• Why do Women Choose to Bed-Share With Their Infants?

      Miller, Victoria (University of Alaska Anchorage, 2014-09-02)
      In the early 1990s, the American Academy of Pediatrics (AAP) initiated Back to Sleep to decrease infant mortality from Sudden Infant Death Syndrome (SIDS). A decline in SIDS followed; however, accidental deaths from asphyxiation, overlaying, falls, and suffocation increased. Classified as Sudden Unexplained Infant Deaths (SUID), these deaths occurred more frequently in infants who bed-shared. To minimize the risk of SUID, the AAP released guidelines in 2011 advising against bed-sharing. However, despite the new guidelines, bedsharing rates remain near 50%. The purpose of this systematic literature review is to examine why women bed-share. The author found better sleep, breastfeeding, closeness, convenience, and safety as frequent reasons for bed-sharing. Less commonly found were culture and financial limitations. A greater understanding of the reasons women bed-share can help providers discuss this issue with parents, guide interventions to reduce bed-sharing, and improve compliance with AAP guidelines.
    • The Role of Alaska's Nurse Practitioners in Preventing Early Childhood Caries

      Maixner, Margaret (University of Alaska Anchorage, 2014-10-06)
      Early Childhood Caries (ECC) is the most common chronic disease of childhood despite being preventable. Because of its high prevalence, its impact on the quality of life of young children, and its potential for increasing their risk of caries in the permanent dentition, ECC is arguably one of the most serious and costly health conditions among young children. Poor access to dental services by rural Alaskans and poor dental care in general are considered the main contributing factors to the continued rise in ECC in Alaska. Primary care providers (PCPs), such as nurse practitioners (NPs), are in unique positions to complement the work of dental professionals because PCPs often provide care before a child’s first dental visit. This project assessed the practice habits and perceived competence of Alaska’s NPs with regards to performing pediatric oral health-related tasks as well as knowledge of current tools. Data was collected from NPs in Alaska by survey. This data was analyzed to find specific areas of educational-need and to model an information kit for NPs in the State of Alaska to improve their primary pediatric practice. The results indicated that NPs in the State of Alaska believe oral heath assessments and preventative education should be included in pediatric well-child care but their frequency of actual performance and perceived confidence was low. Recommendations to improve frequency of oral health-related tasks during visits with pediatric populations focus on increasing education in these areas for Alaska’s NPs.
    • Cost Benefit Analysis of Implementing Building Information Modeling (BIM) for Construction Management of the Sports Arena of University of Alaska Anchorage

      McConnell, Christopher C. (University of Alaska Anchorage, 2014-11-01)
      This research project evaluates the costs and benefits of implementing building information modeling (BIM) as a construction project management tool through the scenario analysis of the UAA Sports Arena project completed August 14, 2014. A literature review was conducted providing general information about BIM, its current status, leading software, cost, benefits, and analysis of two case studies. Cost benefit analysis was applied to account for risk and allow for the comparison of multiple scenarios that are simulated in @RISK. Based on the schedule scenario the project could have ended 11 days early, resulting in an estimated savings of 1.5% of total project cost. Based on the cost scenario the project is estimated to save 1.1% of total project cost, with a 72.8% chance of realizing a positive benefit. When the conditions specific to each scenario in this research are met, the results support a go decision with regards to the implementation of BIM.
    • Knowledge and Perception of Coronary Artery Disease in High-Risk Women

      Kottsick, Summer (University of Alaska Anchorage, 2014-11-17)
      Background: Coronary artery disease (CAD) is the leading cause of death in America and kills more women each year than all other cancers combined. While women’s level of awareness of heart disease has increased, they often do not perceive their risk of heart disease accurately, nor do they understand the importance of adopting heart-healthy behaviors to reduce risk. Objective: By implementing a combination of counseling from a health care provider and computer-based tailored education, this project aimed to test the effectiveness of using the Go Red for Women™ Heart CheckUp as an educational intervention for high-risk women to increase the accurate perception of risk, improve CAD knowledge, and increase intent to make behavioral changes. Methods and Discussion: Twenty-one women with a history of CAD, myocardial infarction, percutaneous transluminal coronary angioplasty, or coronary artery bypass grafting completed the Go Red for Women™ Heart CheckUp tool and rated their perception of risk from CAD and belief that they could change their risk both before and after the tool. There was an increase in perception of risk and belief in change after the tool. Qualitative data showed participants were educated about CAD. Conclusion: The Go Red for Women™ Heart Check-up tool was shown to be useful in educating high-risk women about their cardiac risk and in promoting heart-healthy behaviors.
    • Crystal River Properties - Rental Property Acquisition Guide

      Wareham, Andrew J. (University of Alaska Anchorage, 2014-11-21)
      Crystal River Properties is a privately owned small business started in 2011 whose sole revenue stream relies upon rental income from company owned small multifamily (duplex and triplex) real property assets. In order for the business to expand, additional properties need to be acquired to increase revenue. Current real-estate market conditions make it financially impractical to purchase new construction properties. The most feasible alternative is to consider pre-existing properties which, if not done correctly, could expose the company to considerable financial risk. This project will research and identify methods to select prospective existing rental income properties with the greatest potential for maximum, sustainable net income based on operations and maintenance costs, marginal revenue, turnover rate and vacancy rates. The underlying objectives will used to best meet the expectations of the potential occupant segment of stakeholders. Assessment criteria will be based upon price (anticipated return on investment), location, size, age, type of construction, property condition (recent renovations), insurance and tax rates, lessons learned from past property procurements and risk analysis considerations. Consolidated results of gathered information and research will be packaged into a step-by-step user guide for income property acquisition. The guide will available in electronic PDF and hard copy format. The methodology depicted in the guide will enable a thorough evaluation of property selection alternatives against likely risks and key success criteria providing the tools necessary to acquire additional business assets in the most economical fashion while simultaneously exposing the company to the least amount of financial risk.
    • The Experience of Informal Caregivers for Persons with Metastatic Cancer Perceptions of Support

      Fossler, Erica (University of Alaska Anchorage, 2014-12-01)
      Purpose/Objectives: To investigate the experience and perceptions of support of caregivers for persons with advanced cancer. Research Approach: A qualitative descriptive approach using focus groups to explore the caregiver experience. Setting: An outpatient oncology infusion center in southcentral Alaska. Participants: 14 adult caregivers of persons with stage IV cancer. Methodologic Approach: Participants attended one of two focus groups. They were asked to share their experiences as informal caregivers. Focus groups were digitally recorded and transcribed verbatim for analysis. Krueger’s method for content coding and data analysis was used to identify themes (1998). Findings: Key themes that emerged during data analysis included internal stressors such as emotional and psychological distress, and external stressors of needed financial support and nutritional information, suggesting the stated need of a more comprehensive care approach. Conclusions: Participants recognized needs but did not feel they were supported in accessing resources. The experience of caregiving was often abrupt in onset in this population and the overwhelming amount of information they received did not include enough information on the act of caregiving or the resources available. Implications for Nursing: Advanced practice nurses are instrumental in identifying and addressing caregiver needs. As patient educators and advocates, they provide education and resource support to both the patients and the caregivers in an effort to minimize caregiver exhaustion.
    • Alaska Health Care Costs

      McCourtney, David (University of Alaska Anchorage, 2014-12-05)
    • Development of a Prioritization Tool for BP Exploration (Alaska) Inc. Category C Projects

      Lujan, Carlos (University of Alaska Anchorage, 2014-12-08)
      The production of oil and gas in the major North Slope fields in Alaska is on the decline as it is in any major oilfield of this age. Capital resources must therefore be utilized with the greatest efficiency. BP Exploration (Alaska) Inc. (BPXA) Projects and Modifications Team (PMT) provides front end loading (FEL) engineering and construction planning services for category (Cat) “C” projects (range from $250,000 - $15,000,000) through BP’s Capital Value Process (CVP), a stage gated project development process. One of BPXA’s strategic objectives is to improve the utilization of Cat C projects capital resources. The project will develop and clarify business objectives ensuring only Cat C projects with strong business drivers will be funded, unless the project is an integrity or health and safety project. This approach will ensure that fit-for-service improvements are selected for execution.
    • Determining the Health Problems of Alaska Military Youth Academy Participants

      Doughty, Mark W. (2014-12-08)
      Alaska Military Youth Academy is an accredited residential high school program that utilizes a quasi-military approach to teach life skills to at-risk youth. Physical fitness is a key component and is modeled after military basic training standards. Participants in the program are largely from disadvantaged backgrounds and frequently disconnected from the healthcare system. The purpose of this project was to identify and describe the most life-threatening and/or prevalent pre-existing health conditions of program participants. A retrospective review of applications and pre-participation physical exams submitted by participants (N = 771) from March, 2012 through February, 2014 was conducted in order to better understand the health risks these adolescents face during the program. The top five most prevalent pre-existing health conditions in this sample included obesity (n = 187), allergies (n = 170), asthma/reactive airway disease (n = 103), attention deficit hyperactivity disorder/attention deficit disorder (n = 88), and depression (n = 81). Other potentially life threatening health conditions included a history of cardiac arrhythmias (n = 5), congenital heart defects (n = 5), hypertension (n = 4) and epileptic seizures (n = 3). In an effort to mitigate the risk of injury these young athletes face in an intense physical fitness program, the PPE Pre-Participation Physical Evaluation (4th ed.) monograph (Bernhardt & Roberts, 2010) was utilized as guidelines to make recommendations for improvement of the preparticipation health history and physical exams used to screen AMYA applicants.
    • Project Risk Identification for Government Projects in Anchorage and Palmer

      Banks, August R. (2014-12-08)
      This study reflects the research and analysis associated with identification of risk classifications and potential risks (both positive and negative) for use in project risk analyses in government projects managed via contract. Relying on literature reviews and surveys, a risk breakdown structure (RBS) and risk register with mitigation strategies are developed for use as a checklist by the organizations participating in the project; the General Services Administration (GSA) and the Plant Materials Center of the Alaska Department of Natural Resources (DNR/PMC). The survey findings support the original objective of establishing a common core of risks among the participating organizations. The 50 percent commonality among the top risks identified by both organizations was quite an unexpected result. These results, along with the substantial pool of risks and risk response strategies can serve as a foundation for the development of a risk management process for the participating agencies.
    • Risk Environment in Northern Sea Route Transportation Projects

      Petrova, Lena Y. (University of Alaska Anchorage, 2014-12-10)
      The need for defining the risk environment in the Arctic strengthens as changing ice conditions and economic opportunities drive the demand for expanding traffic volumes in Russia’s Northern Sea Route (NSR). An international commercial shipping route, the NSR is proven to cut transit time up to forty percent compared to the overflowing Suez Canal when traveling from ports in Western Europe to Southeast Asia. The NSR offers a challenging yet attractive project landscape since its opening to global logistics companies in the 1990s. A total of 27 international shipments were made and 1.35 million tons of cargo were moved in 2013. By 2020, cargo volumes shipped along the route are expected to reach 15 million tons per year. With Asian markets pursuing liquefied natural gas from global exporters and large scale exploration and production projects being developed in Northwestern Siberia, the future of the NSR is promising. Compared to other shipping routes, there are unique operational risks for NSR maritime transportation projects; these risks can significantly affect project success. Limited information exists to sufficiently describe risk exposure. This research paper identifies and describes risk factors affecting planning and execution of maritime transportation projects in the Northern Sea Route region based on a review of existing literature and interviews with subject matter experts. Findings are summarized in a descriptive narrative supported by a risk factor breakdown structure. The final project deliverables will be offered to shipping companies and Arctic research organizations to help identify and assess risks for NSR maritime transportation projects.
    • Idea to Invention Project Report

      Aicher, Dan (University of Alaska Anchorage, 2014-12-17)
      The United States Patent and Trademark Office (USPTO) estimates that 1-3% of patented inventions produce profits for the inventor. The cost of filing and examination for a non-provisional patent can range from $2,000 to $10,000 and beyond. ATC Company understands this uncertainty and will undertake a project to invent a new shelter product and determine its marketability, prior to investing in a non-provisional patent. The Idea to Invention project objective is to apply Project Management principles and develop a process for inventing an idea, measuring the idea’s utility and commercial viability as a product, conducting a patent search and producing a thorough Provisional Patent Application. Specifically, the project will deliver both a product line of ATC’s and a process for establishing first to invent rights to patenting the ATC’s function and method of operation. Unlike most recreational tent products available, ATCs do not require a flat or suitable site for setup; rather, ATCs deliver ultralightweight, highly adaptable weather protection and concealment nearly anywhere in the field.
    • Analysis of Thermal Interconnectivity of Utilities in Rural Alaska

      Mercer, Christopher J. (University of Alaska Anchorage, 2014-12-19)
      Throughout the arctic there are two primary community utilities with dramatically contrary thermodynamic concerns. These are the intensely exothermic diesel electric power generation, and the strongly endothermic water and sewer utility. In this context exothermic processes must expel excess heat while endothermic process requires heat input. Failure of engineers, community planners, funding agencies, and interest groups to recognize the full social, economic, and environmental impact to the sustainability of utilities has come at tremendous cost. This is exemplified in many remote Alaskan communities such as Toksook Bay, Minto, Deering, and Kotlik.
    • Pediatric Lead Screening in the United States: A Comparative Analysis

      Sykes, Genevieve (University of Alaska Anchorage, 2015-01-05)
      The purpose of this project is identification of approaches to pediatric lead screening in the United States by each of the fifty states and evaluation of whether best practice is being utilized. Data was obtained from publicly available state based websites and interaction with state departments; there were no participants in this project. The data was compared and contrasted among each of the fifty states and against current screening recommendations from the Centers for Disease Control and Prevention [CDC]. Only one state, Delaware, has screening recommendations current with CDC standards. There is a large amount of variation between how state approaches pediatric lead screening. Several recommendations were proposed for the improvement of pediatric lead screening in the United States, including the following; all test results be reported in every state, states should assess need for screening universally versus screening Medicaid-eligible children only, states update their geographic risk areas yearly, screening recommendations be made available in a single area, and all questionnaire include questions about symptoms, lead sources, hand washing, and children with risk.
    • Caregiver Burden and Perceived Health Competence when Caring for Family Members Diagnosed with Alzheimer’s Disease and Related Dementia

      Bailes, Christine (University of Alaska Anchorage, 2015-02-01)
      Purpose: To identify if there is a relationship between perceived health competence and burden of care of informal caregivers of family members with Alzheimer’s Disease and Related Dementia (ADRD). Methods: Informal caregivers 18 years and older who received services from the Alzheimer’s Resource of Alaska were invited to complete a survey. Conclusion: Findings indicate that there was a significant negative correlation between Perceived Health Competence and Burden of Care (N = 64, r = -.54, p <.001). Furthermore, the three subscales of the Modified Montgomery-Borgatta Caregiver Burden Scale: Relationship burden (r = -.29, p = .021), Objective burden (r = -.65, p = < .001) and Stress burden (r = -.41, p = .001) indicated that different types of burden affect informal caregivers’ health competence. Implications for practice: Based on the findings of this study, it is important to ensure that informal caregivers do have time for themselves as well as taking care of their own health needs. Nurse Practitioners can play an important role in early detection and prevention, with periodic screening to help identify current needs and to ensure optimal health for these informal caregivers.
    • Keep it Local: Resources for Farmers' Market Vendors

      Wedin, Alisa (University of Alaska Anchorage, 2015-03-31)
      Farmers’ markets are growing in Anchorage, Alaska and across the nation. Many of these markets sell more than produce and include non-produce farm goods, baked goods, cooked foods, craft items, and other products. Farmers’ markets provide a low-cost and low-risk opportunity for people to start their businesses. One way to support these new businesses is to provide these microentrepreneurs with the information and skills they need to succeed. This project describes the process undertaken to develop the Keep it Local program, a series of resources designed to provide information and teach participants the skills necessary to be successful at a farmers’ market. I developed a website to provide information related to general business and specific topic related to different types of vendors including farmers, food vendors, and craft vendors. Several classes were offered, including Business Basics, Growing for Market, Booth Basics, and Tips and Tricks: Expert Advice. Participant feedback from the workshops was positive. I offer recommendations to improve upon and expand the current program to support farmers’ markets throughout the state.
    • Recreational Trails Program Applicant Accountability and Process Efficiency Project

      Harris, Darcy B. (University of Alaska Anchorage, 2015-04-01)
      The Recreational Trails Program provides reimbursable grant funding for recreational trail development and repair, and environmental protection and safety/education programs relating to recreational trail use. The Recreational Trails Program Applicant Accountability and Process Efficiency Project developed two tools to improve the effectiveness of the program, New grant applicants and current grantees require clear guidance about state and federal procurement requirements, federal regulations, and programmatic guidelines for the Recreational Trails Program in Alaska. The iterative tool and administrative controls created for this project will help to guide and inform the applicants and add legal protection for the State of Alaska, Department of Natural Resources (DNR) immediately and into the future. The Application Instruction and Information Manual (Manual) details the rules, regulations, requirements, and processes for compliance surrounding procurement and federal grants and is publically-available for applicants to utilize during the grant cycle. Legal language has been added to the signature page of the application so each applicant understands the importance of compliance and integrity when managing a federal grant. The Manual is intended to be a generalizable tool that will continue to evolve as different groups of stakeholders provide input and feedback with regard to its utility. This project was initiated to assist the majority of grant applicants with processes, regulations, and guidelines, increase comprehension and success, and reduce management time coaching and frustration for applicants. To a lesser degree but intended to mitigate a higher risk, this project researched, created, and added supplementary legal language into the application that will serve to both add a layer of legal protection for the DNR and remind applicants of their fiscal responsibilities when managing federal grant funds. The hypothesis for this project is that when applicants have an improved means by which to meet the requirements of the grant program they will become more self-sufficient, knowledgeable, successful, and compliant. It is the program manager’s responsibility to ensure compliance with federal and state regulations, as well as program guidance, and there are now effective tools and administrative controls to consistently achieve this.
    • A Descriptive Analysis of Gastric Cancer in Alaska

      Evengue, Fabrice (University of Alaska Anchorage, 2015-04-01)
      Gastric cancer or stomach cancer represents a major public health problem in the contiguous United States and in Alaska. Stomach cancer is the fourth most common malignancy and the second most common cause of cancer-related deaths throughout the world. A retrospective study of gastric cancer cases from 1996 to 2011 was undertaken and data were extracted from the Alaska Cancer Registry where cases are consistently recorded and centralized. Data were analyzed using the National Cancer Institute’s SEER* Stat statistical software (version 8.1.5). The goal of the project was to provide a detailed epidemiologic descriptive analysis of gastric cancer to better inform health professionals, the public and to provide additional resources for future research. Results showed that gastric cancer incidence rates in Alaska are significantly higher than the rest of the nation. Alaska Natives and American Indians in Alaska have the highest rate of gastric cancer than all races/ethnicities combined. Males have a risk prevalence of gastric cancer that is twice that for females. The Alaska Native male and Asian/Pacific Islander male gastric cancer incidence rates are much higher than males from other races. In addition, Southeast Alaska Natives’ incidence rates are lower than rates for non-Southeast Alaska Natives. Based on the findings, study recommendations include the following: 1) Health education campaigns for at risk-groups; 2) Making health care services available; 3) Education of local health community workers and health care professionals; 4) Promoting new ways of preserving food in rural communities and consumption of fresh fruits and vegetables; 5) Encouraging patients to discuss their family history with healthcare providers to determine potential risks for inherited cancer syndromes.
    • Vaccination Hesitation: Investigation Why Parents Decline Pediatric Influenza Vaccines in Juneau, Alaska

      Leder, Lindsey (University of Alaska Anchorage, 2015-04-14)
      The influenza virus is responsible for hundreds of childhood deaths and costs the health care system millions of dollars each year (Hassan, Lewis, Davis, Gebremariam, and Dombkowski, 2009). The influenza vaccine is the most effective intervention for prevention of pediatric influenza, yet many parents decline this vaccine for their children. Studies completed in various geographic locations cite different factors influencing parents who decline pediatric vaccinations. Alaska has the second lowest rate of influenza vaccination in the country (Center for Disease Control [CDC], 2012). The purpose of this project was to understand the factors that influence parental decision to refuse influenza vaccination in Juneau, Alaska. A modified version of the Childhood Influenza Immunization Questionnaire, an instrument based on the Health Belief Model, was utilized to collect data from a convenience sample of parents at a private pediatric practice in Juneau, AK. Statistical analysis revealed the only significant influencing factor on parents’ decisions on whether to vaccinate against influenza was their perception of vaccine risk (p < .001). Information obtained from this study will be used to educate local providers in the community with the goal of enabling said providers to overcome resistance to vaccination hesitancy based on parent perceptions.
    • Math Anxiety in Pre-Licensure Nursing Students: a Pilot Study

      Lindley, Margaret K. (University of Alaska Anchorage, 2015-04-16)
      Background Math anxiety is a common phenomenon among nursing students. A review of the literature has revealed that math anxiety interferes with student cognition which could ultimately lead to patient harm. The purpose of this project is to determine if a basic math tutorial affects levels of math anxiety in pre-licensure students at the University of Alaska Anchorage (UAA). Methods Thirty-five students were randomly assigned to an experimental or control group. Math anxiety was measured with the Abbreviated Math Anxiety Rating Scale (AMARS). The experimental group participated in a math tutorial while the control group quietly waited outside of the classroom. Results There is no evidence that the math tutorial was useful in reducing math anxiety. Conclusions Both groups of participants had a decrease in math anxiety, yet it is uncertain how significantly the math tutorial (Appendix E) affected their math anxiety levels.