Digital Commons Network^™

Assessing Value Added In The Use Of Electronic Medical Records In Nigeria, Isaiah Gbenga Abimbola

Walden Dissertations and Doctoral Studies

Electronic medical records (EMRs) or electronic health records have been in use for years in hospitals around the world as a time-saving system for patient record keeping. Despite its widespread use, some physicians disagree with the assertion that EMRs save time. The purpose of this study was to explore whether any time saved with the use of the EMR system was actually devoted by doctors to patient-care and thereby to improved patient-care efficiency. The conceptual support for this study was predicated employing the task-technology fit theory. Task-technology theorists argue that information technology is likely to have a positive impact in …

The Effects Of Public Prekindergarten Participation On Kindergarteners' Early Literacy And Reading Skills, Brenda Coley

Walden Dissertations and Doctoral Studies

High quality prekindergarten programs that provide students with core academic skills have been found to increase subsequent student reading achievement. However, students across the United States continue to show deficiencies in reading skills, a problem which may stem from a lack of participation in early childhood education. The study district offered a prekindergarten program, but the impact on later reading achievement was unknown. The purpose of this quantitative study was to examine the effects of a prekindergarten program on the subsequent reading skills of kindergarten students. The constructivist learning theories of Whitehurst, Lonigan, Piaget, and Vygotsky provided foundation. Research questions …

Decision Making And Pediatric Bipolar Disorder Assessment/Diagnosis: A Phenomenographic Study, Kristen Davies

Walden Dissertations and Doctoral Studies

Prior to the 1990s, bipolar disorder, a behavioral disorder characterized by severe mood fluctuations, was not considered an suitable diagnosis for children. However, in recent decades, an increase in pediatric bipolar disorder (PBD) diagnosis has occurred in the U.S. The purpose of this study was to explore the perceptions and lived experiences of licensed mental health clinicians regarding their decision-making processes used during assessment and diagnosis of PBD. This phenomenographic study utilized individual, semi-structured interviews to explore the perceptions and lived experiences of 14 licensed clinicians in the Commonwealth of Massachusetts who assess and diagnose PBD. Data were collected with …

The Perceptions Of Adults Adjusting To Low Vision And Using General Communications Technologies Including Online Forums, Deborah Forest

Walden Dissertations and Doctoral Studies

The number of individuals facing vision loss as adults is increasing, and the need for these adults to have access to training and skills to aid in their adjustment process is prevalent. Guided by the tenets of connectivism, this phenomenological study examined current trends in social networking and the possibilities that are available to adults adjusting to low vision by using technology as a means for continued learning, social interaction, and professional connections. The main research question focused on the participants' perception of the adjustment process and their ability to learn and use technology. Data were collected through semi-structured interviews …

Somos Familia: Family As An Organizing Trope In 20th-21st Century Latina/O Literature, Victoria Anne Bolf

Dissertations

This dissertation examines various ways that family has been employed as a model of both oppression and liberation in Latina/o literature. Working from an interdisciplinary standpoint at the crossroads of literary and cultural studies, women’s, gender, and sexuality studies, Chicano/a studies, and Latino/a studies, this project seeks to uncover how representations of familia in U.S. Latino/a literary texts accomplish their discursive work, as well as complicating conventional formulations of kinship and family.

I examine Down These Mean Streets by Piri Thomas, in Chapter One, in terms of queer family and the counter-domestic logic of “the streets.” In Chapter Two, I …

Mother-Infant Relationships In The Nicu: A Multiple Case Study Approach, Ilona Helin

Dissertations

Parent-child relationships consist of both external and internal components. The external component is the behavioral interaction between mother and child, while the internal components are expectations each member of the dyad has for the both the relationship and of the other partner. These expectations are called internal working models (IWMs) and are blueprints that have been developed from an individual’s childhood experience of sensitive or insensitive parenting. A mother’s IWMs influence how she perceives her child, her relationship with her child and herself as a mother, the sensitivity of her caregiving, and ultimately her child’s IWM of him or her …

Influence Of Maternal Prior Life Adversity On The Psycho-Neuroendocrine-Immune Profile During Pregnancy, Karen J. Kotz

Dissertations

Pregnancy is accompanied by a multitude of physical and psychological changes. Adaptation to these changes through reduced anxiety and attenuated stress responsiveness is necessary across gestation and into the postpartum period for optimal maternal-infant health. In contrast, exposure to higher amounts of stressors during pregnancy can disrupt neuroendocrine-immune processes required for successful pregnancy outcomes. Evolving evidence demonstrates that exposure to adversity early in life has long-lasting effects on stress response systems that alter stress reactivity during adulthood. Given this evidence, it is posited that women who experience greater pre-pregnancy adversity during their childhood are at greater risk for negative maternal-infant …

Learning From The Un Preventive Deployment Mission In Macedonia: Nothing Fails Like Success?, Mary Frances Rosett Lebamoff

Dissertations

Preventive deployment as a conflict prevention tool has not recurred in the past decade-plus, despite the broadly acclaimed success of the United Nations Preventive Deployment in Macedonia (UNPREDEP 1995-1999; and its predecessor mission, UNPROFOR/Macedonia, UNPROFOR/M 1992-1995). The United Nations in particular has continued with mainly first- and second-generation peacekeeping, peacemaking and peacebuilding actions. What may best explain why has there has been no other engagement in preventive deployment missions, when there has been much emphasis placed formally and informally on early warning, detection, mitigation, and prevention of conflict? There have also been an increasing numbers of violent conflicts worldwide, so …

The Global Dystopian: Twenty-First Century Globalization, Terrorism, And Urban Destruction, Ryan Frank Peters

Dissertations

The new millennium has witnessed a staggering outpouring of literature, film and art which depict dystopian and post-apocalyptic societies. These stories have come in the form of massively popular films like the Matrix and Hunger Games trilogies; Emmy-winning television adaptations such as The Walking Dead; and Pulitzer Prize-winning novels like Cormac McCarthy’s The Road, or Kazuo Ishiguro’s Booker Prize-nominated Never Let Me Go. In the last five years, a wave of critically-lauded video games – The Last of Us, Bioshock Infinite, and Dishonored come immediately to mind—have depicted dystopian worlds while reaching mass audiences. Combined, The Last of Us and …

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 …

South-Asian American And Asian-Indian Americans Parents: Children's Education And Parental Participation, Sahil Ashwin Shah

Walden Dissertations and Doctoral Studies

Parental participation supports students' academic success and increases positive peer interactions. Prior to the 1980s, parental participation was viewed as a unidimensional construct; however, it has since been understood as a multidimensional one. Studies from Epstein have demonstrated that culture, community, and family structures are some of the many factors that affect parental participation. In addition, Huntsinger and Jose have demonstrated that Asian-American parents participate in their children's education differently than do European Americans, yet research has not examined the specificities of South-Asian Americans' (SAAs) and Asian-Indian Americans' (AIAs) parental involvement. There are 6 recognized methods that parents can use …

Perceived Effectiveness Of Social Supports For Autism Spectrum Disorders: Postsecondary Student Perspectives, Griselda Wells

Walden Dissertations and Doctoral Studies

College environments can pose both academic and social challenges for students with disabilities. For teachers and parents of children with Asperger's syndrome (AS) and high functioning autism (HFA), these challenges include communication, behavioral, and social difficulties that can hinder their attainment of educational objectives. Limited research has been conducted regarding postsecondary outcomes of elementary and secondary public school interventions provided to these students. This case study gathered information from postsecondary students with AS and HFA regarding their experiences of public school social skills interventions and their perceived impact on current social and academic outcomes. Findings were interpreted using critical theory …

Eliminating Acute Myeloid Leukemia Stem Cells By Targeting The Niche Microenviromnent: Co-Inhibition Of Tnf/Il1- Jnk And Nf-Κb, Andrew Volk

Dissertations

Leukemia Stem Cells (LSCs) from Acute Myeloid Leukemia (AML) require the activity of the transcription factor NF-kB to maintain stemness and drive tumor formation. Blocking NF-kB can preferentially eliminate LSCs in vitro with minimal effects on healthy Hematopoietic Stem and Progenitor Cells (HSPCs), making NF-kB a compelling target for anti-leukemia therapies. However, blocking NF-kB in vivo can only extend survival for a short period of time before transplanted mice succumb to the disease. I propose this is due to components of the in vivo niche supporting LSC survival and compensating for the inhibition of NF-kB.

I observed patients with partially …

Extended Treatment Window Exists For Improving Sensorimotor Recovery Using Anti-Nogo A Immunotherapy In Adult Rats With Chronic Stroke Deficits, Katherine Marie Podraza

Dissertations

Stroke related death ranks as the fourth most common cause of mortality in the United States. Current therapeutic options following stroke are limited. One potential therapy involves the use of anti-Nogo-A immunotherapy post-stroke. Our laboratory has shown that the administration of this novel treatment results in sensorimotor recovery in adult and aged rats. This therapy has been shown to be efficacious when applied immediately, 24 hours, and 1 week post-stroke in rats with mild to moderate sensorimotor deficits. In addition, recent results suggest that administration of anti-Nogo-A immunotherapy up to 9 weeks after stroke still induces functional recovery and neuroanatomical …

The Value Of Diagnostic Software And Doctors' Decision Making, Babatunde Ayodele Alaofin

Walden Dissertations and Doctoral Studies

The prevalence of medical misdiagnosis has remained high despite the adoption of diagnostic software. This ongoing controversy about the role of technology in mitigating the problem of misdiagnosis centers on the question of whether diagnostic software does reduce the incidence of misdiagnosis if properly relied upon by physicians. The purpose of this quantitative, cross-sectional study based on planned behavior theory was to measure doctors' opinions of diagnostic technology's medical utility. Recruitment e-mails were sent to 3,100 AMA-accredited physicians through their database that yielded a sample of 99 physicians for the study. One-sample t tests and, where appropriate because of non-normal …

Public Corruption In Liberian Government, Stephen H. Gobewole

Walden Dissertations and Doctoral Studies

There is a widespread public perception of corruption in Liberia's election process, yet there is little documentation on the characteristics of voters and their perceptions of electoral corruption. The purpose of this correlational study was to explore the relationship between gender, ethnicity, physical location, and perceptions about political activity during the 2005 national election. Roderick Chisolm's conceptualization of the internalist view of justification served as the theoretical construct. Data were acquired from the Afrobarometer survey (n = 1,200), which used a representative cross-sectional sample design, and were subjected to cross-tabulation analysis, a chi-square test, and a correlation analysis. The results …

Personality, Coping, And Burnout In Online Doctoral Psychology Students, Michelle Linn Grigsby

Walden Dissertations and Doctoral Studies

Completion times for doctoral psychology students are twice as long as those of other disciplines, and the attrition rate is over half of the matriculated students. Research indicates that (a) burnout plays an integral part in delayed completion and attrition for doctoral students and (b) personality and coping influence the development of burnout. In an effort to support prevention and intervention strategies, this study explored the gap in research regarding moderating effects of coping styles on the relationship between personality traits and burnout levels in online doctoral psychology students, as this population is growing at a significant rate and possesses …

A Cross-Sectional Study: Dietary Micronutrient Levels In Allied Health And Nursing Students, Grisseel A. Cruz-Espaillat

Walden Dissertations and Doctoral Studies

The adequate intake of micronutrients is important to maintain optimal health and prevent nutritional disorders and chronic disease. Studies have shown that medical students often reduce self-care behaviors and lack adequate dietary intake, leading to nutritional deficiencies. In this quantitative cross-sectional study, measurements of micronutrient levels in a sample of allied health and nursing students were compared to Recommended Daily Allowance (RDA) values. NutritionQuest Data-on-Demand System was used to analyze nutrients and food group intake. The postpositivist paradigm was used to examine how the independent and dependent variables relate to each other. Using a one-sample t test, a comparison of …

Implementing Relationship Based Care In An Emergency Department, Ruthie Waters Rogers

Walden Dissertations and Doctoral Studies

When patients and families come to the emergency department seeking medical attention, they come in with many mixed emotions and thoughts. The fast paced, rapid turnover of patients and the chaotic atmosphere may leave patients who visit the emergency department with the perception that staff is uncaring. The purpose of this project was to implement a patient care delivery model, relationship-based care, in the emergency department. The model is comprised of several caring theories including Jean Watson's model of human care and Kristen Swanson's middle range theory of caring. The main goals of the project were to help staff enhance …

The Complexities Of Female Sexuality: Narratives Of Women Who Have Experienced Both Heterosexual And Same-Sex Marriages, Krista Anne Butland

Walden Dissertations and Doctoral Studies

Due to social stigma, millions of sexual minorities have concealed their true sexual identities by entering into heterosexual relationships and marriages. Eventually, some transition to same-sex relationships and are able to live authentic lives. This latter group had identified as genuinely heterosexual, never questioning their sexuality until a particular time in their lives when same-sex desires spontaneously appeared. The experiences of transitioning from heterosexual to same-sex partners are not well known, particularly for women who have been legally married to both men and women. Diamond's dynamical systems theory for same-sex sexuality and McCarn and Fassinger's lesbian identity formation model provided …

Negotiating Diabetes: Professional Diabetes Care Work In The U.S., Melissa Marie Gesbeck

Dissertations

The rising incidence of diabetes mellitus (types 1 and 2) transcends national borders, creating a global pandemic. The U.S. leads the world in diabetes prevalence, despite its wealth and access to sophisticated medical technologies. Within health care, there is an increasing focus on lifestyle and behavioral interventions that research suggests may be the key to reversing this trend, but thus far their effectiveness in practice is uneven at best. In order to gain a better understanding of the other factors involved in professional diabetes care work that might support or inhibit effective diabetes management, this research treats diabetes as a …

Profiles Of Protective Factors In Urban African American Youth Exposed To Community Violence: A Prospective Study Of Resilience, Devin Colleen Carey

Dissertations

The broad purpose of the study was to investigate the relationship between exposure to community violence and adjustment in an urban sample of African American youth living in Chicago. After years of research on community violence, there has been a call to understand the influences of all levels and systems on child adjustment, as well as to use research to promote positive outcomes and prevention of future violence (Aisenberg & Herrenkohl, 2008). With this in mind, this project used latent profile analysis to create profiles of protection based on individual, family, peer, and community factors, as well as evaluate the …

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 …

Nurses Aides' Perspectives On Training, Joyce Young

Walden Dissertations and Doctoral Studies

In 2008, the Institute of Medicine recommended increasing CNA training programs to 120 hours of training. In accordance with that change, the Pennsylvania Department of Education recommended that the Pennsylvania's CNA training program of a required 80 hours be increased to 120 hours of training. This increase was intended to improve CNA job performance and job satisfaction, as well as the quality of patient care. The purpose of this phenomenological research study was to understand how Certified Nurse's Aide (CNA) graduates of 100-hours or fewer training programs in Lancaster, Pennsylvania, perceived their clinical training as related to effectively performing clinical …

Impact Of Eu Medical Device Directive On Medical Device Software, Guy Foe Owono

Walden Dissertations and Doctoral Studies

Directive 2007/47/EC of the European Parliament amending Medical Device Directive (MDD) provides medical device manufacturers with a compliance framework. However, the effects of the amendments to the MDD on competition in the U.S. medical device software industry are unknown. This study examined the impact of this directive on the competitiveness of U.S. medical device software companies, the safety and efficacy of medical device software, employee training, and recruitment. The conceptual framework for this study included 3 dimensions of medical device regulations: safety, performance, and reliability. The overall research design was a concurrent mixed method study using both quantitative and qualitative …

Mortality Salience Effects On Gender Stereotype Attitudes And Sexism, And The Moderating Effect Of Gender Role Conflicts, Gary Evan Leka

Walden Dissertations and Doctoral Studies

Research on existential mortality fears has indicated that death reminders impact individuals at the cognitive and behavioral levels. One way people cope with this threat is through cherishing cultural values that provide life with meaning. However, little research has explored how death reminders impact cultural standards regarding gender. These cultural values often manifest through various means by male and female groups. Guided by terror management theory, which posits that people address threats to their existence by engaging in culturally-sanctioned behaviors to enhance their self-esteem, the purpose of this study was to examine the effect of mortality salience (MS) on male …

Exploring The Impact Of Mindfulness On Adolescents: A Mixed Methods Approach, Poonam Desai

Dissertations

As social emotional learning gains greater focus, identifying effective interventions for high-risk students, such as students with Emotional/ Behavioral Disorder (EBD), becomes a priority. Mindfulness, as an intervention, offers a unique set of skills to increase emotional awareness and regulation, while also teaching key social emotional skills (Singh et al, 2007). Mindfulness, or the nonjudgmental observation of one's thoughts, feelings, and emotions, has roots in Buddhist philosophy, but is used secularly in the fields of psychology, medicine, and education (Baer, 2003). In this mixed methods study, the researcher aims to examine the experiences of adolescents who have EBD at an …

Incapacitated Fatherhood: The Impact Of Incarceration On African American Fathers, Dara Lewis

Dissertations

This project examines the ways that incarceration can shape the meaning and performance of fatherhood. Using 109 surveys and 30 in-depth interviews, three dominant themes emerged that constitute a model father identity standard: 1) being there for their children; 2) being an example for their children; and 3) providing their children with love, basic needs, and protection. The findings indicate that prison environment and post-incarceration restrictions do not support fathers’ ability to perform their roles as fathers, or the maintenance of healthy relationships between fathers and their children. Specifically, it disrupts the father identity confirmation process. As a result, relational …

Assessment Of Vitamin D Levels And Depression Among Adults In The United States, Troy Jean-Luc Owens

Walden Dissertations and Doctoral Studies

Vitamin D is essential to optimizing health; vitamin D deficiency (VDD) can increase risk of hypertension, cardiovascular disease, and insulin resistance. VDD occurs when individuals do not receive sufficient oral intake or obtain adequate sun exposure. Previous researchers indicated there is a relationship between VDD and depression, while others have indicated there is no relationship. The purpose of this study was to examine the relationship between vitamin D levels and depression, and how this relationship might be moderated by an individual's demographic characteristics (gender, age, smoking status, or marital status). This study was a quantitative data analysis of archival data …

Growing Diversity: Urban Renewal, Community Activism, And The Politics Of Cultural Diversity In Uptown Chicago, 1940-1970, Devin Hunter

Dissertations

“Growing Diversity: Urban Renewal, Community Activism, and the Politics of Cultural Diversity in Uptown Chicago, 1940-1971” examines the development of one of the nation’s most culturally and economically diverse neighborhoods. This character resulted from a historical process centered on the shifting politics of cultural diversity itself. Boosters, urban renewal and redevelopment advocates, community activists, and low-income residents defined diversity on their own—often competing—terms. These dynamics manifested in urban planning and architecture, working-class and middle-class leisure, radical community organizing, and film. Beyond the demographic development of social and economic heterogeneity, “Growing Diversity” traces the ways that historical processes influenced the ways …