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Walden Dissertations and Doctoral Studies

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Sustainability Challenges For Maize And Cassava Farmers In Amankwakrom Subdistrict, Ghana, Franklin Komla Atadja Jan 2016

Sustainability Challenges For Maize And Cassava Farmers In Amankwakrom Subdistrict, Ghana, Franklin Komla Atadja

Walden Dissertations and Doctoral Studies

Agricultural system in Ghana underperformed because of limited financing, which constrained some small-scale maize and cassava farmers. The purpose of this case study design was to explore the methods that some small-scale maize and cassava farmers in Amankwakrom Subdistrict used in obtaining farm financing. Two themes from the literature review were a lack of collateral for small-scale farm financing and the small-scale farmers cooperative associations' role in farm financing. Regional-scale management sustainability index formed the conceptual framework for this study. Data collection included semistructured face-to-face interviews with 8 fluent English speaking small-scale maize and cassava farmers who have obtained farm …

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Effect Of Genetic Background Combined With Excessive Media Screen Time On Markers Of Cardiovascular Risk In United States Youth Aged Newborn To 20 Years, Maria Moroni Jan 2016

Effect Of Genetic Background Combined With Excessive Media Screen Time On Markers Of Cardiovascular Risk In United States Youth Aged Newborn To 20 Years, Maria Moroni

Walden Dissertations and Doctoral Studies

Time with media screens (television, computers, videogames, cell phones, and tablets) is the primary activity of youth, second only to sleeping, and represents a major risk factor for cardiovascular diseases (CVD). Additionally, the populations with highest rates of screen time are also those most at risk of CVD from genetic predisposition (i.e., Blacks, Hispanics). The purpose of this descriptive, correlational study, based on cross-sectional analysis of archived data from the 2009 - 2010 NHANES for United States youth, newborn to 20 years old, was to determine whether the combination of media screen time with genetic background is a better predictor …

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Risk Factors For Measles Among Hiv-Infected Children In Uganda, Miriam Nanyunja Jan 2016

Risk Factors For Measles Among Hiv-Infected Children In Uganda, Miriam Nanyunja

Walden Dissertations and Doctoral Studies

Measles remains a major global public health problem. Attainment of high population immunity to measles through vaccination is necessary to control this disease. Children infected with HIV infection often experience secondary measles vaccine failure by 2 years of age, making them susceptible to measles. It is not clear whether HIV-infected children on Highly Active Antiretroviral Treatment (HAART), older than 2 years, have a higher risk of measles than HIV-uninfected children. This retrospective cohort study, guided by the proximate determinants framework, was conducted to compare the risk of measles between HIV-infected children on HAART (exposed) and HIV-uninfected peers (unexposed). The age …

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Socioecological Determinants Of Obesity Among Hispanic Parents/Child Caregivers In Aurora, Illinois, Deanna Marie Sommers Jan 2016

Socioecological Determinants Of Obesity Among Hispanic Parents/Child Caregivers In Aurora, Illinois, Deanna Marie Sommers

Walden Dissertations and Doctoral Studies

Obesity has increased during the past 30 years in the United States. Obese adults and children are at risk for cardiovascular disease, diabetes, hypertension, and comorbidities. Parents and child caregivers play key roles in the decisions of family health. Studies exploring sociodemographic and socioecological factors associated with obesity among U.S. Hispanic parents and child caregivers are lacking. Guided by the socioecological model, this study examined the following factors: gender; acculturation; dietary intake of fat, sugar, fruits, and vegetables; and role as food purchaser/food preparer that influenced obesity. A 3-paper-based survey, consisting of a demographic survey, the Block Fat-Sugar-Fruit-Vegetable Screener and …

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Donor Coordination And Health Aid Effectiveness In The Nigerian Health Sector, Ifeoma Edna Uduji Jan 2016

Donor Coordination And Health Aid Effectiveness In The Nigerian Health Sector, Ifeoma Edna Uduji

Walden Dissertations and Doctoral Studies

Development partners and donors increasingly acknowledge the importance of coordinating their activities to achieve the outcome of the official development assistance to developing countries. Although stakeholders have recognized the importance of harmonizing donors and development partners' efforts in the Nigerian health sector, little research has addressed the influence of coordination on the health aid effectiveness. This qualitative case study determined the influence of coordination among the donors and development partners involved in the HIV/AIDS, malaria, and nutrition program on the outcome of these programs in Nigeria. Data were collected through interviews with 22 program officers participating in the health programs …

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Experiences Of Chronic Disease Self-Management Program Leaders, Laketa Monique Hillman Jan 2016

Experiences Of Chronic Disease Self-Management Program Leaders, Laketa Monique Hillman

Walden Dissertations and Doctoral Studies

Chronic conditions are public health threats. The Chronic Disease Self-Management Program (CDSMP) is an evidence-based disease management program that addresses personal self-management of chronic conditions. The CDSMP involves peer trainers who instruct and assist with chronic disease preventive measures. Although disease management demonstrates promise to improving patient self-maintenance, previous researchers have not evaluated how the program affects program leaders. The purpose of this study was to discover how self-help leaders feel about the CDSM program. The overarching research question asked about perspectives that self-help leaders had toward the program. Through a narrative qualitative approach, the perceptions of peer leaders were …

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Implementation And Evaluation Of Dietary Modification With Gestational Diabetes, Celia T. Ojeaga Jan 2016

Implementation And Evaluation Of Dietary Modification With Gestational Diabetes, Celia T. Ojeaga

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus (GDM) negatively affects the health of both mothers and babies, and is the most common pregnancy complication in the United States. Many dietary modification programs for pregnant women diagnosed with GDM rely on a one-size-fits-all approach to menu planning. The purpose of this project was to develop a diet modification program for GDM management using a patient-centered approach. The project objective was to develop the policies, procedures, and supporting documents needed to implement a successful GDM management program for pregnant women receiving antenatal care at an obstetrical clinic. The developed program incorporated strategies for clinic nursing staff …

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Self-Care Activities And Nurse Manager Well-Being, Gretchen Eileen Johnson Jan 2016

Self-Care Activities And Nurse Manager Well-Being, Gretchen Eileen Johnson

Walden Dissertations and Doctoral Studies

The role of the nurse manager is important in organizations and influences outcomes such as the safety and quality of care provided on a unit, satisfaction, turnover of nursing staff, and overall health of the work environment. Stressors for managing nurses can impair physical and emotional health and lead to poor patient and staff satisfaction, safety, and outcomes. The evidence-based practice project will explore nurse managers' well-being and self-care activities. The theoretical framework of the project is the Relationship-Based Care Model as well as Kotter's change theory. The literature suggests that self-care activities can reduce stress and improve well-being. A …

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Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi Jan 2016

Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi

Walden Dissertations and Doctoral Studies

Highly active antiretroviral therapy (HAART) contributes to metabolic disorders and the growing prevalence of metabolic syndrome (MetS) in human immunodeficiency virus (HIV)-infected patients. Hypertension, obesity, and hyperglycemia (components of MetS) are risk factors for cardiovascular disease. Studies have shown that HIV patients on HAART have a 2-fold risk of dying from MetS. There are no such studies in Umuahia; hence the need for this study to fill this gap. Using a sample size of 192 medical records of HIV-infected patients in Federal Medical Centre, Umuahia, and applying metabolic syndrome theory, this study examined the relationships among types of HAART regimen, …

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Professional Development Of Head Start Teachers In Emotional And Instructional Support, Marilyn Mcleod Harris Jan 2016

Professional Development Of Head Start Teachers In Emotional And Instructional Support, Marilyn Mcleod Harris

Walden Dissertations and Doctoral Studies

In the southwest region of Tennessee, a local Head Start program classroom assessment scoring system's (CLASS) scores fell in the lowest 10% among national Head Start programs in emotional and instructional support. Since 2012, the Office of Head Start has released reports showing that the average Head Start program has low performance CLASS emotional and instructional support scores. The purpose of this exploratory case study was to investigate the professional development of local Head Start teachers with low CLASS scores in emotional and instructional support. Knowles's adult learning theory of andragogy was the overall conceptual framework and the concentrated theory …

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A Multiple Case Study On Leader Support, Breastfeeding, And Work Commitment, Lisa Marie Rancourt Jan 2016

A Multiple Case Study On Leader Support, Breastfeeding, And Work Commitment, Lisa Marie Rancourt

Walden Dissertations and Doctoral Studies

In the United States, over 50% of women return to paid work after becoming mothers. Mothers who breastfeed are more likely to stop working than peers who chose to use infant formula. The purpose of this research was to explore work commitment among new mothers during the first year of their infant's life. Many of these mothers had skills that were imperative to organizational success, making their retention a priority. The relationship between leadership support for dual roles as mothers and employees had not received attention previously in the literature. This multiple case study analyzed the perceptions of new mothers …

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Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols Jan 2016

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

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Predictors Of Excessive Alcohol Consumption Among U.S. Business Travelers, Jennifer Clore Barrickman Jan 2016

Predictors Of Excessive Alcohol Consumption Among U.S. Business Travelers, Jennifer Clore Barrickman

Walden Dissertations and Doctoral Studies

Excessive alcohol consumption (EAC) is an important public health problem. Several researchers have examined work-related influences on EAC, but few have investigated the predictors of EAC related to business travel. This study measured the association between EAC and frequency of business travel, duration of business travel, and job industry among U.S. business travelers. Research was conducted within the social-ecological theoretical framework. Snowball sampling was used to gather data from 187 business travelers. Data were evaluated using bivariate analysis to assess the association between measures of EAC and each independent variable. Multiple logistic regression was used to adjust for covariates. Respondents …

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Training And Experiences Of General Educators Who Have Students With Externalizing Behaviors, Sheila Ruann Lachelt Jan 2016

Training And Experiences Of General Educators Who Have Students With Externalizing Behaviors, Sheila Ruann Lachelt

Walden Dissertations and Doctoral Studies

In California classrooms, general education teachers have experienced stress due to an increasing number of students with emotional and behavioral disorders (EBD). This study used a hermeneutical phenomenological inquiry approach to explore teachers' perspectives of their pre-service professional development (PD), in-service PD, and classroom experiences with students who have externalizing EBD. The theoretical framework centered on social constructivism. Research questions addressed the teachers' perceptions of their pre-service and in-service PD on students with EBD and their experiences with students' externalizing behaviors. Twenty California general education teachers, each from a different school district, volunteered to participate in face-to-face interviews. Stratified purposeful …

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Standardized Assessments, Care Planning, And Improved Quality Of Life For Residents Of Adult Family Homes, John A. Rogers Jan 2016

Standardized Assessments, Care Planning, And Improved Quality Of Life For Residents Of Adult Family Homes, John A. Rogers

Walden Dissertations and Doctoral Studies

Quality of life for adults living in adult family homes requires further attention as the elderly population continues to grow and moves from minority to majority. There is a lack of data on residents in adult family home settings and their quality of life. The purpose of this project was to identify if individualized nursing care plans had an impact on the residents' quality of life in the adult family home. In this study, a registered nurse assessed the residents to create an individualized nursing care plan that would be implemented to improve quality of life. These care plans were …

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Bedside Nurse Recognition Of Delirium In The Medical-Surgical Setting, Bridget Ann Denzik Jan 2016

Bedside Nurse Recognition Of Delirium In The Medical-Surgical Setting, Bridget Ann Denzik

Walden Dissertations and Doctoral Studies

Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was …

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Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco Jan 2016

Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …

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Type 2 Diabetes Prevention And Management In A Primary Care Clinic Setting, Ada Nwachuku Nwachuku Jan 2016

Type 2 Diabetes Prevention And Management In A Primary Care Clinic Setting, Ada Nwachuku Nwachuku

Walden Dissertations and Doctoral Studies

Approximately 8.3% of the U. S. population has type 2 diabetes. Preventing the onset and improving the management type 2 diabetes are crucial for health care professionals. The purpose of this project was to develop and evaluate a type 2 diabetes prevention and management education program in a primary care setting using group medical appointments (GMAs). The chronic care model provided the framework for the study. The education program consisted of information from the Centers for Disease Control on the management of type 2 diabetes to be delivered by clinic staff using a GMA approach, a timeline for implementing the …

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Using Sbar To Decrease Transfers From The Long-Term Care To The Emergency Room, Phyllis Marie Bowers Garrett Jan 2016

Using Sbar To Decrease Transfers From The Long-Term Care To The Emergency Room, Phyllis Marie Bowers Garrett

Walden Dissertations and Doctoral Studies

Care of the elderly, long-term care resident in the emergency department is an issue of importance because of the overall impact on healthcare costs, potential for negative outcomes for the resident, and the loss of revenue. The purpose of this project was to decrease avoidable transfer of residents to the Emergency Department. Using the Antecedent, Target, Measurement logic model, poor quality assessment data was deemed the antecedent of the avoidable transfer. The goal of the project was the implementation of a standardized process of assessment that would have decreased avoidable transfer of the resident. The project would have involved training …

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Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson Jan 2016

Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a deadly, yet curable, infectious disease that continues to be a global health threat. Armenia suffers from rising TB incidence and mortality rates. Armenians living in Los Angeles (LA) County, where TB incidence is higher than national averages, is the second largest Armenian community in the world; therefore implications are that many TB cases are attributed to this group. Using the social ecological model as a theoretical framework, this concurrent, mixed-methods study compared Armenians to non-Armenians in LA County about their knowledge of TB and perceived barriers to seeking and adhering to treatment. Bivariate chi-square analysis from …

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African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard Jan 2016

African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard

Walden Dissertations and Doctoral Studies

Insufficient physical activity detracts from healthy living and has a disparate impact on African American women and their female children. The extensive body of prior research addressing preventable chronic disease and other consequences of insufficient physical activity includes limited information specific to African American single mothers. The purpose of this descriptive phenomenological study was to gain an understanding of African American single mothers' perceptions of physical activity. Specifically investigated were African American women's familial influences and potential effects of these influences on their children's health behaviors. The health belief model served as the theoretical framework for this study and provided …

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Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling Jan 2016

Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling

Walden Dissertations and Doctoral Studies

The oral health and hygiene of incarcerated populations, both in the United States and globally, is known to be poorer than that of the general population. This study examined the prevalence of dental caries and periodontal disease and the relationships between oral health status and the oral health knowledge, attitudes, and practices of jail inmates housed in a large metropolitan jail located in the midwestern United States. This cross-sectional study collected data from 100 inmates using a 21-item closed-ended questionnaire in addition to oral examinations conducted by the jail's dentist to determine the extent of dental caries and periodontal disease …

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Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton Jan 2016

Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton

Walden Dissertations and Doctoral Studies

Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining …

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Water Management Efficiency In The Food And Beverage Industry, Maria Del C Reyes Torres Jan 2016

Water Management Efficiency In The Food And Beverage Industry, Maria Del C Reyes Torres

Walden Dissertations and Doctoral Studies

Water is critical for food production, food security, and health. Water quality management influences freshwater sustainability, land, and energy administration. Global agriculture accounts for more than 70% of all water consumption; the fertilizer, manure, and pesticide overspills are chief sources of water pollution worldwide. On a global scale, food-related waste directly impacts local food production and water resource management. The purpose of this multiple-case study on the food and beverage (FB) industry in the State of Georgia was to identify successful strategies for improving water management efficiency. The concepts of systems thinking, adaptive resource management, and integrated water resource management …

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Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls Jan 2016

Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls

Walden Dissertations and Doctoral Studies

Over 17 million food-insecure households are associated with increasing obesity rates across the United States. Although food insecurity and obesity are distinct social concerns, the two are linked and may be influenced by poverty and geographic location. Public health authorities and state leaders responsible for the health and nutrition of rural populations in particular would benefit from this information. The purpose of this quantitative cross-sectional study was to examine whether poverty mediated the relationship between food insecurity and obesity among urban and rural adults. The study was guided by the poverty, food insecurity, and obesity conceptual framework. The study addressed …

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Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre Jan 2016

Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre

Walden Dissertations and Doctoral Studies

While epidemiological research has generated new knowledge about the treatment and prevention of chronic obstructive pulmonary disease (COPD) through smoking secession, the socioeconomic status (SES) of people with the disease has been under investigated. Thus, the purpose of this study was to determine the predictability of association between SES and COPD. This study was based on the ecological theory, which states that health and disease may have multiple underlying factors. This study was a secondary analysis of archived data from the Inter-University Consortium for Political and Social Research (ICPSR). The dataset was collected for the National Survey of Midlife Development …

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Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader Jan 2016

Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader

Walden Dissertations and Doctoral Studies

Widespread consumption of canned tuna fish since the 1950s may explain some of the increase in breast cancer prevalence in the United States and Europe. Although canned tuna is the primary source of human exposure to methylmercury, its role as an estrogen activating metalloestrogen has been overlooked in the etiology and incidence of breast cancer. Carcinogenic theory asserts that increased exposure to estrogen elevates the risk of breast cancer. The purpose of this population-based, case control study was to examine the association between canned tuna consumption, total blood mercury, and breast cancer in the NHANES 2003-2006 surveys. A multivariable logistic …

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The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran Jan 2016

The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran

Walden Dissertations and Doctoral Studies

Lack of accessibility to healthy foods is a factor associated with the increase in obesity, diabetes, and other negative health consequences. While programs such as WIC (Women, Infants, and Children) provide supplemental nutritional access to healthy foods, few organic food items are included in the WIC authorized food list. Government programs and policy makers that provide to the most vulnerable populations are concerned about equal availability of healthy foods. The purpose of this study was to compare variability and cost of organic food items in 24 large chain grocery stores located in high- and low-income areas. The theoretical concepts of …

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Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua Jan 2016

Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua

Walden Dissertations and Doctoral Studies

Native-born African Americans (NBAA) bear a disproportionate burden of the effect of hypertension (HTN) in comparison to other racial groups in the United States. West African immigrants (Foreign-born African Americans) appear to carry a heavier burden than the NBAA in the United States. Using the social support theory as a guide, this study examined the association between the need to meet socioeconomic responsibility of financial and familial obligations (SERFFO) and perceived stress and the increased likelihood of HTN among West African immigrants, aged 25-54 years, in the United States. In this quantitative, cross-sectional design, self-reported data were collected from a …

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Self-Efficacy, Perceived Skills, And Real Knowledge Of Speech-Language Pathologists, Meredith Lynn Baker-Rush Jan 2016

Self-Efficacy, Perceived Skills, And Real Knowledge Of Speech-Language Pathologists, Meredith Lynn Baker-Rush

Walden Dissertations and Doctoral Studies

Although speech language pathologists' (SLPs) knowledge of communication and swallowing has been undisputed, their knowledge and skills related to tracheostomy and mechanical ventilation (MV) seem varied. The consequences associated with the presence of tracheostomy or MV demonstrate the necessity of training. Guided by Bandura's social cognitive theory, this study was designed to determine if SLPs' training influenced self-efficacy and real knowledge, and to evaluate trends associated with SLPs' pursuit of specialized training. A total of 236 SLPs practicing in the United States responded to a researcher-developed knowledge and confidence test for tracheostomy and mechanical ventilation (KCT-TMV). Data were analyzed via …

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