Digital Commons Network^™

Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias

Walden Dissertations and Doctoral Studies

Antibiotic resistance is a health threat affecting millions of Americans. Microorganisms develop resistance to antibiotics, rendering them useless for treating infections. The purpose of this quantitative study was to assess the associations between sample processing time and antibiotic resistance and is based on the health belief model. A retrospective specimen tracking activity of data from November 2019 to November 2020 was obtained by random sampling of 246 bacterial cultures. One hundred ninety-six (80%) samples were processed on time, and 50 (20%) were delayed; 167 (68%) samples were determined to have the presence of antimicrobial resistance (AMR), and 79 (32%) with …

Community Perceptions Of Syringe Service Programs In Charleston, West Virginia: A Qualitative Socioecological Perspective, Kenya M. Burton

Walden Dissertations and Doctoral Studies

In rural areas of the United States, people who inject drugs (PWID) experience an array of obstacles to accessing adequate healthcare. Locations with high rates of drug use normally offer more healthcare options, including needle exchange programs but, in some communities, there is resistance to providing this kind of care. This increases mortality, morbidity, cost, and adds to the stigma experienced by this vulnerable group. The experiences of people with substance dependency, including PWID, has been widely explored throughout studies that reflect a need for increased support. However, the perspectives of the community, especially in rural areas, though equally important, …

Doctoral Study Effects Of Mandatory Staffing Requirements On Quality Indicators In Long-Term Care, Melissa Reed

Walden Dissertations and Doctoral Studies

Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimbursement. The purpose of this study was to evaluate if state-mandated staffing ratios affected Centers for Medicare and Medicaid Services (CMS) survey ratings for CMS Region 7, which consisted of Iowa, Kansas, Missouri, and Nebraska. The theoretical framework was grounded by Donabedian’s quality theory, which described quality is made up of the elements of structure, process, and outcomes. This study included two research questions evaluating if there was a correlation between minimum staffing ratios and quality of care in long-term care …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

The Reconciliation Of Cognitive Dissonance Among Social Workers In Substance Use Treatment Settings, Miranda Ashley Kieler

Walden Dissertations and Doctoral Studies

Although harm reduction (HR) and abstinence-based treatment approaches are both useful in addiction treatment, the former is less accepted and integrated into practice. Social workers who embrace an HR approach but who work at substance abuse treatment facilities that are abstinence based may experience cognitive dissonance because they perceive their work role to be incompatible with social work practice values and education. Little was known regarding how practitioners with a Master of Social Work (MSW) degree experience and reconcile cognitive dissonance related to their HR education and abstinence-only practice in substance use treatment centers. To address this gap in the …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

Influences On Influenza Vaccine Uptake Among Older Lebanese Adults, Doha D'Agostini

Walden Dissertations and Doctoral Studies

Influenza is a viral infection that is globally transmitted and that increases the risk for infectious diseases, hospitalization, and morbidity and mortality, especially among the older adult population. Although influenza vaccines are recommended in several countries, influenza vaccine hesitancy remains a challenge. In Lebanon, there is minimal research related to older adults’ attitudes and perceptions associated with influenza vaccination. To explore older Lebanese adults’ vaccination experiences and perceptions of the factors that affect their influenza vaccine uptake, a qualitative investigation was conducted. The theory of planned behaviors served as the theoretical framework for the study. A thematic analysis was conducted …

A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, there was a high need for mental health services, which resulted in a shortage of mental health clinicians. This shortage of mental health clinicians then resulted in a high burnout rate due to client intake. This doctoral case study was grounded in the Baldrige Excellence Framework and focused on how a behavioral health organization in South Texas managed burnout in clinicians during the COVID-19 pandemic. This study aimed to help behavioral health leaders find a solution to preventing burnout during a high demand pandemic. This doctoral study had several data sources, including semistructured interviews with three …

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

Representation Counts: Intern Teachers Of Color And Their Perspectives Of Teaching In A California County, Girlie M. Hale

University of the Pacific Theses and Dissertations

Intern teachers are more likely to be placed in hard-to-fill content areas, such as math, science, and special education, which exacerbates their initial teaching experiences as teachers of record. For new teachers in their intern credential program, these factors compound the stress of attending coursework while managing their experience as a novice in the classroom. Without proper mentoring and support in these placements, teachers of color may perceive themselves as feeling less successful in the classroom. In this mixed methods study, the researcher investigated the types of support intern teachers of color need in successfully completing their teacher preparation program. …

The Remains Of The Establishment Clause, Ira C. Lupu, Robert W. Tuttle

GW Law Faculty Publications & Other Works

The very first words of the Bill of Rights mark religion as constitutionally distinctive. Congress may not enact laws respecting an establishment of religion – in particular, acts of worship, religious instruction, or proselytizing. A pluralist, liberal democracy requires separation of civil government from these distinctively religious activities.

From the middle of the 20 th Century until Justice O’Connor’s retirement in 2005, the Supreme Court energetically animated that principle of distinctiveness. In a series of decisions in the last decade, however, the Court has upended its longstanding approach to what is distinctive about religion in constitutional law. Notably, this process …

Changes In Distribution Of Severe Neurologic Involvement In Us Pediatric Inpatients With Covid-19 Or Multisystem Inflammatory Syndrome In Children In 2021 Vs 2020., Kerri L. Larovere, Tina Y. Poussaint, Cameron C. Young, Margaret M. Newhams, Suden Kucukak, Katherine Irby, Michele Kong, Stephanie P. Schwartz, Tracie C. Walker, Melania M. Bembea, Kari Wellnitz, Kevin M. Havlin, Natalie Z. Cvijanovich, Mark W. Hall, Julie C. Fitzgerald, Jennifer E. Schuster, Charlotte V. Hobbs, Natasha B. Halasa, Aalok R. Singh, Elizabeth H. Mack, Tamara T. Bradford, Shira J. Gertz, Adam J. Schwarz, Katri V. Typpo, Laura L. Loftis, John S. Giuliano, Steven M. Horwitz, Katherine V. Biagas, Katharine N. Clouser, Courtney M. Rowan, Aline B. Maddux, Vijaya L. Soma, Christopher J. Babbitt, Cassyanne L. Aguiar, Amanda R. Kolmar, Sabrina M. Heidemann, Helen Harvey, Laura D. Zambrano, Angela P. Campbell, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: In 2020 during the COVID-19 pandemic, neurologic involvement was common in children and adolescents hospitalized in the United States for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related complications.

OBJECTIVE: To provide an update on the spectrum of SARS-CoV-2-related neurologic involvement among children and adolescents in 2021.

DESIGN, SETTING, AND PARTICIPANTS: Case series investigation of patients reported to public health surveillance hospitalized with SARS-CoV-2-related illness between December 15, 2020, and December 31, 2021, in 55 US hospitals in 31 states with follow-up at hospital discharge. A total of 2253 patients were enrolled during the investigation period. Patients suspected of having …

Corporate Social Responsibility (Csr) Activities And Communications In Response To The Covid Crisis: Evidence From The U.S., Hyun Ju Jeong, Deborah S. Chung

Iowa Journal of Communication

This study investigates how corporations responded to the COVID-19 crisis through their fulfillment of corporate social responsibility (CSR). We quantitatively analyzed a total of 60 CSR news stories published during the year of 2020. We then provided context through the close readings of all 60 news stories. CSR news coverage was selected as the focal content because it is considered to be a more objective communication of CSR compared to corporations’ self-disclosed CSR reports. Results show that CSR was provided throughout the year as corporations’ timely responses to the unprecedented pandemic. Specifically, corporations emphasized philanthropic CSR activities to support health …

Advanced Applications Of Existing Technology And Their Influence On Quality Outcomes In Federally Qualified Health Centers, Ali Riza Demirbas

All ETDs from UAB

Increasing competition in the healthcare industry is compelling organizations to adopt new strategies to obtain and/or maintain a competitive advantage. To obtain a competitive advantage, healthcare organizations may need either more efficient processes or offer new or improved products and services through the utilization of these strategies. In competitive market environments, technological innovations can be a key competitive advantage to reduce expenses, improve quality, attract more customers, or a combination of all. All healthcare organizations can benefit from technological innovations, especially those with limited resources. One type of healthcare organization that highlights the disparity in resources is the Federally Qualified …

In The Shadows, But Not Left Behind: Female Sex Workers' Acceptance Of Social Media For Hiv Prevention In Northwest And Southwest Provinces, Cameroon, Hassanatu Blake

All ETDs from UAB

The purpose of this dissertation was to evaluate the acceptance of social media in HIV prevention education for female sex workers in Cameroon. The objectives included: (1) provide a review of literature on the use of social media in HIV prevention education among Female Sex workers (FSWs); (2) determine the acceptance of Secret Facebook Group (SFG) for HIV prevention education among FSW in Cameroon; and (3) explain the acceptance of SFG in HIV prevention education and social media platform alternatives to SFG in Cameroon. Utilizing a sequential explanatory mixed methods design, three methods were employed for this dissertation and guided …

Patterns Of Fatal Drug Overdose_ A Multi-City Investigation Of Geospatial Correlates, Keith R. Chichester

All ETDs from UAB

Fatal drug overdoses are now the leading cause of accidental death in the U.S., responsible for over 107,600 deaths in 2021. Since 2000 the rate of overdose fatalities has increased over 140%. This epidemic has been particularly impactful in rural areas as from 2006-2016, the rural overdose death rate surpassed those in urban areas. Geospatial analytics provide an effective strategy for identifying profiles and patterns in the spatial distribution of overdose locations as well as geographic and demographic variables that associate with overdose occurrences. Furthermore, predictive risk modeling platforms allow for the identification of anticipated overdose hotspots across a geography …

Induction Of Antibiotic Activity Against Methicillin-Resistant Staphylococcus Aureus In Small Molecules Through Zinc Activation, Rachel Michaela Andrews

All ETDs from UAB

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious human pathogen with a staggering potential for multi-drug resistance. Because of this, the Centers for Disease Control and Prevention and the World Health Organization monitor the spread of MRSA and encourage antibiotic development efforts targeting this pathogen. Despite this, few antibiotics have been developed and brought to market in recent decades. To continue treating infections caused by this organism, we must identify novel antibiotic molecules with different mechanisms of action from known antibiotics. Bacterial copper-dependent inhibitors (CDIs), molecules that become antibacterial in the presence of copper (Cu), have been studied as a novel …

The Effect Of Temperature On The Rate Of Antibiotic Resistance Development In Vibrio Vulnificus, Amber Marie Richardson

All ETDs from UAB

Vibrio vulnificus is an environmentally encountered pathogen that humans may be exposed to through open wound contact with brackish waters or by ingestion of contaminated shellfish. In susceptible individuals, a V. vulnificus infection can spread rapidly, resulting in hospitalization, amputation, or even death. This bacterial species can cause aggressive infection, so treatment must often be aggressive as well. A typical treatment regimen includes combination therapy with a third-generation cephalosporin along with either a tetracycline or a fluoroquinolone. Although this method can work for now, antibiotic resistance is a looming threat that has emerged in many bacterial pathogens, including V. vulnificus. …

Temporal Trends In Tularemia Incidence In The United States From 2010 To 2020. Are Age And Sex Associated With These Changing Trends?, Carla V. Brooks

All ETDs from UAB

Background: Tularemia or Rabbit Fever was discovered in 1911 in a plague-like outbreak among rodents in Tulare County, California. Tularemia in the US has expanded from rural to more metropolitan areas, which may be potentially correlated with the escalating exposure of humans to animal vectors. There has not been a recent study evaluating trends in Tularemia, especially one that has evaluated if the trends in Tularemia over time differ by demographic characteristics. Methods: This is an ecological study to evaluate the temporal trends and if trends Tularemia incidence over time differs by age and sex in the United States from …

Antimicrobial Resistance In Type Ii Diabetic Patients In Southeastern U.S., Onyebuchi Angela Elegede

All ETDs from UAB

Background: In the Southern and Appalachian regions of the United States, antibiotic prescription rates surpass the national average, coinciding with a higher prevalence of Type II diabetes (DM2). Although international research has previously described the correlation between DM2 and increased risk of antimicrobial-resistant (AMR) infections, comprehensive studies on this relationship are lacking in the U.S. The objective of this study was to investigate the association between AMR infections and DM2 and examine the association in two DM2 positive racial groups. This study also examined the differences in the prevalence of clindamycin resistance of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus …

Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit

All ETDs from UAB

Introduction: Syphilis is a sexually transmitted infection (STI) that can cause serious health problems, including neurological disorders, blindness, and fetal abnormalities. Routine STI screenings can help prevent its spread. Despite effective treatments, syphilis cases have risen sharply in the last decade, particularly among marginalized communities. Understanding the ecological and contextual factors contributing to syphilis incidence could inform prevention efforts and improve healthcare outcomes for all. Methods: Retrospective secondary data analyses, at the county level, from 2020 to 2022, were conducted to assess for mean differences among social vulnerability index (SVI) scores, SVI scores by four primary categories, Black Belt regional …

Covid-19 Impact On Nbcot Passing Rates, John Damiao

Journal of Occupational Therapy Education

The COVID-19 pandemic changed the delivery of education as many occupational therapy (OT) programs temporarily transitioned to remote learning. The purpose of this article is to describe the impact of the COVID-19 pandemic on the National Board for Certification in Occupational Therapy (NBCOT) pass rates. A mixed methods research design was used consisting of quantitative data from all 35 OT programs from New York (NY), New Jersey (NJ), Connecticut (CT), and California (CA). Qualitative data was gathered from NY OT program graduates with fourteen convenience sampled graduate students who completed the qualitative survey. NBCOT exam scores from 2019-2021 were gathered …

The Effect Of Larval Competition On Adult Life History Traits And The Immune Response Of Adult Cat Fleas (Ctenocephalides Felis), Piper N. Zellner, Lisa D. Brown

Honors College Theses

In holometabolous insects, conditions during the larval stage can affect the adult stage. For instance, in mosquitoes, reduced larval food and high density can make adults more susceptible to infection. Fleas (Siphonaptera), like mosquitoes, go through complete metamorphosis and have adult stages that exclusively feed on the blood of vertebrates, including humans. However, flea larvae have chewing mandibles and rely on nutrients from dried fecal matter containing vertebrate blood proteins. Their limited mobility and unique nutritional needs confine their development to specific areas, likely leading to frequent larval competition in natural conditions. Yet, the influence of larval density on the …

Is There A Fundamental Right To Privacy When An Educational Institution Requires A Student To Disclose Proof Of His Or Her Vaccination Status?, Mary D. Fatscher

Touro Law Review

In 2020, the coronavirus disease (“COVID-19”) dominated the world. Although the public has progressively become more informed about the disease and how to safeguard itself, challenges persist as there is still much unknown. Aside from wearing masks, social distancing, and despite its undetermined consequences, the COVID-19 vaccination has emerged as a primary solution to substantially reducing the incidence and severity of the virus in our country. Many COVID-19 vaccine mandates were initiated once three pharmaceutical and biotechnology companies including Pfizer-BioNTech, Moderna, and Johnson & Johnson received Emergency Use Authorization from the Food and Drug Administration (“FDA”).

Gender Dynamics In The Management Care Of Internally Displaced Persons: The Boko Haram Insurgency, Evelyn Kikelomo Ikuenobe Otaigbe

Walden Dissertations and Doctoral Studies

The Boko Haram asymmetric insurgency and warfare have decimated the Northeastern region of Nigeria and its neighboring environs of Chad, Niger, and Benin. The purpose of this study was to explore the peculiar socioethnic and cultural challenges encountered by female victims of Boko Haram terrorism at internally displaced persons camps in Abuja, Nigeria, including challenges in functioning, relocating, and acclimating back into society. A phenomenological approach was applied to understand participants’ lived experiences. Data collection occurred through interviews and observation. Data analysis involved the synthesis of narratives, and generation of themes. Among the emergent themes were poor feeding; lack of …

Organizational Strategies And Best Practices For Telehealth Delivery During Covid-19, Maria D. Mejia

Walden Dissertations and Doctoral Studies

Organizational Strategies and Best Practices for Telehealth Delivery during COVID-19

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

Assessing Spurious Correlations In Big Search Data, Jesse T. Richman, Ryan J. Roberts

Political Science & Geography Faculty Publications

Big search data offers the opportunity to identify new and potentially real-time measures and predictors of important political, geographic, social, cultural, economic, and epidemiological phenomena, measures that might serve an important role as leading indicators in forecasts and nowcasts. However, it also presents vast new risks that scientists or the public will identify meaningless and totally spurious ‘relationships’ between variables. This study is the first to quantify that risk in the context of search data. We find that spurious correlations arise at exceptionally high frequencies among probability distributions examined for random variables based upon gamma (1, 1) and Gaussian random …