Digital Commons Network^™

Staff Education Of Diabetic Foot Care In An Ambulatory Setting, Riza Grace Nielsen

Walden Dissertations and Doctoral Studies

One of the most important factors affecting the quality of diabetes care is the association between a patient’s knowledge and their practices. The practice gap in this primary care clinic was a lack of standardized diabetic foot care. The purpose of this DNP project was to provide nursing staff with an evidence- based, culturally congruent diabetic footcare curriculum that could help decrease inconsistencies in care. The practice-focused question for this project addressed whether an educational program for nursing staff on diabetic footcare would increase their knowledge and translate this knowledge into practice to prevent diabetic foot infections and its complications. …

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

AbstractThe COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

Nursing Guideline For Specimen Handoff, Kathleen Marie Pearce

Walden Dissertations and Doctoral Studies

AbstractThe absence of clinical practice guidelines (CPGs) and collaboration with significant stakeholders may lead to gaps in the delivery of patient care. Specimen handoff in the endoscopy unit plays a critical role in patient diagnosis and treatment plans; errors can compromise patient safety. The purpose of this project was to provide endoscopy nursing staff with a CPG to improve the accuracy of the specimen handoff process during the endoscopy procedure. The practice-focused question addressed the feasibility of developing a quality and usable CPG to improve the accuracy and efficacy of handling the specimen handoff process during endoscopy procedures. Walden University …

Strategies To Reduce Employee Turnover In The Insurance Industry, Ebony Phillips

Walden Dissertations and Doctoral Studies

Employee turnover continues to increase in the insurance industry because no minimum skill or education level is required to enter the U.S. insurance industry. Insurance leaders are concerned with reducing employee turnover, as it creates a risk to employee productivity and profitability. Grounded in Herzberg’s two-factor theory of motivation, the purpose of this qualitative multiple-case study was to explore strategies five insurance leaders from central Kansas used to reduce employee turnover. Data were collected using semistructured virtual interviews and a review of company records. Data were analyzed using Yin’s five-step approach, and three themes emerged: (a) supportive leadership, (b) incentives/benefits, …

Perceptions Of Veteran Middle And High School Stem Teachers On Integrating Tablets Into The Classroom, Joanie Marie Rice

Walden Dissertations and Doctoral Studies

Abstract Despite the availability of technology for instruction, veteran science, technology, engineering, and mathematics (STEM) teachers are still reluctant to incorporate recent technologies, such as tablets, into the classroom. This qualitative case study was conducted to explore the perceptions of eight middle and high school veteran STEM teachers integrating tablets into the classroom. This study focused on how veteran STEM teachers viewed the integration of tablets into the school, the challenges experienced when integrating tablets into the classroom, and the opportunities that experienced STEM teachers observed when integrating tablets into the classroom based on the technological pedagogical content knowledge (TPACK) …

Perceptions And Experiences Of The Benefits Of Premarital Counseling Among African American Couples, Evelyn N. Roberts

Walden Dissertations and Doctoral Studies

Researchers have conducted studies on the benefits of premarital counseling. However, little was known about the experiences of African American couples. The purpose of this generic qualitative study was to explore African American couples’ perceptions and experiences concerning the benefits of premarital counseling. Social learning theory provided the framework for the study. Data were collected from semistructured interviews with eight heterosexual African American couples. Colaizzi’s seven-step method of coding was used to analyze participants’ responses. Four themes emerged: couples’ expectations of premarital counseling, influences regarding participation, quality and structure of sessions, and overall experience. Findings could impact social change by …

Catheter Associated Urinary Tract Infection Prevention Education, Mary Jo Roskos

Walden Dissertations and Doctoral Studies

AbstractCatheter associated urinary tract infections (CAUTIs) are infections that happen in the urinary tract in men and women when foley catheterization is not done using strict aseptic techniques. Bacteria can then travel up the urinary catheter into the bladder; therefore, contaminating urine in the bladder. This project site’s nursing staff was experiencing a lack of knowledge regarding CAUTI prevention. This lack of knowledge on the importance of sterile technique when inserting urinary catheters can lead to CAUTIs. The project question for this project addressed whether the educational program on the importance of a strict sterile technique on urinary catheter insertion …

Effective Revenue Planning For Small Minority-Owned Mental Health Organizations, Beonko Alejandro Sampson

Walden Dissertations and Doctoral Studies

AbstractRevenue planning for minority-owned organizations is vital for sustainability. This is a significate concern for behavioral health practitioners who must deal with the changing landscape of mental health and the financial worries of sustaining a successful organization. This case study examined effective revenue planning for a minority-owned behavioral health organization located in the mideastern part of the United States. The organization provides several different behavioral treatment services for children, adolescents, and adults. The Baldrige excellence framework for healthcare guided a system-based approach to assessing the minority-owned organization. The systems approach identified noted organizational components of leadership, strategy, and operations. Themes …

Nursing Graduates' Strategies For Success On The Nclex-Rn, Karla Lashonda Sanders

Walden Dissertations and Doctoral Studies

AbstractA nursing program has had difficulty from the years 2015-2022 consistently meeting the national pass rate requirement during students’ first attempts taking the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The purpose of this qualitative study was to explore perceptions of recent traditional and nontraditional nursing school graduates regarding which evidence-based learning strategies and resources were most effective in leading students to be successful during their first NCLEX-RN attempt. Knowles’ theory of andragogy was the conceptual framework for this study. Research questions involved traditional and nontraditional nursing graduates’ perceptions of which evidence-based strategies were successful for them. Using a …

Adult Attitudes And Adverse Childhood Experiences: Implications For Child Maltreatment, Carla M. Santana

Walden Dissertations and Doctoral Studies

In the United States, approximately $124 billion is spent annually on mental health and medical diagnosis as a result of the negative effects of adverse childhood experiences. These experiences can result in both mental and physical illness as well as a pattern of instability across the lifespan, which may affect adult attitudes toward child maltreatment and perpetuate the cycle of abuse. The purpose of this quantitative regression study was to examine any association between a person’s adverse childhood experiences and attitudes of what defined child maltreatment. Bronfenbrenner’s ecological systems theory was the framework. A total of 98 participants took part …

Leading A Motivated Home Healthcare Company, Jekea Scott

Walden Dissertations and Doctoral Studies

The lack of employee engagement and increase in employee turnover adversely affect the healthcare industry’s business outcomes. Home healthcare leaders need engagement strategies to retain experienced employees as failure to engage employees results in decreased productivity and increased expenses associated with recruiting and training new hires. Grounded in Blau’s social exchange theory, the purpose of this qualitative multiple case study was to explore strategies that home healthcare leaders use to increase employee engagement and decrease employee turnover. The participants comprised eight current and former leaders and employees of home healthcare companies in Charlotte, North Carolina. The data collection processes included …

Implementing Music Therapy Into Behavioral Healthcare To Treat Autism Spectrum Disorder, Arthur George Scott

Walden Dissertations and Doctoral Studies

AbstractThis study explored how best to implement Music Therapy (MT) in any hospital setting when working with autistic children, teenagers, and adults. Baldrige’s theory and concepts were used as a benchmark to facilitate all findings through the research conducted. Multiple factors affect the workforce and the existing staff at a large medical facility in the Western United States. The methodology employed included interviews with two behavioral health leaders using structured questions. This was an ideal research setting given that over fifty providers, including doctors, psychiatrists, and therapists, who work daily with the ASD population. Key findings included MT treatments at …

Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff

Walden Dissertations and Doctoral Studies

Amid the dynamic changes and innovations of the healthcare field, healthcare providers seek educational activities that enhance their growth and decrease their knowledge gap. Healthcare education organizations responsible for providing high-quality healthcare education, have opportunities to differentiate their programs to acquire, attract, activate, and retain healthcare providers. Grounded in the five forces of competition and the value chain theories, this mixed method formative program evaluation aimed to improve the business development program by developing a differentiation by quality strategy that will increase its competitive advantage. Participants included three decision-makers and nine leaders in a healthcare education organization in the Kingdom …

Elementary Teachers’ Perceptions Of Instructional Strategies For Reading, Erin Sponaugle

Walden Dissertations and Doctoral Studies

The problem investigated in this study was decreasing annual reading proficiency among students in intermediate elementary grades (Grades 3-5). Deficiencies in reading proficiency can negatively impact overall student achievement. The purpose of this study was to investigate intermediate elementary teachers’ perceptions of their instructional strategies to improve students’ reading proficiency and potentially increase Generalized Summative Assessment scores. The conceptual framework was Vygotsky’s zone of proximal development theory. The key research questions were about elementary reading teachers’ perceptions of effective instructional practices used to increase students’ reading proficiency and elementary reading teachers’ perceptions about teachers’ instructional strengths and challenges associated with …

Juvenile Delinquency: The Effectiveness Of The Juvenile Direct File Law, Kimberlee Nicole Taggart

Walden Dissertations and Doctoral Studies

The juvenile direct file law stands firm among Florida laws despite lacking research to show its effectiveness in the prevention of juvenile delinquency. In Florida, juvenile delinquency and the juvenile direct file law cause significant concern due to the uncertainty surrounding the law. The Florida juvenile justice system fosters a vital position in the lives of many children, young adults, and families. Florida’s direct file law has a negative impact on the health, mental health, education, and brain development of juveniles and their ability to separate from a criminal lifestyle. Identifying the direct file law’s effects on the future of …

Integrating The Pedagogy Of United States’ Fourth-Grade Math Teachers With International Approaches, Dennis Francis Tierney

Walden Dissertations and Doctoral Studies

Standardized testing results in fourth-grade math have shown that students in the United States continually score below students in many other nations, despite funding education at levels well above the global average. The problem addressed in this study was that fourth-grade math students in the United States were not performing as well on standardized tests as students of other nations and international cities. Guided by Vygotsky’s social learning theory, the purpose of this qualitative, exploratory case study was to investigate the perceptions of teachers from U.S. and international settings about different approaches to effective fourth-grade math instruction, inherent obstacles to …

Comparing The Performance Of Initial Coin Offerings To Crowdfunded Equity Ventures, Elijah Joseph Turan

Walden Dissertations and Doctoral Studies

Uncertainty in markets increases the likelihood of market failure due to volatility and suboptimal functioning. While initial coin offerings (ICOs) and crowdfunded equity (CFE) offerings may improve functioning in growing markets, there is a lack of knowledge and understanding pertaining to the relative efficiency and behavior of ICO markets compared to CFE markets, potentially perpetuating and thwarting the various communities they are intended to serve. The purpose of this correlational study was to compare a group of ICOs with a group of CFE offerings to identify predictive factors of funding outcomes related to both capital offering types. Efficient market hypothesis …

Discrepancies In Race, Occupational Prestige Score, Socioeconomic Index, Income/Wealth, And Social Class Between Blacks And Whites, Queensley Udofia

Walden Dissertations and Doctoral Studies

An argument that has gained prominence recently is that race is/will no longer be a significant factor in explaining any Black - White gaps. The argument is that in the post-Civil Rights era, the implementation of affirmative action and antidiscrimination policies at local, state, and federal levels has closed, if not almost erased, the gaps between Blacks and Whites. Research, however, has disputed the claims of proponents of color-blindness that issues of race are on the decline and will no longer be a factor in explaining racial inequalities between Blacks and Whites. This study used General Social Survey 2021 data …

Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs), specifically clostridioides difficile (CDI) and methicillin-resistant staphylococcus aureus (MRSA) bacteremia, increase mortality and length of stay and cost the United States billions of dollars each year. Though preventable, continued incidence demonstrates that infection prevention interventions remain challenging for health system administrators. The purpose of this quantitative study was to identify whether there was a significant difference between Magnet accreditation and non-Magnet accreditation and the frequency of HAIs, specifically, CDI and MRSA bacteremia. The independent variable was Magnet accreditation status; the dependent variables were CDI and MRSA bacteremia. The foundation of the study focused on Donabedian’s framework of …

Mental Health Outpatient Services And Hospital Readmissions Among Adolescent Patients In Louisiana, Whitney Walker

Walden Dissertations and Doctoral Studies

Hospital admissions and readmissions among Medicaid patients significantly impact increased healthcare costs for the state of Louisiana and are associated with poor quality of care. The specific research problem under study was the relationships, if any, between mental health outpatient services in Louisiana, either individual therapy or home and community-based services post-hospital discharge, gender of the patient, and age of the adolescent patient with the number of hospital readmissions over 1 year. Secondary quantitative data analysis was performed using the Island Peer Review Organization Annual External Quality Review Technical Report and data from the managed care organization in Louisiana. No …

Effective Strategies For Small Business Sustainability, Kathleen A. Watson-Wilkin

Walden Dissertations and Doctoral Studies

AbstractSmall businesses in the United States experience a higher failure rate than medium-sized and large corporations. Small business owners without successful strategies to sustain their businesses may fail. Grounded in the McKinsey 7S model, the purpose of this multiple case study was to explore strategies small general construction contractor business owners use to sustain their businesses beyond 5 years. The participants were three small general construction contractor business owners within Miami, Florida, who sustained businesses for 5 years. Data were collected using semistructured and audio-recorded face-to-face interviews. Through thematic analysis, four themes emerged: (a) creating strategies for a solid customer …

Issues Of Inmates Not Receiving Mental Health Treatment: A Prison-Based Counselor Perspective, Ashley Celestine Westmoreland

Walden Dissertations and Doctoral Studies

Mental illnesses in correctional facilities have been an issue for decades and have increased over time. According to recent studies, correctional facilities have become known as mental health institutions without access to treatment. It is unclear why correctional facilities have limited resources, but research indicates that offenders are not receiving the appropriate treatment. This qualitative phenomenological study aimed to explore how five prison-based counselors perceive the quality and quantity of mental health services provided to inmates. The data were analyzed and coded using the Interpretative Phenomenological Analysis (IPA). The current study’s findings further added to the base of knowledge that …

Strategies Call Center Managers Use To Reduce Employee Turnover, Sheena R. Wheeler

Walden Dissertations and Doctoral Studies

Excessive employee turnover can disrupt an organization's efficient operational performance. Call center managers remain concerned with excessive employee turnover due to the expense of lost productivity, recruiting, and training new employees. Grounded in Herzberg’s two-factor theory of motivation, the intent of this qualitative single case study was to explore strategies call center managers use to reduce employee turnover. The participants consisted of five managers in one financial service call center in Nebraska who used successful strategies to reduce employee turnover. Data was collected using semistructured interviews and a review of the employee handbook. Four themes emerged through Yin’s 5-step process: …

Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is a significant cause of nurse burnout (BO). Oncology nurses are particularly susceptible to CF because of the continual contact with terminally ill patients and recurrent experiences with patients’ death. A search of existing literature found no published studies that explicitly focused on interviewing oncology nurses to gain their expression of their lived experiences with CF while caring for terminally ill patients. This phenomenological qualitative study explored oncology nurses’ experiences dealing with and managing CF when caring for terminally ill patients. Figley’s compassion fatigue theory grounded this study. The research questions focused on the lived experiences of …

Corrigendum: Semnet: Learning Semantic Attributes For Human Activity Recognition With Deep Belief Networks, Shanmuga Venkatachalam, Harideep Nair, Ming Zeng, Cathy Shunwen Tan, Ole J Mengshoel, John Paul Shen

Faculty, Staff and Student Publications

This corrects the article "SemNet: Learning semantic attributes for human activity recognition with deep belief networks" in volume 5, 879389.

PMID: 36968617

Computed Tomography: State-Of-The-Art Advancements In Musculoskeletal Imaging, Hamza Ahmed Ibad, Cesar De Cesar Netto, Delaram Shakoor, Alejandro Sisniega, Stephen Z Liu, Jeffrey H Siewerdsen, John A Carrino, Wojciech Zbijewski, Shadpour Demehri

Faculty, Staff and Student Publications

Although musculoskeletal magnetic resonance imaging (MRI) plays a dominant role in characterizing abnormalities, novel computed tomography (CT) techniques have found an emerging niche in several scenarios such as trauma, gout, and the characterization of pathologic biomechanical states during motion and weight-bearing. Recent developments and advancements in the field of musculoskeletal CT include 4-dimensional, cone-beam (CB), and dual-energy (DE) CT. Four-dimensional CT has the potential to quantify biomechanical derangements of peripheral joints in different joint positions to diagnose and characterize patellofemoral instability, scapholunate ligamentous injuries, and syndesmotic injuries. Cone-beam CT provides an opportunity to image peripheral joints during weight-bearing, augmenting the …

Severe Radiation-Induced Lymphopenia During Concurrent Chemoradiotherapy For Stage Iii Non-Small Cell Lung Cancer: External Validation Of Two Prediction Models, Peter S N Van Rossum, Celia Juan-Cruz, Barbara Stam, Maddalena M G Rossi, Steven H Lin, Azadeh Abravan, José S A Belderbos, Jan-Jakob Sonke

Faculty, Staff and Student Publications

BACKGROUND: Severe radiation-induced lymphopenia (RIL) in patients undergoing chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC) is associated with decreased immunotherapy efficacy and survival. At The Christie and MD Anderson Cancer Center (MDACC), prediction models for lymphopenia were developed in lung and esophageal cancer patients, respectively. The aim of this study was to externally validate both models in patients with stage III NSCLC.

METHODS: Patients who underwent concurrent CRT for stage III NSCLC in 2019-2021 were studied. Outcomes were grade ≥3 and grade 4 lymphopenia during CRT. The Christie model predictors for grade ≥3 lymphopenia included age, baseline lymphocyte count, …

The Cx3cl1-Cx3cr1 Chemokine Axis Can Contribute To Tumor Immune Evasion And Blockade With A Novel Cx3cr1 Monoclonal Antibody Enhances Response To Anti-Pd-1 Immunotherapy, Apoorvi Chaudhri, Xia Bu, Yunfei Wang, Michael Gomez, James A Torchia, Ping Hua, Shao-Hsi Hung, Michael A Davies, Gregory A Lizee, Ulrich Von Andrian, Patrick Hwu, Gordon J Freeman

Faculty, Staff and Student Publications

CX3CL1 secreted in the tumor microenvironment serves as a chemoattractant playing a critical role in metastasis of CX3CR1 expressing cancer cells. CX3CR1 can be expressed in both cancer and immune-inhibitory myeloid cells to facilitate their migration. We generated a novel monoclonal antibody against mouse CX3CR1 that binds to CX3CR1 and blocks the CX3CL1-CX3CR1 interaction. We next explored the immune evasion strategies implemented by the CX3CL1-CX3CR1 axis and find that it initiates a resistance program in cancer cells that results in 1) facilitation of tumor cell migration, 2) secretion of soluble mediators to generate a pro-metastatic niche, 3) secretion of soluble …

Huge Abdominopelvic Mass Arising From Cervical Fibroid Around An Infected Cervical Diverticulum: A Very Rare Case And A Review Of Literature, Arpita De, Reva Tripathi, Abhinav Jain, Safia Rana

Faculty, Staff and Student Publications

Primary uterine diverticula are a very rare congenital anomaly of the uterus with only 21 reported cases. Even rarer is the occurrence of primary cervical diverticula with only six cases reported so far. This is a unique case of a huge abdominopelvic mass arising from cervical fibroid around an infected cervical diverticulum. A 44 year-old, P4L4 came to the OPD with a eighteen weeks size abdomino-pelvic mass. She had a failed surgery 6 months back, attempted to remove the mass. Magnetic resonance imaging revealed a cervical diverticulum which possibly had a pus collection. Relaparotomy was done. It revealed a huge …

Preoperative Tractography Algorithm For Safe Resection Of Tumors Located In The Descending Motor Pathways Zone, Edgar G Ordonez-Rubiano, Jason M Johnson, Nadin Abdalá-Vargas, Oscar F Zorro, Jorge H Marin-Munoz, Ricardo Álvarez-Tobián, Valeria Forlizzi, Carlos Castillo Rangel, Sabino Luzzi, Alvaro Campero, Javier G Patiño-Gómez, Matias Baldoncini

Faculty, Staff and Student Publications

BACKGROUND: Diffusion tensor imaging (DTI) tractography facilitates maximal safe resection and optimizes planning to avoid injury during subcortical dissection along descending motor pathways (DMPs). We provide an affordable, safe, and timely algorithm for preoperative DTI motor reconstruction for gliomas adjacent to DMPs.

METHODS: Preoperative DTI reconstructions were extracted from a prospectively acquired registry of glioma resections adjacent to DMPs. The surgeries were performed over a 7-year period. Demographic, clinical, and radiographic data were extracted from patients' electronic medical records.

RESULTS: Nineteen patients (12 male) underwent preoperative tractography between January 1, 2013, and May 31, 2020. The average age was 44.5 …