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Blood Culture Staff Education To Improve Knowledge And Contamination Prevention, Christina Michelle Harvey

Walden Dissertations and Doctoral Studies

AbstractThere was an underlying issue with nurses improperly drawing blood cultures resulting in false results that impact patient care. The project examined the question whether a staff education program for Veteran’s Affairs Registered Nurses on the effects of correct blood culture specimen collection can demonstrate an increase in knowledge in the VA’s collection procedure leading toward increasing compliance. The purpose was to correct a knowledge deficit leading to a lack of compliance of the VA nurses on the target unit. The project was directed by the principles of the Knowles’ adult learning model. The sources that generated evidence for the …

Evaluating Compliance With The Produce Safety Rule And Managing Mycotoxins, Yvette May Molajo

Walden Dissertations and Doctoral Studies

Foodborne diseases are the cause of many illnesses that occur from foods that contain mycotoxins. Mycotoxins are produced from fungi and are environmental and carcinogenic agents that contaminate agricultural foods during preharvest and postharvest conditions. While researchers have conducted many studies on mycotoxin occurrence and production, there is a significant gap in the current literature regarding which environmental factors could put farmers’ ability to remain in compliance with the Food Safety Modernization Act’s Produce Safety Rule at risk. Therefore, the purpose of this quantitative study was to investigate which environmental factors could put farmers’ ability to remain in compliance with …

Misuse Of Prescription Pain Relievers Among Pregnant Women In The United States, Winnie Chebet Rono

Walden Dissertations and Doctoral Studies

The non-medical use of prescription pain relievers has increased remarkably, posing social and public health concerns particularly in developed countries such as the United States. The management of pain experienced by pregnant women poses a challenge to clinicians considering the effects of the regimen on unborn babies. Guided by the health belief model, which aims to predict health-related behavior in terms of certain health beliefs and explain change and behavior maintenance as well as to guide health behavior interventions, this cross-sectional study aimed to understand the associations between misusing pain relievers and social determinants of health such as education level …

Predictors Of Obesity Among Young Adults In The State Of Maryland, Kala Shahi

Walden Dissertations and Doctoral Studies

AbstractObesity has become a global wellness concern for young adults. In the past, there were very few studies conducted on predictors of obesity among young adults, even though there have been several studies on the potential predictors of obesity on the general population. The social ecological model was used to guide this quantitative cross-sectional study to identify the possible predictors of obesity among young adults. The Behavioral Risk Factor Surveillance System was used to analyze the potential predictors of obesity among young adults between the ages 18 – 34 years old in Montgomery County, Frederick County, and Princess Georges County, …

Social/Cultural Factors In Preschool Immunizations, Mozambique, Kristine Gayle Bernabe

Walden Dissertations and Doctoral Studies

Immunizations are scientifically proven, effective global health interventions that prevent infectious diseases and save lives. Yet, in Mozambique at the national level, less than 65% of children are fully immunized, i.e., received all the basic/routine vaccinations. The overall purpose of the doctoral study was to conduct quantitative research examining the sociocultural factors that may impact childhood immunization status in the context of the social ecological model. The study examined the relationship between child’s gender, mother’s and her husband/partner’s educational level, household wealth index, religion, ethnicity/language, urban-rural residency, and province/region with the child’s full immunization status in Mozambique. Secondary analysis of …

The Exploration Of Clinical Supervision For Substance Abuse Social Workers In Bermuda, Steva Aria Bean

Walden Dissertations and Doctoral Studies

As specialists who bridge the gap between the social work and substance abuse treatment fields, substance abuse social workers are expected to develop themselves as social workers by designation, substance abuse counselors by occupation, and deliver competent therapeutic services that align both professions seamlessly. As documented in the National Association of Social Workers Code of Ethics, their support in achieving this feat is clinical supervision. Despite this documentation, a review of the social work literature revealed an absence of information on clinical supervision between the social work and substance abuse fields, their supervisory alliance, and outcomes. Accordingly, this project was …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

Operation Enduring Freedom And Operation Iraqi Freedom Veterans In The Veterans Health Administration, Exekiel Montoya Aranez

Walden Dissertations and Doctoral Studies

The Veterans’ Health Administration (VHA) has faced critical issues regarding the deaths of war veterans, the result of which stakeholders raised questions about the quality of health care given within the VHA. Through patient-centered care standards of health care, the VHA worked diligently to end such horrific events that more than 300,000 veterans may have died while waiting for health care service. This study examined five core concepts of the health care system and whether VHA has utilized its five core concepts of patient-centered care to deliver proper health care to war veterans. This study used qualitative research in the …

Improving Nursing Knowledge On Antibiotic Therapy To Prevent Pneumonia Readmissions, Muskuda Deen

Walden Dissertations and Doctoral Studies

Lack of education on the appropriate use of antibiotic therapy can lead to an increase in early readmissions for patients with community-acquired pneumonia (CAP). The purpose of this project was to educate medical-surgical nurses at an inpatient hospital in the southern region of the United States on the appropriate use of antibiotic therapy to decrease early CAP readmissions. The project practice question was whether the infection control clinical practice guidelines would increase the medical-surgical nurses’ knowledge on the appropriate use of antibiotic therapy to decrease the 30-day readmission rates for patients diagnosed with CAP. The staff education development was guided …

Bayesian-Derived Vancomycin Auc24h Threshold For Nephrotoxicity In Special Populations, Dan Ho

University of the Pacific Theses and Dissertations

A Bayesian-derived 24-hour area under the concentration-time curve over minimum inhibitory concentration from broth microdilution (AUC24h/MICBMD) ratio of 400 to 600 is recommended as the new monitoring parameter for vancomycin to optimize efficacy and minimize nephrotoxicity. The AUC24h threshold of 600 mg*h/L for nephrotoxicity was extrapolated from studies that assessed the general population. It is unclear if this upper threshold is consistent or varies when used in special populations such as critically ill patients, obese patients, patients with preexisting renal disease, and patients on concomitant nephrotoxins.The purpose of this study is to investigate the generalizability of the proposed vancomycin AUC24h …

Bioenergy And Minigrids For Sustainable Human Development, Andrew Allee

Dartmouth College Ph.D Dissertations

Human-caused climate change and deep disparities in human development imperil a prosperous and just future for our planet and the people who live on it. Transforming our society to mitigate global warming offers an opportunity to rebuild energy systems to the benefit of those who are harmed by global inequality today. I examine this opportunity through the lens of two sustainable energy technologies: bioenergy and miniature electricity grids (minigrids).

Bioenergy requires land to produce biomass and is inextricably connected to the surrounding environment, agricultural livelihoods, and food system. I apply data science tools to study aspects of land use and …

Tlr3 Controls Constitutive Ifn-Β Antiviral Immunity In Human Fibroblasts And Cortical Neurons, Daxing Gao, Michael S Diamond, Et Al

Open Access Publications

Human herpes simplex virus 1 (HSV-1) encephalitis can be caused by inborn errors of the TLR3 pathway, resulting in impairment of CNS cell-intrinsic antiviral immunity. Deficiencies of the TLR3 pathway impair cell-intrinsic immunity to vesicular stomatitis virus (VSV) and HSV-1 in fibroblasts, and to HSV-1 in cortical but not trigeminal neurons. The underlying molecular mechanism is thought to involve impaired IFN-α/β induction by the TLR3 recognition of dsRNA viral intermediates or by-products. However, we show here that human TLR3 controls constitutive levels of IFNB mRNA and secreted bioactive IFN-β protein, and thereby also controls constitutive mRNA levels for IFN-stimulated genes …

Use Of Machine Learning To Develop And Evaluate Models Using Preoperative And Intraoperative Data To Identify Risks Of Postoperative Complications, Bing Xue, Dingwen Li, Chenyang Lu, Christopher R. King, Troy Wildes, Michael S. Avidan, Thomas Kannampallil, Joanna Abraham

Open Access Publications

Importance: Postoperative complications can significantly impact perioperative care management and planning.

Objectives: To assess machine learning (ML) models for predicting postoperative complications using independent and combined preoperative and intraoperative data and their clinically meaningful model-agnostic interpretations.

Design, Setting, and Participants: This retrospective cohort study assessed 111 888 operations performed on adults at a single academic medical center from June 1, 2012, to August 31, 2016, with a mean duration of follow-up based on the length of postoperative hospital stay less than 7 days. Data analysis was performed from February 1 to September 31, 2020.

Main Outcomes and Measures: Outcomes included …

Taking Account Of Asymptomatic Infections: A Modeling Study Of The Covid-19 Outbreak On The Diamond Princess Cruise Ship, Li-Shan Huang, Li Li, Lucia Dunn, Mai He

Open Access Publications

The COVID-19 outbreak on the Diamond Princess (DP) cruise ship has provided empirical data to study the transmission potential of COVID-19 with the presence of pre/asymptomatic cases. We studied the changes in R0 on DP from January 21 to February 19, 2020 based on chain binomial models under two scenarios: no quarantine assuming a random mixing condition, and quarantine of passengers in cabins-passengers may get infected either by an infectious case in a shared cabin or by pre/asymptomatic crew who continued to work. Estimates of R0 at the beginning of the epidemic were 3.27 (95% CI, 3.02-3.54) and 3.78 (95% …

Broadly Neutralizing Monoclonal Antibodies Protect Against Multiple Tick-Borne Flaviviruses, Laura A. Vanblargan, John M. Errico, Natasha M. Kafai, Prashant N. Jethva, Christopher A. Nelson, David Wang, Scott A. Handley, Michael L. Gross, Daved H. Fremont, Michael S. Diamond, Et Al

Open Access Publications

Although Powassan virus (POWV) is an emerging tick-transmitted flavivirus that causes severe or fatal neuroinvasive disease in humans, medical countermeasures have not yet been developed. Here, we developed a panel of neutralizing anti-POWV mAbs recognizing six distinct antigenic sites. The most potent of these mAbs bind sites within domain II or III of the envelope (E) protein and inhibit postattachment viral entry steps. A subset of these mAbs cross-react with other flaviviruses. Both POWV type-specific and cross-reactive neutralizing mAbs confer protection in mice against POWV infection when given as prophylaxis or postexposure therapy. Several cross-reactive mAbs mapping to either domain …

Variables Associated With Intravenous Rehydration And Hospitalization In Children With Acute Gastroenteritis: A Secondary Analysis Of 2 Randomized Clinical Trials, Naveen Poonai, Philip Tarr, Et Al

Open Access Publications

Importance: Despite guidelines endorsing oral rehydration therapy, intravenous fluids are commonly administered to children with acute gastroenteritis in high-income countries.

Objective: To identify factors associated with intravenous fluid administration and hospitalization in children with acute gastroenteritis.

Design, Setting, and Participants: This study is a planned secondary analysis of the Pediatric Emergency Research Canada (PERC) and Pediatric Emergency Care Applied Research Network (PECARN) probiotic trials. Participants include children aged 3 to 48 months with 3 or more watery stools in 24 hours between November 5, 2013, and April 7, 2017, for the PERC study and July 8, 2014, and June 23, …

Thermoneutrality Alters Gastrointestinal Antigen Passage Patterning And Predisposes To Oral Antigen Sensitization In Mice, Taeko K Noah, Jee-Boong Lee, Christopher A Brown, Amnah Yamani, Sunil Tomar, Varsha Ganesan, Rodney D Newberry, Gary B Huffnagle, Senad Divanovic, Simon P Hogan

Open Access Publications

Food allergy is an emerging epidemic, and the underlying mechanisms are not well defined partly due to the lack of robust adjuvant free experimental models of dietary antigen sensitization. As housing mice at thermoneutrality (Tn) - the temperature of metabolic homeostasis (26-30°C) - has been shown to improve modeling various human diseases involved in inflammation, we tested the impact of Tn housing on an experimental model of food sensitization. Here we demonstrate that WT BALB/c mice housed under standard temperature (18-20°C, Ts) conditions translocated the luminal antigens in the small intestine (SI) across the epithelium

Guidelines For Conducting Virtual Cognitive Interviews During A Pandemic, James A Shepperd, Gabrielle Pogge, Jean M Hunleth, Sienna Ruiz, Erika A Waters

Open Access Publications

The COVID-19 pandemic has challenged researchers working in physical contact with research participants. Cognitive interviews examine whether study components (most often questionnaire items) are worded or structured in a manner that allows study participants to interpret the items in a way intended by the researcher. We developed guidelines to conduct cognitive interviews virtually to accommodate interviewees who have limited access to the internet. The guidelines describe the essential communication and safety equipment requirements and outline a procedure for collecting responses while maintaining the safety of the participants and researchers. Furthermore, the guidelines provide suggestions regarding training of participants to use …

Whipworm-Associated Intestinal Microbiome Members Consistent Across Both Human And Mouse Hosts, Bruce A Rosa, Caroline Snowden, John Martin, Kerstin Fischer, Jonah Kupritz, Ethiopia Beshah, Taniawati Supali, Lincoln Gankpala, Peter U Fischer, Joseph F Urban, Makedonka Mitreva

Open Access Publications

The human whipworm

Get Privacy Trending: Best Practices For The Social Media Educator, Sara W. Dong, Nathanial S. Nolan, Miguel A. Chavez, Yijia Li, Gerome V. Escota, Wendy Stead

Open Access Publications

Social media is an increasingly popular forum for medical education. Many educators, including those in infectious diseases, are now creating and sharing unique and educational patient cases online. Unfortunately, some educators unknowingly threaten patient privacy and open themselves to legal liability. Further, the use of published figures or tables creates risk of copyright infringement. As more and more infectious diseases physicians engage in social media, it is imperative to create best practices to protect both patients and physicians. This summary will define the legal requirements of patient de-identification as well as other practical recommendations as they relate to use of …

Clinical Prediction Rule For Sars-Cov-2 Infection From 116 U.S. Emergency Departments 2-22-2021, Jeffrey A. Kline, Stacey House, Et Al.

Open Access Publications

OBJECTIVES: Accurate and reliable criteria to rapidly estimate the probability of infection with the novel coronavirus-2 that causes the severe acute respiratory syndrome (SARS-CoV-2) and associated disease (COVID-19) remain an urgent unmet need, especially in emergency care. The objective was to derive and validate a clinical prediction score for SARS-CoV-2 infection that uses simple criteria widely available at the point of care.

METHODS: Data came from the registry data from the national REgistry of suspected COVID-19 in EmeRgency care (RECOVER network) comprising 116 hospitals from 25 states in the US. Clinical variables and 30-day outcomes were abstracted from medical records …

Acute Symptoms Of Mild To Moderate Covid-19 Are Highly Heterogeneous Across Individuals And Over Time, Thomas L. Rodebaugh, Madelyn R. Frumkin, Angela M. Reiersen, Eric J. Lenze, Michael S. Avidan, J. Philip Miller, Jay F. Piccirillo, Charles F. Zorumski, Caline Mattar

Open Access Publications

Background: The symptoms of coronavirus disease 2019 (COVID-19) appear to be heterogenous, and the typical course of these symptoms is unknown. Our objectives were to characterize the common trajectories of COVID-19 symptoms and to assess how symptom course predicts other symptom changes as well as clinical deterioration.

Methods: One hundred sixty-two participants with acute COVID-19 responded to surveys up to 31 times for up to 17 days. Several statistical methods were used to characterize the temporal dynamics of these symptoms. Because 9 participants showed clinical deterioration, we explored whether these participants showed any differences in symptom profiles.

Results: Trajectories varied …

Cxcl17 Is A Specific Diagnostic Biomarker For Severe Pandemic Influenza A(H1n1) That Predicts Poor Clinical Outcome, Jose Alberto Choreño-Parra, Shabaana A Khader, Et Al

Open Access Publications

The C-X-C motif chemokine ligand 17 (CXCL17) is chemotactic for myeloid cells, exhibits bactericidal activity, and exerts anti-viral functions. This chemokine is constitutively expressed in the respiratory tract, suggesting a role in lung defenses. However, little is known about the participation of CXCL17 against relevant respiratory pathogens in humans. Here, we evaluated the serum levels and lung tissue expression pattern of CXCL17 in a cohort of patients with severe pandemic influenza A(H1N1) from Mexico City. Peripheral blood samples obtained on admission and seven days after hospitalization were processed for determinations of serum CXCL17 levels by enzyme-linked immunosorbent assay (ELISA). The …

Gestational Age-Specific Complete Blood Count Signatures In Necrotizing Enterocolitis, Julia M Pantalone, Silvia Liu, Oluwabunmi O Olaloye, Erica C Prochaska, Toby Yanowitz, Melissa M Riley, Justin R Buland, Beverly S Brozanski, Misty Good, Liza Konnikova

Open Access Publications

No abstract provided.

Single-Cell Analyses Of Crohn’S Disease Tissues Reveal Intestinal Intraepithelial T Cells Heterogeneity And Altered Subset Distributions, Natalia Jaeger, Ramya Gamini, Marina Cella, Jorge L. Schettini, Mattia Bugatti, Shanrong Zhao, Charles V. Rosadini, Ekaterina Esaulova, Blanda Di Luccia, Baylee Kinnett, William Vermi, Maxim N. Artyomov, Thomas A. Wynn, Ramnik J. Xavier, Scott A. Jelinsky, Marco Colonna

Open Access Publications

No abstract provided.

Old Vaccines For New Infections: Exploiting Innate Immunity To Control Covid-19 And Prevent Future Pandemics, Konstantin Chumakov, Michael S. Avidan, Christine S. Benn, Stefano M. Bertozzi, Lawrence Blatt, Angela Y. Chang, Dean T. Jamison, Shabaana A. Khader, Shyam Kottilil, Mihai G. Netea, Annie Sparrow, Robert C. Gallo

Open Access Publications

No abstract provided.

Diagnostic Accuracy Of Health Care Administrative Diagnosis Codes To Identify Nontuberculous Mycobacteria Disease: A Systematic Review, Carlos Mejia-Chew, Lauren Yaeger, Kevin Montes, Thomas C. Bailey, Margaret A. Olsen

Open Access Publications

Background: Health care administrative database research frequently uses standard medical codes to identify diagnoses or procedures. The aim of this review was to establish the diagnostic accuracy of codes used in administrative data research to identify nontuberculous mycobacterial (NTM) disease, including lung disease (NTMLD).

Methods: We searched Ovid Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from inception to April 2019. We included studies assessing the diagnostic accuracy of

Results: We identified 5549 unique citations. Of the 96 full-text articles reviewed, 7 eligible studies of moderate quality (3730 participants) were included in …

Surgical Infection Society 2020 Updated Guidelines On The Management Of Complicated Skin And Soft Tissue Infections, Therese M. Duane, Jared M. Huston, Morgan Collom, Adam Beyer, Sara Parli, Sara Buckman, Mark Shapiro, Amy Mcdonald, Jose Diaz, Jeffrey M. Tessier, James Sanders

Open Access Publications

No abstract provided.

Trem2 Is A Receptor For Non-Glycosylated Mycolic Acids Of Mycobacteria That Limits Antimycobacterial Macrophage Activation, Ei'ichi Iizasa, Yasushi Chuma, Takayuki Uematsu, Mio Kubota, Hiroaki Kawaguchi, Masayuki Umemura, Kenji Toyonaga, Hideyasu Kiyohara, Ikuya Yano, Marco Colonna, Masahiko Sugita, Goro Matsuzaki, Sho Yamasaki, Hiroki Yoshida, Hiromitsu Hara

Open Access Publications

No abstract provided.

Microbial Sharing Between Pediatric Patients And Therapy Dogs During Hospital Animal-Assisted Intervention Programs, Kathryn R Dalton, Kathy Ruble, Laurel E Redding, Daniel O Morris, Noel T Mueller, Roland J Thorpe, Jacqueline Agnew, Karen C Carroll, Paul J Planet, Ronald C Rubenstein, Allen R Chen, Elizabeth A Grice, Meghan F Davis

Open Access Publications

Microbial sharing between humans and animals has been demonstrated in a variety of settings. However, the extent of microbial sharing that occurs within the healthcare setting during animal-assisted intervention programs is unknown. Understanding microbial transmission between patients and therapy dogs can provide important insights into potential health benefits for patients, in addition to addressing concerns regarding potential pathogen transmission that limits program utilization. This study evaluated for potential microbial sharing between pediatric patients and therapy dogs and tested whether patient-dog contact level and a dog decolonization protocol modified this sharing. Patients, therapy dogs, and the hospital environment were sampled before …