Childhood obesity has been on the rise for decades with negative impact on health, psychology of the people and with significant economic cost to the society. Some risk factors attributed to obesity are quality and quantity of food, sugary drinks, and sedentary lifestyle. This project evaluates the effect of an educational intervention to improve parents’ nutrition label literacy as parents make healthy food choices for their children.
The literature review discussed the causes and consequences of childhood obesity, and importance of nutrition label literacy in prevention of childhood obesity. This quantitative descriptive study was conducted at an outpatient pediatric clinic among parents. One of the aims of the project was to identify the participants’ nutrition label illiteracy by administering a Food Label Literacy for Applied Nutrition Knowledge (FLLANK) pretest. Thirty participants completed the pre and post intervention questionnaire. 73.3% of the participants had a least a 2-year college degree and 60% made more than $45,000/ year. The results showed that irrespective of socioeconomic status, the participants improved in their nutrition label literacy after the educational intervention. It is important for healthcare providers to initiate early intervention in nutrition literacy in prevention of childhood obesity.
This dissertation features financial market innovation and product market innovation. Two essays feature return predictability in commodity futures, which have been financialized during the past two decades. One essay studies the relation between CEO’s external job market tournament and product innovation in the stock market. The first essay identifies a trend factor that exploits the short-, intermediate-, and long-run moving averages of settlement price in commodity futures markets. The trend factor generates statistically and economically large returns during the sample period 2004-2019. It outperforms the well-known momentum factor by more than five times the Sharpe ratio and less downside risk. The trend factor cannot be explained by existing factor models and is priced cross-sectionally. Then we find that the trend factor can be explained by funding liquidity measured by TED spread. Overall, the results indicate that there are significant economic gains from using the information on historical prices in commodity futures markets. The second essay uses machine learning tools to study the serial dependence (lead-lag relations) of commodity futures returns. We use LASSO to select the predictors because the number of predictors is large relative to the number of observations. We find significant full-sample and out-of-sample predictability. In the full sample, we find that LASSO can identify a sparse set of predictors that either come from economically linked commodities or are likely driven by excessive speculative trading. The out-of-sample forecasts based on LASSO generate statistically and economically large gains. When we use more complex machine learning models such as regression trees and neural networks to forecast commodity futures returns, the out-of-sample performance is worse than LASSO portfolios, suggesting that nonlinearities and interactions do not appear substantial in the data. We also find that index trading due to financialization drives the excess comovement among commodity futures. The third essay examines how the tournament-like progression in the CEO labor market influences corporate innovation strategies. By exploiting a text-based proxy for product innovation based on product descriptions from 10-Ks, we find a significant positive relation between industry tournament incentives (ITIs) and product innovation. We then explore the trade-off effects of ITIs on product innovation created through long-term patenting technologies and short-term “routine” product development. We discover that ITIs strengthen routine product development activities but decrease patent-based innovation. Further analyses show that the effect of ITIs on product innovation is stronger when the product market is more competitive and when CEO characteristics indicate a higher probability of winning the tournament prize.
Most of the coagulation studies done thus far were either site-specific or focused on only one variable and hence do not apply to real-world conditions. Developing a universal and practical model of coagulation has been a near-impossible task because 1) water is a chemically complex medium that varies spatially and temporally 2) the sheer number of factors and their interactions that determine the performance of the coagulant. The focus of this research is to develop a general model for coagulation with aluminum sulfate that has practical applications. The goal is also to identify the parameters that control optimum coagulation conditions while considering the removal of particulate (e.g., bacteria) and dissolved (e.g., organic matter) contaminants as well as chemical costs.
Wearable technology became popular not only in the consumer market, but also in the field of academic research. Studies related to smart wearables have increased dramatically during recent years. However, personal safety perspectives of wearable devices have not been adequately addressed in the literature so far. There have been debates regarding the potential health risk of using wireless technology and batteries from wearable devices. Regardless of the actual health risks from wearable devices, these controversial debates could affect and form users’ perceptions toward purchasing and using the technology. The uniqueness of wearable devices is that they are not only considered as technical devices, but also considered as fashion items. By adding perceived risk and fashnology (combination of fashion and technology) constructs to the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), this study examines how perceived risks and fashion-related perceptions influence a consumer’s intention to purchase and use wireless earbuds. Based on survey data from a sample group of 205 respondents, Perceived Health Risk, Perceived Fashionability, and wearable comfort have a significant impact on a consumer’s intention to purchase wireless earbuds. These results fill in the gap of wearable technology literature and provide a reason why Perceived Health Risk should be studied more for future research. In addition, practitioners should make sure they produce wearable devices that are safe, fashionable, and comfortable to wear.
Latinas’ lack of knowledge regarding cervical cancer screening (CCS) guidelines has a significant impact on CCS adherence and ultimately impacts their health outcomes related to cervical cancer. Studies have demonstrated that small media, culturally relevant educational interventions are highly effective in improving Latinas’ knowledge of CCS (Moran et al., 2016; Thompson et al., 2019; Warner et al., 2018). The purpose of this scholarly project was to implement and evaluate the efficacy of a small media educational intervention on Latinas’ knowledge of CCS and human papillomavirus (HPV) and evaluate the participants’ satisfaction with the intervention. A convenience sample of 50 Hispanic female patients between the ages of 21-65 was obtained from a community health center in the Southeast region of the United States. The fotonovela utilized in the Thompson et al. (2019) study was the intervention used for this project; it was offered in Spanish and English and included information on CCS and HPV. A pre- and post-test questionnaire assessing the participants’ CCS and HPV knowledge was administered. In addition, the post-questionnaire included questions that evaluated the participants’ satisfaction with the fotonovela. Following implementation of the fotonovela, participants significantly increased their average post-test CCS and HPV knowledge scores (Pre: 50.6; Post: 83.6, p<.000). All 50 participants (100%) reported overall satisfaction with the fotonovela. The findings of this project were both statistically and clinically significant indicating that the fotonovela is an effective and favorable educational intervention, thus its implementation is warranted in healthcare settings that provide care to Latinas.
Many people are affected by chronic pain. The use of opioids for pain has resulted in an increase in the number of opioid-related overdose deaths. The Center for Disease Control (CDC) created opioid prescribing guidelines to help providers safely prescribe opioids for chronic pain. The purpose of this project was to create an electronic medical record (EMR) template and urine drug test (UDT) alert to increase the providers’ adherence to the CDC opioid guidelines in a small, hospital-owned, family practice clinic. A pre/post implementation chart review tool was used to evaluate the medical records of 60 patients prescribed chronic opioids. The tool was used to determine if providers were adhering to the guidelines. Measures included the number of patients who completed an annual UDT, signed control substance agreement (CSA), documented pain diagnosis, quarterly office visits, and if providers reviewed the prescription drug monitoring program (PDMP) every 3 months. Adherence improved in the post-implementation data compared to pre-implementation. There were statistically significant increases in CSA (p=.000), PDMP reviewed (p=.000), annual UDT (p=.005), and quarterly appointments (p=.006). Although not statistically significant, there was an increase in documented pain diagnosis (p=.492). Implementation of an EMR template and UDT alert led to an increase in provider adherence to opioid prescribing guidelines.
For decades, district level administrators and policy makers have been searching for ways to combat the ever growing issue of teacher attrition. Each year teachers leave the profession prior to retirement age. This problem is even more prevalent in schools who serve low-income, high-minority students.
The purpose of this qualitative transcendental phenomenological study was to determine the lived experiences that keep elementary school teachers teaching in low-income, high-minority schools, when so many of their peers choose to leave. For this study, six elementary level teachers, who have taught in the same low-income, high-minority school for five years or more, participated in one hour long semi-structured interviews. These interviews helped see through the lens of the participants, providing rich, real world experiences they used to sustain their positions when so many of their peers leave.
The results revealed that both intrinsic and extrinsic motivators played a role in the teacher’s decision to remain in low-income, high-minority schools. These motivators ranged from their professional work environments to past experiences as teachers and students. The information discovered during this study may help administrators and policy makers find ways to increase teacher attrition especially in low-income, high-minority schools
Introduction: Postoperative delirium is a common cognitive complication characterized by an abrupt disturbance in brain function after surgery. It occurs in 15 to 25% of patients undergoing major elective surgeries and up to 50% of patients who have had high-risk procedures such as cardiac surgery or hip fracture repair. Postoperative delirium can result in negative outcomes such as increased healthcare costs, increased length of stay, and lasting cognitive impairment. Although nurses play a critical role in recognizing delirium, the complication remains under-recognized and poorly managed. This finding emphasizes the need for improved delirium recognition and management strategies; therefore, educational initiatives designed to improve delirium care are necessary for nurses caring for patients with this complication.
Objectives: This study evaluated the effect of structured delirium education on nursing knowledge, recognition, and management of delirium.
Methods: This quality-improvement project utilized the Nurses’ Delirium Knowledge Assessment (NDKA) tool, a 36-item scale divided into three subscales, to evaluate medical-surgical nurses’ knowledge before and immediately following the implementation of an on-demand web-based delirium education module. Participation in this study was voluntary and consisted of nurses working on two surgical units. Assessment scores were evaluated pre-and post-education and the Wilcoxon signed-rank test was used to detect significant changes.
Results: Sixteen nurses participated in the study. Overall mean scores improved from 67.99% on the pre-assessment to 81.84% on the post-assessment. Subscale mean scores also improved and were as follows: knowledge of assessment tools and scales 71.84% pre and 87.5% post, general knowledge of delirium 75.89% pre and 85.71% post, and risk factors for delirium 56.25% pre and 72.32% post.
Conclusion: The educational intervention provided in this study increased nurses’ knowledge and recognition of delirium, validating similar findings in the literature. An educational intervention delivered via electronic format is an effective method to provide delirium education to nurses. Improving nursing knowledge of delirium is essential in improving patient outcomes.
Purpose:
The purpose of this educational project was to determine whether interprofessional team members who participate in a structured educational session demonstrate an increase in knowledge, confidence and self-efficacy in the care of adult brain tumor (ABT) patients. The aim was to evaluate baseline ABT knowledge of neuroscience registered nurses (RNs) and advanced practice providers (APPs) and to identify barriers associated with specialized educational programs.
Methods:
An evidence-based education program on ABT’s was developed and delivered to neuroscience interprofessional team members in a single institution in Charlotte, North Carolina. Three measurement tools were used for data collection. One tool was used to collect demographic information, one was used for a knowledge pre/post-intervention and one for the participants to rate their confidence level. RNs and APPs functioning in a neurosurgical, neurointensivist or neurohospitalist role were eligible to participate. Travel RNs were excluded.
Results:
Seventeen care providers participated in this project. Descriptive statistics were used to analyze the demographic characteristics of the participants, belief in supplemental education, and pre/post-intervention knowledge assessment items. McNemar’s test for paired binary data and StataCorp v.16 statistical software (2019) were used. Six participants recalled prior education specific to ABTs and 94% (n=16) believed additional education would be beneficial. A statistically significant increase in correct responses from the pre-posttest was seen in one question pertaining to histological grading classification system (p=.031). The lowest response recorded on the confidence survey was regarding the APP’s level of comfort in discussing treatment plans with patients and caregivers.
Implications:
The results of the project created a basis for understanding neuroscience team members level of knowledge and confidence. Further study is needed to determine effective educational strategies for the neuroscience team.
Keywords: brain neoplasm, clinical guidelines, specialized training