Digital Commons Network^™

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 …

Factors Associated With The Uptake Of Hiv Testing Among African American Male College Students, Brittney Sade Washington-Ball,Drph

Walden Dissertations and Doctoral Studies

HIV testing rates are much lower among African American male college students than male college students of other racial groups. Routine HIV testing on college campuses can decrease HIV rates among African Americans and increase students' awareness of their HIV status. This study was an investigation of factors associated with HIV testing among a sample of 140 African American male college students. The health belief model guided the research study and served as the theoretical framework to examine the influence of factors such as the location of testing, STD status, number of sexual partners, insurance coverage, health information, and alcohol …

Diabetes, Obesity, Geographic Location Of The Patient And Clostridium Difficile Infection In The United States, Mary (Maribeth) Greenway

Walden Dissertations and Doctoral Studies

AbstractClostridium difficile infection (CDI) is a major nosocomial threat to be reckoned with in the current health care setting in the United States. Advancing age, underlying chronic disease associated with inflammation (including Diabetes Mellitus Type I ([DMI]), Diabetes Type II ([DMII]), and obesity), trauma, immunodeficiency and other factors that diminish the overall health of an individual, and increase an individual’s susceptibility to CDI. The ecological framework was used to determine the relationship between geographic, chronic diseases and the occurrence of infectious diseases. To continue enhancing knowledge related to CDI susceptibility this quantitative study used the 2010 National Hospital Discharge Survey …

Educating Nursing Staff On Clostridioides Difficle Infection Bundle Use, Amber Lee Winkis

Walden Dissertations and Doctoral Studies

Clostridioides difficile infection (CDI) is a local, national, and global issue impacting patient outcomes and healthcare organizations. CDI is costly to treat, painful, and at times deadly. Given an increase in CDI over the past year at the project site, the current gap in practice is the nonadherence of nursing staff to using a CDI bundle. This project addresses that gap. The practice-focused question targeted at nursing staff (N = 18) on an adult medical-surgical unit in an acute care hospital and asks whether education on use of a CDI bundle would result in a knowledge gain about the importance …

Evaluating The 2012 Vaccination Reporting Mandate: Applications To Adventist Health Network, May Abdalla

Walden Dissertations and Doctoral Studies

Influenza is a public health concern that claims up to 56,000 lives annually in the United States, though it is a vaccine-preventable disease. Influenza vaccination among health care personnel (HCP) is highly encouraged to prevent influenza transmission in health care settings. The objective of this study was to examine the relationship between mandatory reporting of HCP influenza vaccination rates (implemented in 2012) and HCP influenza vaccination intake in a health care network with 20 hospitals. The protection and motivation theory was used as the theoretical framework. Data collected from surveys of hospital administrators and archives of the Center for Medicare …

Food Availability And Sanitation Conditions In Pademba Road Prisons, A Case Study, Santos Alimamy Bangura

Walden Dissertations and Doctoral Studies

Abstract Prisons generally suffer from poor sanitation and food shortages that undermine the health and overall quality of inmates’ lives. Focusing on Pademba Road Prison in Freetown, Sierra Leone, the purpose of this study was to provide policy recommendations that benefit the inmates by ensuring they receive nutritious meals and improved conditions of hygiene. The following research question shaped the study: What policies can be formulated that would give inmates access to adequate food and improved sanitation at Pademba Road Prison? This qualitative case study took place in single research setting and focused on the dilemma of the workers and …

Treatment Outcomes And Associated Factors In Tb/Hiv-Coinfected Patients In Namibia, Esland Shilongo

Walden Dissertations and Doctoral Studies

AbstractHIV and TB have merged into a deadly co-epidemic in Namibia. Currently, though, TB and HIV data at the national, regional, and district level might be underreported and insufficient to understand the full burden and outcome rates of TB and HIV. Targeting the TB outcomes rate among TB/HIV-coinfected individuals is an effective strategy for decreasing future TB burden and furthering the gains in the control of both diseases. The objective of this study was: to assess the outcomes of patients registered for anti-TB treatment in //Karas Region which has the largests burden of TB in Namibia. A 5-year retrospective cohort …

Lived Experiences Of African American Women Climbing The Corporate Ladder For Executive Positions In Healthcare Administration, Oriaku Hampton Sowell

Walden Dissertations and Doctoral Studies

The need for strong African American leadership and increased diversity remains a significant challenge in healthcare. While the issue of women in executive healthcare leadership has gained awareness, they remain underrepresented in the industry. A qualitative descriptive phenomenological study collected data from 12 participants through semistructured in-depth interviews. In this study, the experiences and perceptions of African American women regarding the limited number of women being promoted to executive roles were examined. The glass ceiling and critical race theories were the theoretical foundation used to cultivate a voice for African American women who aspire to healthcare executive roles. However, findings …

Faculty Perspectives On Quality Of Online Courses In Health Education And Promotion Programs, Dana Wawrzyniec

Walden Dissertations and Doctoral Studies

The need to make quick transitions online due to COVID-19 challenged many Health Education and Promotion (HEP) faculty to identify how to create quality online HEP courses. A review of the literature identified the need for qualitative research on the quality of online courses from the faculty’s perspective. The purpose of this general qualitative study was to explore the perceptions and experiences of HEP faculty at multiple universities, in terms of the organization and facilitation of their online courses, communication between instructor and student, and assessment of students. The community of inquiry (COI) framework, which evaluates the teaching, social, and …

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 …

Alternative Diet Practices As Predictors For Vaccine Confidence, Nancy Dolin

Walden Dissertations and Doctoral Studies

Perceived risks and side effects have left some with a lack of confidence in the safety and efficacy of vaccines. This may lead to not adhering to the recommended vaccination schedule and result in outbreaks that have the potential to harm those who are unable to get vaccinated due to age or infirmity. It is vital to seek and address the characteristics that may predict one’s confidence in vaccines. The aim of this study was to identify whether an individual’s alternative diet behavior may be able to predict their confidence in the measles, mumps, and rubella (MMR) vaccine. The theoretical …

The Outcome Of Stroke Education And Management On Cerebrovascular Accident Patients In Bermuda, Antoinette Simone Dyer

Walden Dissertations and Doctoral Studies

AbstractIncidence of cardiovascular accident (CVA), also referred to as a stroke, has increased in Bermuda. Understanding key contributing factors is necessary to reduce incidences that are associated with this disease process. This dissertation examined the outcome of stroke education and management on CVA patients in Bermuda. The health belief model, incorporating a reflection of the public health framework, guided the analysis of a quantitative dataset obtained through Bermuda Hospitals Board’s Neurology Department. A cross-sectional study design was used to sample 253 stroke patients over a 2-year period (2019 -2021). The Wilcox test was employed to compare two groups – stroke …

Thermodynamic Mechanisms Of Helix Stabilization In A Model Peptide And Protein, Ryan Murray

University of the Pacific Theses and Dissertations

Biologics are large, complex therapeutic agents generally produced from living organisms. One group of biologics is peptide/protein based. Biological agents offer unique advantages over traditional therapeutics including longer half-lives, higher specificity, greater efficacy, and reduced off-target effects. However, protein/peptide based drugs suffer from both delivery and stability issues. The higher order of protein structures (secondary, tertiary, etc.) derive ~80% of their conformational stability from paltry hydrophobic effects, with net stabilization of 5-15 kcal/mole observed for many proteins. Loss of conformational stability can lead to increased aggregation, precipitation, and degradation; and reduced activity and side effects. To increase stability and improve …

The Role Of Rad51 In Trichomonas Vaginalis, Dominique Hall

University of the Pacific Theses and Dissertations

Drug resistance to the current treatments on the market is on the rise, therefore there is strong interest in understanding what could be causing the resistance, how resistance could be spreading through the population, and finding some possible new drug targets. One protein of interest is Radiation Sensitive Protein 51 (Rad51). It is a protein that is involved in homologous recombination as well as other processes such as DNA damage repair. While Trichomonas vaginalis traditionally has been known to replicate via binary fission, a modified form of closed mitosis, there is some evidence that meiosis, or at least some form …

Determining Effective Treatment Regimens For Breast Cancer Using Combined Immunotherapy And Chemotherapy In Vivo, Akhila R. Kunuthuru, Laura Graham, Harry D. Bear Md, Phd

UROP Posters

Breast cancer has the highest incidence rate of all cancers globally in women, and those of African descent, especially West African females, face higher rates of triple-negative breast cancer (TNBC), a more aggressive form of breast cancer. Immunotherapy for breast cancer is a relatively new treatment option, and research is ongoing to identify the best combination treatments for increasing survival of those diagnosed with TNBC. Eganelisib (IPI-549: a PI3K-gamma inhibitor that works to shift M2 macrophages to M1 to augment T cell function) with other combinatory treatments has shown promising results in reducing tumor growth and increasing survival in mice. …

Checkpoint Inhibitors As Immunotherapy For Fungal Infections: Promises, Challenges, And Unanswered Questions, Sebastian Wurster, Stephanie S Watowich, Dimitrios P Kontoyiannis

Faculty, Staff and Student Publications

Opportunistic fungal infections have high mortality in patients with severe immune dysfunction. Growing evidence suggests that the immune environment of invasive fungal infections and cancers share common features of immune cell exhaustion through activation of immune checkpoint pathways. This observation gave rise to several preclinical studies and clinical case reports describing blockade of the Programmed Cell Death Protein 1 and Cytotoxic T-Lymphocyte Antigen 4 immune checkpoint pathways as an adjunct immune enhancement strategy to treat opportunistic fungal infections. The first part of this review summarizes the emerging evidence for contributions of checkpoint pathways to the immunopathology of fungal sepsis, opportunistic …

Prediction Of Groundwater Quality Index In The Selected Divisions Of Srikakulam Using Artificial Neural Networks Approach, Santhosh Kumar Nadikatla, Mushini Venkata Subbarao, M.P.S. Murali Krishna

Applied Environmental Research

Applicability of artificial neural network (ANN) modelling in predicting the water quality index (WQI) and in turn to ascertain the suitability of the water for human consumption has been presented in the paper. In the light of the present study, seventy-nine (79) groundwater samples were collected from two mandals (divisions) Veeraghattam (VGT) and Palakonda (PLKD) and analyzed for physicochemical parameters during the pre-monsoon and post-monsoon seasons of 2015 and 2016. In computing the WQI, physicochemical parameters such as  pH, EC, TDS, TH, Ca, Mg, chlorine, fluoride, nitrite, DO and TA have been considered. From the results it was found that …

Protecting International Travelers During The Pandemic: Charting The Way Forward, Fernando Dias Simoes

Minnesota Journal of International Law, Vols. 28:2 onward (2019-present)

No abstract provided.

Low Knowledge Of Hiv Prep Within A Midwestern Us Cohort Of Persons Who Inject Drugs, Sena Sayood, Laura R. Marks, Rupa Patel, Nathanial S. Nolan, Stephen Y. Liang, Michael J. Durkin

Open Access Publications

We interviewed persons who inject drugs (PWID) to understand perceptions of pre-exposure prophylaxis (PrEP) to prevent HIV infection. Knowledge of PrEP was poor. Patients felt that PrEP was for sexual intercourse rather than injection drug use, and PWID managed on medications for opioid use disorder felt that they had no need for PrEP.

Prospective Nasal Screening For Methicillin-Resistant Staphylococcus Aureus In Critically Ill Patients With Suspected Pneumonia, Nicholas Raush, Kevin D. Betthauser, Karen Shen, Tamara Krekel, Marin H. Kollef

Open Access Publications

We carried out a prospective de-escalation study based on methicillin-resistant

Understanding And Application Of Daptomycin-Susceptible Dose-Dependent Category For Enterococcus: A Mixed-Methods Study, Jennifer L. Adema, Laurel N. Lake, Ryan W. Stevens, Breann M. Hogan, Audrey N. Schuetz, Aaron J. Tande, Kristin C. Mara, Allison R. Eberly, Christina G. Rivera

Open Access Publications

Background: In 2018, the Clinical Microbiology Laboratory at our institution adopted updated daptomycin

Methods: This mixed-methods study combined a clinician survey with a retrospective pre-post prescribing analysis. An 8-question survey was distributed to infectious diseases (ID) and internal medicine (IM) clinicians. A retrospective chart review of hospitalized adults with infections due to

Results: Survey response rates were 40 of 98 (41%) for IM and 22 of 34 (65%) for ID clinicians. ID clinicians scored significantly higher than IM clinicians in knowledge of SDD. Chart review of 474 patients (225 pre- vs 249 post-SDD) showed that daptomycin dosage following susceptibility testing …

Outcomes Of Sars-Cov-2-Positive Youths Tested In Emergency Departments: The Global Pern-Covid-19 Study, Anna L. Funk, Fahd A. Ahmad, Et Al

Open Access Publications

Importance: Severe outcomes among youths with SARS-CoV-2 infections are poorly characterized.

Objective: To estimate the proportion of children with severe outcomes within 14 days of testing positive for SARS-CoV-2 in an emergency department (ED).

Design, Setting, and Participants: This prospective cohort study with 14-day follow-up enrolled participants between March 2020 and June 2021. Participants were youths aged younger than 18 years who were tested for SARS-CoV-2 infection at one of 41 EDs across 10 countries including Argentina, Australia, Canada, Costa Rica, Italy, New Zealand, Paraguay, Singapore, Spain, and the United States. Statistical analysis was performed from September to October 2021. …

Understanding Contributors To Racial And Ethnic Inequities In Covid-19 Incidence And Mortality Rates, Karen E. Joynt Maddox, Mat Reidhead, Joshua Grotzinger, Timothy Mcbride, Aaloke Mody, Elna Nagasako, Will Ross, Joseph T. Steensma, Abigail R. Barker

Open Access Publications

BACKGROUND: Racial inequities in Coronavirus 2019 (COVID-19) have been reported over the course of the pandemic, with Black, Hispanic/Latinx, and Native American individuals suffering higher case rates and more fatalities than their White counterparts.

METHODS: We used a unique statewide dataset of confirmed COVID-19 cases across Missouri, linked with historical statewide hospital data. We examined differences by race and ethnicity in raw population-based case and mortality rates. We used patient-level regression analyses to calculate the odds of mortality based on race and ethnicity, controlling for comorbidities and other risk factors.

RESULTS: As of September 10, 2020 there were 73,635 confirmed …

Advances And Gaps In Sars-Cov-2 Infection Models, César Muñoz-Fontela, Michael S. Diamond, Et Al

Open Access Publications

The global response to Coronavirus Disease 2019 (COVID-19) is now facing new challenges such as vaccine inequity and the emergence of SARS-CoV-2 variants of concern (VOCs). Preclinical models of disease, in particular animal models, are essential to investigate VOC pathogenesis, vaccine correlates of protection and postexposure therapies. Here, we provide an update from the World Health Organization (WHO) COVID-19 modeling expert group (WHO-COM) assembled by WHO, regarding advances in preclinical models. In particular, we discuss how animal model research is playing a key role to evaluate VOC virulence, transmission and immune escape, and how animal models are being refined to …

Mitigating The Effects Of Covid-19 On Hiv Treatment And Care In Lusaka, Zambia: A Before-After Cohort Study Using Mixed Effects Regression, Jake Pry, Kombatende Sikombe, Aaloke Mody, Shilpa Iyer, Jacob Mutale, Natalie Vlahakis, Theodora Savory, Mwanza Wa Mwanza, Keith Mweebo, Annie Mwila, Consity Mwale, Mpande Mukumbwa-Mwenechanya, Andrew Kerkhoff, Izukanji Sikazwe, Carolyn Bolton Moore, Daniel Mwamba, Elvin Geng, Michael Herce

Open Access Publications

INTRODUCTION: The Zambian Ministry of Health (MoH) issued COVID-19 mitigation guidance for HIV care immediately after the first COVID-19 case was confirmed in Zambia on 18 March 2020. The Centre for Infectious Disease Research in Zambia implemented MoH guidance by: 1) extending antiretroviral therapy (ART) refill duration to 6 multi-month dispensation (6MMD) and 2) task-shifting communication and mobilisation of those in HIV care to collect their next ART refill early. We assessed the impact of COVID-19 mitigation guidance on HIV care 3 months before and after guidance implementation.

METHODS: We reviewed all ART pharmacy visit data in the national HIV …

M6a Modifications Regulate Intestinal Immunity And Rotavirus Infection, Anmin Wang, Gaopeng Hou, Siyuan Ding, Et Al

Open Access Publications

N6-methyladenosine (m6A) is an abundant mRNA modification and affects many biological processes. However, how m6A levels are regulated during physiological or pathological processes such as virus infections, and the in vivo function of m6A in the intestinal immune defense against virus infections are largely unknown. Here, we uncover a novel antiviral function of m6A modification during rotavirus (RV) infection in small bowel intestinal epithelial cells (IECs). We found that rotavirus infection induced global m6A modifications on mRNA transcripts by down-regulating the m6a eraser ALKBH5. Mice lacking the m6A writer enzymes METTL3 in IECs (

Perceptions Of Telemedicine And Costs Incurred By A Visit To A General Infectious Diseases Clinic: A Survey, Emily C. Evers, Stephanie A. Fritz, Graham A. Colditz, Jason P. Burnham

Open Access Publications

Background: The costs of attending in-person general infectious diseases clinics and preferences for visit type (telemedicine vs in-person) are not well known. We aimed to measure the time-related, monetary, social, and societal costs associated with travel to an in-person clinic visit and to assess patients' preferences, questions, and concerns regarding telemedicine.

Methods: Patients (≥18 years, living ≥25 miles from clinic at time of clinic visit) were recruited for this survey study from the general infectious diseases (ID) clinic at Washington University from June 2019 to February 2020. We calculated time and money potentially saved by telemedicine, as well as carbon …

Perceptions Of Risk Of Sars-Cov-2 Transmission In Social And Educational Activities By Infectious Diseases And General Pediatric Healthcare Providers, A Pre-Vaccine Risk Perception Cross-Sectional Survey, Andrew B. Janowski, Philip M. Polgreen, Susan E. Beekmann, Jason G. Newland

Open Access Publications

BACKGROUND: The perception of the transmission risks of SARS-CoV-2 in social and educational settings by US healthcare providers have not been previously quantified.

METHODS: Respondents completed an online survey between September and October 2020 to estimate the risk of SARS-CoV-2 transmission on a scale of 0-10 for different social and educational activities prior to the availability of the SARS-CoV-2 vaccines. Demographic information and experiences during the pandemic were also collected. The risk assessment was emailed to three listservs of healthcare providers, including national listservs of pediatric (PID) and adult infectious diseases (AID) providers, and a listserv of general pediatric practitioners …

Isolation Of Sars-Cov-2 In Viral Cell Culture In Immunocompromised Patients With Persistently Positive Rt-Pcr Results, Abby Sung, Adam L Bailey, Henry B Stewart, David Mcdonald, Meghan A Wallace, Kate Peacock, Candace Miller, Kimberly A Reske, Caroline A O'Neil, Victoria J Fraser, Michael S Diamond, Carey-Ann D Burnham, Hilary M Babcock, Jennie H Kwon

Open Access Publications

Immunocompromised adults can have prolonged acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive RT-PCR results, long after the initial diagnosis of coronavirus disease 2019 (COVID-19). This study aimed to determine if SARS-CoV-2 virus can be recovered in viral cell culture from immunocompromised adults with persistently positive SARS-CoV-2 RT-PCR tests. We obtained 20 remnant SARS-CoV-2 PCR positive nasopharyngeal swabs from 20 immunocompromised adults with a positive RT-PCR test ≥14 days after the initial positive test. The patients' 2

Ethical, Regulatory, And Practical Barriers To Covid-19 Research: A Stakeholder-Informed Inventory Of Concerns, Bryan A. Sisk, Kari Baldwin, Meredith Parsons, James M. Dubois

Open Access Publications

INTRODUCTION: SARS-CoV-2 (COVID-19) has caused death and economic injury around the globe. The urgent need for COVID-19 research created new ethical, regulatory, and practical challenges. The next public health emergency could be worse than COVID-19. We must learn about these challenges from the experiences of researchers and Research Ethics Committee professionals responsible for these COVID-19 studies to prepare for the next emergency.

MATERIALS AND METHODS: We conducted an online survey to identify the ethical, oversight, and regulatory challenges of conducting COVID-19 research during the early pandemic, and proposed solutions for overcoming these barriers. Using criterion-based, convenience sampling, we invited researchers …