The purpose of this study was to investigate the role of hardiness in health perception and psychosocial adaptation in adult hispanics with chronic hepatitis C (n = 32). The Health Related Hardiness Scale and the Psychosocial Adaptation to Illness Scale were administered to 32 adult hispanics diagnosed with chronic heptitis C at a gastroenterology center. The results indicate that a comparison of subjects with low and high hardiness scores did not reveal significant differences on any of the PAIS domains (health care orientation, sexual relationships, psychological distress, vocational, domestic and social environments). Furthermore, hardiness subscales of control and committment did not have any influence on patient's psychosocial adaptation nor in its domains. However, a comparison of subjects with low and high challenge scores indicates that those with low challenge had lower total psychosocial adaptation scores (M = 5.55, SD = 2.13) than subjects with high challenge scores (M = 4.24, SD = .67) ,t = (1, 30) = 2.34, p < 0.05. Differences were also found for the domains of health care orientation, psychological distress, social and vocational environment. Lastly, there were significant differences on perceived health rating (poor, fair, and good) for the total hardiness score (F = (2,29) =5.49, p < 0.05), control (F =(2,29) = 4.09, p < 0.05), committment (F=(2,29) = 3.76, p < 0.05) and challenge (F=(2,29)= 4.92, p < 0.05). Thus, those patients who rated their health as poor had lower hardiness levels. Findings have implications for promoting hardiness for better health perception and in certain aspects of psychosocial adaptations in adult hispanics with chronic hepatitis C.

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Background: Rural areas of Peru lack access to healthcare resources and poor nutritional knowledge of what should be given to their children throughout their growth and development. The majority of the rural areas rely on a high carbohydrate, moderate vegetable diet, and lacking a protein source. Lower protein intake can lead to problems of malnutrition and growth stunting. Families rarely have monetary resources to provide a protein at every meal for the entire family. There is also a lack of a clean water supply, free of parasites and helminths. Caregivers often rely on replenishing intake with other fluids high in sugar. These issues create healthcare needs within the community and may go unmet. Objectives: Identify specific educational needs for children living in rural Peru related to nutrition and health practices. The needs assessment was conducted to create identify specialized programming for children accompanying their parents at a local clinic. Methodology: Survey analysis was conducted on caregiver responses, related to children under the age of 18 living in Peru. Institutional Review Board approval was obtained at the university in the USA and the clinic in Yantalo, Peru. Caregivers were invited to participate in the study in person or on social media. The explanation of research was distributed and placed as a top sheet prior to the survey ensuring consent. Anonymous survey completion was conducted while in the waiting room, a private office was available upon request. Electronic links were also provided via Facebook on the clinic website. Results: Approximately 55 participants completed the Peruvian Nutritional Survey. There were 43 in-person surveys completed with an additional 13 online. Demographic data collected included: the average age of the caregiver, 34 years old, and children per household (children). The average home rarely consumed water as a beverage. The primary resource of fluids offered to children was fruit juice or evaporated milk. Two meals a day are served with a protein, one of which is eggs. The main carbohydrate varied, however; it was offered to the child at every meal. Children under the age of 12 receive immunization at the yearly checkup. There is minimal knowledge related to the purposes of the immunizations. Discussion: Root vegetables comprise the majority of every meal. Root vegetables are readily grown in the community and are inexpensive. There is a noted lower protein intake in the rural area. Fluid intake is minimally monitored and not seen as a priority. Water is an important source of fluid especially due to the humid climate but is often contaminated with parasites (Cabada et. al, 2015). Filtered water is expensive and harder to locate in the home setting. Conclusion: Medical attention in rural Peru is scarce and limited. The clinic offers a hub of resources for community families. The caregivers noted they access specialized care when advertised by the clinic. Pediatric well-check is provided annually until the age of 12, while older children only seek medical attention when ill. There is a lack of misinformation and lack of communication about when free healthcare is no longer provided for their children.

<p><strong> Objective:</strong> The purpose of this systematic review is to identify the effectiveness of KT strategies used to promote evidence-informed decision making (EIDM) among public health decision makers.</p> <p><strong> Methods: </strong>A search strategy was developed to identify primary studies published between 2000-2010.<strong> </strong>Studies were obtained from multiple electronic databases, supplemented by checking the reference lists of included articles and background papers. Two independent reviewers screened studies for relevance, assessed methodological quality and extracted data from relevant studies using standardized tools. Disagreements were resolved through consensus.</p> <p><strong> Results: </strong>The search identified 92, 548 titles related to KT interventions. After duplicate articles were removed 64, 391 were imported into Distiller SR of which 345 articles were deemed potentially relevant on double title and abstract review. Of the 345 articles, 30 met all relevance criteria on full text screen and after revisions to the inclusion criteria, 6 studies of moderate quality were included in this review.</p> <p>KT interventions tested in the systematic review included organization change, provider reminders, education, financial incentives and feedback. Interventions tested in the five primary studies ranged from; educational sessions; dissemination channels including print, CD-ROM and Internet; technical assistance and staff training; and web-based services such as databases, information services, registries of pre-processed research evidence and tailored targeted messaging.</p> <p>KT strategies shown to be less effective included access to registries of pre-processed research evidence or print materials. Simple or single KT interventions were shown in some circumstances to be as effective as multifaceted ones including organizational change, provider reminders and tailored targeted messaging. While knowledge brokering did not have a significant effect generally, results suggest that it did have a positive effect on organizations with low research culture.</p> <p><strong> Conclusion:</strong> KT research in public health is in early stages. Single interventions can be effective. Researchers and practitioners must pay attention to contextual factors.</p> / Master of Science in Nursing (MSN)

Methicillin-resistant Staphylococcus aureus (MRSA) is a problem nationally and affects many people from all walks of life. Community associated MRSA is often ignored and not viewed as significant, thus there is a lack of education on the topic. One area that is at a particular risk for the transmission of Community Associated MRSA is physical activity centers. Education in these areas could improve the knowledge of community acquired MRSA among employees and decrease the likelihood of infection at physical activity centers. In this study a pre-test was given. After the pre-test an educational powerpoint on MRSA was presented and then the participants were given a post-test to complete. The goal of this study was to determine if the staff’s knowledge and opinions of MRSA would change after being educated on the topic.

Research shows that one of the major contributors for an extended stay in a long-term care facility is lack of knowledge regarding goals for rehabilitation after being discharged from an acute care facility. It is important to determine patients’ levels of engagement because individuals who are actively involved in discharge planning and rehabilitation goals are able to manage their ongoing care more effectively, which results in increased quality of life. The data was collected using a survey method and the instrument used was the Patient Activation Measure or PAM which is a highly accurate and reliable tool. The 22 question survey was used to determine the level of patient activation among patients who are currently receiving rehabilitation services at a rehabilitation or long-term care facility. Determining the level of engagement in patients receiving rehabilitation services will provide health care providers insight into the how willing patients are to be engaged in their own care. A total of 11 surveys were completed by patients varying age, gender, and length of stay. Each patient was currently receiving rehabilitation services at National Healthcare Corporation of Johnson City or John M. Reed Health and Rehabilitation Facility in Limestone.

As the Hispanic population continues to grow in the United States, especially in the South, it is critical for healthcare workers to provide culturally competent care as required by certain laws. The Latina experience is of significant importance due to the role Latina mothers play in their families and communities. It is necessary to understand the perspective of this population and the experience of the Latina mother in regards to healthcare; specifically, how have language barriers hindered care, what perceptions of bias or discrimination have been encountered, and how do these factors influence their healthcare decisions and outcomes. Research has been conducted that identifies language and bias as barriers to access; however, further research is necessary to identify how these barriers influence a Latina mother’s perception of the healthcare system with an emphasis placed on East Tennessee. Therefore, it is critical for more studies to be conducted in order to identify what public health officials can change in order to provide equal access to this significant demographic.

This study was designed to create a high-risk fall profile for a specific Appalachian community. Data were obtained from 1,598 individuals with fall-related injuries who had been had been evaluated at a Level 1 Trauma center in Northeast Tennessee throughout 2011 and 2012, ages of individuals were 18 to 85 years. Data collected included: age, gender, county of fall, site of fall, type of fall, number of co-morbidities, season of fall, and time of day of fall. Results showed differences in criteria for categorizing individuals at high risk of falls, as well as data that had not appeared in the literature such as high-risk counties, a new high-risk age range, and the specific type of fall occurring. Tailored interventions should be created to fit the needs of this at risk community.