Digital Commons Network^™

Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis, Ani K. John

Walden Dissertations and Doctoral Studies

Nonalcoholic fatty liver disease (NAFLD) has become one of the most common hepatic diseases worldwide, making the diagnosis and management of NAFLD an emerging public health issue. Theories associated with NAFLD surmise that inflammation may be the root cause, along with the complex interplay of other chronic conditions such as obesity, metabolic syndrome, diabetes, dyslipidemia, and cardiovascular disease (CVD). It is unknown if other inflammatory conditions such as rheumatoid arthritis (RA), along with the use of methotrexate (MTX), might confer increased risk for NAFLD. Longitudinal data collected from a retrospective cohort of 17,481 adult RA patients in the United States …

Obesity Among Women In Rural Kenya: Knowledge, Beliefs, And Perceptions., Ann Mugo

Walden Dissertations and Doctoral Studies

Obesity or being overweight is a prevalent health concern around the world. Despite the growing problem in developing countries such as Kenya, there is scant literature available on obesity or being overweight among women in rural Kenya. This research study provides information necessary for bridging the gap in understanding the perceptions, beliefs, and knowledge of obesity among women in rural Kenya. This study used the social cognitive theory (SCT) framework to assist in understanding the impact of obesity or being overweight among women living in rural Kenya. Participants were women aged 20 to 45 recruited from a local church in …

Insecticide Treated Nets As An Effective Malaria Control Strategy In Liberia, Taiyee Nelson Quenneh

Walden Dissertations and Doctoral Studies

Malaria is a vector-borne disease that presents the most persistent and serious public health burden in Liberia. Numerous studies have examined the relationship between ITN use and malaria prevalence. However, little research has explored the effectiveness of ITNs in controlling malaria among children in postwar Liberia. The aim of this study was to examine the association between ITN ownership, parental economic status, ITN installation support, and malaria prevalence among children. This was a quantitative cross-sectional study guided by the health belief model. The study used secondary data from the 2011 Liberia Malaria Indicator Survey. Chi-square for association and Logistic regression …

Chiropractic Student Infection Control Practices And Methicillin-Resistant Staphylococcus Aureus Skin Infections, Jonathon Todd Egan

Walden Dissertations and Doctoral Studies

Chiropractic training involves many hours of skin contact, and chiropractors have manual contact with millions of patients annually, but chiropractic has only had professional clinical hygiene guidance since 2010. Methicillin-resistant Staphylococcus aureus (MRSA) is the most common cause of cultured skin and soft tissue infection (SSTI) in the United States. Using the epidemiologic triad of person, place, and time as a framework, this quantitative, cross-sectional study obtained the first assessment of MRSA SSTI incidence among chiropractic students and its association with infection control behaviors (hand and table hygiene, sharing gowns, and sharing lotion) and initiation of patient care. The study …

Associations Between Healthcare Facility Types And Healthcare-Associated Infections, Aretha D. Miller

Walden Dissertations and Doctoral Studies

Healthcare-Associated Infections (HAIs) continue to be an epidemiological issue burdening patients and public health systems worldwide. The purpose of this study was to determine if specific healthcare facility types (Acute Care Hospitals, Long Term Acute Care Hospitals, and Inpatient Rehabilitation Facilities) were associated with particular categories of HAIs: Ventilator-Associated Pneumonias (VAPs), Central Line-Associated Bloodstream Infections (CLABSIs), and Catheter-Associated Urinary Tract Infections (CAUTIs). The theoretical framework for this study was the environmental determinants of infectious disease framework. A single research question focused on whether an association existed among the specified health care facility types and HAIs. Three independent categorical variables were …

Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass

Walden Dissertations and Doctoral Studies

The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen's model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and …

The Effect Of Personal Beliefs And Perceptions On Influenza Vaccination Uptake Among Older Adults, Rani Sujatha Athota

Walden Dissertations and Doctoral Studies

Despite a 90% fatality rate and high risk of complications from influenza infection, vaccination coverage remains lower among African American (AA) and Hispanic American (HA) older adults. Health care professionals, families, and older adults are concerned with improving vaccination uptake. The purpose of this study was to examine differences among older adult AA and HA compared to European Americans (EA) on how their personal beliefs and perceptions affect vaccination uptake. The health belief model guided this study. The study research design was a quantitative cross-sectional analysis of the 2009 National H1N1 Flu Survey. Weighed prevalence of vaccine uptake indicated all …

Predictors Of Influenza Vaccination Compliance Among Union And Nonunion Workers In A Pennsylvania Health Care System, Ericka Lynne Kalp

Walden Dissertations and Doctoral Studies

To improve U.S. residents' health, advocates are focusing their efforts on workplace health. Researchers have found that unionization is a positive influence on workers' participation in health promotion programs relating to smoking and obesity prevention. However, the effect of union membership on other health promotion initiatives, such as influenza vaccination compliance among health care workers, has not been examined. The purpose of this quantitative study was to address this knowledge gap between a union and a nonunion health care facility in the U.S. state of Pennsylvania. The health belief model was used to determine if different domains of influenza vaccination …

Experience With Social Support Systems Among Women Exposed To Intimate Partner Violence In Cameroon, Ahone Esther-Alice Ngujede

Walden Dissertations and Doctoral Studies

The southwest and northwest regions of Cameroon have experienced high rates of intimate partner violence (IPV). Limited information is available about IPV victims' experiences with social support systems. This phenomenological study was aimed at investigating IPV victims' lived experiences with social support systems in Cameroon. Some of these systems are the judicial system, police officers, hospitals and clinics, and domestic violence agencies. The Health Belief Model (HBM) and the Transtheoretical Model of Change (TTM) were used to understand how 8 self-identified victims of IPV were able to discuss their lived experiences with social support systems. The research questions addressed women's …

Barriers To Exclusive Breastfeeding Among Mothers During The First Four Weeks Postpartum, Jessy V. Thomas

Walden Dissertations and Doctoral Studies

According to the World Health Organization, breastfeeding is natural and the most effective way of nourishment to feed infants and young children to ensure child health and survival. Currently, the World Health Organization, the American Academy of Pediatrics, and other health organizations recommend exclusive breastfeeding during the first 6 months of life. Although exclusive breastfeeding has been shown to reduce the occurrence of adverse health outcomes to the infant and mother, the duration of exclusive breastfeeding remains relatively low in the United States. The theory of planned behavior was used as a theoretical framework for this study. The purpose of …

The Role Of Religiosity In The Development Of Obesity From Adolescence To Adulthood, Trini Gene Rangel

Walden Dissertations and Doctoral Studies

The development of obesity from adolescence to adulthood is not well understood, nor does the research support a multidimensional approach for this understanding. Studies have described primarily cross-sectional bivariate relationships between combinations of obesity, religiosity, depression, and social support, but it is still not known whether there is a relationship between adolescent religiosity, depression, and social support in the development of adult obesity or whether depression and social support mediate the religiosity-obesity relationship. The dynamic, multidimensional, functional model of wellness presented by Hawks was the basis for the spiritual, social, emotional, and physical interactions proposed in this study. The research …

A Community's Perception Of Pregnancy And Sexually Transmitted Infections And Prevention Programs, Felecity Nicole Burns

Walden Dissertations and Doctoral Studies

The United States has the highest rates of teenage pregnancies, births, abortions, and sexually transmitted infections in the industrialized world. African American teen pregnancies and sexually transmitted infections are on the rise in many rural southwest school districts in the State of Georgia where the sex education curriculum is nonexistent or solely focuses on abstinence. Georgia ranked 4th in cases of primary and secondary syphilis, 6th in AIDS, 12th in gonorrhea, 14th in teen pregnancies, and 17th in chlamydia in the United States in 2012. The purpose of this qualitative study was to evaluate the perceptions of residents of a …

Hospital Preparedness: Effects Of Designated Preparedness Coordinators On Hospital Preparedness For Special Hazard Classes, Rodney Sinelair Jones

Walden Dissertations and Doctoral Studies

Since 9/11, little statistical rigor has been placed on identifying the correlates of hospital preparedness. This quantitative study explores the research question: Is there a correlation between the employment of a designated hospital preparedness coordinator and the reported level of preparedness for: (a) general preparedness; (b) chemical, biological, radiological, and nuclear (CBRN) events; (c) pandemic disease outbreaks; (d) mass casualty events; and (e) internal infrastructure failure, as assessed by an online survey. Alternative analysis was conducted to assess the relationship between access to resources and the 5 dependent variables. Using complexity theory as the theoretical framework, point biserial correlation and …

Incidence Of And Risk Factors For Thromboembolic Events In Elderly Medicare Patients With Kidney Cancer, Monica Kobayashi

Walden Dissertations and Doctoral Studies

The incidence of venous and arterial thromboembolic events (VTEs/ATEs) varies greatly by cancer type and age, with increased risk in the elderly. Very little research has been reported specific to elderly kidney cancer patients. Retrospective cohort analyses of Medicare patients, 11,463 with and 11,463 without kidney cancer, between 2003 and 2010 were conducted to compare incidence rates of VTEs/ATEs in cancer patients with matched noncancer patients and to assess independent risk factors for VTEs in cancer patients. The advanced epidemiology triangle was the theoretical framework used to interpret the association between incident events and other factors. Using Cox proportional hazard …

An Examination Of African American Women With Hiv And Health Care Barriers, Robert Salvatore Petralia

Walden Dissertations and Doctoral Studies

For over 40 years, HIV has been seen as an epidemic and problem on health care that disproportionately affects the African American women (AAW) and population. This epidemic represents 12% of the total U.S. population, yet accounts for 37% of the commutative HIV cases, and 45% of the new HIV cases reported since 1998. Research in this case was needed for increased understanding to this health care problem, between AAW and HIV. A review in the literature indicated the problem and found new alternatives that helped support aspects on today's health care. The purpose of the study was to help …

Best Practices For Controlling Tuberculosis - Training In Correctional Facilities: A Mixed Methods Evaluation, Ellen Reynolds Murray

Walden Dissertations and Doctoral Studies

According to the literature, identifying and treating tuberculosis (TB) in correctional facilities have been problematic for the inmates and also for the communities into which inmates are released. The importance of training those who can identify this disease early into incarceration is vital to halt the transmission. Although some training has been done by public health authorities for corrections, there is little to no evaluation of such training. The aim of this mixed methods retrospective study was to evaluate the effectiveness of a training to control TB in correctional facilities. The Southeastern National Tuberculosis Center (SNTC) conducted 12 trainings between …

Nigerian Cancer Survivors' Perceptions Of Care Received From Health Care Professionals, Olusegun Akinsuli

Walden Dissertations and Doctoral Studies

Cancer patients worldwide receive care from multidisciplinary teams, and patients

sometimes have little or no knowledge about the different treatment options available, making communication with their care providers an important influence in how they perceive their care. Patient satisfaction with care is an important factor in determining survivorship. The increasing prevalence of cancer worldwide has become a huge public health issue. The World Health Organization has warned that the potential gains from combatting infectious diseases in Nigeria might be lost because of the increasing prevalence of cancer. The purpose of this grounded theory study was to obtain the perceptions of …

The Impact Of Social Determinants On Tuberculosis Incidence Trends In New Jersey, Thomas Larry Brown

Walden Dissertations and Doctoral Studies

Social determinants have impacted disease states. The purpose of this study was to determine the influence of social determinants on the incidence of tuberculosis over a 20-year period for the state of New Jersey to determine interventions that can be developed for the state. The epidemiological triad (host-agent-environment) served as the theoretical foundation for this study. A quantitative series of cross sectional analyses were performed using secondary data from a New Jersey Department of Health database on population tuberculosis incidence for the state. Categorical data analyses were used to describe the data. According to study results, certain social determinants; such …

The Relationship Between Physical Fitness And School Performance In Middle School Girls, Jamie Anne Donnelly

Walden Dissertations and Doctoral Studies

Past research has indicated a significant relationship between physical fitness and standardized test scores; however, the relationship between physical fitness and other aspects of school performance has yet to be empirically examined in a population specifically composed of middle school girls. This study examined several factors that contribute to school success, such as classroom behavior, attendance, and grades, in relation to physical fitness among a group of adolescent girls. It was specifically designed to examine the statistical relationship between physical fitness, as measured by the Fitnessgram, and quantitative data on school performance including grades, standardized test scores, school behavior, and …

Methamphetamine Users And Gender Differences In Their Acceptance Of Long-Term Substance Abuse Treatment Programs, Kevin Garen Stepanyan

Walden Dissertations and Doctoral Studies

Methamphetamine abuse is a problem of public health importance among men and women in the United States. The two genders are affected even though the majority treatment programs are tailored for male alcohol addicts. The gender differences are prevalent in the acceptance of long-term substance abuse treatment programs. The study focuses on gender differences in methamphetamine abuse and whether both male and female addicts benefit from treatment. Respondent's suitability, participant's abuse condition, treatment, and progress questionnaires and interviews are used to collect data from 50 male and 50 female methamphetamine users at the Impact Residential Program in Montreal, Canada. Together, …

The Impact Of The Sentinel Initiative And Faers Surveillance System On Consumer Safety, Sonia Batra

Walden Dissertations and Doctoral Studies

The U.S. Food and Drug Administration (FDA) uses the FDA Adverse Event Reporting System (FAERS) to monitor adverse events resulting from pharmaceutical drug use. However, this system has limitations such as not allowing real-time data collection. To address these limitations, the FDA launched the Sentinel Initiative in 2008. This comparative case study was conducted to describe perceptions of investigating the efficacy of the Sentinel Initiative compared with the FAERS. The study was based on the theory of preemption as it emphasized the need for efficient means for providing unquestionable proof that consumers suffered adverse drug effects. The sample included interivews …

Methicillin-Resistant Staphylococcus Aureus Infections In The Eight Service Planning Areas Of Los Angeles County, Ildiko Roxane Bocskay

Walden Dissertations and Doctoral Studies

Methicillin-resistant staphylococcus aureus (MRSA) has become resistant to antibiotics. The purpose of this quantitative, retrospective cohort study was to examine the relationship between length of hospitalization and invasive MRSA infection rates among different racial and ethnic groups in the 8 service planning areas (SPAs) of Los Angeles County. Cane, O'Connor, and Michie's theoretical domain framework was used. Secondary data from the Healthcare-Associated (HA) Infections Program of the California Department of Public Health were analyzed. For the first research question, a Pearson correlation analysis was conducted to assess the relationships between length of hospitalization and invasive HA-MRSA infection rates and counts. …

Correlates Of Influenza Vaccination Uptake Among Older Adults, Cheryl Hilliman

Walden Dissertations and Doctoral Studies

Seasonal influenza is associated with signiï¬?cant morbidity and mortality among older adults, aged 65 and older. Since vaccination is the single most effective preventive measure against seasonal influenza, clinicians and senior citizen center administrators need a better understanding of the perceptions of older adults concerning the reason for poor influenza vaccine uptake. The purpose of this study was to identify perceived factors that may be associated with poor influenza vaccination uptake among older adults. The health belief model (HBM) guided the study. The research questions examined perceptions predicting the odds of influenza vaccination uptake among older adults. This quantitative cross-sectional …

Breastfeeding Education For Women With Diabetes, Pregnancy-Induced Hypertension And Multiple Gestations, Oluwapelumi Adefunmike Adeboyejo

Walden Dissertations and Doctoral Studies

Breastfeeding is considered a public health concern due to increased maternal/infant mortality and morbidity rates associated with persistent low rates in breastfeeding. Providing early breastfeeding education for women with diabetic, pregnancy-induced hypertension and multiple gestations can result in higher persistence rates and a decrease in maternal and infant mortality and morbidity rates. This quality improvement project provided early prenatal breastfeeding education for women with diabetes, pregnancy-induce hypertension and multiple gestations at a private clinic in Long Beach, Southern California. Evidence-based literature reviews were conducted through CINAHL and Medline (2009-2014). The descriptive study used for the project was made up questionnaires …

Maternal Characteristics And Childhood Immunization Series Completion Rates Among Children 2-Years-Old, Merlene Ramnon

Walden Dissertations and Doctoral Studies

Delays in childhood immunization may have adverse health implications. In the United States, childhood immunization among children who are below 3 years of age continues to be below Healthy People 2020 targets for some vaccines such as DTaP, PCV, HIB, Hep A, Rotavirus, and Hep B birth dose. The purpose of this study was to examine the association between maternal characteristics and childhood immunization series completion rates among children 2 years of age. The social learning theory and self-efficacy theory provided the theoretical foundation for the study. Data from the Florida Department of Health Immunization Surveys were used. ANOVA and …

Influence Of Mothers-In-Law On Infant Feeding Practices Of Mothers Living With Hiv In Rural Cameroon, Kenneth Ngwambokong Muko

Walden Dissertations and Doctoral Studies

Mothers living with HIV (MLHIV) face complex challenges regarding infant feeding practices, which often restrict their ability to adhere to their chosen or medically recommended feeding behaviors. Mothers-in-law (MIL) enjoy significant influence and participate actively in the rearing of grandchildren in Cameroon. However, the extent to which MIL influence infant feeding behaviors of their daughters-in-law have not been studied. The theory of planned behavior (TPB) was used in this phenomenological study to explore how attitudes, subjective norms, and perceived behavioral control influenced infant feeding practices of 9 MLHIV in rural communities of the North West Region of Cameroon. The five …

Predictors Of Non-­Adherence To Medical Follow-­Up Care Among African Americans With Hiv/Aids, Phyllis D. Morgan, Cynthia B. Banks, Joshua Fogel

2010-2016 Archived Posters

Persons living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) who do not adhere to their medical follow-­ up appointments tend to have poorer health outcomes compared to HIV/AIDS patients who adhere to their medical follow-­up appointments (Lima et al., 2009). This study examined factors that influence non-­adherence of African-­Americans with HIV/AIDS to medical follow-­up appointments.

Varying Levels Of Morality Awareness In Corrections Officers, William L. Hanna

Walden Dissertations and Doctoral Studies

Morality has been a focus in criminal justice with recent events involving officers. This quantitative study offered research in the criminal justice field regarding the moral awareness of corrections officers. The main research question investigated the relationship between the security level of the prison unit in which a corrections officer works and his or her level of morality awareness. The study surveyed corrections officers of prison units in the Ohio Department of Rehabilitations and Corrections and focused on morality awareness of corrections officers. The independent variable was the security level of the prison unit worked in. The dependent variables were …

The Lived Experiences Of Limited English Proficiency, Spanish-Speaking Male Ex-Offenders, Paula Nery Sanchez

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to explore the lived experiences of Spanish-speaking men in the United States with limited English proficiency following their release from prison. The study specifically examined the experiences of these men in their efforts to access health care treatment, housing, education, and employment in Central Pennsylvania. An empirical, phenomenological research design was employed that used self-stigma, critical race, and self-determination theories for in-depth interviews with 8 men who spent 5 to 24 years in prison. A tiered coding method was used to generate 6 interconnected themes that tell the story of these men's lives: …

Providers' Knowledge Of The U.S. Health Care System And Their Medical Practice Choices: A Study Of Physicians, Residents, And Non-Physician Practitioners, Cora Case

Walden Dissertations and Doctoral Studies

The expansion of health insurance through health care reform has reduced the number of uninsured. but access to providers has not been addressed. Understanding the relationship between practice choices and aptitude of health policy and delivery is essential to determine other factors or motivators that contribute to the development of health care access policies. This descriptive study explored the value-laden elements of health care reform, such as social constructions, to learn whether there are implicit ways to address the issue of access to health care in the United States. Schneider and Ingrams's conceptualization of policy making through social construction was …