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Articles 31 - 60 of 512
Full-Text Articles in Medicine and Health Sciences
Food Environment As A Moderator In The Relationship Between Ultra-Processed Food Intake And Mortality In The United States, Brandon Jerod Grandy
Food Environment As A Moderator In The Relationship Between Ultra-Processed Food Intake And Mortality In The United States, Brandon Jerod Grandy
Walden Dissertations and Doctoral Studies
According to recent studies, the consumption of ultra-processed food is a major issue that leads to fatal outcomes within the United States, which is relevant because this type of food has become more accessible over the years. Using data from the National Health And Nutrition Examination Survey III (NHANES III), previous researchers found that frequent consumption of ultra-processed foods was associated with greater chances of all-cause mortality in U.S. adults, but little research has focused on factors that can impact ultra-processed food consumption, such as food environment. The purpose of this quantitative longitudinal study was to examine the effect of …
Relationship Between Maternal Language And Use Of Electronic Cigarettes In Pregnancy, Tara Halpern
Relationship Between Maternal Language And Use Of Electronic Cigarettes In Pregnancy, Tara Halpern
Walden Dissertations and Doctoral Studies
Tobacco use has been a long-standing known modifiable risk factor to maternal health. Although there have been many efforts to encourage smoking cessation, use of electronic cigarettes in pregnancy has been increasing over the years. Understanding potential factors that may play a role in the increased use of electronic cigarettes is important to improve maternal and fetal health outcomes. The social ecological model provides the theoretical framework for this study. The purpose of this study is to determine whether a woman’s primary language and pregnancy health care factors (i.e., access to health care 12 months prior to pregnancy, access to …
Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif
Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif
Walden Dissertations and Doctoral Studies
Lung cancer is one of the most common cancers in the United States, and it accounts for 25% of cancer deaths. About 70% of cancer cases are diagnosed during late stages, leading to poor outcomes. An estimated 60% of cancer cases involve underserved and disadvantaged communities. However, there are limited studies had addressed effects of treatment, stage of lung cancer, and socioeconomic status on life expectancy within marginalized communities. Research questions examined effect of treatment, stage of lung cancer, and socioeconomic status on life expectancy of lung cancer patients between 2009 and 2019. This study was grounded in the deductive …
Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula
Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Walden Dissertations and Doctoral Studies
Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.
Food Environment As A Moderator In The Relationship Between Ultra-Processed Food Intake And Mortality In The United States, Brandon Jerod Grandy
Food Environment As A Moderator In The Relationship Between Ultra-Processed Food Intake And Mortality In The United States, Brandon Jerod Grandy
Walden Dissertations and Doctoral Studies
According to recent studies, the consumption of ultra-processed food is a major issue that leads to fatal outcomes within the United States, which is relevant because this type of food has become more accessible over the years. Using data from the National Health And Nutrition Examination Survey III (NHANES III), previous researchers found that frequent consumption of ultra-processed foods was associated with greater chances of all-cause mortality in U.S. adults, but little research has focused on factors that can impact ultra-processed food consumption, such as food environment. The purpose of this quantitative longitudinal study was to examine the effect of …
Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif
Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif
Walden Dissertations and Doctoral Studies
Lung cancer is one of the most common cancers in the United States, and it accounts for 25% of cancer deaths. About 70% of cancer cases are diagnosed during late stages, leading to poor outcomes. An estimated 60% of cancer cases involve underserved and disadvantaged communities. However, there are limited studies had addressed effects of treatment, stage of lung cancer, and socioeconomic status on life expectancy within marginalized communities. Research questions examined effect of treatment, stage of lung cancer, and socioeconomic status on life expectancy of lung cancer patients between 2009 and 2019. This study was grounded in the deductive …
Gender Disparities: 5 Year Survival Rates Of Elderly Colorectal Cancer Patients With Depression, Riya Joshi
Gender Disparities: 5 Year Survival Rates Of Elderly Colorectal Cancer Patients With Depression, Riya Joshi
Walden Dissertations and Doctoral Studies
AbstractColorectal cancer (CRC) is a life-threatening health condition known to greatly affect the elderly than younger populations. CRC, if comorbid with mental condition such as depression, can seriously affect patients’ quality of life with a direct influence on the survival rate. There is a connection between depression and worsened cancer progression and survival rate of CRC, little is known on gender differences in survival rates on elderly CRC patients with pre-existing depression (PD). A socioeconomic model study was used to evaluate gender, initial diagnostic stage, and marital status (MS) at diagnosis as major independent variables and 5-years survival rate (5-YS) …
The Geographic Pattern And Socioecological Factors Of Helicobacter Pylori Infections In The United States, Judith Ann Merryweather
The Geographic Pattern And Socioecological Factors Of Helicobacter Pylori Infections In The United States, Judith Ann Merryweather
Walden Dissertations and Doctoral Studies
AbstractHelicobacter pylori (H. pylori) is one of the most common human pathogens and may play a role in the development of several distinct diseases, which include gastric ulcer, duodenal ulcer, and gastric cancer. Studying geographic territories of the United States may reveal clusters with high rates of H. pylori infection and perhaps the prevalence of gastric cancer; however, geographic mapping of patterns in the United States is scarce. The purpose of this study was to investigate changes in H pylori infection patterns in the United States between two different time points (2000–2002 and 2016–2018). The primary hypotheses of this study …
Gender Disparities: 5 Year Survival Rates Of Elderly Colorectal Cancer Patients With Depression, Riya Joshi
Gender Disparities: 5 Year Survival Rates Of Elderly Colorectal Cancer Patients With Depression, Riya Joshi
Walden Dissertations and Doctoral Studies
AbstractColorectal cancer (CRC) is a life-threatening health condition known to greatly affect the elderly than younger populations. CRC, if comorbid with mental condition such as depression, can seriously affect patients’ quality of life with a direct influence on the survival rate. There is a connection between depression and worsened cancer progression and survival rate of CRC, little is known on gender differences in survival rates on elderly CRC patients with pre-existing depression (PD). A socioeconomic model study was used to evaluate gender, initial diagnostic stage, and marital status (MS) at diagnosis as major independent variables and 5-years survival rate (5-YS) …
Anxiety Risk Factors And Social Isolation Among Young Adults, Jennifer Clancy
Anxiety Risk Factors And Social Isolation Among Young Adults, Jennifer Clancy
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic is a public health concern that impacted the world. Increased feelings of loneliness and social isolation during the pandemic were reported to be associated with those seeking help for symptoms of anxiety and depression. Though symptoms of anxiety have been associated with social isolation, research is limited on the association between the anxiety risk factors and social isolation among young adults in the United States. Using the socioecological model, the association between social isolation (dependent variable) with financial stress, health anxiety, and perceived impact of COVID-19 (independent variable), and the influence of gender, race, and household status …
Impact Of Race And Socioeconomic Factors On Infant Mortality Between Non-Hispanic Black And White Women, Chukuma Clifton Chijioke
Impact Of Race And Socioeconomic Factors On Infant Mortality Between Non-Hispanic Black And White Women, Chukuma Clifton Chijioke
Walden Dissertations and Doctoral Studies
Abstract This quantitative retrospective study with a correlational design examined the impact of race and socioeconomic factors on the high infant mortality (IM) among non-Hispanic Black women compared to non-Hispanic White women in one midwestern US state county. Though the IM in the U.S. has consistently decreased, a disparity exists between non-Hispanic Black and non-Hispanic White women. Non-Hispanic Black women are twice as likely to experience infant deaths as non-Hispanic White women. This study utilized secondary data derived from vital records maintained by the county public health department. The research was grounded in the ecological model. Logistic regression was used …
Non-Alcoholic Fatty Liver Disease And Metabolic Syndrome: The Role Of Gender Differences And Menopausal Status Of Women, Kimberly Kushner
Non-Alcoholic Fatty Liver Disease And Metabolic Syndrome: The Role Of Gender Differences And Menopausal Status Of Women, Kimberly Kushner
Walden Dissertations and Doctoral Studies
There are few studies that investigate the association between non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) predominantly in menopausal women. This quantitative study investigated the association between MetS and NAFLD while controlling for age, gender, ethnicity, and menopausal status of women. The theoretical framework that helps establish and guide the research was the diffusion of innovation (DOI). A multivariable logistic regression was conducted using secondary data from the National Health and Nutrition Examination Survey. There is a statistically significant association between MetS, and NAFLD after controlling for age (OR = 2.96, 95% CI = 2.319–3.778, p < 0.001). However, ethnicity was not statistically significant. After further controlling for gender, the relationship remained statistically significant and exhibited a decrease in risk for females compared to males (OR = -.734, 95%CI = .387–.596, p < 0.001). Lastly, focusing on women only, and further controlling for menopausal status, the association between MetS and NAFLD was still statistically significant (OR = 2.227, p < 0.001). Mexican Americans, other Hispanics, and Non-Hispanic Black women were at higher risk (95% CI 1.102–7.039, 1.321–5.351, and 1.255–3.013, respectively). Implications for positive social change include adopting proactive and preventative strategies that can improve the quality of life for vulnerable patients and reduce morbidity and mortality associated with MetS and NAFLD.
Evaluation Of Recovery Level And Surgical Site Infection For Hip Replacement Surgeries, Misha Foster
Evaluation Of Recovery Level And Surgical Site Infection For Hip Replacement Surgeries, Misha Foster
Walden Dissertations and Doctoral Studies
Surgical site infection (SSI) is one of the most common healthcare associated infections and is a major cause of morbidity and mortality. Existing studies have focused primarily on perioperative intervention strategies to reduce infection risks following total joint replacement (TJA) procedures. However, postoperative (post-op) SSI risk factors may account for a significant percentage of hospital readmissions due to infections at the surgical site. Therefore, the purpose of this study was to examine the association between post-op recovery level and SSI among patients who underwent primary hip arthroplasty procedures. Using the social ecological model, which conceptualizes health broadly and focuses on …
A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch
A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch
Walden Dissertations and Doctoral Studies
Evidence from an urban hospital initially revealed that ethnicity had no bearing on treatment modalities or mortality among patients admitted and diagnosed with COVID-19 symptoms from January 1, 2020 to January 1, 2021. The purpose of this study was focused on answering three principal research questions concerning evidence at one hospital of differences in medication used, whether intubation was used, and mortality by ethnicity for those treated for COVID-19 while controlling for age, gender, and co-morbidities. The health belief model served as the theoretical framework. Data was collected from 1188 patient charts, and binary logistic regression was used to test …
Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers
Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers
Walden Dissertations and Doctoral Studies
Pancreatic cancer is the fourth-leading cause of cancer-related deaths in the United States, killing more than 90% of individuals diagnosed within 5 years. Due to the lack of signs and symptoms, 82% of all pancreatic cancer cases are diagnosed in terminal stages. As such, the most powerful method to reducing the morbidity and mortality of pancreatic cancer is to further investigate the risk factors. According to the theoretical framework of the ecosocial theory, long-term exposure to exposures to unfavorable socioecological and environmental factors serve as a “web of causation” for adverse health outcomes. Using data from the North Carolina Department …
Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey
Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey
Walden Dissertations and Doctoral Studies
Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …
The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew
The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew
Walden Dissertations and Doctoral Studies
The purpose of this quantitative correlational design using secondary data from Colorado Department of Public Health and Environment was to examine the relationship between different types of sexually transmitted infections (STIs), specifically, chlamydia, gonorrhea, and syphilis, and race, gender, and age in the United States. This study is significant because it could assist medical personnel to focus on more personally-based STI treatments. This study could also lead to a call for more research regarding sexual health programs across the nation, individuals’ willingness to share personal information regarding STIs, and how sexual health programs could increase testing for STIs. The study …
Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne
Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne
Walden Dissertations and Doctoral Studies
Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …
Association Between Antidepressant Adherence And Major Depressive Disorder Complications, Philip Lisinge
Association Between Antidepressant Adherence And Major Depressive Disorder Complications, Philip Lisinge
Walden Dissertations and Doctoral Studies
Despite evidence that antidepressants are more effective at treating major depressive disorder (MDD) symptoms, there is growing evidence that MDD management is still hampered by nonadherence to antidepressant treatment regimens. Researchers have suggested that MDD, if untreated, might lead to MDD-related complications, but other researchers have argued that adherence to antidepressants can lead to these same MDD-related complications. This quantitative cross-sectional study used primary data collected from 298 volunteers to examine the association between MDD-related complications and antidepressant adherence to clarify these diverging opinions. The study’s objective was to provide evidence to accept or reject the premise that antidepressant adherence …
Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey
Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey
Walden Dissertations and Doctoral Studies
Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …
Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers
Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers
Walden Dissertations and Doctoral Studies
Pancreatic cancer is the fourth-leading cause of cancer-related deaths in the United States, killing more than 90% of individuals diagnosed within 5 years. Due to the lack of signs and symptoms, 82% of all pancreatic cancer cases are diagnosed in terminal stages. As such, the most powerful method to reducing the morbidity and mortality of pancreatic cancer is to further investigate the risk factors. According to the theoretical framework of the ecosocial theory, long-term exposure to exposures to unfavorable socioecological and environmental factors serve as a “web of causation” for adverse health outcomes. Using data from the North Carolina Department …
An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson
An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson
Walden Dissertations and Doctoral Studies
s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …
Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne
Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne
Walden Dissertations and Doctoral Studies
Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …
Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula
Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …
Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi
Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi
Walden Dissertations and Doctoral Studies
Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …
Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias
Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias
Walden Dissertations and Doctoral Studies
Antibiotic resistance is a health threat affecting millions of Americans. Microorganisms develop resistance to antibiotics, rendering them useless for treating infections. The purpose of this quantitative study was to assess the associations between sample processing time and antibiotic resistance and is based on the health belief model. A retrospective specimen tracking activity of data from November 2019 to November 2020 was obtained by random sampling of 246 bacterial cultures. One hundred ninety-six (80%) samples were processed on time, and 50 (20%) were delayed; 167 (68%) samples were determined to have the presence of antimicrobial resistance (AMR), and 79 (32%) with …
Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi
Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi
Walden Dissertations and Doctoral Studies
Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Walden Dissertations and Doctoral Studies
Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.
Nutrient Pollution And Chlorophyll-A As A Precursor To Harmful Algal Blooms And Cyanotoxins In Rehabilitated Machado Lake, California, Michael E. Shiang
Nutrient Pollution And Chlorophyll-A As A Precursor To Harmful Algal Blooms And Cyanotoxins In Rehabilitated Machado Lake, California, Michael E. Shiang
Walden Dissertations and Doctoral Studies
Algal blooms result in the formation of cyanotoxic conditions in a freshwater lake causing severe detrimental impacts to community and public health. Nitrogen, phosphorous, and ammonia stimulate the growth of phytoplankton biomass and algae, as measured by chlorophyll. This retrospective quantitative research study, grounded in the socioecological model, examined the relationship between nutrient pollutants and chlorophyll-a (Chl-a) that forecast harmful algal blooms, a precursor to cyanotoxins. A former impaired lake, Machado Lake in California, provided an ideal setting to assess relationships among nutrient indicators and Chl-a post-lake rehabilitation. Correlation and multiple regression analyses were performed to determine if a relationship …