Digital Commons Network^™

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 …

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 …

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 …

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …

Situating Implementation Science (Is) In Res(Is)Tance: A Conceptual Frame Toward The Integration Of Scholarship From The Black Radical Tradition, Cory D Bradley, Whitney C Irie, Elvin H Geng

2020-Current year OA Pubs

This manuscript undertakes a disciplinary self-critique of the field of implementation science, a field which attempts to bridge the gap between evidence-based interventions and their practical application. Despite the heightened emphasis on health equity and racial disparities, the field's current discourse is limited by key epistemic shortcomings. First, even though prevalence of implementation gaps between racialized groups in the United States necessitates a comprehensive understanding of the systems perpetuating these disparities, the field does not operate with a general explanation for disparities not as a failure of systems, but a system historically and structural designed to produce disparities. Second, the …

Twitter Sentiment Analysis: Applications In Healthcare And Finance, Jiali Wang

Dissertations

This research explores the influence of Twitter sentiment on healthcare and finance industries. It assesses how Twitter sentiment and culture measure influence COVID-19 statistics, and it investigates the impact of Twitter sentiment on S&P 1500 stock mispricing. Furthermore, it examines how tweet sentiment predicts major industry returns.

The first part examines how Hofstede’s Culture Dimensions (HCD) and Twitter economic uncertainty index (TEU) relate to COVID-19 infection rate and death rate. The results show certain aspects in HCD, such as power distance index (PDI) and masculinity (MAS) both are negatively and significantly associated with the infection rate, while indulgence (IVR) and …

The Potencial Of Ginger (Zingiber Officinale R.) As A Standardized Herbal Product In North Sumatera, Rahmad Syukur Siregar, Rika Ampuh Hadiguna, Insannul Kamil, Novizar Nazir, Nofialdi Nofialdi

Journal of Environmental Science and Sustainable Development

Indonesia has more than 9,609 plant species which have medicinal properties that is spread across various regions in Indonesia. Ginger is a group of medicinal plants that are therapeutic. Ginger has been cultivated on a large scale with the highest harvested area, total production and demand in Indonesia, including the Province of North Sumatra. The use of ginger as a medicinal plant has been carried out on the scale of the Traditional Medicine Industry (IOT), of which there are 135 IOTs in Indonesia and one of them is in North Sumatra, namely in the city of Medan. This article uses …

Health Outcomes Of Fitbit, Garmin Or Apple Watch-Based Interventions: A Systematic Review Of Systematic Reviews, Hossein Motahari-Nezhad, Fateme Zare, Hadi Akbari, Aslan Sadeghdaghighi

Baltic Journal of Health and Physical Activity

Introduction: A rising number of systematic reviews of smartwatch clinical effectiveness have been published; however, the findings are conflicting and need further investigation. Our purpose was to assess the methodological and evidence synthesis quality of meta-analyses of the therapeutic efficacy of Fitbit, Garmin, or Apple Watch-based interventions. Material and Methods: Systematic searches were carried out with three electronic databases from inception to October 2021. Full text systematic reviews originally published in English in peer-reviewed journals describing meta-analyses of all clinical outcomes of Fitbit-, Garmin-, or Apple Watch -based interventions were eligible for this study. The Amstar-2 scale and GRADE were …

Telemedicine Payment System Based On Quality:A Scoping Review, Zuhaira Husna Fatma, Ryan Rachmad Nugraha

Jurnal Ekonomi Kesehatan Indonesia

Telemedicine has been proven to improve access to care. However, it is still not sure how a payment system can accommodate high-quality telemedicine services. This paper aims to study the available payment system to accommodate telemedicine with a focus on health services quality. We conducted a scoping review of the telemedicine payment system and telemedicine quality through the PubMed and CINAHL databases including primary research, literature reviews, and expert opinion, aside from policy documents. The number of records identified through the database was 286. In addition, 195 were screened after removing duplicates, and 28 papers were included in the review …

Risk Factors For Emergency Medical Care Or Hospitalization Due To Heat-Related Illness Or Injury: A Systematic Review, Blair Litwiller, Amber N. Barnes

Florida Public Health Review

Background: Temperatures globally have been predicted to increase due to changes in the climate. As the earth gets warmer, it is expected that heat-related illness will also increase worldwide. An effective and appropriate public health response will be critical. Purpose: The aim of this review was to identify risk factors associated with heat-related illness and injury to provide target areas for future interventions. Methods: A review of existing literature was analyzed for risk factors that may increase the likelihood of being admitted to an emergency department for a heat related illness or injury. Results: Of the …

Safety And Microbiological Activity Of Phage Therapy In Persons With Cystic Fibrosis Colonized With Pseudomonas Aeruginosa: Study Protocol For A Phase 1b/2, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial, Pranita D Tamma, Maria Souli, Michael Billard, Joseph Campbell, Douglas Conrad, Damon W Ellison, Beth Evans, Scott R Evans, Kerryl E Greenwood-Quaintance, Andrey A Filippov, Holly S Geres, Toshimitsu Hamasaki, Lauren Komarow, Mikeljon P Nikolich, Thomas P Lodise, Seema U Nayak, Carmelle Norice-Tra, Robin Patel, David Pride, Janie Russell, Daria Van Tyne, Henry F Chambers, Vance G Fowlerjr, Robert T Schooley, Antibacterial Resistance Leadership Group

Faculty, Staff and Student Publications

BACKGROUND: Bacteriophages (phages) are a promising anti-infective option for human disease. Major gaps remain in understanding their potential utility.

METHODS: This is a randomized, placebo-controlled, double-blind study of a single dose of intravenous phage in approximately 72 clinically stable adult cystic fibrosis volunteers recruited from up to 20 US sites with Pseudomonas aeruginosa airway colonization. The single dose of phage consists of a mixture of four anti-pseudomonal phages. Six sentinel participants will be sequentially enrolled with dose escalation of the phage mixture by one log

DISCUSSION: This trial will investigate the activity of phages in reducing P. aeruginosa colony counts …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Assessing The Mental Health Of Women At The Intersection Of Intimate Partner Violence And Animal Cruelty: Personal And Population Level Risk Factors For Co-Victimization, Alaina M. Beauchamp

Dissertations and Theses (Open Access)

One predictor of intimate partner violence (IPV) occurring in the home is pet abuse. The high prevalence of pet cruelty among IPV relationship can create a significant barrier to seeking help due to the inability to bring the pet or concern for the pet’s wellbeing. This human-animal bond is a more common source of emotional support among victims with experiences of pet abuse, as opposed to women whose pets had not been abused. This study 1) explored the relationship between victims of IPV and their pets, the dynamics and characteristics of situations of co-victimization (i.e., abuse of both a human …

Implementing Routine Depression Screening In An Urgent Care Setting: An Implementation Science Project, Lori Conyers

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Identifying patients with depression is essential, and early detection of depression leads to early intervention. Routine screening of patients for depression is the responsibility of the primary care provider, but many patients have not had a primary care visit in the recent past. Those patients without a primary care provider are likely not being screened for depression. Urgent care (UC) may be the best opportunity to screen patients who do not have a medical home. However, the dynamic nature of the urgent care setting may dissuade staff from engaging in routine screening. As a quality improvement (QI) effort, regular PHQ …

Gender Differences In Breast Cancer Treatment Decisions And Related Survival: A Study Using The National Cancer Database, Shamim Shahi

Theses & Dissertations

Despite increasing incidence, male breast cancer (MBC) remains understudied in almost all aspects of disease management. MBC patients are more likely to be diagnosed with larger tumors, at an advanced stage, and to experience poorer survival than female patients. There is a need to identify modifiable factors that can improve MBC patients’ survival.

This dissertation aimed to investigate whether there was a difference in the refusal of recommended treatments and related survival, by gender, in breast cancer patients enrolled in the National Cancer Database. Specifically, we conducted separate analyses for four treatments: hormone therapy, chemotherapy, radiation therapy, and surgery. Then, …

A Bayesian Susceptible-Infectious-Hospitalized-Ventilated-Recovered Model To Predict Demand For Covid-19 Inpatient Care In A Large Healthcare System, Stella Coker Watson Self Ph.D., Ms, Rongjie Huang, Shrujan Amin, Joseph Ewing, Carolina Rudisill, Alexander C. Mclain Ph.D.

Faculty Publications

The COVID-19 pandemic has strained healthcare systems in many parts of the United States. During the early months of the pandemic, there was substantial uncertainty about whether the large number of COVID-19 patients requiring hospitalization would exceed healthcare system capacity. This uncertainty created an urgent need to accurately predict the number of COVID-19 patients that would require inpatient and ventilator care at the local level. As the pandemic progressed, many healthcare systems relied on such predictions to prepare for COVID-19 surges and to make decisions regarding staffing, the discontinuation of elective procedures, and the amount of personal protective equipment (PPE) …

A Bayesian Susceptible-Infectious-Hospitalized-Ventilated-Recovered Model To Predict Demand For Covid-19 Inpatient Care In A Large Healthcare System, Stella Coker Watson Self Ph.D., Ms, Rongjie Huang, Shrujan Amin, Joseph Ewing, Caroline Rudisill, Alexander C. Mclain

Faculty Publications

The COVID-19 pandemic has strained healthcare systems in many parts of the United States. During the early months of the pandemic, there was substantial uncertainty about whether the large number of COVID-19 patients requiring hospitalization would exceed healthcare system capacity. This uncertainty created an urgent need to accurately predict the number of COVID-19 patients that would require inpatient and ventilator care at the local level. As the pandemic progressed, many healthcare systems relied on such predictions to prepare for COVID-19 surges and to make decisions regarding staffing, the discontinuation of elective procedures, and the amount of personal protective equipment (PPE) …

Economic Implications Of State-Wide Covid-19 Response Aggressiveness, Bryan Foltice, Michael Edward Parker

Journal of Vincentian Social Action

This paper aims to evaluate how the aggressiveness of each state’s response to the Covid-19 pandemic affected their respective economies from Q2, 2020 through Q2, 2021. In our study, we utilize the scale developed by McCann (2021, April 6), which ranks the least aggressive state response to the most aggressive state response at three different points of the pandemic. Through this methodology, we test the impact of the aggressiveness of each state governments’ response with the resulting economic impact within that state. Namely, we examine how this level of response affected each state’s unemployment rate, gross domestic product growth, and …

Computer Clinical Decision Support That Automates Personalized Clinical Care: A Challenging But Needed Healthcare Delivery Strategy, Alan H Morris, Christopher Horvat, Brian Stagg, David W Grainger, Michael Lanspa, James Orme, Terry P Clemmer, Lindell K Weaver, Frank O Thomas, Colin K Grissom, Ellie Hirshberg, Thomas D East, Carrie Jane Wallace, Michael P Young, Dean F Sittig, Mary Suchyta, James E Pearl, Antinio Pesenti, Michela Bombino, Eduardo Beck, Katherine A Sward, Charlene Weir, Shobha Phansalkar, Gordon R Bernard, B Taylor Thompson, Roy Brower, Jonathon Truwit, Jay Steingrub, R Duncan Hiten, Douglas F Willson, Jerry J Zimmerman, Vinay Nadkarni, Adrienne G Randolph, Martha A Q Curley, Christopher J L Newth, Jacques Lacroix, Michael S D Agus, Kang Hoe Lee, Bennett P Deboisblanc, Frederick Alan Moore, R Scott Evans, Dean K Sorenson, Anthony Wong, Michael V Boland, Willard H Dere, Alan Crandall, Julio Facelli, Stanley M Huff, Peter J Haug, Ulrike Pielmeier, Stephen E Rees, Dan S Karbing, Steen Andreassen, Eddy Fan, Roberta M Goldring, Kenneth I Berger, Beno W Oppenheimer, E Wesley Ely, Brian W Pickering, David A Schoenfeld, Irena Tocino, Russell S Gonnering, Peter J Pronovost, Lucy A Savitz, Didier Dreyfuss, Arthur S Slutsky, James D Crapo, Michael R Pinsky, Brent James, Donald M Berwick

Faculty, Staff and Student Publications

How to deliver best care in various clinical settings remains a vexing problem. All pertinent healthcare-related questions have not, cannot, and will not be addressable with costly time- and resource-consuming controlled clinical trials. At present, evidence-based guidelines can address only a small fraction of the types of care that clinicians deliver. Furthermore, underserved areas rarely can access state-of-the-art evidence-based guidelines in real-time, and often lack the wherewithal to implement advanced guidelines. Care providers in such settings frequently do not have sufficient training to undertake advanced guideline implementation. Nevertheless, in advanced modern healthcare delivery environments, use of eActions (validated clinical decision …

The Hypertension Cascade Of Care In The Midst Of Conflict: The Case Of The Gaza Strip, Bassam A. Abu Hamad, Zeina Jamaluddine, Gloria Safadi, Marie Elizabeth Ragi, Raeda El Sayed Ahmad, Eszter P. Vamos, Sanjay Basu, John S. Yudkin, Mohammed Jawad, Christopher Millett, Hala Ghattas Ph.D.

Faculty Publications

Although hypertension constitutes a substantial burden in conflict-affected areas, little is known about its prevalence, control, and management in Gaza. This study aims to estimate the prevalence and correlates of hypertension, its diagnosis and control among adults in Gaza. We conducted a representative, cross-sectional, anonymous, household survey of 4576 persons older than 40 years in Gaza in mid-2020. Data were collected through face-to-face interviews, anthropometric, and blood pressure measurements. Hypertension was defined in anyone with an average systolic blood pressure ≥140 mmHg or average diastolic blood pressure ≥90 mmHg from two consecutive readings or a hypertension diagnosis. The mean age …

Advancing Access To Healthcare Through Telehealth: A Brownsville Community Assessment, Edna Ely-Ledesma, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

(1) Background: This paper focuses on the development of a community assessment for telehealth using an interprofessional lens, which sits at the intersection of public health and urban planning using multistakeholder input. The paper analyzes the process of designing and implementing a telemedicine plan for the City of Brownsville and its surrounding metros. (2) Methods: We employed an interprofessional approach to CBPR which assumed all stakeholders as equal partners alongside the researchers to uncover the most relevant and useful knowledge to inform the development of telehealth community assessment. (3) Results: Key findings include that: physicians do not have the technology, …

Creating Rural Nurse Retention Strategies For Nursing Administrators, Susan Lesser

Doctoral Projects

Rural area nurse retention has been referred to as a crisis for decades; this crisis has been exacerbated by several factors including the COVID-19 pandemic, resources being directed towards larger hospitals, the inability to recruit and retain healthcare providers to rural areas, and the aging workforce (Rossetter, 2020). The researcher in this Doctor of Nursing Practice (DNP) Project investigated the elements that encourage rural nurse retention and sought to develop retention strategies that are rooted in the literature and anchored in the concerns of rural nurses. Retention strategy recommendations were drawn from results from the Revised Casey Fink Nurse Retention …

Socioeconomic Deprivation And Cardiometabolic Risk Factors In Individuals With Type 1 Diabetes: T1d Exchange Clinic Registry, Stephanie Griggs, Sadeer Al-Kindi, Heather Hardin, Elliane Irani, Sanjay Rajagopalan, Ronald L. Hickman Jr.

Faculty Scholarship

Aims: Social determinants of health (SDOH) influence cardiovascular health in the general population; however, the degree to which this occurs in individuals with type 1 diabetes (T1D) is not well understood. We evaluated associations among socioeconomic deprivation and cardiometabolic risk factors (hemoglobin A1c, low-density lipoprotein, blood pressure, body mass index, physical activity) in individuals with T1D from the T1D Clinic Exchange Registry. Methods: We evaluated the association between the social deprivation index (SDI) and cardiometabolic risk factors using multivariable and logistic regression among 18,754 participants ages 13 – 90 years (mean 29.2 ± 17) in the T1D Exchange clinic registry …

A Multi-Method Exploration Of Health Disparities And Covid-19 Incidence And Mortality In The United States, S M Asger Ali

Theses and Dissertations

The 21^st century experienced several health crises, especially in the form of infectious disease outbreaks such as the SARS outbreak in 2003, the H1N1 in 2009, and Ebola outbreaks in 2013. However, none has produced a worldwide socio-economic and health impact compared to the recent pandemic, known as COVID-19. As of October 4, 2022, more than 614 million cases with 6 million deaths have been reported worldwide. The United States is currently in the leading position with more than 98 million cases and 1 million deaths. The pandemic, however, did not impact the entire region similarly, and the infections …

Trends In Esophageal Adenocarcinoma And Esophageal Squamous Cell Carcinoma Incidence In The United States From 1992 To 2019, Kyle S Liu, Syed Ahsan Raza, Hashem B El-Serag, Aaron P Thrift

Faculty, Staff and Students Publications

Simple Summary

The incidence of esophageal cancer overall has increased in the United States, driven by increasing rates of esophageal adenocarcinoma (EAC). However, whether rates of EAC are still rising is unclear. We examined trends in esophageal cancer overall and within important sub-groups of the population. We found that esophageal squamous cell carcinoma (ESCC) rates have been steadily declining, while EAC rates rose rapidly before stabilizing in 2000. The trend of decreasing incidence of ESCC was observed almost uniformly by age group, sex, and race/ethnicity, while trends in EAC rates varied across these sub-groups. A cohort effect for EAC was …

Increasing Equitable Access To Care: Implementation Of Universal Palliative Care Screening In The Intensive Care Unit, Sarah Weaver

Student Scholarly Projects

Practice Problem: At a small community hospital in Virginia, there is an absence of standardized screening processes for identifying intensive care unit (ICU) patients with unmet palliative care needs, contributing to delayed and unequitable access to palliative care consultations.

PICOT: The PICOT question that guided this project was “In adult ICU patients, how does implementing a palliative care screening tool upon ICU admission, as compared to standard ICU admission protocol, affect palliative care consultations within an 8-week time frame?"

Evidence: This project was guided by consensus reports from the World Health Organization and the Centers to Advance …

A Gbd 2019 Study Of Health And Sustainable Development Goal Gains And Forecasts To 2030 In Spain, Jeffrey V Lazarus, Alberto Ortiz, Stefanos Tyrovolas, Esteve Fernández, Danielle Guy, Trenton M White, Rui Ma, Simon I Hay, Mohsen Naghavi, Joan B Soriano, Gbd 2019 Spain Collaborators

Faculty, Staff and Student Publications

This study aimed to report mortality, risk factors, and burden of diseases in Spain. The Global Burden of Disease, Injuries, and Risk Factors 2019 estimates the burden due to 369 diseases, injuries, and impairments and 87 risk factors and risk factor combinations. Here, we detail the updated Spain 1990-2019 burden of disease estimates and project certain metrics up to 2030. In 2019, leading causes of death were ischaemic heart disease, stroke, chronic obstructive pulmonary disease, Alzheimer's disease, and lung cancer. Main causes of disability adjusted life years (DALYs) were ischaemic heart disease, diabetes, lung cancer, low back pain, and stroke. …

Evidence-Based Best Practice For Transitions Of Care: A Policy Review On Medication Reconciliation Standards, Lovelyn Chizoba Ogbennah

Student Scholarly Projects

Practice Problem: Medication reconciliation (MR) is crucial in care transitions among healthcare facilities. Developing evidence-based discharge planning strategies, improving communication, optimizing electronic health record intelligence interoperability, and stakeholder engagement will promote a better transition process for patients and healthcare providers.

PICOT: The PICOT question that guided this project was: In an urban-based adult skilled nursing facility, how does an evidence-based structured review, and revision of current MR policy and procedures, compared to the existing MR policy, affect the clarity of the process for communication between clinicians during transitions of care over a 10-week review cycle?

Evidence: Fifteen …

2022 - The Third Annual Fall Symposium Of Student Scholars

Symposium of Student Scholars Program Books

The full program book from the Fall 2022 Symposium of Student Scholars, held on November 17, 2022. Includes abstracts from the presentations and posters.