Medicine and Health Sciences Commons^™

Analysis Of Union Safety: Determining Relationships Between Union Membership And Injury And Fatality Rates, Madelyn K. Street

Online Theses and Dissertations

In under two centuries the labor union transformed the American workplace, improving wages, benefits, employee engagement, and safety. In more recent years, the government and other organizations have caught up in focusing on safety. Countless studies have been conducted and determined that unions have a significant positive impact on safety compared to work environments absent of a union. Using Bureau of Labor Statistics data for 2006-2015, an investigation into the trends of union membership and injuries and fatalities reported in the United States was conducted. It was determined that there was not significant correlation between increased union membership and improved …

Grow Where You Are Planted: The Use Of Gardening As Offender Rehabilitation In Prison, Kendahl Verna Granger

Online Theses and Dissertations

Being outdoors is an integral part of our lives, even as we are experiencing rapid urbanization. Research shows that nature and purposeful work in it have a profound effect on physical and mental health. What, then, about prison inmates? They often do not have the opportunity to engage in nature or enjoyable, outdoor tasks. One way in which this could be remedied is through the use of prison horticulture or garden programs. Prison horticulture is a productive, outdoors activity in which inmates raise gardens that would benefit their group, facility, or the community. In the process, prisoners learn about gardening …

The Development Of Mental Illness Stigma: The Role Of Perceived Social Support, Social Proximity, And Help-Seeking Behavior, Emily Kathryn Reed

Online Theses and Dissertations

The current study sought to explore the relationships mental illness stigmatization may have with perceived social support, proximity, and help-seeking behavior. Based on findings from previously conducted studies, hypotheses were formulated in order to further analyze how perceived social support, proximity, and help-seeking behavior may impact an individual's tendency to stigmatize mental illness. 203 Eastern Kentucky students participated in this study to test these hypotheses. These participants took part in an online study that measured their perceived social support based on their family environment, their proximity to those with a mental illness or mental illness in general, their attitudes regarding …

Targeting Apoptotic Pathways To Overcome Drug Resistance In Acute Myeloid Leukemia, Rongqing Pan

Dissertations & Theses (Open Access)

Evasion of apoptosis is integral to tumorigenesis and drug resistance. BCL-2 and p53 proteins represent two focal nodes in convergent apoptosis signaling. Upregulation of anti-apoptotic BCL-2 family members and inactivation of p53 functions are two canonical approaches exploited by cancer cells to escape apoptosis. In the current study, we find that BCL-2 protein is highly expressed in acute myeloid leukemia (AML) cells. BCL-2–specific inhibitor ABT-199 potently induces mitochondrial apoptosis in AML cells and effectively kills AML stem/progenitor cells. Our biomarker studies demonstrate that both BH3 profiling and the expression profiling of BCL-2 proteins may serve as predictive biomarkers for the …

Radioactive Contamination Of Natural Biological Systems: Oxidative Balance And Genetic Stability, Daniel Einor

Theses and Dissertations

The global demand for nuclear energy grows, and so do the risks of an accidental release of nuclear products into the environment. Therefore, understanding the health and ecological effects of contamination by radionuclides should be of great interest for biomedical specialists and the public. Empirical studies unequivocally show that high doses of ionizing radiation (IR) shift the redox-balance of many biological systems and increase the rates of genetic errors. However, the effects of chronic low doses of radiation vary significantly between tissues and between species. The present dissertation comprises the results of experimental and meta-analytical research of a variety of …

Quality Improvement Initiative To Reduce Fall Risk In The Snf, Ramona C. Lancaster

Walden Dissertations and Doctoral Studies

Residents who fall in SNF either sustain significant decline to quality of life or die from their injuries. The average fall costs about $34,000 per incident. On average, 19.8% of residents fall at least once per month. The purpose of this project was to assess, identify, and advance nursing practice to decrease falls by evaluating current facility standard of practice, fall policy, procedures, and protocol. The objective was to create actions that would close the communication gap between clinicians and residents. This project encourages clinicians to intertwine resident feedback and strategies into the plan of care to help reduce fall …

Evaluating The Impact Of A Smoking Cessation Program., Gideon Eke

Walden Dissertations and Doctoral Studies

Forty-six million individuals in the United States used tobacco products. People who use

tobacco products attempt numerous strategies before giving up smoking habit altogether. The goal of this project was to evaluate the impact of a tobacco cessation program by evaluating pre-and post-cessation program data, and hospital records of participants attending the hospital smoking cessation program over a 6-month period to ascertain the degree of reduction in tobacco use and hospitalization from smoking-related diseases. The population sample comprised of both men and women between the ages of 18 years and above. The project question addressed whether the smoking cessation program …

Senescence Disorder Literacy Among Prelingual/Culturally Deaf Individuals Age 50 And Older, J. Delores Hart

Walden Dissertations and Doctoral Studies

The preferred method of communication for most prelingual/culturally Deaf individuals is American Sign Language (ASL), and members of this linguistic/cultural minority community are often not recognized as being bilingual. Many prelingually/culturally Deaf individuals have limitations and deficits in English proficiency; which can lead to deficits in general knowledge of health-related terminology. Current projections are that older adults are expected to live longer, and will also experience the development of, increases in and more extended periods of living with senescence/age-related health disorders, also includes prelingual/culturally Deaf individuals. This quantitative research project, utilizing the theoretical framework of health literacy and a modified …

Improving Breastfeeding Knowledge Of Staff Nurses, Patience Sirri Mbonifor

Walden Dissertations and Doctoral Studies

The World Health Organization advocates that newborn babies require exclusive breastfeeding until 6 months of age to attain a desired level of growth. Despite this recommendation, exclusive breastfeeding rates continue to be at low levels globally. The purpose of this DNP project was to examine best practices for increasing the breastfeeding knowledge of health care workers, and to understand how breastfeeding is promoted in different healthcare systems. The Critical Appraisal Checklist and the Cochrane Handbook for Systematic Reviews framed this systematic literature review. Additionally, Melnyk's levels of evidence was used to evaluate each article. Articles for inclusion were limited to …

Use Of Tai Chi To Treat Mental Health Disorders In Veterans, Mekeesha Mcclure

Walden Dissertations and Doctoral Studies

Clinicians have a challenge of discovering and implementing new ways to address their patients' health concerns. Some healthcare needs are not completely managed with pharmacotherapy and invasive procedures alone. Military veterans compose a special group due to multiple needs related to physical and emotional symptoms resulting from exposure to trauma. This project explored the benefits of a Tai Chi recreational therapy program. The goal of this trial was to examine gentle movement routines of Tai Chi for emotional benefits for veterans. The literature review provided insight from current evidence into the probable outcome of including alternative medicine options into regular …

Hassles Of African Americans With Type 2 Diabetes, Sharon H. Murff

Walden Dissertations and Doctoral Studies

There has been a steady increase in the incidence of diabetes in the United States. The purpose of this study was to determine whether there was a difference in the daily hassles of African American adults with a self-reported diagnosis of type 2 diabetes compared to those of African American adults without a self-reported diagnosis of type 2 diabetes. The theoretical underpinning for this quantitative, descriptive study was the cognitive appraisal theory (CAT), but the concept of stress and the effects stress has on the body was the broad framework that connected all the variables. The CAT was used to …

Impact Of The Childcare Setting And Caregiver Education On Toddler Language Environment, Snejana Nihtianova

Walden Dissertations and Doctoral Studies

Young children's early language development is strongly related to their school performance, and slow language growth may predict later academic problems. The link between the language quality and amount of speech that children hear and their language development is well documented; however, the factors that impact variability in linguistic input are not well understood. The purpose of this quantitative study was to assess the association between childcare settings and childcare provider education level and toddlers' language environment. The study sample consisted of 29 Bulgarian children. The study used a new technology called Language Environment Analysis, which is the preferred method …

Health Literacy Of Nursing Students And Their Awareness Of Patient Literacy Needs, Jennifer Potter

Walden Dissertations and Doctoral Studies

Research has suggested that providers of health services must be aware of health literacy tools as elements of communication with patients. Poor health literacy is an epidemic that affects quality of care. The purpose of this study was to examine the functional health literacy of associate-degree nursing (ADN) students and their awareness of patients' health literacy needs. This correlational study was designed to examine the relationship between the functional health literacy of ADN students and their awareness of their patients' health literacy needs using the asset model and the health literate care model. A convenience sample of 131 ADN students …

Associate Degree Nursing Graduates Perceptions Of Nclex Performance, Judy Pulito

Walden Dissertations and Doctoral Studies

There has been a shortage of registered nurses in the United States for more than a decade, and an aging population is increasing this problem. This study was prompted by the number of associate degree nursing graduates at a Midwestern community college failing the NCLEX-RN licensure exam, which is required for employment. The purpose of this study was to explore associate degree graduate nurses' views of the effectiveness of classroom and clinical training on NCLEX -RN exam performance. Guided by the conceptual framework of Bigg's students' approaches to learning, which maintains deep learning is associated with achievement of learning outcomes, …

The Use Of A Patient Mobility Sensor To Decrease Hospital-Acquired Pressure Ulcers, Monica Vassallo Shallow

Walden Dissertations and Doctoral Studies

Pressure ulcers are a serious health condition that have negative consequences for patients and organizations. The primary cause of pressure ulcers is intense and/or prolonged pressure or pressure in combination with shear that results in damage to the skin and underlying soft tissue. Early identification of patients at risk for pressure ulcers and 2-hour repositioning to off-load pressure are key components in reducing pressure ulcer development. Despite ongoing efforts to prevent pressure ulcers, the incidence and prevalence of hospital-acquired pressure ulcers (HAPUs) at the practicum site exceeded the benchmark for Magnet hospitals and the health system's goal of 1%. Patient …

Strategies Clinic Managers Use To Reduce Missed Medical Appointments, Sophea Ey Skym

Walden Dissertations and Doctoral Studies

Patients who miss their medical appointments increase health care costs for themselves and for clinics. The purpose of this qualitative, single exploratory case study was to explore strategies health care clinic managers use to reduce medical no-shows for patient-scheduled appointments. Change management theory guided the scope and analysis. The data collection included a single clinical operations manager who have strategies to mitigate no-shows for patient-scheduled appointments participated in a semistructured interview in southeastern Virginia, the direct observation of 2 office workers in their natural setting of scheduling appointments, and for methodological triangulation, a review of organizational archival documents about missed …

Working Alliance Between Interpretive And Noninterpretive Therapy Services For Deaf Individuals, Sherri Lee Spain

Walden Dissertations and Doctoral Studies

Deaf individuals typically have access to 2 types of therapeutic services: interpretive (with an interpreter) and noninterpretive (with a sign-fluent therapist). Previous research indicates that the presence of an interpreter may hinder development of working alliance and attachment. There is a lack of empirical evidence assessing the effect of working alliance and attachment based on whether or not therapy incorporates an interpreter. The working alliance theory and the attachment theory were the theoretical foundations for this study. This study examined the difference between the strength of working alliance and attachment to the therapist given the presence or absence of an …

Predictors Of Uti Antibiotic Resistance For Female Medicaid Recipients In U.S. Ambulatory Care Settings, Wendy Denise Wiesehuegel

Walden Dissertations and Doctoral Studies

Urinary tract infections are diagnosed in female populations primarily in ambulatory care settings in the United States. Yet, published evidence documents that many of the antibiotics prescribed in these settings are unnecessary, erroneous, or, inappropriately prescribed. Improper management of uncomplicated urinary tract infections in nonpregnant women has resulted in higher morbidity rates due to antibiotic resistance. The purpose of this retrospective observational cohort study was to explore a current national database for associations between nonpregnant American female patients who were exposed to poverty and at risk for urinary tract infection antibiotic resistance in an ambulatory care setting. Krieger's ecosocial theory …

Patients And Nurses Attitudes To Hysterectomy And Postoperative Pain Management, Blessing Agu

Walden Dissertations and Doctoral Studies

Over 500,000 hysterectomies are performed yearly in the United States, and they often result in a moderate to severe amount of pain. Nurses play a significant role in postoperative pain management. However, studies have shown that despite technological advances and nurses' theoretical knowledge of pain, postoperative pain management remains a challenge among healthcare providers. The purpose of this study was to examine how nurses' and patients' attitude towards abdominal hysterectomy can impact postoperative pain management and hospital length of stay after a hysterectomy. Informed by the theory of reasoned action, the study examined the differences in the nurses' and patients' …

Using Multi-Theory Model To Predict Low Salt Intake - Nigerian Adults With Hypertension, Christine Adekemi Dokun-Mowete

Walden Dissertations and Doctoral Studies

Hypertension is a chronic non-communicable disease and a major risk factor for cardiovascular diseases, renal malfunction, disability, and premature death. One of the public health recommendations for the management of hypertension is the reduction of sodium/salt intake. There is need to develop and implement new evidence-based theoretical interventions to initiate and sustain behavior change in health education and promotion. Therefore, the quantitative cross-sectional method and design was used to investigate the adequacy of multi-theory model (MTM) constructs for the initiation and the sustenance of low sodium/salt intake behavior in hypertensive Nigerian adults. In addition, the impact of the MTM (initiation) …

Evaluating The Impact Of An Evidence- Based Weight Reduction Program Among The Obese At A Medical Facility In North Central United States, Petronilla Eke

Walden Dissertations and Doctoral Studies

In September 2016, the Centers for Disease Control and Prevention (CDC) determined that more than one-third (36.5%) of U.S. adults have an obesity problem. According to the CDC, this issue results in other medical conditions such as type 11 diabetes, hypertension, cancer, heart disease, and stroke. This project was designed to evaluate the effectiveness of an evidence-based weight reduction program for obese individuals at a medical facility in the North Central United States. The methodology used consisted of a retrospective chart review of pre- and post-data for 45 people who participated in the medical facility's weight-reduction program over a 6 …

Impact Of Emergency Department Patient Flow Model And Triage Level On Patient Wait Times, Joann Lynn Featherstone

Walden Dissertations and Doctoral Studies

Some hospital emergency departments (EDs) are negatively affected by extended patient wait times, resulting in reduced hospital profitability. Therefore, it is critical hospital leaders understand factors impacting ED average patient wait times. Grounded in the business process improvement theoretical framework, the purpose of this causal comparative study was to examine the impact of an ED rapid evaluation unit (REU) patient flow model and emergency severity index (ESI) on average weekly patient wait times. Data collection comprised a census of 26 archival data records pre and postimplementation of an ED REU patient flow model from a hospital ED in Upstate New …

Intimate Partner Violence During Pregnancy And Prenatal Care Attendance In Abuja, Nigeria., Dorothy Ijeoma Ezekwe-Anya

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) among women poses a significant threat to maternal mortality during pregnancy in Nigeria with a prevalence rate of 14% in the southern region versus 43% in the northern region. Early and adequate prenatal care is essential for improving pregnancy outcomes and the reduction of the maternal mortality rate. Previous studies in several countries have demonstrated a unique barrier to healthcare access among women exposed to IPV. This study assessed the association between IPV during pregnancy and prenatal clinic attendance, using a cross-sectional quantitative study design guided by the social learning theory. The modified Conflict Tactile Scale …

The Effect Of Referral Source On Patient Participation In Diabetes Education Programs, Karyn Marie Gallivan

Walden Dissertations and Doctoral Studies

The goal of diabetes education programs (DEPs) is to improve patients' pattern-management habits for those with type 2 diabetes (T2D), though participation in DEPs is lower than expected due to low physician referral rates. This retrospective study examined secondary data of 162 T2D patients who had been referred to a DEP in a community center in RI to determine whether the source of referral affected patient attendance, participation persistence, and outcomes. Self-referred (n = 62) and physician-referred (n = 100) groups were analyzed for possible associations among the aforementioned variables. Chi-square (p = .04) and logistic regression (p = .04) …

K-5 Educators' Perceptions Of The Role Of Speech Language Pathologists, Dr. Karmon D. Hatcher

Walden Dissertations and Doctoral Studies

Rarely is a school-based speech language pathologist (SLP) thought of as an active contributor to the achievement of students or to the learning community in general. Researchers have found benefits for students when members of the learning community collaborate, and the SLP should be a part of this community collaboration. This qualitative case study examined elementary school teachers', administrators', and reading specialists' perspectives related to knowledge of and the inclusion of the SLP in the learning community at a local elementary school in central Georgia. Schon's theory of reflective practice and Coleman's theory of social capital provided the conceptual framework. …

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …

Income, Education, Age, And Physical Activity Among Physically Disabled African American Women, Sherèè Johnson Johnson

Walden Dissertations and Doctoral Studies

This study was designed to identify possible risk factors about physical activity in middle-aged disabled African American women (AAW) aged 45 to 64 years. Disabled middle-aged AAW has a disproportionate prevalence of obesity and chronic illness than nondisabled women. Most disabled middle-aged AAW leads a sedentary lifestyle, and they do not meet the recommended physical activity (PA) guidelines. Little is known about this group, and a social ecological model was used to explain PA patterns. Data were extracted from the 2009 Behavioral Risk Factor Surveillance System (N = 1,599) for women who responded yes to indicate that they needed specialized …

Sucrose Use In Children: A Systematic Review, Dorothy Luongo

Walden Dissertations and Doctoral Studies

Sucrose is a method of pain relief that can be used for children during minor painful procedures. Pain left unrelieved has been found to lead to long-term consequences such as distress, anxiety, needle fear, parental non-adherence with vaccination administration, and avoidance of medical care. Therefore, it is important to ensure pain management methods are provided to infant and toddlers. The purpose of this project was to present a systematic review on the use of sucrose in child in primary care. The comfort theory by Kolcaba served as the theoretical framework in exploring the use of sucrose in children in primary …

Reducing Stigma And Encouraging Help Seeking Intentions Through A Mental Health Literacy Program, Nicole Loreto

Walden Dissertations and Doctoral Studies

Many individuals do not seek help for a mental health problem due to stigma and fear of rejection by peers and family. Researchers have highlighted that the age group least likely to seek help is youth. Stigma acts as an important barrier to help-seeking. Evidence indicating how mental health literacy can reduce stigma and encourage help-seeking remains inconclusive. In this study, the health belief model was used to understand how college students perceived an individual's susceptibility to mental illness and the barriers associated with seeking help. A posttest-only randomized controlled trial evaluated the impact of the Is It Just Me? …

Differentiating Successful And Unsuccessful Nursing Students, Trilla Mays

Walden Dissertations and Doctoral Studies

Administrators of nursing programs in community colleges are aware of the need to retain and to graduate students to meet the growing demand for licensed practical nurses (LPNs). High attrition in a 2-year nursing program in South Carolina affected the number of students either graduating as a LPN after completing the third semester, or continuing in the program to become a registered nurse (RN). Guided by Jeffreys's nursing undergraduate retention and success model, this causal comparative study investigated the differences between students who were and were not successful in the initial 3 semesters of the program. Archival student records for …