Breast cancer (BC) is a significant condition that can result in devastating outcomes without treatment. The purpose of this phenomenological study was to explore barriers to health care disparities among young African American females. The findings of this study may help to address gaps in knowledge, obtain insights in treatments, and comprehend lived experiences with BC. The theoretical framework for this study was Bronfenbrenner's social ecological theory. Data were collected from face-to-face interviews with 10 African American women ages 20 to 40. Data were then transcribed and coded. The findings of the study indicated that women required treatment plans, informative resources enhancing comprehension of procedures, and assurance. The results of this research might motivate health care professionals to promote awareness in preventing delayed diagnosis of BC in African American women between the ages of 20 and 40 years. The findings in this study may increase health care providers' awareness and bring about social change in BC screening implementation.

The effects of nonadherence to prescribed blood pressure medication adversely impacts African Americans (AA) in comparison to their European American counterparts. The associated health consequences of uncontrolled hypertension include heart failure, stroke, and renal dysfunction. And the treatment of the complications negatively impacts quality of life and contributes to increased health care costs. To address the problem at 1 clinic, a quality improvement (QI) project was developed by the clinic nursing staff, but the project had never been evaluated. The project included blood pressure measurements assessed among AA patients before and after implementation of a 4-item Morisky Medication-Taking Adherence Scale (MMAS) and education by the nurses. The purpose of this project was to evaluate whether the use of the MMAS and education improved blood pressure control in the AA hypertensive patients. This QI evaluation project was guided by Johnson's medication adherence model and the Kolkaba comfort theory. Deidentified results of 3 months of patient blood pressures taken before and 3 months after the QI project was implemented were obtained from the site for statistical analysis. A paired sample t test was used to determine if a difference in blood pressure existed between the 2 groups, before and after implementation (n = 33) of the teaching and the MMAS. Results indicated a statistically significant (p < .05) decrease in blood pressures after implementation of the QI project. The findings of this project may positively influence social change by improving adherence to blood pressure medication and thereby improving healthcare outcomes for AA patients.

The persistent and chronic nursing shortage presents an urgency to understand the root causes of nurses' increasing mobility and movement within and outside of the nursing workforce. A key to understanding nurses' dissatisfaction is to explore the work environment in which they practice. The purpose of this heuristic, phenomenological study was to understand nurses' experiences of oppression and the power dynamics in the hospital setting, which may provide insight to nursing turnover. The conceptual framework was Harvey's civilized oppression theory. Data were collected from semistructured interviews of 9 registered nurses by phone that met inclusion criteria of having more than a year of experience in a hospital setting. The data were analyzed for codes and themes. Study findings showed all participants had perceptions and experiences of civilized oppression and claimed that power and ability to influence their work environment resided with groups other than nursing. Lastly, participants also had a perception of an ideal work setting with shared governance and civility at all levels and all nursing roles within the nursing profession. This study has a direct impact on strategies to address population health, community wellness and global health as the nursing workplace plays a role in shifting the paradigm of care from a sickness model to a wellness model.

This study focused on factors that influenced clinician embryo disposition decision-making in in vitro fertilization (IVF). Evidence-based medicine (EBM) should be built on the premise of shared decision-making. This paradigm is often skewed, resulting in clinician stress, a higher probability of errors, reduced productivity, or ineffective decisions. Guided by the theory of planned behavior and the self-perception theory, this study assessed the independent variables' religiosity, ethnicity, level of burnout, gender, age, years of experience, and clinical role in relationship to the dependent variable "decision-making" as measured by the Lyerly Frozen Embryo Survey, Maslach Burnout Inventory, and the Areas of Worklife Survey. IVF clinicians throughout the United States and Europe (n = 151) completed an online survey via a nonrandom, cross-sectional methodology. Study results indicated the factors were not significant. A vast majority of participants identified as: White, (84%), and female (75%), and that religion was very important (73%). The bulk of participants had a moderate level of burnout (85%), which showed that the multitude of participants were not experiencing overly high levels of emotional exhaustion, were not emotionally detached from their patients' needs, and felt a high degree of personal accomplishment. Recommendations included using a larger sample size, different variables, or developing a new survey as the decision making process may have been more multifaceted than anticipated. There are more areas to be studied around factors and decision making to fully understand these concepts. The positive social change implications include an increased awareness of factors that have the potential for impacting clinician decision-making as a reminder of the importance to be cognizant and sensitive of the needs of patients.

Nannies impact the development of children; however, research is nonexistent regarding their influence on children’s eating habits. The purpose of this study was to examine nannies’ nutrition knowledge, feeding behaviors, and beliefs about children and eating. In a descriptive, cross-sectional study, 83 nannies responded to an electronic survey. Respondents were White (94%, n=78), females (100%, n=83) and full-time employees (73.2%, n=60) of one family (82.1%, n=64). Nannies’ mean raw score was 24 out of 32 points resulting In 75% correct in nutrition knowledge. No significant correlations were found between scores and age (p=.51), education (/?=.73), or employment years (/?=.47). Responses to interaction statements indicated more authoritarian (35.8%, n=24) and indulgent (32.8%, n=22) feeding styles towards children than authoritative (14.9%, n=10) or uninvolved (16.4%, n=ll). Nannies believed that parents/guardians (66%, n=45) had the greatest influence on children’s eating habits, however, perceived they had high influence (79.4%, n=54). Although nannies exhibited average nutrition knowledge, their authoritarian and indulgent feeding styles may result in poor nutritional habits for the children. While it is important for nannies to attend nutrition education sessions, it is vital for nannies to obtain knowledge on how the various feeding styles affect a child’s nutrition. ­

The purpose of this correlational study is to investigate the impact of the child’s functional status, family context, parent acculturation, and social support on parenting stress and, ultimately, on parents physical and mental health. A convenience sample of 50 Hispanic parents was recruited through a Facebook page and from agencies in South Florida providing services to children with disabilities and their families. The parents ages range from 21 to 62 years and the majority were mothers (n= 45). The majority of parents in this study live in low income households, have no college education, showed little participation in the workforce, and low acculturation. There were 30 boys and 20 girls between the ages of three to 21 years. Parents provided the data during an interview and through questionnaires. Data analysis included descriptive statistics and correlation analyses. Correlation analyses were conducted with the child’s characteristics, family context, socioeconomic status, parent acculturation, social support, parenting stress, and parent’s physical and mental health. The most frequent health problem reported by parents was neck and back pain. Parenting stress had a positive correlation with low acculturation and depression. The parents’ physical and mental health had a positive correlation with parents’ perception of social support. Parenting stress had a negative correlation with perceived social support, parents’ mental health, educational achievement and years lived in the U.S. There was a negative correlation between parent depression, perceived social support, and parents’ physical health. These parents reported low perceived social support and high levels of parenting stress. The results of this study indicate that parents with low acculturation reported higher level of parenting stress. Future research ought to continue exploring which interventions will better serve these parents and how cultural constructs influence their attitudes, expectations, decision making, and priorities.

This historical study dealt with a specific segment of the Salt Lake City population which foresaw the need of a community center to meet their long range goal s and leisure time needs. The purpose of the study was to accumulate existing details and information related to this subject and present an orderly time line of events which lead to the establishment and dedication of the existing Salt Lake Jewish Community Center. The pages contained names and events that will forever have a valued meaning to those '"ho became familiar with the Salt Lake Jewish Community Center.

The objectives of this study was to obtain data on five aspects of officials qualification practices presently used in Utah and to make some justifiable conclusion. 1. Qualification Data requested. a. Physical Qualification b. Mental Qualification c. Previous Experience as an Official and Player d. Other Related Athletic Experience e. Basketball Officiating and some existing Problems The survey compiled was sent to all head coaches of class "A" high schools, in Utah, which included 40 coaches in all, and to 60 class "A" high school officials of Regions 1, 2, and 4. The officials were chosen at random from the Utah High School Activities Association certified officiating bulletin issued yearly. From the Analysis of the Data the following conclusions were made: (a) Coaches and officials need to recognize what qualifications are presently used and what has to be done to improve these practices. (b) Physical qualifications as a requirement is only an assumption, not a must. (c) The knowledge that one must receive to make him mentally alert appears to be strong in some areas of the state, while in others it only involves reading the rule book and passing the written test. (d) All the athletic experience that one obtains prior to becoming an official, does have the sanction of all offiicials and coaches , for without it a person who wants to become an official can only hope for limited work, or assignments. (e) Any athletic sports activity that a person is associated with has many carryover advantages in the overall performance of an official. (f) Officiating problems as expressed by the data received are extensive . A few examples of the problems are listed below: 1. Crowd reaction 2. Coach reaction 3. Judgment and consistency , etc

A study was made of the adaptation to dietary protein of nitrogenous components in blood and urine of rats and humans. Forty-four mature male rats "ere adapted to a low protein diet (10 per cent casein diet) for three weeks before they were divided into two groups. Four rats were then killed for a control, and twenty of the remaining rats were switched to a high protein diet (40 per cent casein diet) and the other twenty continued to be fed the low protein diet. Four rats fed each level of protein were killed 2, 4, 6, 8, and 10 days after they were divided into two groups. A study similar to that carried out on rats was conducted on six male college students who were living in the same unit of a cooking dormitory. Blood and urine samples were taken when they were eating a normal diet as a control and then they were adapted on a low protein dict providing 12 per cent of the calories as protein for two weeks. They were then switched to a high protein diet containing 30 per cent protein calories for four consecutive days. The rats fed the 40 per cent casein diet had a higher rate of weight gain and increased amounts of urine per 24 hours than the rats fed the 10 per cent casein diet. Urinary output of the human subjects on the diets containing 30 per cent protein calories was greater than when they received the 12 per cent protein calorie diet. There was a significant increase in total nitrogen and urea in serum and urine of rats and humans as the dietary protein level increased. The urinary excretion of uric acid, of creatinine in humans, and of urinary amino nitrogen and total serum protein in rats and humans were also increased appreciably as the protein intake increased. Ko significant effects or trends in serum amino nitrogen of humans, or serum creatinine in rats or humans were observed with the change in the level of dietary protein. The high casein diet fed to rats reduced the excretion of creatinine and serum uric acid, while the high meat intake increased the excretion of creatinine and of uric acid in the humans. It was also found that there was a high negative correlation between serum uric acid and urinary uric acid of rats, and between serum amino nitrogen and urinary amino nitrogen of human subjects. This study indicates that the body rapidly adjusts to an altered level of protein intake by changing the level of nitrogenous components in blood and urine.

Lamb pregastric (PGE) and gastric extracts (GE) have been evaluated for their role in Italian cheese flavor production. Both have been shown to produce increases in free fatty acids and in non-protein-nitrogen during incubation with milk fat and casein substrates as well as in cheese substrates. Gastric lipase and cathepsins are considered to be the additional active agents in GE. Parmesan cheese manufactured with PGE and GE added to the curd was superior in flavor when both were employed, and either extract alone was better than the uninnoculated control. An assay for GE proteolytic activity has been proposed which involves the use of pH9.0 casein substrate thereby eliminating the effects of pepsin and rennin proteases. Differences among GE and rennin or pepsin preparations have also been established using starch gel electrophoresis and casein-agar gel diffusion techniques.