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Outcomes Among St-Elevation Myocardial Infarction (Stemi) Patients With Cardiogenic Shock And Covid-19: A Nationwide Analysis, Bruce Adrian Casipit, Zurab Azmaiparashvili, Kevin Bryan Lo, Aman Amanullah

Division of Cardiology Faculty Papers

Background: There is paucity of data regarding the characteristics and outcomes of patients admitted for ST Elevation Myocardial Infarction (STEMI) complicated by cardiogenic shock (CS) with concomitant Coronavirus Disease 2019 (COVID-19) infection.

Methods: Using the National Inpatient Sample (NIS) Database for the year 2020, we conducted a retrospective cohort study to investigate the outcomes of patients who sustained STEMI-associated cardiogenic shock (STEMI-CS) with concomitant COVID-19 infection looking at its impact on in-hospital mortality and secondarily at the in-hospital procedure and intervention utilization rates as well as hospital length of stay.

Results: We identified a total of 22,775 patients with STEMI-CS, …

A Novel Digital Digit-Symbol Substitution Test Measuring Processing Speed In Adults At Risk For Alzheimer Disease: Validation Study, Anthony Campitelli, Sally Paulson, Josh L. Gills, Megan D. Jones, Erica N. Madero, Jennifer Myers, Jordan M. Glenn, Michelle Gray

Health, Human Performance and Recreation Faculty Publications and Presentations

Background: Assessing cognitive constructs affected by Alzheimer disease, such as processing speed (PS), is important to screen for potential disease and allow for early detection. Digital PS assessments have been developed to provide widespread, efficient cognitive testing, but all have been validated only based on the correlation between test scores. Best statistical practices dictate that concurrent validity should be assessed for agreement or equivalence rather than using correlation alone.

Objective: This study aimed to assess the concurrent validity of a novel digital PS assessment against a gold-standard measure of PS.

Methods: Adults aged 45-75 years (n=191) participated in this study. …

Part 6: Should Taxpayers Subsidize Private Facilities In Hampton Roads? Glitz Vs. Reality, Dragas Center For Economic Analysis And Policy, Old Dominion University

State of the Region Reports: Hampton Roads

Hampton Roads can learn from the experience of other cities and states. If there is a strong business case for a sports stadium, sports park, or entertainment venue, then investors should be able to tap into financial markets. In this chapter, we examine the arguments surrounding public investments in highly visible facilities. We pose questions that should be asked when considering such investments and explore the potential opportunity costs of these projects. We offer a cautionary tale that such projects are sold as transformative but often fail to generate the promised benefits, not only for taxpayers but also for the …

Comparing Essential Components Of Transnational Jurisdiction: A Proposed Comparative Methodology, Anna C. Conley

Faculty Law Review Articles

Despite vast harmonization across many areas of private international law, approaches to transnational jurisdiction have proved resistant to harmonization. For example, the Choice of Court Convention started as large-scale attempt to unify transnational jurisdiction rules and enforcement of judgments and ended up with a significantly limited scope focused on forum selection clauses. During negotiations, deep rifts between the United States and EU delegates unearthed an unwillingness by the United States to forego common law discretionary jurisdiction doctrines such as forum non conveniens and anti-suit injunctions, and a refusal to allow such doctrines by the EU. Other examples are the European …

Challenges With Multicultural Leadership For Project Managers: A Qualitative Multiple Case Study, Harrison Nnaemeka Nnaji

Walden Dissertations and Doctoral Studies

Culturally diverse teams are becoming the norm with the rising trend of globalization. The phenomenon has been associated with a rise in the number of multicultural teams with diversified team members. The central problem addressed in this study relates to inadequate understanding of challenges posed to project managers of multicultural software development teams operating in Nigeria. The purpose of this qualitative multiple case study was to explore challenges faced by this population. Avruch’s theory of culture, the Human needs theory by Burton, and the cross-cultural adaptation theory by Kim were the conceptual frameworks for this study. Participants included 15 project …

Employer Perceptions Of The Skills Gap In College Graduates’ Written Communication, Julie Minnaugh

Walden Dissertations and Doctoral Studies

U.S. employers have reported that many college graduates are underprepared in written communication when hired and that lack of preparedness hinders these graduates’ employment success. Higher education institution (HEI) administrators need information regarding which writing skills should be taught across the curriculum to improve student outcomes. The purpose of this study was to investigate employers’ perspectives on the written communication skills gap that hinders college graduates from being successful in their professional practice. Swales’s six characteristics of a discourse community provided a conceptual lens for the study, as graduates commencing employment represent newcomers to a discourse community. A basic qualitative …

The Perceived Impact Of Childbirth Related Ptsd And Maternal Bonding, Sheila Baez

Walden Dissertations and Doctoral Studies

AbstractChildbirth has been increasingly viewed as a potentially traumatic event and process impacting both mother and infant. Previous research on childbirth has concentrated on the development of postpartum depression and its impact; research on posttraumatic stress disorder (PTSD) after childbirth has been limited. However, the results of this research study suggested that the development of childbirth-related PTSD may be a far more common phenomenon than previously suggested. Bowlby’s attachment theory and Ainsworth’s further development and expansion of the theory served as a framework which investigated the experiences of 10 biological females, aged 21 and over previously diagnosed with PTSD after …

Effective Succession Planning And Organizational Development For Behavioral Health Leadership, Amanda Brown

Walden Dissertations and Doctoral Studies

High turnover rates can challenge an organization's ability to provide quality care to clients, maintain a safe environment, and achieve strategic goals. Effective retention strategies can allow the organization to grow and develop to continue to provide services for those in need. The focus of this study was identifying how an organization can improve its retention strategies, create succession plans, and decrease turnover to encourage organizational growth. The Baldrige Excellence Framework was used to guide the study, focusing on leadership, workforce, operations, and management. Data were collected through multiple sources. Semi structured interviews were used to gather data through open-ended …

Educating Nurses On Mental Fatigue, Tawanna Ann Canty

Walden Dissertations and Doctoral Studies

Education correlates with nurse performance and avoiding mental fatigue. This project attempted to answer the question, “Educating nurses on mental fatigue will increase knowledge” focusing on educating rehabilitative nurses regarding mental fatigue. The project was guided by the Analysis, Design, Develop, Implement, and Evaluate model. Twenty rehabilitative nurses were administered a pretest consisting of 10 multiple-choice test questions. They received education on mental fatigue through PowerPoint presentations and handouts. After completing the education, participants were administered a posttest with the same 10 questions. An evaluation tool consisting of six questions was completed measuring an increase in knowledge after the posttest. …

Managerial Strategies To Improve Warehouse Safety Culture, Rasheen J. Chatmon

Walden Dissertations and Doctoral Studies

An unsuccessful safety program can negatively affect warehouse efficiency, profitability, and reputation. To provide a safe work environment, warehouse leaders need guidance on establishing policies and training to ensure that all employees are adequately trained and understand the safety expectations of the organization. Grounded in high-reliability organization theory, the purpose of this qualitative single-case study was to explore managerial strategies to improve the warehouse safety culture. The participants were five warehouse managers who demonstrated the ability to successfully improve their organization's safety culture. Data were collected through virtual semistructured interviews and reviews of organizational documentation. The data were analyzed using …

Strategic Leadership Steps For New Certified Community Behavioral Health Clinics, Keisha Stacy-Ann Davis

Walden Dissertations and Doctoral Studies

States grapple with how to address the opioid epidemic and the growing need for behavioral health (BH) services. Certified Community Behavioral Health Centers (CCBHCs) are a new industry solution to address the need for integrated and coordinated physical and BH care. New CCBHCs are funded by the Federal 223 Substance Abuse and Mental Health Services Administration’s (SAMHSA) grant. However, they must be certified by states to meet the SAMHSA criteria for continued funding. This qualitative study presents a single-case study of a Southern state’s behavioral health department’s (SSBHD) leadership strategy for certifying the CCBHCs in its state and creating a …

Fact Finders: Exploring Perspectives Of Abuse Investigators For People With Developmental Disabilities, April Delandro

Walden Dissertations and Doctoral Studies

Abuse towards people with intellectual and developmental disabilities has been a long-standing area of study. One aspect of the post abuse process that has not been thoroughly considered is the perspective of abuse investigators. This is important because abuse investigators are to ascertain the safety of an alleged victim and then gather the information necessary to resolve issues with the intent to prevent further abuse. Using the Thomas theorem of interpretation and action, this study explored the experiences of abuse investigators by delving into how investigators’ experiences influence the conduct of an investigation and how investigators perceive their role and …

Vicarious Trauma And Elementary School Counselors, Erin M. Duduit

Walden Dissertations and Doctoral Studies

Vicarious trauma has been a focus of scholars for many years and demonstrates that vicarious trauma effects professional behaviorally, personally, and physiologically. This quantitative cross-sectional study explored the relationship between vicarious trauma and occupational exposure (caseload size) disrupting the cognitive structures of empathy, control, and esteem. The theoretical framework for this study was the constructivist self-development theory, which described how helping professionals develop vicarious trauma after exposure to traumatic stories. The social cognitive theory was also used for this study, explaining how elementary school counselors can increase their capacity for empathizing through modeling and experiencing empathy from others. The study …

College Students’ Psychosocial Functioning 2 To 5 Years After Death Of A Parent, Carla C. Elbel

Walden Dissertations and Doctoral Studies

The purpose of this study is to examine the relationship regarding a loss of parent during adolescence with psychosocial development into early college years (18 through 22 years of age) as measured by the Modified Erikson Psychosocial Stage Inventory (MEPSI). A sample of 15 young college students, ages 18 to 22, completed the MEPSI and a second sample of young college students 18 to 22, who lost a parent, completed the MEPSI. No significant difference was found in the variance of the means; therefore, the null hypothesis was retained. A small sample t test analysis was used to compare the …

Relationship Between Strategic Dexterity, Absorptive Capacity, And Competitive Advantage, Ifechide Monyei

Walden Dissertations and Doctoral Studies

Small- and medium-sized enterprise (SME) manufacturing executives and managers are concerned with the rapid technological changes involving artificial intelligence (AI), machine learning, and big data. To compete in the global landscape, effectively managing digital and artificial intelligence changes among SME manufacturing executives and managers is critical for leaders to compete in 2023 and beyond. Grounded in the dynamic capabilities view theory, the purpose of this quantitative correlation study was to examine the relationship between strategic dexterity, absorptive capacity, and competitive advantage. The participants were 66 executives and managers of SME manufacturing organizations who use big data and analytics daily and …

Cultural Humility As A Predictor Of Intention To Leave Moderated By Authentic Leadership, Dennis Whitfield

Walden Dissertations and Doctoral Studies

The problem addressed in this research was the inappropriate treatment of multicultural individuals by their immediate supervisors and the need for a thorough examination of cultural humility in organizational settings. This quantitative study used linear regression and moderation analyses to examine the relationship between cultural humility and intention to leave moderated by authentic leadership to determine how the participants’ perception of cultural humility in their immediate supervisor predicted their intention to leave. Another purpose was to examine whether authentic leadership moderated the relationship with intention to leave. The theoretical framework for this study included cultural humility, authentic leadership, and intention …

Attorney Competence In The Algorithm Age, Nantiya Ruan

Scholarly Works

No abstract provided.

Building A Culture Of Scholarship With New Clinical Teachers By Writing About Social Justice Lawyering, Susan Bennett, Binny Miller, Michelle Assad, Maria Dooner, Miriam Hinds, Jessica Millward, Citlalli Ochoa, Charles Ross, Anne Schaufele, Caroline Wick

Scholarly Works

No abstract provided.

Law Enforcement Leaders’ Perceptions Of The Attributes Of Emotional Intelligence, Gordon A. Broussard

Walden Dissertations and Doctoral Studies

AbstractAlthough there have been numerous studies conducted on emotional intelligence and effective leadership, there is a need for increased emotional intelligence among law enforcement leaders. This study aimed at determining how law enforcement leaders perceive the importance of emotional intelligence attributes when leading their organization. A phenomenological qualitative study was used with purposive and snowball sampling of 12 participants who held senior leadership positions for over five years as chiefs and sheriffs throughout the United States. Semistructured interviews were conducted to determine participants’ perceptions of the importance of the four attributes of emotional intelligence: self-awareness, self-management, social awareness, and relationship …

Current Practices For Forensic Assessments Of Offenders, Garet Bradford

Walden Dissertations and Doctoral Studies

AbstractCurrent Practices for Forensic Assessments of Offenders by Garet Bradford MA, University of Cincinnati, 2017 BA, University of Nevada, 2014 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Forensic Psychology Walden University August 2023

Anti-Inflammatory Effects Of Vagus Nerve Stimulation In Pediatric Patients With Epilepsy, Supender Kaur, Nathan R Selden, Alejandro Aballay

Faculty, Staff and Student Publications

INTRODUCTION: The neural control of the immune system by the nervous system is critical to maintaining immune homeostasis, whose disruption may be an underlying cause of several diseases, including cancer, multiple sclerosis, rheumatoid arthritis, and Alzheimer's disease.

METHODS: Here we studied the role of vagus nerve stimulation (VNS) on gene expression in peripheral blood mononuclear cells (PBMCs). Vagus nerve stimulation is widely used as an alternative treatment for drug-resistant epilepsy. Thus, we studied the impact that VNS treatment has on PBMCs isolated from a cohort of existing patients with medically refractory epilepsy. A comparison of genome-wide changes in gene expression …

Endothelial Activation And Fibrotic Changes Are Impeded By Laminar Flow-Induced Chk1-Senp2 Activity Through Mechanisms Distinct From Endothelial-To-Mesenchymal Cell Transition, Minh T H Nguyen, Masaki Imanishi, Shengyu Li, Khanh Chau, Priyanka Banerjee, Loka Reddy Velatooru, Kyung Ae Ko, Venkata S K Samanthapudi, Young J Gi, Ling-Ling Lee, Rei J Abe, Elena Mcbeath, Anita Deswal, Steven H Lin, Nicolas L Palaskas, Robert Dantzer, Keigi Fujiwara, Mae K Borchrdt, Estefani Berrios Turcios, Elizabeth A Olmsted-Davis, Sivareddy Kotla, John P Cooke, Guangyu Wang, Jun-Ichi Abe, Nhat-Tu Le

Faculty, Staff and Student Publications

BACKGROUND: The deSUMOylase sentrin-specific isopeptidase 2 (SENP2) plays a crucial role in atheroprotection. However, the phosphorylation of SENP2 at T368 under disturbed flow (D-flow) conditions hinders its nuclear function and promotes endothelial cell (EC) activation. SUMOylation has been implicated in D-flow-induced endothelial-to-mesenchymal transition (endoMT), but the precise role of SENP2 in counteracting this process remains unclear.

METHOD: We developed a phospho-specific SENP2 S344 antibody and generated knock-in (KI) mice with a phospho-site mutation of SENP2 S344A using CRISPR/Cas9 technology. We then investigated the effects of SENP2 S344 phosphorylation under two distinct flow patterns and during hypercholesteremia (HC)-mediated EC activation.

RESULT: …

Admission Timing, Age, Sex, Pain, And Disability As Outcome Predictors Of Short-Term Pain Programs, Nanesha Courtney

Walden Dissertations and Doctoral Studies

Researchers have found that age, sex, education level, and pretreatment pain levels may be significant predictors of patient outcomes; however, it remained unknown whether the timing of treatment predicts pain and disability after a multidisciplinary short-term intensive pain treatment program. The purpose of this quantitative nonexperimental study was to use archival data to examine whether the timing of entry into a multidisciplinary short-term intensive pain treatment program predicted pain and functioning levels at posttreatment. Glasser’s choice theory was used to examine whether the combined effect of pretreatment pain, occupational disability level, age, sex, education level, and time of entrance predicted …

Strategies Hotel Leaders Use To Improve Employee Engagement, O'Neil Orlando Dacres

Walden Dissertations and Doctoral Studies

Employee engagement is a significant factor that drives performance and productivity in many organizations. Hotel leaders are typically concerned with the negative impact of disengaged employees, which reduces profitability. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hotel leaders use to improve employee engagement. The participants were five hotel leaders in Jamaica who have successfully implemented strategies to improve employee engagement. Data were collected from semistructured interviews and a review of organizational documents. Data were analyzed using thematic analysis, and five themes emerged: staff engagement, communication, rewards and recognition, employee training and …

Student Perspective Of Alternative Education Characteristics Implemented By Public School Social Workers, Jennifer M. Fields

Walden Dissertations and Doctoral Studies

Public schools are facing increased challenges to address the needs of students with significant behavioral issues. In response, Alternative education (AE) programs are used to reengage students in learning and enhance personal development, through a combination of academic and therapeutic strategies. AE placement is intended to be short-term, with the goal of returning students to public school. However, the differences between these two settings make it difficult for students to sustain achievements made in AE upon reentry. The purpose of this qualitative research was to use the student perspective to identify the social-emotional characteristics of AE that have influenced change, …

Oncology-Specific Radiation Dose And Image Noise Reference Levels In Adult Abdominal-Pelvic Ct, Moiz Ahmad, Xinming Liu, Ajaykumar C Morani, Dhakshinamoorthy Ganeshan, Marcus R Anderson, Ehsan Samei, Corey T Jensen

Faculty, Staff and Student Publications

OBJECTIVES: To provide our oncology-specific adult abdominal-pelvic CT reference levels for image noise and radiation dose from a high-volume, oncologic, tertiary referral center.

METHODS: The portal venous phase abdomen-pelvis acquisition was assessed for image noise and radiation dose in 13,320 contrast-enhanced CT examinations. Patient size (effective diameter) and radiation dose (CTDI

RESULTS: The noise reference level was 11.25 HU with a reference range of 10.25-12.25 HU. The dose reference level at a median effective diameter of 30.7 cm was 26.7 mGy with a reference range of 19.6-37.0 mGy. Dose increased with patient size; however, image noise remained approximately constant within …

The Hospital Consumer Assessment Of Healthcare Providers And Systems And Central-Line-Associated Bloodstream Infections, Mary Kerich

Walden Dissertations and Doctoral Studies

Central-line-associated bloodstream infections (CLABSIs) are common healthcare-associated infections (HAIs) contributing to extended hospital stays, morbidity, mortality, and healthcare costs. In 2011, the Centers for Medicare and Medicaid Services implemented the Hospital Value-Based Purchasing initiative, which links acute care hospitals' payments to quality performance. A gap in the literature existed regarding the relationship between hospital characteristics, patient experience, and CLABSI rates. This quantitative study aimed to explore the relationship between patient experience scores reported by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and CLABSI standardized infection ratio (SIR) in nonprofit acute care hospitals in the United States. Three …

Chimeric Rnas Reveal Putative Neoantigen Peptides For Developing Tumor Vaccines For Breast Cancer, Brandon Mistretta, Sakuni Rankothgedera, Micah Castillo, Mitchell Rao, Kimberly Holloway, Anjana Bhardwaj, Maha El Noafal, Constance Albarracin, Randa El-Zein, Hengameh Rezaei, Xiaoping Su, Rehan Akbani, Xiaoshan M Shao, Brian J Czerniecki, Rachel Karchin, Isabelle Bedrosian, Preethi H Gunaratne

Faculty, Staff and Student Publications

INTRODUCTION: We present here a strategy to identify immunogenic neoantigen candidates from unique amino acid sequences at the junctions of fusion proteins which can serve as targets in the development of tumor vaccines for the treatment of breastcancer.

METHOD: We mined the sequence reads of breast tumor tissue that are usually discarded as discordant paired-end reads and discovered cancer specific fusion transcripts using tissue from cancer free controls as reference. Binding affinity predictions of novel peptide sequences crossing the fusion junction were analyzed by the MHC Class I binding predictor, MHCnuggets. CD8+ T cell responses against the 15 peptides were …

Business Success Strategies For Military Veteran Small Business Owners, Traci De-Shay Leonard

Walden Dissertations and Doctoral Studies

Some military veteran small business owners lack strategies for sustaining their business beyond 5 years. Military veteran small business owners are concerned with survivability as it ensures sustained employment opportunities for veteran small business owners and their employees and increases local community tax revenue for citizens. Grounded in the organizational learning theory, the purpose of this qualitative multiple case study was to explore strategies military veteran small business owners use to sustain their business beyond 5 years. The participants comprised three military veteran small business owners in Central Texas who sustained their businesses for over 5 years. Data were collected …

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 …