Digital Commons Network^™

How People With Borderline Personality Disorder Experience Addiction During The Process Of Treatment, Michael Paul Onesto

Walden Dissertations and Doctoral Studies

This study explored the lived experience of Borderline Personality Disorder (BPD) and substance use as a maladaptive coping mechanism during recovery, raising the question of whether recovery itself fosters comorbidity. The study was grounded on several theories, including Linehan’s biosocial model, the Cox and Klinger alcohol motivation model, the affect regulation model, and the self-medication hypothesis. These theories argue that substance use arises from emotional vulnerability, invalidating environment, and affect regulation efforts. The study employed a phenomenological qualitative approach to guide data collection and analysis. Interviews from 20 BPD patients and mental health care providers were completed. The thematic analysis …

The Challenges Faced By Postrelease Offenders In Rural Mississippi, Whitney Starks

Walden Dissertations and Doctoral Studies

Reintegration after incarceration has long been a subject of scholarly inquiry, particularly regarding barriers to employment, housing, and mental health services. However, limited research addresses the reintegration experiences of postrelease offenders in rural regions, where access to essential resources is often restricted. This qualitative single case study is an exploration of the challenges and service needs of formerly incarcerated individuals living in rural Mississippi. Using purposive and snowball sampling, six participants were selected based on residency in rural counties, a nonviolent criminal history, and at least one year of successful community reentry. The conceptual framework was guided by the assess, …

The Experience Of Living With Infertility Among Women Of Color, Claudia Calvario

Walden Dissertations and Doctoral Studies

Infertility affects individuals across all cultural and socioeconomic backgrounds; however, the lived experiences of women of color navigating infertility remain underrepresented in research, health care, and policy. The purpose of this interpretative phenomenological analysis (IPA) study was to explore the lived experiences of infertility among women of color. The specific aims of the study were to (a) understand the significance of cultural values in shaping these experiences, with a focus on cultural norms surrounding motherhood and fertility, and (b) gain insight on the ways in which women of color seek assistance. The conceptual framework integrated the biopsychosocial model, stress and …

Evaluation Of The User Experience For A Point Of Care Molecular Test For Causes Of Vaginitis, Barbara Van Der Pol, Rebecca Lillis, Irving Nachamkin, Stephen Young, La Shonda Crane, Jacqueline Brown, R. Lamar Parker, Alice Weissfeld, Xiaohong Liu, Christina Huang, Aarthi Raman

School of Medicine Faculty Publications

Background: Vaginitis is a major cause of healthcare visits in the US, costing over $1.2 billion annually. Point-of-care (POC) nucleic acid amplification tests (NAATs) could improve accuracy of diagnosis and treatment during initial visit for vaginitis compared to send-out NAATs. Methods: A secondary analysis of data was collected from test operators at POC testing sites where the Xpert Xpress Multiplex Vaginal Panel test (“MVP test”) was performed. Users completed a survey assessing their experience with the instrument system and the PCR-based MVP test. Results: The MVP test demonstrated consistent performance, measured by positive and negative percent agreement, across all user …

Management Of Postoperative Pain In Septorhinoplasty: A Systematic Review, Caitlin M Coviello, Uma R Ramesh, Beatriz Varman, Krista L Olson, Sunthosh K Sivam

Library Staff Publications

Objective: Septorhinoplasties are a common surgery. Effectively managing postoperative pain and identifying opioid reduction techniques is of critical importance. This systematic review characterizes the literature regarding the management of postoperative pain with opioid-based and opioid alternative therapies in patients undergoing septorhinoplasty.

Data sources: Medline (Ovid), Embase (Elsevier), Cochrane Library (Wiley), and Web of Science (Clarivate).

Review methods: A literature search was conducted using multiple medical subject headings (MeSH) and keywords with adherence to preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. Full-text analysis was performed by two independent reviewers using the Critical Appraisal Skills Program (CASP) and National …

Impact Of Firefighters' Work Schedule On Cardiovascular Disease Risk, Wellbeing And Safety In Firefighters: Protocol For The Swift Study, A Multidisciplinary Prospective And Cross-Sectional Study, Walaa F. Abdelmoaty, Shelby L. Watkins, Aanuoluwakiitan Ayeni, David A. Hurtado, Andrew W. Mchill, Jeremy J. Biggs, Kurt T. Hegmann, Steven A. Shea, Todd Bodner, Nicole P. Bowles

Psychology Faculty Publications and Presentations

Firefighters face frequent physical and psychosocial stressors, increasing their risk for hypertension. Rising call volumes with a stable workforce have heightened occupational burdens. To meet their occupational demands while increasing time off-duty, fire departments across the country have switched from a 24 hours on 48 hours off (termed ‘24/48’) work schedule to one that increases the number of consecutive days off (eg, 1 day on, 3 days off, 2 days on, 3 days off (termed ‘1/3/2/3’) or 48 hours on 96 hours off (termed ‘48/96’)). However, these schedule changes come at the expense of increasing time on-duty, which may have …

Quantile Index Predictors Using R Package Hyper.Gam, Tingting Zhan, Misung Yi, Inna Chervoneva

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

MOTIVATION: Evaluation of single-cell protein expression from immunohistochemistry images is used increasingly in biomedical research. Many proteins are used solely for phenotyping cells in the tumor microenvironment. Other proteins with meaningfully quantitative expression levels provide so-called functional protein biomarkers. There is still a limited number of methods and software tools available for utilizing the entire distributions of single-cell expression levels.

RESULTS: We present the R package hyper.gam, providing a supervised learning framework for deriving biomarkers based on single-cell distribution quantiles. The single-cell data are first converted into sample quantile functions, which are then used as predictors in scalar-on-function regression models …

Effectiveness Of Cognitive-Behavioral Therapy For Generalized-Anxiety Disorders In Adolescents: A Systematic Review Using Pico Framework, Rajwa D. Suryanto, Prodio E. Gaharani, Salam Salsabila, Calista Aziz, Fitri A. Khaerani, Salsabila Athaya, Lulu A. Setyowati, Elisya Kartadikaria, Muhammad I. Djamaluddin, Renata B. Soewahju, Dian A. Pitaloka

Pharmacology and Clinical Pharmacy Research

A number of teenagers experience various levels of mental disorders, ranging from mild stress to Generalized Anxiety Disorder (GAD). According to the World Health Organization (WHO), approximately 264 million people suffer from anxiety disorders, including GAD, and this condition is a significant leading cause of suicide incidents, ranking sixth among serious mental health issues. From a societal perspective, Cognitive Behavioral Therapy (CBT) has the advantage of cost-effectiveness by minimizing the use of medications and enhancing productivity in education for adolescents receiving CBT. This study aims to conduct a systematic review of the existing literature on GAD in adolescents, using the …

Qtc Interval Prolongation In Drug-Resistant Tuberculosis Treated With Bedaquiline And Delamanid Under Programmatic Conditions, Oki N. Putra, Yulistiani Yulistiani, Seodarsono Seodarsono, Julaeha Julaeha

Pharmacology and Clinical Pharmacy Research

Background: The cardiac safety of regimens containing bedaquiline and delamanid is not well-established, especially in Indonesia. This study aimed to analyze QTc interval during six months of treatment and factors associated with QTc interval prolongation. Methods: A prospective cohort of drug-resistant tuberculosis (DR-TB) patients received regimens containing bedaquiline and delamanid between September 2022 and May 2023 at the outpatient department of MDR-TB of the Dr. Soetomo Hospital. Patients were divided into bedaquiline and bedaquiline-delamanid-containing regimens groups, respectively. QTc interval was evaluated before and until the sixth month of treatment using ECG. QTc interval prolongation was categorized as clinically significant if …

Effectiveness Of Pharmacist-Led Intervention For Hepatitis C Patients - A Systematic Review, Geraldo Surya, Angelica Angelica, Zerra Rizki Amalia, Diflaa Kayla Nisrina, Widya Norma Insani

Pharmacology and Clinical Pharmacy Research

Pharmacist-led interventions, encompassing patient education, adherence monitoring, and personalized care, have emerged as a critical strategy to optimize treatment outcomes in Hepatitis C (HCV) management, particularly in improving Sustained Virologic Response (SVR) and mitigating drug-related challenges. This review evaluates evidence from randomized controlled trials (RCTs), cohort studies, and retrospective analyses to assess the impact of pharmacist-led interventions on key HCV treatment outcomes, including SVR, medication adherence, and management of adverse drug reactions (ADRs) and drug-drug interactions (DDIs). A systematic search was conducted on PubMed database for studies published between January 2000 and December 2024 following PRISMA guidelines. The search strategy …

Identification Of Drug Related Problems (Drps) Based On Drug And Dosage Selection In Type 2 Diabetes Mellitus Patients, Dhani Wijaya, Fathia F. Rahmadanita, Ria R. Atmaja, Sadli Syarifuddin, Roihatul Mutiah, Atiqoh N. Habibah, Fika S. Nafisah

Pharmacology and Clinical Pharmacy Research

Pharmacological therapy for type 2 diabetes mellitus involves more than one type of drug, this increases the potential for Drug Associated Problems (DRPs) in terms of selecting the type and dose of the drug. This study aimed to determine the treatment profile and identify the occurrence of DRPs based on drug selection and dosage in patients with type 2 diabetes mellitus. This descriptive observational study was conducted in October 2022 in the medical record room of one general hospital in Batu, East Java. The study sample was obtained by total sampling using 36 medical records of inpatients with type 2 …

Comprehensive In Silico Analysis Of Bioactive Compounds From Pyrrosia Piloselloides Leaves As Xanthine Oxidase Inhibitors, Masira Sinuhaji, Husnul Havid, Ysrafil Ysrafil, Fransisza D. Alexandra

Pharmacology and Clinical Pharmacy Research

This study aimed to evaluate the potential of bioactive compounds from Pyrrosia piloselloides leaves as xanthine oxidase (XO) inhibitors through an in silico approach. Methods included molecular docking and molecular dynamics simulations to identify the binding affinity of test compounds to XO. Among 59 screened compounds, 3 compounds (2,6,10,14,18,22-Tetracosahexaene, 6-Hydroxymethaqualone, and β-Sitosterol acetate) exhibited the lowest binding energy in comparison to the control, Allopurinol, with key residue contributions from GLU 802, ARG 880, and THR 1010. Molecular dynamics simulations confirmed the interaction stability, with β-Sitosterol acetate showing the lowest total binding free energy (-46.23 ± 0.66 kcal/mol). ADMET predictions revealed …

Antioxidant Properties Of N-Hexane Extract From Tobacco Leaves (Nicotiana Tabacum L.) Using 2,2-Diphenyl-1-Picrylhydrazil (Dpph) Method, Vinda M. Patricia, Dhea K. Az-Zahra, Taufik M. Fakih, Farendina Suarantika

Pharmacology and Clinical Pharmacy Research

Tobacco (Nicotiana tabacum L.) is a commercial plant that often used for making cigarettes. In 2012, the government issued regulations for the diversification of tobacco products besides cigarettes. Some of these diversified tobacco products include organic pesticides, anesthetics, cosmetic ingredients, and biochar as an alternative to coal. Therefore, in order to further to diversification of tobacco product, this study aimed to determine the antioxidant activity from n-hexane extract from leaves using the Soxhlet extraction method. Antioxidant activity was assessed by the DPPH (2,2-diphenyl-1-picrylhydrazyl) method, while the total phenolic content was determined using the Folin-Ciocalteu method that allowed quantification of phenolic …

Trauma Resuscitation With Low-Titer Group O Whole Blood Or Products: Study Protocol For A Randomized Clinical Trial (The Troop Trial), Jan O Jansen, Claudia Pedroza, Luis Leon Novelo, Tianyao Hao, Gina R Dewildt, Charles F Coton, Kiran Mansoor, Shannon W Stephens, Marisa B Marques, James R Stubbs, Jillian R Richter, Henry E Wang, John B Holcomb, Stacia M Desantis

Faculty, Staff and Student Publications

Background: Hemorrhage is the most common cause of potentially preventable death after injury. Balanced transfusion with red blood cells, plasma, and platelets (component therapy, CT) has been shown to reduce mortality, and is the standard of care. Low-Titer Group O Whole Blood (LTOWB) is an attractive alternative to CT, but existing evidence comprises observational studies, and a small single center pilot randomized controlled trial, which evaluated a type of whole blood that is no longer in use. The aim of the "Trauma Resuscitation with Low-Titer Group O Whole Blood Or Products" (TROOP) trial is to compare the effectiveness and safety …

Development Of A Clinical Practice Guideline For Trauma-Informed Care In Interprofessional Health Care Settings, Ngwi Rita Etiendem

Walden Dissertations and Doctoral Studies

Developing a standardized Clinical Practice Guideline for Trauma Informed Care was a central objective of this Doctor of Nursing project. This project followed an evidence-based, collaborative, and structured methodology that prioritized interdisciplinary input, organizational alignment, and rigorous appraisal using the AGREE II instrument.

Relationship Between Processing Speed And Perceptual Reasoning Index Scores In Contact Vs Noncontact Child Sex Offenders, Mylena Smith

Walden Dissertations and Doctoral Studies

Child sexual offending remains a critical societal issue with complex psychological and behavioral underpinnings. Although prior research has emphasized recidivism and risk assessment, there is limited information regarding neurocognitive functioning and its potential role in terms of differentiating contact versus noncontact offender subtypes. This quantitative cross-sectional study involved examining whether cognitive functioning, measured using the Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI) via the Wechsler Adult Intelligence Scale predicted offender subtype among 90 adult males who completed psychosexual evaluations. Additionally, the study involved testing whether age moderated the relationship between cognitive indices and offender subtype classification. Guided by …

Staff Education To Same Day Surgery Nurses, Katherine Lutman

Walden Dissertations and Doctoral Studies

The aim of this doctor of nursing practice staff education project was to provide a staff education program to the same day surgery staff at the practicum site on the Enhanced Recovery After Surgery (ERAS) evidence-based approach to surgical care to improve patient outcomes. ERAS includes multiple modalities designed to optimize a patient’s condition before, during, and after surgery. When implemented correctly, ERAS can reduce the need for narcotics, shorten recovery time, and improve surgical outcomes. The practice gap identified was that the only ERAS modality being actively implemented and tracked was nutrition in colorectal surgical patients and that the …

Beyond The Individual: Community Socioecological Correlates Of Mass Shootings In A Cross-Sectional Analysis, Barbara (Basia) E. Lopez

Walden Dissertations and Doctoral Studies

Mass shootings represent an urgent and persistent threat to public safety in the United States, yet most research has focused on individual-level characteristics, leaving community-level socioecological conditions comparatively underexamined. This study addressed this gap in knowledge through an examination of the statistical correlations between community-level characteristics and mass shooting incidence using Ostrom’s social-ecological systems theory as a guiding framework. A cross-sectional quantitative design was employed using secondary data from The Violence Project, the U.S. Census Bureau, Neighborhood Atlas National Data Archive, and publicly available law enforcement and policy records. Multiple regression analysis was performed to test both main and interaction …

Relationship Between Doctor Communication And Patient Satisfaction In Inpatient Units In California, Sandra Viehoever

Walden Dissertations and Doctoral Studies

Effective doctor communication is an important determinant of patient satisfaction in inpatient units. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patient satisfaction and influences reimbursement rates under the Hospital Value-Based Purchasing Program. The purpose of this retrospective quasi-experimental quantitative study was to examine the possible relationship between doctor communication and patient satisfaction in inpatient units in California. The Donabedian framework provided the theoretical framework to examine possible relationships between the variables. Publicly available data were collected from 290 hospitals in California that participated in the HCAHPS survey between July 2022 and June 2023. Results of …

The Treatment Experiences Of Female Domestic Violence Offenders Who Have Completed Court-Mandated Counseling Programs, Chelsea S. King

Walden Dissertations and Doctoral Studies

Domestic violence is a significant societal problem. However, aspects of domestic violence (DV) perpetrated by women are often overlooked or inadequately addressed in existing counseling and intervention programs, leaving counselor educators ill-equipped to effectively train counselors to treat this specific population. The research question addressed the treatment experiences of female DV offenders who completed court-mandated counseling programs. Given the limited current research on female domestic violence offender treatment, Heidegger’s hermeneutic phenomenological methodology was employed to further understand the perspectives of participants, potentially identifying areas of improvement and addressing the needs of female program participants. Semistructured interviews were completed with six …

Lived Experiences Of Police Officers With Vicarious Sexual Trauma, Resiliency, And Departmental Support, Joseph Schreiner

Walden Dissertations and Doctoral Studies

This qualitative study involved addressing lived experiences of police officers who investigate sex crimes. Vicarious sexual trauma experienced by officers can lead to both short- and long-term issues for these individuals, particularly if they are left unaddressed. The constructivist self-development and resiliency theories were used to examine these experiences. Specifically, this study involved investigating how police officers perceived vicarious sexual trauma and viewed the accessibility and practicality of mental health and wellness resources provided by their departments. It was guided by two research questions, which were addressed through 12 semistructured interviews, which were thematically analyzed and interpreted. Five themes emerged …

Efficacy Of Angiotensin Receptor Blockers (Valsartan, Candesartan, Losartan) In Lowering Blood Pressure: A Systematic Review, Shafa S. Maharani, Dika P. Destiani

Pharmacology and Clinical Pharmacy Research

Hypertension is a significant health issue that significantly increases the risk of cardiovascular disease. Angiotensin II receptor blockers (ARBs) are commonly used in Indonesia to treat hypertension, yet comprehensive comparative efficacy data within this drug class remain limited. This review seeks to evaluate the blood pressure-lowering efficacy of three particular angiotensin receptor blockers (ARBs)—Valsartan, Candesartan, and Losartan—in individuals diagnosed with hypertension. This systematic review identified randomized controlled trials (RCT) obtained from PubMed and Google Scholar using several keyword combinations. Among 20 RCTs with 6.425 patients treated with three ARBs, all included studies demonstrated significant blood pressure reductions. The mean reductions …

Phytochemical And Nutritional Composition Of Vernonia Amygdalina: Antioxidant, Antidiabetic Efficacy, And Hematological Benefits, Hassan A. Adewuyi, Atapia I. Messiah, Ochonung E. Ogar, Waheed S. Adio, Adebimpe H. Aluwatoyin, Obunadike Obunadike, Adeleye A. Edema, Samad Hussein, Usman A. Mohammed, Kevin L. Sebastine, Tolulope O. Jaiyeola

Pharmacology and Clinical Pharmacy Research

Vernonia amygdalina, a traditionally used medicinal plant, has been purported to possess health-promoting properties.The aim of this study is to investigate the phytochemical and nutritional composition of V. amygdalina, evaluate its antioxidant and antidiabetic efficacy, and assess its hematological benefits. Phytochemical screening, proximate analysis, antioxidant assays (DPPH, ABTS), antidiabetic evaluations in streptozotocin-induced diabetic rats, and hematological assessments were conducted according to standard protocol. V. amygdalina exhibited a rich phytochemical profile, comprising flavonoids, phenolic acids, and terpenoids, alongside significant antioxidant activity (IC50 = 12.5 μg/mL) and complete source of protein. Proximate analysis revealed high protein (21.1%) and fiber (15.6%) content. Antidiabetic …

A Force To Be Reckoned: Strategic Equity Sense Leadership Of Unit-Level Higher Education Leaders, Jin M. Mims

LMU Theses and Dissertations

The #BlackLivesMatter (#BLM) movement in 2020 pressured higher education institutions to address their oppressive and exclusive systems. As these institutions communicated their diversity, equity, and inclusion, (DEI) commitments and processes, it was those who took charge to facilitate the operational and cultural change for their respective area through the DEI lens, those who assumed DEI roles in their designated units, actualized the ground-level work of designing and implementing DEI programs and policies to produce the institutional progress reported by the university’s executive leadership. I will refer to those change agents as Unit-level DEI Officers (UDOs). Meanwhile, the current body of …

Rsph4a-Pcdx: An Index To Predict Lung Function Decline In Primary Ciliary Dyskinesia, Gabriel Román-Ríos, Gabriel Rosario-Ortiz, Marcos J Ramos-Benitez, Ricardo A Mosquera, Wilfredo De Jesús-Rojas

Faculty, Staff and Student Publications

Primary ciliary dyskinesia (PCD) is a rare, genetically heterogeneous disorder that impairs mucociliary clearance and leads to progressive lung disease. This study aimed to characterize lung function decline in a genetically homogeneous cohort of Puerto Rican patients with

Rna Sequencing And Immunohistochemistry Jointly Improve Tumor Biomarker Interpretation, Vladimir Kushnarev, Danil Stupichev, Suren Davitavyan, Kirill Kriukov, Basavaraja U Shanthappa, Anna Butusova, Sofia Menshikova, Anna Belozerova, Anastasia Shvyrkova, Arina Tkachuk, Olga Khatenkova, Linda Balabanian, Ekaterina Postovalova, Jochen K Lennerz, Funda Meric-Bernstam, Alexander Bagaev

Faculty, Staff and Student Publications

This study aimed to assess the correlation between RNA sequencing (RNA-seq) and immunohistochemistry (IHC) in detecting key cancer biomarkers across solid tumors, and then, to establish RNA-seq thresholds that accurately reflect clinical IHC classifications. Expression levels of nine biomarkers-ESR1, PGR, AR, MKI67, ERBB2, CD274, CDX2, KRT7, and KRT20-were analyzed in 365 formalin-fixed, paraffin-embedded samples from breast, lung, gastrointestinal, and other solid carcinomas. Correlations between RNA-seq data and IHC scores were determined using Spearman's correlation coefficients, with RNA-seq cut-offs established to distinguish positive from negative IHC scores. The results revealed strong correlations for most biomarkers, with coefficients ranging from 0.53 to …

Minority Female Political Representation In Westchester County Politics: A View From Minority Female Elected Office Holders, Dwanita Michelle Crosby

Walden Dissertations and Doctoral Studies

African American women have historically been underrepresented in political leadership, a disparity largely attributed to the persistent absence of structured support systems—particularly mentorship—that promote advancement across federal, state, and local levels. Existing literature highlights gender and racial disparities in political trajectories but often overlooked the specific role of mentorship in shaping leadership outcomes for African American women at the municipal level. This gap was particularly critical given the increasing civic engagement and influence of African American women in local governance. The purpose of this general qualitative study was to examine how mentorship shaped the political journeys of African American women …

Strategies To Reduce Waiting Times In A Hospital Emergency Department, Gillian Denise Browne-Farrell

Walden Dissertations and Doctoral Studies

Leaders of the emergency departments (EDs) globally, especially in the United States face persistent challenges addressing staffing issues in the ED and increased wait times. The purpose and review question for this integrative review was to investigate strategies and best practices to decrease waiting times in a hospital ED. The Theory of Constraints framework served as the theoretical foundation for this review. An examination of the literature published within the past five years identified 101 relevant articles. From these articles, 30 empirical and non-empirical articles were selected for further analysis using the Johns Hopkins evidence-based practice model and six major …

Enhancing Communication Among New Nurses Using Scenario-Based Education, Anita Clark Chambers

Walden Dissertations and Doctoral Studies

This staff education project was designed to enhance communication among new nurses with 2 years or less of experience in a Level One trauma center emergency department (ED). The aim of this project initiative was to enhance learners’ communication strategy knowledge and confidence by using scenario-based education via a web-based format. When ineffective communication exchanges occur with healthcare personnel, such as with new nurses, negative patient care outcomes can occur such as sentinel events. Transitional challenges such as lack of prioritization, clinical decision-making skills and low confidence can affect the new nurse’s ability to appropriate effective communication strategies into their …

Prediction Of Collegial Relationships And Teachers’ Commitment To Stay In A Compulsory Swedish School, Chermaine Clunie

Walden Dissertations and Doctoral Studies

The problem addressed in this study was the high annual teacher turnover rate of 30% in a Swedish compulsory school, which significantly exceeded national averages. The purpose of this quantitative study was to investigate the relationship between the quality of collegial relationships, as measured by emotional support, task-related support, and feedback from colleagues which are subscales of the workplace social support (WSS) scale, and Swedish teachers’ commitment to stay in their current teaching positions in a Swedish compulsory school, measured on a continuous scale, using a 5 point Likert scale. The study was grounded in Blau’s social exchange theory, which …