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Drug Prices, Dying Patients, And The Pharmaceutical Marketplace: A New Conditional Approval Pathway For Critical Unmet Medical Needs, Robert A. Bohrer

Faculty Scholarship

Prescription drugs have been a major topic in the news for much of the past year. There are two issues which appear often: first, the very high prices of new drugs, particularly the "specialty" drugs developed for serious diseases; and second, the time required for FDA approval in relation to the perceived need for earlier access to new therapies for critically ill patients. Much less in the news, but lurking behind both issues, is the need for better information for physicians and patients to use in making decisions about prescribing and taking drugs, and for insurance companies and the government …

The Value Of Deviance: Understanding Contextual Privacy, Timothy Casey

Faculty Scholarship

Recent decisions by the Supreme Court in Carpenter v. United States and the Illinois Supreme Court in Rosenbach v. Six Flags Entertainment Corporation signal a shift in the traditional understanding of what exactly is protected by a privacy interest. Carpenter distinguished between a police officer’s observation of a suspect’s location and a perpetual catalogue of a person’s movements obtained through cell site location information (CSLI). The pervasive and vast quantity of information from CSLI exposed a protected privacy interest. In Rosenbach, the Illinois Supreme Court found the unique and personal quality of biometric information meant that consent and disclosure requirements …

African American Christian Senior Pastor's Beliefs About Mental Health Treatment, Trinaa L. Copeland

Walden Dissertations and Doctoral Studies

In the African American community, the Black Church and its clergy have served as gatekeepers to formal mental health treatment. Little is known about the beliefs of African American Christian senior pastors about mental health treatment and their personal views influencing their counsel to congregants seeking support through the church. This transcendental phenomenological study explored the lived experiences of African American Christian senior pastors in relation to how they understand mental health treatment and provide it to their congregants. The research questions explored three areas: (a) the senior pastors' experiences in rendering mental health treatment, (b) the senior pastors' personal …

Vitamin D Receptor Gene Polymorphisms Knowledge And Breast Cancer In Texas, Ejike Roland Egwuekwe

Walden Dissertations and Doctoral Studies

Breast cancer is a world health problem and is a leading cause of cancer-related death among women in the United States. However, breast cancer risks were reported to be reduced through exposure to Vitamin D through its Receptors identified as the p53 target gene. The purpose of this study was to assess the associations between VDR gene polymorphisms knowledge/awareness and decisions to reduce breast cancer risks and likelihood of mammogram screening among women in Texas. Data from survey were used. Roy adaptation model was the theoretical framework that guided this quasi- experimental, quantitative research. The dependent variables were decisions to …

Recent Parolees Participating In An Adult Basic Education And Work Skills Program, Charles Jenkins

Walden Dissertations and Doctoral Studies

Abstract

The issue addressed in this study was the increasing number of prisoners in U.S. prisons and the related issue of recidivism after release. The purpose of this qualitative study was to examine the experiences of 8 formerly incarcerated adults. The conceptual foundation of this study was based on Bandura's self-efficacy theory and Vygotsky's concept of the zone of proximal development and transformational learning. The research question for this study inquired about how released prisoners perceive their educational experiences in the MTM program. Participants were selected among adults who were incarcerated for at least 12 months and living in the …

Dicer Regulates Activation Of The Nlrp3 Inflammasome, David M. Ojcius, Ardavan Jafari, Laxmi Yeruva, Christian W. Schindler, Ali A. Abdul-Sater

All Dugoni School of Dentistry Faculty Articles

Inflammation plays a critical role in initiation of adaptive immunity, pathogen clearance and tissue repair. Interleukin (IL)-1β is a potent pro-inflammatory cytokine and therefore its production is tightly regulated: its secretion requires the assembly of a macromolecular protein complex, termed the inflammasome. Aberrant activation of the inflammasome has been linked to debilitating human diseases including chronic inflammatory and autoimmune diseases. Thus, there is a great interest in understanding how inflammasomes are regulated. Here we show that Dicer, an enzyme necessary for the production of mature micro-RNAs (miRNAs), is required for optimal activation of NLRP3 inflammasomes in bone marrow macrophages. Our …

Customer Engagement Strategies Leaders Use To Sustain Small Businesses, John A. Coy

Walden Dissertations and Doctoral Studies

The purpose of this single-case study was to explore strategies small business leaders used to engage the next generation of customers to ensure sustainability for longer than 5 years. The study population included senior leaders from a for-profit company headquartered in the mid-Atlantic region of the United States. Von Bertalanffy's general systems theory (GST) was the conceptual lens used in this study. Data were collected via semistructured interviews with 3 leaders of the organization. Participants for this doctoral study were members occupying leadership roles in a small, family-owned, for-profit business. Member checking was incorporated to help ensure accuracy, consistency, and …

Influence Of Two Instructional Models On Reading Achievement Of Esl Middle School Students, Thomasine Campbell Hassell

Walden Dissertations and Doctoral Studies

English as second language (ESL) students are not meeting reading proficiency standards

compared to their native English-speaking middle school peers. To address the low achievement

scores among ESL students, the study site implemented an instructional hub in which trained

ESL resource teachers used the sheltered instruction observation protocol (SIOP) model. The

purpose of this quasi-experimental study was to examine the difference in reading achievement

scores between ESL students who participated in the instructional hub and those who

participated in traditional instruction. Krashen's second language acquisition theory and Terrell's

natural approach theory provided the framework for the study. Archival data from …

Sextortion: Psychological Effects Experienced And Seeking Help And Reporting Among Emerging Adults, Tonya Howard

Walden Dissertations and Doctoral Studies

Sextortion is a phenomenon that has made an impact on the digital technology domain. Sexting is a transmission of sensual messages or performances, provocation, and schemes exhibited through an array of sexual behaviors. The purpose of this cross-sectional study was to examine the psychological effects experienced of sextortion and to uncover the willingness to seek help and report the incident to authorities. Arnett's emerging adulthood theory provided the framework for this study. The sample consisted of N = 27 responders between 18-24 years of age who have engaged in sexting behaviors and may or may not have experienced sextortion. Simple …

Strong Black Women, Depression, And The Pentecostal Church, Dawn E. Davis

Walden Dissertations and Doctoral Studies

Depression is a global health concern and among the top two causes of disability

and disease. African-Americans often seek help from the Black church, but

Pentecostal churches may fail to provide effective support due to doctrinal beliefs.

African-American women with depression struggle due to psychosocial implications

of the diagnosis. This research study used social constructionism and the

biopsychosocial model of health to explore the lived experiences of African-

American women suffering from self-reported depression while attending

Pentecostal churches in the Northeast United States. Fourteen women, ages

20 to 76, participated in this qualitative, phenomenological study. Data obtained

from the semistructured, …

Computational Experimentation, Tabrez Y. Ebrahim

Faculty Scholarship

Experimentation conjures images of laboratories and equipment in biotechnology, chemistry, materials science, and pharmaceuticals. Yet modern day experimentation is not limited to only chemical synthesis, but is increasingly computational. Researchers in the unpredictable arts can experiment upon the functions, properties, reactions, and structures of chemical compounds with highly accurate computational techniques. These computational capabilities challenge the enablement and utility patentability requirements. The patent statute requires that the inventor explain how to make and use the invention without undue experimentation and that the invention have at least substantial and specific utility. These patentability requirements do not align with computational research capabilities, …

Leptin Level Variance In Adults With And Without Cancer, Vilisa Chatman-Terry

Walden Dissertations and Doctoral Studies

Abstract

In 2018, health statistics revealed that, despite the many preventive measures established,

cancer was the second leading cause of death in the United States and the leading cause

of death in 22 states, exceeded only by heart disease. With obesity/leptin levels reaching

pandemic levels worldwide, and cancer having a well-known association with obesity,

both chronic diseases represent a large proportion of public health challenges. Guided by

the social ecological model, the purpose of this cross-sectional, quantitative study was to

examine if a significant difference exists in leptin levels among adults with different

types of obesity-associated and common cancers and …

Support Services From Prison To Home: Reentry Programs In A Western State, Bridget Burden

Walden Dissertations and Doctoral Studies

People released from incarceration are not equipped to deal with the challenges of transitioning back into society. Previous research on reentry suggests that correctional institutions may fail to adequately prepare inmates to transition to community life at the time of release, and little research addresses the perspectives of incarcerated people who have experienced reentry. Using social justice theory and the institutional analysis and development framework as guides, the purpose of this ethnographic study of reentry programs in a western state was to (a) determine how well they meet the needs of ex-offenders receiving reentry services, (b) identify best practices if …

Parent Stress Adaptation Among Caregivers Of Youth With Autism Spectrum Disorder, Victoria M. Ambrus

Walden Dissertations and Doctoral Studies

This study was a nonexperimental correlational study that took a strengths-based approach and utilized family systems theories to examine parenting stress, as measured by the Parenting Stress Index-Short Form, and posttraumatic growth (PTG), as measured by the Posttraumatic Growth Inventory, and the relationship between the two constructs. The study was conducted with a national sample of 136 maternal caregivers of transition-age youth on the autism spectrum (ASD), ages 14 to 22 years, recruited through social media, flyers, and referrals. Participants were primarily biological mothers (83.9%), White (87.5%), and resided in the South (68.4%); the mean age of the adolescent with …

Blubber Transcriptome And Proteome Responses To Repeated Adrenocorticotropic Hormone Administration In A Marine Mammal, Jared Deyarmin

University of the Pacific Theses and Dissertations

Chronic physiological stress impacts animal fitness by catabolizing metabolic stores and suppressing reproduction and immunity. This can be especially deleterious for capital breeding carnivores, such as marine mammals, which rely on lipid stores accrued during intensive foraging to sustain prolonged periods of fasting associated with reproduction. Therefore, chronic stress may cause a decrease in fitness in these animals, leading to population declines and potentially detrimental shifts in food web dynamics as a result. However, the impacts and indicators of chronic stress in animals are currently poorly understood. To identify downstream mediators of repeated stress responses in marine mammals, adrenocorticotropic hormone …

Army Reservists Spouses' Perceptions Of Secondary Traumatic Stress: A Phenomenological Study, Wendy Whinnery

Walden Dissertations and Doctoral Studies

While it is commonly known that combat-related posttraumatic stress disorder (PTSD) has profound, long-term effects on soldiers, its effects on spouses of affected soldiers are less understood. Some spouses who provide care for soldiers with PTSD develop symptoms that are similar in nature. These symptoms include but are not limited to depression, anxiety, isolation, hypervigilance, and a strong startle effect. This study explored the lived experiences of 8 spouses of Army Reservists who returned from deployment in either Iraq or Afghanistan with combat-related PTSD. This study used the couple adaptation to traumatic stress model to explore the couple's response to …

Impact Of Emergency Department Prescriber Type On The Rate Of U.S. Opioid Prescriptions, Edward Worlanyo Agbevey

Walden Dissertations and Doctoral Studies

Many drug overdoses in the United States are from prescription drugs, most of which are classified as opioid pain relievers (OPRs) and commonly prescribed in emergency departments (EDs) to treat pain. OPR abuse and addiction is a major public health issue. Researchers have identified the role of various patient characteristics (race, gender, demographics, etc.) in the variation in OPR prescription rates, but the contribution of provider-type differences to that variation has not been exposed. The purpose of this study was to evaluate the strength of the association between provider type and the likelihood of an opioid prescription by ED providers …

Increasing The Efficacy Of Virtual Reality Exposure Therapy For Fear-Of-Flying, Chad Macmillan

Walden Dissertations and Doctoral Studies

Virtual reality exposure therapy (VRET) is a treatment often used to treat fear-of-flying (FOF), which research shows is effective for treating this phobia. Researchers have identified that the realism of the virtual environment is an important component in the efficacy of VRET and increased realism is likely to increase the efficacy of VRET. Guided by cognitive theory, emotional processing theory, and behaviorism, the purpose of this quantitative study was to demonstrate if a new generational technique called true reality-virtual reality exposure therapy (TR-VRET) is at least as efficacious as traditional VRET for treating the fear and anxiety associated with FOF. …

Disadvantaged Preschool Children: Public Policy, Education Models, And Kindergarten Readiness, Virginia H. Byerson

Walden Dissertations and Doctoral Studies

There is a high rate of academic failure among disadvantaged preschool and post preschool students in some school districts in Virginia, yet little is understood about the relationship between education models and academic performance among economically disadvantaged students (EDS). The problem explored is the absence of classroom exercises in pre and post preschools that capitalize on cognitive development to improve executive function (EF) and self-regulation (SR) skills. The purpose of this study is to understand if a change in current classroom practices impacts academic performance among low-income students. Narrative policy serves as a theoretical guide in this qualitative case study …

Relationship Between Adolescent Perception Of Harm, Electronic Cigarette Use, And Texas Antitobacco Campaigns, Candace Rasheedah Campbell

Walden Dissertations and Doctoral Studies

The increase in use of e-cigarettes in adolescents is a major public health concern that must be addressed. Research studies showed some e-cigarettes contained varying amounts of nicotine and sever cancer-causing chemicals. The purpose of this quantitative, cross-sectional study was to assess the perception of harm (dependent variable) from using e-cigarettes and being exposed to state and school-based antitobacco programs (independent variable) and to determine if the association was modified by socioeconomic status or area of residence. Attitude-social influence-self-efficacy theory was the chosen theory for research and suggests that attitude, social influence, and self-efficacy variables can be persuaded via specific …

Sharing Of Threat-Related Information Among Public Safety Agencies In Honolulu, Hawaii, Cortney M. Chambers

Walden Dissertations and Doctoral Studies

There is a lack of knowledge regarding how public safety organizations communicate threat-related information at the local level. The purpose of this qualitative exploratory case study was to explore the benefits and challenges of sharing threat-related information between public safety agencies (law enforcement, fire services, emergency medical services, and public health) in Honolulu, Hawaii. The conceptual framework for the study was general systems theory. The sample for this study was a subset of 13 individuals from the larger population of approximately 50 subject matter experts who worked within four public safety agencies and had extensive experience analyzing and sharing threat-related …

Influence Of Combat Veterans’ Attitudes And Behaviors On Community Reintegration, Nicole Dawn Cmerek

Walden Dissertations and Doctoral Studies

A civil-military divide exists within the United States and is perpetuated by a distinct lack of communication between the civilian and military sectors within the population. The purpose of this correlational study was to examine whether attitudes and behaviors of combat veterans affect their positive reintegration into civilian communities. Binder’s social ecology theory provided the framework for the study. Data were collected from 255 combat veterans who responded to a survey. Results were analyzed using a hierarchical multiple linear regression model to determine the influence of military job satisfaction, post-deployment stressors, post-deployment support, and civic engagement on community reintegration efforts, …

Healthy Lifestyle Practice Among Online Health Psychology Graduate Students, Judi Elster

Walden Dissertations and Doctoral Studies

Research focused on health behaviors of online graduate students is sparse. Health psychology graduate training prepares individuals to share health information with others; the information may be more credible if they present a healthy appearance. The present study tested concepts from social cognitive theory (general perceived self-efficacy) and self-determination theory (autonomy, competence, and relatedness basic needs) to determine predictive value for graduate students’ engaging in health behaviors. Participants were 121 (29 health psychology group, 92 other programs group) online graduate students who lived in the United States and attended the same online university, recruited from multiple social media sources. The …

Factors Contributing To Burnout Levels Among Public Sector Rehabilitation Counselors, Monica Elizabeth Jackson

Walden Dissertations and Doctoral Studies

Burnout has led to turnover and poor counselor performance within public sector rehabilitation. Scholarly literature on burnout among mental health counselors and school counselors are abundant. However, few researchers have compiled studies to evaluate burnout among rehabilitation counselors. No research could be found that examined the relationships among job demand, control, support, and burnout among public sector rehabilitation counselors. The Job Demand Control- Support (JDC-S) model indicates that stress from work is developed based on work demands, perceptions of control, and the perceived support that is received. The purpose of this research study was to determine the extent of the …

Positive Deviance Behaviors And Definition In Nursing, Stacy L. January

Walden Dissertations and Doctoral Studies

The concept of positive deviance (PD) has not been studied in the context of nursing. Grounded in narrative inquiry and combined with vocabularies of motive and symbolic interactionism, the purpose of this study was to explore whether PD behaviors existed in nursing, and if so, to develop an operational definition of PD for nursing. The research question addressed what PD behaviors, if any, were present in nurses’ workplace stories. Using posted flyers, eight participants either self-selected or were selected by snowball method to participate. Interviews were conducted in locations decided on by each participant. Interview data were obtained, transcribed, then …

A Staff Training Plan On Screening African Americans For Prediabetes, Valerie Kershaw-Berry

Walden Dissertations and Doctoral Studies

African American adults have higher risks of undiagnosed Type 2 diabetes, uncontrolled Type 2 diabetes, and complications from Type 2 diabetes than members of other racial groups. Health care providers in rural Tennessee lack staff training plans for prediabetes screening of older African American adults. In addition, few rural Tennessee health care providers have programs in place to train staff in prediabetes screening, screening instrument use, and interventions for Type 2 diabetes prevention. The focus of this DNP project was on developing an evidence-based staff training program designed to improve knowledge regarding prediabetes screening in older African American adults. Concepts …

Professional Identity Development In Blended Clinical Psychology Doctoral Students, Lindsay Nolan

Walden Dissertations and Doctoral Studies

As online graduate programs gain popularity, it has become more important to understand how students enrolled in these programs develop their professional identities. Researchers have demonstrated that there are both benefits and drawbacks to participation in blended learning programs (which incorporate in person and online instruction). It is not known how students enrolled in blended clinical psychology PhD programs experience the in-person portion of these programs and what their experiences mean for their professional identity development. This study examined the perceived impact of one part of an online clinical psychology doctoral program, the in-person classroom experiences, on the professional identity …

Characteristics Of Cause Of Death, Victim, Crime, Offender, And Familial Relationship, William J. Reilly

Walden Dissertations and Doctoral Studies

Broad personality or global traits are unlikely to assist in solving capital crimes, so forensic psychologists have begun to focus on characteristics of the crime to create differentiating profiles. The purpose of this study was to determine if offender and victim characteristics and method of murder could provide cluster profiles differentiating familial relationship between offender and victim. Guided by classical conditioning theory and social learning theory, an archival database of 147 capital offenders responsible for 506 victims was analyzed. Cluster analysis yielded 3 distinct profiles. Compared to other clusters, Cluster 1 offenders tended to be Black and unfamiliar with their …

Utilizing Food Safety Knowledge In Comprehensive Patient Care Among Harlem Hospital Physicians, Sean Alexander Shivers

Walden Dissertations and Doctoral Studies

According to the World Health Organization (WHO), people throughout the world become sick every year from consuming contaminated foods, which impacts countries’ socioeconomic development, straining their healthcare system, travel and tourism, and foreign trade markets. To help alleviate the impact foodborne illness (FBI) has on society, scholars suggest physicians incorporate food safety in their standard work practice. The purpose of this study was to determine if Harlem Hospital physicians utilized food safety knowledge in comprehensive patient care with a diagnosis of FBI, in addition to how physicians passed this food safety information onto the patient. A qualitative methodology using an …

Repercussions Of The Mechanistic Dehumanization Of Muslim Americans, Resilience, And Sustainable Communities, Melvin Walters

Walden Dissertations and Doctoral Studies

There is a lack of research on the relationship between dehumanization of minority religious groups and affiliation with terrorism, which suggests a need to consider the consequences of dehumanization perceptions beyond promoting aggression. This qualitative case study addresses whether dehumanization embedded in public policies influences Muslim Americans 18 to 25 years of age, native and nonnative, to engage in homegrown terrorism. Using Schneider and Ingram’s social constructions of target populations as the foundation, research questions focused on how perceptions of mechanistic dehumanization in policy design influence homegrown terrorism among Muslim- American adults. Data were acquired through archival data that included …