Wound Related Pain Management in a Community Healthcare Setting

Chronic wounds affect millions of individuals in the United States with a large percentage of these individuals experiencing wound-related pain. Dressing removal has been reported to be the most painful procedure related to wound care. Pain is typically well controlled in the hospital setting, but once the patient leaves, pain control becomes more difficult in the community setting. It is not clear why pain management is more difficult for community-dwelling individuals. The purpose of this program evaluation is to evaluate pain management strategies in a community-dwelling population. The setting for this program evaluation is an outpatient wound healing clinic in rural eastern North Carolina which serves between 50-60 individuals/day. Clients of all ages receive wound care for diabetic ulcers, pressure ulcers, trauma wounds, and burns. In collaboration with a wound care Registered Nurse, a chart audit tool was developed to evaluate factors such as demographic profile, wound type, dressing type, pain management strategy, pain scale during wound care, and dressing change frequency. The audit tool will also look at if the patient’s reported pain is controlled or uncontrolled, and if a change in the management plan was documented for those with uncontrolled pain. These factors will be compared to the most recent evidence-based practices for wound management

Effects of rodents on ecosystem structure and function

What structures systems across the landscape and over time has long been a focus of ecosystem ecology. Together, abiotic and biotic components interact to shape the flow of nutrients and energy through a system. My Ph.D. explores how small mammals directly and indirectly affect ecosystem structure and function using a manipulation experiment in an old-field system in East Tennessee. Despite previous research showing herbivores have large and sustained impacts on ecosystems, small mammals, specifically, are oft overlooked despite their ubiquitous presence. Specifically, I will examine how small mammals contribute to above and belowground community structure, nutrient cycling and decomposition, and how they influence an ecosystem’s stability in response to fire disturbance. By manipulating their presence, I can explore how a biotic ecosystem component directly structures an ecosystem and indirectly by examining an interaction with an abiotic disturbance

Armor and Amour

Armor and Amour is an artistic outcome grounded in French history, namely the interpretation of Joan of Arc, along with the use of modern 3D printing technology. It is a women\u27s apparel silhouette combining elements of the French heroine\u27s life, namely, the juxtaposition of feminine youth against the masculine warrior. Using historical armor as a reference, the hand embellishment mimics military garments of the past, with the decidedly modern utilization of 3D printed elements and a feminine touch. It is a work that explores how the past consistently informs the future and is intended to illustrate the strength, resiliency and duality of the female spirit

WHY DO DIFFERENCES BETWEEN STATE-MEASURED ACHIEVEMENT GAPS AND NATIONALLY-MEASURED ACHIEVEMENT GAPS EXIST?

This dissertation addresses two research questions: 1. To what degree do states differ in measuring the achievement gap? 2. Are there predictors to suggest why this differential occurs? The first research question requires that the degree of difference, the differential quotient, is determined. For the purposes of this dissertation, I calculated the reported achievement gaps between white and black fourth graders for the years 2005, 2007, and 2009 on the individual state reading and math assessments and the reading and math portions of the National Assessment of Educational Progress, NAEP, by percentage. For example, if whites scored 90% proficient on the state-developed measure and blacks scored 70%, the state-based achievement gap was recorded as 20. If the white proficiency percentage on the NAEP was reported at 40% and the black percentage was reported at 10%, the NAEP-based achievement gap was recorded as 30. The state-established achievement gap percentage was then subtracted from the NAEP-based achievement gap percentage to create an assessment differential quotient. In the previously explained example, the differential quotient would be 10. These calculations were also completed for the differences between fourth grade white achievement and Hispanic achievement on these assessments. The larger the differential quotient, the further the state assessment achievement gap was from the NAEP achievement gap. The differential quotient was calculated for the reading and math assessments at the fourth grade level creating six individual differential quotients for each state or 300 observations for analysis. The findings of this dissertation evidence that states vary in measuring the achievement gap locally from the national exam (NAEP) at differing degrees. These disparities fluctuate by content, by year, and from state to state. For example, the number of states reporting a positive differential quotient on the white/black achievement gap for the fourth grade reading assessment over the years studied remained relatively stable at an average of 49%. This means that 49% of states reported a smaller achievement gap between whites and blacks in fourth grade reading than was reported by the NAEP. In comparison, the percentage of states reporting a positive differential quotient for the white/black achievement gap on fourth grade math reached 78% in 2009. More state reports differed from the national reports in math than in reading with more states showing growth in math as compared to the NAEP. This dissertation also found that differential quotients increased over the three years studied in all areas except white/black reading. As reporting for No Child Left Behind was not required until 2006, it logically follows that states became more interested in reporting narrowed achievement gaps in 2007 and 2009. States struggled to reach 100% proficiency by the year 2014 and adjustments to test content, format, and procedures were made to construct an illusion of better results at the local level thus causing larger differential quotients. Finally, these findings show that some states such as Nebraska, Texas, and Virginia are consistently found to have the highest disparity between state reports and the national reports. This output leads to the second research question: are there predictors to suggest why this differential occurs more frequently in some states versus others? The answer to this question is yes. The level of black and the level of Hispanic within a state were statistically significant in both math models. The coefficients of these predictors indicate that states with higher black and Hispanic populations show a greater disparity between state-based achievement reports and national-based reports

Parental views of otitis media and antibiotic treatment

Antibiotic resistance is a rapidly growing problem throughout the world. Antibiotic resistance can be due to a number of factors, including unnecessary antibiotic prescriptions, antibiotic misuse, and transmission of resistant bacteria. Otitis media is the most often diagnosed childhood illness and accounts for the majority of the United States\u27 annual antibiotic prescriptions. Both parents and physicians can contribute to unnecessary antibiotic treatment for otitis media. Understanding parental views of otitis media and antibiotic treatment may help reduce unnecessary antibiotic prescriptions and lead to the subsequent reduction in antibiotic resistance. The purpose of this capstone project is to develop a questionnaire that effectively gathers information about parent/guardian views toward otitis media and antibiotic treatment. The population of interest for this pilot study is parents/guardians of children 2 to 5 years of age. Individuals of all ages, races, and backgrounds will be encouraged to participate. The questionnaire was developed using a variety of items and response styles. The questionnaire items are broken into different categories/sections, including knowledge-based, opinion-based, behavior-based, and demographic. The respondents are provided with instructions for each section. The questionnaires will be placed at South Arkansas Otolaryngology Associates, where parents/guardians will have the opportunity to complete them while waiting to see the physician. There will be a drop-box in the otolaryngology clinic for the participants to return the questionnaires. The primary investigator will collect the completed questionnaires for analysis. The questionnaire data will be entered into a spreadsheet and analyzed using measures of central tendency. The results of the questionnaire can be used to determine the effectiveness of the study and can also be used to assist with future research