Digital Commons Network^™

Quantifying Farm-To-Fork Greenhouse Gas Emissions For Five Dietary Patterns Across Europe And North America: A Pooled Analysis From 2009 To 2020, Daniel Burke, Paul Hynds, Anushree Priyadarshini

Articles

Dietary patterns are inherently related to greenhouse (GHG) emissions via agricultural practices and food production systems. As the global population is predicted to increase from 8 billion (current) to 9.6 billion by 2050 added pressure will be placed on existing agricultural systems, resulting in increased GHG emissions thus exacerbating climate change. Therefore, there is an urgent need to understand present-day dietary patterns to shift to sustainable and healthy diets to mitigate GHG emissions and meet future climate targets. However, no review or pooled analyses of dietary pattern emissions from a farm-to-fork perspective has been undertaken to date. The current study …

Behavioral Pathways To Private Well Risk Mitigation: A Structural Equation Modeling Approach, Simon Mooney, Martin Boudou, Jean O'Dwyer, Paul Hynds

Articles

Complex, multi hazard risks such as private groundwater contamination necessitate multiannual risk reduction actions including seasonal, weather-based hazard evaluations. In the Republic of Ireland (ROI), high rural reliance on unregulated private wells renders behavior promotion a vital instrument toward safeguarding household health from waterborne infection. However, to date, pathways between behavioral predictors remain unknown while latent constructs such as extreme weather event (EWE) risk perception and self-efficacy (perceived behavioral competency) have yet to be sufficiently explored. Accordingly, a nationwide survey of 560 Irish private well owners was conducted, with structural equation modeling (SEM) employed to identify underlying relationships determining key …

Identifying The Characteristics, Constraints, And Enablers To Creating Value In Applied Performance Analysis, Denise Martin, Peter G. O'Donoghue, Jonathan Bradley, Sam Robertson, Denise Mcgrath

Articles

While applied performance analysts (PAs) are a well-established applied sports science practitioner group, there is no clear definition of the purpose of an analyst, their key relationships, or the expertise required to execute the role successfully. This research sought to understand how PA practitioners and educators perceive their role as applied PA practitioners. Twenty-seven applied PAs and educators with applied PA experience participated in six online focus groups, completing an online survey in advance. Reflexive thematic analysis of transcripts and survey data generated an overarching theme: embedded applied PA practitioners have a value co-creation role within performance ecosystems which is …

Walkable Neighborhoods: Linkages Between Place, Health, And Happiness In Younger And Older Adults, Kevin M. Leyden, Michael J. Hogan, Lorraine D'Arcy, Brendan Bunting, Sebastiaan Bierema

Articles

Problem, research strategy, and findings: We examined whether living in a walkable neighborhood influenced the happiness of younger and older city residents. The data for this study came from a comprehensive household population survey of 1,064 adults living in 16 neighborhoods in Dublin City (Ireland) and its suburbs. We used multigroup structural equation modeling to analyze the direct and indirect effects of walkability on happiness, mediated by health, trust, and satisfaction with neighborhood appearance. We found living in a walkable neighborhood was directly linked to the happiness of people aged 36 to 45 (p¼.001) and, to a lesser extent, those …

Delphi Panel Consensus Regarding Current Clinical Practice Management Options For Demodex Blepharitis, Marjan Farid, Brandon D Ayres, Eric Donnenfeld, Ian Benjamin Gaddie, Preeya K Gupta, Edward Holland, Richard Lindstrom, Stephen C Pflugfelder, Paul M Karpecki, Kelly K Nichols, Christopher E Starr, Elizabeth Yeu

Faculty, Staff and Students Publications

PURPOSE: To obtain consensus on Demodex blepharitis (DB) treatment using a modified Delphi panel process.

METHODS: Literature search identified gaps in knowledge surrounding treatment of DB. Twelve ocular surface disease experts comprised the Demodex Expert Panel on Treatment and Eyelid Health (DEPTH). They completed a live roundtable discussion in addition to 3 surveys consisting of scaled, open-ended, true/false, and multiple-choice questions pertaining to the treatment of DB. Consensus for scaled questions using a 1 to 9 Likert scale was predefined as median scores of 7–9 and 1–3. For other question types, consensus was achieved when 8 of 12 panelists agreed. …

Retail Pharmacies And Drug Diversion During The Opioid Epidemic, Aljoscha Janssen, Xuan Zhang

Research Collection School Of Economics

This study investigates the role of retail pharmacy ownership in the opioid epidemic. Using data of prescription opioid orders, we show that compared with chain pharmacies, independent pharmacies dispense 39.1% more opioids and 60.5% more OxyContin. After an independent pharmacy becomes a chain pharmacy, opioid dispensing decreases. Using the OxyContin reformulation, which reduced non-medical demand but not the legitimate medical demand, we show that at least a third of the difference in the amount of OxyContin dispensed can be attributed to non-medical demand. We show that differences in competitive pressure and whether pharmacists own the pharmacy drive our estimates.

Addressing Training Gaps: A Competency-Based, Telehealth Training Initiative For Community Health Workers, Laura Porterfield, Victoria Warren, Vanessa Schick, Shannon Gulliot-Wright, Jeff R Temple, Elizabeth M Vaughan

Faculty, Staff and Student Publications

BACKGROUND: To overcome vast variations in Community Health Worker (CHW) training, investigators for the CHW Core Consensus Project (CCCP) derived three types of CHW (Category 1, 2, 3) and established competencies for each category. However, studies are needed that implement these competencies in real-world settings.

OBJECTIVE: Using the six competency domains of the CCCP as a theoretical backbone, we developed and evaluated a training for

METHODS: We developed five telehealth-based, bilingual (Spanish/English) training sessions and implemented them among

RESULTS: All (18/18) CHWs achieved at least 70% on the posttest (mean: 93.7%; range 73.3-100%). Training attendance was 98.9%. Using a six-point …

Incorporating Public Health Into Transportation Decision Making, Bruce Appleyard, Tim Garrett

Mineta Transportation Institute

Investments in transportation have the potential to significantly affect public health outcomes. Decisions to build highways, transit, or bikeways, for example, influence how residents and visitors move around a metropolitan area. Personal travel habits and proximity to transportation infrastructure play a role in how likely people are to be physically active or be exposed to dangerous traffic and toxic pollution. For this study, the research team reviewed the literature that links transportation infrastructure, the surrounding built environment context, and public health outcomes such as chronic heart and lung diseases, obesity, and death. The team then researched publicly available data that …

Association Of Income, Education, Employment And Covid-19 Mortality In Brazil, Marcelina Machado

Walden Dissertations and Doctoral Studies

The increased mortality rates from COVID-19 in Brazil have adversely affectedvulnerable populations and placed a severe burden on its public health system as compared to other nations. Focusing on socioeconomic status as a risk factor in this retrospective cohort study, I investigated the association between Brazilian COVID-19 mortality rate, income, school enrollment rate, and employment rate after controlling for the demographics and immunization rate. This is an important issue as an increase in incidence and mortality rates affects how governmental and public health leaders can effectively control and prevent disease spread. Using the fundamental causes of disease theory as the …

Assessment Of Factors That Affect Men’S Access And Utilization Of Tuberculosis Services In Zululand District In South Africa, Maureen Fatsani Tshabalala

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) remains the leading cause of death in South Africa, with higher mortality rates among men compared to women, despite the availability of free TB services and a reduction in TB death rates. However, research on the factors influencing men's access to and utilization of TB services is limited. The purpose of this study was to assess the factors affecting men's geographical access and quality utilization of TB services in the Zululand district of KwaZulu Natal province, South Africa. A survey questionnaire was used to collect data from 200 men recruited from selected primary health care facilities. Andersen's model …

Rethinking Adolescent School Nutrition Education Through A Food Systems Lens, Margaret Miller, Donna Barwood, Amanda Devine, Julie Boston, Sandra Smith, Martin Masek

Research outputs 2022 to 2026

BACKGROUND: Obesity-driven nutrition education in schools does not appear to result in healthier adolescent food choices. This study explored food systems as an alternative pedagogical approach to engage students in nutrition education. METHODS: After playing a food systems computer game, 250 13- to 16-year-old students in 5 Western Australian secondary schools, participated in group discussions to distinguish learning and interests in food systems. Discussion records were thematically coded using constant comparative analysis. RESULTS: Students reported crop growth, food production and food waste, healthier food choices, and food systems as knowledge outcomes of game play. They requested additional content on food …

Exploring Perceptions Of Travel-Eligible Individuals With Dementia And Hotel Operators, Jun Wen, Danni Zheng, Yangyang Jiang, Haifeng Hou, Ian Phau, Wei Wang

Research outputs 2022 to 2026

Although people with dementia have leisure travel needs, no scholars appear to have empirically explored how to meet this group’s needs as hotel guests. To bridge this research gap in tourism literature, the current study employed in-depth interviews to collect first-hand data from 15 travel-eligible tourists with early-stage dementia and 15 senior luxury hotel managers in China. Specifically, six key themes were extracted from Chinese hotel guests with dementia. Hotel managers’ commentary on meeting travel-eligible tourists with dementia’ needs during leisure travel led to three themes. Innovatively, this study further sheds light on possible contributions the tourism and hospitality industry …

What Makes A Space Safe? Consumers' Perspectives On A Mental Health Safe Space, Lesley Andrew, Shantha Karthigesu, David Coall, Moira Sim, Julie Dare, Kathy Boxall

Research outputs 2022 to 2026

The provision of community-based space for people experiencing a mental health crisis is regarded as a favourable alternative to the emergency department. However, the only non-emergency department safe spaces in Western Australia are located within hospitals or hospital grounds. This qualitative study asked mental health consumers in Western Australia with experience of presentation at the emergency department during a mental health crisis to describe what a safe space would look and feel like. Data were collected through focus groups and thematically analysed. The findings present the voices of mental health consumers through the framework of health geography and the therapeutic …

Clinical Practice Guideline For Best Practice Management Of Pediatric Patients By Chiropractors: Results Of A Delphi Consensus Process, Genevieve Keating, Cheryl Hawk, Lyndon Amorin-Woods, Deisy Amorin-Woods, Sharon Vallone, Ronald Farabaugh, Angela Todd, Randy Ferrance, Jessie Young, Stephanie O. Bhogal, Helen Sexton, Helen Alevaki, Joyce Miller, Gregory Parkin-Smith, Alec Schielke, Andrew Robinson, Robyn Thompson

Research outputs 2022 to 2026

Objective: To build upon existing recommendations on best practices for chiropractic management of children by conducting a formal consensus process and best evidence synthesis. Design: Best practice guide based on recommendations from current best available evidence and formal consensus of a panel of experienced practitioners, consumers, and experts for chiropractic management of pediatric patients. Methods: Synthesis of results of a literature search to inform the development of recommendations from a multidisciplinary steering committee, including experts in pediatrics, followed by a formal Delphi panel consensus process. Results: The consensus process was conducted June to August 2022. All 60 panelists completed the …

Do Physiological Variables Predict The Need For Transport To Hospital From Music Festivals? An Analysis Of Australian Festival Data, Ned Douglas, Jake Donovan, James Carew, Kayla Brouwer, Ebony Edwards, Mitchell Gibson, Jacqueline Leverett, Joseph Paul, Lachlan Holbery-Morgan, Jessica Pritchard, Elyssia Bourke, Erin Smith

Research outputs 2022 to 2026

Objective:

Using physiological markers to detect patients at risk of deterioration is common. Deaths at music festivals in Australia prompted scrutiny of tools to identify critically unwell patients for transport to hospital. This study evaluated initial physiological parameters to identify patients selected for transport to hospital from a music festival.

Methods:

A retrospective audit of 2045 presentations at music festivals in Victoria, Australia, was performed. Presentation heart rate, systolic blood pressure, respiratory rate, oxygen saturation, temperature, and Glasgow Coma Scale were assessed using area under the receiver operating characteristic curve (AUROC) analysis, with a prespecified threshold of 0.7.

Results:

The …

Ems Administration Of Systemic Corticosteroids To Pediatric Asthma Patients: An Analysis By Severity And Transport Interval, Lauren Riney, Sam Palmer, Erik Finlay, Andrew Bertrand, Shannon Burcham, Phyllis Hendry, Manish Shah, Kathryn Kothari, David Ashby, Daniel Ostermayer, Olga Semenova, Benjamin N Abo, Benjamin Abes, Nichole Shimko, Emily Myers, Marshall Frank, Tim Turner, Mac Kemp, Kim Landry, Greg Roland, Jennifer Fishe

Faculty, Staff and Students Publications

INTRODUCTION: Pediatric asthma exacerbations are a common cause of emergency medical services (EMS) encounters. Bronchodilators and systemic corticosteroids are mainstays of asthma exacerbation therapy, yet data on the efficacy of EMS administration of systemic corticosteroids are mixed. This study's objective was to assess the association between EMS administration of systemic corticosteroids to pediatric asthma patients on hospital admission rates based on asthma exacerbation severity and EMS transport intervals.

METHODS: This is a sub-analysis of the Early Administration of Steroids in the Ambulance Setting: An Observational Design Trial (EASI AS ODT). EASI AS ODT is a non-randomized, stepped wedge, observational study …

Crossing The Decarbonization Chasm: A Call To Action For Hospital And Health System Leaders To Reduce Their Greenhouse Gas Emissions, Hardeep Singh, Walt Vernon, Terri Scannell, Kathy Gerwig

Faculty, Staff and Students Publications

No abstract provided.

The Rationale And Logistics For Incorporating Community Health Workers Into The Multidisciplinary Team, Elizabeth M Vaughan, Aliye B Cepni, Uyen Phuong N Le, Craig A Johnston

Faculty, Staff and Students Publications

Community Health Workers (CHWs) have shown value in diabetes care. CHWs are often the individuals who provide behavioral lifestyle intervention to underserved communities and are often the first to assist patients in gaining appropriate access to care. As trusted members of their communities, they have the ability to significantly impact psychosocial and biomedical outcomes, making them important members of the behavioral medicine team. However, lack of recognition of CHWs within multidisciplinary teams (MDTs) gives rise to the issue of the underutilization of their services. Therefore, barriers to including CHWs in MDTs including standardized training and strategies to overcome these are …

Using Visual Arts Education And Reflective Practice To Increase Empathy And Perspective Taking In Medical Students, Sina Rezaei, Andrew Childress, Bhavika Kaul, Kelly Magill Rosales, Alana Newell, Stacey Rose

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Empathy is a critical competency for health care providers. However, empathy levels in medical students and residents have been shown to paradoxically decrease during training. Arts and humanities education and reflective practice may reduce burnout and promote empathy during medical school.

Methods: We developed and implemented an art education elective for medical students focusing on observation and reflective practice and measured its impact on empathy. Between 2017 and 2022, first-year medical students were offered an annual, 4-week elective led by art educators that featured visualization exercises and discussions on the role of bias and perspective in art interpretation. Curriculum …

Targeted Therapy For Intractable Cancer On The Basis Of Molecular Profiles: An Open-Label, Phase Ii Basket Trial (Long March Pathway), Xiao-Dong Jiao, Bao-Dong Qin, Zhan Wang, Ke Liu, Ying Wu, Yan Ling, Wen-Xing Qin, Miao-Miao Wang, Ling-Yan Yuan, Savio George Barreto, Anthony W Kim, Kimberley Mak, Hao Li, Yuan-Yuan Xu, Xiao-Ming Qiu, Min Wu, Min Jin, Li-Chao Xu, Yi Zhong, Hui Yang, Xue-Qin Chen, Yu Zeng, Jun Shi, Wen-Yu Zhu, Qing-Qing Ding, Wei Jia, Su-Fen Liu, Jun-Jing Zhou, Hong Shen, Shi-Hua Yao, Zhao-Ji Guo, Ting Li, Pei-Juan Zhou, Xue-Wei Dong, Wen-Feng Lu, Robert L Coleman, Mehmet Akce, Chérif Akladios, Francesco Puccetti, Yuan-Sheng Zang

Faculty, Staff and Student Publications

Purpose: We evaluated he effects of molecular guided-targeted therapy for intractable cancer. Also, the epidemiology of druggable gene alterations in Chinese population was investigated.

Materials and methods: The Long March Pathway (ClinicalTrials.gov identifier: NCT03239015) is a non-randomized, open-label, phase II trial consisting of several basket studies examining the molecular profiles of intractable cancers in the Chinese population. The trial aimed to 1) evaluate the efficacy of targeted therapy for intractable cancer and 2) identify the molecular epidemiology of the tier II gene alterations among Chinese pan-cancer patients.

Results: In the first stage, molecular profiles of 520 intractable pan-cancer patients …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon

Walden Dissertations and Doctoral Studies

AbstractWhether from natural or human causes, every global community is at risk for overwhelming, destabilizing incidents. Hurricanes Irma and Maria devastated the U.S. Virgin Islands in late August and early September 2017, necessitating the urgent evacuation of hemodialysis patients over 1000 miles to the U.S. mainland. Because the damage and response to the U.S. territory were unprecedented, the public health implications of the government’s strategies on the evacuated population subset were unexplored. However, available information suggested that some evacuees sustained avoidable harm while in the protracted care and custody of the government. This qualitative case study, conceptually framed by Bronfenbrenner’s …

Designing Implementation Strategies To Improve Identification, Cascade Testing, And Management Of Families With Familial Hypercholesterolemia: An Intervention Mapping Approach, Laney K Jones, Ross C Brownson, Anne C Goldberg, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Familial hypercholesterolemia (FH) is a common inherited cholesterol disorder that, without early intervention, leads to premature cardiovascular disease. Multilevel strategies that target all components of FH care including identification, cascade testing, and management are needed to address gaps that exist in FH care. We utilized intervention mapping, a systematic implementation science approach, to identify and match strategies to existing barriers and develop programs to improve FH care.

METHODS: Data were collected utilizing two methods: a scoping review of published literature, related to any component of FH care, and a parallel mixed method study using interviews and surveys. The scientific …

Racial Disparities In Access To Dbs: Results Of A Real-World U.S. Claims Data Analysis, Michael Frassica, Drew S Kern, Mitra Afshari, Allison T Connolly, Chengyuan Wu, Nathan Rowland, Juan Ramirez-Castaneda, Mwiza Ushe, Claudia Salazar, Xenos Mason

2020-Current year OA Pubs

INTRODUCTION: Deep brain stimulation (DBS) is an effective and standard-of-care therapy for Parkinson's Disease and other movement disorders when symptoms are inadequately controlled with conventional medications. It requires expert care for patient selection, surgical targeting, and therapy titration. Despite the known benefits, racial/ethnic disparities in access have been reported. Technological advancements with smartphone-enabled devices may influence racial disparities. Real-world evidence investigations can shed further light on barriers to access and demographic disparities for DBS patients.

METHODS: A retrospective cross-sectional study was performed using Medicare claims linked with manufacturer patient data tracking to analyze 3,869 patients who received DBS. Patients were …

Applying Hybrid Effectiveness-Implementation Studies In Equity-Centered Policy Implementation Science, Yuka Asada, Aimee Kroll-Desrosiers, Jamie F Chriqui, Geoffrey M Curran, Karen M Emmons, Debra Haire-Joshu, Ross C Brownson

2020-Current year OA Pubs

Policy implementation science (IS) is complex, dynamic, and fraught with unique study challenges that set it apart from biomedical or clinical research. One important consideration is the ways in which policy interacts with local contexts, such as power and social disadvantage (e.g., based on ability, race, class, sexual identity, geography). The complex nature of policy IS and the need for more intentional integration of equity principles into study approaches calls for creative adaptations to existing implementation science knowledge and guidance. Effectiveness-implementation hybrid studies were developed to enhance translation of clinical research by addressing research questions around the effectiveness of an …

Prevalence Of Diarrheagenic Escherichia Coli And Impact On Child Health In Cap-Haitien, Haiti, Jenna N. Diaz, Lora L. Iannotti, Sherlie Jean Louis Dulience, Sydney Vie, Xuntian Jiang, Vadim Grigura, Jacques Boncy, Francesca J. Marhone Pierre, F. Matthew Kuhlmann

2020-Current year OA Pubs

BACKGROUND: Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti.

METHODS: We performed pre-specified secondary analysis of a case-control study of community-dwelling children, 6-36 months of age, enrolled 96 cases with diarrhea and 99 asymptomatic controls. Assessments were performed at enrollment and one month later at follow-up. Established endpoint PCR methodologies targeted DEC gDNA isolated from fecal swabs. The association between DEC and anthropometric z-scores at enrollment was …

Translating Energy Balance Research From The Bench To The Clinic To The Community: Parallel Animal-Human Studies In Cancer, Miriam B Garcia, Keri L Schadler, Joya Chandra, Steven K Clinton, Kerry S Courneya, Zobeida Cruz-Monserrate, Carrie R Daniel, Andrew J Dannenberg, Wendy Demark-Wahnefried, Mark W Dewhirst, Carol J Fabian, Stephen D Hursting, Melinda L Irwin, Neil M Iyengar, Jennifer L Mcquade, Kathryn H Schmitz, Karen Basen-Engquist

Faculty, Staff and Student Publications

Advances in energy balance and cancer research to date have largely occurred in siloed work in rodents or patients. However, substantial benefit can be derived from parallel studies in which animal models inform the design of clinical and population studies or in which clinical observations become the basis for animal studies. The conference Translating Energy Balance from Bench to Communities: Application of Parallel Animal-Human Studies in Cancer, held in July 2021, convened investigators from basic, translational/clinical, and population science research to share knowledge, examples of successful parallel studies, and strong research to move the field of energy balance and cancer …

Circulating Vitamin D And Breast Cancer Risk: An International Pooling Project Of 17 Cohorts, Kala Visvanathan, Alison M Mondul, Anne Zeleniuch-Jacquotte, Molin Wang, Mitchell H Gail, Shiaw-Shyuan Yaun, Stephanie J Weinstein, Marjorie L Mccullough, A Heather Eliassen, Nancy R Cook, Claudia Agnoli, Martin Almquist, Amanda Black, Julie E Buring, Chu Chen, Yu Chen, Tess Clendenen, Laure Dossus, Veronika Fedirko, Gretchen L Gierach, Edward L Giovannucci, Gary E Goodman, Marc T Goodman, Pascal Guénel, Göran Hallmans, Susan E Hankinson, Ronald L Horst, Tao Hou, Wen-Yi Huang, Michael E Jones, Corrine E Joshu, Rudolf Kaaks, Vittorio Krogh, Tilman Kühn, Marina Kvaskoff, I-Min Lee, Yahya Mahamat-Saleh, Johan Malm, Jonas Manjer, Gertraud Maskarinec, Amy E Millen, Toqir K Mukhtar, Marian L Neuhouser, Trude E Robsahm, Minouk J Schoemaker, Sabina Sieri, Malin Sund, Anthony J Swerdlow, Cynthia A Thomson, Giske Ursin, Jean Wactawski-Wende, Ying Wang, Lynne R Wilkens, Yujie Wu, Emilie Zoltick, Walter C Willett, Stephanie A Smith-Warner, Regina G Ziegler

Faculty, Staff and Student Publications

Laboratory and animal research support a protective role for vitamin D in breast carcinogenesis, but epidemiologic studies have been inconclusive. To examine comprehensively the relationship of circulating 25-hydroxyvitamin D [25(OH)D] to subsequent breast cancer incidence, we harmonized and pooled participant-level data from 10 U.S. and 7 European prospective cohorts. Included were 10,484 invasive breast cancer cases and 12,953 matched controls. Median age (interdecile range) was 57 (42-68) years at blood collection and 63 (49-75) years at breast cancer diagnosis. Prediagnostic circulating 25(OH)D was either newly measured using a widely accepted immunoassay and laboratory or, if previously measured by the cohort, …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …