus, plantaris, and diaphragm. The soleus is composed of slow twitch muscle fibers. The plantaris is composed of fast twitch muscle fibers, and the diaphragm is composed of both slow and fast twitch muscle fibers. Fisher 344 Brown x Norway Cross Rats were used as subjects for this project. A total of 12 animals were used: six in group 12 months and six in group 27 months. A Jasco CAF-110 Fluorometer and fura-2 were used to determine the rate of Ca2+ uptake and release by isolated SR vesicles. In the aged animals, mass of the soleus was reduced by 22%, while the plantaris was reduced by 23%, and the diaphragm by 15%. However, these differences were eliminated when masses were normalized by body mass. In all three muscles examined, the rates of Ca2+ uptake were not significantly different between the young and aged animals. Rates of Ca2+ release, however, were reduced by 30% in both the plantaris and diaphragm of the aged animals. These results suggest that SR function is altered in "fast" muscles of the rat. It is possible that changes in SR Ca release may contribute to diminished muscle function and also lead to the decline in physical ability of older adults.
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    Clinical decision making by beginning nurses: a naturalistic study
    Clark, Rebecca Culver (Virginia Tech, 1996-04-15)
    The ability to make accurate clinical decisions and implement appropriate nursing interventions is an essential component of nursing practice. Clinical decision making is the process nurses use to gather information about patients, evaluate it and make judgments that result in the provision of nursing care. However, competency in this area requires integration of knowledge and experience which occurs over time. Beginning nurses are expected to function in the clinical environment, making accurate clinical decisions. While they have had theoretical information in their educational process, they have had limited clinical experience. This presents the beginners with a difficult practice environment. A naturalistic study was conducted to describe clinical decision making from the perspective of beginning nurses and to identify factors which were influential in this process. The study design was emergent, based upon the assumptions that the reality of the phenomenon is best understood through the lived experiences of the participants. A purposive sample of nine registered nurses with less than one year’s experience in acute care, medical-surgical nursing were interviewed. Four participants completed journals, recording additional experiences with decision making. These data were analyzed using Ethnography 4, identifying common themes among the participants. A comprehensive summary of the themes was returned to the participants for validation. The results are presented in a narrative format. For beginning nurses, decision making is the foundation of their daily work. It is a difficult process for them, as they work to apply theory to clinical practice. Common themes emerged from the data: the role of experience; the importance of the interpersonal environment; the significance of interacting with physicians and the process of developing as a nurse. Implications for education and practice were derived from these themes. In both these, it is essential to listen to the perspectives of the beginning nurses. It is important to foster interactions among practitioners from different levels of skill, encouraging beginners to reflect on their experiences. Beginning nurses need to be supported in transitions from the educational environment to the work environment, and throughout their careers, to maximize skill development in the process of clinical decision making.
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    Clinical Response, Outbreak Investigation and Epidemiology of the Fungal Meningitis Epidemic in the United States: Systematic Review.
    Abbas, Kaja M.; Dorratoltaj, Nargesalsadat; O'Dell, Margaret L.; Bordwine, Paige; Kerkering, Thomas M.; Redican, Kerry J. (2016-10-01)
    We conducted a systematic review of the 2012-2013 multistate fungal meningitis epidemic in the United States from the perspectives of clinical response, outbreak investigation, and epidemiology. Articles focused on clinical response, outbreak investigation, and epidemiology were included, whereas articles focused on compounding pharmacies, legislation and litigation, diagnostics, microbiology, and pathogenesis were excluded. We reviewed 19 articles by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. The source of the fungal meningitis outbreak was traced to the New England Compounding Center in Massachusetts, where injectable methylprednisolone acetate products were contaminated with the predominant pathogen, Exserohilum rostratum. As of October 23, 2013, the final case count stood at 751 patients and 64 deaths, and no additional cases are anticipated. The multisectoral public health response to the fungal meningitis epidemic from the hospitals, clinics, pharmacies, and the public health system at the local, state, and federal levels led to an efficient epidemiological investigation to trace the outbreak source and rapid implementation of multiple response plans. This systematic review reaffirms the effective execution of a multisectoral public health response and efficient delivery of the core functions of public health assessment, policy development, and service assurances to improve population health.
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    Community-Based Education through a Paraprofessional Model: An Experiential Learning Perspective of Peer Education
    Seibel, Megan M. (Virginia Tech, 2012-03-16)
    In community-based peer education models, it is necessary to understand the relationship between learning, context and paraprofessional identity construction. Social relations are important in community education program implementation (Merriam, Caffarella, & Baumgartner, 2007); impacting power structure within communities and organizations (Cervero & Wilson, 1994, 2006; Forester, 1989). This study explored the conceptual and practical role of experience in a paraprofessional educator model and focused on the situated, contextual experiences of paraprofessionals in the communities they work and live as unique, challenging, and potentially positive for learning outcomes. Schön's narrative dialogue of reflection (1983) proved to be the essential missing piece in working with community educators toward successful development and autonomy. In-depth qualitative interviews with 19 paraprofessional community-based peer educators with a state level family nutrition program contributed to findings relevant to how social context, critical reflection, and identity development influence an understanding of experience and the ability to impact knowledge and behavior change in clients. Individual interviews and focus groups allowed narrative exploration of topics as they evolved throughout the study; giving voice to paraprofessional program assistants in a way not previously done. The findings of this study provide insight necessary for the assessment of new conceptualizations of practice for paraprofessional models in expanding community impact and highlight the need for assessment of contemporary program delivery in a way that fosters the continual development of lay educators through reflective practice. Recommendations are made for a reassessment of historically significant program models in order to embrace paraprofessionals as more broadly defined socially mediated and socially situated influential practitioners.