<p> Type 1 diabetes is an autoimmune condition which has seen numbers increase in recent years. Being a diabetic is neither easy for the diabetic themselves nor the parents raising the diabetic child. In looking over the literature, very little research was found on the lived experiences of fathers raising a child with type 1 diabetes. Therefore, a qualitative design with a phenomenological approach was used in order to discover and describe the phenomenon. This study was based on 12 male respondents (fathers) who shared their experiences on parenting a child with type 1 diabetes. The responses of the 12 participants revealed four major themes discovered via the hermeneutic method of textual description, and sought to present the essence of their lived experience. The four major themes were diabetes is forever, dealing with it, increased pressure, and the &ldquo;new normal.&rdquo; The lived experiences of fathers who participated in this study disclosed a sense of resiliency, while learning a lot of information, quickly to better understand type 1 diabetes. The interviewees wanted to share their stories and help others, interested in this topic, gain a better understanding of what life is like parenting and raising a child with type 1 diabetes.</p>

<p> Estudiar c&oacute;mo las mujeres ejercen el liderazgo educativo es necesario para reconocer su influencia y poder de transformaci&oacute;n en los diversos escenarios laborales. Al analizar los contextos en los cuales se manifiesta su liderazgo se pueden delinear oportunidades para la adaptaci&oacute;n transdisciplinaria en el campo de la salud. </p><p> El enfoque de esta investigaci&oacute;n gir&oacute; en torno a la trayectoria profesional de Judith Danielsen de Lugo, una mujer, educadora en salud y profesora que ocup&oacute; m&uacute;ltiples puestos de liderazgo en Puerto Rico a partir de la d&eacute;cada de los 50. Con tal fin, se indag&oacute; respecto a: c&oacute;mo las acciones de su trayectoria profesional la caracterizan como l&iacute;der al ejercer las dimensiones del liderazgo educativo; los elementos hist&oacute;ricos, sociales y culturales que se desarrollaron a lo largo de su trayectoria profesional; sus contribuciones a la pr&aacute;ctica profesional de la Educaci&oacute;n en Salud y los desaf&iacute;os y cuestionamientos que se plantean con su liderazgo educativo para el desarrollo y el avance de la salud p&uacute;blica en Puerto Rico. </p><p> La investigaci&oacute;n se fundament&oacute; en los est&aacute;ndares de liderazgo educativo establecidos en el 2011 por el <i>Educational Leadership Constituent Council</i> [ELCC]. Estos consisten de las siguientes dimensiones: la did&aacute;ctica, la comunitaria, la administrativa, la pol&iacute;tica, la estrat&eacute;gica y la &eacute;tica. Se adopt&oacute; el m&eacute;todo cualitativo y un dise&ntilde;o biogr&aacute;fico para llevar a cabo la investigaci&oacute;n. Los hallazgos se desprenden del an&aacute;lisis de las entrevistas semi-estructuradas con personas que conocieron a Judith Danielsen de Lugo en vida y en contextos profesionales y del an&aacute;lisis de documentos. Posteriormente, se efectu&oacute; un an&aacute;lisis de contenido de la informaci&oacute;n obtenida. </p><p> Mediante esta investigaci&oacute;n se concluy&oacute; que Judith Danielsen de Lugo desarroll&oacute; acciones profesionales vinculadas a todas las dimensiones que componen el liderazgo educativo. Con sus ejecutorias se ejemplifica que el liderazgo educativo incide y puede ser ejercido exitosamente en m&uacute;ltiples contextos laborales y a nivel transdisciplinario. Por consiguiente, se brindan recomendaciones para la pr&aacute;ctica efectiva del liderazgo educativo y para el desarrollo de investigaciones futuras.</p>

<p> The Village Market is a nonprofit Healthy Corner Store that has been open since May of 2011 in the mixed-use, mixed-income New Columbia housing development in Portland, Oregon&rsquo;s Portsmouth neighborhood. The venture began as a &ldquo;community-led&rdquo; effort in partnership with Janus Youth Programs and Home Forward. The project was conceived after a private enterprise in the small grocery space designed into the development failed, leaving the neighborhood without easy access to healthy foods. This dissertation is a case study of the development process, the operation of the market, and the degree to which it addresses food justice and health equity concerns, among others, of residents. It is a case study of the Healthy Corner Store movement that uses food regime theory and political economy perspectives to critically examine the translation of Healthy Corner Store movement theory into practice, highlighting the perspectives of New Columbia residents on the endeavor. It explores the transition of the store from a community-led project to a management-led social enterprise, and the impacts of that approach on local autonomy, food justice, health equity as well as its successes and shortcomings. The store&rsquo;s situation in a mixed-income community meant that it had a particularly diverse set of expectations to navigate, and the changes to the store over time reflect Village Market&rsquo;s growing understanding of the implications of that situation but also a limited capacity to accommodate residents&rsquo; differing tastes and the price sensitivity that many of them exhibit in their shopping habits.</p>

<p> <b>Introduction:</b> Substance Use Disorders (SUDs) cause significant distress to millions of Americans and considerable impact to society at large. Stigmatization of mental illness has been identified as the number-one barrier to seeking healthcare and it is unclear to what degree Mental Health Professionals (MHPs) share this negative bias. Education in SUDs for MHPs may play a role in reducing stigma in the treatment of SUD patients. The effect of education in SUDs on implicit and explicit attitude change is investigated longitudinally in a Substance Abuse Counseling MA Degree Program in Psychology. Academic outcomes and student demographic characteristics are assessed. <b>Hypotheses: </b> Implicit and explicit attitudes will change over the study period and will be related at follow-up. Knowledge acquired of SUDs will predict attitude change. <b>Methods:</b> This study was longitudinal, following 20 students over one year of study via assessment at baseline and follow-up. The drop-out rate was 20%, with 16 students remaining at follow-up. Implicit attitudes were assessed included the SC-IAT, explicit attitudes were assessed with the SAAS (general attitudes), DDQ (discrimination), and SDS (social distance). Academic progress was assessed via an Addictions Knowledge Test and the DDPPQ (confidence treating SUDs). <b>Results:</b> No significant change was found for implicit attitudes. Significant change in the positive direction was found for the SAAS. SAAS scores were positively correlated with DDQ scores at baseline and DDQ and SDS scores at follow-up. Both Addictions Knowledge Test Scores and DDPPQ scores and increased significantly over the study period, but they were not significantly related. DDPPQ scores were positively correlated with all explicit attitude measures. <b>Conclusion:</b> The CMHSAC Program was effective in increasing positive explicit attitudes toward SUDs, but it is unclear if personal attitudes actually shifted or if awareness was brought to the problematic nature of stigma instead. Students&rsquo; self-perception of their confidence and competence to work clinically strongly predicted explicit attitude change. Actual knowledge and confidence may not be directly related. Further research is needed to clarify the facets of education that are most effective in stigma reduction. Larger studies should be conducted to further investigate the effect of education on implicit attitudes.</p>

<p> The purpose of this qualitative multiple case study was to explore women&rsquo;s perceptions of provider influence in shaping their beliefs about protection against sexually transmitted diseases during provider-patient consultations. Women indicate they prefer to discuss sexual health issues with providers, yet research was not available to fully understand provider influence on women&rsquo;s beliefs regarding sexually transmitted diseases. Telephone interviews were conducted with a purposive sample of 12 adult women in Baton Rouge, Louisiana. Data collected from these interviews and analyzed for emerging themes using NVivo 10 software revealed how women perceived providers&rsquo; discussions and the dissemination of STD related information. Findings also revealed how women believed healthcare providers might present sexual health information to motivate changes in risky sexual behaviors. The three major themes emerging from the analyses of the data collected were providers did not initiate discussions about preventing STDs, no information was received about preventing STDs during consultations, and visuals could motivate changes in risky sexual behaviors. Recommendations based on the study&rsquo;s findings involved identifying opportunities to leverage staff members in healthcare providers&rsquo; settings, illuminate cues to action, develop STD awareness programs specifically for women, and to conduct future research.</p>

<p> The purpose of this study was to increase the knowledge level and change self-reported behavioral intent among a sample of healthcare providers regarding safe sleep messaging. From 1995 through 2015 in New York City, an average of one infant died every week from unsafe sleeping conditions. One agency in New York City experienced four unsafe sleep infant deaths within two months in 2010. In 2011, the city provided case managers with training on infant safety. Before this training, up to six sleep-related infant deaths were reported annually. The following year, one sleep-related infant death occurred. None occurred during the second year subsequent to the training. Current literature demonstrates healthcare providers have considerable influence on safe sleep messaging. This current study utilized a similar educational training designed for healthcare providers working in an urban health facility.</p><p> A single group pre/post-test quasi-experimental design was delivered to 23 participants. The design incorporated an online educational intervention in order to increase healthcare provider&rsquo;s knowledge level and change their self-reported behavioral intent to educate parents and caregivers on the importance of safe sleep practices. Data were gathered at pre-test and post-test to assess changes.</p><p> Final analysis, using a repeated measures general linear model, was carried out on data from the twenty-three participants who returned completed pre- and post-class surveys. There was a statistically significant change in the overall 13-item composite score reflecting knowledge level and change the self-reported behavioral intent from pretest (M=6.13, SD=2.78) to post-test (M=8.78, SD=3.79) at the p &lt;.001 level. These findings support current literature recommendations for healthcare providers to incorporate the safe sleep message into their practice. Nonetheless, supplementary research is needed to conclude whether these results coincide with communities elsewhere and to examine the issues regarding knowledge and behavioral intent regarding safe sleep messaging.</p>

<p> The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients&rsquo; safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians&rsquo; home state, state of license, field of license, age group, and graduation year group. The dependent variable was surgical medical errors. Physicians&rsquo; field of license and state of license were significantly associated with surgical error. Findings contribute to the knowledge base regarding the relationship between physician characteristics and surgical medical errors, and findings may be used to improve patient safety and medical care.</p>

<p> Adventists following a plant-based diet have half the prevalence and incidence of type 2 diabetes than nonvegetarian Adventists. This study used a quantitative, correlational study design to assess if there was a significant difference in type 2 diabetes prevalence rate between Adventists and non-Adventists preprogram, and if there were significant differences in biometrics between Adventists and non-Adventists with diabetes pre- and post-Complete Health Improvement Program (CHIP). This study incorporated the social ecological model for its conceptual framework and examined pre- and postprogram changes among Adventists (<i>n</i>=210; 20.1%) and non-Adventists (<i> n</i>=836; 79.9%) with type 2 diabetes. It used secondary data from participants in the volunteer-delivered CHIP intervention from 2006 to 2012 (<i>n </i>=7,172), a whole foods, plant-based, vegan health program. Analysis showed a significant difference in the pre-CHIP diabetic state between the two groups in step one, but not after controlling for covariates in step two (OR=0.96 and 0.91; <i>CI</i>=1.21 and 1.24). A repeated measures MANOVA analysis indicated that religious affiliation (Adventist or non-Adventist) was the determining factor in improved biometric outcomes pre- and post-CHIP for TC (<i>F</i>(1) = 5.65; <i>p</i> = 0.02), and LDL (<i>F</i>(1) = 5.76; <i>p</i> = 0.02) but not for HDL (<i>F</i>(1) = 0.00; <i>p</i> = 0.99), TG (<i>F</i>(1) = 0.19, <i>p</i> = 0.67), FPG (<i>F</i>(1) = 2.71, <i> p</i> = 0.10), SBP (<i>F</i>(1) = 2.25; <i>p</i> = 0.13), DBP (<i>F</i>(1) = 1.20; <i>p</i> = 0.27), and BMI (<i>F</i>(1) = 1.65; <i>p</i> = 0.20). However, both groups improved post-CHIP in all biometrics. The implications for positive social change from this study showed that CHIP is an effective lifestyle model for improving type 2 diabetes outcomes for both Adventists and non-Adventists, a model that does not involve the use of pharmaceuticals.</p>

<p> Heart failure readmissions place a significant financial burden on the healthcare system. Stakeholders of this system have utilized many approaches to reduce the number and costs of heart failure readmissions, without significant improvement. The purpose of this practice improvement project was to determine whether education on the financial impact associated with readmissions improved a patient&rsquo;s measured quality of life, encouraged adherence to a therapeutic regimen, and thereby reduced readmission rates in Medicare and Medicaid patients diagnosed with heart failure. Theoretical support is derived from the theory of self-care of chronic illness, which recognizes the complex self-care processes a patient with chronic illness negotiates. The project used a quantitative methodology with a pre-test/post-test design. A convenience sample was enrolled of 10 Medicare and Medicaid patients who had recurrent heart failure readmissions. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to collect pre/ post-intervention data which was then analyzed by two-tailed paired t-test. There was no statistically significant difference from the intervention to determine any impact on the participant&rsquo;s measured quality of life (<i>p</i> = .953; &alpha; = .05). However, none of the participants were readmitted during the 30 day period of this project. The findings indicate heart failure patients acknowledge their financial constraints but quality of life is not as impacted by finances as anticipated. Polypharmacy and uncertainty with managing daily regimens during symptom exacerbation were the greatest concerns. It is recommended that heart failure patient education should be persistent and individualized to address the patient&rsquo;s unique needs. </p><p>

<p> Alzheimer&rsquo;s disease (AD) is the most common irreversible form of dementia and accounts for 60&ndash;80% of all dementia cases. It is not a normal part of aging and causes memory problems and other cognitive dysfunctions that may result in unpredictable changes in behavior. AD can be caused by many factors. Recently, Vitamin D deficiency has been recognized as a risk factor for AD. Vitamin D insufficiency and deficiency are major health problems affecting 1 billion people worldwide, across all ethnicities and age groups. Unfortunately, public knowledge about Vitamin D deficiency and risk of AD is limited. The creation of two leaflets as informational tools for experts/professionals and families/caregivers/participants of Alzheimer&rsquo;s Orange County was the goal of this project. The leaflets were reviewed by experts in the field and revisions were made. Future research should evaluate the effectiveness of the leaflets on increasing knowledge about Vitamin D and AD.</p><p>