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2015

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Planning For A Community Supported Farmers Market In A Rural Usda Food Desert, Carrie Lynn Engelbright Jan 2015

Planning For A Community Supported Farmers Market In A Rural Usda Food Desert, Carrie Lynn Engelbright

Walden Dissertations and Doctoral Studies

A community initiative to develop and sustain a farmer's market can address insufficient access to fresh and affordable fruits and vegetables for individuals working and residing in a United States Department of Agriculture (USDA) designated food desert. This project addressed a particular USDA food desert in South Wood County, Wisconsin. The purpose of this project was to develop and plan for implementation and evaluation of a community-supported farmers market in South Wood County, with the goal to increase access to fruits and vegetables. Project objectives included development of a sustainable community infrastructure to support the market, development of policies and …

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Psychosocial Determinants Of Elective Cesarean Section Deliveries In Selected Obstetric Facilities In Nairobi, Kenya, Tom Joseph Oguta Jan 2015

Psychosocial Determinants Of Elective Cesarean Section Deliveries In Selected Obstetric Facilities In Nairobi, Kenya, Tom Joseph Oguta

Walden Dissertations and Doctoral Studies

Cesarean section (CS) rates have generally increased across the world in the past decade. Reducing elective cesarean section (ECS) rates is imperative as many countries aim to maintain threshold CS rates at or below 15%, the level recommended by the United States' National Institutes of Health. Women are believed to consider ECS for various interconnected psychosocial reasons, but few quantitative studies have investigated these factors. This prospective cohort study was based on the social ecological model (SEM) and the theory of planned behavior (TPB) models, and identified the psychosocial predictors of ECS among 1,268 expectant women in 2 hospitals in …

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Herpes Virus Infections, Inflammatory Markers And Risk Of Developing T2dm And Cvd: An Analysis Of Nhanes With Adults, Aged 20-49, 1999-2010, Margarita Irizarry-De La Cruz Jan 2015

Herpes Virus Infections, Inflammatory Markers And Risk Of Developing T2dm And Cvd: An Analysis Of Nhanes With Adults, Aged 20-49, 1999-2010, Margarita Irizarry-De La Cruz

Walden Dissertations and Doctoral Studies

Herpes simplex viruses (HSVs), are among the most virulent and widespread pathogens; they affect 60-90% of the population worldwide. Substantial evidence indicates a possible association between pathogens and chronic disease. HSVs, among other viruses, have been associated with increased risk for inflammatory diseases. However, prior findings have been inconsistent on the role of infection in triggering autoimmune response and chronic disease. This study builds on the premise that pathogens can induce an inflammatory response and increase the risk for disease development. A representative U.S. sample from NHANES, a national population-based cross-sectional survey, was used to examine the relationship between HSVs …

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Caregiver Status And Self-Reported Health Status Among African American, Phanta Soko Sackor Jan 2015

Caregiver Status And Self-Reported Health Status Among African American, Phanta Soko Sackor

Walden Dissertations and Doctoral Studies

African American women (AAW) are at a high risk for type 2 diabetes, a debilitating and potentially fatal disease for which there is no cure. The purpose of this study was to extend the research of Mosca et al. (2012) by examining the relationship between caregiver status and self-reported health status for AAW 18 years or older diagnosed with type 2 diabetes. The chronic care model (CCM) provided the theoretical framework for this study. The CCM promoted routine care for patients with chronic illnesses to migrate from acute care to proactive, planned, and risk-based protocols. A binomial logistic regression investigated …

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Vitamin D Deficiency And Immune Function In African American, Hiv-Infected Men, Rana H. Ismail Jan 2015

Vitamin D Deficiency And Immune Function In African American, Hiv-Infected Men, Rana H. Ismail

Walden Dissertations and Doctoral Studies

Vitamin D deficiency is common in individuals diagnosed with HIV and is known for its detrimental health effects. Its recognition as a potent immune-modulator with possible immune health implications in HIV disease progression was the main impetus for this study. The association between Vitamin D and CD4 count falls short of being consistent and is too weak to allow conclusions. Similarly, the literature is inconsistent with regard to the impact of Vitamin D supplementation on CD4. This observational, retrospective chart review study aimed to explore the relationship between Vitamin D deficiency and CD4 count/percent, and to evaluate whether changes in …

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Food Policy: Urban Farming As A Supplemental Food Source, Bessie Didomenica Jan 2015

Food Policy: Urban Farming As A Supplemental Food Source, Bessie Didomenica

Walden Dissertations and Doctoral Studies

The distance between farms and cities and the limited access that some residents have to fresh foods can be detrimental to a city's capacity to feed people over time. This study addressed the under-studied topic of urban farming as a secondary food source, specifically by exploring the opportunities and limitations of urban farming in a large Northeastern city. Brundtland's food policy was the pivotal theory supporting food production to end global starvation, and was the link between environmental conservation and human survival. The research question for this study examined the potential food policy opportunities and limitations that assist urban farms …

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Impact Of Whole Grain Consumption Compliance On Gluten Sensitivity And Bowel Health, Sarah Anne Roberts Jan 2015

Impact Of Whole Grain Consumption Compliance On Gluten Sensitivity And Bowel Health, Sarah Anne Roberts

Walden Dissertations and Doctoral Studies

While many health benefits have been associated with increased whole grain consumption, current researchers have not considered if the consumption of whole grains in currently recommended or higher amounts actually leads to health problems, specifically to a correlated increase in gluten sensitivity. The purpose of this study was to determine if diets high in whole grains or those that met the recommended daily intake of whole grains help minimize or increase gluten sensitivity, and when whole grains are consumed as recommended if they cause more harm than good. The theoretical basis for this quantitative, cross sectional design was the precaution …

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Relationship Between Whole-Person Learning And Growth Mindset In First-Generation Learners, Marian Willeke Jan 2015

Relationship Between Whole-Person Learning And Growth Mindset In First-Generation Learners, Marian Willeke

Walden Dissertations and Doctoral Studies

Growth mindset is an important component for a journey towards self-actualization. It is unknown if whole-person learning can assist development of that growth mindset for first-generation learners. The purpose of this quasi-experimental study was to examine if exposure to whole-person learning positively influences a growth mindset by exploring the relationship between whole-person learning and a growth mindset in first-generation learners. Whole-person learning was presented as a vehicle for developing that growth mindset towards self-actualization. Dweck's Mindset Survey scores were collected from first-generation learners who participated in orientation courses either with or without whole-person learning in 4 institutions (n = 177) …

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Support Of Maternity Care Practices To Increase Breastfeeding Among First-Time Mothers, Jessica Strauch Jan 2015

Support Of Maternity Care Practices To Increase Breastfeeding Among First-Time Mothers, Jessica Strauch

Walden Dissertations and Doctoral Studies

Breastfeeding offers numerous health benefits to both the mother and infant, yet it is not routinely practiced due to a number of internal and external factors that influence the mother's decision. Guided by the social ecological model, the purpose of this study was to examine the effect of required reporting to The Joint Commission on perinatal measures, a proxy measure for maternity care practices, and those professional effects on breastfeeding initiation and exclusivity for first-time mothers. The hypotheses were that the mandatory reporting, and thus an increase in maternity care practices, would increase the initiation of breastfeeding and exclusive breastfeeding …

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The Impact Of Immigration Variables On Tuberculosis Rates In South Carolina, Lisa J. Dimitriadis Jan 2015

The Impact Of Immigration Variables On Tuberculosis Rates In South Carolina, Lisa J. Dimitriadis

Walden Dissertations and Doctoral Studies

After HIV/AIDS, tuberculosis (TB) is the deadliest single infectious agent worldwide; globally in 2013, 1.5 million people died of the disease. Although TB infection rates in the United States are low compared to that of other countries, TB still remains a threat to public health in the U.S., especially among immigrant populations. The main purpose of this study was to investigate the correlations between the independent variables of immigration status, years of residence, and race/ethnicity and the dependent variable of TB infection within South Carolina between 2006 and 2012. To examine these possible relationships, this quantitative study employed the ecological …

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Predictors Of Knowledge Of Stroke And Intent To Call 911 Among African Americans, Hyacinth Idu Hyacinth Jan 2015

Predictors Of Knowledge Of Stroke And Intent To Call 911 Among African Americans, Hyacinth Idu Hyacinth

Walden Dissertations and Doctoral Studies

Stroke is associated with significant health disparity and predominantly affects the elderly. Stroke outcome is significantly improved if an individual is able to get "clot-bursting" medication. A significant predictor of an on-time arrival to the emergency room for treatment in the event of a stroke is the ability to accurately recognize stroke signs and symptoms. The purpose of this study was to determine the factors (demographic, socioeconomic, and educational) that predict the knowledge of stroke signs/symptoms and intent to call 911 in the event of a stroke. The study was grounded in the social ecological theoretical model and analyzed archived …

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A Proposal For The Development And Validation Of A Diabetic Self-Management Education (Dsme) Program, Melissa Sue Garrison Jan 2015

A Proposal For The Development And Validation Of A Diabetic Self-Management Education (Dsme) Program, Melissa Sue Garrison

Walden Dissertations and Doctoral Studies

The World Health Organization has estimated that by 2030, approximately 350 million people will be diagnosed with Type 2 diabetes mellitus (T2DM). Currently, 18.8 million people are diagnosed with T2DM. An additional 7 million people have high blood sugar but have yet to have an official diagnosis of diabetes. The literature supports early identification and prevention are key to reducing the severity of T2DM its complications. The Health Belief Model, the Chronic Care Model and Orem's Theory of Self-Care guided the current proposal, whose purpose was to develop and validate a new T2DM DSME module. A validation of the DSME …

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Exploring Yoga As A Holistic Lifestyle For Sustainable Human And Environmental Health, Julia A. Leischner Jan 2015

Exploring Yoga As A Holistic Lifestyle For Sustainable Human And Environmental Health, Julia A. Leischner

Walden Dissertations and Doctoral Studies

Improved health indicators, mental and physical health outcomes, and sustainable lifestyle practices have been found among yoga practitioners. The purpose of this study was to examine the impact of mixed styles of yoga practice on the health and behaviors of yoga practitioners. The relationship between yoga and body mass index (BMI), self-reported disease diagnosis, participation in other types of physical activity, adoption of healthy and sustainable lifestyle and dietary behaviors, perceived improvements in medical conditions that yoga was used to treat, quality of life resulting from yoga practice, and the reasons for beginning and continuing yoga were observed and tested …

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Correctional Nurses' Knowledge And Perceptions Of Methicillin-Resistant Staphylococcus Aureus, Deborah Winbush Jan 2015

Correctional Nurses' Knowledge And Perceptions Of Methicillin-Resistant Staphylococcus Aureus, Deborah Winbush

Walden Dissertations and Doctoral Studies

Since 1999, Methicillin-resistant Staphylococcus aureus (MRSA) outbreaks have occurred in many correctional facilities. Even after the Federal Bureau of Prisons developed clinical practice guidelines on the management of MRSA within correctional facilities, the prevalence of MRSA decreased only insignificantly. Other researchers suggested infection control compliance was equally as important as developing clinical practice guidelines in reducing the incidence of MRSA. Several studies identified the healthcare professionals' nonadherence and inconsistencies to clinical practice guidelines as contributors to MRSA transmission. Accordingly, this project was designed to develop evidence-based recommendations for improving nurse professionals' adherence to MRSA practice guidelines in correctional settings. Using …

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Why Some Women Eat Too Much: A Qualitative Study Of Food-Dependent Women, Gigi Van Ostrand Jan 2015

Why Some Women Eat Too Much: A Qualitative Study Of Food-Dependent Women, Gigi Van Ostrand

Walden Dissertations and Doctoral Studies

Obesity has become a worldwide epidemic and limiting one's food intake, or dieting, is usually unsuccessful. The purpose of the study was to explore the effect of food addiction (FA) on the current clinical and behavioral epidemic of obesity. FA, synonymous with food-dependency, is tentatively defined as an eating disorder based on substance dependence, as defined by the Diagnostic and Statistical Manual of Mental Disorders. Measurement of FA has been operationalized by the Yale Food Addiction Scale (YFAS) by applying the diagnostic criteria of substance dependence to eating behaviors. This study was based on the biological theory of chemical addiction …

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The Association Of Maternal Health Literacy Levels And Preterm Birth, Aimee Moynihan Jan 2015

The Association Of Maternal Health Literacy Levels And Preterm Birth, Aimee Moynihan

Walden Dissertations and Doctoral Studies

According to the CDC, each year approximately 0.06 % of the world's population dies in infancy. The March of Dimes indicated that the leading causes of infant mortality include birth defects, preterm birth, low birth weight, sudden infant death syndrome, maternal complications of pregnancy, and respiratory distress syndrome, most of which are considered preventable with access to adequate prenatal care by mothers. The goal of this study was to examine the association between maternal health literacy levels and preterm birth. This research was based on the theoretical framework of the Interaction Model of Client Health Behavior. The hypothesis for this …

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A Transition-To-Practice Residency That Supports The Nurse Practitioner In A Critical Access Hospital, Nancy Jean Stock Jan 2015

A Transition-To-Practice Residency That Supports The Nurse Practitioner In A Critical Access Hospital, Nancy Jean Stock

Walden Dissertations and Doctoral Studies

Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs or physician assistants without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in education and practice expectations and leading to significant role transition stress and turnover. The purpose of this project was to construct an evidence-based transition-to-practice residency program to support NPs providing emergency department care in the CAH. Theoretical frameworks used to …

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Technology As A Health Intervention And The Self-Efficacy Of Men, Karen Denise Maxwell Jan 2015

Technology As A Health Intervention And The Self-Efficacy Of Men, Karen Denise Maxwell

Walden Dissertations and Doctoral Studies

Mortality rates in the United States are higher for men than they are for women as a result of chronic diseases such as heart disease, cancer, and diabetes. Despite these disproportionate rates, few health interventions are targeted to men, and limited knowledge exists regarding the specific components needed to design technology health tools to appeal to men. The purpose of this quantitative study was to examine the relationship between the use of technology health tools and the role of self-efficacy in men and the influence on participation in healthy lifestyle behaviors. A quasi-experimental design was used to analyze data collected …

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Practice Guidelines For Self-Management Of Osteoarthritis Pain In The Home-Based Settings, Oyesola Omowunmi Akintan Jan 2015

Practice Guidelines For Self-Management Of Osteoarthritis Pain In The Home-Based Settings, Oyesola Omowunmi Akintan

Walden Dissertations and Doctoral Studies

Osteoarthritis (OA) is a debilitating chronic illness that can prevent older adults from accomplishing their activities of daily living or ambulate without pain. The project's purpose was to develop and disseminate multidisciplinary educational practice guidelines to nurses for use in older homebound male Veteran's Administration OA patients to improve home-based pain management and self-care preventative strategies. Orem's theory of self-care management constituted the theoretical framework. The design was a quality improvement project and involved formation of 6 panels of interdisciplinary teams who reviewed the American Society of Anesthesiologist (ASA) and Osteoarthritis Research Society International (OARSI) guidelines. The ASA and OARSI …

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Facilitating Weight Tolerance Among Health And Fitness Majors Toward Obese Persons, Stephanie Boss Jan 2015

Facilitating Weight Tolerance Among Health And Fitness Majors Toward Obese Persons, Stephanie Boss

Walden Dissertations and Doctoral Studies

Weight bias exists in some health-related degree programs. Overweight and obese persons who experience weight bias in health-related services often delay or avoid medical attention altogether. Guided by the attribution theory, the purpose of this sequential explanatory study was to examine weight bias among health majors at a southwest regional university to illuminate how attitudes can affect the level of care provided to overweight persons. The Attitudes toward Obese Persons (ATOP) scores from a convenience sample of 184 health majors revealed that participants' scores were found to be significantly lower than the midpoint (60) of the ATOP scale, M = …

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Best Predictors Of A Person's Long-Term Success With Quitting Tobacco, Nhu-Tam P. Villar Jan 2015

Best Predictors Of A Person's Long-Term Success With Quitting Tobacco, Nhu-Tam P. Villar

Walden Dissertations and Doctoral Studies

Smoking relapse rates among tobacco users remain high after quit attempts, with or without interventions. Though researchers have examined stress-related factors contributing to high relapse rate, little empirical research has concentrated on variables predicting long-term quit maintenance. The purpose of this study was to determine the predictability of stress management tools, including exercise motivation, eating behaviors, social support, and self-compassion, as well as the significant combined variance of these variables, in a person's long-term maintenance with tobacco use abstinence. Bandura's social cognitive theory was used to highlight the factors contributing to health behavior such as tobacco use. This study involved …

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Correlations Between Childhood Obesity And Obesogenic Environmental Variables Within Durham County, North Carolina, Eureka Capri Daye Jan 2015

Correlations Between Childhood Obesity And Obesogenic Environmental Variables Within Durham County, North Carolina, Eureka Capri Daye

Walden Dissertations and Doctoral Studies

The application of geographic information systems was used to map obesogenic conditions by zip code tabulation areas in Durham County, North Carolina and evaluated associations between those conditions and the understudied area of early childhood obesity. Of the thirty one percent of the children in Durham County, North Carolina who were considered obese in 2010, four hundred and thirty three (1:5) 2 - 4 year old children who received supplemental nutrition services for women, infants and children were obese with BMI levels greater or equal to the 95th percentile and were used as the criterion variable in the study (N=433). …

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Steps To Reducing Heart Failure Hospital Readmissions Through Improvement In Outpatient Care, Paticia Laubach Dunn Jan 2015

Steps To Reducing Heart Failure Hospital Readmissions Through Improvement In Outpatient Care, Paticia Laubach Dunn

Walden Dissertations and Doctoral Studies

The outpatient care of the heart failure (HF) patient is fragmented due to the lack of evidence-based practice guidelines use. The primary goal of this project was to improve the care of the HF patient in the outpatient arena through use of clinical pathways using the logic model as the project framework. The intervention was carried out over a 4-week period on a convenience, random sample of patients (n = 80) attending a cardiology practice. The patients were recruited from 2 physicians' patient populations and were selected based on an adult diagnosis of HF, reduced ejection fraction of <40% at some point in time, and the New York Heart Association (NYHA) functional class II-V. Comparisons were made in the documentation of care between patients on or off the pathway. The intervention included documentation of patient education, care follow-up, medications, NYHA functional class, and symptom exacerbation, documented in the electronic medical record. The quality of care data were evaluated based on 3 of the Joint Commission core measures for outpatient care of the HF patient. Additional data were collected regarding use of the clinical pathway based on provider and week of implementation. Data were analyzed via a Chi-square test of independence comparing pathway use by provider and use of pathway as study progressed. The comparative results show statistically significant differences in use of the pathway by provider and a statistically significant increase in use during the project . The quality of care results varied in statistical significance. The pathway utilization increased over time and provided a method for standardizing documentation of care for the HF patient in this outpatient clinic, a benefit for HF patients and providers in this cardiology practice and beyond.

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The Effects Of Barriers Toward Fighting Childhood Obesity Within Head Start, Vanessa Chaney Jan 2015

The Effects Of Barriers Toward Fighting Childhood Obesity Within Head Start, Vanessa Chaney

Walden Dissertations and Doctoral Studies

Childhood obesity is associated with significant morbidity and mortality and poses a health care burden. Child care facilities serve at the forefront in fighting childhood obesity among preschoolers. Since 2009, a significant shift has occurred in studying child care settings among children aged 3-5 in North Carolina and South Carolina in response to the rising rates of obesity in this population. Some of the hypothesized determinants of childhood obesity among preschoolers in North Carolina and South Carolina are outdoor activity, staff behavior, center's size and location. The purpose of this study was to investigate if significant relationships exist between childhood …

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The Influence Of Nursing Home Administrator Turnover On Resident Quality Of Life, Juliet Iheoma Madubata Jan 2015

The Influence Of Nursing Home Administrator Turnover On Resident Quality Of Life, Juliet Iheoma Madubata

Walden Dissertations and Doctoral Studies

By 2040, 79.7 million older adults will live in the US, and nearly 40% will need nursing home services that are primarily funded by Medicare and Medicaid. Researchers have underscored the importance of leadership in quality healthcare care delivery, suggesting that nursing home administrator turnover could influence resident quality of life, causing ill-health for the residents and preventable medical costs for taxpayers. In spite of the suggested association, little research has specifically examined the role of administrator turnover on resident quality of life. As such, the purpose and central research questions of this case study were designed specifically to address …

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Perceived Factors Contributing To Coronary Heart Disease In African American Women, Funmilola O. Sholanke Jan 2015

Perceived Factors Contributing To Coronary Heart Disease In African American Women, Funmilola O. Sholanke

Walden Dissertations and Doctoral Studies

African American women (AAW) suffer from disproportionately high death rates due to coronary heart disease (CHD) compared to Caucasian women. Although there have been a number of studies targeting African American adults with CHD in clinical interventions, very few studies have addressed the social determinants of health and the influence of AAW's perceptions of health factors on health outcomes. The purpose of this phenomenological study was to fill the gap in the existing knowledge base by examining the lived experiences of 10 AAW diagnosed with CHD with a focus on the perceptions of environmental, socioeconomic, and cultural factors related to …

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Case Study Of Parental Involvement For Enhanced Kindergarten Students' Development In Low Socioeconomic Households, Robyn Tresnak Jan 2015

Case Study Of Parental Involvement For Enhanced Kindergarten Students' Development In Low Socioeconomic Households, Robyn Tresnak

Walden Dissertations and Doctoral Studies

Evidence suggests that parents in low socioeconomic households may have unaddressed educational needs about their children's development. The purpose of this case study was to discover innovative ways parents in a low socioeconomic community engaged in activities with their young children to influence academic and social development. Bronfenbrenner's ecological theory of human development and Epstein's parental involvement model, the family process model, and the family strength model were used to build the conceptual framework. Parents and educators were asked to describe parent-engagement opportunities that were provided within the kindergarten classroom. Data were collected using a focus group with 13 educators …

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An Investigation Of The Interactions Between Escherichia Coli And The Intestinal Microbiota In Vivo And In Vitro, Matthew E. Mokszycki Jan 2015

An Investigation Of The Interactions Between Escherichia Coli And The Intestinal Microbiota In Vivo And In Vitro, Matthew E. Mokszycki

Open Access Dissertations

We previously proposed that colonizing strains of E. coli likely occupy specific niches as minimal members of mixed biofilms formed primarily by anaerobic members of the gut flora. These "restaurants" formed by the different community members of the gut provide individual strains of E. coli with various unique binding pockets and locally provided mono- and disaccharides by breaking down polysaccharides which facultative anaerobes, such as E. coli, could not break down on their own. This allows strains of E. coli that cannot grow as efficiently on available sugars to colonize if they are able to occupy niches that other …

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The Longitudinal Effects Of Participation In Structured Extracurricular Activities On Educational Achievement, Future Earnings, And Symptoms Of Depression With School Belongingness As A Mediating Variable In A Low-Income Sample, Christina L. Stacy Jan 2015

The Longitudinal Effects Of Participation In Structured Extracurricular Activities On Educational Achievement, Future Earnings, And Symptoms Of Depression With School Belongingness As A Mediating Variable In A Low-Income Sample, Christina L. Stacy

Theses and Dissertations--Educational, School, and Counseling Psychology

The purpose of this study was to examine the potential outcomes of participating in structured extracurricular activities (SEA) as an adolescent. Research has previously demonstrated that beneficial outcomes commonly associated with SEA participation include academic achievement and educational/career ambitions, positive social outcomes, and psychological well-being. It is thought that the benefits of SEA participation may be mediated by adolescents’ feelings of school belongingness and positive relationships. By extension, school belongingness is a key contributor to engagement, academic achievement, positive social relationships, and mental well-being. Although the research is typically positive, one must be careful in overgeneralizing that increasing student participation …

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Evaluation Of Intestinal Microbial Diversity And A New Antibiotic Regimen In Crohn's Disease Patients, Karel Alcedo Jan 2015

Evaluation Of Intestinal Microbial Diversity And A New Antibiotic Regimen In Crohn's Disease Patients, Karel Alcedo

Electronic Theses and Dissertations

Crohn's disease (CD) is a chronic granulomatous inflammatory bowel disease involving Mycobacterium avium subspecies paratuberculosis (MAP). Other microorganisms such as adherent-invasive Escherichia coli (AIEC) have also been proposed in CD association. To date, only one study investigated both MAP and AIEC simultaneously using peripheral blood but not in affected intestinal tissues. A standardized and effective antibiotic therapy against MAP and/or AIEC is needed for better treatment. Three antibiotic drugs – Clarithromycin (CLA), Rifabutin (RIF), and Clofazimine (CLO) have been used to treat CD patients suspected with MAP infection. However, the outcome has been controversial. The treatment dosage is high, the …

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