Theses and Dissertations at Montana State University (MSU)
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Item A description of a project on the use of mindfulness for stroke survivor caregivers(Montana State University - Bozeman, College of Nursing, 2021) Kirby-Johnson, Valerie Katherine; Chairperson, Graduate Committee: Tracy HellemSome stroke survivor caregivers experience caregiver burden and depression after their family member experiences a life-altering cerebrovascular accident. Stroke survivor caregivers may face negative mental and physical health impacts when providing stroke survivors' care within their home, which can lead to the stroke survivor encountering negative health outcomes. Educating stroke survivor caregivers on mindfulness cognitive behavioral therapy provides them with a tool that can allow them to better cope with caregiver burden and depression that can be experienced when providing care. Therefore, the purpose of this project was to provide stroke survivor caregivers with education about the use of mindfulness to improve mental health. Data collection consisted of the Caregiver Burden Scale and Patient Health Questionnaire at baseline, at time of stroke survivors' discharge and two weeks after discharge to home. Largely related to the onset of the COVID-19 pandemic, this project had limited recruitment (n=2) and retention (n=0). Given the mounting evidence on the benefits of mindfulness practices, this project could be implemented in the future when social interactions, such as in-person support groups, resume post COVID-19 era.Item Effect of glutamate neurotoxicity on CaM kinase immunoreactivity in vivo(Montana State University - Bozeman, College of Letters & Science, 1997) Liu, HuiItem Community education on stroke : early recognition and timely access to healthcare(Montana State University - Bozeman, College of Nursing, 2009) Stobie, Paula Anna; Chairperson, Graduate Committee: Susan LuparellIn 2006, data collected from a hospital emergency room centrally located in Sanders County, Montana revealed that 33% of patients presenting with possible stroke symptoms were eligible to be evaluated for treatment with a potentially life-saving intervention. As a member of the community, I felt this rate of treatment could be improved. Review of data from state and national sources showed similar treatment statistics nationwide. One consistent suggestion in the literature for improving stroke detection and treatment was for increased public education. As a result of these findings I developed, presented, and evaluated a community-based education presentation on stroke symptoms and treatment. Knowledge about stroke symptoms and treatment was measured prior to the presentation and again afterwards with a pre- and post-test tool. Results of this testing showed overall improvement in the audience's knowledge. On-going evaluation of emergency room data to assess for an improved percentage of persons being treated was beyond the scope of this project. Information discovered in a review of the literature consistently points out that late arrival to the Emergency Department is one of the major reasons people are not being treated for stroke, and most sources call specifically for increased public awareness regarding stroke and treatment available. This project served to educate a small population of people in a county with multiple risk factors for stroke. Although ongoing refinement and data collection are needed, continued use of this educational tool may serve to improve treatment of stroke, potentially decreasing the death and disability attributed to stroke in this county.Item Object and spatial recognition in the ischemic gerbil(Montana State University - Bozeman, College of Letters & Science, 2010) Clement, Bridget Williams; Chairperson, Graduate Committee: A. Michael BabcockThe Mongolian gerbil is extensively used to model transient cerebral ischemia, a type of stroke that can occur with anoxia and cardiac arrest. A global ischemic insult in the gerbil produces damage to hippocampal CA1 pyramidal cells comparable to that observed in humans. A limited number of models are available to evaluate the behavioral consequences of cerebral ischemia in the gerbil. The goal of the present experiments was to evaluate the impact of transient cerebral ischemia on object and spatial recognition memory as these tasks have not been previously utilized with the gerbil model. Following ischemic insult (5-min bilateral carotid occlusion) or sham procedure, gerbils were tested in a familiar environment with novel objects. A familiarization phase followed by separate test phases for presentations of a novel object or object location were conducted. Exploratory behavior for the novel object or object location was evaluated using an automated tracking system. Results indicated that both ischemic and sham subjects were able to recognize the novel object when placed in the environment. However, when confronted with a familiar object, placed in a novel location, neither group exhibited a significant increase in exploratory behavior. A second experiment was conducted to further investigate the spatial recognition task. Subjects were habituated to the apparatus in addition to the experimental objects. Under this experimental condition, both groups exhibited significant exploratory behavior for the object placed in the novel location. The ischemic and control groups differed from each other during habituation with ischemic subject showing significantly higher activity levels. It is possible that differences between the groups remain but that these recognition findings are a result of extended habituation to the experimental objects. Further investigation of this matter is needed to determine the effect of prior object exposure on exploratory behavior in the spatial recognition task.Item Stroke education packet : the inpatient environment(Montana State University - Bozeman, College of Nursing, 2010) Brandt, Heidi Kay; Chairperson, Graduate Committee: Charlene WintersStroke is a disease process that affects more than 700,000 people per year. Many of those individuals enter the acute care setting with questions and concerns regarding the causes of stroke and implications of a stroke diagnosis. To answer those questions, national guidelines regarding stroke education have been created to help nurses present information to stroke patients and their families. In one acute care facility, there was a lack of an educational packet for nurses to use to teach this vital information. The purpose of this clinical project was to create an evidence-based stroke education packet for nurses at this facility to use to teach stroke patients and their families. Evidence was compiled from the literature, evidence-based guidelines, and multiple stroke-education packets, brochures, and patient education materials used by nurses at other health care facilities. The packet was created and presented to the institution as a usable tool to facilitate the delivery and documentation of stroke education to patients and their families.Item Novel pharmaceutical combination confers protection from delayed cell death following transient cerebral ischemia(Montana State University - Bozeman, College of Letters & Science, 2009) Chapman, Courtney Myfanwy; Chairperson, Graduate Committee: A. Michael BabcockStroke is a leading cause of death and disability throughout the world; ischemia is the most common form of stroke. Medical procedures such as cardio-pulmonary bypass surgery can cause ischemic stroke can be caused. There are no treatments to limit neural impairment following stroke. The current research investigates neuroprotection offered by treatment with a novel drug combination consisting of Simvastatin TM, Gemfibrozil TM, Troglitazone TM, and Spironolactone TM. Animals were treated with the drug cocktail three weeks proceeding and one week subsequent to surgery. Ischemic insult was induced by clamping the carotid arteries for 5 min. Sham subjects underwent similar surgical procedures, but the carotids were not clamped. Twenty-four hrs following the surgical procedure locomotor activity was monitored in an open field for 5 min. Seven to fourteen days following ischemia or the sham procedure animals were sacrificed and sections containing the hippocampal CA1 region were mounted on slides and stained with cresyl violet. The CA1 region was rated on a 4-point scale for level of damage. Rodents generally show increased locomotor activity following transient global ischemia in an open field. In our study, ischemic animals that received vehicle demonstrated increased activity relative to the animals that received the drug treatment on all behavioral measures. Ischemic animals that received vehicle treatment had significantly more neural damage in the hippocampal CA1 region than ischemic animals receiving the drug. The appearance of neurons in the CA1 hippocampal regions of animals in the sham condition was not significantly different from ischemic animals in the drug treatment condition. It is concluded that the drug treatment is effective in offering neuroprotection during transient global ischemia. The next step is to characterize the biochemical mechanisms behind the neuroprotection conferred by the drug treatment. Contrasting the protein expression levels of animals receiving the vehicle treatment with animals receiving the drug treatment following an ischemic insult will assist in elucidating these pathways. Predictions are made regarding the biochemical mechanisms affected by the drug treatment based on previous research on the biochemical pathways affected by each pharmaceutical.Item Development and implementation of a protocol for treatment of in-patient ischemic stroke patients(Montana State University - Bozeman, College of Nursing, 2011) Campbell, Carla Hoffman; Chairperson, Graduate Committee: Elizabeth S. Kinion"Stroke continues to be a significant cause of mortality and morbidity in the United States. Approximately 700,000 Americans have a new or recurrent stroke each year, and stroke remains the third leading cause of death in the United States when considered independently from other cardiovascular diseases. Stroke also remains a leading cause of serious, long-term disability in the United States." (Schwamm, 2005, p.690) The purpose of this project was to develop an evidence based care management protocol for persons admitted to a small rural hospital with the symptoms or diagnosis of Ischemic Stroke. A committee was formed, evidence based best practices were identified, tools were developed and the protocol was implemented. The protocol was based on the Core Measures established by the Joint Commission and adopted by the centers for Medicare and Medicaid as a basis for validating quality and setting reimbursement. The protocol was successfully implemented; a process for the Quality Department of the facility was put in place to insure continued success.