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Strategies For Patient Engagement In A Self-Management Program For Adults With Diabetes, Carolinee Jokotola Ogungbayi

Walden Dissertations and Doctoral Studies

Patients' lack of adherence to diabetes self-management education and support (DSMES) recommendations is a challenge for healthcare. One approach to addressing patient noncompliance with DSMES is through education of staff on current guidelines. In an outpatient facility in South Texas, staff training on current DSMES guidelines was recommended as one of the solutions to the problem of Type 2 diabetes mellitus (T2DM) complications observed among clinic patients. An educational module was created to increase staff knowledge on T2DM and to assist staff members in teaching patients to self-manage T2DM. The module was built on the self-management and health promotion models, …

Predicting Outcomes Of American Youths' Shift Toward E-Cigarette Use, D J. Resendez

Walden Dissertations and Doctoral Studies

There has been a shift toward e-cigarette use and away from tobacco smoking among American youth. Despite effects of ongoing public health campaigns that bring attention to the harmful effects of tobacco and nicotine use generally, youths might not perceive e-cigarette use to be unhealthful in terms of psychological functioning. This study was an investigation of the impact of the method of tobacco use (cigarette or e-cigarette), past cessation attempts, cravings or needs to use tobacco, and serious cognitive difficulties, upon youths' intentions concerning future tobacco usage. The conceptual framework was based upon the self-medication hypothesis, biopsychosocial model, and social …

The Effect Of Interactive Notebooks On The Science Proficiency Of Biology 1 Students, Shereka Faye Newson

Walden Dissertations and Doctoral Studies

Local High School, a pseudonym, located in Northwest Mississippi has in place two differing Biology 1 curricula; in one curriculum, the students use interactive notebooks daily and in the other curriculum, they are not used. The purpose of this ex post facto quasi-experimental study was to investigate the impact that an instructional tool, such as the interactive notebook, could have on student achievement. Instructional design theory and the materials, methods, environment, collaboration, content, and assessment (MMECCA) framework served as the theoretical framework for this study. The standard measure of science proficiency was provided by the test results from the Biology …

Waiting Times And Dwi, Court-Mandated Treatment Completion, Cailyn Florence Green

Walden Dissertations and Doctoral Studies

Drivers under the influence of alcohol cause nearly one third of all fatal motor vehicle accidents. Ambulatory outpatient alcohol abuse treatment has been clinically shown to increase abstinence, which could decrease the chance of subsequent DWI offences. A barrier to successful completion is extended waiting periods prior to treatment engagement. The theory of patient waiting supports the longer a patient waits to begin treatment the lower the likelihood of successful completion. By exploring the impact of waiting times on DWI court mandated clients, referral courts and treatment facilities can work together to create a successful completion strategy for offenders. The …

The Perceived Impact Of Alternative Specialized Education Services On Former Teen Mothers, Malinda Starr Hudson

Walden Dissertations and Doctoral Studies

Many teen parents face challenges when completing secondary education resulting in unsustainable family units. Previous researchers focused on services to teen mothers while completing secondary education, with little addressing the long-term impact of Alternative Specialized Education Services (ASES) as the former teen mother matured. This phenomenological study explored the perceptions of 8 former teen mothers (ranging in age from 20 to 54) of ASES'€™ impact on their values and decision-making as they matured. Program theory was the overarching framework and values clarification the interpretive lens. Data were inductively coded and subjected to interpretive phenomenological and thematic analysis. Four themes emerged: …

Phenomenological Study On Social Workers With Children With Special Needs, Natasha Yvette Mike

Walden Dissertations and Doctoral Studies

Parents with children with special needs experience challenges when caring for their children. These challenges may be uniquely affected by the parent'€™s employment. Because social workers are in professional roles, understanding their lived experiences provides awareness of the needed services and resources that help social workers maintain effectiveness in their home and work life. This phenomenological study explored the lived experiences of social workers who have children with special needs. Bronfenbrenner'€™s ecological theory guided this study. Criterion and snowball sampling were used to recruit 8 participants. Data were gathered through 3 in-depth semistructured interviews. Moustakas phenomenology method was used to …

Experiences Of African American Mothers Raising Gifted Children, Keisha Kavon Mcgill

Walden Dissertations and Doctoral Studies

Equality in educational access has long been an area of concern for U.S. educators, policy makers, and advocates. Congress issued a mandate in 1969 to identify the needs of gifted students and to ensure that those needs were being met. However, the needs of gifted minority students were not specifically addressed. Little is known about how African American mothers are affected by the demands of raising and advocating for their gifted child. The purpose of this hermeneutic phenomenological qualitative inquiry was to explore the lived experiences of African American mothers raising gifted children. The theory of womanism was used to …

Noise Pollution/Reduction Education For Frontline Staff In The Acute Care Setting, Lopa Patel

Walden Dissertations and Doctoral Studies

Noise levels in hospital settings have risen beyond the recommended range of 35-40 decibels, resulting in poor patient healing outcomes and other health conditions ranging from sleep deprivation, anxiety, agitation, delirium, depression, and high heart rate and blood pressure. These negative patient health experiences are evidenced by poor scores for the Hospital Consumer Assessment of Healthcare Providers and Systems, which are indicators of patients' perceptions of care. This project explored whether an educational activity for 48 direct care staff, who include registered nurses and nursing assistants, in a cardiac unit on the impact of noise pollution on patient healing would …

Socioeconomic Impacts: Exploring Relationships Between Parenting Styles And Emotional Intelligence In Odd, Radhia Afif

Walden Dissertations and Doctoral Studies

Children diagnosed with Oppositional Defiant Disorder (ODD) are at a higher risk to develop other serious problems based on reoccurring symptoms such as; aggression, hostility, and lack of empathy for others. Based on the emotional intelligence theory, it may be possible that understanding emotional intelligence in children with ODD could help reduce future psychological and social problems. This quantitative study addresses the problem of poor or low Emotional Intelligence (EI) in children diagnosed with ODD. A correlation between parenting style, as defined by Baumrind's parenting style theory, and the development of emotional intelligence has been found in current research. However, …

Cultural Factors Affecting African Americans Of Caribbean Descent With Type Ii Diabetes, Ruth Runette Aguy-Paulsaint

Walden Dissertations and Doctoral Studies

Type II diabetes is a significant problem in the United States that had affected almost 10% of the American population and over 13% of African Americans. Although culturally competent diabetes education and treatment programs have been significantly more successful, little is known about the cultural factors affecting type II diabetes in African Americans of Caribbean descent (AACD). The purpose of this qualitative, phenomenological study was to explore the cultural factors relevant to the treatment and prevention of type II diabetes among AACD. The theoretical framework for the study consisted of cultural adaptation theory and the transtheoretical model. Data collection consisted …

Adult Character Strength Use And Its Relationship To Physical And Mental Health, Angela Beth Bergen

Walden Dissertations and Doctoral Studies

In this study, the use of human character strengths was evaluated as a component of mental and physical health. The majority of previous character strengths research has been limited to monotonic use of character strengths. This study evaluated subjective outcomes based on a new measure of how much adults reported underusing, optimally using, and overusing their character strengths. This exploratory study was theoretically grounded in the upward spiral model of lifestyle change. The underuse, optimal use, and overuse of character strengths were evaluated as predictors of physical and mental health status, health behaviors, and emotions. Using a convenience sample of …

Trauma-€Informed Care For Persons With Opioid Use Disorder In Ohio, Kimberly Toler

Walden Dissertations and Doctoral Studies

Prevention, social work, and community awareness programs have not led to the successful reduction of opioid overdose deaths nationwide, and particularly in Ohio. This study explored social work perspectives about trauma-€informed care (TIC) for persons with opioid use disorder in Ohio. The research questions for this study examined how social workers in Ohio implemented TIC when providing outpatient treatment to opioid users and what challenges they faced when providing TIC. Using an action research methodology, data were collected through individual semistructured interviews with 5 social work professionals, selected through purposive sampling based on experience in the field of substance use …

Strategies For Nursing Staff Working In A Correctional Facility., Ima James

Walden Dissertations and Doctoral Studies

As primary care providers in correctional facilities, correctional nurses are expected to balance inmates' healthcare needs with the security demands of the facility. This project explored whether an evidence-based education program could provide strategies for promoting health, a healthy work environment, and a sense of well-being to improve the knowledge, coping skills, and well-being of nurses working in a correctional occupational setting. Twenty nurses participated in an educational intervention project that was guided by the transactional theory of stress. Using a pretest/posttest design, data were collected over a 2-week period and calculated using means and percentages. The descriptive statistics using …

Dark Triad Personality Traits Prediction Of Managers' Mind-Set In Business Organizations, Robert Kabat

Walden Dissertations and Doctoral Studies

Presence of the Dark Triad traits of Machiavellianism, narcissism, and psychopathy in the workplace, especially among managers, has received increased attention due to the implications for organizations. One way to influence behavior in business organizations is through controlled interventions to change individual mind-sets. A review of the extant literature indicated that the relationship between Dark Triad traits and mind-set had not been sufficiently examined. A quantitative study was conducted to examine whether a manager's Dark Triad traits predict their mindset. To explore this relationship, a sample of 153 managers' responses was collected online. The Short Dark Triad measure was used …

Validating Bloom's Revised Taxonomy As A Rubric For Assessing Middle School Students' Levels Of Thinking, Siri Torrence Deforest Reynolds

Walden Dissertations and Doctoral Studies

Educators in a rural charter middle school in the United States were challenged with the reliable assessment of student thinking skills even though the development of higher order thinking was an espoused goal for the school. The purpose of this study was to validate a new rubric based on Bloom’s Revised Taxonomy (BRT) to reliably assess student levels of thinking as reflected in the students’ written work. A quantitative, nonexperimental design was used. The focus of the research questions was on the BRT rubric’s reliability and validity. Interrater reliability was assessed using Krippendorff’s alpha. Validity was explored by assessing the …

Self-Injurious Behavior And Social Media Use By Adolescents, Victoria Lynn Fye

Walden Dissertations and Doctoral Studies

There is a surprising dearth of research related to the phenomenon of self-injurious behavior/nonsuicidal self-injury (SIB/NSSI), such as cutting. Research conducted on SIB has revealed that this maladaptive behavior is more common among adolescents than other populations. The act of posting SIB on social media deserves research attention, as it seems to contradict what had previously been considered a very private behavior. The goal of this qualitative case study was to better understand why adolescents engage in SIB as well as investigate why they post these behaviors on social media. Merton's theory of social strain and anomie, which focuses on …

Guardians' Experiences With Mental Health Care For Adolescents With Pediatric Bipolar Disorder, Saudia Y. George

Walden Dissertations and Doctoral Studies

Pediatric bipolar disorder (PBD) is a growing public health problem in the United States, especially among adolescent children. Despite awareness of the diagnosis and the effects that it has on the child, little attention has been given to the effects that PBD has on the guardian. The purpose of this qualitative phenomenological study was to explore the factors influencing guardians' experiences related to PBD. Penchansky and Thomas' Theory of Access and Family Systems Theory were used in this study to explore guardians lived experiences of PBD, its effects on the entire family system, and mental health service treatment. This approach …

Evidenced-Based Staff Education Program For Novice Perioperative Nurses, Marjorie Jasinski

Walden Dissertations and Doctoral Studies

Knowledge of surgical procedures, instruments, and supplies is essential to the perioperative nurse working in the operating room (OR). Nursing school curricula do not specifically educate surgical nurses; therefore, it is difficult to fill open OR positions with experienced perioperative nurses. The purpose of this doctoral project was to develop a perioperative educational program for RNs newly hired in the OR. The practice-focused question asked whether an evidence-based staff education program for the novice perioperative nurse would increase the nurse's knowledge of OR procedures and protocols for patient management. The novice-to-expert framework was used to explore how adult learners acquire …

Resilience And Healthy Adult Relationships Post-Childhood Maltreatment, Nicole Sharie Jackson

Walden Dissertations and Doctoral Studies

The purpose of this study was to understand the role of resilience and protective factors (PFs) in the life of women who have experienced childhood maltreatment (CHM). A further purpose was to understand how women who faced CHM develop resilience, and how the proper use or misuse of PFs later affected their adult relationships, whether intimate, social, or familial. Resiliency theory was the theoretical foundation that informed the study. A qualitative methodology with an interpretative phenomenological analysis design was used in this study. Participants included 7 women who were recruited through social media support groups for adult survivors of child …

Association Of Adaptive Early Phase Study Design And Late Phase Study Results In Oncology, Donna Elise Levy

Walden Dissertations and Doctoral Studies

This quantitative study assessed the association of the design methods used for early phase oncology studies (adaptive versus traditional) and the outcome of late stage clinical trials. Differences by cancer type and by drug classification were also assessed. The theoretical and conceptual frameworks used were the general systems theory and the design and evaluation of complex interventions, respectively. Units of analysis were individual oncology studies in the ClinicalTrials.gov database and Bayesian logistic modeling was applied on a random sample of 381 studies initiated after November 1999 to December 2016. When assessing study design and outcome, there were lower odds of …

Perception Of Self-Worth In African-American Adult Female Children Of Alcoholic Parents, Tahira Lodge

Walden Dissertations and Doctoral Studies

Parental alcoholism is a major risk factor for their children's future alcohol abuse and dependence during adulthood. Thus, the purpose of this descriptive phenomenological study was to understand African-American adult female children's perceptions of self-worth, their lived experiences, and their quality of life as it relates to parental alcoholism. The research focus and questions were addressed by applying the conceptual framework of Bowen's family systems and Covington's self-worth theories. Semi-structured interviews were used to collect data from 8 African-American adult female children of alcoholics. Subsequent data analysis and thematic coding were employed by using Colazzi's 7-step method to ensure rigor. …

Differential Tolerance To Increasing Heterospecific Pollen Deposition In Two Sympatric Species Of Burmeistera (Campanulaceae: Lobelioideae), Juan Moreira-Hernández, Nicholas Terzich, Ricardo Zambrano-Cevallos, Nora Oleas, Nathan Muchhala

Biology Department Faculty Works

Premise of research. Heterospecific pollen deposition on stigmas can impact plant reproduction by decreasing seed set or inducing fruit abortion. Pollinating bats often carry pollen from many species on their fur, and thus bat-pollinated flowers may exhibit tolerance to heterospecific pollen deposition, but to our knowledge this has never been studied. We investigated the relative impact of increasing heterospecific pollen deposition on female reproduction of two sympatric species of Burmeistera that experience pollen transfer between them by their shared bat pollinators.Methodology. We simulated heterospecific pollen deposition by applying pollen mixtures that differed in the ratio of heterospecific to conspecific flowers …

Social Integration And The Mental Health Needs Of Lgbtq Asylum Seekers In North America, Samara Danielle Fox

Yale Medicine Thesis Digital Library

This study examined the mental health burden of LGBTQ asylum seekers and associated psychosocial risk factors with a focus on barriers to social integration. This study also characterized LGBTQ asylum seekers’ interest in interventions aimed at alleviating mental distress and social isolation. Respondents (n = 308) completed an online survey which included the Refugee Health Screener (RHS-15), the NIH loneliness scale, and an adapted scale of sexual identity disclosure. Most respondents (80.20%) screened positive for mental distress. Loneliness (OR = 1.14, 95% CI = 1.09, 1.19) and LGBTQ identity disclosure (OR = 3.46, 95% CI = 1.01, 12.02) were associated …

A Genomic Approach To Idiopathic Liver Disease In Adults, Aaron Hakim

Yale Medicine Thesis Digital Library

Adult patients suffering from liver disease of unknown cause represent an understudied and underserved population. Over the past 15 years, next-generation sequencing technologies have matured into an inexpensive, effective, and widely available set of tools to do genomic analysis. One of these technologies, whole-exome sequencing (WES), allows for high throughput sequencing of all of the genome’s protein coding regions (exons). In pediatric cohorts, WES combined with deep clinical phenotyping has been shown to be an effective and unbiased method of identifying rare protein-altering coding variants in individual genes. WES has also contributed to the diagnosis and individualization of medical care …

The Reproductive Health Needs Of Women At Risk Of Hiv Infection In Connecticut, Emily Hoff

Yale Medicine Thesis Digital Library

Background: The number of women involved in criminal justice systems (WICJ) and women who use opioids has been dramatically increasing in the United States. An often-overlooked aspect of healthcare for women at risk of HIV infection (either WICJ or women who use drugs) is reproductive health. We aim to provide a framework, informed by a systematic review and primary data, to guide future interventions addressing the sexual and reproductive health (SRH) needs of women at risk of HIV infection.

Methods: We completed a systematic literature review of the pregnancy prevention and planning needs of US WICJ published in English from …

Csf Lymphocyte And Monocyte Activation And Trafficking In Primary Hiv Infection, Aveline Xiang Li

Yale Medicine Thesis Digital Library

Trafficking of immune cells to the central nervous system (CNS) is hypothesized to facilitate HIV entry and immune-induced neuronal injury, and is mediated by cell surface proteins such as chemokine receptors and integrins. We longitudinally assessed immune cell activation and surface marker expression in cerebrospinal fluid (CSF) and blood and their relationship with CSF HIV RNA during primary HIV infection (PHI) before and after combination antiretroviral therapy (ART). Longitudinal paired blood and CSF were obtained in initially ART-naïve PHI (infection) participants; some subjects independently initiated ART during follow up. Multiparameter flow cytometry was used to determine activation (% CD38+HLADR+) and …

The Role Of Traf3 And Cyld Mutationin The Etiology Of Human Papillomavirus Driven Head And Neck Cancers, Tejas Sudarshan Sathe

Yale Medicine Thesis Digital Library

The incidence of HPV-positive head and neck squamous cell carcinoma (HNSCC) con-tinues to rise. Though HPV positivity is correlated with improved survival, up to a quar-ter of these tumors recur or metastasize despite aggressive therapy. Currently, there areno biomarkers that can identify HPV-positive HNSCC patients who would benefit fromreduced doses of radiation–which when given at full dose carries significant morbidity.Through analysis of a limited cohort of The Cancer Genome Atlas (TCGA), we previ-ously showed that two genes, TRAF3 and CYLD, were frequently deleted or mutated inHPV-positive HNSCC. TRAF3 and CYLD are functionally related negative regulatorsof the transcription factor NF-κB. In …

Environmental Determinants Of Recruitment Success Of Subalpine Fir (Abies Lasiocarpa) In A Mixed-Conifer Forest, Elizah Z. Stephens, Christopher P. Murar, Daniel B. Tinker, Paige E. Copenhaver-Parry

Faculty Publications - Department of Biological & Molecular Science

Understanding the processes that underlie forest resilience is of increasing importance as climate change and shifting disturbance regimes continue to impact western forests. Forest research and management efforts within the low-diversity conifer forests of the U.S. Rocky Mountains have typically focused on relatively monotypic stands dominated by a single cohort, but mixed-conifer stands, such as those codominated by Abies lasiocarpa and Pinus contorta have been less widely studied. The presence of A. lasiocarpa may enhance resilience to fire- and mountain pine beetle–induced mortality and depends on successful A. lasiocarpa recruitment under a range of environmental conditions. The purpose of this …

Relationship Between Novice Counselors' Supervisory Attachments And Boundary Practices And Perceptions, Glenda Hill Nanna

Walden Dissertations and Doctoral Studies

Novice counselors may struggle to understand and follow ethical guidelines for boundary behaviors with clients. When counselors violate therapeutic boundaries, harmful consequences can result for clients and counselors. The purpose of this quantitative study was to examine the possible relationship between novice counselors' (NCs') attachment to supervisors and NCs' ethical perceptions and boundary practices. This study addressed the possible predictor variables of age, gender, relationship status, and practice setting. Bowlby's attachment theory provided the framework for the study. Survey data from 114 NCs were analyzed using descriptive statistics and hierarchical linear regression. Each regression analyzed predictors of age, gender, relationship …

A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa

Walden Dissertations and Doctoral Studies

Epidemiologic systems failure (ESF) is a major hurdle in minimizing the spread of infectious diseases during outbreaks. The reasons for ESF include the technical limitation of personnel handling epidemic crises, strictly defined health policies that limit the actions of epidemiologists, and personal perspective's reservations towards the intentions of health agencies. The purpose of this triumvirate mixed-methods case study was to examine factors of infectious disease control mechanisms useful for determining ESF. Three juxtaposed pre-emptive factors (technical [T], organizational [O], and personal [P] perspectives were used to determine how the multiple perspectives inquiring systems and fuzzy logic revealed factors causing ESF …