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Bioterrorism Hardening: An Exploratory Study Of Emts Preparedness And Practices, Ndubuisi Chinemerem Ejike
Bioterrorism Hardening: An Exploratory Study Of Emts Preparedness And Practices, Ndubuisi Chinemerem Ejike
Walden Dissertations and Doctoral Studies
The 2001 anthrax attacks heightened awareness of the possibility of weaponizing biological agents such as Ebola, anthrax, and smallpox and hence, the Bioterrorism Act of 2002 to prevent biological attacks and reduce bioterrorism threats and vulnerabilities. However, the 2014 Ebola epidemic raised concerns about unpreparedness for bioterrorism within the healthcare community and about secondary infections from healthcare workers. Using Kingdon's conceptualization of multiple streams as the foundation, the purpose of this case study was to explore the nature of bioterrorism threats and the level of preparedness of Emergency Medical Technicians (EMTs) who were involved in the 2014 Ebola epidemic in …
Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam
Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam
Walden Dissertations and Doctoral Studies
Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Despite most common transmission, HPV immunization in adolescents remains below target rates of 80% as outlined by Healthy People 2020 Objectives. Nearly all individuals will contract HPV during their lifetime. The purpose of this project was to educate providers on successfully promoting HPV immunization in adolescents utilizing evidence-based methods. The health belief model (HBM) was the theoretical underpinning utilized to teach providers on discussions about 9vHPV immunization with parents of adolescents. The practice focused question explored whether an education program using concepts from the HBM would …
Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba
Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba
Walden Dissertations and Doctoral Studies
In the Republic of Chad, primary care physicians play a central role in the detection and control of outbreaks and are critical actors in the integrated disease surveillance system through mandatory reporting. Feedback on such surveillance must reveal the needs and perceptions of these physicians. These needs and perceptions were examined using a questionnaire survey distributed to a sampling of 20 physicians in Chad. The purpose of this qualitative study was to investigate the role of primary care providers in the integrated disease surveillance to identify factors that impact complete, quality, and timely reporting. The theory of planned behavior was …
Papanicolaou Test Status Among Inner-City Adolescent Girls In Accra, Ghana, Collins Kwesi Asamoa-Afriyie
Papanicolaou Test Status Among Inner-City Adolescent Girls In Accra, Ghana, Collins Kwesi Asamoa-Afriyie
Walden Dissertations and Doctoral Studies
Cervical cancer is an emerging public health problem in developing countries. Globally, it is the 3rd most common malignancy in women after breast and colorectal cancers and 4th most frequent cancer in women, with an estimated 570,000 new cases and 311,000 deaths in 2018. Cervical cancer screening in the developed countries is credited with the reductions in cervical cancer morbidity and mortality during the last 50 years. However, nearly 90% of cervical cancer deaths occur in less developed countries. Ghana has a cervical cancer rate of 26.4%. Further, it is the highest cancer incidence faced among women 25 to 44 …
Geospatial Analysis Of Care And Mortality In The 2014 Liberia Ebola Outbreak, Marion Carlton Kinkade
Geospatial Analysis Of Care And Mortality In The 2014 Liberia Ebola Outbreak, Marion Carlton Kinkade
Walden Dissertations and Doctoral Studies
The Ebola outbreak in West Africa in 2014 to 2016 had more than 28,000 suspected, probable, and confirmed cases. It was the largest Ebola outbreak in history. Of the 28,000 cases in the three Ebola-affected countries, Liberia had 10,000 cases with almost 5,000 deaths. The Ebola Virus Disease (EVD) entered Liberia along the border of Guinea and moved to the capital city of Monrovia where the virus spread. Ebola Treatment Units (ETUs) were constructed throughout the response in locations where there were available facilities versus distance to care challenges. This study examined the association of distance from villages to ETUs …
Using Sociodemographic Approach To Examine Health Services And Hiv/Aids Awareness In Nigeria, Mercy I. Ebosie
Using Sociodemographic Approach To Examine Health Services And Hiv/Aids Awareness In Nigeria, Mercy I. Ebosie
Walden Dissertations and Doctoral Studies
The purpose of this study was to examine community health services and HIV/AIDS awareness in rural communities in Abia State Nigeria in respect to the sociodemographic factors of level of community health services, level of education, and community leaders' influence. Two questions guided the research process: To what extent are sociodemographic factors associated with HIV/AIDS awareness, and what is the relationship between level of community health services and extent of HIV/AIDS, as perceived by residents of these communities. A mixed method paradigm was used. A sample of 131 participants, who were HIV/AIDS patients, were purposively drawn from a population of …
The Effectiveness Of Two Types Of Adjunct Acupuncture Exposures On In Vitro Fertilization Outcomes, Lindsey Vacovsky
The Effectiveness Of Two Types Of Adjunct Acupuncture Exposures On In Vitro Fertilization Outcomes, Lindsey Vacovsky
Walden Dissertations and Doctoral Studies
One out of every 8 couples experiences infertility. Few publications exist examining the association between the addition of adjunctive therapies when applied to the in vitro fertilization (IVF) procedure and pregnancy outcome. The purpose of this study was to compare the effectiveness of 2 types of adjunct acupuncture exposures on IVF outcomes by applying the concept of the epidemiology triad. The association between the type of adjunct acupuncture exposure received (the independent variable) and pregnancy (the outcome) was determined via binary logistic regression using SPSS software. Medical records of women having received the IVF procedure along with adjunct acupuncture were …
Primary Care And Behavioral Health Services In A Federally Qualified Health Center, Svetoslav A. Arsov
Primary Care And Behavioral Health Services In A Federally Qualified Health Center, Svetoslav A. Arsov
Walden Dissertations and Doctoral Studies
Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were …
Barriers To Utilization Of Malaria Preventive Measures In Rural Nigeria Among Pregnant Women, Olabosipo O. Oreyomi
Barriers To Utilization Of Malaria Preventive Measures In Rural Nigeria Among Pregnant Women, Olabosipo O. Oreyomi
Walden Dissertations and Doctoral Studies
Malaria is a mosquito transmitted tropical disease that accounts for more cases and deaths in Nigeria than in any other country worldwide. Globally malaria accounts for 300,000 deaths among young children and pregnant women annually. The promotion of the use of insecticide treated nets (ITNs) to reduce pregnant women's contact with mosquitoes has been the focus of malaria prevention efforts in Nigeria. However, the use of ITNs during pregnancy has been inexplicably low in Nigeria. A quantitative cross-sectional study was conducted to examine barriers to the utilization of ITNs among pregnant women in rural Nigeria. The social ecological model was …
Influence Of Low Rate Of Reporting Of Adverse Events Following Immunization On Immunization Dropout, Samuel Errie Yenyi
Influence Of Low Rate Of Reporting Of Adverse Events Following Immunization On Immunization Dropout, Samuel Errie Yenyi
Walden Dissertations and Doctoral Studies
Immunization protects millions of children. Yet, many children drop out of immunization in Jigawa State of north Nigeria. This cross-sectional quantitative correlational study based on the Health Belief Model was designed to determine whether the dropout from routine immunization (RI) was influenced by low rate of reporting of adverse events following immunization (AEFI) to health facilities by caregivers. Primary data was collected from 307 caregivers with dropout children using structured interviewer-administered questionnaire. The data were analyzed using logistic regression and descriptive statistics. The results showed that 61.3% of the children had AEFI and dropped out. Rate of reporting of AEFI …
Antenatal Care And Maternal Sociocultural Determinants Of Childhood Immunization In Northern Nigeria, Amaka Tonia Okafor
Antenatal Care And Maternal Sociocultural Determinants Of Childhood Immunization In Northern Nigeria, Amaka Tonia Okafor
Walden Dissertations and Doctoral Studies
Immunization has been recognized globally as a cost-effective public health intervention. However, despite its benefits, children in northern Nigeria are still adversely affected by the negative consequences of inadequate uptake of immunization. The purpose of this study was to assess antenatal care and maternal sociocultural determinants that influence childhood immunization within 2 months of birth in northern Nigeria. Constructs of social cognitive theory were applied to this retrospective correlational cross-sectional inquiry involving women 15-49 years old in northern Nigeria. Secondary data (the 2013 Nigeria Demographic and Health Survey) were analyzed using univariate, bivariate and multivariate logistic regression. Statistically significant (p < 0.05) predictors of uptake of childhood immunization within 2 months of birth were the person who delivered antenatal care, the number of antenatal care visits, the number of tetanus injections, maternal educational level, religion, wealth index, husband/partner educational level, and the person who decides on health care. Educated Christian women from middle-class or rich homes, whose husbands/partners were also educated and who jointly decided on health care, made numerous contacts with health care professionals, and received at least one tetanus injection during antenatal care, had a higher likelihood of immunizing their children within 2 months of birth. The positive social change implications for this study include providing evidence of deterrents to childhood immunization that could lead to relevant policies and interventions leading to healthier children, communities, and society.
Perspectives Of Sierra Leoneans Healthcare Workers' Mental Health During The Ebola Outbreak, Guy O. Taylor
Perspectives Of Sierra Leoneans Healthcare Workers' Mental Health During The Ebola Outbreak, Guy O. Taylor
Walden Dissertations and Doctoral Studies
The mental health of healthcare workers during the Ebola outbreak in West Africa was a serious concern for healthcare professionals and the mental health field. One area in West Africa where healthcare workers played a significant role during the Ebola outbreak of 2014 and 2015 was Sierra Leone. This qualitative research study was designed to explore the perceptions of Sierra Leoneans healthcare workers' mental health, how they coped, and treatment they received while providing care for Ebola virus patients. This study, with a phenomenological research approach, used purposeful sampling to recruit 10 healthcare workers to participate in semi structured, open-ended …
Women's Empowerment As A Policy For Poverty Reduction In Haiti, Flore Saint.Louis Weinstein
Women's Empowerment As A Policy For Poverty Reduction In Haiti, Flore Saint.Louis Weinstein
Walden Dissertations and Doctoral Studies
Women represent more than 50% of the population of Haiti and embody the poorest group due to their lack of socioeconomic development. Numerous nongovernmental organizations (NGOs) including diaspora NGOs (DINGOs) have engaged in the fight to reduce poverty in Haiti by enabling empowerment programs to help women become self-reliant. The programs appear to be ineffective because the level of poverty remains high and there has been little research on the relative effectiveness and sustainability of the programs implemented by the DINGOs. Using the feminist theories of DeBeauvoir and Friedan in conjunction with the empowerment theory of AlMaseb and Julia as …
Predictors And Risk Factors Of Ebola Virus Disease In Sierra Leone, Kandeh Kamara
Predictors And Risk Factors Of Ebola Virus Disease In Sierra Leone, Kandeh Kamara
Walden Dissertations and Doctoral Studies
Sierra Leone had the highest number of cases of Ebola virus disease in history during the 2014 Ebola epidemic. The purpose of this quantitative, cross-sectional study was to examine the relationship between sociocultural and behavioral risk factors and Ebola status among women and men ages 15 to 49 years in Sierra Leone. The ecological model served as the theoretical framework. Secondary data were collected from the Sierra Leone Ebola Disease Survey. Results of chi-square tests revealed that attending a funeral (p = .001), touching a dead body at a funeral (p = .023), contact with a sick person (p = …
Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata
Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata
Walden Dissertations and Doctoral Studies
Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health …
Health Care Determinants Of Cervical Cancer Screening In Harare Zimbabwe, Dominic Chifamba
Health Care Determinants Of Cervical Cancer Screening In Harare Zimbabwe, Dominic Chifamba
Walden Dissertations and Doctoral Studies
Cervical cancer is the second leading cause of cancer deaths among women of all age groups in Zimbabwe, and mortality and incidence continue to increase. The purpose of this quantitative cross-sectional study was to assess the factors that influence the utilization of cervical cancer screening services by Zimbabwean women living in Harare, Zimbabwe. Because personal beliefs influence screening, this study was guided by the health belief model (HBM). A total of 394 women whose ages ranged from 18 to 65 years were recruited from a health care facility in Harare. A 40-item closed-ended questionnaire was used to assess participants' knowledge, …
Patient Satisfaction Management In Office Visits And Telehealth In Health Care Technology, Todd Price
Patient Satisfaction Management In Office Visits And Telehealth In Health Care Technology, Todd Price
Walden Dissertations and Doctoral Studies
Telehealth and remote medical treatments have begun to be more commonly used in healthcare systems. Researchers have theorized that providers' abilities to treat patients are not directly tied to the proximity of the patient to the doctor, but by the identification and treatment of the patient's symptoms. Although the treatment and cure rates are being established within individual health systems and professional medical associations, empirical research is lacking regarding patient satisfaction with this remote treatment situation. The purpose of this quantitative study was to address this gap by examining satisfaction ratings of patients between virtual provider visits and face-to-face provider …
Complementary Infant Feeding Practices In Afghanistan, Hasibullah Na Niayesh
Complementary Infant Feeding Practices In Afghanistan, Hasibullah Na Niayesh
Walden Dissertations and Doctoral Studies
Children are at greater risk of malnutrition in Afghanistan than they are in many other countries. Malnutrition impairs the mental and physical growth of more than 50% of children in Afghanistan. It also exacerbates the risks of mortality by 45% in infants and children in Afghanistan. The purpose of this study was to determine the association between mothers' knowledge, attitudes, and practices regarding complementary feeding and malnutrition in children in Afghanistan. The precaution adoption process model served as a theoretical framework in this quantitative cross-sectional research study. Data analyzed were collected from 306 mothers and children at 6 randomly selected …
Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu
Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu
Walden Dissertations and Doctoral Studies
The study and practice of epidemiology and public health benefit from the use of mortality statistics, such as mortality rates, which are frequently used as key health indicators. Furthermore, multiple causes of death (MCOD) data offer important information that could not possibly be gathered from other mortality data. This study aimed to describe the interrelationships between various causes of death in the United States in order to improve the understanding of the coexistence of MCOD and thereby improve public health and enhance longevity. The social support theory was used as a framework, and multivariate linear regression analyses were conducted to …
Leadership Strategies For Retaining Mariners Aboard State Maritime Academy Training Ships, Augusta D. Roth
Leadership Strategies For Retaining Mariners Aboard State Maritime Academy Training Ships, Augusta D. Roth
Walden Dissertations and Doctoral Studies
The shortage of qualified merchant marines in the United States requires State Maritime Academy (SMA) leaders to develop competitive retention strategies to retain merchant mariners aboard training vessels. The purpose of this single case study was to identify retention strategies that U.S. SMA leaders used to retain mariners aboard training ships. The conceptual framework of this study was Vroom's expectancy theory. The study participants consisted of 5 SMA leaders overseeing the mariners aboard a training vessel. Semistructured interviews and review of SMA documents pertaining to employment strategies provided the study data. The data analysis included collecting and coding data, and …
Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock
Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock
Walden Dissertations and Doctoral Studies
Glycemic control of the perioperative patient improves patient outcomes, specifically prevention of surgical-site infections. The prevention of surgical-site infections helps to reduce complications that can increase length of stay and readmissions, thereby increasing healthcare costs. The purpose of this project was to provide an educational module to the same-day surgery nurses on a clinical guideline to maintain glycemic control of the perioperative patient to prevent surgical-site infections. Lewin's change theory guided the development of a clinical practice guideline (CPG) for nurses to standardize the glycemic management of the perioperative patient. This project was conducted to determine whether educating nurses through …
Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson
Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson
Walden Dissertations and Doctoral Studies
Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also …
Comparison Of Malaria Control Interventions In Southern Africa, Ferdinand Nsengimana
Comparison Of Malaria Control Interventions In Southern Africa, Ferdinand Nsengimana
Walden Dissertations and Doctoral Studies
There is lack of evidence on which of the two highly recommended malaria prevention methods, insecticide treated bednets and indoor residual spraying, is more effective than the other. There is also limited peer reviewed literature that compares the characteristics of people who use the two malaria prevention methods. Based on the Health Belief Model, the research questions tested whether there is any relationship between the use of mosquito bednet or the use of indoor residual spraying and contracting malaria, and whether there is any relationship between sociodemographic and socioeconomic factors and the use of malaria prevention methods. Using a quantitative …
Improving Hand Hygiene In An Intensive Care Unit, Charles Chukwuemeka Njenje
Improving Hand Hygiene In An Intensive Care Unit, Charles Chukwuemeka Njenje
Walden Dissertations and Doctoral Studies
Health-care-associated infections (HCAIs) affect hundreds of millions of people worldwide, causing morbidity and mortality among hospitalized patients. About 2 million patients suffer from HCAIs in the United States, and it is estimated that 99,000 of them die each year. Studies have indicated that transmission of health-care-associated microorganisms occurs through contaminated hands of health care workers. Hand hygiene (HH) is the single most effective way to prevent health-care-associated infections, yet health care workers' hand hygiene compliance remains low. One factor responsible for poor compliance with hand hygiene guide-lines are lack of knowledge of good hand hygiene and lack of hand hygiene …
Comparing A General And Transitional Registered Nurse Orientation To Facilitate Quality Improvement, Kathryn R. Cortes
Comparing A General And Transitional Registered Nurse Orientation To Facilitate Quality Improvement, Kathryn R. Cortes
Walden Dissertations and Doctoral Studies
Most hospitals orient new graduate nurses and experienced nurses in the same generalized orientation programs. To address the cost of orientation to specialty units, a pediatric hospital developed a tailored transitional residency orientation program for experienced nurses. The purpose of this project was to describe, compare, and evaluate the existing generalized orientation program and the transitional orientation program to determine how the orientations differed in structure, process, and outcomes. Donabedian's model assessing quality of care services and Benner's novice-to-expert theoretical framework served as guides in evaluating the orientation outcomes. Qualitative data about residency classroom time, preceptor selection and time, mentor …
Evaluating Parents' Decisions Regarding Recommended Childhood Vaccinations, Jennifer Kline
Evaluating Parents' Decisions Regarding Recommended Childhood Vaccinations, Jennifer Kline
Walden Dissertations and Doctoral Studies
Vaccinations are among the greatest accomplishments of public health. However, many parents are choosing not to vaccinate. The purpose of this study was to explore the association between social media influence and parents' decisions to vaccinate their children. The health belief model indicates that individuals' likelihood of engaging in a health-related behavior is determined by their perceptions of susceptibility, severity, benefits, and barriers. The research questions addressed whether there is an association between parents' perception of their children's disease susceptibility and their decisions about vaccination, and whether there is an association between exposure to messaging from social media and parents' …
Cross Contamination In Levered Endoscopes, Ernest Lowell Thomason Jr.
Cross Contamination In Levered Endoscopes, Ernest Lowell Thomason Jr.
Walden Dissertations and Doctoral Studies
Contamination is a prevalent issue with reprocessed levered endoscopes. The number of infections caused by resistant enterobacteriaceae in patients due to contaminated endoscopes increased to the point that the United States Food and Drug Administration released a safety alert to health care facilities that perform endoscopic retrograde cholangiopancreatography (ERCP). The purpose of this descriptive project was to evaluate if levered endoscopes used in ERCP procedures met high level disinfection criteria, were properly processed, and were germ free after reprocessing. The project was supported by 2 theories: the middle range theory of patient advocacy and the germ theory. Data (counts and …
Factors Affecting Completion Of Childhood Immunization In North West Nigeria, Sule Abdullahi
Factors Affecting Completion Of Childhood Immunization In North West Nigeria, Sule Abdullahi
Walden Dissertations and Doctoral Studies
North West Nigeria has the lowest vaccination rate of the geopolitical regions of the country. The purpose of this cross-sectional study was to examine associations between the parents'/caregivers' biological, cultural, and socioeconomic factors and the completion or noncompletion of routine immunization schedules. Andersen's behavioral model provided the framework for the study. Data were obtained from the 2013 National Demographic Health Survey. Descriptive statistics were calculated for all variables. Chi-square tests were used for categorical predictor variables, simple logistic regression models were used for the age variable, and multiple linear regression models were used for the biological, cultural, and socioeconomic variables …
The Lived Experiences Of Managing Uncertainty In Chronic Illness, Amanda Brown
The Lived Experiences Of Managing Uncertainty In Chronic Illness, Amanda Brown
Walden Dissertations and Doctoral Studies
Chronic illness is an increasing concern in the United States as the CDC reports that about 50% of adults have at least 1 chronic illness. When individuals must adjust to chronic illness they may experience uncertainty regarding the illness, prognosis, and symptoms. The purpose of this qualitative, phenomenological study was to explore the lived experiences of individuals living with uncertainty in chronic illnesses. A Merle Mishel's uncertainty in illness theory was the framework used to explore the lives of individuals diagnosed and living with chronic illness. In-depth interviews were conducted with 8 individuals who have chronic disease; data were audio-recorded …
Perceived Cardiovascular Risk Among West Africa Immigrants In Dekalb County, Georgia, Oluwayomi Fabayo
Perceived Cardiovascular Risk Among West Africa Immigrants In Dekalb County, Georgia, Oluwayomi Fabayo
Walden Dissertations and Doctoral Studies
West African immigrants appear to carry a heavier burden of hypertensive heart disease than the native-born African Americans in the United States. In this study, I used the socioecological model theory as a guide to examine the association between perceived stress, length of stay in United States, smoking status, housing conditions, and the risk of hypertensive heart disease among West African immigrants, ages 18 - 54 years in DeKalb County, Georgia. In this quantitative, cross-sectional design, self-reported data were collected from a sample of West African immigrant (N=107) in the DeKalb County of Georgia, using a demographic data/screening sheet and …