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      • Assessment of Nursing Home Residents with Frequent Urinary Incontinence

        Overstreet, Nancy Kiley University of Virginia 2011 해외박사(DDOD)

        RANK : 247343

        Study aim. To (1) Determine factors influencing continence in nursing home residents identified as having frequent urinary incontinence and (2) explore the barriers and facilitators that influence nursing staff when developing and implementing best practice care plans for residents with urinary incontinence. Setting. Study sites were two 90 bed, for-profit nursing and rehabilitation centers in 2 Southeastern communities. Method. All study participants were residents identified as having frequent urinary incontinence by Minimum Data Set (MDS) 3.0 criteria. Following consent, subject's chart were reviewed for current medications and a complete list of medical diagnoses. The participants were interviewed regarding history of their incontinence and a profile of the symptoms they experienced. A functional assessment was performed to evaluate the participant's ability to toilet. Post void residual urine measurement was obtained by a BladderScan RTM Verathon BVI 3000 bladder scanner. A brief physical examination included an inspection of the perineal area and a rectal examination. Results from items in the Urinary Incontinence Assessment tool(c) were reviewed for frequency of occurrence. Results from the anonymous questionnaire completed by facility professional nursing staff describing facilitators and barriers to incontinence care and care planning were reviewed for frequency of responses. Results. A total of 22 residents (average age 82.3 years, female, 91% Caucasian) in 2 nursing homes participated. Most common risk factors identified include: impaired mobility (100%), dementia (55%). Symptom history revealed: urge incontinence symptoms (40%), stress incontinence symptoms (55%) and functional incontinence (100%). Nurses identify incontinence as the 3 rd most common resident issue for care planning and resident immobility and advanced dementia as the most common barriers to providing continence care. Availability of therapy services and support of administration are the key supports to facilitating a continence care program. Conclusions. Mobility and impaired cognitive status impact continence care. Use of a comprehensive incontinence assessment tool provides a consistent pathway for the creation of individualized, evidenced based plans of care.

      • Effect of Transformational Leadership and Organizational Innovativeness on Motor Carrier Performance

        Overstreet, Robert E ProQuest Dissertations & Theses Auburn University 2012 해외박사(DDOD)

        RANK : 247343

        This dissertation developed a theoretical model of the relationship between transformational leadership, organizational innovativeness, and organizational performance, both operational and financial. To test the model, data were collected from upper management at motor carriers that provide for-hire transportation services within the continental United States. A survey was developed using existing, validated scales for each of the constructs. Contact data were collected for 500 motor carriers to include individual names, positions, and e-mail addresses. The survey was administered on-line using Qualtrics. Over 4,000 e-mails were sent directly to 1,959 desired points of contact with the link to the survey. The 158 usable responses represented an 8% individual response rate and a 32% company response rate.Analysis of the data using structural equation modeling revealed that all hypotheses were supported. The results of this study support a direct and indirect effect of transformational leadership on the bottom line performance of an organization. Two mediators, organizational innovativeness and operational performance, were tested and the amount of variance in financial performance accounted for by the hypothesized model was 38%. Implications for researchers and practitioners are discussed along with limitations and areas for future research.

      • The effect of textual enhancement on second language learner reading comprehension and form recognition

        Overstreet, Mark Holman University of Illinois at Urbana-Champaign 2002 해외박사(DDOD)

        RANK : 247343

        Research in second language acquisition has established that some sort of focus on form may be beneficial to adult second language learners. One type of focus on form that has received attention is textual enhancement. The instructor attempts to draw the learner's attention to specific forms by using any of a variety of enhancement techniques, such as bolding, underlining, italics, and so on. Previous textual enhancement research, however, has produced equivocal results. The present study examined the effects of textual enhancement on second language learner reading comprehension and form recognition based on how much of the target verb was enhanced and the relative communicative value of the target items. Two main variables were defined. The first was amount of enhancement. In previous research with verbs, the entire verb word was enhanced. In the present study there are two enhancement conditions: whole word and morphology only. The second main variable was communicative value of the target. The progressive has high communicative value and the imperfect subjunctive has low communicative value. A total of 109 participants enrolled in third-semester Spanish read a text in one of five conditions: no enhancement, morphology enhancement/progressive, whole word enhancement/progressive, morphology enhancement/imperfect subjunctive, whole word enhancement/imperfect subjunctive. After reading the text, participants completed a free recall task and a form recognition task. Results on the free recall task suggest that neither of the main variables had an effect on global recall, but that enhancement of the entire word increased recall of target sentences. Results on the form recognition task suggest that amount of enhancement has no effect, but relative communicative value does have an effect. Learners detected and identified the item of higher communicative value more than the item of lower communicative value. These results indicate that textual enhancement of a form of lower communicative value does impede processing of both form and meaning, but that enhancement of the item of greater communicative value does not.

      • Spiritual vs. religious: A study of undergraduate Catholics' beliefs and practices

        Overstreet, Dawn V Boston College 2006 해외박사(DDOD)

        RANK : 247343

        Contemporary American college students simultaneously express both increased interest in spirituality and declining interest in traditional religion. Recent research recognizes the trend of young adults separating spirituality from religion, but utilizes varied definitions of each term developed by the researchers. This study is the first to ask students directly whether and how they differentiate spirituality from religion. It examines how undergraduate Catholics attending a Catholic university conceive of religiousness and spirituality and the relationship of this understanding to their religious and spiritual practices. A qualitative multi-case study design with in-depth semi-structured interviews (N=20) was the primary method for data collection. Data gathered from a previously administered web-based questionnaire (N=936) served to contextualize the data gathered from the interviews. The interviews covered students' definitions of religiousness and spirituality, practices of prayer, conversations about religious and spiritual beliefs, and participation in religious services. The findings suggest that the students in this study have re-appropriated their religious and spiritual search by moving away from organized religion or what they perceive organized religion to be. Students asserted that there is a difference between being religious and being spiritual, but their distinctions between the two concepts did not impact how they practiced or experienced religion and spirituality. These students used a vocabulary of spirituality for defining both religious and spiritual beliefs and practices. This study found a deep desire among these students, no matter what their self-understanding of being religious and/or spiritual, to search for the transcendent and live lives directed towards helping those in need. However, the findings support Hamer's (2004) assertion that many young adults today separate belonging from believing. While these young Catholics desired to be part of a community and lead lives in pursuit of the common good, they did not generally associate this way of life with what it means to be religious. The developmental process of young adults and the individualistic spirit of American culture into which Catholics have assimilated help to explain why these undergraduate Catholics separate spirituality from religion. From these findings, several recommendations were suggested for fostering the religious and spiritual development of students within the context of Catholic higher education.

      • CD8 T cell responses to malaria vaccination: Functionality and survival

        Overstreet, Michael Glen The Johns Hopkins University 2009 해외박사(DDOD)

        RANK : 247343

        Protection against malaria can be induced by immunization with radiation-attenuated Plasmodium sporozoites. CD8+ T cells play a major role in this protection by limiting parasite development in the liver. In the current work, we evaluated the role of CD4+ T cells in supporting the anti-sporozoite CD8+ T cell response, both in the survival of activated T cells and in the ability of these cells to produce cytotoxic effector molecules. We found that, in the absence of CD4 + T cells, CD8+ T cells induced by irradiated sporozoites failed to reach optimal clonal expansion and formed a diminished memory population. These cells were unable to inhibit liver-stage parasite development and displayed a severely impaired ability to produce cytotoxic effector molecules. Intriguing observations from this work led to the evaluation of polyfunctional effector profiles among normal tissue-resident anti-parasite CD8+ T cells. These studies demonstrated that the number and combinations of effector molecules produced by individual T cells changed dramatically over time and was dependent on the local tissue microenvironment, as well as the pathogen that induced them. Strikingly, liver-resident memory CD8+ T cells induced by irradiated sporozoites failed to secrete cytokines in response to antigen. As another model to study CD8+ T cell responses in the absence of CD4 help, we immunized mice with MHC I-restricted peptides to target only CD8+ T cells for activation. We found that immunization with soluble peptide resulted in the abrupt death of activated CD8 + T cells that could not be rescued by activation of CD4+ T cells, indicating that other factors were equally important in helping the development of the CD8+ T cell response. The survival of the T cells could be augmented by innate immune signaling but was strongly inhibited by B cells. In total, the data presented here offer new insight into the development and regulation of CD8+ T cell effector functions and survival, which is significantly impacted by CD4+ T cells, as well as distinct tissue microenvironments and the pathogen that induced them.

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