Digital Commons Network^™

Optimizing Vaccine Supply Chains With Drones In Less-Developed Regions: Multimodal Vaccine Distribution In Vanuatu, Deng Pan

Dissertations

In recent years, many less-developed countries (LDCs) have been exploring new opportunities provided by drones, such as the capability to deliver items with minimal infrastructure, fast speed, and relatively low cost, especially for high value-added products such as lifesaving medical products and vaccines. This dissertation optimizes the delivery network and operations for routine childhood vaccines in LDCs. It analyzes two important problems using mathematical programming, with an application in the South Pacific nation of Vanuatu. The first problem is to optimize the nation-wide multi-modal vaccine supply chain with drones to deliver vaccines from the national depot to all health zones …

Livestock Ticks In The Uae: Prevalence, Distribution, Population Dynamics, And Associated Microorganisms, Nighat Perveen

Dissertations

Ticks are important vectors of an array of viral, bacterial, and protozoan pathogens resulting in a wide range of animal and human diseases in the Middle East and North Africa (MENA). In this study, ticks were collected from camels, cows, sheep, and goats in Abu Dhabi, Dubai, and Sharjah in the United Arab Emirates (UAE). The objectives of the study were to (1) identify tick species of livestock through taxonomic keys and using molecular markers, and determine their prevalence and distribution in the UAE, (2) assess Hyalomma dromedarii seasonal population fluctuation over a year under common camel breeding and management …

Essays On The Impacts Of Extreme Natural Events On Health, Moumita Ghorai

Dissertations

This dissertation comprises three chapters that examine how extreme events impact health outcomes such as short-term illness, body mass index, probability of pre-term birth, and mortality. The study reveals the severe consequences of these events and shows that certain groups within a particular country are affected disproportionately.

The first chapter examines whether National Rural Employment Guarantee Scheme (NREGS), India’s flagship workfare program, mitigates adverse health outcomes of a drought. This paper contributes to a growing area of research on adaptations to climate change. Using Indian Human Development Survey (2004-2005 and 2010-2011), a nationally representative panel data set, and high resolution …

Humanizing The Inhumane: The Meaning Of The American Indian Patient-Cancer Care Nurse Relationship, Natalie M. Pool

Dissertations

This study described the unique relationships that develop while providing cancer care to AI populations and the underlying meaning that nurses ascribed to these experiences. Methods: This was an interpretive phenomenological study with multiple data collections and analysis. Nine cancer care nurses with a minimum of three years of experience working with AI patients participated by engaging in 2-3 exploratory, open-ended, reflective interviews over a period of nine months. Thematic reduction was completed to explicate the fundamental structures of this particular relationship. I then engaged in extensive reflective writing resulting in a linguistic transformation illuminating the essential meaning for nurses …

Coping Strategies, Social Support, And Self-Care Among Young Women With Pelvic Inflammatory Disease, Jessica L. Tillman

Dissertations

Pelvic inflammatory disease (PID), a spectrum of inflammatory disorders of the female upper genital tract, is a serious complication of sexually transmitted infections (STIs) that may lead to chronic pelvic pain, ectopic pregnancy, and tubal infertility. Although PID treatment is critical for the preservation of fertility and health-related quality of life, many young women diagnosed with PID do not fully adhere to treatment recommendations. Interventions focused on clinician practices, patient education, and behavioral modeling have generated limited improvements in outpatient PID treatment adherence among young women, thereby suggesting the influence of other determinants, such as psychosocial factors. Coping and social …

Impact Of Water, Hygiene And Sanitation On Medication Adherence Intention Among Hiv Positive Women Enrolled In Option B+ Treatment Regimen In Zambia, Jerry John Yao Nutor

Dissertations

Mother-to-child transmission (MTCT) of HIV is a major problem in sub-Saharan Africa despite increasing availability of free and subsidized antiretroviral treatment (ART); MTCT can be significantly reduced provided pregnant and breastfeeding mothers adhere to prescribed regimens. Access to potable water and adequate sanitation is a major problem in low-resource countries including Zambia, located in sub-Saharan Africa. This study investigated the influence of water hygiene and sanitation (WASH) on ART adherence intention among HIV positive women enrolled in Option B+ regimen, the current World Health Organization recommendation for low resource countries.

Speaking Up Or Remaining Silent: Understanding The Influences On Nurses When Patients Are At Risk, Jennifer Boice Rainer

Dissertations

Objective: The purpose of this study was to understand speaking up behavior among RNs.

Background: Speaking up is the use of one's voice to share information or alert those in authority of one's concerns about patients, and is primarily influenced by organizational culture, personal culture, and workforce generation. Failure to speak up can lead to moral distress; speaking up can lead to moral courage.

Methods: A cross-sectional electronic survey was distributed to several thousand RNs resulting in 303 surveys providing usable data.

Results: We found that organizational culture was a strong predictor of speaking-up behaviors, and that speaking up partially …

Educational Intervention To Enhance Staff Knowledge And Increase Awareness Regarding Risk Assessment And Personal Protective Equipment Selection To Reduce Blood And Body Fluid Exposures, Teresa Smoot

Dissertations

Accidental occupational blood borne pathogen exposures pose a great occupational risk for healthcare workers, worldwide. After an occupational exposure, there is a potential risk for transmission of blood borne infections such as human immunodeficiency virus (HIV), hepatitis B and hepatitis C, to health care workers. Blood and body fluid exposures reported in an academic healthcare facility in Northeast Florida have been trending upward since 2015. The literature shows accidental blood borne pathogen exposures were greater among healthcare workers with little or no training in exposure prevention.

Should We Wear A Mask? Household Assessment Of Mask Wearing For Covid-19 In Ya’An, China, Leonard Peterson

Dissertations

In late 2019 and 2020, the novel SARS-CoV-2 virus spread worldwide and resulted in the COVID-19 pandemic, the second deadliest pandemic in modern history since the 1918 influenza pandemic. Since the virus was novel, no therapeutics and vaccines existed. Effective implementation of non-pharmaceutical interventions was essential to reducing the transmission of the disease until the discovery of effective therapeutics and vaccines. This study explores the influence of the facilitating protective action attribute on adopting mask-wearing as a protective action in Ya’an, Sichuan Province, China. The study found that perceptions of mask effectiveness to reduce the probability of contracting and spreading …

Infrastructure Risk Reduction: The Case Of Drinking Water Emergencies, Mark Paine

Dissertations

Public water systems are an integral part of community infrastructure. Drinking water contamination or service disruptions have the potential to cause economic losses, limit fire suppression capability, and result in human illnesses. Until 2016, the United States federal government had not issued a disaster declaration due to contaminated water. The first federal drinking water disaster declaration due to contaminated water serves as a sentinel event demonstrating the need to increase focus on public water systems during all phases of emergency management: mitigation, preparation, response, and recovery. Previous studies evaluating risks to vulnerable populations associated with drinking water primarily utilized qualitative …

The Willingness And Ability Of First Responders To Report For Duty During Disasters: A Case Study Of Local Law Enforcement Officers, William Peak

Dissertations

Role abandonment of employees is a vulnerability of first responder organizations that can be exposed when disasters occur. Organizational vulnerabilities created by role abandonment of first responders can be reduced by understanding the willingness and ability of employees to report for duty during disasters. To gain a better understanding of law enforcement organizational vulnerability to disasters, this study utilizes an online survey disseminated to police officers (n = 314) working for a police department along the Gulf Coast to determine their willingness and ability to report for duty and examines the barriers and facilitators impacting their decision to report …

Telework Intensity, Work-Family Conflict, And Work-Family Balance, During The Covid-19 Pandemic, Timir Jayesh Bharucha

Dissertations

The COVID-19 pandemic has led to increased popularity, application, and utilization of telework. To vastly reduce the spread of COVID-19, governmental agencies worldwide have implemented lockdowns and emphasized businesses and corporations should implement telework wherever possible (Anderson & Kelliher, 2020; Belzunegui- Eraso & Erro-Garces, 2020; Buomprisco et al., 2021; Chong et al., 2020; Contreras et al., 2020; Mouratidis & Papagiannakis, 2021; Nguyen, 2021; Oz & Crooks, 2020; Raišienė et al., 2020; Tavares et al., 2020). States of emergency can disturb employees’ workflow and lead to financial difficulties; thus, telework presents an option to reduce that disruption. In such unprecedented times, …

How Do Faculty Foster The Development Of Nursing Student Empathy In The Clinical Learning Environment?, Caroline E. Rae

Dissertations

The purpose of this qualitative case study was to explore how faculty foster the development of nursing student empathy in the clinical learning environment. While much of nursing education focuses on building technical knowledge and skills, the literature supports a growing need to focus on developing an empathetic practice. It is important to support the development of empathic skills to better prepare future nurses to provide high-quality patient-centered care.

Effectiveness Of An Educational Intervention At An Academic Medical Center To Reduce Stigma Of Accelerated Pre-Licensure Nursing Students Toward Patients Living With Hiv, James Strickland Miller

Dissertations

Some health care providers may be reluctant to care for patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). The inclusion of educational opportunities for students to advance knowledge of HIV transmission risks, while decreasing stigma, is important, and many health care providers have not participated in these types of activities, which could promote learning and the practice of unbiased care.

Healthcare Providers' And Community Leaders' Knowledge And Perceptions Of Neurocysticercosis In Rural Bolivia, Amy J. Alberts

Dissertations

Neurocysticercosis (NCC) is a preventable infectious disease that is considered a major cause of epilepsy in developing nations. Bolivia is one of the least developed nations in Latin America and in rural Bolivia persons with epilepsy (PWE) go largely without treatment. Epilepsy is a devastating disease that has the capacity to significantly decrease the quality of life, not only for PWE, but for their families as well. The development and implementation of a self-sustainable program for the prevention and treatment of NCC and the consistent treatment of epilepsy is essential. However, research on epilepsy and NCC in Bolivia, whether in …

Effects Of Thermal And Non-Thermal Methods On The Chemical Composition And Bacterial Inactivation Of Camel Milk, Namariq Dhahir

Dissertations

Understanding the composition of camel milk coupled with studying the effects of thermal and non-thermal treatments on its components and bacterial inactivation were the general objectives of this dissertation. In the first study (Chapter 2), the gross composition of camel milk including milk protein, fat, casein, total solids, lactose, ash, and mineral content were analyzed. In addition, fatty acid profile, amino acid profile, protein fractions, and volatile compounds were evaluated as well. Our results revealed that camel milk has its unique nutrients profile. These findings make it easier for the researchers and consumers to understand some of the nutritional attributes …

An Exploration Of Parental And Health Professional Perceptions Of Transition For Chronically Ill Students, Iris Robinson

Dissertations

When a young person is diagnosed with a chronic illness, it impacts every phase of the person’s life. During the stages of childhood and adolescence, school is the central socialization site for the student’s developmental and personal identity. That is why it is difficult to replace school as one of the maturing spaces for young people’s transition to adulthood. Chronic illness interrupts the normative life process for an extended period or permanently.

Engaged parents, legal and social advocacy, innovative medical research, public policy, educational workshops, and finally, the consortium of family, health, medical, educational and community support have been advocates …

Stochastic Programming And Agent-Based Simulation Approaches For Epidemics Control And Logistics Planning, Xuecheng Yin

Dissertations

This dissertation addresses the resource allocation challenges of fighting against infectious disease outbreaks. The goal of this dissertation is to formulate multi-stage stochastic programming and agent-based models to address the limitations of former literature in optimizing resource allocation for preventing and controlling epidemics and pandemics. In the first study, a multi-stage stochastic programming compartmental model is presented to integrate the uncertain disease progression and the logistics of resource allocation to control a highly contagious infectious disease. The proposed multi-stage stochastic program, which involves various disease growth scenarios, optimizes the distribution of treatment centers and resources while minimizing the total expected …

Alcohol As A Catalyst For Hiv-Associated Neuroinflammation And Tbi-Induced Iron Toxicity, Agnieszka Agas

Dissertations

Alcohol has long been considered an exacerbator of diseases, disorders, and injuries as well as many of the accompanying symptoms. As an alternative approach, this dissertation explores alcohol as a catalyst for two different human disease conditions, human immunodeficiency virus (HIV)-associated neuroinflammation and traumatic brain injury (TBI)-induced iron toxicity. In HIV-1 infection, this dissertation presents a novel anti-viral drug, called Drug-S, for a possible inhibition and treatment of HIV-1 disease progression.

The first aim explores the influence of alcohol with HIV-associated neuroinflammation on macrophage migration across an in vitro model of the blood brain barrier. There is a gap in …

Male Nurses' Experiences Of Gender Stereotyping Over The Past Five Decades: A Narrative Approach, Michael W. Finnegan

Dissertations

Negative stereotyping of men in nursing has been a chronic problem that has a direct effect on males and detracts from efforts to recruit and retain them. At this time in American history (2018), traditionally male-dominated professions are making significant progress toward the goal of a gender-balanced workplace. However, the opposite is not true. Traditionally female-dominated professions are not attracting or appealing to men. In the nursing profession, the number of male nurses is relatively small and has remained relatively fixed over time. Estimates vary between 6-15 percent, with the current average being approximately 11 percent (American Nurses Association, 2014). …

Interleukin-17a Facilitates Chikungunya Virus Infection By Inhibiting Ifn-Α2 Expression, Biswas Neupane

Dissertations

Interferons (IFNs) are the key components of innate immunity and are crucial for host defense against viral infections. Here, we report a novel role of interleukin-17A (IL-17A) in inhibiting IFN-α2 expression, thus promoting chikungunya virus (CHIKV) infection. CHIKV infected IL-17A deficient (Il17a^-/-) mice expressed a higher level of IFN-α2 and developed diminished viremia and milder footpad swelling in comparison to wild-type (WT) control mice, this was also recapitulated in IL-17A receptor-deficient (Il17ra^-/-) mice. Interestingly, IL-17A selectively blocked IFN-α2 production during CHIKV, but not West Nile virus (WNV) or Zika virus (ZIKV), infections. Recombinant IL-17A …

Identifying Health Priorities For A Vulnerable Underserved Population In Uganda, Africa Using Community Base Participatory Research And The Photovoice Approach, Cheryl Wallin

Dissertations

The purpose of this descriptive phenomenological study was to give voice to an underserved and vulnerable population in Uganda, Africa to advocate for health priorities. Nineteen members of the village of Namagera, identified as a leper colony, were selected by community members and volunteered to participate in every element of this study. Descriptive phenomenology was the guiding philosophy and community-based participatory research methods and photovoice provided the lens for social action. Leininger's theory of culture care diversity and universality (Leininger & McFarland, 2006) anchored the study in cultural caring and the community nursing practice model (Parker et al., 2020) kept …

Promoting Prep Uptake In Primary Care Practice For The Prevention Of Hiv Transmissions, Sokonie S. Reed

Dissertations

The nation is charged with the great task of eradicating human immunodeficiency virus (HIV) by year 2030. PrEP is an acronym for pre-exposure prophylaxis. Multiple clinical trials have recognized it as a safe and highly effective regimen that includes taking a daily dose of an antiretroviral medication to prevent HIV transmissions. The regimen is backed by prominent healthcare organizations like the Centers for Disease Control and Prevention (CDC) that have developed guidelines for PrEP implementation. Yet, there is a nationwide problem of low provider uptake of PrEP. Investigators in the literature on PrEP implementation concur that PrEP, as a preventative …

Safe Opioid Prescribing Through Proper Screening, Joelle M. Carson

Dissertations

It is known in today's healthcare that opioid abuse is on the rise in the United States. The project site noted aberrant behaviors and the seeking of narcotics from certain clients in the occupational health clinic. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of Webster's Opioid Risk Tool (ORT) would impact the number of opioid prescriptions written for acute pain among patients seen an occupational health clinic in central Indiana over four-weeks. The theoretical frameworks utilized in the project included Skinner's behaviorist theory, Bandura's social cognitive theory, and Orem's self-care deficit theory. …

The Mother's Lived Experience Of Breastfeeding In The First 4 Weeks Postpartum: A Heideggerian Hermeneutic Phenomenological Analysis, Stacy Rosales

Dissertations

The purpose of this study was to more fully understand, in their own words, the experiences of mothers who began breastfeeding their infant after birth and may or may not have been breasting at four weeks postpartum. A single research question guided this study: What are the lived experiences of breastfeeding mothers during the first four weeks postpartum? Eight mothers who delivered in the past four to six weeks were interviewed. Data were analyzed using a Heideggerian hermeneutic phenomenological approach. This method was chosen because it allowed the researcher to conduct interviews and explore the lived experience of breastfeeding mothers …

County Youth Athletics Response To Covid-19 Pandemic, Elise Schaller

Dissertations

Problem: To ensure safe participation in youth athletics and prevent COVID-19 transmission during the COVID-19 pandemic, St. Louis County Department of Public Health (DPH) implemented Youth Sports Guidelines on October 14, 2020. This project aimed to identify level of adherence to precautions listed in the guidelines at six county public high school athletic events.

Methods: An observational descriptive study design was used to monitor guideline adherence at high school athletic events. Two observers tallied violations by participants and spectators to Youth Sports Guidelines at St. Louis County public high school athletic events. Six high-frequency contact (basketball and wrestling) events …

Impact Of Social Isolation In Hiv-Positive Individuals During A Pandemic, Corina Jane Bakoylis

Dissertations

Problem: The global pandemic of COVID-19 caused concern for immunocompromised individuals. The purpose of this quality improvement initiative was to assess the impact of social isolation on feelings of loneliness, depression, and social isolation experiences in HIV-positive individuals residing in a long-term care facility.

Methods: A mixed-method convergent design with a purposeful sample of HIV-positive adult residents residing in a long-term care facility was utilized. An evaluation of loneliness using the University of California Los Angeles (UCLA) Loneliness Scale (Version 3) and depression using the Patient Health Questionnaire-8 (PHQ-8) were completed. Personal experiences were also assessed with five predetermined open-ended …

Bladder Management Post Epidural Anesthesia: Impact On The Second Stage Of Labor, Megan Hedgcorth

Dissertations

Abstract

Problem

Currently, no national practice guidelines or organizations suggest the use of continuous bladder catheterization during labor for women receiving epidural anesthesia (DeSevo & Semeraro, 2010). Despite there being no national practice guidelines supporting the use of continuous bladder catheterization, many labor and delivery units still utilize this method for bladder drainage following epidural anesthesia in labor. The purpose of this project is to evaluate if the type of bladder management post-epidural anesthesia affects the length of the second stage of labor and the mode of delivery after implementation of new intermittent catheterization pilot.

Methods

This quality improvement project …

A Standardized Approach To Awakening And Breathing Trials, Maureen Awuor Abongo

Dissertations

Abstract

Problem: Mechanical ventilation with sedation, are crucial co-therapies for the critically ill. Risks of both, known as Ventilator Associated Events( VAEs), can worsen outcomes. Performing Spontaneous Awakening Trials (SATs), with Spontaneous Breathing Trials(SBTs), is a targeted evidence-based strategy in reducing VAE rates. The Intensive Care Unit (ICU) lacked a coordinated approach to operationalizing SATs with SBTs.

Methods: An observational retrospective study involving a review of VAE and patient data for corresponding months in years before, and after an improvement strategy application, and making comparisons. The multimodal strategy includes filling out checklists outlining criteria for performing a SAT with …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …