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Combinatorial Administration Of Synthetic Tlr4 Agonist Ini-2002 And Novel Mincle Agonist Um-1098 Delivered Via A-Snps Results In Synergistic Il-1Β Production In Human Primary Cells And Enhances Th1 And Th17 Responses In Vivo, Grace D. Jones, Asia Marie Stephanie Riel, Alexander Riffey, Cassandra Buhl

Graduate Student Theses, Dissertations, & Professional Papers

Tuberculosis (TB) kills more people each year than any infectious disease worldwide with recent exception of SARS-CoV-2. Though the Bacille Calmette Guerin (BCG) vaccine confers protection against severe extrapulmonary forms of TB, there is no licensed vaccine for the prevention of pulmonary tuberculosis. The strongest correlate of protection against pulmonary tuberculosis is Th1/Th17 biased cell mediated immunity. Several candidates for TB vaccine adjuvants have shown Th1/Th17 polarizing capacity in clinical trials including Mincle agonist trehalose dibehenate (TDB) and TLR4 agonist monophosphoryl lipid A (MPL). Furthermore, combinatorial administration of MPL and TDB formulated in dimethyldioctadecylammonium (DDA) liposomes has been previously reported …

Pharmacy-Based Immunization Laws And Adolescent Well-Child Checkup Tradeoffs: Results From The Nis-Teen 2019, Teigan Avery

Graduate Student Theses, Dissertations, & Professional Papers

Pharmacy-based immunization (PBI) has been heralded as a barrier-reducing way to immunize Americans and reach public health targets. PBI programs vary by state; some states prohibit vaccinating children in pharmacies while others allow pharmacists to prescribe and immunize persons of any age. There is concern that liberal PBI programs may boost vaccination rates at the cost of well-child visits. Parents may see PBI as an alternative to preventive well-check visits at a doctor’s office rather than as a complement, particularly for adolescents. This paper estimates the effect of state vaccination policies on individual adolescent 11–12-year-old well-checks using probit regression for …

Trends And Correlates Of Breakthrough Infections With Sars-Cov-2, Jose-Miguel Yamal, Savitri Appana, Mengxi Wang, Luis Leon-Novelo, Eric Bakota, Yuanqing Ye, Shreela Sharma, Alanna C Morrison, Dritana Marko, Stephen H Linder, Alison Rector, Katelyn K Jetelina, Eric Boerwinkle, Marcia De Oliveira Otto

Faculty, Staff and Student Publications

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant has been hypothesized to decrease the efficacy of COVID-19 vaccines. Factors associated with infections with SARS-CoV-2 after vaccination are unknown. In this observational cohort study, we examined two groups in Harris County, Texas: (1) individuals with positive Nucleic Acid Amplification test between 12/14/2020 and 9/30/2021 and (2) the subset of individuals fully vaccinated in the same time period. Infected individuals were classified as a breakthrough if their infection occurred 14 days after their vaccination had been completed. Among fully vaccinated individuals, demographic and vaccine factors associated with breakthrough infections were …

Population-Based Correlates Of Covid-19 Infection: An Analysis From The Dfw Covid-19 Prevalence Study, Amit G Singal, Andrew Masica, Kate Esselink, Caitlin C Murphy, Jill A Dever, Annika Reczek, Matthew Bensen, Nicole Mack, Ellen Stutts, Jamie L Ridenhour, Evan Galt, Jordan Brainerd, Noa Kopplin, Sruthi Yekkaluri, Chris Rubio, Shelby Anderson, Kathryn Jan, Natalie Whitworth, Jacqueline Wagner, Stephen Allen, Alagar R Muthukumar, Jasmin Tiro

Faculty, Staff and Student Publications

BACKGROUND: COVID-19 has resulted in over 1 million deaths in the U.S. as of June 2022, with continued surges after vaccine availability. Information on related attitudes and behaviors are needed to inform public health strategies. We aimed to estimate the prevalence of COVID-19, risk factors of infection, and related attitudes and behaviors in a racially, ethnically, and socioeconomically diverse urban population.

METHODS: The DFW COVID-19 Prevalence Study Protocol 1 was conducted from July 2020 to March 2021 on a randomly selected sample of adults aged 18-89 years, living in Dallas or Tarrant Counties, Texas. Participants were asked to complete a …

Knowledge, Attitude And Practice Related To Covid-19 Among People- A Descriptive Survey, Pramilaa R

Manipal Journal of Nursing and Health Sciences

Introduction: Corona virus can be deemed as one of the rapidly spreading viral infections. More than 200 countries in less than four months were infected. Findings of a study proved that insight of people in the community is remarkable to render care during pandemics. Characteristics that influence the people to adhere with sound healthy practices and desirable behaviors can be acquired by examining the level of awareness related to COVID-19 among people. Objectives: The objectives of the study were to assess knowledge, attitude and practice related to COVID-19 among people; correlate the knowledge, attitude and practice scores related to COVID-19 …

Incidence Of Tuberculosis In The Association Of South-East Asia Nation (Asean) Countries And Its Relation With Health Expenditure: A Secondary Data Analysis., Vaanita Shanmuham, Jeevan K. Shetty, Venkatesh Ramaswamy Naik

Manipal Journal of Nursing and Health Sciences

Introduction: Tuberculosis (TB) is an infectious disease that mainly affects the lungs. ASEAN is responsible for the high incidence of tuberculosis recorded worldwide. Therefore, this study analyses the trend of tuberculosis and its association with per capita health expenditure in ASEAN.

Methods: The incidence of tuberculosis and the per capita health expenditure are collected from Global Health Observatory resources and World Bank Organization. The data were interpreted using SPSS Software Version 23 and the results were presented in graphs and tables.

Results: Six ASEAN countries showed a declining trend, three countries had a fluctuating trend, and one country had an …

Strategies For Preventing And Mitigating Counterfeit Medication From Entering The U.S. Supply Chain, Denise Blais

Walden Dissertations and Doctoral Studies

Some pharmaceutical brand protection managers lack strategies to mitigate financial losses from counterfeit prescription drugs. A multilayered approach involving guiding principles, supply chain security, investigations, enforcement, advocacy, and awareness can help mitigate potential financial losses and keep patients safe. Guided by the Six Sigma define, measure, analyze, improve, and control (DMAIC) model and the fraud triangle conceptual framework, the purpose of this multiple case study was to explore strategies brand protection managers use to mitigate financial losses from counterfeit prescription drugs. Data collection included three semi-structured interviews using Zoom. Analyzing data entailed transcribing and coding themes within data and relating …

Dystonia Patients' Use Of Mindfulness To Address Pain, Diana Boyd

Walden Dissertations and Doctoral Studies

This qualitative, phenomenological study was conducted to explore the lived experiences of 10 women who used mindfulness to alleviate their chronic pain associated with cervical dystonia (CD). Individuals who suffer from CD face challenges related to symptom management and the psychological effects from experiencing chronic pain. Since treatments for CD are limited and pharmacological options to treat chronic pain, like opioids, can lead to addictions, individuals with CD may seek non-pharmacological treatment options. Women, 18-60 years of age were interviewed using a semi-structured interview process. Bandura’s self-regulation theory provided a framework for this study. Results from this study found that …

The Nutrition Environment Among Young San Children In Oshandi: A Case Study, Evelyn Ndinelao Breuer

Walden Dissertations and Doctoral Studies

AbstractUndernutrition among young San children under the age of five remains prominent in Namibia, despite nutritional intervention programs. Guided by the model of community nutritional environment conceptual framework and social-ecological model, this case study involved exploring perceptions of San parents and local nutritional service providers regarding the nutritional environment of San children in Oshandi Village. Semi-structured interviews and observations were used to conduct this research with 12 participants, five local nutritional service providers and seven San parents who had children under five. Irregular and unreliable nutritional support was a factor leading to not explicitly addressing needs of the San people, …

Rural Older Adults’ Wellbeing During The Covid-19 Pandemic, Christina Clevenger

Walden Dissertations and Doctoral Studies

Recent studies reveal adults 65 and over are living longer, healthier lives than ever before. However, this older generation is often vulnerable to exclusion, marginalization, and discrimination, made worse by the events and circumstances of the COVID-19 pandemic. The pandemic brought unprecedented challenges and disproportionate threats to the integrity and wellbeing of older adults, especially those living in rural communities. Nonetheless, little is known about the effects the pandemic had on rural older adults’ wellbeing. This generic qualitative study explored rural older adults’ wellbeing during the pandemic, using the theoretical frameworks of Erikson’s stage theory of psychosocial development and Seligman's …

The Association Between Vocational Training Programs And Recidivism In A South Florida Prison, Audrey Karlene Ives

Walden Dissertations and Doctoral Studies

AbstractTo lower recidivism, a private rehabilitation and correctional facility (PRCF) in South Florida provides educational and therapeutic programs to inmates; however, the facility reported increased recidivism rates for several successive years. The purpose of this quantitative study was to examine the association between 12 vocational training programs at the local PRCF and recidivism. The study’s theoretical framework was Hirschi’s social bond theory of attachment, involvement, commitment, and belief. The research question sought to determine whether significant associations exist between specific vocational training programs and recidivism. A convenience sample of 187 inmates who completed one vocational training program and left the …

Sociodemographic Factors As Predictors Of Low Influenza Vaccination In Chicago, Illinois, Ingrid L. Jeske

Walden Dissertations and Doctoral Studies

Outbursts of seasonal influenza contribute to morbidity and mortality in the United States. Influenza is a contagious disease caused by influenza viruses. The main subtypes of the influenza virus are Type A and Type B. Influenza vaccines are among the most effective methods in preventing the spread of the influenza virus because they offer the best immune defense. However, health care providers face significant challenges due to low patient compliance with current vaccine recommendations and misinformation. Scholars have yet to expand and further explore the reasons for the gap in influenza vaccination between White individuals and minorities, such as the …

Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan

Walden Dissertations and Doctoral Studies

Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …

Covid-19 Ethical Decisions Encountered By Healthcare Professionals In Southwest Ohio, Joshua Lader

Walden Dissertations and Doctoral Studies

The COVID-19 coronavirus has wreaked havoc on the world and medical community. Treating individuals during a worldwide pandemic is nothing short of heroic. With limited supplies and treatment options, healthcare professionals were forced to make ethical considerations when treating patients with COVID-19. The pandemic exposed stress in the healthcare system, leading to difficult ethical decisions such as providing access or denying access to treatment. Knowing these ethical considerations can assist healthcare professionals with practical policies for future pandemics. The key research question in this study explored how healthcare professionals in Southwest Ohio made ethical decisions related to who and how …

The Effects Of Stress Reduction For Healthcare Workers On Covid Units, Rosita Cynthia Mctaggart

Walden Dissertations and Doctoral Studies

The rise of the COVID pandemic was a surprise to many. Since Florence Nightingale, society has suffered from various epidemic infectious diseases. This specific educational project was developed because of the stress and the aftereffects experienced by many healthcare workers coping with the working conditions related to COVID. This educational project is important because according to the World Health Organization, a healthy environment is a place for physical, mental, and social well-being, which supports optimal health and safety. Healthcare workers should be provided an educational program to assist them in minimizing stress. Havelock’s and Lewin’s theory of change was chosen …

Strategies To Improve Quality Of Care And Increase Medicare Payments In Hospitals, Emmanuel Mendoza

Walden Dissertations and Doctoral Studies

The difficulty that nurse leaders experience in administrating quality of care while increasing Medicare payments threatens the hospital's patient well-being and financial stability. Health care administrators should be concerned about these issues to ensure their hospitals meet patient and community needs. Grounded in the performance improvement model, the purpose of this qualitative single case study was to explore strategies that hospital managers use to improve the quality of care and increase Medicare payments. The participants were six nurse leaders of a medium size hospital based in Houston, Texas. Data were collected using semistructured virtual interviews and a review of company …

The Relationship Between Team Engagement And Physician Engagement, Lynne Miles

Walden Dissertations and Doctoral Studies

AbstractWhile physician engagement has previously been shown to be related to both turnover and burnout, there are no studies that focus primarily on the relationship between the physician and team. The purpose of this quantitative study was to examine the relationship between team engagement and physician engagement. The theoretical framework used to guide this research study is the neoclassical organizational theory. The secondary data source was from an engagement survey taken by employed team members and physicians. The independent variable is team engagement. The dependent variable is physician engagement. The instrument for the study is valid and reliable and was …

Perceptions Of Hiv Testing Among African-Born Immigrants In Washington State, Phoebe Kirigo Mugo

Walden Dissertations and Doctoral Studies

African born immigrants (ABIs) face challenges associated with HIV testing. As a result, many ABIs are not tested for HIV, and this population is among some of the most diagnosed at late stages of HIV/AIDS. The purpose of this qualitative phenomenological study was to explore and seek to understand the lived experiences of ABI adults ages 25 to 49 living in Washington State. I gathered data to gain their perceptions of HIV testing through in-depth interviews. The study was informed by the health belief model, which helped to understand the complex nature of healthcare-seeking behaviors among this population and how …

Exploring Vaccination Hesitancy Among Nonmandated Nurses And Health Care Workers, Germaine Lazett Nelson

Walden Dissertations and Doctoral Studies

COVID-19 vaccinations have been mandated for most healthcare professionals providing direct patient care, but there are a group of nonmandated healthcare professionals who have been hesitant to receive the vaccine. Given prolonged hesitancy among key health professionals charged with providing direct patient care, it is crucial to understand why they are hesitant; their apprehension may impact the pool of professionals available to provide direct patient care. This is a cross-sectional quantitative study that included an online survey. The health belief model served as the theoretical framework. The research questions addressed whether there is an association between type of patient care …

Understanding The Perspectives Of African American Gay And Bisexual Men Toward Hiv, Victor Onwezi , Ikechukwu Nwanguma

Walden Dissertations and Doctoral Studies

There is an urgent need to stop the HIV epidemic among African American gay and bisexual men in the United States. The purpose of this basic qualitative study was to identify the health issues responsible for the HIV epidemic among African gay and bisexual men. Two theoretical frameworks that guided the study were the transtheoretical model and the syndemic theory. The study's research involved understanding African American gay and bisexual men's perspective toward HIV infections and their understanding of possible reasons HIV rates appear to increase in their community. Semi-structured telephone interviews and field notes were used to collect primary …

Variables On The Proportion Of Children With Sickle Cell Hemoglobin, Oyekola Oluyimika Oloyede

Walden Dissertations and Doctoral Studies

AbstractThe case fatality rate among children living with sickle cell disease was approximately 50% to 90% in Sub-Saharan Africa. Though researchers have contributed social determinants of health more broadly, they have not provided adequate screening information on children living with sickle cell disease aged 6 months to 59 months. The purpose of this cross-sectional study was to examine the association between sickle cell disease status, infection prevention, pain and anemia management, demography, socioeconomic status, and healthcare use. This study included approximately 11,536 genotype results of children under 5-years-old in Nigeria. Bronfenbrenner’s systems theory and Krieger’s ecological theory formed the theoretical …

Age And Pain Predicting Hospital Length Of Stay Among Individuals With Sickle Cell Disease, Tyanna Qualls

Walden Dissertations and Doctoral Studies

Most patients with sickle cell disease (SCD), especially those from low socioeconomic status, experience financial constraints in meeting their hospital bills resulting from prolonged hospital stays. The research was guided by Andersen’s (1995) behavioral model of health services (BMHS) as the theoretical framework. The purpose of this retrospective quantitative correlational study was to evaluate whether and the extent to which age and pain crisis affect the length of hospital stay among patients with SCD in the United States. Secondary data were collected from the Healthcare Cost and Utilization Project (HCUP). A chi-square test was used to test the relationship between …

Impact Evaluation Of The Brfss In New York On Obesity Prevention For Weight Loss Among Women, Nikisha Skeete

Walden Dissertations and Doctoral Studies

Abstract Obesity has increased among the adult population, specifically women, in the United States within the past few decades. While the increase in obesity has been linked to a lack of physical activity and poor dietary intake, obesity lacks contextual analysis within adult women as a group. The purpose of this quantitative study was to examine the impact of the Behavioral Risk Factor Surveillance System (BRFSS) on obesity prevention for weight loss in women. Health behavior change theory, the transtheoretical theory model, and the health behavior model guided this study. The research questions were designed to examine whether modifiable lifestyle …

The Lived Experience Of Older, Independent Residents During The Covid-19 Pandemic, Karen Graeb Stanley

Walden Dissertations and Doctoral Studies

The growing older population confronting the risks of the COVID-19 pandemic have a story to tell of their experiences that may influence the way society confronts future pandemics. Little research has been done on older adults in independent living communities and their experiences with the COVID-19 pandemic. This study aimed to fill that gap using the biopsychosocial model as a framework to guide the exploration of the research question addressing the lived experiences of older, independent residents during the COVID-19 pandemic. Using a basic qualitative analysis design, a purposive sample of 10 participants from a continuing care retirement community were …

Impact Of Poverty On Antibiotic Prescribing Rates In The United States Through Mediation Effects Of Underlying Health Conditions, Nato Tarkhashvili

Walden Dissertations and Doctoral Studies

Resistance to antibiotics among bacteria develops largely due to frequent use of antibiotics in human and animal medicine. Little is known about how patients’ socioeconomic factors, in conjunction with chronic health conditions, impact antibiotic prescribing rates in the United States. The research questions aimed to explore the relationship between poverty and antibiotic prescribing rates while also adjusting for confounders such as population aged ≥ 65, physician density, prevalence of obesity, diabetes, and chronic obstructive pulmonary disease (COPD). The relationships were evaluated using a quantitative, ecological study design using the ecosocial theory and mediation analysis of 2020 survey results provided by …

Military Health Services Impact On Patient Understanding Of The Zika Virus Within A Military Community, Gabrielle Tellis

Walden Dissertations and Doctoral Studies

AbstractThe Zika virus does not have a known treatment, despite ongoing efforts since 2016 to develop a vaccine. The Zika virus has been labeled by World Health Organization and the Department of Defense as a threat to the readiness, resiliency, and preparedness of military service members and dependents that currently travel or serve in areas where high concentrations of the virus are present. As such, it is important to understand how the military community understanding of the Zika virus is impacted by military health services and education. A phenomenological qualitative approach was utilized to conduct this study. Twenty active-duty military …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Hand Hygiene Education For Nursing Homes, David La Rosa-Presume

Walden Dissertations and Doctoral Studies

In the health care sector, hand hygiene has been identified as one of the most appropriate approaches to preventing health-associated infections or nosocomial infections. A nursing home in the western United States had repeated survey findings showed that their hand hygiene compliance rates did not meet the expectations of the Long-Term Care Institute. This project was aimed to develop and implement an education program to improve hand hygiene compliance in a nursing home setting. The project practice question asked whether an education program would increase staff’s knowledge of hand hygiene methods within a skilled nursing facility. The Joint Commission’s Targeted …

Prison Medical Professionals’ Perspectives On Dignity In Death For End-Of-Life Inmates, Charlene Lupo

Walden Dissertations and Doctoral Studies

Health care requirements of older persons in prison are complicated, and many may require palliative care before their term is completed. The purpose of this qualitative interpretative phenomenological analysis was to explore perspectives on dignity in death for end-of-life inmates through the lens of nine prison medical professionals. Concepts of dignity provided the conceptual framework for the study. Data were collected from one-to-one audio-recorded Zoom interviews and reflective literature articles. Axial coding and thematic data analysis were used to identify five themes: committed to their vocation, lack of services in administering proper health care, institutional barriers prohibiting death with dignity, …

Gaps In Immunization Prevention In The State Of Ohio, Audrey Shaw

Walden Dissertations and Doctoral Studies

In the United States, the total cost for vaccine preventable diseases was $8.95 billion in 2015. The unvaccinated accounted for 80% of the total costs. This quantitative study was conducted to investigate the success and/or gaps in the implementation of the measles, mumps, and rubella (MMR) vaccine through the Vaccine for Children (VFC) Program by the Ohio Department of Health. General systems theory was chosen as a theoretical framework due to the complicated nature of the healthcare system. Healthcare is a complex system composed of multidisciplinary units that have their own structure and purpose that interact to accomplish the mission …