Digital Commons Network^™

Factors Associated With Adherence To Diabetes Medication Among Individuals With Type 2 Diabetes In Cambridge, Ontario, Canada., Benedict Osamuimen Atekha

Walden Dissertations and Doctoral Studies

Although it is known that the prevalence of type 2 diabetes is on the rise in Canada, more information is needed on how well type 2 diabetes patients living in Cambridge, Ontario self-manage their diabetes and what factors influence their adherence to diabetes medication regimens. The objective of this cross-sectional study based on the theory of planned behavior was to determine if there are predictors of adherence to diabetes medications among patients living with type 2 diabetes in Cambridge. The World Health Organization STEPwise Approach to Surveillance was used to collect demographic data. Adherence and diabetes knowledge were assessed with …

The Need For Public Policy Initiatives To Retain Medical Doctors In Ethiopia, Berhanu Bankashe Balaker

Walden Dissertations and Doctoral Studies

Ethiopia suffers from a medical shortage or brain drainthat has severely affected its already fragile health care system. The country has a very low physician-to-population ratio,whilemany in the medical community continue to leave in great numbers. Aphenomenological approach was used in this study to explore the lived experiences of medical doctors who have left Ethiopia, with contemporary migration theory serving as the conceptual framework. The central research question focused onwhy Ethiopian medical doctors leave their country and what can be done to retain them. Participants were 10 medical doctors of Ethiopian origin who live and practice medicine in the Washington, …

Rediscovery Of Self After Counseling For Female Survivors Of Intimate Partner Violence, Tiffany Crayton

Walden Dissertations and Doctoral Studies

Researchers have indicated that survivors of intimate partner violence (IPV) have lost a sense of self while being with their abuser. But little or nothing has been published on the rediscovery of self after counseling among female survivors of IPV. The purpose of this phenomenological study which helped to guide the research question and the method of the study was to help bridge the gap in the professional counseling literature by exploring the rediscovery of self after counseling from the perspective of female survivors of IPV. The research question for this study examined the lived experiences of 7 women who …

Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes

Walden Dissertations and Doctoral Studies

Chronic pain affects approximately 100 million adults in the United States annually, and costs exceeding $635 billion. Pain is the most common complaint in primary care, and chronic pain accounts for up to 16% of emergency room visits. Additionally, chronic pain accounts for 25% of missed workdays annually. Veterans are particularly vulnerable to chronic pain and have an increased incidence of chronic non-cancer pain. Chronic pain for veterans cost the Veterans Administration (VA) about $385 billion each year. This project evaluated the Patient Aligned Care Team (PACT) model to manage chronic lower back pain (CLBP) at a VA primary care …

Strategies Used By Cloud Security Managers To Implement Secure Access Methods, Eric Harmon

Walden Dissertations and Doctoral Studies

Cloud computing can be used as a way to access services and resources for many organizations; however, hackers have created security concerns for users that incorporate cloud computing in their everyday functions. The purpose of this qualitative multiple case study was to explore strategies used by cloud security managers to implement secure access methods to protect data on the cloud infrastructure. The population for this study was cloud security managers employed by 2 medium size businesses in the Atlanta, Georgia metropolitan area and that have strategies to implement secure access methods to protect data on the cloud infrastructure. The technology …

Customer Relationship Management In The E-Retailing Environment, Nikki R. Hicks

Walden Dissertations and Doctoral Studies

Small business enterprise (SBE) managers often lack resources, expertise, and impact when selling in an online environment. SBEs can overcome increased competition by adopting customer relationship management (CRM) into their business model for survival and longevity. Using the conceptual framework technology, organization, environment (TOE), this multiple case study explored effective marketing strategies that small store retail managers use to successfully sell apparel and accessories in online markets. The study population included leaders from independent small online retail enterprises with brick-and-mortar stores located in the Central, Tri-Cities, or Southside areas in Virginia. The data collection process included semistructured, on-site interviews of …

Correlation Between The Spirit Bike Maximal Power Output And Other Lower Extremity Power Output Tests, Tyler Adams, Joseph Brown, Gunnar Mendiola, Ryan Sullivan, Cody Williams

Clinical Sciences: Graduate Physical Therapy Capstone Projects (2008-2021)

The assessment of a patient’s lower extremity function is important for physical therapists to make clinical judgements about the subject’s mobility and physical capabilities. For physical therapists to accurately assess a patient’s lower extremity function, clinicians must utilize the most appropriate tests, evaluation techniques, and/or tools. It is not clear that single leg hop tests will provide the most accurate assessment of lower extremity function for patients with hip, knee, ankle, and or foot biomechanical dysfunctions, as in some severe cases, these tests may even be contraindicated.

Empowerment Or Threat: Perceptions Of Childhood Sexual Abuse In The #Metoo Era, Melissa Samantha De Roos

Open Access Theses & Dissertations

Most victims of Childhood Sexual Abuse (CSA) will not disclose the abuse until they reach adulthood. When victims do disclose, they often face negative responses such as disbelief or blame. The specifics of both the individual and the abuse can create barriers for individual victims to disclose the abuse (i.e. gender of the perpetrator or age of the victim at the time of abuse). These situational and individual differences create societal expectations and stereotypical beliefs about CSA that further complicate the disclosure process for the victim. The aim of these studies is to explain why men tend to be less …

Development And Validation Of A Measure Assessing Blind Patients' Perceptions Of Their Healthcare Providers' Stereotype Content, Nazanin Mina Heydarian

Open Access Theses & Dissertations

People with disabilities (PWDs) constitute about 15-20% of the total population. Health disparities among PWD's are due, in part, to stereotypes about PWDs as incompetent. These stereotypes may lead some healthcare providers (HCP) to patronize PWDs, over-focus on the PWDs' impairments and potentially neglect their presenting problem. Moreover, if the PWD violates stereotypical assumptions, the HCP may actively interfere with the PWD's goals. This Dissertation focused on the blind population because this is a large, stigmatized and understudied subpopulation of PWDs. In Study 1, the content of stereotypes about blind patients in the clinical setting were examined from the patient …

An Integrated Machine Learning Geological Field Tool In The Age Of Big Data And Drones, Guillermo Vargas

Open Access Theses & Dissertations

Unmanned aerial vehicles (UAVs) and machine learning are relatively new research tools in the geosciences that can be used to collect and analyze large data sets rapidly. We combine the power of rapid data collection using unmanned aerial vehicles with machine learning algorithms to develop a field-based system to identify targeted geological features. For data collection, we have used a commercial-grade UAV which carried visible-wavelength and multispectral (visible- infrared) cameras. We analyzed the data with machine learning and machine vision algorithms that can classify rock units exposed in a field area. We have identified algorithms that in previous literature have …

Comparison Of Stride Length And Stride Frequency Patterns Of Sprint Performance In Overground Vs Motorized Treadmill Sprinting., Fayon Kamieka Gonzales

Open Access Theses & Dissertations

The purpose of this study was to investigate the relationship between different kinematic parameters when maximal effort sprints are performed overground and on a motorized treadmill by recreationally trained and collegiate level sprinters. To accomplish the goals of this study, we measured stride length, stride frequency, contact time, and flight time overground and on a motorized treadmill to determine what differences or similarities can be identified. Anthropometric measurements such as the height, body weight, lower limb length, and lower limb circumference were also recorded. Subjects' performance of a 60 meter sprint (50 meter acceleration, 10 meter maximal velocity) was measured …

Seeking Health Information In The Diabetes Online Community (Doc); The Role Of Health Literacy, Social Support And Community Interaction On Treatment Adherence, Allyson Hughes

Open Access Theses & Dissertations

Social support, being valued and cared for by others (Wills, 1991), is a critical construct for disease management and often includes providing advice and information to peers online. Approximately 83% of individuals with chronic disease search for health information online and there are more than 500,000 active social media users in the Diabetes Online Community (DOC) who have varying levels of disease management expertise. Due to the strenuous nature of Type 1 Diabetes (T1D), members of the DOC are continuously asking for and receiving anecdotal health information, yet very few studies have evaluated the impact of the DOC on treatment …

What's Next: Into A Third Decade Of Latcrit Theory, Community, And Praxis, Steven W. Bender, Francisco Valdes, Shelley Cavalieri, Jasmine Gonzalez Rose, Saru Matambanadzo, Roberto Corrada, Jorge Roig, Tayyab Mahmud, Zsea Bowmani, Anthony E. Varona

Articles

No abstract provided.

Opioids Delay Healing Of Spinal Fusion: A Rabbit Posterolateral Lumbar Fusion Model, Nikhil Jain, Khaled Himed, Jeffrey M. Toth, Karen C. Briley, Frank M. Phillips, Safdar N. Khan

Biomedical Engineering Faculty Research and Publications

Background Context

Opioid use is prevalent in the management of pre- and postoperative pain in patients undergoing spinal fusion. There is evidence that opioids downregulate osteoblasts in vitro, and a previous study found that morphine delays the maturation and remodeling of callus in a rat femur fracture model. However, the effect of opioids on healing of spinal fusion has not been investigated before. Isolating the effect of opioid exposure in humans would be limited by the numerous confounding factors that affect fusion healing. Therefore, we have used a well-established rabbit model to study the process of spinal fusion healing that …

Use Of A Dynamic Balance System To Quantify Postural Steadiness And Stability Of Individuals With Lower-Limb Amputation: A Pilot Study, M. Barbara Silver-Thorn Phd, Joel Kempfer, Alyssa J. Schnorenberg, Brooke Slavens

Biomedical Engineering Faculty Research and Publications

Introduction Despite rehabilitation and gait training, the gait of individuals with lower-limb amputation is often asymmetric and falls and/or fear of falling are common. Clinical assessments of balance and stability include the Berg BalanceScale and the Dynamic Gait Index. Biomechanical assessments, conducted largely in research laboratories, are more objective, quantitative, and may provide greater resolution. These biomechanical measures include postural sway during both unilateral and bilateral standing tasks and the dynamic postural response to applied or volitional perturbations. The objective of this study was to investigate the utility of a dynamic balance system, a relatively new clinical tool incorporating dual …

Inverse Kinematic Assessment Of Rehabilitative Therapy In Children Using Orthotics, Michael P. Murphy, Jacob R. Rammer, Kaleb L. Vinohout, Meghan R. Caballero, Christy M. Cornwell, Jessica M. Fritz, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Pathologic movement patterns are characterized by abnormal kinematics that alter how muscles support the body during walking. Individual muscles are often the target of interventions with physical therapy and surgery alike, yet the tools to assess individual muscles clinically remain limited. The aim of this study is to assess OpenSim as a clinical tool for individualized rehabilitative evaluation of children using orthotics. This anatomic and kinematic modeling study was focused on pre- and post-treatment assessment of gait characteristics in fourteen children using orthotic devices. A range of four to twelve acceptable gait capture trials was collected for each child before …

Recertification And Reentry To Practice For Nurse Anesthetists: Determining Core Competencies And Evaluating Performance Via High-Fidelity Simulation Technology, Matthew E. Heyes, Lauren Schnitzen, Deana G. Starr, Charles Vecchiano, Virginia C. Muckler, Lisa Thiemann, J. Frank Titch

College of Nursing Faculty Research and Publications

Introduction

The National Board of Certification and Recertification for Nurse Anesthetistsaddressed a barrier to return to practice of uncertified practitioners by replacing required direct patient care experiences with high-fidelity simulation.

Objectives

The aims of this study were to: (a) validate a set of clinical activities for their relevance to reentry and determine if they could be replicated using simulation, (b) evaluate the content validity of an existing simulation scenario containing the proposed clinical activities and determine its substitutability for a clinical practicum, and (c) evaluate the validity of two methods to assess simulation performance.

Methods

A modified Delphi method …

Factor Structure And Psychometric Properties Of Cognitive-Behavioral Scales In Caregivers Of Persons With Dementia, Abir K. Bekhet, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

Background/Purpose

Caregiving can be costly to dementia caregivers' well-being. Assessing the factor structure and psychometric properties of Cognitive-Behavioral Scales in dementia caregivers is an essential step in addressing the gap in the current state of research. Specifically, it is essential to determine first whether the factorial structure of the three measures used in this study namely, the Positive Thinking Skills Scale, the Revised Memory and Behavior Problems Checklist, and the Zarit Burden Interview are good representation of the data by studying the good model fit. Next, evaluating the reliability of each factor of the three measures used are essential to …

Crawler Inspection Robot With Machine Vision (Lifelong Endevour), Francisco Martinez

Open Access Theses & Dissertations

The presence of foreign objects (FO) in an aircraft can mean failure to achieve a mission's objective, loss of aircraft, or a catastrophic failure such as loss of life. Currently, Lockheed Martin inspection methods for foreign objects include a person accessing very tight areas that have the potential for FO to be present. There is a need that has been identified to remove the person from this very tight/potentially hazardous area that is being inspected and placing them behind the control center of a remote inspection system that can identify, objectively, whether or not FO is present or not. The …

Prevalence Of Methicillin-Resistant Staphylococcus Aureus (Mrsa) Colonization In Medical Students At The El Paso/Cd. Juarez Border Region, Samantha Michelle Meza

Open Access Theses & Dissertations

Background: Due to the constant use, misuse, and over-prescription of antibiotics, antibiotic resistance has become a global public health threat. Methicillin-Resistant Staphylococcus aureus (MRSA) continues to prevail in healthcare settings and is the cause of many nosocomial infections worldwide. A risk factor for developing an active MRSA infection is the colonization of the pathogen in the anterior nares. Over the past two decades, MRSA infections have increased in both the hospital and the community setting, often infecting healthy individuals lacking common risk factors. Healthcare workers with constant exposure to MRSA are more likely to be colonized and can potentially serve …

The Role Of Circulating Mirnas As Clinical Biomarkers Of Insulin Sensitivity And Exercise Adaptation In Young Offpsring Of Type 2 Diabetes Patients, Cesar Arturo Meza

Open Access Theses & Dissertations

Background: A family history of Type 2 Diabetes (FH) is considered a risk factor for development of type 2 diabetes (T2D). Exercise training is an effective strategy to improve insulin resistance. Recently, micro-RNAs (miRNAs) have emerged as mediators of various intracellular processes, including insulin signaling, and may act as signaling molecules when released into circulation. The miRNAs -29a, -133a and -155 have been implicated in the regulation of insulin sensitivity, however their roles in exercise training-induced improvements in insulin sensitivity are yet to be elucidated. The purpose of this study was to determine whether circulating miRNA-29a, miRNA-29b, miRNA-29c, miRNA-133a, miRNA-133b …

Trends In Antibiotic Resistance And Correlations Of Antibiotic Use And Antibiotic Resistance In A Small Hospital In El Paso, Texas 2013-2015, Christopher Olivas

Open Access Theses & Dissertations

Antibiotic resistance is a serious public health threat, primarily, resulting from the excess and inappropriate use of antibiotics. Antibiotic resistance and antibiotic consumption trends may differ along the U.S-Mexico border from the rest of the U.S. due to geographical and cultural differences unique to the border region. The objectives of this study were: 1.) To examine the trends in antibiotic resistance among E. coli, ESBL producing E. coli, P. aeruginosa, S. aureus, and MRSA over a 3-year period (2013, 2014, 2015) in a U.S.-Mexico border area hospital; 2.) To examine the trends in antibiotic consumption among aztreonam, cefazolin, cefepime, ceftriaxone, …

Process Evaluation Of The Batterer Intervention And Prevention Program Of The Center Against Sexual And Family Violence In El Paso, Texas, Kathleen Anne O'Connor

Open Access Theses & Dissertations

Background: Intimate partner violence (IPV) is a significant public health issue. One in five women and one in seven men will experience severe physical violence from an intimate partner in their lifetime in the US; and one in three women globally (Breiding, Basile, Smith, Black, & Mahendra, 2015; World Health Organization, 2017). Notwithstanding such stark statistics, there is a gap in research on batterers and on batterer intervention and prevention programs (BIPP). Purpose: Program processes related to follow-up of clients were evaluated at the Center Against Sexual and Family Violence Batterer Intervention and Prevention Program (CASFV BIPP) through a mixed-methods …

Using Baby Sign As A Facilitating Technique To Segment Speech With 4-18-Month-Old Monolingual And Bilingual Hearing Infants-An Extension Study, Johanna Puga-Martinez

Open Access Theses & Dissertations

The intricacies involved in learning language are astounding, nonetheless, infants are more than capable of accomplishing this feat within their first few years of life. This unbelievable achievement is carried out through numerous milestones and exposure to multiple modalities of stimuli all around them. Through the use of these modalities, be it auditory or visual, infants begin their journey to learn language with the task of extracting words from fluent speech, speech segmentation. Researchers have found that infants as young as 6-months can segment words from the speech stream by using their own name or highly familiar words like momma …

Evaluation Of Powdered Activated Carbon For Control Of Taste And Odors Caused By Geosmin, Anthony Joe Rodriguez

Open Access Theses & Dissertations

The primary sources of taste and odor problems associated with surface water supplies spawn from algae and bacterial blooms that secrete odorous chemicals such as Geosmin and MIB. These musty, odorous, organic compounds are usually detectable by the human nose at concentrations of 5 to 10 ppt and can create considerable concern by consumers that can lead to complaints and misconceptions of odors as a water quality problem. Typically, since chemical or ozone treatment can be costly, activated carbon (powdered or granular) is generally employed in the process of removing organic compounds, such as Geosmin and MIB. The research presented …

Novel Therapeutic Approaches For Trypanosoma Cruzi Infection, Caresse Lynn Torres

Open Access Theses & Dissertations

Trypanosoma cruzi (T. cruzi) is the causative agent of Chagas disease (ChD), an emerging illness prevalent in South and Central America. Presently, benznidazole and nifurtimox are the only two clinically available drugs against T. cruzi, which have high toxicity and limited efficacy in the chronic phase of the disease. This ailment affects 8-10 million people and has become an emerging concern in the U.S leading to an urgent need for the discovery of new treatments. Despite all efforts, there is no human vaccine available. Therapeutic vaccines are a possible option for chronic ChD in which the vaccine is used after …

An Evaluation Of Interprofessional Knowledge And Attitudes In Graduate Students From Six Programs In Health Sciences After An Interprofessional Education Workshop Experience, Joanna Velasco

Open Access Theses & Dissertations

Interprofessional Education (IPE) occurs when two or more disciplines learn about, from, and with each other to provide interprofessional patient-centered care which ultimately improves patient health care outcomes (WHO, 2010). Through collaboration, students not only bring their own expertise, but are given an opportunity to learn what the other disciplines can offer for the same patient. Although IPE's importance is highly recognized, many universities do not engage in IPE practice because of scheduling difficulties, lack of faculty involvement, implementation challenges for various levels of competency, and uncertainty of how to measure the effectiveness of IPE activities (Johnson et al., 2015). …

Glycoconjugate-Based Vaccines For Chagas Disease, Brenda Guadalupe Zepeda

Open Access Theses & Dissertations

Chagas disease is caused by the protozoan parasite Trypanosoma cruzi. About 6–8 million people are estimated to be infected worldwide. It is a blood borne pathogen and transmitted to humans by the insect vector (kissing bug), blood transfusion, organ transplant, contaminated foods and juices, and by congenital contagion. The chemotherapy is partially effective in chronic phase of the disease, and the drugs cause several side effects. There is no vaccine to prevent or treat Chagas disease. The great majority of experimental vaccines have employed whole parasite extracts, purified or recombinant proteins, synthetic peptides, or DNA; however, most of them provide …

Community And Clinical Epidemiology Of Borderline Personality Disorder, William D. Ellison, Lia Rosenstein, T. A. Morgan, Mark Zimmerman

Psychology Faculty Research

Several studies of the prevalence of Borderline Personality Disorder (BPD) in community and clinical settings have been carried out to date. Although results vary according to sampling method and assessment method, median point prevalence of BPD is roughly 1%, with higher or lower rates in certain community subpopulations. In clinical settings, BPD prevalence is around 10-12% in outpatient psychiatric clinics and 20-22% among inpatient clinics. Further research is needed to identify the prevalence and correlates of BPD in other clinical settings (e.g., primary care) and to investigate the impact of demographic variables on BPD prevalence.

Formulation Of Nanoparticle Systems For Drug Delivery Application In Biomedical Sciences, Victor Alfredo Rodriguez

Open Access Theses & Dissertations

Antibiotic-resistant strains of bacteria may result in serious infections which are difficult to treat. In addition, the poor antibiotic pipeline has also contributed to the crisis. Recently, the complex of furosemide and silver (Ag-FSE) has been reported as a potential antibacterial agent. However, its poor aqueous solubility is limiting its activity as an effective antibacterial agent. The purpose of this study was to encapsulate Ag-FSE into chitosan nanoparticles (CSNPs) and evaluate antibacterial efficacy. Ag-FSE CSNPs were prepared using ionic gelation technique. The particle size, polydispersity index and zeta potential of Ag-FSE CSNPs were determined using dynamic light scattering (DLS) technique. …